Orbital complications after endoscopic sinus surgery (ESS), such as optic nerve or medial rectus injuries, are well known, but isolated complete oculomotor nerve palsy has never been reported. In this case, a 31-year-old male was transferred to our hospital after ESS. Physical examination showed complete left oculomotor nerve palsy, with a bony defect on the sellar floor, which had not fully recovered after more than 1 year. We hypothesized that blunt trauma could be the main cause of the oculomotor palsy. Surgeons performing ESS must keep in mind the possibility of oculomotor palsy due to blunt trauma, especially when operating around the sphenoid and posterior ethmoid sinus.
Adult ; Ethmoid Sinus ; Ethmoid Sinusitis ; Fistula* ; Humans ; Male ; Oculomotor Nerve Diseases ; Optic Nerve ; Orbit ; Paralysis ; Physical Examination

Chromoblastomycosis is a chronic fungal disease of the skin and subcutaneous tissues caused by a group of dematiaceous (black) fungi. The most common etiologic agents are Fonsecaea pedrosoi and Cladophialophora carrionii, both of which can be isolated from plant debris. The infection usually follows traumatic inoculation by a penetrating thorn or splinter wound. Several months after the injury, painless papules or nodules appear on the affected area; these papules then progress to scaly and verrucose plaques. We report a case of chromoblastomycosis caused by Phialophora richardsiae, which has been rarely associated with chromoblastomycosis. The case involved a 43-year-old male, who for the past 2 months had noted an erythematous, pustulous plaque that was somewhat dark brown in color on his right shin; the plaque also had intermittent purulent discharge and crust formation. On histopathological examination, chronic granulomatous inflammation and sclerotic cells were seen. The tissue fungus culture grew out the typical black fungi of P. richardsiae, which was confirmed by polymerase chain reaction. The patient has been treated with a combination of terbinafine and itraconazole for 3 months with a good clinical response.
Adult ; Chromoblastomycosis ; Fungi ; Humans ; Inflammation ; Itraconazole ; Male ; Naphthalenes ; Phialophora ; Plants ; Polymerase Chain Reaction ; Skin ; Subcutaneous Tissue

PURPOSE: This study aims to identify the role and function of the RNP (rehabilitational nurse practitioner) expected by nurses and doctors. METHOD: This study was a survey. The data were collected 188 nurses and 21 doctors who worked for disabled patients in the rehabilitation hospital during months of June, 2004 and August, 2005. RESULTS: 98.4% of nurse and 61.9% of doctors agreed at opening of RNP course. The major role of RNP expected by nurses were educator, counsellor and case manager. The major role of RNP expected by doctors were direct care, self care promoter & exercise and emotional care. There was a significant difference about the need for opening of RNP course and major role and function of RNP between the group of nurses and doctors. CONCLUSION: The results of this study showed that the need for opening of RNP was identified and the major role of RNP was educator, counsellor, case manager and direct care. So there is a need for further research about major role of RNP related to various setting including rehabilitation hospital, nursing home, home care etc.
Home Care Services ; Humans ; Nurse Practitioners* ; Nursing Homes ; Rehabilitation* ; Self Care