No abstract available.
Orbit*

No abstract available.
Retrospective Studies ; Surgery, Oral ; Tracheostomy

No abstract available.

The approach we suggest was developed for cases in which the fourth and fifth lumbar and first sacral spinal nerves were affected in lumbar degenerative disc disease. Retrodiscal transforaminal epidural injection is known to be very effective for lumbar radiculopathy because of excellent access to primary pathology; however, access below L5 is often restricted by the anatomic characteristics of the L5–S1. In the translateral recess approach (TLR), proper final needle placement (i.e., in the axillary portion between the exiting and traversing nerve roots) can be achieved by setting the direction of the needle laterally and superiorly from the distal tip of the infra-adjacent spinous process toward the medial wall of the pedicle and neural foramen of the given level without neural injury. This approach is possible because of the wide interlaminar space in the L5–S1. Preganglionic epidural injection through TLR is an effective and safe spinal intervention for lumbosacral radiculopathy.
Injections, Epidural ; Needles ; Pathology ; Radiculopathy ; Spinal Nerves

The relationship between infective endocarditis and mycotic aneurysm formation appers clear : In about two to ten percent of patients with infective endocarditis harbor septic intracranial aneurysms. But the pathogenesis, natural course and management of these lesions remains controversial. Aggressive medical treatment of the underlying infected cardiac valve or surgical replacement therapy have significantly reduced the morbidity and mortality rates associated with infective endocarditis. Clinical predictors of mycotic aneurysm, especially neurologic prodromes prior to rupture have been ill-defined since most series contain few patients or include patients with infective aneurysms who have no infective endoarditis. Similarly there has been no consensus regarding the indications and timing of cerebral angiography in patients with infective endocarditis. We have experienced a case of cerebral mycotic aneurysm complicated with subarachnoid hemorrhage due to infective endocarditis in a 29 year-old female patient, who admitted to our hospital because of the pain and paralysis of sudden onset in right forearm, which was diagnosed by echocardiography, brain computed tomography and 4-vessel cerebral angiography. The patient died of sudden rupture of mycotic aneurysm in the 7th hospital day despite intensive medical treatment. We report one case of cerebral mycotic aneurysm with a brief of literature.
Adult ; Aneurysm ; Aneurysm, Infected* ; Brain ; Cerebral Angiography ; Consensus ; Echocardiography ; Endocarditis* ; Female ; Forearm ; Heart Valves ; Humans ; Intracranial Aneurysm ; Mortality ; Paralysis ; Rupture ; Subarachnoid Hemorrhage*

PURPOSE: Our purpose in this study is to evaluate the effectiveness of bronchial and nonbronchial systemic arteries for the control of hemoptysis. MATERIALS AND METHODS: Seventy patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1991 and 1993. Retrospectively we reviewed 77 cases of bronchial artery embotization and 32 cases of nonbronchial systemic artery embolization in the 70 patients. RESULTS: Immdiate control of hemoptysis was achieved in 33 of 39 patients with massive hemoptysis(84.6%) and 20 of 24 patients with recurrent hemopt ysis(83.3%). In 32 cases, nonbronchial systemic arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. CONCLUSION: Bronchial artery embolization is an effective and life saving procedure in non-surgical candidates. Recognition and occlusion of nonbronchial systemic arteries that feed to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis* ; Humans ; Retrospective Studies

Seborrheic dermatitis is a chronic, recurrent papulosquamous skin disorder characterized by flaking of the skin, erythema, pruritus, and oily skin. It is a common dermatosis, with a prevalence of approximately 1% to 3% of the general population in the United States. The incidence of this skin disease has a bimodal distribution, with peaks noted in newborns and in adults between 30 and 60 years of age. In adults, it predominantly occurs over areas of the body with a high concentration of sebaceous glands. The etiology of this disease is thought to be an inflammatory response of the body to Malassezia yeasts. It is also related to abnormal sebum secretion, as well as a heightened immune response of the host. Based on the characteristic features of this inflammatory skin disease, the mainstays of treatment for seborrheic dermatitis are antifungals, corticosteroids, and immunomodulatory agents. The primary goal of therapy for seborrheic dermatitis is to manage acute symptoms, including pruritus, erythema, and scaling. Maintenance treatment is directed toward preventing the recurrence of acute exacerbations. Patients should be informed that seborrheic dermatitis is a chronic condition, with a tendency to recur despite proper treatment. Clinicians should offer suggestions about lifestyle modifications to avoid triggers and choose proper treatment options that ensure the patient's safety.
Adrenal Cortex Hormones ; Adult ; Dandruff ; Dermatitis, Seborrheic* ; Erythema ; Humans ; Incidence ; Infant, Newborn ; Life Style ; Malassezia ; Prevalence ; Pruritus ; Recurrence ; Sebaceous Glands ; Sebum ; Skin ; Skin Diseases ; United States ; Yeasts

PURPOSE: To investigate corneal surface changes and subjective symptoms after small incision cataract surgery and to compare the changes between clear corneal incision and corneoscleral incision. METHODS: The present prospective randomized study included 18 eyes of 18 patients with corneoscleral incision (Group 1) and 25 eyes of 25 patients with clear corneal incision (Group 2). All patients were examined for tear break-up time (BUT), Schirmer test, cornea and conjunctiva fluorescein staining, and dry eye symptoms using the Ocular Surface Disease Index (OSDI). All values were compared before surgery and at one day, one week, four weeks, and seven weeks after surgery. RESULTS: BUT decreased significantly (p < 0.05) and fluorescein staining scores increased significantly (p < 0.05) at postoperative day 1. The values of BUT and fluorescein staining returned to the preoperative level at postoperative week 3 in Group 1. In Group 2, fluorescein staining scores returned at one week and BUT returned to the preoperative level at postoperative week 3. Postoperative Schirmer test results were unchanged compared to preoperative values, and there was no difference between the two groups. OSDI scores significantly improved compared to preoperative scores at postoperative one week. In Group 1, the scores improved at postoperative one week (p < 0.05) compared to those in Group 2 at postoperative three weeks (p < 0.05). CONCLUSIONS: Phacoemulsification with a small incision induced transient corneal surface changes and tear film instability, but the changes returned to the preoperative level at postoperative three weeks. Dry eye symptoms also improved at postoperative one week. The changes lasted longer with clear corneal incision than with corneoscleral incision but returned to the preoperative level at postoperative three weeks in both groups.
Cataract ; Conjunctiva ; Cornea ; Eye ; Fluorescein ; Humans ; Phacoemulsification ; Prospective Studies ; Tears

BACKGROUND: There are several ways to treat for recurrent pericardial effussion and cardiac tamponade due to malignancy. They are repeated pericardiocentesis, pericardial instillation of sclerosing and chemotherapeutic agents, surgical creation of a pericardial window and transthoracic pericardiectomy. Surgical techniques are usually effective but bear a significant morbidity and mortality especially in chronic debilitating cancer patients. So percutaneous balloon pericardial window as an alternative to surgery in these patients. METHODS: After pericardiocentesis was performed, a 0.035 inch J-tip guidewire was advanced into the pericardial space. And a pigtail catheter was advanced over the wire. A moderate amount of pericardial fluid were removed. A nd then the pigtail catheter was withdrawn and 8F sheath was inserted. A20mm diameter, 4cm long(Single balloon method) or two 10mm diameter, 4cm long balloon dilating catheter(Double balloon medium) was advanced over the wire to straddle the parietal pericardial border though the sheath. Several inflations of the balloon with a solution containing 50% radiographic contrast medium were performed until disappearance of the balloon waist. After balloon dilation, contrast medium from the pericardial space to subcutaneous tisse suggesting successful PBPWF. Single ballon method was employed in 4 patients and Dould balloon method in 2 patients. RESULT: We performed percutaneous balloon pericardial window formation in 6 patiemts with malignant pericardial effusion. We did percutaneous balloon pericardial window formation successfully in 5 patients and failed due to adhesion of parietal pericardium in 1 patient. One patient developed recurrent pericardial effusion with tamponade at a mean follow-up of 11.49.6 months(1.5-26 months). Conclusion: These results suggest that PBPWF is an alternative method less invasive than subxiphoid surgical windowing, espesially in critically ill patients with recurrent malignant pericardial effussion. It carries less risks and has more constant effect than repeated pericardiocentesis.
Cardiac Tamponade ; Catheters ; Critical Illness ; Follow-Up Studies ; Humans ; Mortality ; Pericardial Effusion* ; Pericardiectomy ; Pericardiocentesis ; Pericardium ; Rabeprazole

Syphilis is a communicahble disease caused by the motile microaerophilic spirochete Treponema pallidum, which is only a netural pathogen for human. Prevalence of syphilis and other sexually transmitted diseases has traditioially fluctuated with changes in sccia, conditions and sexual behavior. Although sexual contact is the main route of transmission, T. pallidum may also be infected through direct contact with syphilitic lesions, blood transfusion, ingestion of menstrual blood or vaginal secretions, or trsnsplacental transemission. Fomites as the means of transfer is only hypothetical and account for very few, if any, infection. Prosectors, blood handlers and laboratory technicians are at risk for accidental inoculation with infected materials. In extremely unusual circumstances, infection by means of contact with a skin lesion and human bite have been reported. We report two cases of eyphilis following the abnormal imposition of hands, which caused unnecessary erosive trauma with fingernails,
Bites, Human ; Blood Transfusion ; Eating ; Fomites ; Hand* ; Humans ; Laboratory Personnel ; Nails ; Prevalence ; Sexual Behavior ; Sexually Transmitted Diseases ; Skin ; Spirochaetales ; Syphilis* ; Treponema pallidum