PURPOSE: Intravesical instillation of bacillus Calmette-Guerin(BCG) is an established and effective therapy for the superficial bladder carcinoma. The viability of BCG is crucial for the induction of a local immune response as well as effective therapy of recurrent superfical bladder carcinoma. Lubricants are used to facilitate catheterization during intravesical instillation of BCG. Moreover bacteriostatic components contained in them have potential to reduce the viability of the BCG. To verify this assumption, inhibitory effect of four commercially available lubricants on the BCG growth was analyzed. MATERIALS AND METHOD: Four different lubricants and their components were co-incubated with Connaught strain BCG and the resultant growth of BCG was assessed. RESULTS: Significant impairment of BCG viability with lubricants was noted. Chlorhexidine digluconate which is the component of lubricant was considered as responsible for this inhibition. CONCLUSIONS: During intravesical BCG, lubricants might reduce the number of viable BCG in clinical use. For this reason, during intravesical immunotherapy with BCG small amounts of lubricants should be used for urethral catheterization and use of lubricant which does not contain bacteriostatic agent should be considered.
Administration, Intravesical ; Bacillus* ; Catheterization ; Catheters ; Chlorhexidine ; Immunotherapy ; Lubricants ; Mycobacterium bovis ; Thiram ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters

PURPOSE: The crushing injury is one of the most severe type injuries in the finger. For the reconstruction of fingers with crushed and devitalized tissue, various surgical methods have been attempted to cover the soft tissue defects. We performed free flaps for finger reconstruction and investigated the results. MATERIALS AND METHODS: Between March 2010 and July 2011, we retrospectively reviewed 14 patients who had soft tissue defects of fingers after severe crushing injuries. There were 8 pulp losses, 4 dorsal skin losses with bony exposure, 1 nail complex loss, and 1 total loss of distal phalanx. In all cases, soft tissue defects in fingers were reconstructed with a free flap. RESULTS: All flaps survived successfully. We could reserve the functional length without additional necrosis and amputation. Reconstructed fingers were returned to normal activity in a short time and the atrophy or deformity was not observed. CONCLUSION: Free flap transfer for the reconstruction of the finger defect after crushing injury is useful for the functional recovery and cosmesis.
Amputation ; Atrophy ; Congenital Abnormalities ; Fingers ; Free Tissue Flaps ; Humans ; Nails ; Necrosis ; Retrospective Studies ; Skin

PURPOSE: Epinephrine itself exhibits some cardiotoxicity. However, it rarely induces cardiomyopathy when used in standard doses during surgery for local hemostasis. This paper reports a rare case of stress-induced cardiomyopathy in a young woman after the local infiltration of epinephrine. METHODS: Corrective rhinoplasty was planned in a 20-year-old woman. Lidocaine mixed with epinephrine 1:100,000 was injected around the skin of the nose and nasal septum after inducing anesthesia, which resulted in sinus tachycardia and hypotension. Postoperative ECG showed a T wave inversion in the lead V2 and echocardiography revealed transient hypokinesia in the cardiac apex. Cardiac enzyme was mildly elevated. RESULTS: Symptoms and laboratory findings improved considerably, and the patient was discharged from hospital without complications on the sixth day after surgery. CONCLUSION: The prognosis of catecholamine-induced cardiomyopathy is generally favorable. However, it is important to be aware of the possible adverse effects of local epinephrine infiltration. This case highlights the need for caution when using epinephrine.
Anesthesia ; Cardiomyopathies ; Echocardiography ; Electrocardiography ; Epinephrine ; Female ; Hemostasis ; Humans ; Hypokinesia ; Hypotension ; Lidocaine ; Nasal Septum ; Nose ; Prognosis ; Rhinoplasty ; Skin ; Surgery, Plastic ; Tachycardia, Sinus ; Young Adult

No abstract available.
Atrial Fibrillation ; Mesenteric Arteries ; Mesenteric Artery, Superior ; Stroke

Malacoplakia is an uncommon granulomatous inflammatory disease, which predomina- ntly affected the urinary tract, particularly the urinary bladder. The prostatic involve- ment of malacoplakia is extremely rare and may clinically mimic prostate cancer. A correct diagnosis of malacoplakia can be made by histopathologic findings characterized by accumulations of macrophages containing typical intracytoplasmic inclusions(Michael is-Gutmann bodies). We report a case of prostatic malacoplakia, which was incidentally found in prostate biopsy performed to confirm clinically suspected prostate cancer.
Biopsy ; Diagnosis ; Macrophages ; Malacoplakia* ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Tract

PURPOSE: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. MATERIALS AND METHODS: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). RESULTS: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands > or =20 Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. CONCLUSION: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.
Brain ; Humans ; Parotid Gland ; Xerostomia

Sparganosis is a parasitic infestation caused by the larval stage of Spirometra erinacei. Human infection results from ingestion of raw or undercooked flesh of any of the numerous intermediate hosts and from application of such flesh as poultices. Sparganosis have been reported from orbit and bulbar conjunctiva. But, urogenital infestation of Sparganum is rarely observed. We report an additional case of the sparganum infestation in the right scrotum.
Conjunctiva ; Eating ; Humans ; Orbit ; Scrotum* ; Sparganosis* ; Sparganum ; Spirometra

Actinomyces ; Actinomycosis ; Actinomycosis, Cervicofacial ; Anti-Bacterial Agents ; Bacteria ; Calculi ; Dental Caries ; Dental Plaque ; Humans ; Male ; Molar, Third ; Mucous Membrane ; Root Canal Therapy ; Tooth Fractures ; Young Adult

Purpose: To investigate the incidence of tuberculosis (TB) in healthcare workers (HCWs) with positive interferon-gamma release assay (IGRA) results based on chest X-ray (CXR) and CT findings and determine the role of imaging in the diagnosis of TB. Materials and Methods: Among 1976 hospital personnel screened for TB using IGRA, IGRApositive subjects were retrospectively investigated. Clustered nodular and/or linear streaky opacities in the upper lung zone were considered positive on CXR. The CT findings were classified as active, indeterminate, inactive, or normal. The active or indeterminate class was considered CT-positive. Results: IGRA was positive in 255 subjects (12.9%). CXR and CT were performed in 249 (99.2%) and 113 subjects (45.0%), respectively. CXR- and CT-positive findings were found in 7 of 249(2.8%) and 9 of 113 (8.0%) patients, respectively. Among the nine CT-positive subjects, active and indeterminate TB findings were found in 6 (5.3%) and 3 (2.7%) patients, respectively. Microbiological tests, including acid-fast bacilli staining, culture, and polymerase chain reaction for TB, were negative in all nine CT-positive subjects. Empirical anti-TB medications were administered to 9 CT-positive subjects, and 3 of these nine subjects were CXR-negative for pulmonary TB. Conclusion CT helped diagnose asymptomatic TB in IGRA-positive HCWs.