Newborns with ileal atresia frequently present with abdominal distension, bilious vomiting, and failure to pass meconium. Diagnosis is usually established on plain x-ray of the abdomen by the findings of distended small bowel loops and air-fluid levels. In the period of October 1988 to February 1994, 8 patients with congenital ileal atresia were operated and the following results were obtained. 1. Eight patients were comprise of 4 males and 4 females, the ratio of male and female was 1 : 1. 2. Six patients(75%) had been admitted to our hospital during three days of life. 3. Congenital ileal atresia was in 8 cases : Type I in two(25%), Type II in two(25%), Type III a in three(37.5%), Type III b in one(12.5%). 4. There was one premature patient who was small for gestational age. 5. Overall, abdominal distension and bilious vomiting occurring in seven patients, were frequent presenting complaints. 6. Diagnosis was possible with clinical symptom and simple abdomen. 7. Operative treatment was undertaken as soon as the diagnosis was made. In seven cases a primary end-to-end anastomosis was performed after resection of dilated proximal loop. 8. A total of four associated congenital anomalies were found in one patient. 9. Postoperative complications occurred in three cases(37.5%).
Abdomen ; Diagnosis ; Female ; Gestational Age ; Humans ; Infant, Newborn* ; Male ; Meconium ; Postoperative Complications ; Vomiting

BACKGROUND: Though implant dentistry is very successful and predictable in treatment of patients with destroyed dentition, there are some cases with limitations to implant therapy. In these cases, alternative treatment modality should be considered. CASE DESCRIPTION: A patient with destroyed dentition was rehabilitated with a lateral rotational path removable partial denture. According to the diagnosis, we determined to raise vertical dimension for esthetic and functional restoration. The final restoration was performed after four months of provisional period. CLINICAL IMPLICATION: The edentulous patients with compromised esthetics and functions can be successfully treated with a rotational path removable partial denture through adequate treatment planning and precise laboratory procedure.
Dentistry ; Dentition ; Denture, Partial, Removable ; Esthetics ; Humans ; Mouth ; Mouth Rehabilitation ; Tooth Attrition ; Vertical Dimension

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

Percutaneous endoscopic gastrostomy (PEG) is a common method for providing long-term enteral nutrition to patients. PEG tube placement and removal are relatively safe; generally, a PEG tube can be removed using gentle traction, and excessive bleeding is rare. The over-the-scope clip system is a new device that can be used for gastrointestinal hemostasis and for closing gastrointestinal fistulae. In the present case, a 68-year-old male patient had to remove the PEG tube because of persistent leakage around the PEG tube. Although it was gently removed using traction, incessant bleeding continued, with a Rockall score of 5 points, even after hemocoagulation was attempted. An over-the-scope clip device was used to achieve hemostasis and fistula closure.

Background/Aims: Recent reports suggest that the biliary self-expandable metallic stent (SEMS) is highly effective for maintaining hemostasis when endoscopic hemostasis fails in endoscopic retrograde cholangiopancreatography (ERCP)-related bleeding. We compared whether temporary SEMS offers better efficacy than angioembolization for refractory immediate ERCP-related bleeding. Methods: Patients who underwent SEMS placement or underwent angioembolization for bleeding control in refractory immediate ERCP-related bleeding were included in the retrospective analysis. We evaluated the hemostasis success rate, severity of bleeding, change in hemoglobin levels, amount of transfusion, and delay to the start of hemostasis. Results: A total of 27 patients with SEMS and 13 patients who underwent angioembolization were enrolled. More transfusions were needed in the angioembolization group (1.0±1.4 units vs. 2.5±2.0 units; p=0.034). SEMS failure was successfully rescued by angioembolization. The partially covered SEMS (n=23, 85.1%) was generally used, and the median stent-indwelling time was 4 days. The mean delay to the start of angioembolization was 95.2±142.9 (range, 9–491) min. Conclusions Temporary SEMS had similar results to those of angioembolization (96.3% vs. 92.3%; p=0.588). Immediate SEMS insertion is considered a bridge treatment modality for immediate refractory ERCP-related bleeding. Angioembolization still has a role as rescue therapy when SEMS does not work effectively.

Background: Pityriasis rosea is a self-limiting, acute, or subacute inflammatory skin disease that usually starts with a herald patch on the trunk and progresses to a generalized rash over the trunk and limbs. Some clinical trials have suggested that antibiotic macrolides help shorten the duration of skin manifestations in pityriasis rosea; however, the extent of the benefits is unclear. Objective: To evaluate the effectiveness of antibiotic macrolides compared to placebo in pityriasis rosea. Methods: A computerized search was performed using different databases, including Cochrane, Embase, and PubMed. Five randomized controlled trials were included. Then, statistical analyses of the outcome data extracted from the studies were performed using Rex Software (version 3.0.1). Results: Total 160 records were identified by searching databases including Cochrane, Embase, and PubMed. The results of the meta-analysis demonstrated statistical differences between the use of antibiotic macrolides and placebo in the complete and partial resolution of pityriasis rosea (effectiveness) (RR: 1.84, 95% CI: 1.21∼2.78, p=0.004).However, in subgroup analyses, there were no statistical differences compared to placebo in the skin manifestation effectiveness group for azithromycin and clarithromycin, whereas erythromycin showed statistical differences. Conclusion Erythromycin was superior to placebo in the treatment of pityriasis rosea. However, this study had some limitations, including insufficient articles and data. Therefore, further investigation is required.

Background: Pityriasis rosea is a self-limiting, acute, or subacute inflammatory skin disease that usually starts with a herald patch on the trunk and progresses to a generalized rash over the trunk and limbs. Some clinical trials have suggested that antibiotic macrolides help shorten the duration of skin manifestations in pityriasis rosea; however, the extent of the benefits is unclear. Objective: To evaluate the effectiveness of antibiotic macrolides compared to placebo in pityriasis rosea. Methods: A computerized search was performed using different databases, including Cochrane, Embase, and PubMed. Five randomized controlled trials were included. Then, statistical analyses of the outcome data extracted from the studies were performed using Rex Software (version 3.0.1). Results: Total 160 records were identified by searching databases including Cochrane, Embase, and PubMed. The results of the meta-analysis demonstrated statistical differences between the use of antibiotic macrolides and placebo in the complete and partial resolution of pityriasis rosea (effectiveness) (RR: 1.84, 95% CI: 1.21∼2.78, p=0.004).However, in subgroup analyses, there were no statistical differences compared to placebo in the skin manifestation effectiveness group for azithromycin and clarithromycin, whereas erythromycin showed statistical differences. Conclusion Erythromycin was superior to placebo in the treatment of pityriasis rosea. However, this study had some limitations, including insufficient articles and data. Therefore, further investigation is required.

Flavonoids are major plant constituents with numerous biological/pharmacological actions both in vitro and in vivo. Of these actions, their anti-inflammatory action is prominent. They can regulate transcription of many proinflammatory genes such as cyclooxygenase-2/inducible nitric oxide synthase and many cytokines/chemokines. Recent studies have demonstrated that certain flavonoid derivatives can affect pathways of inflammasome activation and autophagy. Certain flavonoids can also accelerate the resolution phase of inflammation, leading to avoiding chronic inflammatory stimuli. All these pharmacological actions with newly emerging activities render flavonoids to be potential therapeutics for chronic inflammatory disorders including arthritic inflammation, meta-inflammation, and inflammaging. Recent findings of flavonoids are summarized and future perspectives are presented in this review.
Autophagy ; Flavonoids ; In Vitro Techniques ; Inflammasomes ; Inflammation ; Nitric Oxide Synthase ; Plants

Obstruction of the common bile duct (CBD) by direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but a bile duct tumor embolus caused by intrabiliary transplantation of a free floating tumor is a rare complication of a hepatocellular carcinoma. A patient of ours was recently observed with a fragment of tumor from a primary hepatocellular carcinoma (HCC) that obstructed the distal CBD. A-46-year-old man was admitted to our hospital with a distal CBD mass, measuring 1.2x1.5 cm, found by a biliary computed tomography (CT) scan. Four month prior to his admission, he had undergone a right hemihepatectomy for a HCC accompanied by direct intrahepatic bile duct invasion, without obstructive jaundice. On admission, there were no abnormal findings in the physical and laboratory examinations. An Endoscopic retrograde cholangiopancreatography and papillotomy had been performed, which showed an irregular shaped filling defect in the distal CBD. Endoscopic nasobiliary drainage (ENBD) was carried out for biliary decompression. Partially extracted soft tissue from the CBD by ERCP revealed a HCC. On performed a pylorus- preserving pancreaticoduodenectomy, a 1cm sized tumor remnant was found attached to the mucosa of the intrapancreatic portion of the bile duct, but without any invasive growth into the submucosa. The tumor may have been an intrabiliary transplantation from the HCC in the right lobe through the bile duct. When an obstructive mass is found in the distal CBD, tumor embolus should be considered, and a radical pancreaticoduodenectomy can be adopted as a safe and effective treatment modality.
Bile Ducts ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Decompression ; Drainage ; Embolism* ; Humans ; Jaundice, Obstructive ; Liver Neoplasms ; Mucous Membrane ; Neoplastic Cells, Circulating ; Pancreaticoduodenectomy

A 55-year-old male presented with dysesthesia of the right anteromedial thigh. A magnetic resonance image revealed a globular mass at the right extraforaminal area of the L3/4 level. Based on the diagnosis of neurogenic tumor, surgical excision was performed. The surgical impression and pathology confirmed extrusion of intervertebral disc. In a retrospective review of the magnetic resonance image, we noticed a fibrillary pattern directed from the intervertebral disc space to the lesion, and disrupted annulus fibrosus and indentation caused by the ring apophysis. We suggest aforementioned features, indicative of intervertebral disc lesions, to be checked when interpreting mass lesions around the intervertebral foramen.
Diagnosis ; Humans ; Intervertebral Disc* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Paresthesia ; Pathology ; Retrospective Studies ; Thigh