No abstract available.
Breast Neoplasms* ; Breast*

OBJECTIVE: Immediate contralateral epidural hematoma (EDH) and traumatic intracerebral hematoma (T-ICH) after craniectomy for traumatic subdural hematoma (SDH) are rare but devastating post-operative complications. Their clinical features and outcomes are not well studied. In this report, we present the clinical features and outcomes of immediate contralateral acute hematoma cases requiring a second operation. METHODS: This study includes 10 cases of immediate contralateral EDH and T-ICH following bilateral craniectomy for the evacuation of traumatic SDH and contralateral hematoma between 2004 and 2015. Their medical records and radiographic findings were reviewed and analyzed retrospectively. RESULTS: Ten of the 528 patients (1.89%) who underwent craniectomy for the evacuation of traumatic SDH developed post-operative EDH (n=5), T-ICH (n=5). The trauma was caused by a fall in 5 patients and by a traffic accident in 5 patients. The patients who suffered trauma due to pedestrian accidents died. Seven patients had a low admission Glasgow Coma Scale (GCS; GCS≤8) score in the preoperative state (average admission GCS, 7.7; average discharge GCS, 3.4; and average discharge Glasgow Outcome Scale, 2.0). Severe intra-operative brain swelling was noted in all patients, while skull fracture was observed in 8. Multiple associated injuries and medication for heart disease were characteristic of patients who died. CONCLUSION: The prognosis of delayed contralateral hematoma was very poor. Multiple associated injuries, past medical history and traffic accidents, especially pedestrians were seemed to be associated with higher mortality rates. Finally, contralateral skull fractures can indicate high risk of delayed contralateral acute intracranial hematoma.
Accidents, Traffic ; Brain Edema ; Decompression* ; Decompressive Craniectomy ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Heart Diseases ; Hematoma* ; Hematoma, Subdural ; Hematoma, Subdural, Acute* ; Humans ; Medical Records ; Mortality ; Pedestrians ; Prognosis ; Retrospective Studies ; Skull Fractures

We performed a clinical observation on the 208 cases of infectious hepatitis who were cared at the pediatric department of Fatima Hospital from July, 1, 1970, to June, 30, 1977, and obtained the following results. 1. The ratio of infectious hepatitis to the total number of in-patients was 3.25 in average. 2. There was no significant difference in seasonal incidence except spring when the incidence was lower than the other seasons. 3. The age-group of 3~8 years old occupied 69% of the total cases and sex incidence revealed mali predominence with the ratio about 2:1. 4. The frequently observed clinical manifestations included ; Anorexia(71%)Nausea/Vomiting(65%), Tiredness(53%), Dark urine(59%), Abdominal pain(54%), Fever(45%), Jaundice(75%), Hepatomegaly(71%), Tenderness on upper adbomen(40%), and Palpable spleen(12.3%). 5. In the most of the cases the hematologic findings were with-in normal limit. 6. Bilirubinuria was observed in about 65% of the tested cases during the first 2 weeks of the illness and urinary urobilinogen was decreased during the second week of the illness. 7. In the majority of the cases the serum bilirubin reached peak during the second week of the illness and ranged 2~15mg%. And by the end of the 4th week illness, they returned to less than 2mg% in the 85%of the tested cases. 8. SGOT and SGPT reached peak during the first week of the illness and by the end of 4th week, they returned to less than 100 unit in the most the tested cases. And the values of SGOTwere higher than SGOT throughout the course of the illness. 9. The electrophoresis of the serum protein revealed as follow ; 1-globulin decreased slightly and -globulin in creased. 10. We experienced 30 cases (14.4%) of anicteric hepatitis. 11. ABHg was positive in 2(3.8%) of the 52 tested cases. 12. 10 of the 208 cases complicated hepatic coma and 10 of them expired and 3 of them dischared without clinical improvement.
Alanine Transaminase ; Aspartate Aminotransferases ; Bilirubin ; Child* ; Electrophoresis ; Hepatic Encephalopathy ; Hepatitis ; Hepatitis A* ; Humans ; Incidence ; Mali ; Seasons ; Urobilinogen

A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.
Blood Cell Count ; Cardiomegaly ; Chemistry ; Conus Snail ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart Atria ; Humans ; Leg ; Middle Aged ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Paresthesia ; Thoracic Surgery ; Thorax ; Thrombosis*

Guillain-Barre syndrom(GBS) is not a single entity, but may arise from a variety of pathogenic mechanisms. In GBS, abnormally increased autoantibody levels to GM, constitute a group with motor neuropathy predominantly and substantial axonal damage, particularly those following Campylobacter enteritis. We report a patient, 43 years old male, who presented with 3 days history of rapidly progressive weakness of all extremities. Electreophysiologic studies were suggestive of axonal form of motor dominant polyneuropathy, Using ELISA, autoantibody of MAG(myelin associated glycoprtein) and SGPG(sulfoglucuronyl paraglobiside) showed normal ranges, but IgG GM. Autoantibodies abnormally elevated. Additionally antibody titer of Campylobacter jejuni increased. We reported the axonal form of Guillain, Barr syndrome associated with IgG GM,, Ab and antiCampylobacter jejuni antibody.
Adult ; Autoantibodies ; Axons* ; Campylobacter jejuni* ; Campylobacter* ; Enteritis ; Enzyme-Linked Immunosorbent Assay ; Extremities ; Humans ; Immunoglobulin G* ; Male ; Polyneuropathies ; Reference Values

Multiple system atrophy (MSA) is an idiopathic neurodegenerative disorder involving many neuronal structures. It is a heterogeneous system disorder affecting extrapyramidal, cerebellar and autonomic nervous system. Only a minority of MSA patients are diagnosed before reaching the full blown stage. Its autonomic features like orthostatic hypotension, vocal cord paralysis are directly related to mortality. Up to now, rehabilitation of MSA patients had been rarely reported. Early, proper diagnosis and comprehensive rehabilitation for their heterogeneous clinical features are important. We experienced 54 year old hemiplegic paient who overlaps MSA. He showed some improvement in ADL and cerebellar symptoms after comprehensive rehabilitation programs.
Activities of Daily Living ; Autonomic Nervous System ; Diagnosis ; Humans ; Hypotension, Orthostatic ; Middle Aged ; Mortality ; Multiple System Atrophy* ; Neurodegenerative Diseases ; Neurons ; Rehabilitation ; Stroke* ; Vocal Cord Paralysis

The major problems of revision surgery for recurrent lumbar disc herniation (LDH) include limited visualization due to adhesion of scar tissue, restricted handling of neural structures in insufficient visual field, and consequent higher risk of a dura tear and nerve root injury. Therefore, clear differentiation of neural structures from scar tissue and adhesiolysis performed while preserving stability of the remnant facet joint would lower the risk of complications and unnecessary fusion surgery. Biportal endoscopic spine surgery has several merits including sufficient magnification with panoramic view under very high illumination and free handling of instruments normally impossible in open spine surgery. It is supposed to be a highly recommendable alternative technique that is safer and less destructive than the other surgical options for recurrent LDH.
Adult ; Diskectomy/*methods ; Endoscopy/*methods ; Humans ; Intervertebral Disc Displacement/*surgery ; Lumbar Vertebrae/surgery ; Lumbosacral Region/*surgery ; Male ; Minimally Invasive Surgical Procedures/*methods ; Patient Positioning

This study was performed in order to compare the functional imaging by 99m Tc-HMPAO brain SPECT with structural neuroimaging by CT or MRI. Eighteen patients with diffuse axonal injury underwent HMPAO brain SPECT(18), CT(9) and MR(14), and neurological status were then evaluated. Seventeen patients(94%) were revealed abnormal SPECT whereas nine patients(50%) demonstrated abnormal CT compared with ten patients(71%) demonstrated abnormal MRI. The neurololgical deficits correlated well with abnormal SPECT lesion except in one case. It is therefore concluded that brain perfusion SPECT is not only more sensitive than CT or MRI, it is also more cost effective and clinically well correlated in diffuse axonal injury patient.
Brain* ; Diffuse Axonal Injury* ; Humans ; Magnetic Resonance Imaging ; Neuroimaging ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

No abstract available.

Rhinophyma is a disfiguring soft tissue hypertrophy of the nose. It is an uncommon disease that primarily affects Caucasian men in the fifth to seventh decades of life. Many treatment methods have been advocated, often with acceptable success, but there appears to be no one modality that is universally endorsed. We present a case of a 70 year old male who was treated with dermabrasion for rhinophyma in the nose.
Aged ; Dermabrasion ; Humans ; Hypertrophy ; Male ; Nose ; Rhinophyma*