BACKGROUND: The aim of this study was to investigate the relationships between left ventricular ejection fraction (LVEF) and mortality and neurologic outcomes with post-cardiac arrest syndrome (PCAS) after out-of-hospital cardiac arrest (OHCA). METHODS: Patients with PCAS after OHCA admitted to the intensive care unit between January 2014 and December 2015 were analyzed retrospectively. RESULTS: total of 104 patients were enrolled in this study. The mean age was 54.4 ± 15.3 years, and 75 of the patients were male (72.1%). Arrest with a cardiac origin was found in 55 (52.9%). LVEF < 45%, 45-55%, and > 55% was measured in 39 (37.5%), 18 (17.3%), and 47 (45.2%) of patients, respectively. In multivariate analysis, severe LV dysfunction (LVEF < 45%) was significantly related to 7-day mortality (odds ratio 3.02, 95% Confidence Interval 1.01-9.0, p-value 0.047). CONCLUSIONS: In this study, moderate to severe LVEF within 48 hours after return of spontaneous circulation was significantly related to 7-day short-term mortality in patients with PCAS after OHCA. Clinicians should actively treat myocardial dysfunction, and further studies are needed.
Echocardiography ; Humans ; Intensive Care Units ; Male ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Passive Cutaneous Anaphylaxis ; Retrospective Studies ; Stroke Volume*

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Four consecutive cases of a colonic stricture following a da Vinci robot-assisted ultra-low anterior resection (LAR) with coloanal anastomosis and diverting ileostomy for the treatment of rectal cancer are reported. The colonic strictures developed after early proximal colonic ischemia without anastomotic site leakage or disruption. All patients were treated with preoperative chemoradiation therapy. During the postoperative recovery period, patients developed colonic ischemia, presenting with a high, spiking fever, but without any symptoms of peritonitis. Patients were treated with conservative management (antibiotic therapy) and discharged after two weeks when in good condition. Several months after discharge, all four patients developed a long-segment colonic stricture from the anastomosis site to the distal colon. Management of the colon strictures, including the anastomotic site, involved colonic dilation with a Hegar dilator in an outpatient clinic for several months. The ileostomies in three patients could not be closed.
Ambulatory Care Facilities ; Colon* ; Constriction, Pathologic* ; Fever ; Humans ; Ileostomy ; Ischemia* ; Peritonitis ; Rectal Neoplasms

Port site hernias are a rare complication after laparoscopic and robotic surgery. The current case is an 8-mm port site hernia which occurred after robot-assisted colorectal surgery. A 70-year-old female with a BMI (body mass index) of 25.7 was diagnosed as rectosigmoid colon cancer. She underwent a robot-assisted low anterior resection with double-stapled anastomosis for AJCC (American Joint Committee on Cancer) stage IIIB. After the main procedure, fascial defects in the supra-pubic and the supra-umbilical site were closed with a routine procedure (12 mm). Thirty two months after surgery, she developed an incisional hernia in the left mid abdomen (8-mm port). Recognition of the potential for a port site hernia using an 8-mm bladeless trocar port as well as a 12-mm port is essential in robotic surgery. Patients with risk factors for a port site hernia may require complete port site closure.
Abdomen ; Aged ; Colonic Neoplasms ; Colorectal Surgery* ; Female ; Hernia* ; Humans ; Joints ; Risk Factors ; Surgical Instruments*

OBJECTIVE: Abnormal uterine bleeding is the most common disorder of gynecologic department. Organic causes of abnormal uterine bleednig are chronic cervicitis, submucosal myoma, endometrial polyp, endometrial malignancy. To find the exact cause of uterine bleeding, hysteroscopic endometrial biopsy was used. METHODS: 214 patients were included in the study, who received hysteroscopic endometrial biopsy from Feb. 2000 to Dec. 2002 with abnormal uterine bleeding, negative in urine pregnancy test, normal in cervix cytology, and without organic lesion causing uterine bleeding in pelvic examination and ultrasonography. Age, parity, hysteroscopic biopsy result were analyzed retrospectively. RESULTS: Mean age of study group was 42 and mean parity was 2.75. When final hysteroscopic biopsy histology were analysed, proliferative phase was most common (28.9%). Next followed secretory phase (18.2%), simple hyperplasia (13.5%), endometrial polyp (9.8%), chronic endocervicitis (5.1%). Submucosal myoma (4.2%), endometrial cancer (4.2%). Complex hyperplasia were detected in 3.2%. Of 214 patients, who complained uterine bleeding, only 99 (47.1%) patients were proved true non- organic uterine bleeding on hysteroscopic biopsy. Remainder had organic disorder (39.8%). CONCLUSION: When a patient visits the hospital with abnormal uterine bleeding, doctor should be suspicious of endometrial organic disease and treat the patient under exact diagnosis. In these patients, hysteroscopic examination and biopsy were very useful and safe method to determine exact diagnosis and treatment plan.
Biopsy ; Cervix Uteri ; Diagnosis ; Endometrial Neoplasms ; Female ; Gynecological Examination ; Humans ; Hyperplasia ; Hysteroscopy ; Myoma ; Parity ; Polyps ; Pregnancy ; Pregnancy Tests ; Retrospective Studies ; Ultrasonography ; Uterine Cervicitis ; Uterine Hemorrhage*

No abstract available.
Primary Myelofibrosis* ; Xanthogranuloma, Juvenile*

No abstract available.
Brain* ; Hydrocephalus*

Ovarian leiomyoma is a very uncommon tumor that usually presents as an unilateral neoplasm typically associated with uterine leiomyoma in middle aged to postmenopuasal women. These probably originate from smooth muscle cells of the ovarian blood vessel or from the smooth muscle fibers near the attachment of the ovarian ligament. We report a case of ovarian leiomyoma, bilateral and massive in 17 year-old woman. We document the smooth muscle origin of the tumors with immunohistochemical studies that show appropriate staining with antibodies to actin, desmin, vimentin, S-100 protein.
Actins ; Adolescent* ; Antibodies ; Blood Vessels ; Desmin ; Female* ; Humans ; Leiomyoma* ; Ligaments ; Middle Aged ; Muscle, Smooth ; Myocytes, Smooth Muscle ; S100 Proteins ; Vimentin

Objective: To investigate the incidence and timing of late growth of subsolid nodules (SSNs) ≥6 mm after initial 5-year stability, its clinical implications, and the appropriate follow-up strategy. Materials and Methods: This retrospective study included SSNs ≥6 mm that remained stable for the initial five years after detection. The incidence and timing of subsequent growth after five years of stability were analyzed using the Kaplan–Meier method. Descriptive analyses were conducted to evaluate the clinical stage shift in the SSNs, showing growth and the presence of metastasis during the follow-up period. Finally, an effective follow-up CT scan strategy for managing SSNs after a 5-year period of stability was investigated. Results: Two hundred thirty-five eligible SSNs (211 pure ground-glass and 24 part-solid nodules) in 235 patients (median age, 63 years; 132 female) were followed for additional <1 to 181 months (median, 87.0 months; interquartile range [IQR], 47.0– 119.0 months) after 5-year stability. Fourteen SSNs (6.0%) showed growth at two to 145 months (median, 96 months; IQR:43.0–122.25 months) from the CT scan confirming 5-year stability, with the estimated cumulative incidence of growth of 0.4%, 2.1%, and 6.5% at 1, 5, and 10 years, respectively. Nine SSNs (3.8%) exhibited clinical stage shifts. No lung cancer metastases were observed. Hypothetical follow-up CT scans performed at 5, 10, and 15 years after 5-years of stability, would have detected 5 (36%), 11 (79%), and 14 (100%) of the 14 growing SSNs, along with 4 (44%), 8 (89%), and 9 (100%) of the nine stage shifts, respectively. Conclusion During a long-term follow-up of pulmonary SSNs ≥6 mm after 5-years of stability, a low incidence of growth without occurrence of metastasis was noted. CT scans every five years after the initial 5-year stability period may be reasonable.

Objective: To investigate the incidence and timing of late growth of subsolid nodules (SSNs) ≥6 mm after initial 5-year stability, its clinical implications, and the appropriate follow-up strategy. Materials and Methods: This retrospective study included SSNs ≥6 mm that remained stable for the initial five years after detection. The incidence and timing of subsequent growth after five years of stability were analyzed using the Kaplan–Meier method. Descriptive analyses were conducted to evaluate the clinical stage shift in the SSNs, showing growth and the presence of metastasis during the follow-up period. Finally, an effective follow-up CT scan strategy for managing SSNs after a 5-year period of stability was investigated. Results: Two hundred thirty-five eligible SSNs (211 pure ground-glass and 24 part-solid nodules) in 235 patients (median age, 63 years; 132 female) were followed for additional <1 to 181 months (median, 87.0 months; interquartile range [IQR], 47.0– 119.0 months) after 5-year stability. Fourteen SSNs (6.0%) showed growth at two to 145 months (median, 96 months; IQR:43.0–122.25 months) from the CT scan confirming 5-year stability, with the estimated cumulative incidence of growth of 0.4%, 2.1%, and 6.5% at 1, 5, and 10 years, respectively. Nine SSNs (3.8%) exhibited clinical stage shifts. No lung cancer metastases were observed. Hypothetical follow-up CT scans performed at 5, 10, and 15 years after 5-years of stability, would have detected 5 (36%), 11 (79%), and 14 (100%) of the 14 growing SSNs, along with 4 (44%), 8 (89%), and 9 (100%) of the nine stage shifts, respectively. Conclusion During a long-term follow-up of pulmonary SSNs ≥6 mm after 5-years of stability, a low incidence of growth without occurrence of metastasis was noted. CT scans every five years after the initial 5-year stability period may be reasonable.