No abstract available.
Occupational Health*

OBJECTIVE: Most of the studies that have described surgical procedures for moyamoya disease(MMD) have had the aim to improve the blood flow mainly in the middle cerebral artery(MCA) territory. The purpose of this study is to clarify the good indications for a multiple burrhole operation to treat MMD. METHODS: With the patient under local anesthesia, burrhole trephination with a diameter of 1.5 to 2cm at 3 to 5cm lateral to the midline was performed in a total of 18 hemispheres during 12 procedures. The burrholes were opened in the frontal lobe at 19 sites in 10 patients and in the parietal lobe at 22 sites in 12 patients. Revascularization through multiple burrholes and arachnoid openings was performed in 12 patients who suffered from MMD. RESULTS: As seen on the follow up angiograms, good revascularization was achieved in 27 of 41 burrholes, and mainly from the middle meningeal artery and then from the superficial temporal artery. The moyamoya vessels were decreased in four patients. The neovascularization covered 68.4% of the frontal lobe and 63.5% of the parietal lobe. Compared with the preoperative 99mTc-HMPAO-SPECT, 6 patients showed improvement of cerebral blood flow on the postoperative 99mTc-HMPAO-SPECT. Transient ischemic attack disappeared in three of the four patients who presented with this symptom, and the preoperative symptoms improved in both of the patients who presented with headache and cerebral infarction. CONCLUSIONS: A multiple burrhole operation is a simple technique. The results of our series suggest that the revascularization obtained for adult MMD patients who underwent a multiple burrhole operation is similar to that obtained with other indirect surgeries, but long term follow up studies are needed.
Adult ; Anesthesia, Local ; Arachnoid ; Cerebral Infarction ; Follow-Up Studies ; Frontal Lobe ; Headache ; Humans ; Ischemic Attack, Transient ; Meningeal Arteries ; Moyamoya Disease ; Parietal Lobe ; Temporal Arteries

Cutaneous metastases of malignant tumors are relatively rare, and breast cancer is the most common malignancy in women with cutaneous metastases. Since newly developed cutaneous lesions can be the first signs of metastases in breast cancer patients, it is crucial to rule out the possibility of malignancy. Although only a few cases have been reported, breast cancer contributes to a large portion of scalp metastases. This case report demonstrates a rare case of breast cancer metastasis only confined to the scalp. The patient was a 55-year-old woman who was diagnosed with scalp metastasis from breast cancer 10 years after the first curative surgery. The scalp lesion was palpable for 4 years and showed a sudden increase in size over a few months. The patient underwent wide excision with flap coverage. After surgery the patient received radiotherapy, but she has refused additional hormonal therapy. To date, there is no evidence of disease recurrence.
Breast Neoplasms* ; Breast* ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis* ; Radiotherapy ; Recurrence ; Scalp Dermatoses ; Scalp*

Background: Topical recombinant human epidermal growth factor (rhEGF) is effective in the treatment of diabetic foot ulcers, surgical wounds, burns, and scars. Binding of EGF to EGF receptors results in cell proliferation and differentiation. Objective: This study aimed to evaluate the efficacy of topical rhEGF ointment compared with that of topical mupirocin in healing herpes zoster (HZ) lesions. Methods: Thirty patients diagnosed with typical HZ were recruited in August, 2018. The rats were randomly divided into two groups: topical mupirocin and topical rhEGF ointment. HZ lesions were evaluated using the Vancouver Scar Scale (VSS) at the initial visit, 1st, 2nd, and 4th weeks. Results: The total number of recruited patients (n=30) included males (n=16, 53.3%) and females (n=14, 46.7%) with a mean age of 58.2. The proportion of patients with a 50% reduction in the VSS score (VSS 50) at 2nd week was significantly higher in the rhEGF group (33.0% vs. 72.0%, respectively, p=0.035). The complete resolution rate (VSS=0, 1) at 4th week was also higher in the rhEGF group (17.5% vs. 50.0%, p=0.03). Conclusion Topical rhEGF showed a more rapid treatment response and anti-scarring effect than topical mupirocin in patients with HZ lesions.