A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte ; Pneumonia ; Pneumonia, Aspiration ; Shock, Septic ; Spine ; Vomiting

No abstract available.
Ear Cartilage ; Ectropion ; Eyelids ; Transplants

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Humans ; Plasma* ; Tranexamic Acid* ; Urticaria*

BACKGROUND: Tourniquet pain is probably mediated by C-fiber. The ability of fentanyl to interrupt this nociceptive conduction was studied by administering either fentanyl or saline intrathecally along with hyperbaric bupivacaine for spinal anesthesia. METHOD: The incidence of tourniquet pain was evaluated in 60 patients having orthopedic surgery of the lower extremities during spinal anesthesia by administering either 30 mcg fentanyl (group 2) or saline (group 1) along with 0.5% hyperbaric bupivacaine 10 mg. We measured the maximal sensory spread of analgesia to pinprick, the incidence of tourniquet pain, and the sensory anesthesia to pinprick at the onset of tourniquet pain. RESULTS: The average maximal sensory spread of analgesia was the same in both groups (T9). The incidence of tourniquet pain was significantly greater in group 1 (33%) than in group 2 (10%). The sensory levels of anesthesia at the onset of tourniquet pain were not different in two groups. CONCLUSIONS: Intrathecal fentanyl was effective against tourniquet pain for 2 hours of the orthopedic surgery of the lower extremities.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Bupivacaine* ; Fentanyl* ; Humans ; Incidence ; Lower Extremity ; Orthopedics ; Tourniquets*

BACKGROUND: Dermal papilla cells, which are mesenchymal components of the hair bulb are considered to play an important role in the regulation of hair growth by production of diffusible factors that stimulate follicular epithelial cells. Degenerative changes in the dermal papilla cells in the involved scalp of alopecia areata cases indicate that these cells are one of the important targets in this disease. OBJECTIVE: We investigated the effects of serum from alopecia areata patients on the proliferation of dermal papilla cells. METHOD: Dermal papilla cells and fibroblasts from normal human scalp were cultured in DMEM media with 10% or 20% of normal and alopecia areata serum for 48hrs and 96hrs. Cell proliferation was measured by cell counts and [3H]-thymidine incorpoartion. RESULTS: Both 10% and 20% alopecia areata serum had no significant effects on the proliferation of dermal papilla cells and fibroblasts after 48hrs and 96hrs. CONCLUSION: These results suggest that there are no serum factors that inhibit the proliferation of dermal papilla cells.
Alopecia Areata* ; Alopecia* ; Cell Count ; Cell Proliferation ; Epithelial Cells ; Fibroblasts ; Hair ; Humans ; Scalp

In an open reduction of the mandibular angle fracture, it is crucial to approximate each fracture segment as closer as possible for the reduction of the healing period. In this case report, we proposed a new technique for the mandibular angle fracture. This was designed to minimize the gap between two separated segments using mini-implants and surgical wires. Mini-implants were placed around the fracture line, followed by wire ligation to minimize the fracture gap. And then internal fixation was easily employed with plates and screws. The advantages of this technique were reduced time for operation, the promotion of healing, rapid functional recovery, and few complications.
Ligation

Segmentally distributed cutaneous eruptions and neuralgia are common manifestations of herpes zoster. However, motor loss is another aspect of this manifestation, which is less well known and considered a rare finding. In many cases the loss of motor function may be easily overlooked because the pain is the more prominent feature and the weakness probably goes unrecognized with only a mild impairment of the motor function. We experienced a 71-year-old male patient with a herpes zoster-related motor paralysis of right arm whose clinical features of a weak limb mimicked other spinal motor diseases and confirmed motor involvement using electromyographic (EMG) and motor nerve conduction velocity (MNCV) studies.
Aged ; Arm ; Extremities* ; Herpes Zoster* ; Humans ; Male ; Neural Conduction ; Neuralgia ; Paralysis*