PURPOSE: The purpose of this study was to evaluate the value of regional flap surgery for diabetic foot ulcers combined with infection or bone and tendon exposure. MATERIALS AND METHODS: We reviewed eight patients, nine cases of diabetic foot ulcers, which were treated by regional flap surgery. There were two Wagner's grade 2 ulcers and six Wagner's grade 3 ulcers. We performed four reversed sural artery neurocutaneous flaps, two lateral supramalleolar flaps, two medial plantar artery flaps and one first dorsal metatarsal artery flap. RESULTS: Seven of nine flaps completely survived after regional flap surgery. One partial and one complete flap necrosis occurred. One partially necrotized flap needed an additional skin graft. One completely necrotized flap needed free rectus abdominis myocutaneous flap surgery. There were two new ulcers, which were treated by free flap surgery. No patient needed amputation above the ankle joint. CONCLUSION: Satisfactory results were obtained by regional flap surgery for diabetic foot ulcers. Regional flap surgery is regarded as an effective treatment modality for diabetic foot ulcer combined with bone and tendon exposure with infection.
Amputation ; Ankle Joint ; Arteries ; Diabetic Foot* ; Foot ; Free Tissue Flaps ; Humans ; Metatarsal Bones ; Myocutaneous Flap ; Necrosis ; Rectus Abdominis ; Skin ; Tendons ; Transplants ; Ulcer*

It has been shown that iodinated fatty acid esters such as Ethiodol(*) or Lipiodol(**) are selectively retained in hypervascular hepatic tumors following intrahepatic arterial admininstration. Such agents have been utilized in the detection and treatment of hepatocellular carcinoma (HCC) along with anticancer drug emulsions. Radioildination of Lipiodol(1-131-Lipiodol) was achieved by using a simple exchange method and the agent was used in the treatment of HCC following intrahepatic arterial-injection via superselective catheterization of tumor feeding vessels. Forty patients with HCC (massive 18; multinodular 12; infiltrative 10) were treated in an attempt to deliver a high dose of internal radiation; a cumulative tumor dose of 12,000 rad(120 GY) or higher was aimed in single or multiple procedures. Following therapy, the patients were divided into 2 groups, responsive or nonresponsive. Patients classfied as massive type responded to this treatment best (72.3%) followed by multinodular type (33.3%) and infiltrative type(10.0%). According to the size of tumor there was an 80.0% response for tumors of less than 5cm in diameter, 60.0%, between 5 to 8cm and 9.0% larger than 10cm in diameter. The clinical results of this treatment modality appear to be quite promising in the management of HCC, especially in the less than 8cm sized massive type of HCC. Also this method was able to not only provide long term local control but also a good quality of life without complications.
Adult ; Aged ; Carcinoma, Hepatocellular/blood supply/*radiotherapy ; Case Report ; Clinical Trials ; Female ; Hepatic Artery ; Human ; Injections, Intra-Arterial ; Iodine Radioisotopes/administration and dosage/*therapeutic use ; Iodized Oil/administration and dosage/*therapeutic use ; Liver Neoplasms/blood supply/*radiotherapy ; Male ; Middle Age ; Support, Non-U.S. Gov't

Background: and Purpose Oral administration of cholinesterase inhibitors is often associated with adverse gastrointestinal effects, and so developing an alternative administration route, such as transdermal, is urgently needed. The primary objective of this study was to determine the efficacy and safety of the IPI-301 donepezil transdermal patch compared with donepezil tablets (control) in mild-to-moderate probable Alzheimer’s disease (AD). Methods: This prospective, randomized, double-blind, double-dummy, two-arm parallel, multicenter trial included 399 patients, among whom 303 completed the trial. For randomization, the patients were stratified based on previous treatment and donepezil dose; patients in each stratum were randomized to the test and control groups at a 1:1 ratio. Results: The difference between the control group and the IPI-301 group, quantified as the Hodges–Lehmann estimate of location shift, was 0.00 (95% confidence interval: -1.00 to 1.33), with an upper limit of less than 2.02. The change in Alzheimer’s Disease Cooperative Study– Activities of Daily Living (ADCS-ADL) score differed significantly between the IPI-301 and control groups (p=0.02). However, the changes in the full-itemized ADCS-ADL scores at week 24 did not differ significantly between the two groups. There were no differences between the two groups regarding the scores for the Clinician Interview-Based Impression of Change (f0.9097), Mini-Mental State Examination (p=0.7018), Neuropsychiatric Inventory (p=0.7656), or Clinical Dementia Rating (p=0.9990). Adverse events, vital signs, and laboratory test results were comparable between the two groups. Conclusions IPI-301 was safe and efficacious in improving cognitive function in patients with mild-to-moderate AD.