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

Purpose: This study evaluated the effectiveness of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) treatments using multiple pharmaceutical agents that could simultaneously preserve or enhance fertility capability. Materials and Methods: This was a single-center-based, randomized controlled study, whereas the final analysis evaluated a total 350 CP/CPPS patients (age range, 28–40 years) and 50 patients were randomly allocated to each therapeutic group, with a 1:1 ratio. The therapeutic groups consist of tadalafil (group 1, 5 mg daily), L-carnitine (group 2, 2 g daily), Serenoa repens extract (group 3, 320 mg daily), group 4 (tadalafil+L-carnitine), group 5 (tadalafil+S. repens), group 6 (L-carnitine+S. repens), and group 7 (tadalafil+L-carnitine+S. repens). The treatment outcomes at 3 months post-therapy were analyzed. Results: At 3 months post-therapy, the mean total sperm motility was significantly improved in all groups. A normal morphology improvement was observed in L-carnitine receiving groups. The mean total score on the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the mean International Prostate Symptom Score (IPSS) showed the greatest reduction in intensity in group 7. Logistic regression analyses showed that group 5 and group 7 were significantly associated with improvements in total IPSS and total NIH-CPSI scores at 3 months post-therapy. Group 7 was a significant predictor for improving total sperm motility, leukocytospermia and normal form of sperm. Conclusions Tadalafil, carnitine, and S. repens combination therapy could be considered a feasible treatment option for CP/CPPS males with subfertility.

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

No abstract available.
Male ; Penis* ; Xanthogranuloma, Juvenile*

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*

Bowenoid papulosis is manifested by clinically the benign-appearing papules of anogenital region and histopathologically similar features of squamous cellurar inoma in situ in human. A cause is thought to be Human Papillomavirus infection, type 16. The treatment is mainly through conservative management but others are topical application of podophyllin, shave excision, local excision, cryotherapy, electrodessication, topical applcation of 5-FU ointment and subcutaneous injection of recombinant interferon gamma. We present a case of Howenoid papulosis treated with DNCB imriunotherapy. The patient, had multiple papules on the penis with mild pruitus. Histopatnologic findings showed crowding and irregular arrangement of the nucleic many of which are large, hyperchromatic, and pleomorphic. Dyskeratotic and multinucleated keratinocytes wire also present, as were atypical mitoses, scattered in epidermal layer. We treated him with DNCB immunotherapy. Initially he was sensitized with 2,000 ug/0.1ml and two weeks later he received 50 ug/0.1ml per every week. After 3 weeks, he had showed no improvement and we elevated the dose to 100 ug/0.1ml. He was improved after 6th trial and his skir. lesions were almostly disappeared at present.
Crowding ; Cryotherapy ; Dinitrochlorobenzene* ; Fluorouracil ; Humans ; Immunotherapy* ; Injections, Subcutaneous ; Interferons ; Keratinocytes ; Male ; Mitosis ; Papillomavirus Infections ; Penis ; Podophyllin