BACKGROUND: Axillary osmidrosis is a distressing problem characterized by unpleasant odor, profuse sweating, and occasional wetting of clothes that may handicap those affected both socially and psychologically. A variety of surgical methods have been developed for the treatment of axillary osmidrosis. OBJECTIVE: To introduce the manual subdermal excision combined with the tumescent liposuction and subcutaneous tissue shaver for axillary osmidrosis. METHODS: Twenty-five patients with axillary osmidrosis were treated by the manual subdermal excision combined with the tumescent liposuction and subcutaneous tissue shaver. RESULTS: Twenty-one(84%) patients had good results, four(16%) fair, and none had a poor result or recurrence. Complications included one case of hematoma, two cases of partial skin necrosis. The wound complication rate was 6.0%(3/50) for the axilla and 12%(3/25) for patients. CONCLUSION: The manual subdermal excision combined with the tumescent liposuction and subcutaneous tissue shaver is effective surgical procedure for the treatment of axillary osmidrosis with a low complication rate and recurrence.
Axilla ; Hematoma ; Humans ; Hyperhidrosis* ; Lipectomy* ; Necrosis ; Odors ; Recurrence ; Skin ; Subcutaneous Tissue* ; Sweat ; Sweating ; Wounds and Injuries

BACKGROUND: Laser resurfacing of cutaneous scars, rhytides, and photodamaged skin has become very popular. Pulsed erbium:YAG laser resurfacing has recently come into favor for the treatment of pitted acne scars. OBJECTIVE: This study was designed to investigate the efficacy and safety of pulsed erbium:YAG laser in cutaneous resurfacing of pitted acne scars. METHODS: 100 patients with pitted acne scars were enrolled in this study. All patients were treated by means of a pulsed erbium:YAG laser with a 2 mm handpiece at the setting of 500 to 1000mJ/pulse and fluences used varied between 5-15J/cm2. Photographs of the face were obtained at baseline and 2 week postoperatively. Two weeks after treatment, postoperative care such as applying hydroquinone 4% and tretinoin 0.05% was recommended for 2 to 4 weeks. RESULTS: Out of 100 patients, 20% of patients showed an excellent response, 50% a good response, 21% a fair response and 9% a poor response. After 6 months, erythema had developed in two patients and and three patients had developed postinflammatory hyperpigmentation, hypopigmentation and delayed contact dermatitis. CONCLUSION: Treatment with pulsed erbium:YAG laser shows high efficacy and low morbidity in pitted acne scar resurfacing.
Acne Vulgaris* ; Cicatrix* ; Dermatitis, Contact ; Erythema ; Humans ; Hyperpigmentation ; Hypopigmentation ; Postoperative Care ; Skin ; Tretinoin

Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control.
Acanthosis Nigricans* ; Axilla ; Biopsy ; C-Peptide ; Fasting ; Fingers ; Glucose Tolerance Test ; Humans ; Hyperandrogenism ; Insulin Resistance* ; Insulin* ; Metabolism ; Mitogens ; Obesity ; Peptides ; Receptor, Insulin ; Skin ; Somatomedins

No abstract available.
Capillaries* ; Granuloma, Pyogenic* ; Hyperplasia* ; Nose* ; Sebaceous Glands*

To determine an optimal invasive intervention for renal colic patients during pregnancy after conservative treatments have been found to be unhelpful. Among the available invasive interventions, we investigated the reliability of a ureteral stent insertion, which is considered the least invasive intervention during pregnancy. Between June 2006 and February 2015, a total of 826 pregnant patients came to the emergency room or urology outpatient department, and 39 of these patients had renal colic. The mean patient age was 30.49 years. In this retrospective cohort study, the charts of the patients were reviewed to collect data that included age, symptoms, the lateralities and locations of urolithiasis, trimester, pain following treatment and pregnancy complications. Based on ultrasonography diagnoses, 13 patients had urolithiasis, and 13 patients had hydronephrosis without definite echogenicity of the ureteral calculi. Conservative treatments were successful in 25 patients. Among these treatments, antibiotics were used in 15 patients, and the remaining patients received only hydration and analgesics without antibiotics. Several urological interventions were required in 14 patients. The most common intervention was ureteral stent insertion, which was performed in 13 patients to treat hydronephrosis or urolithiasis. The patients' pain was relieved following these interventions. Only one patient received percutaneous nephrostomy due to pyonephrosis. No pregnancy complications were noted. Ureteral stent insertion is regarded as a reliable and stable first-line urological intervention for pregnant patients with renal colic following conservative treatments. Ureteral stent insertion has been found to be equally effective and safe as percutaneous nephrostomy, which is associated with complications that include bleeding and dislocation, and the inconvenience of using external drainage system.
Analgesics ; Anti-Bacterial Agents ; Cohort Studies ; Diagnosis ; Dislocations ; Drainage ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Hydronephrosis ; Nephrostomy, Percutaneous ; Outpatients ; Pregnancy Complications ; Pregnancy ; Pyonephrosis ; Renal Colic ; Retrospective Studies ; Stents ; Ultrasonography ; Ureter ; Ureteral Calculi ; Urinary Catheters ; Urolithiasis ; Urology

When the oculomotor nerve is completely paralyzed. the affected eye shows severe outward displacement and poor cosmetic appearance. The results of many surgical procedures for oculomotor palsy have been generally unsatisfactory. We tried a new surgical approach experimentally. in which the disinserted lateral rectus muscle was used as an adductor by medial transposition of the muscle. Five adult cats underwent tenectomy of the medial rectus muscle of the eyes to induce iatrogenic medIal rectus paralysis. The segment of the medial rectus was removed as far back as possible to prevent reattachment. Then, right lateral rectus muscle was disinserted and passed beneath the superior rectus muscle and resutured to the sclera 4mm superoposterior to the medial rectus insertion site. After tenectomy of bilateral medial rectus. large exotropia of an average of 47.6 delta (42.0 delta - 55.5 delta) was induced. The medial transposition of the right lateral rectus produced an average 36.6 delta (24.8 delta - 45.8 delta) of correction of exotropia. A satisfactory cosmetic result was achieved by this procedure. It may be a good alternative procedure in difficult cases of oculomotor nerve palsy with severe outward deviation.
Adult ; Animals ; Cats ; Exotropia ; Humans ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Paralysis* ; Sclera

PURPOSE: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). MATERIALS AND METHODS: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. RESULTS: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or > or =1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). CONCLUSION: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Estrogens ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

The Taylor's approach is a special paramedian approach to enter the L5-S1 interspace. The L5-S1 interspace is the largest in vertebral column. This approach is particularly useful when the interspace has been narrowed by pathologic bone destruction such as rheumatoid arthritis or osteoarthritis. Surgery in geriatric patients is associated with a markedly higher incidence of perioperative complication or mortality rate. Optimal anesthetic management of geriatric patients depends on understanding of the normal anatomy and physiologic changes in response to drug in aging. We studied of 3-geriatric patients with Taylor's approach. These patients had problems with respiratory dysfunction and anatomic constraints, which make other approaches unfeasible.
Aging ; Arthritis, Rheumatoid ; Humans ; Incidence ; Mortality ; Osteoarthritis ; Spine

When the oculomotor nerve is completely paralyzed, the affected eye shows severe outward displacement and poor cosmetic appearance. Past results of many surgical procedures for oculomotor palsy have been generally unsatisfactory. We tried a new surgical approach experimentally, in which the disinserted lateral rectus muscle was used as an adductor by medial transposition of the muscle. Five adult cats underwent disinsertion of the medial rectus muscle of both eyes to induce iatrogenic medial rectus paralysis. The disinserted medial rectus was removed as far back as possible to prevent reattachment. Then, the right lateral rectus muscle was disinserted and passed beneath the superior rectus muscle and resutured to the sclera 4mm superoposterior to the medial rectus insertion site. After excision of the bilateral medial rectus, a large exotropia of an average 47.6 delta (42.0-55.5 delta) was induced. The medial transposition of the right lateral rectus produced an average 36.6 delta (24.8-45.8 delta) correction of the exotropia. A satisfactory cosmetic result was achieved by this procedure.
Animals ; Cats ; Exotropia/etiology ; Oculomotor Muscles/*surgery ; Oculomotor Nerve Diseases/physiopathology/*surgery ; Vision Disparity

Failure of a glaucoma filtering surgery mainly results from scarring at thefiltering wound. Postoperative proliferation of fibroblasts plays an imrortant role in scar tissue formation. Colchicine is a cytoplasmic microtubule inhibitor capable of inhibiting fibroblast proliferation. The effect of colchicine on fibroblast proliferation at the filtering wound after filtering surgery was investigated. Posterior lip sclerectomies were performed in each eye of albino rabbits.Intraocular pressures, conjunctival fibrosis, histologic findings and drug tox-icities were examined postoperatively under the topical or oral administration of colchicine. Reductions of intraocular Pressure and conjunctival fibrosis in colchicinetreated groups after filtering surgory were statistically significant (p< 0.05), and changes in the topical administration group were more significant than in the oral administration group (pl 0.05). Histologicallyr reductions of active fibroblasts and collagen fibers at the filtering wound and the subconjunctival area were seen in colchicine treated eyes.Histologic changes were more prominent in the topical administration group. Signs of orular and systemic toxicity were absent. The above results suggest that administration of colchicine, especially topicaladministration, can increase the success rate of filtering surgery.
Administration, Topical ; Animals ; Colchicine/*pharmacology ; Fibroblasts/*drug effects ; Glaucoma/*surgery ; Rabbits