A young metastatic lung cancer patient developed empyema due to an infection with carbapenem-resistant Acinetobacter baumannii. Hydropneumothorax was detected and managed by a tube thoracotomy. However, persistent air leakage through the chest tube was observed due to the presence of a bronchopleural fistula (BPF). As hypercapnic respiratory failure had progressed and the large air leak did not diminish by conservative management, a pumpless extracorporeal lung assist (pECLA) device was inserted. The pECLA allowed the patient to be weaned from mechanical ventilation and the BPF to heal. The present case shows the effective application of pECLA in a patient with empyema complicated with BPF and severe hypercapnic respiratory failure. pECLA enabled us to minimize airway pressure to aid in the closure of the BPF in the mechanically ventilated patient.
Acinetobacter baumannii ; Bronchial Fistula ; Carbon Dioxide* ; Carbon* ; Chest Tubes ; Empyema* ; Fistula ; Humans ; Hydropneumothorax ; Hypercapnia ; Lung ; Lung Neoplasms ; Respiration, Artificial ; Respiratory Insufficiency ; Thoracotomy

No abstract available.

PURPOSE: The purpose of the study was to compare CT with scintigraphy in the detection of parenchymal lesionsof acute pyelonephritis in children, and to assess the diagnostic value of CT. MATERIALS AND METHODS: This studyinvolved 32 children with acute pyelonephritis ; their ages ranged from 1 month to 10 years. Renal CT , TC-99mDMSA planar and SPECT images, and medical records were retrospectively reviewed. We evaluated the number, size,shape, density, and location of pyelonephritic lesions, as seen on CT and scintigraphic images. RESULTS: In 43involved kidneys, 193 parenchymal lesions of acute pyelonephritis were identified. The results of CT were abnormalin 42 kidneys (98%), and those of scintigraphy, in 39(91%). CT showed single or multiple hypoenhancing parenchymallesions ; these were streaky(n=151), wedge-shaped (n=34), or oval (n=8), and ranged from about 3-30mm in maximumdiameter. Abscess (n=5), renal fascial thickening (n=6) and thickening of the bridging septae (n=7) wereassociated. Scintigraphic findings were diffuse or localized area of varying degrees of diminished corticalactivity, and these were more precisely identified on SPECT than on planar images. For the detection of 55 of 193pyelonephritic lesions, CT was more sensitive than scintigraphy ; 29 of the 55 lesions were less than 5 mm indiameter. CONCLUSION: For the detection of pyelonephritic lesions, particularly smaller ones, and for theevaluation of complications such as abscess formation, CT is more sensitive than Tc-99m DMSA scintigraphy. Weconclude that in children with subtle scintigraphic findings who are in serious clinical condition or in whomcomplications are suspected, CT is a useful tool for assessing a therapeautic plan and the prognosis of acutepyelonephritis.
Abscess ; Child* ; Humans ; Kidney ; Medical Records ; Prognosis ; Pyelonephritis* ; Radionuclide Imaging* ; Retrospective Studies ; Succimer* ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Poliomyelitis*

No abstract available.
Compliance* ; Humans

No abstract available.
Compliance* ; Humans

PURPOSE: To report a case in which radiotherapy damaged the microvasculatures of the retinal vessels and developed cotton-wool patches and retinal hemorrage as well as rubeosis iridis and intractable neovascular glaucoma. METHODS: A 64-year-old female presented with visual loss in her left eye two years after radiotherapy for malignant melanoma of the nasal cavity. The visual acuity of her left eye was counting fingers. Although any specific signs were not shown in the cornea or lens, multiple cotton-wool patches and retinal hemorrhages were noted around the optic disc. RESULTS: Multiple cotton-wool patches and retinal hemorrhages disappeared gradually. Finally, rubeosis iridis and intractable neovascular glaucoma developed which could not be controlled by panretinal photocoagulation. CONCLUSIONS: Radiotherapy for malignancy of the nasal cavity was associated with intractable neovascular glaucoma.
Cornea ; Female ; Fingers ; Glaucoma, Neovascular* ; Humans ; Light Coagulation ; Melanoma ; Middle Aged ; Nasal Cavity ; Radiotherapy ; Retinal Hemorrhage ; Retinal Vessels ; Retinaldehyde ; Visual Acuity

No abstract available.
Animals ; Carbohydrate Metabolism* ; Hindlimb Suspension* ; Hindlimb* ; Insulin* ; Muscle, Skeletal* ; Rats* ; Receptor, Insulin*

BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Arthrography* ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joint Instability ; Recurrence ; Retrospective Studies ; Shoulder*

No abstract available.