No abstract available.
Dermatitis* ; Streptococcus pyogenes

Purpose: This study assessed the efficacy and safety of preoperative chlorhexidine gluconate (CHG) double-cleansing in reducing the incidence of surgical site infections (SSI) in surgical patients in neonatal intensive care units. Methods: A retrospective chart review involved 56 patients who underwent 73 surgical procedures in the neonatal intensive care unit (NICU) from 2013 to 2022. CHG double-cleansing involves the following 2 processes. Firstly, preoperative cleansing with 0.5% CHG for elective surgeries the night before or at least 1 hour before emergency surgery. The anterior trunk cleansing spanned from the neck to the pubis, including both axillary lines. Secondly, the surgical site underwent skin preparation using 2% CHG with 72% isopropyl alcohol before an incision. A control group (2013–2018) that used iodine and a CHG group (2019–2022) employing CHG double-cleansing were compared. The occurrence of SSIs within 30 days after the surgical procedure was assessed. Results: The overall SSI rate was 16.4% (n = 12) in the total procedures. The SSI rate was significantly higher (22.6%) in the control group; no SSI occurred in the CHG group (P = 0.029). No significant differences were observed in the other parameters. No adverse effects were observed in the CHG group. Conclusion CHG double-cleansing, a modified approach for surgical patients in the NICU, effectively reduced the incidence of SSI compared to traditional iodine-based skin preparations. This study supports the safe use of CHG in neonates, including premature infants, without significant complications.

Purpose: This study assessed the efficacy and safety of preoperative chlorhexidine gluconate (CHG) double-cleansing in reducing the incidence of surgical site infections (SSI) in surgical patients in neonatal intensive care units. Methods: A retrospective chart review involved 56 patients who underwent 73 surgical procedures in the neonatal intensive care unit (NICU) from 2013 to 2022. CHG double-cleansing involves the following 2 processes. Firstly, preoperative cleansing with 0.5% CHG for elective surgeries the night before or at least 1 hour before emergency surgery. The anterior trunk cleansing spanned from the neck to the pubis, including both axillary lines. Secondly, the surgical site underwent skin preparation using 2% CHG with 72% isopropyl alcohol before an incision. A control group (2013–2018) that used iodine and a CHG group (2019–2022) employing CHG double-cleansing were compared. The occurrence of SSIs within 30 days after the surgical procedure was assessed. Results: The overall SSI rate was 16.4% (n = 12) in the total procedures. The SSI rate was significantly higher (22.6%) in the control group; no SSI occurred in the CHG group (P = 0.029). No significant differences were observed in the other parameters. No adverse effects were observed in the CHG group. Conclusion CHG double-cleansing, a modified approach for surgical patients in the NICU, effectively reduced the incidence of SSI compared to traditional iodine-based skin preparations. This study supports the safe use of CHG in neonates, including premature infants, without significant complications.

Purpose: This study assessed the efficacy and safety of preoperative chlorhexidine gluconate (CHG) double-cleansing in reducing the incidence of surgical site infections (SSI) in surgical patients in neonatal intensive care units. Methods: A retrospective chart review involved 56 patients who underwent 73 surgical procedures in the neonatal intensive care unit (NICU) from 2013 to 2022. CHG double-cleansing involves the following 2 processes. Firstly, preoperative cleansing with 0.5% CHG for elective surgeries the night before or at least 1 hour before emergency surgery. The anterior trunk cleansing spanned from the neck to the pubis, including both axillary lines. Secondly, the surgical site underwent skin preparation using 2% CHG with 72% isopropyl alcohol before an incision. A control group (2013–2018) that used iodine and a CHG group (2019–2022) employing CHG double-cleansing were compared. The occurrence of SSIs within 30 days after the surgical procedure was assessed. Results: The overall SSI rate was 16.4% (n = 12) in the total procedures. The SSI rate was significantly higher (22.6%) in the control group; no SSI occurred in the CHG group (P = 0.029). No significant differences were observed in the other parameters. No adverse effects were observed in the CHG group. Conclusion CHG double-cleansing, a modified approach for surgical patients in the NICU, effectively reduced the incidence of SSI compared to traditional iodine-based skin preparations. This study supports the safe use of CHG in neonates, including premature infants, without significant complications.

Although malignant melanoma usually occurs after the diagnosis of vitiligo-like depigmentation, the latter is rarely followed by the former. We herein report on such a case in which recognition of the vitiligo-like depigmentation preceded diagnosing the metastatic melanoma by several months. A 56-year-old woman had first developed vitiligo-like depigmentation on the forehead, eyelids, neck and back 18 months previously and thereafter she detected a hard mass in the left axilla 2 months previously. Based on the histologic findings, the axillary mass was diagnosed as metastatic melanoma. To evaluate the primary tumor focus, thorough examinations that included PET-CT, bone scan and sigmoidoscopy were performed, but we couldn`t find any the original primary tumor. Our case suggests that the vitiligo-like depigmentation could be a sign that heralds metastatic melanoma.
Axilla ; Eyelids ; Female ; Forehead ; Humans ; Melanoma ; Middle Aged ; Neck ; Sigmoidoscopy

PURPOSE: To evaluate the efficacy and long-term prognosis of pars plana vitrectomy and Ahmed valve implantation for intractable glaucoma comorbid with retinal disorders. METHODS: A retrospective review of 34 eyes of 30 patients receiving pars plana vitrectomy and Ahmed valve implantation for intractable glaucoma comorbid with retinal disorders was performed. Preoperative and postoperative intraocular pressure (IOP) and visual acuity, the usage of IOP-lowering medications and postoperative complications, and surgical success rate were evaluated. RESULTS: IOP and the number of IOP-lowering medications showed a significant decrease after pars plana vitrectomy and Ahmed valve implantation, as compared to before surgery (p < 0.001). The success rate was 88%, 88%, 84% and 85% postoperatively at 1 month, 6 months, 1 year and 3 years respectively. The mean follow up period was 24.21 +/- 14.99 months. Complications related to surgery included hyphema in 2 eyes, recurrent corneal epithelial erosion and defect in 2 eyes, corneal ulcer in 2 eyes and vitreous hemorrhage in 4 eyes. Visual acuity improved in 14 eyes (41.1%), no changes in 13 eyes (38.2%) and decreased in 7 eyes (20.6%). CONCLUSIONS: Pars plana vitrectomy and Ahmed valve implantation for intractable glaucoma comorbid with retinal disorders show long-term efficacy in lowering IOP.
Corneal Ulcer ; Eye ; Follow-Up Studies ; Glaucoma ; Humans ; Hyphema ; Intraocular Pressure ; Postoperative Complications ; Prognosis ; Retinaldehyde ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

No abstract available.
Dopamine* ; Injections, Spinal*

No abstract available.
Dopamine* ; Injections, Spinal*

PURPOSE : The 17beta-hydroxysteroid dehydrogenases(17HSDs) play an important role in the regulation of the physiologic activities of sex steroid hormones. The predominance of 17HSD type 1 in the malignant breast tissue could increase the estrogen-dependent proliferation and stimulate the cancer progression. On the other hand, the oxidative 17HSD type 2 may protect the normal breast cells from an excessive estradiol effect. To identify the role of 17HSD type 2 in the carcinogenesis of breast cancer, we investigate the mutation of 17HSD type 2 in 35 breast cancers. METHODS : We analyzed the entire coding region of the 17 HSD type 2 gene for detection of the somatic mutations in 35 invasive ductal carcinomas of the breast by polymerase chain reaction, single strand conformation polymorphism, and DNA sequencing. RESULTS : We found one missense mutation in exon 6(2.86%). It revealed the CCT-->CTT (Pro-->Leu) transition type at codon 262 in exon 6. CONCLUSION : In present study, we found only a mutation of the 17beta -HSD type 2 gene in breast cancer and could not demonstrate the direct relationship between the mutation of the 17beta -HSD type 2 gene and the development of breast cancer. These results suggest that the mutation of 17HSD type 2 doesn? play a major role in the development of breast cancer.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Clinical Coding ; Codon ; Estradiol ; Exons ; Gonadal Steroid Hormones ; Hand ; Mutation, Missense ; Oxidoreductases* ; Polymerase Chain Reaction ; Sequence Analysis, DNA

PURPOSE : The 17beta-hydroxysteroid dehydrogenases(17HSDs) play an important role in the regulation of the physiologic activities of sex steroid hormones. The predominance of 17HSD type 1 in the malignant breast tissue could increase the estrogen-dependent proliferation and stimulate the cancer progression. On the other hand, the oxidative 17HSD type 2 may protect the normal breast cells from an excessive estradiol effect. To identify the role of 17HSD type 2 in the carcinogenesis of breast cancer, we investigate the mutation of 17HSD type 2 in 35 breast cancers. METHODS : We analyzed the entire coding region of the 17 HSD type 2 gene for detection of the somatic mutations in 35 invasive ductal carcinomas of the breast by polymerase chain reaction, single strand conformation polymorphism, and DNA sequencing. RESULTS : We found one missense mutation in exon 6(2.86%). It revealed the CCT-->CTT (Pro-->Leu) transition type at codon 262 in exon 6. CONCLUSION : In present study, we found only a mutation of the 17beta -HSD type 2 gene in breast cancer and could not demonstrate the direct relationship between the mutation of the 17beta -HSD type 2 gene and the development of breast cancer. These results suggest that the mutation of 17HSD type 2 doesn? play a major role in the development of breast cancer.
Breast Neoplasms ; Breast* ; Carcinogenesis ; Carcinoma, Ductal ; Clinical Coding ; Codon ; Estradiol ; Exons ; Gonadal Steroid Hormones ; Hand ; Mutation, Missense ; Oxidoreductases* ; Polymerase Chain Reaction ; Sequence Analysis, DNA