No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

We report an autopsy case of secondary hemochromatosis associated with multiple frequent blood transfusion for the treatment of aplastic anemia. A 23-year-old man had been diagnosed as having aplastic anemia at the age of 13. He received a whole blood transfusion, about 1280 ml, every month during the past 10 years. Recently he developed diabetes mellitus and a congestive heart failure. The autopsy revealed that multiple organs were affected by secondary hemochromatosis, including the liver, heart, pancreas, spleen, bone marrow, stomach, thyroid gland, adrenal glands, and testes. The lungs and liver showed gross and microscopic findings consistent with a congestive heart failure in addition to hemochromatosis. The details are presented. This is a case of rare secondary hemochromatosis occurring in a young man and presenting the classic histopathologic changes indistinguishable from those of primary hemochromatosis.
Adrenal Glands ; Anemia ; Anemia, Aplastic* ; Autopsy* ; Blood Transfusion ; Bone Marrow ; Diabetes Mellitus ; Heart ; Heart Failure ; Hemochromatosis* ; Humans ; Liver ; Lung ; Pancreas ; Spleen ; Stomach ; Testis ; Thyroid Gland ; Young Adult

No abstract available.
Humans ; Tuberculosis, Pulmonary*

Purpose: We report a case of iatrogenic Horner’s syndrome developing after robot-assisted transaxillary total thyroidectomy.Case summary: A 31-year-old female with right-eye ptosis was referred to our clinic. Three weeks prior, she had undergone robot-assisted total thyroidectomy via the right transaxillary approach to treat right-side thyroid cancer. On ocular examination, the palpebral fissure widths were 5.0 mm in the right lid and 8.0 mm in the left lid, the marginal reflex distances 1, 1.0 mm in the right lid and 4.0 mm in the left lid, and the levator muscle function of both eyes normal. In a dark room, the pupil diameter was 2.5 mm in the right eye and 4.0 mm in the left eye. She did not complain of facial anhidrosis. Thirty minutes after instillation of 0.5% (w/v) apraclonidine into the right eye, the right palpebral fissure width increased from 5.0 to 8.0 mm, and the pupil size from 2.5 to 4.0 mm in the dark. Conclusions Horner’s syndrome can develop after robot-assisted transaxillary total thyroidectomy; patients should be counselled in this regard.

Intravenous Patient Controlled Analgesia (IV PCA) after general or spinal anesthesia may be a method of postoperative pain control, but side effects such as nausea, vomiting, and sedation occurs in most patients. The following research is based on the ultrasound guided femorosciatic nerve block held on parts below the knee joint operation. Because this anesthesia is held locally on the sciatic nerve with continuous anesthesia performed through perineural catheterization, the complications of nausea, vomiting, and sedation may be reduced while postoperative pain caused by the sciatic nerve is controlled. The following report is held on this experience.
Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, Spinal ; Catheterization ; Catheters ; Humans ; Knee Joint ; Nausea ; Nerve Block ; Pain, Postoperative ; Sciatic Nerve ; Vomiting

PURPOSE: To evaluate the effectiveness of a combined procedure of peeling the internal limiting membrane with vitrectomy in diabetic macular edema. METHODS: This study comprised 16 eyes of 16 patients hospitalized during a 1-year period. They were randomized to either a vitrectomy group (10 eyes in 10 patients) or to a combined procedure group (6 eyes in 6 patients). Preoperative and postoperative macular center thickness, best corrected visual acuity and postoperative complications 4 months postoperative were investigated. RESULTS: There were no statistically significant differences in the mean values of preoperative and postoperative best corrected visual acuity (logMAR) between the two groups. The mean values of preoperative and postoperative macular center thickness in the vitrectomy group were respectively 509.50+/-36.77 and 332.60+/-91.73; while in the combined procedure group, they were 516.17+/-55.43 and 333.83+/-51.64. Again, there were no statistically significant differences between the two groups. At the 4-month follow-up, decreased visual acuity was found in 3 eyes of the vitrectomy group and in 2 eyes of the combined procedure group. Vitreous hemorrhage (3 eyes) and tractional retinal detachment (1 eye) were found in the vitrectomy group and vitreous hemorrhage (2 eyes) was diagnosed in the combined group. CONCLUSIONS: In our study, vitrectomy with peeling of the internal limiting membrane was not more effective than vitrectomy alone in decreasing macular edema or in improving best corrected visual acuity. Additional studies of the combined procedure are needed to verify this result.
Follow-Up Studies ; Humans ; Macular Edema* ; Membranes ; Postoperative Complications ; Retinal Detachment ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

Objectives: ：The purpose of this study is to compare bleeding tendency of selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) using platelet function analyzer (PFA-100) in patients with major depressive disorder. Methods: ：This study is a prospective open-label study conducted by a single institution. A total of 41 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study.The subjects were classified into SSRI (escitalopram) groups and SNRI (duloxetine) groups, respectively, according to random assignments. The closure time (CT) was measured using a platelet function analyzer (PFA-100) before each antidepressant was administered and after 6 weeks. Paired-sample t-test was conducted within each group to determine whether a specific antidepressant had an effect on closure time. In order to confirm the rela-tive change in platelet function between the two groups, an independent sample t-test was conducted to compare and analyze the change in closure time between the two groups. Results: ：There was no significant changes in closure time (CEPI-CT, CADP-CT) before and 6 weeks after drug administration in the SSRI and SNRI groups, and there was no difference in the amount of changes in closure time between the two groups. Conclusions ：Our results showed no difference in bleeding tendency between SSRI and SNRI. This study suggests that further large-scale studies on bleeding tendency for various antidepressants are needed in the future.

Aneurysms of superior mesenteric artery (SMA) represent an uncommon but important vascular disease. High mortality rates from rupture of aneurysm and thrombosis of SMA are reported. These lesions are most often infectious in etiology. In the case of relatively abundant collaterals, aneurysm exclusion or SMA ligation is a safe surgical method to prevent serious complications. But in insufficient collaterals, stent-grafting of aneurysm or reconstruction of mesenteric blood flow is unavoidable. Recently we treated a 49-year-old man with SMA pseudoaneurysm and its large orifice located at near the enlarged jejunal branch which is a main collateral of mesenteric blood flow.
Aneurysm ; Aneurysm, False* ; Humans ; Ligation ; Mesenteric Artery, Superior* ; Middle Aged ; Mortality ; Rupture ; Thrombosis ; Vascular Diseases

Hepatic subcapsular steatosis is a rare and unique form of fatty change in the liver. It is a specific finding in diabetic patients receiving continuous ambulatory peritoneal dialysis (CAPD) and intraperitoneal insulin treatment. Intraperitoneal administration of insulin and high glucose cause a unique pattern of fatty infiltration in the subcapsular location of the liver. We report a case of hepatic subcapsular steatosis in a diabetic CAPD patient who has not received intraperitoneal insulin. A 63-year-old diabetic woman on CAPD presented with uncontrolled blood glucose. The patient received a total amount of 44 units of NPH via subcutaneous injection. Her initial blood chemistry showed mildly increased serum lipid profiles. Abdominal CT scan images and MRI revealed characteristic findings consistent with hepatic subcapsular steatosis. We report a case of hepatic subcapsular steatosis in a diabetic patient not taking intraperitoneal insulin who recovered through strict blood sugar control without changing dialysis modality.
Blood Glucose ; Diabetes Mellitus ; Dialysis ; Fatty Liver ; Female ; Glucose ; Humans ; Injections, Subcutaneous ; Insulin ; Liver ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory

OBJECTIVE: The purpose of this experimental study was to evaluate the effect of immediate orthodontic loading on the stability at the bone-implant interface of titanium miniscrews in a rabbit model. METHODS: Forty titanium miniscrews (1.6 mm diameter, 8 mm length) were inserted in the tibiae of 10 rabbits. Twenty test group miniscrews were subjected to continuous orthodontic forces of 200 g immediately after implantation for a period of 6 weeks. The remaining 20 control group miniscrews were left unloaded for the same follow-up interval. Removal torque values were recorded using a digital torque gauge. An independent t-test was performed. RESULTS: All the miniscrews were stable, and exhibited no mobility or displacement throughout the experimental period. Histologically, miniscrews were well-integrated into bone. No statistically significant differences in removal torque data were found between the loaded test and the unloaded control groups. CONCLUSIONS: These findings suggest that titanium miniscrews can be used as anchoring units for orthodontic tooth movement immediately after insertion.
Follow-Up Studies ; Rabbits ; Tibia ; Titanium ; Tooth Movement ; Torque*