Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

Systemic lupus erythematosus is a connective tissue disease which can affect every organ system. Neurologic abnormalities are common, occuring in approximately half of all patients at some time during the course of their illness. But symptoms of nervous system as the sole presenting symptoms occur in less than 1% of lupus patients. In patients initially presenting with neurologic symptoms and signs, differential diagnosis is difficult and sometimes it may be misdiagnosed. Therefore extensive laboratory investigations should be carried out in all patients with unusual neurological symptoms, since early diagnosis of lupus can help in providing effective treatment. We report a patient with systemic lupus erythematosus who presented with dysarthria and dysphagia resembling multiple sclerosis.
Connective Tissue Diseases ; Deglutition Disorders ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis* ; Nervous System ; Neurologic Manifestations

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal*

Three cases of successful pregnancy outcome after intensive care in the patients with rare mullerian anomaly of complete uterine septum, hypoplastic cervical duplication and longitudinal vaginal septum in infertility clinic are reported. These presented three cases are the reports of supporting the embryologic hypothesis of bidirectional mullerian development which fusion and resorption begins at the isthmus and proceeds simultaneously in both the cranial and caudal directions rather than the classical views of unidirectional(caudal to cranial) mullerian development. Thus, we present here three cases of rare mullerian anomaly and their pregnancy outcomes in an attempt to alert gynecologist to the possible occurrence of such a malformation. In 2 cases, successful pregnancy outcomes were achieved after abdominal or hysteroscopic uterine septotomy before pregnancy and in the last case, successful pregnancy outcome intensive obstetric care was achieved even under uncorrected uterine anomaly and complete removal of uterine septum resulted in uneventful postoperative courses at the same time of cesarean section.
Cesarean Section ; Female ; Humans ; Infertility ; Critical Care* ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

Persistent cloaca is a very rare congenital malformation with the incidence of 1/50,000-250,000 births. This malformations have a single common perineal opening for the genital, urinary and gastrointestinal tracts. Because of wide spectrum of abnormal anatomy involving upper urinary tract, gastrointestinal systems, cardiovascular system, central nervous system, and respiratory system, prenatal diagnosis is difficult through ultrasound during pregnancy. It has been reported that if the anomalies are diagnosed early, they can be corrected surgically. We present a case of persistent cloaca with meconium peritonitis and hydrometrocolpos confirmed by neonatal surgery after emergency cesarean section.
Cardiovascular System ; Central Nervous System ; Cesarean Section ; Cloaca* ; Emergencies ; Female ; Gastrointestinal Tract ; Incidence ; Meconium* ; Parturition ; Peritonitis* ; Pregnancy ; Prenatal Diagnosis ; Respiratory System ; Ultrasonography ; Urinary Tract

PURPOSE: To evaluate changes in corneal and ocular high-order aberration, ocular fatigue, and tear break-up time (TBUT) before and after playing computer games and the correlations among the variables. METHODS: Thirty-nine normal healthy subjects played computer games for 1 hour. Ocular fatigue was evaluated with a questionnaire, TBUT was measured with slit-lamp biomicroscopy, and high-order aberrations were measured with a KR-1W aberrometer (Topcon Medical System, Inc., Tokyo, Japan) in each subject before and after playing computer games. The right eye was used for statistical analyses. RESULTS: Subjective ocular fatigue (expressed as the interview score) increased from 4.23 +/- 5.35 to 12.05 +/- 8.68 after playing games (p < 0.001) and TBUT decreased from 8.03 +/- 6.43 sec to 4.90 +/- 3.31 sec (p < 0.001). Ocular high-order aberrations in the 4 mm and 6 mm zones were not significantly changed before and after playing games (p = 0.150, p = 0.202, respectively). However, corneal high-order aberrations in the 4 mm and 6 mm zones were significantly increased after playing computer games (p = 0.002, p = 0.002, respectively). Changes in TBUT, interview score, and corneal high-order aberration were not correlated with each other. CONCLUSIONS: Playing computer games increased corneal high-order aberrations as well as subjective ocular fatigue and TBUT.
Eye ; Fatigue ; Surveys and Questionnaires ; Tokyo

Laparoscopic procedures for urological diseases in children have been proven to be safe and effective. However, the availability of laparoscopic procedures is still partly limited to experienced, high-volume centers because the procedures are technically demanding. The da Vinci robot system is being used for an increasing variety of reconstructive procedures because of the advantages of this approach, such as motion scaling, greater optical magnification, stereoscopic vision, increased instrument tip dexterity, and tremor filtration. Particularly in pediatric urologic surgery, where the operational field is limited owing to the small abdominal cavity of children, robotic surgical technology has its own strengths. Currently, robots are used to perform most surgeries in children that can be performed laparoscopically. In this review, we aimed to provide a comprehensive overview of the current role of robot-assisted laparoscopic surgery in Pediatric Urology by analyzing the published data in this field. A growing body of evidence supports the view that robotic technology is technically feasible and safe in pediatric urological surgery. Robotic technology provides additional benefits for performing reconstructive urologic surgery, such as in pyeloplasty, ureteral reimplantation, and enterocystoplasty procedures. The main limitations to robotic surgery are its high purchase and maintenance costs and that the cost-effectiveness of this technology remains to be validated.
Child ; Humans ; Laparoscopy/*methods ; Robotic Surgical Procedures/*methods ; Urologic Diseases/*surgery ; Urologic Surgical Procedures/*methods

No abstract available.
Cytomegalovirus* ; DNA* ; Glomerulonephritis* ; Polymerase Chain Reaction*

Cardio-pulmonary responses to a given step-up exercise test were studied in 43 patients who previously received various thoracic operations such as pleural decortication, one or two segmental resections, right or left upper lobectomy, plombage or pneumonectomy. Fourteen control subjects were also studied for comparison. Following a 30 minute rest, the step-up exercise was performed to heights of 20, 30 and 40cm, in that order, for 8 to 10 min. at each height. During the rest and the steady-state exercise period, the expired gas was collected for a period of 5 minutes for the determinations of the minute volume, the O2 consumption and the CO2 Output. Alveolar gas samples were a1so taken following the expired gas collection. The heart rate and blood pressure were also checked during the rest and immediately after each exercise. Various cardio-pulmonary functions of the patient at rest were little different from those of the control, except the heart rate which tended to be higher in the patient than in the control. Although the work capacity of the patient was lower than in the control, most patients were able to complete the required exercise test. However, in carrying out a given exercise load, the patient groups had a greater minute volume, the respiratory rate, the O2 consumption and the CO2 output as compared to the control, indicating that the mechanical efficiency is considerably lowered in the patient. Of various patient groups, the work performance was most limited in the pneumonectomy group while the group with one or two segmental resections was little affected. It is suggested that the patient with one or two segmental resections may be allowed to engage in physical activity up to 700 kg-m/min or more while those with pneumonectomy should not exert themselves above 500 k-gm/min.
Adult ; *Exercise Test ; *Heart Function Tests ; Human ; Male ; Pleura/*surgery ; *Pneumonectomy ; *Respiratory Function Tests