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At least 541 records · Page 30Linked to original sources
PubMed1992

[Delayed onset of heparin induced thrombocytopenia--a case report].

A 64-year-old man underwent CABG. 18000 unit of bovine lung heparin was used during operation for extracorporeal circulation and small amount of heparin was injected until the 5th postoperative day to keep intravenous line patent. His postoperative course was uneventful until the 10th postoperative day when marked ecchymosis developed on his eyelid. Laboratory data showed marked thrombocytopenia (1.3 x 10(4)/microliters) and disseminated intravascular coagulation. The diagnosis of heparin-induced thrombocytopenia (HIT) was confirmed by platelet aggregation test with heparin. Gabexate mesilate and platelet-concentrates were administered and platelet count returned to normal within a week. HIT usually occurs during administration of heparin. In this case, it occurred 5 days after we stopped heparin. Delayed onset of HIT might be related to delayed metabolism of heparin due to postoperative fluid shift.

Coronary Artery Bypass↗
PubMedDate not supplied

[Wunderlich disease. First manifestation of a renal adenocarcinoma].

We present a case of the classical Wünderlich syndrome or circumscribed extracapsular renal hematoma in a 54-year-old male patient who had consulted for an inguinal mass and hemiscrotal ecchymosis. The patient had referred an episode of intense pain in the left renal fossa and the clinical picture of syncope 3-4 days earlier. Surgery disclosed severe perirenal hemorrhage from an undiagnosed renal adenocarcinoma that had ruptured.

Adenocarcinoma↗
PubMed2005

Delayed recovery of radial nerve function after axillary block in a patient receiving ipsilateral ulnar nerve transposition surgery.

A 68-year-old female who underwent right ulnar nerve transposition surgery under axillary block (AB) by dual-technique (paresthesia and axillary artery penetration techniques) developed postoperative wristdrop. Physical examination showed local hematoma formation with ecchymosis at her right axillary region. Both ultrasonography and nerve conduction studies on her brachial plexus revealed neither direct hematoma compression, intraneural hematoma, nor peripheral neuropathy. Fortunately, she was completely restored to her right hand function 20 h after anesthesia, and was discharged without sequelae 17 days later. In this case, delayed recovery of radial nerve function after AB was suspected and the mechanism which led to this unusualness is discussed.

Aged↗
PubMed1992

[Long-term tolerance of inhaled corticosteroids].

The effect of inhaled steroids on adrenal glands of asthmatic subjects are often difficult to assess because subjects may have received oral steroids before. Moreover, even if the Synacthen test is abnormal, it does not necessarily mean that the adrenals are clinically inefficient. Adrenal insufficiency can certainly occur at high doses of inhaled steroids. Possible long term effects on bone are under study. Ecchymosis has been described. Oropharyngeal candidiasis is frequent but rarely symptomatic and responds well to treatment. Hoarseness is rare but troublesome. In children, inhaled steroids, even taken at low dose, can induce growth impairment. After cessation of inhaled steroids, adrenal insufficiency is only theoretical. Asthmatic flare-ups are more of a threat. Although inhaled steroids are of remarkable efficacy and tolerance, one should not exclude the possibility of long-term negative effects, especially in children.

Administration, Inhalation↗
PubMed2005

[A case of renal cell carcinoma associated with idiopathic thrombocytopenic purpura].

A 29-year-old woman was referred to another hospital with complaints of bruising and ecchymosis and thrombocytopenia (12,000/microl) was pointed out. After some examinations, the patient was diagnosed with idiopathic thrombocytopenic purpura and was started on steroid therapy. Then the patient consulted our hospital and computerized tomography revealed a left renal tumor 4 cm in diameter. Under the diagnosis of left renal neoplasm we performed left nephrectomy and splenectomy with preoperative high-dose intravenous gammaglobulin treatment. Pathological examination revealed clear cell carcinoma. After the operation, the platelet count increased gradually. We should consider bleeding tendency by thrombocytopenia and side effect of long-term steroid treatment when we perform operations on patients with idiopathic thrombocytopenic purpura.

Adenocarcinoma, Clear Cell↗
PubMed2005

Etiology and pattern of zygomatic complex fractures: a retrospective study.

PURPOSE: To document the etiology and clinical data of patients with fractures of the zygomatic complex seen in two university teaching hospitals in Nigeria and to compare the findings with other studies in the literature. PATIENTS AND METHODS: A six-year retrospective study involving 134 patients with zygomatic complex fractures. These patients were selected from a pool of 960 patients who sustained maxillofacial fractures during the period under review. Recorded were demographic, etiologic and clinical data as well as radiologic findings, treatment and postoperative complications. The Chi-squared test was used to test for significance and p values < 0.05 were regarded as significant. RESULTS: 76.1% were males and 23.9% females. Most (46.3%) patients were aged 21-30 years and road traffic accidents (82.1%) caused the most injuries (p < 0.05). Regarding the site of fracture, 88.8% of the patients had fractures of the zygomatic bone, 8.2% had fractures of the arch, and 3.0% had fractures of both the zygomatic bone and arch. The most frequently associated maxillofacial fracture was mandibular (21.0%). The commonest clinical feature was subconjunctival ecchymosis (63.4%), while the commonest radiologic findings were fractures at the zygomatico-frontal and zygomatico-maxillary sutures (38.8%). The Gillies approach (23.4%) was the commonest method of reduction. CONCLUSION: This study has shown that road traffic accidents are responsible for most zygomatic complex fractures in our environment. Urgent enforcement of road traffic legislation is therefore necessary to minimize zygomatic complex fractures due to road traffic accidents. It also showed a low utilization of technological advances in the imaging and treatment of these fractures. These may play a role in the frequency of postoperative complications.

Accidents, Traffic↗
PubMed1992

Complications of intracavernous injections and penile prostheses in spinal cord injured men.

Erectile dysfunction is a common complication in men who have had spinal cord injury (SCI). This retrospective study focuses on the complications encountered at our institution with both penile prostheses and intracavernous injections in men with SCI. Seventy-two men with SCI were treated with intracavernous injections for erectile dysfunction, and 30 penile prostheses were implanted in 19 men with SCI. Twenty-two of the 72 patients in the intracavernous injection program had adverse effects; none were severe. Prolonged erections lasting four to six hours and ecchymosis were the most common complications. No complication required discontinuation of treatment. There were 23 inflatable prostheses and seven semirigid rods. Mechanical failures occurred in 15 instances, infection occurred in nine, and late erosion occurred in three. Although multiple revisions and replacements were necessary, 14 of the 19 patients had satisfactorily functioning implants at their last outpatient visit. Patients were selected carefully for penile implant placement and yet significant complications and expense were incurred to obtain satisfactory results. Although follow-up has been relatively short, the intracavernous injections of vasoactive medications appear to be a more attractive initial means of treating the erectile dysfunction in men with SCI. The complications are relatively minor and the incidence of prolonged erections has decreased with increased experience. Furthermore, the cost of treatment will be considerably less than that with implant surgery, particularly in view of the high drop-out rate. Although improved implants have decreased the occurrences of mechanical failure, it seems likely that infection and extrusion will continue to be significant problems among men with SCI.

Adult↗
PubMedDate not supplied

[Day surgery management of varicocele with Doppler-assisted dissection at the external inguinal ring (subinguinal varicocelectomy)].

We performed a total of 172 varicocelectomies with the subinguinal technique in 151 patients. Of these, 129 patients (85%), undergoing a total of 140 varicocelectomies, were monitored for at least one year (11 had bilateral varicocele) with a mean follow-up of 3 years. Ninety-nine of these (77%) presented preoperative semen abnormalities and 62 (48%) had infertility problems. The diagnosis of varicocele was confirmed in all cases with a duplex ultrasound examination. The morbidity rate was low: 26 patients (20%) presented epididymal discomfort, and 9 patients (7%) ecchymosis in the wound site and/or scrotum, while in 5% (4 patients) of the 140 varicoceles operated on we observed a temporary reactive hydrocele; in 1 case (0.7%) the hydrocele persisted for one year postoperatively. One case (0.7%) presented persistence of varicocele. The following semen variables were evaluated before and after the operation: number of spermatozoa per ml, motility, percentage of morphologically normal spermatozoa. In 70% of patients (70 cases) with alterations of semen variables we observed a statistically significant postoperative improvement in these variables. The spontaneous pregnancy rate one year postoperatively, in those cases where the couple had fertility problems, was 35.5% (22 pregnancies). We believe that the technique using the subinguinal approach is a safe, simple procedure and therefore that it should be regarded as the gold standard in the management of varicocele, in that it allows the simultaneous ligature of the internal and external branches of the spermatic vein. This technique can be performed in the day-surgery setting with minimal invasiveness and at extremely low cost compared to other procedures. This technique is the procedure of choice not only in the treatment of varicocele but also, above all, in the treatment of varicocele recurrence or persistence.

Adolescent↗
PubMedDate not supplied

Zygomatic implants using the sinus slot technique: clinical report of a patient series.

PURPOSE: The management of 5 patients with extreme maxillary atrophy and treatment consisting of maxillary fixed prostheses supported by conventional implants and zygomatic fixations positioned according to the sinus slot technique is reported. MATERIALS AND METHODS: A total of 16 conventional implants were placed, together with 2 pterygoid implants and 10 zygomatic fixations. In 2 cases zygomatic fixation could not be performed on the alveolar ridge, thus requiring palatal displacement. One patient presented nasogenian ecchymosis. The fixed rehabilitations were either screwed or cemented after 5 to 6 months. RESULTS: Follow-up from implantation lasted 12 to 18 months, during which the prostheses and implants remained stable and in function. DISCUSSION: The placement of zygomatic fixations based on the sinus slot technique offers advantages over the conventional technique, though extreme atrophy of the alveolar processes does not allow fixation at the supracrestal level, and complications may develop. CONCLUSION: While zygomatic fixation is a valid alternative for treating the atrophic jaw, long-term studies are required to confirm its efficacy.

Adult↗
PubMed1992

[Hematopoietic failure of a healthy child with human parvovirus B19 infection--studies on the hematopoiesis].

An 8 year-old boy, who had been healthy since his birth, presented fever, ecchymosis and nasal bleeding. His peripheral blood picture showed pancytopenia and bone marrow showed erythroblastopenia, but these findings recovered spontaneously in two weeks. The diagnosis of human parvovirus B19 (HPVB19) infection was made by the presence of anti HPVB19 IgM antibodies in the sera. In order to investigate the mechanisms of erythroblastopenia and pancytopenia, we performed in vitro hematopoietic cell culture in both acute phase and the convalescent phase (3 months after the onset). In the acute phase, the formation of CFU-E colony was inhibited but that of BFU-E, CFU-G, GEMM colony was not inhibited. Unexpectedly, HPVB19 DNA was detected in CFU-GEMM colony cells with the PCR technique. It is suggested that HPVB19 infected not only to erythroid progenitor cells but also to other progenitors.

Cells, Cultured↗
PubMed1998

Contrast therapy does not cause fluctuations in human gastrocnemius intramuscular temperature.

OBJECTIVE: Contrast therapy has a long history of use in sports medicine. Edema and ecchymosis reduction, vasodilation and vasoconstriction of blood vessels, blood flow changes, and influences on the inflammatory response are physiologic effects attributed to the ability of this modality to evoke tissue temperature fluctuations. Our purpose was to measure the change in human gastrocnemius intramuscular tissue temperature during a typical contrast therapy treatment. DESIGN AND SETTING: A randomized-group design was used to examine differences between 2 groups of subjects following a 31-minute warm whirlpool (control) and a 31-minute contrast therapy (experimental) treatment. A hydrotherapy room in a small- college sports medicine facility served as the test environment. SUBJECTS: Twenty (7 females and 13 males) healthy college students (age = 20.9 +/- 1.2 years; ht = 178.5 +/- 11.1 cm; wt = 79.2 +/- 21.7 kg) volunteered to participate in this study. Subjects were randomly assigned to either a control or a treatment group. MEASUREMENTS: Intramuscular tissue temperatures in the gastrocnemius were recorded every 30 seconds. RESULTS: There was a significant difference in mean overall temperature change between the experimental group (0.85 degrees C +/- 0.60 degrees C) and the control group (2.10 degrees C +/- 1.50 degrees C). In addition, there were significant differences between the 2 groups at 10, 15, 16, 20, 21, 25, 26, 30, and 31 minutes. At each recording point, the control group temperature change was significantly higher than that of the experimental group. There was no difference in absolute temperatures at the 11-minute recording point between the groups. CONCLUSIONS: Contrast therapy did not lead to significant fluctuations in muscle tissue temperature at 4 cm below the skin's surface. Therefore, it seems unlikely that the physiologic effects attributed to these fluctuations occur. A 1-minute exposure to a cold whirlpool during a typical contrast treatment does not appear to be long enough to significantly decrease tissue temperature after exposure to the warm hydrotherapy environment.

Journal Article↗
PubMed2006

Purpura fulminans during meningococcal sepsis treated with Drotrecogin alpha. A clinical case.

A male patient, 29 years old, was admitted to our unit with purpura fulminans, coagulation deficiency, renal failure and subsequent septic shock accompanied by respiratory insufficiency in the absence of meningeal signs. The serum levels of endogenous protein C, ATIII and calcium were well below the norm. The bacteriological examination revealed the presence of gram-negative diplococci. The onset of adult respiratory distress syndrome (ARDS) revealed aa early complication of the meningococcal sepsis. Forty-eight hours after being admitted, the recombinant protein C infusion was started at a dose of 24 microg/kg/h for the duration of 96 h. The skin lesions regressed, starting from the ecchymosis and the edema of the face, trunk and auricular pavilions. A week after the onset of the symptomatology the chest X-ray appeared clear, the renal function had normalised, and the signs of shock had disappeared.

Adult↗
PubMedDate not supplied

[Inguinal hernioplasty with PHS: our experience].

Three hundred patients underwent inguinal hernia repair from January 2003 to December 2004; 40 patients, randomly selected, received the PHS (Prolene Hernia System) mesh. Surgery was performed under local anesthesia in 80% of cases and under spinal anesthesia in the remaining 20%. There were 29 men and 11 women; mean age was 58,5 years (range 39-78). Postoperative pain was light and morbidity was low; all patients had early return to normal activities. Particularly, there were differences between the self-employed and the employees: the former began work again 2-4 days after surgery in 85% of cases, while the latter began after 15-20 days. Immediate complications were rare and always minor: they included seroma (1%) and ecchymosis (1%). Follow-up examinations did not show any recurrences.

Adult↗
PubMed2006

Cortical blindness after motorcycle accident: a case report.

A 47 year-old Thai man presented with acute bilateral blindness after suffering head trauma in a motorcycle accident. No neurological deficit was found. The visual acuity was light perception with poor light projection on both eyes. Other ocular examinations were normal except ecchymosis on both lower eyelids and mild subconjunctival hemorrhage on the left eye. Emergency computerized tomography showed normal appearance of optic nerves, optic canals and multiple contusional intracerebral hemorrhages at both occipital lobes. This case demonstrated a rare condition of permanent cortical blindness without other neurological deficits resulting from a head trauma.

Accidents, Traffic↗
PubMed2006

A case of bilateral testicular calcifications in a bicycle motocross rider accompanied by bulbar urethral injury.

A 21-year-old Japanese man who was a professional bicycle motocross rider injured his perineum during a competition. Chief complaints were gross hematuria, perineal pain, and subcutaneous ecchymosis of the scrotum. Urethrocystography revealed a torn bulbar urethra and extravasation in the same region. Scrotal ultrasonography revealed small calcifications in the bilateral testes. Here, we report a case of bilateral testicular calcifications caused by the continuous shock and vibration of the saddle in an off-road bicycle rider.

Adult↗
PubMed2006

[Applying matching matrix, factor analysis and clustering analysis to investigation of characteristics of syndromes of phlegm and blood stasis in patients with coronary heart disease].

OBJECTIVE: To investigate the characteristics of syndromes of phlegm and blood stasis in patients with coronary heart disease by multiple statistical methods of matching matrix, factor analysis and clustering analysis, and to provide some references for classification and normalization of diagnosis of syndromes of phlegm and blood stasis of coronary heart disease. METHODS: The correlations among 46 kinds of symptoms in syndrome of non-phlegm and non-blood stasis, syndrome of blood stasis, syndrome of phlegm and syndrome of phlegm-blood stasis blocking in 200 patients with coronary heart disease were analyzed by matching matrix, factor analysis and clustering analysis. RESULTS: The manifestations of tongue and pulse in syndromes of phlegm and blood stasis were significantly different from those in syndrome of non-phlegm and non-blood stasis. The pathogenesis of viscera in syndromes of phlegm and blood stasis lied in the heart and kidney, and the syndrome of deficiency of heart qi was the most common one while the syndrome of deficiency of kidney qi took the secondary place. The syndrome of phlegm was often accompanied by syndrome of deficiency of spleen qi. Only 15 ones of 46 clinical symptoms showed high frequency in concomitant appearance in syndrome of blood stasis, syndrome of phlegm and syndrome of phlegm-blood stasis blocking. Apart from having the common symptoms in syndrome of deficiency in origin, the syndrome of phlegm especially showed white and greasy fur and slippery pulse as well as distention and fullness of chest and abdominal distension; the syndrome of blood stasis showed purplish tongue and ecchymosis on tongue as well as fixed pain; and the syndrome of phlegm-blood stasis blocking showed the main symptoms of both syndrome of phlegm and syndrome of blood stasis. CONCLUSION: The statistical methods of matching matrix, factor analysis and clustering analysis are convenient, and can definitely indicate the clinical characteristics and syndrome differentiation of viscera of different syndromes of phlegm and blood stasis, which are beneficial to further research of diagnosis and differentiation of such syndromes of coronary heart disease.

Cluster Analysis↗
PubMed2006

Spontaneous retropharyngeal hemorrhage causing airway obstruction: a case report with a review of the literature.

Spontaneous retropharyngeal hemorrhage, although uncommon, can be rapidly progressive and potentially life-threatening. Timely recognition and appropriate treatment are essential for a successful outcome. We report a case of retropharyngeal hemorrhage in an 81-year-old male with a history of arteriosclerotic disease who presented with cough, dysphagia, dyspnea, and cervical ecchymosis. Lateral plain films and computerized tomography (CT) revealed a diffuse soft tissue density distending the retropharyngeal space and adjacent fascial compartments but sparing the glottic and subglottic airway. Emergency tracheostomy was required to relieve progressive upper airway obstruction. The literature on spontaneous retropharyngeal hematoma is reviewed including clinical presentation, causative factors, and recommended treatment.

Aged, 80 and over↗
PubMedDate not supplied

Facial nerve paralysis following mandibular trauma: a case report.

A strong posteriorly directed force applied to the mandible resulting in fracture, can also displace the mandibular condyle towards the external auditory canal or superiorly against the mandibular fossa, causing its penetration into the middle cranial fossa or even the fracture of the temporal bone. We report the case of a 30-year-old male patient victim of a bicycle accident that developed facial expression muscles paralysis on the left side soon after the trauma. On physical examination he presented left side postauricular ecchymosis, diminished muscular tonus of the left mouth angle and difficulty to close the left eye, he did not present clinical signs of facial fractures. The neurological and CT scan examination revealed fracture of the left temporal bone with total facial expression muscles paralysis. The patient was referred to the neurosurgical team for evaluation and they opted for a conservative treatment. After 3 months the patient showed a marked improvement with almost normal facial expression muscle movements. The trauma dynamics and treatment details are discussed.

Adult↗