This study evaluated the efficacy of a new, single-dose otic solution combining florfenicol, terbinafine, and mometasone furoate for the treatment of canine otitis externa (OE) in vitro and in vivo. Forty-one client-owned dogs with OE were included in the study and divided into a treatment group that received the test solution and a negative control group that received a normal saline solution. On day 0, the dogs were treated either with the test or the control solution and evaluated over 30 days. Clinical efficacy was evaluated by clinical signs and cytological organism counts. In vitro antimicrobial susceptibility was evaluated by the minimum inhibitory concentration (MIC). After treatment with the test solution, clinical signs continuously decreased and cytological scores were significantly reduced. The results of MIC testing showed that the test solution was potent against the common pathogenic causes of canine OE. In this study, the most common causative pathogens were Staphylococcus pseudintermedius, Pseudomonas spp. and Malassezia pachydermatis. No issues related to safety were identified. Based on these results, this new ototopical drug can be used as first line treatment for canine OE.

The objective of this study was to report on a new surgical technique, hybrid laparoscopic myomectomy that integrates the advantages of transumbilical laparoendoscopic single-site surgery and those of isobaric laparoscopy, and the initial experience with 14 cases. All of the procedures were performed by a single surgeon who has over 18 years of experience in laparoscopic surgery and 4 years of experience in laparoendoscopic single-site surgery. All cases of hybrid laparoscopic myomectomy were completed safely and effectively without conversion to conventional laparoscopic procedure. The median operative time was 75 minutes (range, 30 to 100 minutes). No postoperative complication was observed. The findings show that hybrid laparoscopic myomectomy is a safe and feasible surgical technique, and therefore can be a feasible, minimally invasive alternative to either abdominal or laparoendoscopic single-site surgery myomectomy.
Laparoscopy ; Leiomyoma ; Operative Time ; Postoperative Complications

Antiphospholipid syndrome (APS) is a rare disease in which patients display prolonged coagulation test results in vitro, but usually develop thrombotic symptoms in vivo. Patients with APS are at increased risk of valvular heart disease or coronary vascular disease, conditions that often necessitate cardiac surgery via bypass. The management of anticoagulation during cardiopulmonary bypass (CPB) is particularly challenging in these patients because of the unique features of APS. Patients with APS are constantly at risk of arterial and venous thrombotic events. Therefore it is very important to maintain proper anticoagulation perioperatively, especially during CPB. In this paper, we present three successful cases of APS patients who underwent cardiac surgery with CPB.
Antiphospholipid Syndrome* ; Cardiopulmonary Bypass ; Heart Valve Diseases ; Humans ; Rare Diseases ; Thoracic Surgery* ; Vascular Diseases

BACKGROUND: There exists a treatment challenge with periungual warts. Topical immunotherapy with diphenylcyclopropenone (DPCP) has recently been reported to be an effective treatment for recalcitrant warts, including periungual types. OBJECTIVE: We aimed to evaluate the effectiveness and preference of topical immunotherapy with DPCP in treating periungual warts. METHODS: Twenty-seven patients with periungual warts who were treated with DPCP immunotherapy (2007 through 2010; Dongguk University Ilsan Hospital, Goyang, Korea) were retrospectively recruited. Other treatment modalities were also used in some patients. Lesions were grouped into the types according to the following locations: proximal nail fold, lateral nail fold and hyponychium. Total and group clearance rates as well as treatment periods according to location and disease duration were evaluated. A patient questionnaire was performed to assess the satisfaction for the treatments in those who received multiple therapies. RESULTS: Total success rates were 85% (by subjects) and 91% (by individual lesions). Success rate and treatment period for proximal nail fold type seemed more desirable than other locations. Success rate decreased and treatment period increased as disease duration increased. The questionnaire revealed a significantly higher satisfaction rate for DPCP immunotherapy than for cryotherapy and pulsed-dye laser. CONCLUSION: Topical immunotherapy with DPCP is an effective and preferred method in the treatment of periungual warts.
Cryotherapy ; Cyclopropanes ; Humans ; Immunotherapy* ; Retrospective Studies ; Warts* ; Surveys and Questionnaires

No abstract available.
Dermatitis, Allergic Contact ; Petrolatum

BACKGROUND: Hypotension often occurs after induction of general anesthesia. Although preload status has been considered as an important factor for the occurrence of this hypotension, there have been inconsistent results on this topic. The dynamic preload parameters have not been studied as a predictor of hypotension, and therefore we hypothesized that the passive leg raising (PLR) test, a dynamic preload parameter, could predict anesthesia-induced hypotension and conducted a prospective clinical study. METHODS: In 40 patients undergoing elective cardiac surgery, mean arterial pressure (MAP), stroke volume variation, stroke volume (SV) and cardiac index (CI) were measured using arterial line and FloTrac(TM)/Vigileo(TM) system before, during and after PLR test, respectively. Occurrence of anesthesia-induced hypotension was recorded. The ability of PLR test to predict hypotension was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: The incidence of hypotension was 90%, which includes 12.5% of refractory hypotension. Changes in MAP and CI induced by PLR test predicted hypotension (area under ROC curves: 0.722 and 0.788, respectively). Changes in SV and CI induced by PLR test predicted refractory hypotension (area under ROC curves: 0.863 and 0.789, respectively). CONCLUSIONS: Our results suggest that PLR test can predict hypotension and refractory hypotension occurring after induction of anesthesia in patients undergoing cardiac surgery.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Humans ; Hypotension ; Incidence ; Leg ; Prospective Studies ; ROC Curve ; Stroke Volume ; Thoracic Surgery ; Vascular Access Devices

Vitiligo is an acquired cutaneous disorder of pigmentation with no definite etiology. Although there are a number of treatment modalities including phototherapy, topical corticosteroids and topical immunomodulators, few studies on the effect of systemic cyclosporine for the treatment of vitiligo have been conducted. We have experienced the improvement of vitiligo lesions after 8 months of systemic administration of cyclosporine (2.5~3.3 mg/kg/day) in a patient with vitiligo and atopic dermatitis. We believe this case report warrants further investigations of cyclosporine for the treatment of vitiligo in terms of mechanisms and clinical outcomes as well.
Adrenal Cortex Hormones ; Cyclosporine ; Dermatitis, Atopic ; Humans ; Immunologic Factors ; Phototherapy ; Pigmentation ; Vitiligo

No abstract available.
Aneurysm, False ; Catheterization ; Catheters ; Humans ; Takayasu Arteritis

Mounier-Kuhn-syndrome patients have markedly dilated trachea and main bronchi due to an atrophy or absence of elastic fibers and thinning of smooth muscle layers in the tracheobronchial tree. Although this syndrome is rare, airway management is challenging and general anesthesia may produce fatal results. However, only a few cases have been reported and this condition is not widely known among anesthesiologists. We present the case of a tracheobronchomegaly patient undergoing an emergency off-pump coronary artery bypass. Although the trachea was markedly dilated with numerous tracheal diverticuli, there was an undilated 2 cm portion below the vocal cords found on the preoperative CT. Under a preparation of extracorporeal membrane oxygenation, we intubated and placed the balloon of an endotracheal tube (I.D. 9 mm) at this portion, and maintained ventilation during the operation. This case showed that a precise preoperative evaluation and anesthetic plan is essential for successful anesthetic management.
Airway Management ; Anesthesia, General ; Atrophy ; Bronchi ; Coronary Artery Bypass, Off-Pump ; Elastic Tissue ; Emergencies ; Extracorporeal Membrane Oxygenation ; Humans ; Muscle, Smooth ; Trachea ; Tracheobronchomegaly ; Transplants ; Ventilation ; Vocal Cords

Pacinian neuroma, also known as hyperplasia and/or hypertrophy of pacinian corpuscles is a rare skin condition usually occurring in the hand. Although it is known to cause pain and tenderness on the affected skin, asymptomatic cases have also been reported. We report a 46-year-old male monk who presented with asymptomatic skin lesions of paler color than the adjacent normal skin on the tips of the fingers of both hands. The 3 mm punch biopsy conducted on the lesion showed an increased number of onion bulb-like structures with a nerve fiber in each center. The patient was diagnosed with pacinian neuroma and has been under regular follow up without treatment.
Biopsy ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Hyperplasia ; Hypertrophy ; Male ; Middle Aged ; Nerve Fibers ; Neuroma ; Onions ; Pacinian Corpuscles ; Skin