Asia ; epidemiology ; Diabetes Mellitus ; epidemiology ; etiology ; prevention & control ; Humans ; Morbidity ; Risk Factors ; Socioeconomic Factors ; Survival Rate

Advances in the medical management of secondary hyperparathyroidism due to renal failure have decreased the use of parathyroidectomy as a treatment option. However, some patients with end-stage renal disease still progress to refractory hyperparathyroidism and debilitating bone disease, for which parathyroidectomy may be warranted. We describe a case of a 35-year-old female on chronic hemodialysis who presented with bone pains, deformities, decrease in height and recurrent pathologic fractures. She had markedly elevated parathyroid hormone (PTH), vitamin D deficiency, persistent hyperphosphatemia and hypocalcemia despite therapeutic measures. Subtotal parathyroidectomy was done with eventual improvement of biochemical abnormalities, resolution of bone pains and healing of fractures.

Human ; Female ; Adult ; Bone Diseases ; Fractures, Spontaneous ; Hyperparathyroidism, Secondary ; Hyperphosphatemia ; Hypocalcemia ; Kidney Failure, Chronic ; Parathyroid Hormone ; Parathyroidectomy ; Renal Dialysis ; Renal Insufficiency ; Vitamin D Deficiency

Twenty two patients presenting with chronic non-healing wound of the foot were evaluated. The ages range from 49 to 72 years old. There were 15 males and 7 females. Sixteen patients had NIDDM. Two were diagnosed to have Buergers disease with four others had both NIDDM and Buergers disease. Using a pulse oximeter with a sensor attached to the toes, the oxygen saturation level of the distal limbs was determined. Twelve patients were amputated. The mean oxygen saturation level of the non-amputated group was 91.2%, while that of the amputated group was 32.8%. In the non-amputated group, all the wounds improved. It is therefore suggested that determination of oxygen saturation level using pulse oximeter is a safe and convenient way of predicting wound healing. A level below 80% is correlated with poor healing which may assist the surgeon in his decision to amputate. (Author)

Human ; Male ; Female ; Aged ; Middle Aged ; Oxygen ; Amputation

Acute laryngeal trauma is a great challenge for the otoloaryngologist. Early recognition, accurate evaluation and proper treatment may be crucial to immediate survival and long-term function. Objective:To describe an endoscopically-guided open reduction and adaptation plate fixation of an acute laryngeal fracture secondary to vehicular accident. Methods: a. Study Design: Surgical Innovation/ Case Report b. Setting:Tertiary Hospital in Metro Manila Results: Post-operative follow-up showed good vocal fold function and arytenoid position, with no food regurgitation, signs of aspiration or penetration on fiberoptic endoscopic evaluation of swallowing Conclusion: Endoscopic guidance allows higher magnification minimizing iatrogenic mucosal damage during manipulation. (Author)
LARYNX

The use of local regional flaps is often the most practical and easy means of reconstruction in the management of head and neck tumors. The temporalis muscle coronoid swing has been used to reconstruct the orbital floor and is described in literature as early as 1983. Difficulty is encountered when the medial wall and orbital floor are completely removed and a temporalis muscle-coronoid swing is rendered insufficient for orbital reconstruction. Objective: To describe a combination of forehead island flap and temporalis muscle-coronoid swing in orbital reconstruction. Design: Surgical Innovation/ Case Report. Subject: 12-year-old female with recurrent maxillary chondroblastic osteosarcoma one year after chemotherapy. Methods: The course of tumor excision and defect reconstruction is described. Results:There was no diplopia or other morbidity.There was minimal added operative time for reconstruction with acceptable results. Conclusion: Local flaps can be combined in order to repair the orbital floor. Acceptable function with minimal cosmetic deformity can be achieved with less extensive surgery. (Author)
FOREHEAD TEMPORAL MUSCLE ORBIT RECONSTRUCTIVE SURGICAL PROCEDURES SURGICAL FLAPS

A total of 97 children aged 1 month to 16 years (mean 6.6 years) had upper endoscopies performed in Paediatric Institute, Kuala Lumpur Hospital between January 1997 and December 1999 for various gastrointestinal symptoms. Of these 70 children were tested for Helicobacter pylori. The four most common indications for upper endoscopy were recurrent abdominal pain, upper gastrointestinal bleeding, epigastric pain and vomiting. The overall prevalence of this infection in this heterogenous group of symptomatic children was 10% (7/70). This study shows that H.pylori positivity in a routine endoscopy population is low and does not appear to be associated with specific symptoms.
Child ; seconds ; Endoscopy ; Prevalence aspects ; Helicobacter pylori

Scrotal calcinosis is a rare condition with controversy surrounding its unclear etiopathogenesis. Several schools of thought have emerged from recent publications supported by histological findings seen in the respective cases reported. The recommendation of surgery as management, and its outcome, however, have remained the same throughout history. This paper reports a 36-year-old male who presented with gradually progressing multiple pruritic nodules over the scrotum who underwent wide excision with favorable outcome on follow up. Histological examination confirmed the diagnosis of scrotal calcinosis and showed evidence of intact epidermoid cysts that have undergone dystrophic calcification.

Adolescent ; Adult ; Ankle Injuries ; Ankle Joint ; diagnostic imaging ; Female ; Humans ; Ligaments, Articular ; diagnostic imaging ; injuries ; Male ; Middle Aged ; Radiography ; Rupture

Mammography remains the mainstay of screening for primary breast cancer, however, some limitations persists in women with dense breast, in its inability to differentiate a benign from a malignant lesion, and in its heavy reliance on the radiologists' skill. Breast specific gamma imaging, which evaluates the functional images rather than anatomic images seen in mammography, addresses these limitations and can be a potential adjunct in screening for breast cancer. This meta-analysis aims to determine the diagnostic accuracy of breast specific gamma imaging for diagnosing breast cancer in women who are high risk. We searched PUBMED (1999-2009) and Google Scholar (1999-2009) for diagnostic accuracy studies that compared breast specific gamma imaging with histopathologic diagnosis of breast cancer in high risk women. Citation searches and screening of references of included studies were conducted. Two authors searched citations that correlated with the criteria using a data collection form. The methodological quality was then assessed by three authors using the QUADAS method. HSROC meta-analytical tool was used to estimate summary ROC curves. Four studies with 360 participants and 411 lesions were included. Breast specific gamma imaging has a high sensitivity (84%-97%) and specificity (60%-86%). SROC shows the included studies have high overall accuracy. Breast specific gamma imaging has high diagnostic accuracy in detecting breast cancer in women at high risk.

Human ; Female ; Breast Neoplasms ; Neoplasms ; Neoplasms By Site ; Breast ; Mammography ; Roc Curve ; Radiologists ; Sensitivity And Specificity