• 대한두개안면성형외과학회지
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• 제13권2호
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• pp.147-150
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• 2012

Purpose: Varicella-zoster virus (VZV) infection is a common childhood disease. However, old and immune compromised patients are also at risk. Necrotizing fasciitis is a life threatening infection of the subcutaneous tissues, rapidly extending along the fascial planes. It is associated with a significant mortality rate, reported between 20% and 50%, and is therefore regarded as a surgical emergency. The authors treated a patient, who developed skin necrosis of her nose and left hemifacial area, following VZV infection. There are few literatures concerning this case; therefore, we present a rare case with review of literature. Methods: A 39-year-old woman had shown a localized, painful, multiple bullae and eschar formation in her nose and left hemifacial area for several days. Her skin lesion had rapidly worsened in size and morphology. Results: We diagnosed her as a necrotizing fasciitis, following herpes zoster, and then we performed a debridement of necrotic tissue and took a full thickness skin graft on her nose and left hemifacial area. Now, she was followed up with acceptable aesthetic result after 6 months. Conclusion: Secondary bacterial skin infection following VZV, can cause a result in a higher risk of complications. Among the complication, a necrotizing fasciitis of the head and neck is uncommon, and involvement of the nose is even more rare. Through this uncommon case report, we intend to emphasize the fact that early diagnosis of necrotizing fasciitis is very important, since it frequently necessitates surgical treatment which improves morbidity and leads to good recovery.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6233-6237
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• 2014

Background: Intraperitoneal spread of gynecologic cancers is a major cause of mortality and morbidity and often presents with malignant ascites. Microscopic tumor spread can be demonstrated by a peritoneal wash cytology and help assess the prognosis of the disease. In our study, the roles of paraoxonase and ceruloplasmin, measured in peritoneal washing fluid of patients operated for gynecologic pathologies in differential diagnosis was investigated. Materials and Methods: Patients operated for malign or benign gynecologic pathologies in Antalya Education and Research Hospital Gynecology Clinic between 2010-2012 were included in the study. Samples were obtained during surgery. Results: A statistically significant difference was detected between patients with benign and malign diseases with regards to PON1 levels measured in peritoneal washing fluid (p:0.044), the average values being $64.2{\pm}30.8$ (Range 10.8-187.2) and $41.4{\pm}21.4$ (Range 10.4-95.5), respectively. No significant variation was evident for ceruloplasmin. Conclusions: Paraoxonase levels measured in peritoneal washing fluid may contribute to the differentiation of malign-benign diseases in gynecologic pathologies.

• 대한핵의학회지
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• 제14권1호
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• pp.29-36
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• 1980

Most of clinical morbidity in cardiology are associated with abnormalities of the left ventricle. Several methods have been developed to measure the left ventricular function, including cardiac catheterization with cineangiography, echocardiography, and systolic time interval. But these methods have many limitations. ECG gated cardiac blood pool scan provides a safe, noninvasive, repeatable method for determining the left ventricular function. Utilizing the cardiac blood pool scan, we measured the left ventricular function in 165 cardiac patients, and in 26 normal subject. 1. Left ventricular ejection fractions were measured by cardiac blood pool scan, and compared in 20 patients with that measured by x-ray cineangiography. Correlation coefficient was 0.885. 2. Ejection fractions were classified by funtional class made in New York Heart Association. Ejection fractions well represented the functional status. 3. Ejection fractions decreased in cardiomyopathy ($20.1{\pm}4.8%$) and ischemic heart disease ($34.4{\pm}16.7%$). Impaired ejection fractions in myocardial infarction were associated with the extent of infarction. 4. Regional left ventricular wall motion was evaluated from the end-diastolic and end-systolic images. In cardiomyopathy diffuse hypokinesia was noted and in myocardial infarction akinesia was noted on the infarcted areas.

• 셀메드
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• 제10권4호
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• pp.31.1-31.6
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• 2020

Introduction: Dyslipidaemia is directly associated with cardiovascular diseases. Temperament, the unique constitutional make-up of an individual, is responsible for one's personality traits, physical appearances, and disease predispositions. The rising prevalence of dyslipidaemia becomes a challenge to control morbidity and mortality due to cardiovascular diseases. Objective: To study clinical patterns and risk factors of dyslipidaemia and its association with temperament at the individual level was the main objective of this study. Materials and Methods: It was a descriptive and analytical cross sectional study. The participants (n=88) were screened on the basis of raised serum lipid profile from the outpatient department of National Research Institute of Unani Medicine for Skin Disorders, Hyderabad. The data were collected on a case record form designed for this study and analyzed retrospectively. Results: In this study, there were 57% participants (n=50) of phlegmatic temperament in which mean total cholesterol, triglycerides, low density lipoprotein- cholesterol and high density lipoprotein-cholesterol were 230.92 (±49.48) mg/dl, 182.34 (±110.61) mg/dl, 153.24 (±50.21) mg/dl and 46.3 (±10.83) mg/dl respectively. Discussion: This study showed the prevalence of different clinical patterns of dyslipidaemia in the population and the phlegmatic participants were dyslipidaemic in a higher percentage. The prevalence of dyslipidaemia in phlegmatic participants may be linked to the constitutional make-up of the individual. The temperament of an individual may be considered as one of the risk factors for dyslipidaemia. Conclusion: It was concluded that the temperament of an individual may be used as a screening tool to predict the individual's tendency to develop dyslipidaemia.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3205-3211
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• 2013

Background: Bladder cancer is the second most incident malignancy among Lebanese men. The purpose of this study was to investigate potential risk factors associated with this observed high incidence. Methods: A case-control study (54 cases and 105 hospital-based controls) was conducted in two major hospitals in Beirut. Cases were randomly selected from patients diagnosed in the period of 2002-2008. Controls were conveniently selected from the same settings. Data were collected using interview questionnaire and blood analysis. Exposure data were collected using a structured face-to-face interview questionnaire. Blood samples were collected to determine N-acetyltransferase1 (NAT1) genotype by PCR-RFLP. Analyses revolved around univariate, bivariate and multivariate logistic regression, along with checks for effect modification. Results: The odds of having bladder cancer among smokers was 1.02 times significantly higher in cases vs. controls. The odds of exposure to occupational diesel or fuel combustion fumes were 4.1 times significantly higher in cases vs controls. The odds of prostate-related morbidity were 5.6 times significantly higher in cases vs controls. Cases and controls showed different clustering patterns of NAT1 alleles. No significant differences between cases and controls were found for consumption of alcohol, coffee, tea, or artificial sweeteners. Conclusions: This is the first case-control study investigating bladder cancer risk factors in the Lebanese context. Results confirmed established risk factors in the literature, particularly smoking and occupational exposure to diesel. The herein observed associations should be used to develop appropriate prevention policies and intervention strategies, in order to control this alarming disease in Lebanon.

• 대한관절경학회지
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• 제9권1호
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• pp.34-39
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• 2005

회전근 개 부전층 파열은 임상적으로 잘 알려진 질환이지만 이에 대한 수술적 치료 원칙은 명확히 정립되어 있지 않다. 파열된 회전근 개에 대한 치료법은 단순 변연절제술에서 견봉하 감압술과 퇴행성 파열 부위의 절제 및 봉합술까지 여러 가지 방법이 추천되고 있다. 수술은 관혈적 혹은 소 절개, 관절경적 술식을 시행할 수 있다. 관혈적과 관절경적 방법의 장단점에 따른 치료 방법을 결정할 때 정밀성과 이환률을 고려한다면 비슷한 위치를 가진다. 회전근 개 질환의 이환 정도를 결정할 때 관절면과 점액낭면 양쪽의 회전근 개를 관찰하고 치료 방침을 결정하여야 한다 때때로 파열이 이차적으로 발생할 수 있으므로 일차적인 병인을 고려하는 것이 중요하다. 부전층 파열은 일차적인 원인을 치료해야 하지만 심한 부전층 파열이 있는 경우는 관절경적 혹은 관혈적 방법으로 퇴행성 병변이 있는 회전근 개를 치료해야 좋은 치료 결과를 얻을 수 있다.

• 재활간호학회지
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• 제1권1호
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• pp.27-42
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• 1998

Osteoporosis is a major health problem in countries with aging populations, resulting in excess morbidity and mortality. This study was conducted to investigate knowledge and practices about osteoporosis in adults and to identify some factors which were influenced to that. 56-item questionnaire was developed including five domains(general characteristics, osteoporosis-related characteristics, knowledge of risk factors, knowledge of prevetion and practices). Subjects of this study were 368 adult ranged from 30 to 59. Data were collected during the period from June 15 to July 10, 1998 by means of a structured questionnare. The data were analyzed using descriptive statistics, t-test, ANOVA, Post Hoc, Pearson Correlation by SPSSWIN program. The results were as follows: 1. The mean knowledge score of risk factors for osteoporosis was 7.46(full score=15) and that of prevention of osteoporosis was 8,79(full score=12). 2. The mean practice score of osteoporosis was slightly higher than median value. 3. Women had better knowledge about osteoporosis risk factors and practiced more osteoporosis-prevention measures than men. Although the data demonstrated fairly good general knowledge about osteoporosis in the subjects, the older group(age 50-59), those at the highest risk of developing the disease, knew less about osteoporosis than the younger group(age 30-39) did. 4. The persons who had heard about osteoporosis and bone mineral density though mass media medical pratitioners and who didn't take any medicine for osteoporosis had better knowledge about osteoporosis and preventive measures. The practice score was significantly higer in the postmenopausal women and persons who were already diagnosed as osteoporosis patients, or who underwent bone mineral density measurements. 5. The relation between knowledge and practice was significant. In conclusion, there was a modest degree of general knowledge about osteoporosis and its consequences in adults. Further randomized studies are needed to evaluate the relationship between osteoporosis and risk factors. However, these results support the importance of education to prevent osteoporosis.

• Archives of Plastic Surgery
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• 제47권4호
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• pp.324-332
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• 2020

Background The deep inferior epigastric artery perforator (DIEP) flap is the commonest flap used for breast reconstruction after mastectomy. It is performed as a unilateral (based on one [unipedicled] or two [bipedicled] vascular pedicles) or bilateral procedure following unilateral or bilateral mastectomies. No previous studies have comprehensively analyzed analgesia requirements and hospital stay of these three forms of surgical reconstruction. Methods A 7-year retrospective cohort study (2008-2015) of a single-surgeon's DIEP-patients was conducted. Patient-reported pain scores, patient-controlled morphine requirements and recovery times were compared using non-parametric statistics and multivariable regression. Results The study included 135 participants: unilateral unipedicled (n=84), unilateral bipedicled (n=24) and bilateral unipedicled (n=27). Univariate comparison of the three DIEP types showed a significant difference in 12-hour postoperative morphine requirements (P=0.020); bipedicled unilateral patients used significantly less morphine than unipedicled (unilateral) patients at 12 (P=0.005), 24 (P=0.020), and 48 (P=0.046) hours. Multivariable regression comparing these two groups revealed that both reconstruction type and smoking status were significant predictors for 12-hour postoperative morphine usage (P=0.038 and P=0.049, respectively), but only smoking, remained significant at 24 (P=0.010) and 48 (P=0.010) hours. Bilateral reconstruction patients' mean hospital stay was 2 days longer than either unilateral reconstruction (P<0.001). Conclusions Although all three forms of DIEP flap breast reconstruction had similar postoperative pain measures, a novel finding of our study was that bipedicled DIEP flap harvest might be associated with lower early postoperative morphine requirements. Bilateral and bipedicled procedures in appropriate patients might therefore be undertaken without significantly increased pain/morbidity compared to unilateral unipedicled reconstructions.

• Parasites, Hosts and Diseases
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• 제49권1호
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• pp.33-38
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• 2011

Prompt and accurate diagnosis of malaria is the key to prevent disease morbidity and mortality. This study was carried out to evaluate diagnostic performance of 3 commercial rapid detection tests (RDTs), i.e., Malaria Antigen Pf/Pan$^{TM}$, Malaria Ag-Pf$^{TM}$, and Malaria Ag-Pv$^{TM}$ tests, in comparison with the microscopic and PCR methods. A total of 460 blood samples microscopically positive for Plasmodium falciparum (211 samples), P. vivax (218), mixed with P. falciparum and P. vivax (30), or P. ovale (1), and 124 samples of healthy subjects or patients with other fever-related infections, were collected. The sensitivities of Malaria Ag-Pf$^{TM}$ and Malaria Antigen Pf/Pan$^{TM}$ compared with the microscopic method for P. falciparum or P. vivax detection were 97.6% and 99.0%, or 98.6% and 99.0%, respectively. The specificities of Malaria Ag-Pf$^{TM}$, Malaria Ag-Pv$^{TM}$, and Malaria Antigen Pf/Pan$^{TM}$ were 93.3%,98.8%, and 94.4%, respectively. The sensitivities of Malaria Ag-Pf$^{TM}$, Malaria Antigen Pf/Pan$^{TM}$, and microscopic method, when PCR was used as a reference method for P. falciparum or P. vivax detection were 91.8%, 100%, and 96.7%, or 91.9%,92.6%, and 97.3%, respectively. The specificities of Malaria Ag-Pf$^{TM}$, Malaria Ag-Pv$^{TM}$, Malaria Antigen Pf/Pan$^{TM}$, and microscopic method were 66.2%, 92.7%, 73.9%, and 78.2%, respectively. Results indicated that the diagnostic performances of all the commercial RDTs are satisfactory for application to malaria diagnosis.

• Journal of Chest Surgery
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• 제24권1호
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• pp.15-25
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• 1991

From February 1988 to December 1990, 42 patients underwent so called REV operation for pulmonary stenosis or atresia with or without anomalies of ventriculoarterial connection and truncus arteriosus. The principles of operative technique are mobilization of pulmonary arterial tree beyond the pericardial reflection, transection of pulmonary trunk between the pulmonary ventricle and pulmonary artery, suture of distal pulmonary arterial stump to the upper margin of Pulmonary ventriculotomy site with absorbable suture, and anterior patch with 0.625% glutaraldehyde fixed autologous pericardium with monocusp inside it. Age at operation ranged 3-156months [mean 41.8 month] with twelve of whom infants. Operative indications were pulmonary atresia, with ventricular septal defect[16], and pulmonary stenosis with double outlet right ventricle[8], with ventricular septal defect[16], with double outlet right ventricle[8], with complete transposition of the great arteries[8], with corrected transposition of the great arteries[6], with Fallot`s tetralogy[3], and truncus arteriosus[1]. There were six hospital deaths[14%] and no late death. Twenty-four of 36 survivals were followed up more than 12 months with good clinical results. Postoperative angiocardiogram was performed in fifteen patients. Hemodynamically, two patents had residual pressure gradients along the pulmonary outflow tract, one patient showed severe pulmonary regurgitation; morphologically, there were six significant stenosis of left pulmonary arterial tree, two of whom showed significant pressure gradients. Our present experience with REV operation suggests that this technique make it possible to perform anatomic repair in a wide variety of congenital anomalies of abnormal ventriculoarterial connection associated with pulmonary outflow tract obstruction without using the prosthetic material, even in infants, with relatively low mortality and morbidity.