BACKGROUND AND OBJECTIVES: Tympanostomy tube insertion is one of the most common surgical procedures in children. Despite aseptic procedures with prophylactic antibiotic treatment, postoperative otorrhea may be encountered in some patients. The purpose of this study is to identify the relation between the types of immune cells in otitis media with effusion (OME) and tympanostomy tube otorrhea (TTO) in children. SUBJECTS AND METHOD: Fifty-six patients underwent tympanostomy tube insertion with OME were analyzed retrospectively. Fluid from OME was harvested by suction via syringe connector after myringotomy. Light microscopic examination of middle ear effusion was performed by a pathologist after hematoxylin and eosin staining. We analyzed the relation between the types of immune cells from middle ear effusion and TTO. RESULTS: Of 56 children, 36 were male and 22 were female. The mean age for tympanostomy tube insertion was 3.56 (±2.63) years, with the average follow-up period of 12.56 (±9.96) months. Neutrophils were detected in 19, eosinophils in 14, lymphocytes in 22, mast cells in 2, plasma cells in 7, and histiocytes in 9. TTO occurred in 15 patients. In patients with early TTO, eosinophils were detected more frequently than in patients without TTO (p=0.006). Plasma cells were detected more frequently in patient with late TTO than without TTO (p=0.011). CONCLUSION: According to the analysis of different types of immune cells, eosinophils in the middle ear effusion related with the occurrence of TTO.
Child* ; Ear, Middle* ; Eosine Yellowish-(YS) ; Eosinophils ; Female ; Follow-Up Studies ; Hematoxylin ; Histiocytes ; Humans ; Lymphocytes ; Male ; Mast Cells ; Methods ; Middle Ear Ventilation* ; Neutrophils ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Plasma Cells ; Retrospective Studies ; Suction ; Syringes

Vitiligo is a commonly acquired cutaneous depigmentation disorder that affects 0.5~1% of the population worldwide. While phototherapy is the primary treatment for vitiligo, surgical methods can be used for treating patients who are refractory to conventional treatments. Herein, we present the case of a 14-year-old Korean girl who developed vitiligo after hematopoietic stem cell transplantation for the treatment of acute lymphoblastic leukemia. She had multiple depigmented patches on her lower legs that did not respond to narrow-band ultraviolet B phototherapy for 7 months. The depigmented patches were successfully treated by transplantation of non-cultured epidermal cell suspension from the epidermal roof of the suction blister in the right inner thigh. No adverse event, such as secondary infection or scarring in both the donor and recipient sites, was noted. We recommended that non-cultured epidermal cell suspension transplantation using the suction blister method would be a safe and effective option for the treatment of refractory vitiligo.
Adolescent ; Blister* ; Cicatrix ; Coinfection ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Leg ; Methods* ; Phototherapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Suction* ; Thigh ; Tissue Donors ; Vitiligo*

PURPOSE: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. METHODS: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. RESULTS: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were 36.44±4.82, 13.44±1.71, and 42.32±5.05, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. CONCLUSION: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.
Adult ; Checklist ; Clinical Competence ; Humans ; Judgment* ; Methods ; Nursing* ; Patient Simulation ; Pneumonia ; Respiratory System ; Students, Nursing* ; Suction*

A 70-year-old female patient was diagnosed with low rectal adenocarcinoma (cT3N2) based on the initial CT and MRI. The patient underwent neoadjuvant chemoradiotherapy consisting of short course radiotherapy with 5-fluorouracil (5-FU) and leucovorin (LV) chemotherapy. Three additional cycles of simplified infusional 5-FU/LV were given every 2 weeks to the patient during the resting period (8 weeks) before surgery. For transanal TME, a purse-string suture of the distal rectum was performed just above the dentate line. Transanal circumferential dissection including the mesorectum was performed from the dentate line until the peritoneal reflection. Thereafter, laparoscopic dissection was conducted using the medial to lateral approach and the inferior mesenteric artery was ligated at the pedicle. Lateral detachment and splenic flexure mobilization were completed. After full mobilization of the distal transverse colon and rectum, the specimen was retrieved through the anus and resected. Colo-anal anastomosis was performed by the hand-sewn method. A closed suction drain was inserted into the pelvis. We also demonstrate our procedure for transanal TME using a short video clip.
Adenocarcinoma ; Aged ; Anal Canal ; Chemoradiotherapy ; Colon, Transverse ; Drug Therapy ; Female ; Fluorouracil ; Humans ; Leucovorin ; Magnetic Resonance Imaging ; Mesenteric Artery, Inferior ; Methods ; Pelvis ; Radiotherapy ; Rectal Neoplasms* ; Rectum ; Suction ; Sutures

OBJECTIVE: To evaluate the technical feasibility and clinical outcome of percutaneous aspiration embolectomy for embolic occlusion of the superior mesenteric artery (SMA). MATERIALS AND METHODS: Between January 2010 and December 2013, 9 patients with embolic occlusion of the SMA were treated by percutaneous aspiration embolectomy in 2 academic teaching hospitals. The aspiration embolectomy procedure was performed with the 6-Fr and 7-Fr guiding catheter. Thrombolysis was performed with urokinase using a multiple-sidehole infusion catheter. The clinical outcome was investigated retrospectively. RESULTS: Superior mesenteric artery occlusion was initially diagnosed by computed tomography (CT) in all patients, and all patients had no obvious evidence of bowel infarction on CT scan. Percutaneous aspiration embolectomy was primarily performed in 6 patients, and thrombolysis was initially performed in 3 patients. In 3 patients who received primary thrombolysis, percutaneous aspiration was undertaken because the emboli were resistant to urokinase. Complete angiographic success was achieved in 6 patients and partial angiographic success was accomplished in 3 patients. One patient underwent bowel resection. One patient died of whole bowel necrosis and sepsis, and 8 patients survived without complications. CONCLUSION: Percutaneous aspiration embolectomy is a useful tool in recanalization of embolic occlusion of the SMA in select patients.
Adult ; Aged ; Aged, 80 and over ; Angiography/methods ; Embolectomy/*methods ; Embolism/complications/radiography/*surgery ; Female ; Humans ; Male ; Mesenteric Artery, Superior/radiography/*surgery ; Mesenteric Vascular Occlusion/etiology/radiography/*surgery ; Middle Aged ; Retrospective Studies ; Suction/instrumentation/methods ; Thrombolytic Therapy/methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Urokinase-Type Plasminogen Activator/administration & dosage ; Vascular Access Devices

OBJECTIVE: To investigate the efficacy of Coblation-channelling for the tongue(CCT) treatment of tongue hypertrophy. METHOD: The 31 patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) combining tongue hypertrophy staged as Friedman ll or N were performed CCT after nasal septum surgery, coblation channelling of bilateral inferior turbinate and coblation-assisted UPPP. While the vertical channelling in the base and the body of the tongue, the tilted one parallel side edge and posterior to the tongue were combined. The intraoperative and postoperative complications such as bleeding were observed. The 12 months postoperative follow-up were done by MRI of the tongue. RESULT: The retrolingual space were expanded postoperatively. The 2 bleedings occurred immediately after channellings in the tongue body, and they were stopped by local compression. No postoperative tongue paralysis, no tongue hematoma and abscess happened. The tongue sizes changed from preoperative III or IV degree to postoperative I to II degrees. One case received three CCT sessions. CONCLUSION CCT treatment tongue hypertrophy is a individually safe, effective and minimally invasive treatment.
Catheter Ablation ; methods ; Female ; Humans ; Hypertrophy ; complications ; surgery ; Macroglossia ; complications ; surgery ; Male ; Postoperative Hemorrhage ; etiology ; Postoperative Period ; Sleep Apnea, Obstructive ; etiology ; surgery ; Suction ; methods ; Tongue ; pathology

We report two cases of surgical removal of a retained subfoveal perfluorocarbon liquid (PFCL) bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade. Two patients underwent pars plana vitrectomy with PFCL injection for rhegmatogenous retinal detachment. In both cases, a retained subfoveal PFCL bubble was noticed postoperatively by funduscopy and optical coherence tomography. Both patients underwent surgical removal of the subfoveal PFCL through a therapeutic macular hole and gas tamponade. The therapeutic macular holes were completely closed by gas tamponade and the procedure yielded a good visual outcome (best-corrected visual acuity of 20 / 40 in both cases). In one case, additional intravitreal PFCL injection onto the macula reduced the size of the therapeutic macular hole and preserved the retinal structures in the macula. Surgical removal of a retained subfoveal PFCL bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade provides an effective treatment option.
Aged ; Female ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Fovea Centralis ; Humans ; Intravitreal Injections ; Retinal Perforations/diagnosis/physiopathology/*surgery ; Suction/*methods ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy/*methods

Structure, working principle, use method and clinical application of a central suction bottle is proposed. It boasts such features as simply produced and easily used. The workload of nurses can be reduced by using disposable attract bags, Also cross-infection can be effectively controlled. It is worth to be widely use in clinical application.
Disposable Equipment ; Equipment Design ; Suction ; instrumentation ; methods

OBJECTIVETo explore the effect of anhydrous alcohol sclerotherapy following transrectal ultrasound-guided puncture in the treatment of Mülllerian duct cyst.

METHODSTotally 44 patients with Müllerian duct cyst underwent transrectal ultrasound-guided puncture and sclerotherapy, 21 injected with anhydrous alcohol of half the volume of the aspirated cystic fluid followed by aspiration of all the fluid 5 minutes later (treatment group) , and the other 23 treated by cystic fluid aspiration only (control group). The clinical effects of the two methods were compared.

RESULTSThe response rate and cure rate were 80.95 and 52.38% in the treatment group, as compared with 56.52 and 26.09% in the control (P < 0.001). No adverse events were observed in either of the two groups.

CONCLUSIONTransrectal ultrasound-guided puncture and anhydrous alcohol sclerotherapy is a safe and effective approach to the treatment of Mülllerian duct cyst.

Cysts ; therapy ; Endosonography ; Humans ; Male ; Middle Aged ; Mullerian Ducts ; Rectum ; diagnostic imaging ; Sclerotherapy ; Suction ; methods

OBJECTIVETo evaluate the effect of fenestration and suction drainage in the treatment of large odontogenic mandibular cystic lesions.

METHODSFrom 2005 to 2009, 24 cases of large odontogenic mandibular cystic lesions were treated with fenestration and suction drainage. The clinical symptoms and radiographical findings were evaluated before the operation and at 1 month and 6 months after suction drainage.

RESULTSFollow-up for 1-3 years showed that all the cystic lesions disappeared without recurrence, and the clinical symptoms were resolved.

CONCLUSIONFenestration and suction drainage can reduce the cystic size and rapidly correct the deformity to serve as a useful modality for primary management of large odontogenic mandibular cystic lesions.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Mandibular Diseases ; surgery ; Middle Aged ; Odontogenic Cysts ; surgery ; Suction ; methods ; Young Adult