Background and Objectives: Following the transsphenoidal approach (TSA), appropriate sphenoid sinus fat packing has been preferred to prevent postoperative cerebrospinal fluid leakage; however, studies on the behavior of fat tissue transplanted in the sphenoid sinus are lacking. This study aimed to determine the long-term fate of these fat grafts using magnetic resonance imaging (MRI).Subjects and Method: A total of 139 postoperative MRI scans of 41 patients who underwent sphenoid sinus fat packing using the standard TSA were evaluated. Additionally, MRI time series indicating the vital fat volumes were assessed postoperatively. Results: In 82.9% of cases, the fat volumes measured in the final MRI scans declined to <20% of the initial volumes; only 4.9% of cases exhibited declines to >60% of the initial volume. The fat tissue volume decreased significantly with time, with a median half-life of 18 months. Typically, the sphenoid sinus was eventually almost filled with air rather than transplanted fat. In the subgroup analysis, the fat clearance rate was significantly lower in patients with residual tumors than in those without such remnants (p=0.013). Conclusion Long-term MRI surveillance of fat grafts in the sphenoid sinus revealed that the transplanted fat graft had degraded and was gradually eliminated.

PURPOSE: The purpose of this study is to examine and share experiences of male nurses who have been rejected during their nursing practice by their patients. METHODS: The participants were 12 male nurses who have worked in several hospitals. Data were collected through personalized in-depth interviews. Collected data were analyzed with the content analysis method. RESULTS: The results can be categorized into three main themes. 1. Rejection based on gender stereotypes of nurses' roles. 2. Nurses' reactions when nursing was rejected 3. Reestablishing the role as a nurse. The results of this study showed that male nurses were struggling to maintain their own positions as professional nurses. They were refused by their patients and they experienced a lack of skill and knowledge in nursing practice. They were harmed physically and psychologically from being turned down, and sometimes they had serious conflicts with female nurses. Meanwhile, the male nurses tried to be faithful to their role as professional nurses. CONCLUSION: The results of this study show the following findings. 1. The male nurses' experiences where mostly ones of understanding and cooperation with patients' caregivers. 2. The need for public relations advertising and systematic support from the media. 3. The need for improving gender equality for nurses. 4. Strengthening male nursing students' endeavors for sound nursing professionalism.
Caregivers ; Female ; Humans ; Male ; Methods ; Nurses, Male ; Nursing ; Professionalism ; Public Relations ; Qualitative Research

BACKGROUND/AIMS: The incidence and severity of Clostridium difficile infection (CDI) have increased worldwide, resulting in a need for rapid and accurate diagnostic methods. METHODS: A retrospective study was conducted to compare CDI diagnosis methods between January 2014 and December 2014. The stool samples, which were obtained in presumptive CDI patients, were compared for their diagnostic accuracy and rapidity, including real-time polymerase chain reaction (PCR) of toxin genes, C. difficile toxin assay, and culture for C. difficile. RESULTS: A total of 207 cases from 116 patients were enrolled in this study and 117 cases (56.5%) were diagnosed as having CDI. Among the 117 cases, the sensitivities of real-time PCR, C. difficile toxin assay, and culture for C. difficile were 87.2% (102 cases; 95% CI, 80.7%–92.8%), 48.7% (57 cases; 95% CI, 41.0%–59.8%), and 65.0% (76 cases; 95% CI, 60.2%–78.5%), respectively (P < 0.005). Notably, 34 cases (29.0%) were diagnosed with CDI by real-time PCR only. The time required to obtain results was 2.27 hours (136.62±82.51 minutes) for real-time PCR, 83.67 hours (5,020.66±3,816.38 minutes) for toxin assay, and 105.79 hours (6,347.68±3,331.46 minutes) for culture (P < 0.005), respectively. CONCLUSIONS: We confirmed that real-time PCR of toxin genes is the most effective diagnostic method for accurate and early diagnosis of CDI. It also helps to diagnose hypervirulent CDI, such as ribotype 027 infection.
Clostridium difficile ; Clostridium ; Diagnosis ; Early Diagnosis ; Humans ; Incidence ; Methods ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Retrospective Studies ; Ribotyping

No abstract available.
Granuloma Annulare* ; Granuloma* ; Humans

BACKGROUND: Q-switched lasers have made it possible to remove tattoos without leaving unsightly scars. OBJECTIVE: Tobdetermine the optimal time for permanent makeup removal using Q-switched Nd:YAG and ruby lasers, we compared the degree of removal and associated histological changes following irradiation at different time points. METHODS: Using black ink and a permanent makeup machine, we performed 108 separate permanent makeup applications on rat skin. The 1,064-nm Q-switched Nd:YAG laser (QSNDL) and 694-nm Q-switched ruby laser (QSRL) were used to irradiate the permanent makeup on the day of its application and also 3, 5, 7, 14, and 21 days later. We assessed changes in pigmentation over time at each irradiated site using Mexameter® measurements and skin biopsies. RESULTS: The Mexameter® analysis demonstrated no significant differences in pigment removal among irradiations with QSNDL or QSRL on the day of permanent makeup application or at 3, 5, 7, 14, and 21 days later. Histological analysis demonstrated that permanent makeup pigment migrated from the epidermis to the superficial and mid dermis over time. QSNDL more effectively removed pigment throughout the epidermis and dermis compared to QSRL. CONCLUSION: For maximum pigment removal efficacy, the melanin index results suggest that laser treatment should be performed on the day permanent makeup is applied. However, from the histological perspective, permanent makeup should be removed approximately 1 week later, at which point the crusts have peeled off and the wound repair process is almost complete. In this study, histological analysis suggested the superiority of treatment with QSNDL to that with QSRL.
Animals ; Biopsy ; Cicatrix ; Dermis ; Epidermis ; Ink ; Lasers, Solid-State* ; Melanins ; Pigmentation ; Rats ; Skin* ; Wounds and Injuries

No abstract available.
Female ; Gastrointestinal Stromal Tumors* ; Humans ; Liver* ; Middle Aged* ; Neoplasm Metastasis*

No abstract available.
Acne Keloid* ; Acne Vulgaris* ; Humans

No abstract available.
Cross Infection ; Foot* ; Pseudomonas aeruginosa

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States