The rupture of ventricular septum complicating acute myocardial infarction requires prompt recognition for the correct management of the patient. The diagnosis of this condition had required right heart catheterization. We performed two-dimensional and Doppler echocardiography in patients with systolic murmur after acute myocardioal infarction. Ventricular septal defect was found at lower interventricular septum by mapping technique of pulsed wave Doppler system and obtained high velocity Doppler tracting by continuous wave Doppler echocardiography. Doppler echocardiography could be useful noninvasive method for detection of ventricular septal rupture after acute myocardial infarction.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Heart Septal Defects, Ventricular* ; Humans ; Infarction ; Myocardial Infarction* ; Rupture ; Systolic Murmurs ; Ventricular Septal Rupture ; Ventricular Septum

Pelvic organ prolapse(POP) is a major health care problem. Up to 50% of parous women have some degree of pelvic organ prolapse although only 10?20% are symptomatic. The first line of treatment is surgical repair. Many surgical procedures have been described to correct pelvic organ prolapse. The majority of these procedures are performed either vaginally or abdominally, or with a combined abdominovaginal approach. With recent advancements of laparoscopic instruments and surgical techniques, interest in laparoscopic treatment of pelvic organ prolepse has surged. Beyond the well-known advantages of laparoscopy - less postoperative discomfort, shorter hospital stay, the laparoscopic approach offers the superior visualization of the pelvis, thereby allowing better exposure of the pelvic floor anatomy and more exact identification of the defect. Moreover, laparoscopic surgery provides a magnified view of the operative field and enables to perform an easier and more precise dissection. This enhances the identification of pelvic floor defects and allows more precise suture placement and improved correction of specific site defects. Laparoscopic pelvic floor repair is an effective procedure and enables to combine the advantages of laparotomy with the low morbidity of the vaginal route. This article reviews pelvic support anatomy and various laparoscopic surgical techniques currently available for reconstructive pelvic surgery.
Delivery of Health Care ; Female ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Pelvic Floor ; Pelvic Floor Disorders ; Pelvic Organ Prolapse ; Pelvis ; Sutures

No abstract available.
Animals ; Magnetic Resonance Spectroscopy* ; Rats* ; Skin*

To attempt a rigorous definition of the structure of the accessory spleen (AS) in the Chinese hamster, we examined twenty-one animals, and found AS in 5 animals (23.8%), which were over 7-month-old. The AS had no connection with the main spleen and was seen as a dark red oval organ (0.7 mm x 1.5 mm), which was embedded in the adipose tissue near the tail of the pancreas. It was demarcated from the adipose tissue and some pancreatic tissue. The organ was encapsulated by thin collagenous connective tissue and smooth muscle fibers, and contained lymphatic nodules, reticular fibers, nodular central arterioles, macrophages and megakaryocytes. Notably the incidence of AS appeared to increase with age in the Chinese hamsters.
Adipose Tissue/anatomy & histology ; Age Factors ; Animals ; Connective Tissue/anatomy & histology ; Cricetinae ; Cricetulus/*anatomy & histology ; Erythrocytes/cytology ; Lymphocytes/cytology ; Muscle, Smooth/anatomy & histology ; Pancreas ; Spleen/*anatomy & histology/cytology

PURPOSE: The purpose of this study is to provide a comprehensive overview of the various measures available for assessment of oxaliplatin-induced peripheral neuropathy (OXLIPN) and to evaluate the measurement properties of each assessment tool. METHODS: A systematic review was conducted to identify existing measures for OXLIPN found in the databases of PubMed, Cochrane Library, Embase, RISS and KoreaMed. The quality of the 24 identified tools was evaluated based on their properties of measurement including content validity, internal consistency, criterion validity, construct validity, reproducibility, responsiveness, floor-ceiling effects and interpretability. RESULTS: Ten (41.7%) of the 24 tools were identified as specific measures for assessing OXLIPN and the most popular type of measures were clinical grading systems by clinicians (58.3%) and only 29.2% of measures were identified as patient reported outcomes. The most frequently used tool was National Cancer Institute-Common Toxicity Criteria (NCI-CTC), but the validity of NCI-CTC has not been reported appropriately. Overall, the Neuropathic Pain Symptom Inventory (NPSI) received the best psychometric scores, and the Chemotherapy-induced Peripheral Neuropathy Assessment Tool (CIPNAT) and Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-neurotoxicity-12 (FACT/GOG-Ntx-12) followed NPSI. CONCLUSION: To select appropriate measure, evidences should be accumulated through the clinical use of tools. Therefore, practitioner and researchers are urged to report relevant statistics required for the validation of the currently used measures for assessment of OXLIPN.
Activities of Daily Living ; Antineoplastic Agents/*adverse effects/therapeutic use ; Databases, Factual ; Humans ; Neoplasms/drug therapy ; Organoplatinum Compounds/*adverse effects/therapeutic use ; Peripheral Nervous System Diseases/*etiology ; Psychometrics

OBJECTIVES: To compare results of 4 different extraction methods in laparoscopic management of dermoid cyst. STUDY DESIGN: This article is a retrospective, multicenter study for 247 patients with benign dermoid cyst in period of 1995-1998. Dermoid cyst was extracted by Endopouch (99 cases), puncture-irrigation-extraction (69 cases), colpotomy (35 cases), and dermoid cyst as a "pouch bag" (44 cases). RESULTS: We analyzed irrigation amount, operative time, postoperative hospital stay and complications by four different extraction methods. Endopouch extraction method needed less amount of irrigation fluid for cleaning the abdominal cavity and had a shorter postoperative hospital stay (ANOVA, p=0.0001). There were no significant differences in operative times among groups. There were four cases of morbidity in puncture-irrigation-extraction method (6%), three had fever (> 38degrees C) and one intraabdominal abscess. One incisional hernia was noted in "pouch bag" method (2%). CONCLUSIONS: We recommend minimal spillage method for extraction of dermoid and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis such as Endopouch, "pouch bag", and colpotomy with the exception of puncture-irrigation-extraction method.
Abdominal Cavity ; Abscess ; Colpotomy ; Dermoid Cyst* ; Fever ; Hernia ; Humans ; Laparoscopy* ; Length of Stay ; Operative Time ; Peritonitis ; Retrospective Studies*

Nonselective beta-adrenergic blocker (NSBB) therapy for the prevention of initial and recurrent gastrointestinal bleeding in cirrhotic patients with gastroesophageal varices has been used for the past four decades. NSBB therapy is considered the cornerstone of treatment for varices, and has become the standard of care. However, a 2010 study from the group that pioneered β-blocker therapy suggested a detrimental effect of NSBBs in decompensated cirrhosis, especially in patients with refractory ascites. Since then, numerous additional studies have incompletely resolved whether NSBBs are deleterious, although more recent evidence weighs against a harmful effect. The possibility of a “therapeutic window” has also been raised. We aimed to review the literature to analyze the pros and cons of using NSBBs in patients with cirrhosis, not only with respect to bleeding or mortality but also to other potential benefits and risks. β-blockers are highly effective in preventing first bleeding and recurrent bleeding. Furthermore, NSBBs improve congestion/ischemia of the gut mucosa, decrease intestinal permeability, and therefore indirectly alleviate systemic inflammation. β-blockers shorten the electrocardiographic prolonged QTc interval and may also decrease the incidence of hepatocellular carcinoma. On the other hand, the possibility of deleterious effects in cirrhosis has not been completely eliminated. NSBBs may be associated with an increased risk of portal vein thrombosis, although this could be correlational artifact. Overall, we conclude that β-blockers in cirrhosis are much more of a friend than enemy.

Nonselective beta-adrenergic blocker (NSBB) therapy for the prevention of initial and recurrent gastrointestinal bleeding in cirrhotic patients with gastroesophageal varices has been used for the past four decades. NSBB therapy is considered the cornerstone of treatment for varices, and has become the standard of care. However, a 2010 study from the group that pioneered β-blocker therapy suggested a detrimental effect of NSBBs in decompensated cirrhosis, especially in patients with refractory ascites. Since then, numerous additional studies have incompletely resolved whether NSBBs are deleterious, although more recent evidence weighs against a harmful effect. The possibility of a “therapeutic window” has also been raised. We aimed to review the literature to analyze the pros and cons of using NSBBs in patients with cirrhosis, not only with respect to bleeding or mortality but also to other potential benefits and risks. β-blockers are highly effective in preventing first bleeding and recurrent bleeding. Furthermore, NSBBs improve congestion/ischemia of the gut mucosa, decrease intestinal permeability, and therefore indirectly alleviate systemic inflammation. β-blockers shorten the electrocardiographic prolonged QTc interval and may also decrease the incidence of hepatocellular carcinoma. On the other hand, the possibility of deleterious effects in cirrhosis has not been completely eliminated. NSBBs may be associated with an increased risk of portal vein thrombosis, although this could be correlational artifact. Overall, we conclude that β-blockers in cirrhosis are much more of a friend than enemy.

No abstract available.
Animals ; Collagen* ; Interferons* ; Rats* ; Urinary Bladder*

PURPOSE: To evaluate clinical outcomes after silicone oil removal, we analyzed retinal redetachment, visual acuity, and postoperative complications. METHODS: 73 consecutive eyes who underwent silicone oil removal were studied in a retrospective fashion. 41 eyes with proliferative vitreoretinopathy, 20 eyes with proliferative diabetic retinopathy, 6 eyes with traumatic detachment, 6 eyes with high myopic macular hole were included. In addition to anatomic and visual results, associated complications were assessed. RESULTS: Anatomic success rate was 90.4% in 73 eyes. 64 eyes achieved attachment after oil injection combined vitrectomy and 8 of 64 eyes (12.5%) were redetached after oil removal. 37 eyes of the 64 eyes (57.8%) had an increase in visual acuity at least one Snellen line after oil removal. Glaucoma (21.9%), keratopathy (8.2%) and cataract (9.5%) were the complications. The mean duration of oil tamponade of detached group was 7.75 months and that of attached group was 7.14 months and there were no siginificant difference between two groups(P>0.05). CONCLUSIONS: The duration of the silicone oil tamponade had no siginificant effect on the redetachment rate. We recommend not to apply standard criteria for timing of silicone oil removal, but to decide individually, considering underlying disease and complications.
Cataract ; Diabetic Retinopathy ; Glaucoma ; Postoperative Complications ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Silicone Oils* ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative