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Sample records for case successfully treated

  1. Synchronous dual malignancy: Successfully treated cases

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    Agrawal Rashi

    2007-01-01

    Full Text Available The occurrence of a second malignancy in a patient with a known malignant tumour is not uncommon. Synchronous primary malignancies are still unusual We are presenting two cases treated successfully at our centre. Case report 1-A 70 year old female presented to us with lump in right breast for two years and bleeding per vaginum for two years.Histopathology of cervix showed squamous cell carcinoma (large cell non keratinizing and clinical stage was IIIB. HPE mastectomy specimen showed infiltrating duct carcinoma and stage II. Patient was treated with external beam radiotherapy for carcinoma cervix and breast simultaneously and chemotherapy as required. Patient is on regular follow up and clinically no evidence of disease. Case Report 2 -A 40 year old female presented with mild headache off and on for one year, projectile vomiting for three months and right side facial swelling for three months. HPE brain tissue showed astrocytoma grade II and HPE parotid tumour showed low grade muco-epidermoid carcinoma. Patient was treated with surgery first then radiotherapy. Patient is in regular follow up,having no complain,clinically no neurological dysfunction and no evidence of disease at right parotid and neck region. Thus it was concluded that patients responded well to treatment. Treatment strategies in case of synchronous double malignancy depend on treating the malignancy that is more advanced first or sometimes both could be treated simultaneously. In our case we concluded that synchronous double malignancy may be treated successfully. Both sites should be treated fully as if they were occurring separately considering toxicities.

  2. A Case of Successfully Treated Rhinocerebral Mucormycosis: Dental Implications

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    Nikolaos Papadogeorgakis

    2010-01-01

    Full Text Available This paper presents a case of rhinocerebral mucormycosis in a 22-year-old female patient with type I diabetes mellitus, who was successfully treated with surgery and long-term antifungal medication. The patient had initially been submitted to extraction of an upper third molar by a general dental practitioner but was referred to our department three days postoperatively because of double vision. Immediately following histopathological confirmation of the infection, the patient was administered Amphotericin B and Posaconazole intravenously. Surgical excision of the affected site was relatively conservative. The patient was free of the disease 15 months after initial admission to the hospital and has recently returned for reconstruction. The aim of this paper is to increase the awareness of general dental practitioners regarding uncommon serious conditions in diabetic patients, which may be confused with periodontal or dental diseases.

  3. Factors predicting recurrence in successfully treated cases of anisometropic amblyopia

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    Rohit Saxena

    2013-01-01

    Full Text Available Context: Recurrence after successful treatment of amblyopia is known and understanding the risk factors could help effective management. Aim: To measure incidence of recurrence in successfully treated cases of anisometropic amblyopia and evaluate factors predicting it. Settings and Design: Cohort Study at a tertiary level institution. Materials and Methods: Successfully treated anisometropic amblyopes aged 4−12 years were followed up for 1 year after stopping therapy. Best corrected visual acuity (BCVA, refractive error, stereoacuity and contrast sensitivity were evaluated at baseline and follow-up. Statistical Analysis: Intergroup analysis with appropriate tests: Chi-square test, Fisher′s exact test, Wilcoxon rank sum test and paired t-test. Results: One hundred and two patients with mean age at diagnosis 7.06 μ 1.81 years were followed-up for a mean duration of 1.0 μ 0.2 years. The mean pre-treatment BCVA (LogMAR score at diagnosis was 0.73 μ 0.36 units which improved to 0.20 μ 0.00 with treatment and after 1 year of stopping treatment was 0.22 μ 0.07. Thirteen (12.74% patients showed amblyopia recurrence during follow-up. Risk of recurrence was higher with older age of onset of treatment (6.64 μ 1.77 years without recurrence v/s 8.53 μ 1.39 years with recurrence, P = 0.0014. Greater extent of improvement of VA (P = 0.048 and final VA at stopping occlusion (P = 0.03 were associated with higher recurrence. Binocularity status or stereoacuity changes were not associated with risk of recurrence. Conclusions: Significant numbers of children suffer recurrence of amblyopia after stopping therapy. Older age, better BCVA after stopping therapy and greater magnitude of improvement in BCVA are important risk factors for recurrence. Careful follow-up is essential for early detection and management of recurrence.

  4. Nail psoriasis successfully treated with intralesional methotrexate: case report.

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    Sarıcaoglu, Hayriye; Oz, Arife; Turan, Hakan

    2011-02-01

    Psoriasis is a common, chronic disease which affects nearly 3% of the population. The lifetime incidence of nail involvement increases up to 80-90% for psoriatic patients. Nail psoriasis is considered a significant social problem. Many topical agents have been used for psoriatic nails with various side effects and some benefits; management is currently inconclusive. Methotrexate (MTX) is a folic acid analog, which irreversibly binds to dehydrofolate reductase and blocks deoxyribonucleic acid synthesis. It is considered a potential treatment option for rapidly growing cells and has an anti-inflammatory effect through inhibition of the polyamine pathway in autoimmune diseases. Intralesional MTX has been used successfully for various indications. We present a case successfully treated with low-dose intralesional MTX with no observed side effects in a 26-year-old female psoriatic patient suffering from nail dystrophy. In contrast, conventional topical and systemic therapies have various side effects, which limit their use. We conclude that intralesional MTX injection seems to be a safe and effective treatment option for nail psoriasis; however, large controlled studies are needed.

  5. A SUCCESSFULLY TREATED CASE OF MOYA MOYA DISEASE

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    Yashodhara

    2015-01-01

    Full Text Available Moyamoya disease is a rare cerebrovascular disease characterized by progressive occlusive cerebral arteritis affecting the distal internal carotid arteries near the circle of Willis. A collateral circulation develops around the blocked vessels which appear as a "pu ff of smoke". Incidence is variable depending on the geographical location. The clinical features of Moyamoya disease are recurrent transient ischemic attacks (TIAs, strokes, sensorimotor paralysis, convulsions and/or migraine - like headaches. Magnetic resonance imaging (MRI and MR Angiogram (MRA should be performed for the diagnosis and follow - up of Moyamoya disease. Neurosurgical proceures like Encephalo myo synangiosis (EMS, multiple burr holes and some direct procedures are useful to reestablish new circulation after a few weeks. The long term outlook for patients with treated Moyamoya seems to be good. Once major stroke or bleeding take place, even with treatment, the patient may be left with permanent loss of function . So it is very important to treat this condition promptly. Herewith, we are reporting a 15 month old child with history of right focal adversive seizures, 3 - 4 events a month followed by post ictal drowsiness. Imaging studies revealed a vascular insult with infarct in the left fronto parietal lobes as well as multiple infarcts in other regions of the brain. MR Angio Brain revealed Moya moya disease. Child was successfully managed by prompt referral to Neurosurgical C entre where he underwent EMS and he is under their follow up.

  6. [A recurrent case of adult favus successfully treated with terbinafine].

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    Erkan, Deniz; Kolukırık, İlkay; Acar, Alpaslan; Kandemir, Hazal; İlkit, Macit

    2015-10-01

    Favus or tinea capitis favosa, is a chronic inflammatory dermatophytosis of the scalp. The disease is particularly common in children aged 6 to 10 years, more often in boys, and it also occurs in adults. Human-to-human transmission is therefore possible. Anthropophilic Trichophyton schöenleinii is responsible for over 95% of favus cases. In addition, there are rare cases of anthropophilic T.violaceum, zoophilic (T.verrucosum, T.quinckeanum, and Microsporum canis) and geophilic M.gypseum species recorded as agents of favus. It is also reported in mice (T.quinckeanum), poultry (M.gallinae), and cats (M.incurvatum). Favus is common in Iran, Nigeria, and China, however it has been reported rarely in the last two decades in Turkey. Although Turkish records are not sufficient to indicate an accurate incidence rate, favus is still present in Turkey. In this report, a 20-year-old female with favus was presented. She had squames and areas of alopecia on the right frontoparietal area of her scalp. Scalp biopsy and hair follicle samples were taken for histopathological examination and fungal culture. According to the conventional identification by mycological methods and internal transcribed spacer (ITS) sequencing analysis, the pathogen was identified as T.schöenleinii. The patient was treated with oral terbinafine (250 mg/day) for 4 weeks and topical isoconazole and ketoconazole for 6 weeks. Clinical recovery was observed after 6 weeks, however, fungal culture could not be repeated. Six months after the initial presentation, the patient's symptoms recurred due to the poor adherence and T.schöenleinii was repeatedly grown in culture. Antifungal treatment was administered with the same drugs for the same period. There was a clinical and mycological recovery 8 months after initial presentation. Favus, which is not frequently observed in adults, is an uncommon disease. Confusion arises in its diagnosis because other diseases have similar clinical appearances, and

  7. Recurrent impetigo herpetiformis successfully treated with methotrexate: a case report.

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    Luewan, Suchaya; Sirichotiyakul, Supatra; Tongsong, Theera

    2011-06-01

    Impetigo herpetiformis is a rare disease and its occurrence is specific for pregnancy. The lesions are characterized by sterile, pustular eruptions. The disorder is usually seen in the third trimester, but cases of impetigo herpetiformis appearing in the first trimester have also been reported. The lesions are expected to disappear after birth, but the disorder may recur during subsequent pregnancies. In this case report we discuss a 28-year-old pregnant woman, G3P1011, with a history of impetigo herpetiformis in the first pregnancy, who presented with generalized pustular lesions at 30 weeks' gestation. Her disease responded poorly to corticosteroids and was more severe than in the previous pregnancy. She delivered prematurely at 34 weeks' gestation and then received aggressive postpartum treatment with methotrexate, resulting in a dramatic response. This case supports the current understanding that recurrent impetigo herpetiformis in subsequent pregnancy tends to be more severe and to have an earlier onset. Additionally, it provides additional evidence that methotrexate may be used as an alternative treatment for impetigo herpetiformis in the case of a poor response to corticosteroids.

  8. A case of ocular toxocariasis successfully treated with albendazole and triamcinolon.

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    Seong, San; Moon, Daruchi; Lee, Dong Kyu; Kim, Hyung Eun; Oh, Hyun Sup; Kim, Soon Hyun; Kwon, Oh Woong; You, Yong Sung

    2014-10-01

    We present a case of ocular toxocariasis treated successfully with oral albendazole in combination with steroids. A 26-year-old male visited the authors' clinic with the chief complaint of flying flies in his right eye. The fundus photograph showed a whitish epiretinal scar, and the fluorescein angiography revealed a hypofluorescein lesion of the scar and late leakage at the margin. An elevated retinal surface and posterior acoustic shadowing of the scar were observed in the optical coherence tomography, and Toxocara IgG was positive. The patient was diagnosed with toxocariasis, and the condition was treated with albendazole (400 mg twice a day) for a month and oral triamcinolone (16 mg for 2 weeks, once a day, and then 8 mg for 1 week, once a day) from day 13 of the albendazole treatment. The lesions decreased after the treatment. Based on this study, oral albendazole combined with steroids can be a simple and effective regimen for treating ocular toxocariasis.

  9. [A case of MRSA infection in multiple artificial joints successfully treated with conservative medical treatment].

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    Nemoto, Takaaki; Yamasaki, Yukitaka; Torikai, Keito; Ishii, Osamu; Fujitani, Shigeki; Matsuda, Takahide

    2012-07-01

    We report herein on a case with multiple MRSA prosthetic arthritis and osteomyelitis successfully treated medically. Our patient was a 64-year-old Japanese woman with a previous medical history of malignant rheumatoid arthritis and multiple surgical interventions with an atlantoaxial fixation in 2003, artificial joint replacement of both knee joints in 2006, and of the right hip joint in September, 2007. She was initially hospitalized due to MRSA arthritis in the right hip in October, 2007. Thereafter, multiple joint infections occurred sequentially in the right knee joint in January 2008 and the left hip joint in June 2008. More recently, the patient was re-admitted in January 2009 due to cervical osteomyelitis with MRSA infection. The patient had been treated with a combination of vancomycin and rifampin for 17 weeks and followed by sulfamethoxazole/trimetoprim in the out-patient setting up to the present. Although the complete resolution of multiple deep MRSA infections with prosthetic arthritis and osteomyelitis is not expected without removing the infectious sources, our patient was successfully treated with chronic antibiotic suppressive therapy. Therefore, we report on our case with a literature review.

  10. Congenital peripheral primitive neuroectodermal tumor: A case treated successfully with multimodality treatment

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    Shikha Goyal

    2014-12-01

    Full Text Available Neonatal tumors comprise less than two percent of childhood malignancies. Most are solid tumors, most common histologies being teratoma and neuroblastoma. We encountered a child who was detected to have a right arm mass on antenatal sonogram, which was diagnosed to be a primitive neuroectodermal tumor involving the triceps on fine needle aspiration cytology performed in the post-natal period. The child was successfully treated with multimodality treatment consisting of surgery, chemotherapy and radiotherapy. We also discuss briefly the problems associated with therapy in neonatal period. A review of all cases reported to have congenital Ewing’s sarcoma family of tumors is presented. Novel therapies are needed to improve efficacy and decrease the devastating side effects of treatment in this age group.

  11. Congenital peripheral primitive neuroectodermal tumor: a case treated successfully with multimodality treatment.

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    Goyal, Shikha; Biswas, Ahitagni; Gupta, Ruchika; Mohanti, Bidhu Kalyan

    2014-12-01

    Neonatal tumors comprise less than two percent of childhood malignancies. Most are solid tumors, most common histologies being teratoma and neuroblastoma. We encountered a child who was detected to have a right arm mass on antenatal sonogram, which was diagnosed to be a primitive neuroectodermal tumor involving the triceps on fine needle aspiration cytology performed in the post-natal period. The child was successfully treated with multimodality treatment consisting of surgery, chemotherapy and radiotherapy. We also discuss briefly the problems associated with therapy in neonatal period. A review of all cases reported to have congenital Ewing's sarcoma family of tumors is presented. Novel therapies are needed to improve efficacy and decrease the devastating side effects of treatment in this age group.

  12. [A case of pancreatic and duodenal fistula after total gastrectomy successfully treated with coagulation factor XIII].

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    Nishino, Hitoe; Kojima, Kazuhiro; Oshima, Hirokazu; Nakagawa, Koji; Fumura, Masao; Kikuchi, Norio

    2013-11-01

    Pancreatic fistula( PF) is a challenging postoperative complication. We report a case of PF following gastrectomy successfully treated using intravenous coagulation factor XIII( FXIII).A 78-year-old man with early gastric cancer underwent total gastrectomy with Roux-en-Y reconstruction. PF developed postoperatively, following which, leakage from the duodenal stump was observed. Percutaneous drainage and re-operative surgery were performed. A somatostatin analogue, antibiotic drugs, and gabexate mesilate were administrated along with nutritional support. The pancreatic and duodenal fistula had been producing duodenal juice for over 30 days since the re-operative surgery. As suspected, reduced FXIII activity was confirmed in the patient. After administering FXIII for 5 days, the amount of duodenal juice from the fistula markedly reduced, and the fistula closed immediately afterwards. The results of our study suggest that administration of FXIII could be a reasonable and effective treatment for patients with pancreatic or/and enterocutaneous fistula who are resistant to standard treatments.

  13. A rare case of adult-onset nesidioblastosis treated successfully with diazoxide.

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    Arao, Tadashi; Okada, Yosuke; Hirose, Akiko; Tanaka, Yoshiya

    2006-02-01

    A 54-year-old man was admitted to our hospital for evaluation of hypoglycemia. He had frequent episodes of loss of concentration before dinner. The ratio of IRI to plasma glucose (PG) was 0.8-1.0. Abdominal CT revealed no pancreatic tumor, and angiography of splenic artery showed no definite tumor stain within the pancreas. Based on the results of selective arterial calcium stimulation and hepatic venous sampling (ASVS), the provisional diagnosis was a small insulinoma in the pancreatic body. The patient underwent subtotal distal pancreatectomy. However, histopathological and immunohistochemical examinations of the resected tissue showed hypertrophy of islets of Langerhans islands and beta cells around pancreatic ducts. The final diagnosis was adult-onset nesidioblastosis. Postoperatively, the patient continued to exhibit hyperinsulinemia and nighttime hypoglycemia. Octreotide, voglibose and diet therapies failed to improve the nocturnal hypoglycemia. However, treatment with diazoxide at a starting dose of 200 mg/day resulted in immediate amelioration of nocturnal hypoglycemia. This is the first Japanese adult case of nesidioblastosis treated successfully with diazoxide. This case report suggests that diazoxide may be effective for adult-onset nesidioblastosis in a manner similar to that described for pediatric cases.

  14. Two cases of kidney transplantation-associated thrombotic microangiopathy successfully treated with eculizumab.

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    Ikeda, Takashi; Okumi, Masayoshi; Unagami, Kohei; Kanzawa, Taichi; Sawada, Anri; Kawanishi, Kunio; Omoto, Kazuya; Ishida, Hideki; Tanabe, Kazunari

    2016-07-01

    Transplantation-associated thrombotic microangiopathy (TA-TMA) is relatively rare and requires immediate intervention to avoid irreversible organ damage or death; however, consensus regarding the treatment approach is lacking. Atypical haemolytic uraemic syndrome (aHUS) is a rare disease caused by dysregulation of the alternative complement pathway resulting in TMA. aHUS is histologically similar to TA-TMA; approximately 60% of TA-TMA patients have complement dysregulation. Eculizumab, a humanized anti-C5 monoclonal antibody, inhibits terminal membrane-attack complex formation and TMA progression. Eculizumab has been successfully used to treat aHUS post-transplant. We present two cases of kidney TA-TMA due to unknown causes, suspected antibody-mediated rejection, or calcineurin inhibitor (CNI)-related toxicity that developed on day 1 or 2 post-kidney transplantation. Low platelet count and haemoglobin level with red cell fragments were detected. Despite steroid pulse, plasma exchange (PE), and intravenous immunoglobulin therapy, TA-TMA did not improve; therefore, eculizumab was administered despite no genetic testing. Laboratory data, including renal function, improved immediately. TA-TMA treatment primarily involves PE initiation or CNI discontinuation; eculizumab can be used to safely treat TA-TMA and then be ceased in the short term. Therefore, eculizumab administration might be beneficial for kidney TA-TMA as early as the diagnosis of refractory to PE.

  15. A successfully treated case of severe periodontitis using interdisciplinary approach: Report of a case

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    Mahajan Ajay

    2016-01-01

    Full Text Available Treatment options for severely misaligned teeth with advanced bone loss are limited. We report the management of a case of advanced periodontitis in a labially placed extruded maxillary canine. A 24 years old male reported to the periodontal clinic to preserve his mobile and misaligned upper left lateral incisor. Clinical and radiographic examination revealed advanced attachment loss with bone resorption around the affected tooth. The decision was taken to reconstruct the lost periodontal tissues in coordination with orthodontic intervention to align the tooth in a functionally esthetic position. At the end of the combined periodontal and orthodontic treatment, the tooth was preserved and was well-aligned in the arch; the patient was satisfied with the treatment outcome. It can be concluded that severely misaligned teeth with advanced bone loss can be salvaged with a combined and meticulously planned Periodontal Orthodontic treatment approach.

  16. A successfully treated case of severe periodontitis using interdisciplinary approach: Report of a case

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    Ajay, Mahajan; Negi, Kehar Singh; Saroj, Thakur; Kanwarjeet, Asi Singh

    2016-01-01

    Treatment options for severely misaligned teeth with advanced bone loss are limited. We report the management of a case of advanced periodontitis in a labially placed extruded maxillary canine. A 24 years old male reported to the periodontal clinic to preserve his mobile and misaligned upper left lateral incisor. Clinical and radiographic examination revealed advanced attachment loss with bone resorption around the affected tooth. The decision was taken to reconstruct the lost periodontal tissues in coordination with orthodontic intervention to align the tooth in a functionally esthetic position. At the end of the combined periodontal and orthodontic treatment, the tooth was preserved and was well-aligned in the arch; the patient was satisfied with the treatment outcome. It can be concluded that severely misaligned teeth with advanced bone loss can be salvaged with a combined and meticulously planned Periodontal Orthodontic treatment approach. PMID:27041848

  17. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

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    Watanabe, Kae; Rajderkar, Dhanashree A.; Modica, Renee F.

    2016-01-01

    Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors' knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition. PMID:27018080

  18. A Case of Polyarteritis Nodosa Associated with Vertebral Artery Vasculitis Treated Successfully with Tocilizumab and Cyclophosphamide

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    Kae Watanabe

    2016-01-01

    Full Text Available Pediatric polyarteritis nodosa is rare systemic necrotizing arteritis involving small- and medium-sized muscular arteries characterized by aneurysmal dilatations involving the vessel wall. Aneurysms associated with polyarteritis nodosa are common in visceral arteries; however intracranial aneurysms have also been reported and can be associated with central nervous system symptoms, significant morbidity, and mortality. To our knowledge extracranial involvement of the vertebral arteries has not been reported but has the potential to be deleterious due to fact that they supply the central nervous system vasculature. We present a case of a 3-year-old Haitian boy with polyarteritis nodosa that presented with extracranial vessel involvement of his vertebral arteries. After thorough diagnostic imaging, including a bone scan, ultrasound, Magnetic Resonance Imaging/Angiography, and Computed Tomography Angiography, he was noted to have vertebral artery vasculitis, periostitis, subacute epididymoorchitis, arthritis, and myositis. He met diagnostic criteria for polyarteritis nodosa and was treated with cyclophosphamide, methylprednisolone, and tocilizumab, which resulted in improvement of his inflammatory markers, radiographic findings, and physical symptoms after treatment. To the authors’ knowledge, this is the first report of vertebral artery vasculitis in polyarteritis nodosa as well as successful treatment of the condition using the combination cyclophosphamide and tocilizumab for this condition.

  19. A case of advanced intrahepatic cholangiocarcinoma successfully treated with chemosensitivity test-guided systemic chemotherapy

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    Kazumichi Abe; Takeru Wakatsuki; Fumiko Katsushima; Kyoko Monoe; Yukiko Kanno; Atsushi Takahashi; Junko Yokokawa; Hiromasa Ohira

    2009-01-01

    Intrahepatic cholangiocarcinoma (ICC) is a relatively rare and highly fatal neoplasm that arises from the biliary epithelium. Prognosis is generally poor and survival is limited to a few months. Here we present a case of advanced ICC successfully treated by chemosensitivity test-guided systemic chemotherapy combining S-1 and cisplatin (CDDP). A 65-year-old woman with a liver tumor was referred to our hospital on November 21, 2007. Abdominal ultrasonography and computed tomography (CT) showed low-density masses of 50 and 15 mm in diameter, respectively in segment Ⅷ of the liver and in the enlarged lymph node in the para-aorta. Ultrasonography-guided fine needle biopsy diagnosed the tumors as ICC. Since the patient was inoperable for lymph node metastasis, she underwent systemic chemotherapy with gemcitabine. Six months after initiation of chemotherapy, CT revealed ICC progression in the liver and pleural dissemination with pleural effusion. The patient was admitted to our hospital for anticancer drug sensitivity testing on June 9, 2008. Based on the sensitivity test results, we elected to administer systemic chemotherapy combining S-1 and CDDP. Two months into the second chemotherapy treatment, CT revealed a reduction of the tumors in the liver and lymph node and a decrease in pleural effusion.After eight cycles of the second chemotherapy, 17 mo after ICC diagnosis, she is alive and well with no sign of recurrence. We conclude that chemosensitivity testing may effectively determine the appropriate chemotherapy regimen for advanced ICC.

  20. Four cases of dysthymic disorder and general malaise successfully treated with traditional herbal (kampo) medicines: kamiuntanto.

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    Kogure, Toshiaki; Tatsumi, Takeshi; Oku, Yuko

    2010-01-01

    Traditional herbal (Kampo) medicines have been used since ancient times to treat patients with mental disorders. In the present report, we describe four patients with dysthymia successfully treated with Kampo medicines: Kamiuntanto (KUT). These four patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dysthymic disorder with easy fatigability and sleeplessness, but did not fulfill the criteria for major depressive disorder. Treatment with KUT relieved depressive status, fatigue and sleeplessness in these patients. As a result, their QOL (quality of life) was considerably improved. KUT may be useful as an additional or alternative treatment for dysthymia, especially in the field of primary health care.

  1. Four Cases of Dysthymic Disorder and General Malaise Successfully Treated with Traditional Herbal (Kampo Medicines: Kamiuntanto

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    Toshiaki Kogure

    2010-05-01

    Full Text Available Traditional herbal (Kampo medicines have been used since ancient times to treat patients with mental disorders. In the present report, we describe four patients with dysthymia successfully treated with Kampo medicines: Kamiuntanto (KUT. These four patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV criteria for dysthymic disorder with easy fatigability and sleeplessness, but did not fulfill the criteria for major depressive disorder. Treatment with KUT relieved depressive status, fatigue and sleeplessness in these patients. As a result, their QOL (quality of life was considerably improved. KUT may be useful as an additional or alternative treatment for dysthymia, especially in the field of primary health care.

  2. Primary squamous cell carcinoma of the liver: A successful surgically treated case

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    Hsiang-Lin Lee; Yu-Yin Liu; Chun-Nan Yeh; Kun-Chun Chiang; Tse-Ching Chen; Yi-Yin Jan

    2006-01-01

    Primary squamous cell carcinoma (SCC) of the liver is rare. Totally nine such cases have been reported in the literature. Primary SCC of the liver has been reported to be associated with hepatic teratoma,hepatic cyst, or hepatolithiasis. Complete remission of poorly differentiated SCC of the liver could be achieved by systemic chemotherapy followed by surgery or remarkably respond to hepatic arterial injection of low dose chemotherapeutic drugs. Here we report the first case of primary SCC of the liver presenting as a solid tumor and receiving successful hepatic resection with 9-mo disease free survival.

  3. Ruptured Left Gastric Artery Aneurysm Successfully Treated by Thrombin Injection: Case Report and Literature Review

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    S. Chandran

    2005-01-01

    Full Text Available This short report describes the successful use of a new minimally invasive technique for the treatment of acute gastric artery aneurysm rupture. It emphasises the importance of persistence and multiple imaging modalities in the presence of gastrointestinal bleeding. The photographs and case history clearly illustrate the nonoperative management and highlight learning points for experienced surgeons and trainees alike in the management of this potentially fatal condition.

  4. Tentorial dural arteriovenous fistula successfully treated with surgical interruption of leptomeningeal venous drainage:a case report

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    LI Mei-hua; XU Geng-sheng; LI Yi-yun

    2005-01-01

    @@ Tentorial dural arteriovenous fistula (DAVF) is a rare disease, accounting for some 4% of all cases of intracranial DAVF.1 Because of a high risk of intracranial hemorrhage, patients with DAVF need aggressive treatment. Despite recent advances in endovascular technology, many researchers2-4 advocate open surgery for the treatment of tentorial DAVF. In this report, we present a case of tentorial DAVF with pure leptomeningeal venous drainage successfully treated by interruption of the draining vein.

  5. A Case Report of Successfully Treated Microsporidial Keratitis at a Tertiary Care Centre in Western India

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    Jagruti Jadeja

    2016-06-01

    Full Text Available A 43 year old male patient, who was initially diagnosed with chronic viral stromal keratitis but was refractory to conventional treatment, underwent a corneal biopsy on the basis of strong clinical suspicion. The biopsy revealed the presence of multiple microsporidial spores. Treatment with Polyhexamethylene Biguanide (PHMB and Chlorhexidine showed poor response. A therapeutic penetrating keratoplasty under the cover of Fluoroquinolones led to successful resolution of the infection. To our knowledge, this is the first case of microsporidial keratitis being reported from our region.

  6. [A successfully treated case of cerebrospinal fluid fistula caused by fracture of the sella turcica].

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    Kuge, Atsushi; Kinjo, Toshihiko; Kayama, Takamasa

    2003-05-01

    Fracture of the sella turcica is rare and is associated with many complications. We successfully treated a cerebrospinal fluid fistula caused by a fracture of the sella turcica. A 66-year-old male in a motor vehicle accident was admitted to an outside hospital with disturbance of consciousness. A computed tomography (CT) scan of the head revealed a subarachnoid hemorrhage and pneumocephalus. Cerebrospinal fluid rhinorrhea developed after admission. Repair of the fistula was attempted without success, and the patient was transferred to our hospital for further examination and treatment. A fracture of the sella turcica was clearly visualized on coronal and sagittal head CT and on a three-dimensional reconstructed CT (3D-CT) image. The source of the CSF fistula was thought to be the anterior wall of the sella turcica. Through a bifrontal interhemispheric approach, the cerebrospinal fluid fistula was repaired microscopically with the assistance of endoscopy. Postoperatively, the fistula stopped completely. Coronal and sagittal head CT and 3D-CT images are useful for making a diagnosis of CSF leakage. Endoscopic images can assist in observation of the dead angle of the microscope.

  7. Synchronous lung and gastric cancers successfully treated with carboplatin and pemetrexed: a case report

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    Sato Takashi

    2012-08-01

    Full Text Available Abstract Introduction Lung and gastric cancers are the first and second leading causes of death from cancer worldwide, and are especially prevalent in Eastern Asia. Relatively few reports are available in relation to the treatment and outcome of synchronous lung and gastric cancers, although there are increasing numbers of patients with these cancers. Efforts to develop more effective drugs for the treatment of synchronous cancers, without serious adverse effects, have been intensifying. Pemetrexed, a multi-targeted antifolate enzyme inhibitor, was approved by the United States Food and Drug Administration as a first-line chemotherapy for advanced non-squamous non-small cell lung cancer in 2007. Although clinical activity against several tumor types of adenocarcinoma, including gastric cancer, has been demonstrated, the efficacy of pemetrexed for gastric cancer remains to be fully evaluated. Case presentation We report a case involving a 62-year-old Japanese woman with synchronous locally-advanced poorly-differentiated lung adenocarcinoma and poorly-differentiated gastric adenocarcinoma, containing signet-ring cells distinguished by immunohistochemical profiles. She had been treated with carboplatin and pemetrexed as a first-line chemotherapy for lung cancer, and had achieved partial responses for both lung and gastric cancers. These responses led to a favorable 12-month progression-free survival after the initiation of chemotherapy, and the patient is still alive more than 33 months after diagnosis. Conclusions This case suggests a new chemotherapeutic regimen for patients with synchronous multiple primary cancers that have an adenocarcinoma background.

  8. Behavioural and psychological symptoms of dementia in an Alzheimer's disease case successfully treated with natural medicine: association with gonadotropins.

    Science.gov (United States)

    Niitsu, Tomihisa; Okamoto, Hideki; Iyo, Masaomi

    2013-06-01

    Pharmacotherapies for the behavioural and psychological symptoms of dementia are limited; novel agents for the symptoms are still needed. Herein, we report the case of an 80-year-old male patient with Alzheimer's disease whose severe agitation, insomnia and sexual delusions were successfully treated with a traditional natural Japanese (Kampo) medicine, keishi-ka-ryukotsu-borei-to. We found that administrating keishi-ka-ryukotsu-borei-to increased his serum luteinizing hormone level, which could be inversely associated with his behavioural and psychological symptoms. This report suggests that keishi-ka-ryukotsu-borei-to is a possible alternative treatment for the behavioural and psychological symptoms of dementia, especially sexual delusions.

  9. Ulcerative necrobiosis lipoidica successfully treated with photodynamic therapy: case report and literature review.

    Science.gov (United States)

    Borgia, Francesco; Vaccaro, Mario; Cantavenera, Laura G; Aragona, Emanuela; Cannavò, Serafinella P

    2014-12-01

    Ulcerative necrobiosis lipoidica (NL) is a rare skin condition refractory to conventional therapies. We treated a forty-four year old woman affected by widespread ulcerative NL with 6 sessions of topical ALA-PDT at two weeks intervals. At the end of the treatment a dramatic improvement of the clinical features was observed, with complete healing of cutaneous ulcers and marked reduction of erythema in all the treated areas. The mechanism of action of PDT in ulcer healing is still unknown; however, it is possible to hypothesize a combination of anti-inflammatory effect, immunomodulatory activity and keratinocytes photoactivation.

  10. A case of organic brain syndrome following head injury successfully treated with carbamazepine.

    Science.gov (United States)

    Bouvy, P F; van de Wetering, B J; Meerwaldt, J D; Bruijn, J B

    1988-03-01

    A case of organic brain syndrome occurring in relation to psychological stress 2 years after a severe head injury is described. Treatment with haloperidol resulted only in slight improvement. A dramatic improvement was achieved with carbamazepine.

  11. Ranula successfully treated by botulinum toxin type A: report of 3 cases.

    Science.gov (United States)

    Chow, Tam-Lin; Chan, Sharon W W; Lam, Siu-Ho

    2008-01-01

    The conventional treatment of ranula is surgical procedure. We report an innovative method for ranula by using botulinum toxin type A on 3 patients. All 3 cases of ranula resolved after this minimally invasive therapy. The treatment complication was minimal.

  12. Case report: allergic bronchopulmonary aspergillosis and allergic fungal sinusitis successfully treated with voriconazole.

    Science.gov (United States)

    Erwin, Gary E; Fitzgerald, John E

    2007-12-01

    Allergic bronchopulmonary aspergillosis and allergic fungal sinusitis are closely related disorders that rarely present in the same individual. The mainstay of treatment for allergic bronchopulmonary aspergillosis is systemic corticosteroids. Itraconazole is used as adjunctive therapy in refractory cases. Allergic fungal sinusitis requires initial sinus surgery followed by systemic steroids. Antifungal therapy has not proven to be beneficial in allergic fungal sinusitis. We report a case of concomitant allergic bronchopulmonary aspergillosis and allergic fungal sinusitis that was refractory to standard therapy but had dramatic clinical response following treatment with voriconazole.

  13. A case of pneumonia caused by Legionella pneumophila serogroup 12 and treated successfully with imipenem.

    Science.gov (United States)

    Nishizuka, Midori; Suzuki, Hiroki; Ara, Tomoka; Watanabe, Mari; Morita, Mami; Sato, Chisa; Tsuchida, Fumihiro; Seto, Junji; Amemura-Maekawa, Junko; Kura, Fumiaki; Takeda, Hiroaki

    2014-06-01

    The patient was an 83-year-old man hospitalized for Haemophilus influenzae pneumonia, who developed recurrent pneumonia after improvement of the initial episode. Legionella pneumophila serogroup 12 was isolated from the sputum, accompanied by increased serum antibody titers to L. pneumophila serogroup 12. Therefore, the patient was diagnosed as having Legionella pneumonia caused by L. pneumophila serogroup 12. Case reports of pneumonia caused by L. pneumophila serogroup 12 are rare, and the case described herein is the first report of clinical isolation of this organism in Japan. When the genotype was determined by the protocol of The European Working Group for Legionella Infections (Sequence-Based Typing [SBT] for epidemiological typing of L. pneumophila, Version 3.1), the sequence type was ST68. Imipenem/cilastatin therapy was found to be effective for the treatment of Legionella pneumonia in this patient.

  14. [A case of recurrent biliary cystadenocarcinoma successfully treated with 5FU/CDDP systemic chemotherapy].

    Science.gov (United States)

    Iyama, Satoshi; Takahashi, Yasuo; Shintani, Naoaki; Fujikawa, Koshi; Ohkubo, Syunichi; Sato, Yasushi; Sato, Tsutomu; Sato, Yasuhiro; Ohnuma, Keisuke; Niitsu, Yoshiro

    2006-10-01

    We report a case of biliary cystadenocarcinoma which recurred 41 months postoperatively. A 60-year-old woman was admitted for further examination of multiple metastatic tumors and a large amount of ascites. Systemic administration of 5FU and CDDP caused her CEA level to decrease gradually and abdominal computed tomography revealed considerable reduction of the metastatic tumors and ascites. Since her general condition had improved, chemotherapy was continued in the outpatient clinic.

  15. Massive variceal bleeding secondary to splenic vein thrombosis successfully treated with splenic artery embolization: a case report

    Directory of Open Access Journals (Sweden)

    Michalopoulos Antonis

    2010-05-01

    Full Text Available Abstract Introduction Splenic vein thrombosis results in localized portal hypertension called sinistral portal hypertension, which may also lead to massive upper gastrointestinal bleeding. Symptomatic sinistral portal hypertension is usually best treated by splenectomy, but interventional radiological techniques are safe and effective alternatives in the management of a massive hemorrhage, particularly in cases that have a high surgical risk. Case presentation We describe a 23-year-old Greek man with acute massive gastric variceal bleeding caused by splenic vein thrombosis due to a missing von Leiden factor, which was successfully managed with splenic arterial embolization. Conclusions Interventional radiological techniques are attractive alternatives for patients with a high surgical risk or in cases when the immediate surgical excision of the spleen is technically difficult. Additionally, surgery is not always successful because of the presence of numerous portal collaterals and adhesion. Splenic artery embolization is now emerging as a safe and effective alternative to surgery in the management of massive hemorrhage from gastric varices due to splenic vein thrombosis, which often occurs in patients with hypercoagulability.

  16. Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

    Directory of Open Access Journals (Sweden)

    José Edward Hagan

    2014-04-01

    Full Text Available Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma.

  17. Pustulotic arthro-osteitis report of a case successfully treated with laser-assisted arthroscopic synovectomy.

    Science.gov (United States)

    Yamada, K; Imaizumi, T; Uemura, M

    1999-02-01

    A 61-year-old man with palmoplantar pustulosis had pain and swelling persisting in his left knee for more than 3 years. The rheumatoid factor and HLA B 27 antigen were absent. Plain radiographs of the knee revealed no abnormalities despite the persistent synovitis. The bone scintigraphy showed increased uptake in the manubriosternal joint as well as in the knee. Eventually, the patient underwent arthroscopic synovectomy assisted with a holmium: YAG laser. No postoperative complications such as hemarthrosis were noted. The patient was pain free with full range of motion of the knee 22 months after surgery. Peripheral arthritis associated with palmoplantar pustulosis is usually transient. This unique case suggests that laser-assisted arthroscopic synovectomy would be a useful therapeutic option for persistent severe synovitis resistant to conservative treatment in pustulotic arthro-osteitis.

  18. Dialysis-associated pseudoporphyria successfully treated with vitamin D. Report of two cases.

    Science.gov (United States)

    Pranteda, G; Bottoni, U; Tayefeh Jafari, M; Pranteda, G; De Micco, S; Muscianese, M; Menè, P

    2015-06-01

    Pseudoporphyria refers to a rare bullous dermatosis characterized by the clinical and histological features of porfiria cutanea tarda without abnormalities in porphyrin metabolism. The pathogenesis is heterogeneous and several exogenous factors may promote the bullous lesion formation, including medications, end stage renal disease, dialysis and tanning beds. Regarding treatment of this condition, in literature different therapy have been reported, such as glutathione and his precursor N-acetylcysteine, which presents anti-oxidant properties; however even more toxic drugs, such as chloroquine, are used. Moreover, in patients with drug-induced PP discontinuation of the offending agent, if possible, is a crucial aspect of the clinical management. We report two cases of dialysis patients presenting blisters on extremities, which healed with the avoidance of UV exposure and oral Vitamin D supplementation. Interestingly Vitamin D despite the lack of antioxidant properties led to a completely resolution of PP in both our patients within 30 days. A possible explanation of this finding is that Vitamin D, playing a key role in the regulation of serum Ca2+, can modulated cadherin-cadherin interactions and led to healing of pseudoporphyria bullous lesions. Finally we highlight the prominent role of UV-exposure in PP elicitation thus a good photoprotection is essential for all patients with pseudoporphyria.

  19. A case of microscopic polyangiitis in an elderly patient presenting predominantly with cholecystitis successfully treated with mizoribine.

    Science.gov (United States)

    Ichinose, Kunihiro; Iwanaga, Nozomi; Okada, Akitomo; Tamai, Mami; Yamasaki, Satoshi; Nakamura, Hideki; Origuchi, Tomoki; Kawakami, Atsushi

    2014-11-01

    An 82-year-old woman was previously diagnosed with cholecystitis and treated with antibiotics at another hospital. Because her fever and inflammation persisted, therapeutic cholecystectomy was performed. Histopathology of the gallbladder revealed periarterial vasculitis. After transfer to our hospital, an elevated titer of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) was observed (47 U/mL). The patient's renal dysfunction had previously been thought to be sequelae of her cholecystectomy. We diagnosed microscopic polyangiitis (MPA) and began treatment with 40 mg orally of prednisolone daily. The titer of MPO-ANCA decreased with the treatment, but fever recurred with prednisolone taper. We, therefore, added 50 mg orally of mizoribine (MZR) daily as an immunosuppressant and increased the MZR to 100 mg daily while monitoring its blood peak concentration. The peak level of MZR was 1.58 μg/mL at 6 h after administration. After adding MZR, we successfully tapered the orally dosed prednisolone without recurrent fever or complications. We describe this case of MPA in an elderly patient manifesting predominantly with cholecystitis and successfully treated with orally dosed prednisolone and MZR.

  20. An uncommon clinical presentation of retroperitoneal non-Hodgkin lymphoma successfully treated with chemotherapy: A case report

    Institute of Scientific and Technical Information of China (English)

    Chiara Fulignati; Pietro Pantaleo; Greta Cipriani; Marianna Turrini; Rosalia Nicastro; Roberto Mazzanti; Bruno Neri

    2005-01-01

    We report the case of apetient affedted by an extra-nodal non-Hodgkin lymphoma presenting as a unique, large retroperitoneal mass with an unusual clinical presentation mimicking gastric peptic or neoplastic disease. The patient was successfully treated with a first generation therapy, CHOP modified regimen (cyclophosphamide 600 mg/m2 intravenously on d 1, epirubicin 55 mg/m2 intravenously on d 1, vincristine 1.2 mg/m2 intravenously on d 1, prednisone 60 mg/m2 on d 1-5), and a complete response was achieved. The (18)F-fluorodeoxyglucose positron emission tomography was used to assess the therapy outcome. A brief review of literature is provided.

  1. A Case of Malignant Biliary Obstruction with Severe Obesity Successfully Treated by Endoscopic Ultrasonography-Guided Biliary Drainage

    Science.gov (United States)

    Yamasaki, Shuuji

    2016-01-01

    Here, we present a case of malignant biliary tract obstruction with severe obesity, which was successfully treated by endoscopic ultrasonography-guided biliary drainage (EUS-BD). A female patient in her sixties who had been undergoing chemotherapy for unresectable pancreatic head cancer was admitted to our institution for obstructive jaundice. She had diabetes mellitus, and her body mass index was 35.1 kg/m2. Initially, endoscopic retrograde cholangiopancreatography (ERCP) was performed, but bile duct cannulation was unsuccessful. Percutaneous transhepatic biliary drainage (PTBD) from the left hepatic biliary tree also failed. Although a second PTBD attempt from the right hepatic lobe was accomplished, biliary tract bleeding followed, and the catheter was dislodged. Consequently, EUS-BD (choledochoduodenostomy), followed by direct metallic stent placement, was performed as a third drainage method. Her postprocedural course was uneventful. Following discharge, she spent the rest of her life at home without recurrent jaundice or readmission. In cases of severe obesity, we consider EUS-BD, rather than PTBD, as the second drainage method of choice for distal malignant biliary obstruction when ERCP fails.

  2. A Case Report of Coronary Arteriovenous Fistulas with an Unruptured Coronary Artery Aneurysm Successfully Treated by Surgery

    Directory of Open Access Journals (Sweden)

    Nobuhiro Takeuchi

    2012-01-01

    Full Text Available A 58-year-old female with a history of Wolff-Parkinson-White syndrome presented at our institution with palpitations and chest pain. Electrocardiography revealed paroxysmal supraventricular tachycardia with a heart rate of 188 beats/min. Antiarrhythmic drugs were ineffective, and tachycardia was resolved by electrical cardioversion. Transthoracic echocardiography revealed abnormal vessels around the right coronary artery (RCA and pulmonary artery (PA; in addition, we suspected coronary arteriovenous fistula (CAVF. Coronary angiography and coronary computed tomography revealed dilated fistula vessels, with a 1 cm saccular aneurysm around the RCA, originating from the proximal RCA and left anterior descending artery into the main trunk of PA. Therefore, we confirmed the diagnosis of CAVF with an unruptured aneurysm. We surgically ligated and clipped the fistula vessels and resected the aneurysm. The resected aneurysm measured  cm in size. Pathological examination of the resected aneurysm revealed hypertrophic walls comprising proliferating fibroblasts cells thin elastic fibers. Very few atherosclerotic changes manifested in the aneurysm walls. We report the case of a patient with CAVF and an unruptured coronary artery aneurysm who was successfully treated by surgery.

  3. Lyme neuroborreliosis in HIV-1 positive men successfully treated with oral doxycycline: a case series and literature review

    Directory of Open Access Journals (Sweden)

    Gisslén Magnus

    2011-09-01

    Full Text Available Abstract Introduction Lyme neuroborreliosis is the most common bacterial central nervous system infection in the temperate parts of the northern hemisphere. Even though human immunodeficiency virus (HIV -1 infection is common in Lyme borreliosis endemic areas, only five cases of co-infection have previously been published. Four of these cases presented with typical Lyme neuroborreliosis symptoms such as meningoradiculitis and facial palsy, while a fifth case had more severe symptoms of encephalomyelitis. All five were treated with intravenous cephalosporins and clinical outcome was good for all but the fifth case Case presentations We present four patients with concomitant presence of HIV-1 infection and Lyme neuroborreliosis diagnosed in Western Sweden. Patient 1 was a 60-year-old Caucasian man with radicular pain and cognitive impairment. Patient 2 was a 39-year-old Caucasian man with headaches, leg weakness, and pontine infarction. Patient 3 was a 62-year-old Caucasian man with headaches, tremor, vertigo, and normal-pressure hydrocephalus. Patient 4 was a 50-year-old Caucasian man with radicular pain and peripheral facial palsy. Patients one, two, and three all had subnormal levels of CD4 cells, indicating impaired immunity. All patients were treated with oral doxycycline with good clinical outcome and normalization of CSF pleocytosis. Conclusion Given the low HIV-1 prevalence and medium incidence of Lyme neuroborreliosis in Western Sweden where these four cases were diagnosed, co-infection with HIV-1 and Borrelia is probably more common than previously thought. The three patients that were the most immunocompromised suffered from more severe and rather atypical neurological symptoms than are usually described among patients with Lyme neuroborreliosis. It is therefore important for doctors treating HIV patients to consider Lyme neuroborreliosis in a patient presenting with atypical neurological symptoms. All four patients were treated with

  4. Emphysematous cholecystitis successfully treated by laparoscopic surgery

    Science.gov (United States)

    Katagiri, Hideki; Yoshinaga, Yasuo; Kanda, Yukihiro; Mizokami, Ken

    2014-01-01

    Emphysematous cholecystitis (EC) is an uncommon variant of acute cholecystitis, which is caused by secondary infection of the gallbladder wall with gas-forming organisms. The mortality rate of EC is still as high as 25%. Emergency surgical intervention is indicated. Open cholecystectomy has been traditionally accepted as a standard treatment for EC. We present a case of EC successfully treated by laparoscopic surgery. Laparoscopic cholecystectomy for EC is considered to be safe and effective when indicated. PMID:24876461

  5. [Arterial injury associated with tension-free vaginal tape procedure successfully treated by radiological embolization: a case report].

    Science.gov (United States)

    Takatera, Hiroshi; Mukai, Masatoshi; Fujii, Takahiro; Nishi, Masayo; Okada, Hiroshi; Nishimine, Kiyoshi; Tsushima, Juichi

    2006-09-01

    A 75-year-old woman underwent a tension-free vaginal tape (TVT) procedure for urinary stress incontinence. The patient complained of lower abdominal pain, a feeling of lower abdominal distension and nausea three hours after the operation. In addition, systolic blood pressure decreased gradually to 80 mmHg. Enhanced computed tomography revealed a retropubic hematoma sized up to 16 cm X 12 cm X 11 cm and bleeding from a vessel running through the posterosuperior aspect of the pubic bone. Successively, arteriography was performed. The arteriogram also confirmed arterial injury, which was successfully treated by selective embolization using a gelatin sponge and pushable coils. Postoperative course was uneventful requiring neither blood transfusion nor surgical removal of the hematoma.

  6. Refractory acute promyelocytic leukemia successfully treated with combination therapy of arsenic trioxide and tamibarotene: A case report

    Directory of Open Access Journals (Sweden)

    Minoru Kojima

    2016-01-01

    Full Text Available A 40-year-old male developed refractory acute promyelocytic leukemia (APL after various treatments including all-trans retinoic acid, tamibarotene, arsenic trioxide (As2O3, conventional chemotherapy, and autologous peripheral blood stem cell transplantation. We attempted to use both tamibarotene and As2O3 as a combination therapy, and he achieved molecular complete remission. Grade 2 prolongation of the QTc interval on the electrocardiogram was observed during the therapy. The combination therapy of As2O3 and tamibarotene may be effective and tolerable for treating refractory APL cases who have no treatment options, even when they have previously been treated with tamibarotene and As2O3 as a single agent.

  7. Relapsing polychondritis associated with psoriasis vulgaris successfully treated with adalimumab: A case report with published work review.

    Science.gov (United States)

    Matsuo, Haruka; Asahina, Akihiko; Fukuda, Takeshi; Umezawa, Yoshinori; Nakagawa, Hidemi

    2017-03-07

    Relapsing polychondritis (RP) is a rare autoimmune-mediated disease characterized by inflammation involving cartilaginous tissues. We report here a case of RP in a 38-year-old Japanese man with 13-year duration of psoriasis vulgaris treated with topical steroids and vitamin D3 . The patient presented with tender swelling and erythema of both auricles, and the antibody to type II collagen was detected. The biopsy specimen revealed a dense mixed cell infiltration over the auricular cartilage. We reviewed eight cases with the association of RP and psoriasis, and in all cases the clinical course of psoriasis did not correlate with that of RP. The severity of RP was mild in the majority of cases, and our case was unique in that the patient had no joint symptoms. Adalimumab treatment was effective for both RP and psoriasis. Fat-suppressed contrast-enhanced magnetic resonance imaging was beneficial, not only to demonstrate subclinical inflammation in the nasal septum, but also to subjectively assess the improvement of RP.

  8. A Case of Dermatomyositis and Anti-EJ Autoantibody with Chronic Intestinal Pseudoobstruction Successfully Treated with Octreotide

    Directory of Open Access Journals (Sweden)

    Chiho Yamada

    2016-01-01

    Full Text Available Chronic intestinal pseudoobstruction (CIPO is a serious complication in patients with connective tissue disease (CTD and is sometimes life-threatening or fatal despite intensive medical treatment. Here, we report a patient with dermatomyositis (DM and anti-EJ autoantibody who developed CIPO that was improved by octreotide. Because her abdominal pain and bloatedness were so severe and persistent, we introduced octreotide to relieve symptoms. In this case, continuous intravenous administration as well as long-acting subcutaneous injection of octreotide was effective for treating CIPO.

  9. Spontaneous rupture of a liver cell adenoma after long term methyltestosterone: report of a case successfully treated by emergency right hepatic lobectomy.

    Science.gov (United States)

    Bird, D; Vowles, K; Anthony, P P

    1979-03-01

    A case of spontaneous rupture of a liver cell adenoma is reported in a female transexual treated with methyltestosterone 150 mg daily for 7 years. Emergency right hepatic lobectomy was performed successfully. Histology showed peliosis hepatis also. Emergency resection of a liver cell adenoma has been reported in a young woman taking oral contraceptives, and an elective resection in another female transexual treated with methyltestosterone. However, to the best of our knowledge this is the first case of emergency resection of a spontaneously ruptured liver cell adenoma in a transexual treated with long term methyltestosterone. Since there are numerous other patients similarly treated, it may be expected that this complication will be seen again.

  10. Fontan patient with plastic bronchitis treated successfully using aerosolized tissue plasminogen activator: a case report and review of the literature.

    Science.gov (United States)

    Do, Thomas B; Chu, James M; Berdjis, Farhouch; Anas, Nick G

    2009-04-01

    Plastic bronchitis is an uncommon condition characterized by the production of large pale bronchial casts that obstruct the tracheobronchial tree. The cellular content, cohesiveness, and often rubber-like consistency distinguish bronchial casts from the usual mucus plugs found with such disease states as asthma. Plastic bronchitis can be found secondary to many conditions, and a simplified classification scheme organizes it into two groups: an inflammatory type consisting of casts with an eosinophilic inflammatory infiltrate and an acellular type with a predominance of fibrin distinguished by its relative lack of cellular infiltrate, its mucin predominance, and its appearance only in children with congenital cyanotic heart disease. This report describes a 5-year-old girl who experienced plastic bronchitis 3 months after a Fontan procedure for hypoplastic left heart syndrome that was treated successfully with aerosolized tissue plasminogen activator.

  11. [A Case of Advanced Seminoma in a 79-Year-Old Man Successfully Treated with Etoposide and Cisplatin].

    Science.gov (United States)

    Shiga, Masanobu; Kawai, Koji; Kojyo, Kousuke; Kurobe, Masahiro; Ichioka, Daishi; Yoshino, Takayuki; Ikeda, Atsushi; Kojima, Takahiro; Joraku, Akira; Suetomi, Takahiro; Tsutsumi, Masakazu; Miyazaki, Jun; Nishiyama, Hiroyuki

    2015-12-01

    Testicular tumors are representative solid cancers that occur in young men, and the standard multi-drug combination chemotherapy has been established for metastatic tumors. However, they develop rarely in elderly men over 70 years old, and there are few reports about the information of combination chemotherapy for elderly testicular tumor patients. Here, we present a case in a 79-year-old who had right testicular tumors (seminoma, cT2N3M1a, IGCC classification : good prognosis) safely treated with multi-drug combination chemotherapy. To reduce the risk of side effects, we selected 4 courses of etoposide and cisplatin (EP) to the patient. The patient suffered from febrile neutropenia (FN) and oral mucositis during the first cycle of EP. However, no further episodes of oral mucositis and FN were observed after introduction of oral health care by a dentist. The patient received 4 courses of EP without dose reduction or treatment postponement. There was no evidence of recurrence 6 months after chemotherapy. To our knowledge, the present case is the oldest patient with metastatic testicular treated with combination chemotherapy including cisplatin.

  12. Magnetic resonance evaluation of temporomandibular joint components in successfully treated cases of closed lock with a stuck disc

    Energy Technology Data Exchange (ETDEWEB)

    Ohnuki, Takayoshi; Fukuda, Masayuki; Seki, Hiroshi; Iino, Mitsuyoshi [Akita Univ. (Japan). School of Medicine; Funaki, Katsuyuki; Takahashi, Tetsu

    2002-02-01

    The purpose of this study was to evaluate morphological changes in temporomandibular joint components by magnetic resonance imaging (MRI, 1.5 Tesla) before and after treatment for closed lock with a stuck disc. A total of 25 joints (25 patients) that were successfully treated and showed marked improvement in range of motion and articular pain after treatment were studied. Each joint was evaluated on the basis of pretreatment and posttreatment MRI findings, including disc mobility, condylar translation, disc reduction, disc shape, degree of disc displacement, bone changes of the condyle, and signal intensity of the posterior disc attachment. Posttreatment MRI revealed that all joints had mobile discs, and the range of the condylar translation had increased. Deformity of the disc and condyle had progressed remarkably. The posterior disc attachment showed low signal intensity. These results suggest that improved disc mobility is indispensable for successful treatment. The results also reveal that the disc, condyle, and posterior attachment showed various changes caused by remodeling. (author)

  13. Solar urticaria successfully treated with intravenous immunoglobulin.

    LENUS (Irish Health Repository)

    Hughes, R

    2012-02-01

    Idiopathic solar urticaria (SU) is a rare, debilitating photodermatosis, which may be difficult to treat. First-line treatment with antihistamines is effective in mild cases, but remission after phototherapeutic induction of tolerance is often short-lived. Other treatment options include plasma exchange, photopheresis and cyclosporin. We present two cases of severe, idiopathic SU, which were resistant to conventional treatment. Both patients achieved remission after administration of intravenous immunoglobulin (IVIg) and have remained in remission at 13 months and 4 years, respectively. There are only two case reports of successful treatment of solar urticaria with IVIg. In our experience IVIg given at a total dose of 2 g\\/kg over several 5-day courses about a month apart is an effective treatment option for severe idiopathic SU. It is also generally safe, even if certainly subject to significant theoretical risks, such as induction of viral infection or anaphylaxis.

  14. Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM): a case report.

    Science.gov (United States)

    Melham, T J; Sevier, T L; Malnofski, M J; Wilson, J K; Helfst, R H

    1998-06-01

    This clinical case report demonstrates the clinical effectiveness of a new form of soft tissue mobilization in the treatment of excessive connective tissue fibrosis (scar tissue) around an athlete's injured ankle. The scar tissue was causing the athlete to have pain with activity, pain on palpation of the ankle, decreased range of motion, and loss of function. Surgery and several months of conventional physical therapy failed to alleviate the athlete's symptoms. As a final resort, augmented soft tissue mobilization (ASTM) was administered. ASTM is an alternative nonsurgical treatment modality that is being researched at Performance Dynamics (Muncip, IN). ASTM is a process that uses ergonomically designed instruments that assist therapists in the rapid localization and effective treatment of areas exhibiting excessive soft tissue fibrosis. This is followed by a stretching and strengthening program. Upon the completion of 6 wk of ASTM therapy, the athlete had no pain and had regained full range of motion and function. This case report is an example of how a noninvasive augmented form of soft tissue mobilization (ASTM) demonstrated impressive clinical results in treating a condition caused by connective tissue fibrosis.

  15. First documented case of successful kidney transplantation from a donor with acute renal failure treated with dialysis.

    Science.gov (United States)

    Bacak-Kocman, Iva; Peric, Mladen; Kastelan, Zeljko; Kes, Petar; Mesar, Ines; Basic-Jukic, Nikolina

    2013-10-01

    There is a widening gap between the needs and possibilities of kidney transplantation. In order to solve the problem of organ shortage, the selection criteria for kidney donors have been less stringent over the last years. Favorable outcome of renal transplantation from deceased donors with acute renal failure requiring dialysis may have an important role in expanding the pool of donors. We present the case of two renal transplantations from a polytraumatized 20-years old donor with acute renal failure requiring dialysis. One recipient established good diuresis from the first post-transplant day and did not require hemodialysis. The second recipient had delayed graft function and was treated with 8 hemodialysis sessions. The patient was discharged with good diuresis and normal serum creatinine. After two years of follow-up, both recipients have normal graft function. According to our experience, kidneys from deceased young donors with acute renal failure requiring dialysis may be transplanted, in order to decrease the number of patients on transplantation waiting lists.

  16. Acquired Hemophilia A successfully treated with rituximab

    Directory of Open Access Journals (Sweden)

    Giovanni D'Arena

    2015-02-01

    Full Text Available Acquired hemophilia A (AHA is a rare bleeding disorder due to the development of specific autoantibodies against factor VIII. The anti-CD20 monoclonal antibody Rituximab has been proven to be effective in  obtaining a long-term suppression of inhibitors of AHA,  besides other immunosuppressive standard treatments. Here we describe a case of idiopathic AHA in a 60-year old man successfully treated with rituximab. He showed a complete clinical response with  a normalization of clotting  parameters after 5 weekly courses of rituximab given at a dose of 375 mg/sqm. , but after stopping rituximab, an initial worsening of coagulation  parameters  induced the addition of 3 further courses. At present, the patient is in complete clinical and hematological remission after 200 days.  This case confirms that Rituximab may be a safe and useful tool to treat AHA and, a prolonged administration can overcome the initial resistance. However, the precise position of this drug in the therapeutic strategy (first or second-line, alone or in combination with other drugs remains to be established and warrants further investigation.

  17. [Two case reports of recurrent mediastinitis with chronic mediastinal fistula successfully treated with muscle flap re-transposition].

    Science.gov (United States)

    Hashimoto, Y; Kanazawa, H; Kasuya, S; Irisawa, T; Ohzeki, H; Kuraoka, S; Goto, S; Sakashita, I; Takahashi, H

    1994-04-01

    We experienced two cases of recurrent poststernotomy mediastinitis with chronic mediastinal fistula. Both cases had already received muscle flaps for post operative mediastinitis. However, chronic mediastinal fistula appeared after nine months in the first case, and eleven months in the second case. We removed the infected tissue and the predgets, which were used on the ascending aorta. Then closed the wound by the muscle flap closure. The chronic fistula were closed, and the functional and cosmetic results were excellent.

  18. Successful Chemotherapy with Nab-Paclitaxel in a Heavily Treated Non-Small Cell Lung Cancer Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Mikiko Ishihara

    2014-06-01

    Full Text Available Non-small cell lung cancer (NSCLC accounts for the majority of all lung cancers. A 69-year-old female with postoperatively recurrent NSCLC was treated weekly with nanoparticle-albumin-bound paclitaxel (nab-paclitaxel monotherapy every 4 weeks as a tenth line chemotherapy, and stable disease was achieved by seven cycles of this regimen. The patient developed grade 4 neutropenia and grade 3 leukopenia, but none of the other toxicities, including febrile neutropenia and peripheral neuropathy, were severe, and thus she was able to tolerate this salvage chemotherapy. To our knowledge this is the first report of the efficacy of nab-paclitaxel monotherapy in a heavily treated NSCLC patient.

  19. [A Case of Wilson's Disease with Psoriasis Vulgaris, Complicated with Hepatocellular Carcinoma and Successfully Treated with Sorafenib].

    Science.gov (United States)

    Nakagawa, Tamotsu; Chubachi, Seiji

    2015-09-01

    A 55-year-old man had been diagnosed with Wilson's disease and was treated with D-penicillamine 36 years earlier. He also had a 20-year history of psoriasis vulgaris and cyclosporine treatment. In 2012, a he presented with a hepatocellular carcinoma(HCC)that was removed via partial hepatic resection. In 2014, multiple HCC and a portal vein tumor thrombus were found in his posterior lobe. Sorafenib treatment was initiated. Cyclosporine treatment was continued. Three months later, abdominal enhanced CT revealed marked tumor reduction and shrinkage of the portal vein tumor thrombus. The therapeutic effect of sorafenib continued for 6 months. We did not observe deterioration in his psoriasis vulgaris and Wilson's disease for 9 months after sorafenib initiation.

  20. Sudden hearing loss and vertigo after tooth extraction successfully treated with combined therapy including HBO2: a case report.

    Science.gov (United States)

    Yilmaz, Huseyin Baki; Erdogan, Raziye Banu Atalay; Paksoy, Mustafa; Sanli, Arif

    2015-01-01

    Sudden sensorineural hearing loss (SSNHL) is a decrease in hearing of at least 30 dB that occurs within three days and which affects at least three consecutive frequencies in either ear or both ears. This case report describes a woman who had sudden hearing loss and vertigo in the right ear after tooth extraction. As the first-line therapy, systemic and intratympanic steroid injections were used this led to a slight improvement; however, the majority of improvement in hearing was not observed until hyperbaric oxygen (HBO2) therapy was instituted on the 20th day of hearing loss. Sudden hearing loss and vertigo after tooth extraction is an otologic emergency and early evaluation and treatment are effective. HBO2, although employed beyond the Undersea and Hyperbaric Medical Society's recommended initial 14 days of symptom onset, very was effective for this particular case.

  1. Deep vein thrombosis in a patient of adenomatous polyposis coli treated successfully with aspirin: A case report

    Science.gov (United States)

    Agrawal, Neha; Santra, Tuhin; Kar, Arnab; Guha, Pradipta; Bar, Mita; Adhikary, Apu; Datta, Sumana

    2016-01-01

    Background: Deep vein thrombosis is an important cause of morbidity and mortality. However, its association with adenomatous polyposis coli is extremely rare. Here we present an interesting case of deep vein thrombosis associated with adenomatous polyposis coli. Case Presentation: A 15 year old female who was having fever and diarrhea for 5 months developed bilateral asymmetric painful swelling of lower limbs for 1 month. Doppler ultrasound of lower limbs revealed presence of thrombosis from inferior vena cava up to popliteal vein. Colonoscopy and biopsy were suggestive of adenomatous polyposis coli. However, she could not tolerate anticoagulant therapy and was put on aspirin therapy for 6 months to which she responded well with the resolution of thrombus. Conclusion: Role of aspirin therapy may be considered whenever a patient of venous thrombosis cannot tolerate anticoagulant therapy. PMID:27386068

  2. A successful case of anti-NMDAR encephalitis without tumor treated with a prolonged regimen of plasmapheresis

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    Mateus Mistieri Simabukuro

    Full Text Available ABSTRACT Anti-NMDA receptor encephalitis is a severe but treatable autoimmune disease of the CNS. However, the use of immunotherapy and long-term outcomes have yet to be defined for this disease. We describe a case of an 18-year-old male diagnosed with anti-NMDAR encephalitis not associated with tumor, which did not respond to initial treatment with immunoglobulin, followed by corticosteroids, cyclophosphamide and evolved with significant clinical improvement after a prolonged course of plasmapheresis. Although it is not possible to affirm the good outcome was due solely to the prolonged plasmapheresis regimen, recently published data shows that improvement may take weeks or months to occur. This case discloses another therapeutic possibility for patients with refractory disease who fail to respond to recommended first-line and second-line therapy.

  3. Recurrent pyriform sinus fistula successfully treated by endoscopic Glubran 2 sealing: A rare case and literature review

    Science.gov (United States)

    Di Nardo, Giovanni; Valentini, Valentino; Angeletti, Diletta; Frediani, Simone; Iannella, Giannicola; Cozzi, Denis; Roggini, Mario; Magliulo, Giuseppe

    2016-01-01

    Objectives: The authors present the case of a 3-year-old girl with a history of complicated surgery for removing a third branchial cleft fistula. Methods: An endoscopic approach using N-butyl-2-acrylate and metacrilosisolfolane glue (GLUBRAN 2) to seal the fistula was performed. Results: The clinical and radiological 6-year follow-up confirmed the absence of the fistulous orifice and the persistence of scar due to previous open-neck surgical procedures. Conclusion: endoscopic Glubran 2 sealing has been an effective treatment procedure for branchial fistula. PMID:27781098

  4. Japanese case of Budd-Chiari syndrome due to hepatic vein thrombosis successfully treated with liver transplantation.

    Science.gov (United States)

    Iwasaki, Tomohiro; Kawai, Hirokazu; Oseki, Koushi; Togashi, Tadayuki; Shioji, Kazuhiko; Yamamoto, Satoshi; Sato, Yoshinobu; Suzuki, Kenji; Toba, Ken; Nomoto, Minoru; Hatakeyama, Katsuyoshi; Aoyagi, Yutaka

    2012-02-01

    A 22-year-old Japanese woman was found to have severe esophageal varices and then suffered from hepatic encephalopathy. She was diagnosed with Budd-Chiari syndrome (BCS) due to hepatic vein (HV) thrombosis accompanied by portal vein thrombosis without inferior vena cava (IVC) obstruction. Latent myeloproliferative neoplasm (MPN) lacking the JAK2-V617F mutation was considered to be the underlying disease. Liver transplantation was strikingly effective for treating the clinical symptoms attributable to portal hypertension. Although thrombosis of the internal jugular vein occurred due to thrombocythemia, which manifested after transplantation despite anticoagulation therapy with warfarin, the thrombus immediately disappeared with the addition of aspirin. Neither thrombosis nor BCS has recurred in more than 4 years since the amelioration of the last thrombotic event, and post-transplant immunosuppression with tacrolimus has not accelerated the progression of MPN. In Japan, IVC obstruction, which was a predominant type of BCS, is suggested to have decreased in incidence with recent improvements in hygiene. The precise diagnosis of BCS and causative underlying diseases should be made with attention to the current trend of the disease spectrum, which fluctuates with environmental sanitation levels. Because the stepwise strategy, including liver transplantation, has been proven effective for patients with pure HV obstruction in Western countries, this strategy should also be validated for utilization in Japan and in developing countries where HV obstruction potentially predominates.

  5. Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: report of 4 cases treated by mandibular sagittal osteotomy.

    Science.gov (United States)

    Scolozzi, Paolo; Lombardi, Tommaso; Jaques, Bertrand

    2004-05-01

    Endodontic overfilling involving the mandibular canal may cause an injury of the inferior alveolar nerve (IAN) resulting in disabling sensory disturbances such as pain, dysesthesia, paresthesia, hypoesthesia, or anesthesia. Two fundamental mechanisms are responsible for the injury: the chemical neurotoxicity and the mechanical compression caused by the extruded material. Although spontaneous resorption has been described for some materials, early surgical exploration with removal of the material and decompression of the IAN should be performed, irrespective of the material used, given that the importance of nerve damage increases with the duration of the injury. We report 4 cases of disabling dysesthesia and paresthesia following endodontic treatment of lower molars in which sagittal osteotomy was used to remove the endodontic paste and to perform nerve decompression. All the patients experienced immediate relief of dysesthesia and paresthesia.

  6. A case of minimal change disease treated successfully with mycophenolate mofetil in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Hong, Young Hoon; Yun, Dae Young; Jung, Yong Wook; Oh, Myung Jin; Kim, Hyun Je; Lee, Choong Ki

    2011-12-01

    The World Health Organization classifies lupus nephritis as class I to V or VI. However, a few cases of minimal change glomerulopathy have been reported in association with systemic lupus erythematosus (SLE). Mycophenolate mofetil has been shown to be effective for treatment of minimal change disease and lupus nephritis. A 24-year-old woman diagnosed with SLE five years prior to presentation complained of a mild generalized edema. The urinalysis showed microscopic hematuria and proteinuria. The assessed amount of total proteinuria was 1,618 mg/24 hours. A renal biopsy demonstrated diffuse fusion of the foot processes of podocytes on electron microscopy. Mycophenolate mofetil was started in addition to the maintenance medications of prednisolone 10 mg/day and hydroxychloroquine 400 mg/day. After six months of treatment, the microscopic hematuria and proteinuria resolved, and the total urine protein decreased to 100 mg/24 hours.

  7. Primary hepatic malignant peripheral nerve sheath tumor successfully treated with combination therapy: a case report and literature review

    Science.gov (United States)

    Jung, Hae Il; Lee, Hyoung Uk; Ahn, Tae Sung; Lee, Jong Eun; Lee, Hyun Yong; Cho, Hyon Doek; Lee, Sang Cheol

    2016-01-01

    Primary malignant peripheral nerve sheath tumor (MPNST) in a young female patient, not associated with neurofibromatosis type-I is extremely rare in the liver. A 33-year-old female was admitted with a right flank pain for a weak. The CT scan showed 12.5-cm-sized mass located at the right hepatic lobe. At laparotomy, about 20.0-cm-sized mass was on the right hepatic lobe with attachment to right diaphragmatic pleura. Right hepatic lobe and adherent part of diaphragmatic pleura were resected. On histology and immunohistochemistry, it was diagnosed MPNST. Adjuvant radiotherapy for the right diaphragmatic pleura and adjuvant chemotherapy with adriamycin, ifosfamide and cisplatin were sequentially performed. The prognosis of MPNST is generally poor and it is associated with a highly aggressive course of recurrence, metastases, and death. Our case is probably a first report about combination therapy. PMID:27904856

  8. Hypopigmented mycosis fungoides treated successfully with puva

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    Khanna N

    1999-01-01

    Full Text Available Hypopigmented lesions are rarely encountered in mycosis fungoides. We here report a 22-year old female patient who presented with a 5-year history of asymptomatic progressively increasing discrete and confluent hypopigmented macules and a 1-year history of a few itchy erythematous, scaly, indurated plaques. The histological features were consistent with a clinical diagnosis of mycosis fungoides. She was successfully treated with PUVA therapy.

  9. [A case of possible retroperitoneal metastasis of breast cancer successfully treated with oral S-1 and cyclophosphamide therapy after TC therapy].

    Science.gov (United States)

    Yoneyama, Kimiyasu; Takeshita, Toshio; Suzuki, Hiroshi; Morise, Masaki; Suzuki, Tetsutarou; Kishi, Shinya; Tsutsui, Atsuko; Matsumoto, Akiko

    2011-03-01

    We report a case of possible retroperitoneal metastasis of breast cancer successfully treated with oral S-1 and cyclophosphamide therapy after docetaxel and cyclophosphamide (TC) therapy. A 57-year-old woman with a history of bilateral breast cancer showed an increase in tumor markers during treatment with oral anastrozole as postoperative adjuvant therapy 4 years after her second cancer surgery. After careful examination, the patient was diagnosed as having multiple bone metastases and her medication was changed to oral letrozole. After 3 months, the patient developed left back pain and was referred to our hospital. CT scanning showed an enhanced mass in the region from the left perirenal and posterior pararenal spaces to the left psoas major muscle and the anterior aspect of the left iliacus muscle, suggesting retroperitoneal metastasis. TC therapy was performed and, as a result, tumor markers decreased and the mass disappeared on CT imaging. After discontinuation of TC therapy, the tumor markers increased again, following which oral S-1 and cyclophosphamide therapy were administered, and the tumor markers decreased. At the time of this writing, the patient is still undergoing therapy, and no recurrence has been observed. We concluded that oral S-1 and cyclophosphamide therapy were useful in the present case and were associated with few adverse effects.

  10. Active bleeding from a periampullary duodenal diverticulum that was difficult to diagnose but successfully treated using hemostatic forceps: a case report

    Directory of Open Access Journals (Sweden)

    Nishiyama Noriko

    2012-10-01

    Full Text Available Abstract Introduction Although duodenal diverticula are common, periampullary duodenal diverticula are rare. Periampullary duodenal diverticula are usually asymptomatic and may be difficult to diagnose and treat. However, they may present with massive bleeding, requiring prompt diagnosis. Case presentation We report the case of a 71-year-old Asian woman with bleeding from a periampullary duodenal diverticulum. She presented with severe anemia and tarry stools. Two examinations using a forward-viewing endoscope did not identify the source of the bleeding. However, examination using a side-viewing endoscope found an exposed bleeding vessel overlying the bile duct within a periampullary diverticulum of the descending part of the duodenum. The bleeding was successfully controlled by using hemostatic forceps. Conclusions Bleeding periampullary duodenal diverticula are rare, and a bleeding point in the mucosa overlying the bile duct within a large periampullary duodenal diverticulum is very rare. Identification of a bleeding point within a duodenal diverticulum often requires repeated examination and may require the use of a side-viewing endoscope. Use of hemostatic forceps to control bleeding from a periampullary duodenal diverticulum is very rare but, for bleeding lesions overlying the bile duct within a periampullary duodenal diverticulum, is the best way to prevent obstructive jaundice.

  11. Refractory autoimmune hemolytic anemia in a patient with DiGeorge syndrome treated successfully with plasma exchange: a case report and review of the literature.

    Science.gov (United States)

    Damlaj, Moussab; Séguin, Chantal

    2014-11-01

    Warm antibody autoimmune hemolytic anemia (AIHA) results from targeted antibodies towards the red blood cells (RBCs) and can be either idiopathic or secondary to certain diseases, such as autoimmune disorders or malignancy, drugs, or infection. Patients with DiGeorge syndrome are particularly vulnerable to autoimmune conditions secondary to thymic hypoplasia and dysfunction of the immune system. First-line therapy for AIHA consists of corticosteroids, with most patients showing signs of response. Relapses are not uncommon and are treated with splenectomy or rituximab. There is a paucity of reports in the literature regarding treatment options beyond this stage. Herein, we describe an unusual case of a 20-year-old female affected by DiGeorge syndrome with a history of immune thrombocytopenia (ITP), who presented with life-threatening AIHA. Standard first- and second-line therapeutic modalities were ineffective in controlling her disease and she ultimately underwent plasma exchange therapy with successful resolution of hemolysis. At her last follow-up, one year after her initial presentation, she remains clinically well without signs of hemolysis. We conclude that in refractory cases of warm AIHA, plasma exchange therapy can be a valuable tool in the therapeutic armamentarium.

  12. Palmoplantar lichen planus successfully treated with acitretin.

    Science.gov (United States)

    Solak, Berna; Kara, Rabia Oztas; Kosem, Mustafa

    2015-09-07

    Palmoplantar lichen planus (PPL) is an uncommon type of lichen planus (LP) that exclusively affects the palms and soles. We report a case of a 50-year-old man who had palmoplantar hyperkeratotic papules and plaques. The patient was diagnosed as a case of PPL by skin biopsy, and treated with acitretin. He showed a good response to acitretin within 2 months. Clinical appearance and some features of PPL may differ from classic LP. Acitretin may be a favourable treatment option for PPL.

  13. A case of severe chlorite poisoning successfully treated with early administration of methylene blue, renal replacement therapy, and red blood cell transfusion : case report

    NARCIS (Netherlands)

    Gebhardtova, Andrea; Vavrinec, Peter; Vavrincova-Yaghi, Diana; Seelen, Mark; Dobisova, Anna; Flassikova, Zora; Cikova, Andrea; Henning, Robert H.; Yaghi, Aktham

    2014-01-01

    The case of a 55-year-old man who attempted suicide by ingesting <100 mL of 28% sodium chlorite solution is presented. On arrival in the intensive care unit, the patient appeared cyanotic with lowered consciousness and displayed anuria and chocolate brown serum.Initial laboratory tests revealed 40%

  14. Acquired pure megakaryocytic aplasia successfully treated with cyclosporine

    Directory of Open Access Journals (Sweden)

    Halima El Omri

    2010-12-01

    Full Text Available Acquired pure megakaryocytic aplasia is a rare hematological disorder characterized by thrombocytopenia with absent or markedly reduced megakaryocytes in the bone marrow. We report a case of a 25-year-old male diagnosed as acquired pure megakaryocytic aplasia. Treatment with prednisone and intravenous immunoglobulin failed, but he was successfully treated with cyclosporine, with complete remission after 90 days and normal platelet count maintained thereafter.

  15. A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a "Doctor-helicopter" Ambulance Staffed by Skilled Emergency Physicians.

    Science.gov (United States)

    Otsuka, Hiroyuki; Sato, Toshiki; Morita, Seiji; Nakagawa, Yoshihide; Inokuchi, Sadaki

    2016-03-20

    We report a 55-year-old man who relapsed into a state of shock in an ambulance before arriving at our critical care center after a fall injury. The diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis and drainage were performed at the heliport. He was then transported immediately to our hospital with continuous drainage and surgery was performed. After surgery, the patient was transferred to the intensive care unit in stable condition. After undergoing rehabilitation, he made a full recovery and was discharged. This case illustrates that such patients can be treated reliably by pericardial drainage performed by skilled emergency physicians in the field by making use of the "doctor-helicopter" ambulance transportation system, followed by emergency surgery in a critical care center.

  16. Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report

    Directory of Open Access Journals (Sweden)

    Mehmet Balcı

    2015-08-01

    Full Text Available ABSTRACTWe report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

  17. Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report.

    Science.gov (United States)

    Balcı, Mehmet; Yağcı, Ramazan; Güler, Emre; Haltaş, Hacer; Duman, Rahmi; Hepşen, İbrahim F

    2015-01-01

    We report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

  18. Successful management of pregnancy and hepatic toxicity in a CML female patient treated with nilotinib : a case report and a review

    Directory of Open Access Journals (Sweden)

    Domenico Santorsola

    2015-02-01

    Full Text Available We report a case of a young patient with HBV hepatopathy, diagnosed with CML in March 2006 and treated with imatinib 400mg/die as first line therapy with concomitant Lamivudine. Patient obtained a complete hematologic response (CHR in 2 months, complete cytogenetic response (CCyR in six months and major molecular response (MMR at 24 months.  After three years of treatment she became imatinib intolerant and resistant.  In November 2009 patient started nilotinib 400mg/BID. Patient tolerated well the new molecule never experiencing hepatic impairment.  After switching to nilotinib she reached in 12 months transcript reduction more than 3 log (MMR.  Even if patient had been informed of the need of continuous therapy and to use effective methods of contraception during TKI treatment, in 2012 she decided to plan a pregnancy.  In August 2012 a MR4 was documented and treatment discontinued before starting pregnancy. She was observed throughout her pregnancy. The disease remained stable achieving an undetectable transcript level; she delivered a healthy boy in September 2013. Treatment with nilotinib was re-started three months after delivery and she is still in molecular remission (MR5. A complete discussion of the case and the available literature will be presented.

  19. Langerhans cell histiocytosis: An uncommon presentation, successfully treated by thalidomide

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    Mohammad Shahidi-Dadras

    2011-01-01

    Full Text Available Langerhans cell histiocytosis (LCH is a rare disease and generally affects children under 15 years of age. Adult onset form and cutaneous features at presentation are uncommon. There are some options for treatment of the skin lesions of LCH such as topical and intralesional corticosteroid, nitrogen mustard, etc., which are not completely curative. Herein, we report a case of perianal LCH in a 20-year-old man with one-year history of recalcitrant well-demarcated, erythematous, and ulcerated plaque surrounding the anal orifice, with pain and difficulty in defecation that was successfully treated with thalidomide.

  20. Adolescent Catatonia Successfully Treated with Lorazepam and Aripiprazole

    Directory of Open Access Journals (Sweden)

    Aaron J. Roberto

    2014-01-01

    Full Text Available Catatonia is especially concerning in children and adolescents. It leads to significant impairment, including emotional distress, difficulty communicating, and other debilitating symptoms. In this case report, we discuss a patient with no previous history of neuroleptic medication or psychotic symptoms, presenting with first-episode catatonia in the presence of disorganized, psychotic thoughts. We then review the catatonia syndrome, citing examples in the literature supporting its underdiagnosis in children and adolescents, and discuss successful treatment modalities. It is important to diagnose and treat catatonia as efficiently as possible, to limit functional and emotional distress to the patient.

  1. A severe infective endocarditis successfully treated with linezolid

    Directory of Open Access Journals (Sweden)

    Graziano Antonio Minafra

    2010-03-01

    Full Text Available Despite significant improvements in surgical and medical therapy, prosthetic valve endocarditis (PVE is a diagnostic and therapeutic challenge and is often associated with a severe prognosis. We report a case of a 59-year-old woman, with  PVE and bacterial endocarditis (Streptococcus bovis successfully treated with linezolid. Linezolid is a bacteriostatic oxazolidinone antibiotic that has been proven to be effective for the treatment of patients with pneumonia, skin and soft tissue infections, and infections due to Gram-positive cocci. Linezolid is not yet recognised as a standard therapy for infective endocarditis, but its use becomes a necessity when infection is due to multidrug-resistant microorganisms.

  2. Extensive Darier Disease Successfully Treated with Doxycycline Monotherapy

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    Alicia Sfecci

    2015-10-01

    Full Text Available Darier disease (DD is a rare dominantly inherited genodermatosis characterized by loss of intercellular adhesion (acantholysis and abnormal keratinization. DD is often difficult to manage. Numerous treatments have reportedly been used for the treatment of DD, with limited success. Systemic retinoids are considered the drug of choice for treating DD. However, their use is limited by potential deleterious side effects. Considering the recently reported efficacy of doxycycline for Hailey-Hailey disease, an inherited acantholytic skin disorder pathogenetically similar to DD, we report the case of a patient with extensive DD who showed a dramatic response to oral doxycycline monotherapy.

  3. [Primary diffuse large B-cell lymphoma of the uterine cervix successfully treated with rituximabplus cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy-a case report].

    Science.gov (United States)

    Hashimoto, Akari; Fujimi, Akihito; Kanisawa, Yuji; Matsuno, Teppei; Okuda, Toshinori; Minami, Shinya; Doi, Tadashi; Ishikawa, Kazuma; Uemura, Naoki; Jyomen, Yuko; Tomaru, Utano

    2013-12-01

    Primary malignant lymphoma of the uterine cervix is a rare disease, and the therapeutic strategy has not been clearly established. A 45-year old woman presented with vaginal bleeding and hypermenorrhea in January 2012. Physical examination revealed a mass in the pelvic cavity approximately the size of a neonate's head. Pelvic magnetic resonance imaging(MRI) showed a solid mass 11 cm in size in the uterine cervix with homogeneous low intensity on T1-weighted images, iso-high intensity on T2-weighted images, and heterogeneous iso-high intensity on gadolinium-diethylenetriaminepentaacetate(Gd- DTPA)-enhanced images. Multiple lymphadenopathy were also detected in the pelvis. The Papanicolaou smear indicated class 5 cervical cytology, and a subsequent histological examination by a punch biopsy of the cervix showed diffuse infiltration of medium- to large-sized mononuclear cells that stained positive for CD20 and CD79a and negative for CD3, CD5, and EBER. Bone marrow biopsy revealed no abnormality. Positron emission tomography-computed tomography(PET-CT)showed strong fluorodeoxyglucose(FDG)accumulation in the uterine cervix mass, and in the pelvic and right inguinal lymphadenopathy. The patient was diagnosed with diffuse large B-cell lymphoma of the uterine cervix, Ann Arbor stage II AE. She was successfully treated with 8 courses of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone(R-CHOP) chemotherapy, and maintains a complete remission.

  4. A case of Candida famata sepsis in a very low birth weight infant successfully treated with fluconazole following antifungal susceptibility testing

    Directory of Open Access Journals (Sweden)

    Shilpee Raturi

    2015-01-01

    This case report highlights the growing number of cases arising due to nonalbicans Candida infections in the neonatal intensive care units and the usefulness of antifungal susceptibility testing in deciding optimal antifungal therapy and preventing the emergence of drug resistance.

  5. A Complicated Case of Acute Promyelocytic Leukemia in the Second Trimester of Pregnancy Successfully Treated with All-trans-Retinoic Acid.

    Science.gov (United States)

    Agarwal, Kanika; Patel, Megha; Agarwal, Vandana

    2015-01-01

    A 40-year-old female at 26-week gestation was diagnosed with acute promyelocytic leukemia (APL) after an abnormal prenatal lab workup showed pancytopenia. She was treated with all-trans-retinoic acid (ATRA), idarubicin, and dexamethasone. After day one of treatment, she developed differentiation syndrome, which was treated with dexamethasone. At 30-week gestation, she had preterm premature rupture of membranes and delivered by cesarean section because of the fetus' breech presentation. Despite ATRA's potential for teratogenicity, a viable infant was born without apparent anomalies. Postpartum, she underwent consolidation treatment with ATRA and arsenic trioxide (ATO). The patient continued ATRA therapy after delivery and is currently in remission.

  6. Hantavirus cardiopulmonary syndrome successfully treated with high-volume hemofiltration

    Science.gov (United States)

    Bugedo, Guillermo; Florez, Jorge; Ferres, Marcela; Roessler, Eric; Bruhn, Alejandro

    2016-01-01

    Hantavirus cardiopulmonary syndrome has a high mortality rate, and early connection to extracorporeal membrane oxygenation has been suggested to improve outcomes. We report the case of a patient with demonstrated Hantavirus cardiopulmonary syndrome and refractory shock who fulfilled the criteria for extracorporeal membrane oxygenation and responded successfully to high volume continuous hemofiltration. The implementation of high volume continuous hemofiltration along with protective ventilation reversed the shock within a few hours and may have prompted recovery. In patients with Hantavirus cardiopulmonary syndrome, a short course of high volume continuous hemofiltration may help differentiate patients who can be treated with conventional intensive care unit management from those who will require more complex therapies, such as extracorporeal membrane oxygenation. PMID:27410413

  7. A misdiagnosed Riedel's thyroiditis successfully treated by thyroidectomy and tamoxifen.

    Science.gov (United States)

    Wang, Chih-Jung; Wu, Ta-Jen; Lee, Chung-Ta; Huang, Shih-Ming

    2012-12-01

    Riedel's thyroiditis, known as invasive fibrous thyroiditis, is a very rare form of chronic thyroiditis. It is hard to make the diagnosis without surgical biopsy. We present a case of Riedel's thyroiditis in a 52-year-old female with past history of Hashimoto's thyroiditis. She suffered from bilateral neck pain, which radiated to both lower jaws. The erythrocyte sedimentation rate was 125 mm/hour. Subacute thyroiditis superimposed on Hashimoto's thyroiditis was diagnosed and treated with steroid. However the response was poor and she had a history of severe peptic ulcer. To avoid inducing the peptic ulcer by steroid, she received bilateral subtotal thyroidectomy. During surgery, the thyroid had severe adhesion to surrounding soft tissue and the pathology showed Riedel's thyroiditis. The neck pain improved after thyroidectomy. Tamoxifen has been given for 8 months and the size of remnant thyroid decreased to 8 mm. We concluded that combined thyroidectomy and tamoxifen successfully cured a patient with Riedel's thyroiditis.

  8. A Complicated Case of Acute Promyelocytic Leukemia in the Second Trimester of Pregnancy Successfully Treated with All-trans-Retinoic Acid

    Directory of Open Access Journals (Sweden)

    Kanika Agarwal

    2015-01-01

    Full Text Available A 40-year-old female at 26-week gestation was diagnosed with acute promyelocytic leukemia (APL after an abnormal prenatal lab workup showed pancytopenia. She was treated with all-trans-retinoic acid (ATRA, idarubicin, and dexamethasone. After day one of treatment, she developed differentiation syndrome, which was treated with dexamethasone. At 30-week gestation, she had preterm premature rupture of membranes and delivered by cesarean section because of the fetus’ breech presentation. Despite ATRA’s potential for teratogenicity, a viable infant was born without apparent anomalies. Postpartum, she underwent consolidation treatment with ATRA and arsenic trioxide (ATO. The patient continued ATRA therapy after delivery and is currently in remission.

  9. Type B insulin resistance syndrome induced by systemic lupus erythematosus and successfully treated with intravenous immunoglobulin: case report and systematic review.

    Science.gov (United States)

    Zhang, Sigong; Wang, Guochun; Wang, Jinping

    2013-02-01

    Type B insulin resistance syndrome is characterized by the formation of autoantibodies against insulin receptors, which can cause severe hyperglycemia and insulin resistance. Systemic lupus erythematosus is the most common underlying diseases of the syndrome. This report details our study of a case involving a Chinese female with type B insulin resistance syndrome as well as systemic lupus erythematosus who completely recovered after undergoing immunosuppressive therapy, specifically pulse therapy utilizing intravenous immunoglobulin. We also conducted search in MEDLINE and Chinese BioMedicine database to identify relevant literatures published in the past 46 years. From our searches, six case reports in Chinese, 15 case reports, and a 28-year perspective article in English met our criteria; a total of 67 cases were included in our report. The mean age of subjects at presentation for groups A, B, and C were 42.95, 44.10, and 41.68 years, respectively, yielding no significant difference between these groups. African Americans were the most susceptible group to type B insulin resistance syndrome, followed by Asians representing 20.90 % of all cases. Comparisons between the three main racial groups surveyed indicated that the mean age of subjects at presentation were very contiguous for African Americans and Asians, and mean age of white people was remarkably higher than either of the first two groups. The syndrome appeared most common among Asian males, and white males were relatively less likely to suffer from type B insulin resistance syndrome. Hypoglycemia was most commonly observed in white people than in other racial groups. Hypoalbuminemia, elevated serum immunoglobulin G, and elevated sedimentation rates were more common in African Americans; Asian cases were more likely to show low serum C3 or C4 and nephritis. Two cases received intravenous immunoglobulin therapy, which has a remarkably rapid effect on insulin resistance.

  10. Hairy Cell Leukemia Presenting with Isolated Skeletal Involvement Successfully Treated by Radiation Therapy and Cladribine: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ipek Yonal-Hindilerden

    2015-01-01

    Full Text Available We describe an unusual case of hairy cell leukemia (HCL in a 55-year-old male presenting with isolated skeletal disease as the initial manifestation without abnormal peripheral blood counts, bone marrow involvement, or splenomegaly. To the best of our knowledge, there have been only two previous reports of a similar case. The patient presented with pain in the right femur. Anteroposterior radiographs of both femurs revealed mixed lytic-sclerotic lesions. PET scan showed multiple metastatic lesions on axial skeleton, pelvis, and both femurs. Histopathological examination of the bone biopsy revealed an infiltrate of HCL. Localized radiation therapy to both proximal femurs and subsequently 4 weeks later, a 7-day course of 0.1 mg/kg/day cladribine provided complete remission with relief of symptoms and resolution of bone lesions. We addressed the manifestations and management of HCL patients with skeletal involvement.

  11. Primary cutaneous b-cell lymphoma successfully treated with highly active antiretroviral therapy alone: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    María F Villafañe

    2011-01-01

    Full Text Available Cutaneous B-cell lymphoma (CBCL is an unusual skin neoplasm with a great range of clinical presentations. Here, we report a case of CBCL in an AIDS patient presented as a single and nodular/ulcerative lesion in the perianal area. The patient was started on highly active antiretroviral therapy alone with a good clinical and oncological response. Two years later, the patient is asymptomatic with undetectable viral load and immune reconstitution.

  12. [A Case of Familial Adenomatous Polyposis with a Desmoid Tumor Probably Communicating to the Intestinal Lumen That Was Successfully Treated with Non-Surgical Therapy].

    Science.gov (United States)

    Ito, Tetsuya; Chika, Noriyasu; Yamamoto, Azusa; Ogura, Toshiro; Amano, Kunihiko; Ishiguro, Toru; Fukuchi, Minoru; Kumagai, Youichi; Ishibashi, Keiichiro; Eguchi, Hidetaka; Okazaki, Yasushi; Mochiki, Erito; Ishida, Hideyuki

    2016-11-01

    A 44-year-old man with familial adenomatous polyposis underwent laparoscopic-assistedtotal proctocolectomy with ilealpouch anal anastomosis(IPAA). Computed tomography conducted 21 months after IPAA demonstrated bilateral hydronephrosis andan intra-abdominal mass with a maximal diameter of 22 cm, leading to a diagnosis of stage IV desmoid disease, according to the classification by Church and associates. Six courses of combination chemotherapy with doxorubicin plus dacarbazine were administered. Computed tomography after chemotherapy demonstrated marked shrinkage of the desmoidtumor with intraabdominal air andfluidcollection extending just below the skin of the ileostomy closure site. Stoollike fluidoverflowedspontaneously through the site of the ileostomy closure andthe abscess cavity was successfully drained. The patient was discharged 30 days after the start of drainage. The patient is doing well 10 months after the drainage without regrowth of the desmoid tumor, even though a cavity-like lesion encapsulatedby a thick wall remains.

  13. Blue foot: a second case of "tattoo blow-out" pigment spread successfully treated with the QS-Nd:YAG laser.

    Science.gov (United States)

    Khetarpal, Shilpi; Molenda, Matthew; Seiger, Eric; Pui, John; Obagi, Suzan

    2010-11-01

    The "tattoo blow-out" phenomenon occurs when tattoo pigments spread outside the border of a tattoo. It is thought to occur when ink is injected too deeply. A healthy 36-year-old female presented to a dermatologist with diffuse spread of tattoo pigment outside the original tattoo that occurred within one day of the placement of a professional tattoo on the dorsum of her foot. The patient was seeking treatment six weeks after the tattoo was placed because she thought the discoloration would improve or resolve on its own, but it worsened. Two punch biopsies were obtained for histology. The biopsy results confirmed granular black pigment consistent with a tattoo in the dermis and subcutaneous fat. The location of pigment was deeper than expected. Due to the success of the QS-Nd:YAG laser in a prior patient, the same treatment was recommended for this patient. The patient received nine laser sessions using the Q-switched laser at 1064 nm, 4 mm, 10 Hz, with gradually increasing energy from 4.5 to 6.0 J/cm2. The pigment outside of the original tattoo borders faded and is barely perceptible. It is important that physicians be made aware of tattoo complications so they can advise patients in regards to the associated risks.

  14. Phaeoacremonium parasiticum phaeohyphomycosis in a patient with systemic lupus erythematosus treated successfully with surgical debridement and voriconazole: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Rima I. El-Herte

    2014-01-01

    Full Text Available A 26-year old woman presented for evaluation of extensive edema, erythema, sinus tract formation and purulent drainage from the left lower extremity after trauma from a wooden object approximately three months prior. Skin biopsies and blood cultures revealed Phaeoacremonium parasiticum consistent with a diagnosis of phaeohyphomycosis. Despite hospitalization and initial treatment with several antifungals, including voriconazole, her infection progressed. Surgical debridement with split thickness skin grafting was performed. Subsequent clinical improvement allowed a transition from intravenous to oral voriconazole and discharge home. Seven months post presentation she remained on oral voriconazole with significant improvement and no clinical evidence of recurrence. This case illustrates an approach to management where aggressive debridement with split-thickness skin grafting and a prolonged course of intravenous and oral antifungals resulted in a good long-term outcome for the patient.

  15. [A case of ascariasis in the gallbladder successfully treated with an anthelmintic injection into the gallbladder via a percutaneous transhepatic catheter].

    Science.gov (United States)

    Ikuta, Syuzo; Mizuguchi, Yasuhiro; Tsuji, Yuichiro; Tsukamoto, Sakiko; Oba, Nobuyuki; Nishinakagawa, Syuta; Kojima, Tatsuya

    2010-05-01

    A man in his 40s who had made frequent visits abroad was admitted to our hospital complaining of epigastric pain. Ultrasonography (US) revealed an "inner tube sign" in the gallbladder, which suggested a diagnosis of ascariasis in the gallbladder. Pyrantel pamoate was directly injected into the gallbladder via a percutaneous transhepatic catheter. The worm was dead 10 minutes after the injection. US revealed reduction of the worm's length and then the disappearance of the worm from the gallbladder at both 13 days and 2 months after the injection. This method is less invasive than operation and therefore is possibly more safe. It is known that the number of cases of ascariasis may increase in Japan due to increased organic vegetable consumption and foreign travel. We need to consider this disease in the differential diagnosis of epigastric pain.

  16. Leadership Succession and Successful Leadership: The Case of Laura Martinez

    Science.gov (United States)

    Garza, Encarnacion, Jr.; Murakami-Ramalho, Elizabeth; Merchant, Betty

    2011-01-01

    This case study follows the work of principal Laura Martinez as moving from leading Stevens Elementary for 9 years, and now opening a new P-8th grade academy in the same south Texas urban, inner-city district. The purpose of this case study was to observe successful leadership and the principal's strategies both in her previous and present school,…

  17. Three Typical Dermatological Cases Treated by Dr. Li Yueping

    Institute of Scientific and Technical Information of China (English)

    Xie Shaoqiong

    2005-01-01

    @@ Dr. Li Yueping has been engaged in dermatological clinic for more than 40 years, accumulating rich experience in treating dermatological diseases. The following is three typical cases she gave successful treatment.

  18. Fetal Tachycardia Treated Successfully with Maternally Administered Propylthiouracil

    Directory of Open Access Journals (Sweden)

    Barbara V. Parilla

    2014-01-01

    Full Text Available Background. Fetal tachycardia may result from the transplacental passage of thyroid stimulating immunoglobulins in a patient with hypothyroidism secondary to ablation of Graves’ disease. Case. A 32-year-old woman, gravida 4, para 2, and abortus 1, with hypothyroidism and a history of Graves’ disease, presented at 23 6/7 weeks of gestation with a persistent fetal tachycardia. The treatment of the fetal tachycardia with maternally administered digoxin and Sotalol was unsuccessful. Maternal thyroid stimulating immunoglobulins were elevated, and treatment with maternally administered propylthiouracil (PTU resulted in a normal sinus rhythm for the remainder of the pregnancy. An induction of labor was performed at 37 weeks. Four to five days after delivery, the neonate exhibited clinical signs of hyperthyroidism necessitating treatment. Conclusion. Fetal tachycardia resulting from the transplacental passage of thyroid stimulating immunoglobulins can be successfully treated with maternally administered PTU. The neonate needs to be followed up closely as clinical signs of hyperthyroidism may occur as thyroid stimulating immunoglobulins continue to circulate in the neonate, while the serum levels of PTU decline.

  19. Plummer-Vinson syndrome successfully treated by endoscopic dilatation.

    Science.gov (United States)

    Enomoto, Masaru; Kohmoto, Madoka; Arafa, Usama Ahmed; Shiba, Masatsugu; Watanabe, Toshio; Tominaga, Kazunari; Fujiwara, Yasuhiro; Saeki, Yoshihiko; Higuchi, Kazuhide; Nishiguchi, Shuhei; Shiomi, Susumu; Osugi, Haruji; Kinoshita, Hiroaki; Arakawa, Tetsuo

    2007-12-01

    Plummer-Vinson (Paterson-Brown-Kelly) syndrome is uncommon nowadays. Although iron repletion improves its symptoms, endoscopic dilatation of associated esophageal webs is sometimes required. The case is described of a 69-year-old woman with Plummer-Vinson syndrome who was successfully treated by endoscopic bougienage. The patient had a longstanding history of anemia and slowly progressive dysphagia of solid food. Laboratory data on admission showed iron deficiency anemia (red blood cell count 402 x 10(4)/microL, hemoglobin 6.8 g/dL, serum iron 8 microg/dL, and serum ferritin 2.4 ng/mL). Radiographic esophagography revealed two circumferential webs at the level of the cervical esophagus. Upper gastrointestinal endoscopy showed a severe upper esophageal stricture caused by a smooth mucosal diaphragm. The patient was prescribed 40 mg of intravenous iron supplements daily for 30 days; her anemia improved but the dysphagia did not. Endoscopic bougienage was performed with the use of Celestin dilators of serially increasing diameters. The webs were easily disrupted without complications. The patient's dysphagia resolved shortly after the treatment and did not recur. This experience indicates that endoscopic bougienage is safe, effective, and relatively easy to perform in patients with severe esophageal stenosis.

  20. [Endodontically treated teeth. Success--failure. Endorestorative treatment plan].

    Science.gov (United States)

    Zabalegui, B

    1990-01-01

    More and more often the general dentist is finding the presence of endodontically treated teeth during his treatment planning procedure. He has to ask himself if the endo-treated tooth functions and will continue to function function successfully, when deciding which final endo-restorative procedure to apply. For this reason the dentist or the endodontist with whom he works should clinically evaluate these teeth, establish a diagnostic criteria of their success or failure and a treatment plan according to the prognosis. The purpose of this article is to offer an organized clinical view of the steps to follow when evaluating an endodontically treated tooth and how to establish a final endo-restorative plan.

  1. [Autism and catatonia: successful treatment using lorazepam. A case study].

    Science.gov (United States)

    de Winter, C F; van Dijk, F; Verhoeven, W M A; Dhossche, D M; Stolker, J J

    2007-01-01

    A 24-year-old man who was mentally retarded and had an autistic disorder, developed mutism and motor symptoms. He was diagnosed with catatonia and was treated successfully with lorazepam. Additionally, we review the literature about the diagnosis and treatment of catatonia in patients with autism; in such cases accurate diagnosis is vital but is complicated by overlapping symptoms.

  2. [Two treated cases of botulism].

    Science.gov (United States)

    Işik, N; Elibol, B; Oztekin, N S; Zileli, T

    1990-01-01

    Botulism is a severe neuroparalytic disease caused by the neurotoxins of Clostridium botulinum which exert their effects on peripheral nerve junctions. Guillain-Barre syndrome, Myasthenia Gravis, acute Poliomyelitis and diphtheria must be considered in the differential diagnosis. In this study we have discussed two patients who were treated in our clinic, the differential diagnosis and the role of anti-Cholinesterase drugs in the treatment.

  3. Intramedullary spinal neurocysticercosis treated successfully with medical therapy.

    Science.gov (United States)

    Ahmed, Shameem; Paul, Siba Prosad

    2014-12-01

    Neurocysticercosis caused by Taenia solium and is a common parasitic disease of the cental nervous system. It usually presents with seizures, headaches, progressively worsening focal neurologic symptoms, visual disturbances, loss of bladder control, etc. However, acute onset symptoms may also be seen. MRI scans can accurately diagnose spinal or cerebral lesions and is also helpful in monitoring progress while on treatment. Albendazole is currently the drug of choice along with steroids for medical management of neurocysticercosis. The case of intramedullary spinal neurocysticercosis was treated with praziquantel.

  4. Penile pyoderma gangrenosum successfully treated with topical Imiquimod

    Directory of Open Access Journals (Sweden)

    Santosh P Rathod

    2011-01-01

    Full Text Available Pyoderma gangrenosum(PG is a rare ulcerating inflammatory neutrophilic dermatosis. Genital involvement has been rarely reported. We report such a case of 24- year- old, male patient living with HIV/AIDS(PLHIV who presented with progressive genital ulceration, not responding to oral antibiotics and aciclovir, gradually increasing in size over 15-18 months. Repeated biopsies showed acute on chronic inflammation. The lesion partially responded to oral and topical corticosteroids but soon increased in size after tapering the dosage of the steroids.Then patient was given Imiquimod 5% cream to be applied over the lesion once daily for 2-4 weeks. Lesion cleared completely in 4 weeks and is in remission since last 6 months. The case report highlights the successful use of topical Imiquimod 5% cream in the treatment of penile PG.

  5. Gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery successfully treated with coil embolization: a case report and review of the literature.

    Science.gov (United States)

    Namikawa, Masashi; Kakizaki, Satoru; Takakusaki, Satoshi; Saito, Shuichi; Yata, Yutaka; Mori, Masatomo

    2011-12-01

    Endoscopic hemostasis is a useful treatment modality for gastric ulcer bleeding. However, it is sometimes difficult to achieve hemostasis in cases with arterial bleeding, especially those complicated with vascular abnormalities. We describe a case with gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery. A 50-year-old female was admitted to our hospital with dizziness and tarry stools. Upper gastrointestinal endoscopy revealed bleeding from a gastric ulcer, and endoscopic hemostasis by endoscopic clipping was carried out. Computed tomography and abdominal angiography revealed the variant left gastric artery running below the gastric ulcer. In spite of endoscopic hemostasis and medication, re-bleeding from the gastric ulcer occurred. A transcatheter coil embolization for the variant left gastric artery was performed and successfully achieved hemostasis. This case was accompanied by congenital absence of the splenic artery, which is an extremely rare condition. We herein describe this rare case and review previously reported cases.

  6. A case of acne fulminans in a patient with ulcerative colitis successfully treated with prednisolone and diaminodiphenylsulfone: a literature review of acne fulminans, rosacea fulminans and neutrophilic dermatoses occurring in the setting of inflammatory bowel disease.

    Science.gov (United States)

    Wakabayashi, Makiko; Fujimoto, Noriki; Uenishi, Toshiaki; Danno, Kiichiro; Tanaka, Toshihiro

    2011-01-01

    A 19-year-old Japanese man had been treated for ulcerative colitis for 2 years. He was admitted to our hospital with nodulocystic inflammatory papules and pustules on his face and chest, high-grade fever, arthralgia and general malaise. A biopsy specimen from a pustule showed prominent infiltration of neutrophils in the epidermis and dermis, particularly around hair follicles. We made a diagnosis of acne fulminans. The systemic administration of prednisolone at 30 mg daily for 1 week immediately improved his skin lesions and other symptoms; however, during tapering of prednisolone at 20 mg daily, skin lesions flared up. The addition of oral diaminodiphenylsulfone improved the skin lesions. Although there have been a few reports of acne fulminans associated with Crohn's disease, this is the first case report of acne fulminans in a patient with ulcerative colitis. It is noteworthy that the addition of diaminodiphenylsulfone was effective for treating the relapse of acne fulminans in this case.

  7. Symptomatic subserosal gastric lipoma successfully treated with enucleation.

    Science.gov (United States)

    Krasniqi, Avdyl-Selmon; Hoxha, Faton-Tatil; Bicaj, Besnik-Xhafer; Hashani, Shemsedin-Isuf; Hasimja, Shpresa-Mehmet; Kelmendi, Sadik-Mal; Gashi-Luci, Lumturije-Hasan

    2008-10-14

    Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed.

  8. Symptomatic subserosal gastric lipoma successfully treated with enucleation

    Institute of Scientific and Technical Information of China (English)

    Avdyl Selmon Krasniqi; Faton Tatil Hoxha; Besnik Xhafer Bicaj; Shemsedin Isuf Hashani; Shpresa Mehmet Hasimja; Sadik Mal Kelmendi; Lumturije Hasan Gashi-Luci

    2008-01-01

    Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed.

  9. A pediatric non-protein losing Menetrier's disease successfully treated with octreotide long acting release

    Institute of Scientific and Technical Information of China (English)

    Giovanni Di Nardo; Salvatore Oliva; Marina Aloi; Federica Ferrari; Simone Frediani; Adriana Marcheggiano; Salvatore Cucchiara

    2012-01-01

    Pediatric Menetrier's disease (MD) is an uncommon,acute,self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein losing gastropathy.Gastric cytomegalovirus infection is found in one third of MD children and its treatment is often associated with remission.Diagnosis often requires fullthickness biopsy due to inability to detect typical histological findings with conventional endoscopic biopsy.We report an uncommon case of non self-limited pediatric MD needing endoscopic mucosal resection for diagnosis which was then successfully treated with octreotide long-acting release (LAR).To the best of our knowledge,this is the first pediatric MD case successfully treated with octreotide LAR.Our experience suggests octreotide LAR as treatment for refractory MD before gastrectomy.

  10. Bioprosthetic mitral valve thrombosis complicating antiphospholipid antibody syndrome, successfully treated with thrombolysis.

    Science.gov (United States)

    Chamsi-Pasha, Mohammed A; Alyousef, Tareq; Sayyed, Samer

    2014-10-01

    The incidence of bioprosthetic valve thrombosis and related embolic complications is extremely rare, obviating the need for long-term anticoagulation. As a result, experience in the diagnosis and treatment of bioprosthetic valve thrombosis is fairly limited. We report the first case of antiphospholipid antibody syndrome presenting as bioprosthetic mitral valve thrombosis, 15 months after valve replacement, and successfully treated with thrombolytic therapy.

  11. Linear Darier's disease successfully treated with 0.1% tazarotene gel "short-contact" therapy.

    Science.gov (United States)

    Brazzelli, Valeria; Prestinari, Francesca; Barbagallo, Tania; Vassallo, Camilla; Agozzino, Marina; Borroni, Giovanni

    2006-01-01

    We report the case of a 25 year old man affected by linear Darier's disease. The patient presented with brownish keratotic papules involving the trunk in a linear pattern. These lesions were successfully treated within 6 weeks with 0.1% tazarotene gel "short contact". The good response that was obtained suggests that the use of "short contact" tazarotene could be useful in the treatment of linear Darier's disease.

  12. Disseminated mucormycosis in a paediatric patient: Lictheimia corymbifera successfully treated with combination antifungal therapy

    Directory of Open Access Journals (Sweden)

    Anita Campbell

    2014-10-01

    Full Text Available Mucormycosis is a severe fungal infection that largely affects immunocompromised individuals. It carries a high morbidity and mortality rate and is characterised by extensive angioinvasion and necrosis of host tissue. This case report details success in treating disseminated mucormycosis in a paediatric patient with an underlying haematological malignancy. Treatment included institution of combination antifungal therapy with liposomal amphotericin B and caspofungin, aggressive surgical debridement of infected tissue and reversal of underlying immunosuppression.

  13. Chronic depression treated successfully with novel taping therapy: a new approach to the treatment of depression

    Science.gov (United States)

    Han, Chang Hyun; Hwang, Hwa Soo; Lee, Young Joon; Lee, Sang Nam; Abanes, Jane J; Lee, Bong Hyo

    2016-01-01

    Introduction Despite improved research in the treatment, depression remains difficult to treat. Till date, successful treatment of depression using taping therapy has not been known yet. We report cases where patients with severe depressive symptoms were successfully treated by taping therapy, a new approach. Methods In case 1, a patient was taking several psychiatric medications for 10 years and admitted often to the psychiatric hospital with a leaning head, flexible legs, and nearly closed eyes; in case 2, a patient after a hysterectomy complained with heart palpitations, depressive- and anxiety-like behaviors, insomnia, and gastrointestinal problems; and in case 3, a patient with complaints of adverse effects from antidepressant medications had suicidal thoughts frequently. The medical tapes were placed on acupoints, trigger points, and pain points found by finger pressing examination in the chest, sides, and upper back of the patients. Results In case 1, the patient started weeping immediately after the first treatment. He discontinued psychiatric drugs and returned to baseline functioning after 2 months. In case 2, the patient felt at ease showing decreased palpitation immediately after the first treatment, and after 1 week, she quit medications. In case 3, the patient experienced a sense of calmness following the first treatment and recovered from her symptoms after 2 weeks. Conclusion These results suggest the following key points: examination of acupoints and trigger points of chest, sides, and upper back is useful in the assessment of depression; regulating bioelectric currents on these points is helpful in the treatment of depression; and depression can be treated successfully with taping therapy. PMID:27330295

  14. Successful case-based reasoning applications 2

    CERN Document Server

    Jain, Lakhmi

    2014-01-01

    Case-based reasoning paradigms offer automatic reasoning capabilities which are useful for the implementation of human like machines in a limited sense. This research book is the second volume in a series devoted to presenting Case-based reasoning (CBR) applications. The first volume, published in 2010, testified the flexibility of CBR, and its applicability in all those fields where experiential knowledge is available. This second volume further witnesses the heterogeneity of the domains in which CBR can be exploited, but also reveals some common directions that are clearly emerging in recent years. This book will prove useful to the application engineers, scientists, professors and students who wish to develop successful case-based reasoning applications.

  15. Donor Kidney With Renal Cell Carcinoma Successfully Treated With Radiofrequency Ablation

    DEFF Research Database (Denmark)

    Christensen, S F; Hansen, Jesper Melchior

    2015-01-01

    BACKGROUND: The risk of donor-transmitted cancer is evident. CASE REPORT: We report the case of a 69-year-old woman who was transplanted with a kidney from a deceased donor. Four days after transplantation a routine ultrasound scan revealed a 3-cm tumor in the middle-upper pole of the allograft....... A biopsy showed the tumor to be papillary renal cell carcinoma. The patient was treated with radiofrequency ablation. This procedure was complicated by the development of a cutaneous fistula and open surgery was done with resection of an area of necrosis in the kidney and of the fistula. The maintenance.......04 mg/dL]). CONCLUSIONS: To the best of our knowledge, this is the first case in which a donor-transmitted tumor was diagnosed in the renal allograft only 4 days after transplantation and subsequently treated successfully with radiofrequency ablation....

  16. An archetype of the collaborative efforts of psychotherapy and psychopharmacology in successfully treating dissociative identity disorder with comorbid bipolar disorder.

    Science.gov (United States)

    Lakshmanan, Manu N; Meier, Stacey L Colton; Meier, Robert S; Lakshmanan, Ramaswamy

    2010-07-01

    We present a case where dissociative identity disorder was effectively treated with memory retrieval psychotherapy. However, the patient's comorbid bipolar disorder contributed to the patient's instability and fortified the amnesiac barriers that exist between alter personality states in dissociative identity disorder, which made memory retrieval difficult to achieve. Implications from this case indicate that a close collaboration between psychologist and psychiatrist focused on carefully diagnosing and treating existing comorbid conditions may be the most important aspect in treating dissociative identity disorder. We present our experience of successfully treating a patient with dissociative identity disorder and bipolar disorder using this collaborative method.

  17. Primary parotid B-cell lymphoma successfully treated with chemotherapy plus highly active antiretroviral therapy with prolonged survival and immune reconstitution in an acquired immunodeficiency syndrome patient: Case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Marcelo Corti

    2014-01-01

    Full Text Available Non-Hodgkin′s lymphoma (NHL is the second most common acquired immunodeficiency syndrome (AIDS-defining cancer. In this population, up to 70-80% of cases may present as extranodal location as the primary clinical manifestation of the neoplasm disease. Gastrointestinal tract is the most frequent location of AIDS-associated NHL. However, salivary gland involvement, including the parotid gland is a rare complication in human immunodeficiency virus (HIV-patients. Here, we describe a patient seropositive for the HIV, who developed a primary NHL of the parotid gland histologically classified as a high-grade diffuse large B-cell lymphoma. Patient was treated with a combination of chemotherapy plus highly active antiretroviral therapy with a good clinical, virological and immunological response and a prolonged survival, more than 5 years, without evidence of neoplasm relapse.

  18. Adult Multisystem Langerhans Cell Histiocytosis Presenting with Central Diabetes Insipidus Successfully Treated with Chemotherapy

    Science.gov (United States)

    Choi, Jung-Eun; Lee, Hae Ri; Ohn, Jung Hun; Moon, Min Kyong; Park, Juri; Lee, Seong Jin; Choi, Moon-Gi; Yoo, Hyung Joon; Kim, Jung Han

    2014-01-01

    We report the rare case of an adult who was diagnosed with recurrent multisystem Langerhans cell histiocytosis (LCH) involving the pituitary stalk and lung who present with central diabetes insipidus and was successfully treated with systemic steroids and chemotherapy. A 49-year-old man visited our hospital due to symptoms of polydipsia and polyuria that started 1 month prior. Two years prior to presentation, he underwent excision of right 6th and 7th rib lesions for the osteolytic lesion and chest pain, which were later confirmed to be LCH on pathology. After admission, the water deprivation test was done and the result indicated that he had central diabetes insipidus. Sella magnetic resonance imaging showed a mass on the pituitary stalk with loss of normal bright spot at the posterior lobe of the pituitary. Multiple patchy infiltrations were detected in both lung fields by computed tomography (CT). He was diagnosed with recurrent LCH and was subsequently treated with inhaled desmopressin, systemic steroids, vinblastine, and mercaptopurine. The pituitary mass disappeared after two months and both lungs were clear on chest CT after 11 months. Although clinical remission in multisystem LCH in adults is reportedly rare, our case of adult-onset multisystem LCH was treated successfully with systemic chemotherapy using prednisolone, vinblastine, and 6-mercaptopurine, which was well tolerated. PMID:25309800

  19. Duloxetine-induced Sleep Bruxism in Fibromyalgia Successfully Treated With Amitriptyline

    Directory of Open Access Journals (Sweden)

    Şule Şahin Onat

    2015-10-01

    Full Text Available A 44-year-old woman, who was suffering from widespread musculoskeletal pain, fatigue, and sleep disorder, was diagnosed as fibromyalgia. There was no apparent organic disease. Duloxetine therapy was introduced with a dose of 60 mg/day at bedtime. A few days later her husband noted severe teeth clenching and associated loud grinding noises during sleep. Then, duloxetine dosage was reduced to 30 mg/day. The bruxism continued with this dosage, thus the therapy was discontinued. The bruxism resolved after cessation. Three weeks later, duloxetine therapy was restarted at the dosage of 60 mg/day. On the third day of the therapy, bruxism started again and amitriptyline therapy at the dosage of 10 mg/day was added to duloxetine therapy. The dosage of amitriptyline was incrementally adjusted to 25 mg/ day. On the fourth day of the combined therapy, bruxism symptoms improved. Two months later, the bruxism symptoms were resolved and the complaints for fibromyalgia were under control. Although bruxism has been reported due to venlafaxine use, there is only one duloxetine-induced bruxism case in the literature which was treated with buspirone. However, we report duloxetine-induced bruxism treated successfully with amitriptyline in a patient with fibromyalgia. Tricyclic antidepressants have a suppression effect on the REM phase of the sleep cycle; this may help to cease the bruxism symptoms appearing in that phase of the sleep cycle. This is the first reported case of fibromyalgia with duloxetine-induced sleep bruxism successfully treated with amitriptyline.

  20. A massive neglected giant basal cell carcinoma in a schizophrenic patient treated successfully with vismodegib.

    Science.gov (United States)

    Andersen, Rosa Marie; Lei, Ulrikke

    2015-01-01

    The small molecule vismodegib is a great treatment alternative to patients challenged, e.g. psychiatric disorders, suffering from severe basal cell carcinoma of the skin in which surgery or other treatment modalities is not possible because of patient's wish or condition. We present a case of a 73-year-old schizophrenic patient with a 15-year history of a neglected tumour located at the forehead and scalp, admitted to hospital in a state of inanition because of tumour expansion to the meninges and severe anaemia caused by bleeding, treated successfully with vismodegib.

  1. Auditory Brainstem and Middle Latency Responses Measured Pre- and Posttreatment for Hyperacusic Hearing-Impaired Persons Successfully Treated to Improve Sound Tolerance and to Expand the Dynamic Range for Loudness: Case Evidence.

    Science.gov (United States)

    Formby, Craig; Korczak, Peggy; Sherlock, LaGuinn P; Hawley, Monica L; Gold, Susan

    2017-02-01

    In this report of three cases, we consider electrophysiologic measures from three hyperacusic hearing-impaired individuals who, prior to treatment to expand their dynamic ranges for loudness, were problematic hearing aid candidates because of their diminished sound tolerance and reduced dynamic ranges. Two of these individuals were treated with structured counseling combined with low-level broadband sound therapy from bilateral sound generators and the third case received structured counseling in combination with a short-acting placebo sound therapy. Each individual was highly responsive to his or her assigned treatment as revealed by expansion of the dynamic range by at least 20 dB at one or more frequencies posttreatment. Of specific interest in this report are their latency and amplitude measures taken from tone burst-evoked auditory brainstem response (ABR) and cortically derived middle latency response (MLR) recordings, measured as a function of increasing loudness at 500 and 2,000 Hz pre- and posttreatment. The resulting ABR and MLR latency and amplitude measures for each case are considered here in terms of pre- and posttreatment predictions. The respective pre- and posttreatment predictions anticipated larger pretreatment response amplitudes and shorter pretreatment response latencies relative to typical normal control values and smaller normative-like posttreatment response amplitudes and longer posttreatment response latencies relative to the corresponding pretreatment values for each individual. From these results and predictions, we conjecture about the neural origins of the hyperacusis conditions (i.e., brainstem versus cortical) and the neuronal sites responsive to treatment. The only consistent finding in support of the pre- and posttreatment predictions and, thus, the strongest index of hyperacusis and positive treatment-related effects was measured for MLR latency responses for wave Pa at 2,000 Hz. Other response indices, including ABR wave V

  2. Symptomatic radial artery thrombosis successfully treated with endovascular approach via femoral access route

    Energy Technology Data Exchange (ETDEWEB)

    Pasha, Ahmed Khurshid [Department of Internal Medicine, University of Arizona (United States); Elder, Mahir D. [Heart and Vascular Institute, Detroit, MI (United States); Division of Cardiology, Wayne State University, Detroit, MI (United States); Malik, Umer Ejaz [Department of Internal Medicine, Texas Tech University Health Science Center at Permian Basin, TX (United States); Khalid, Abdullah Mian [Department of Internal Medicine, University of Pittsburg Medical Center, Mercy Hospital, Pittsburg, PA (United States); Noor, Zeeshan [Department of Internal Medicine, St. Joseph Mercy Hospital, Ann Arbor, MI (United States); Movahed, Mohammad Reza, E-mail: rmova@aol.com [Department of Internal Medicine, University of Arizona (United States); Sarver Heart Center, University of Arizona (United States); CareMore HealthCare, AZ (United States)

    2014-09-15

    Radial access has been increasingly utilized for coronary intervention due to higher safety profile in comparison to femoral access site with lower bleeding rate. Radial artery occlusion is not uncommon with radial access site. This usually does not lead to any harm due to ulnar artery collaterals that are sufficient to prevent hand ischemia and is usually left alone. However, in the case of significant hand ischemia, treatment is often necessary. We are reporting an interesting case of symptomatic radial artery thrombosis leading to arm ischemia that was successfully treated percutaneously using femoral access. Using femoral access for radial artery intervention has not been reported previously. This case is followed by review of the literature.

  3. Chronic depression treated successfully with novel taping therapy: a new approach to the treatment of depression

    Directory of Open Access Journals (Sweden)

    Han CH

    2016-06-01

    Full Text Available Chang Hyun Han,1,* Hwa Soo Hwang,2,* Young Joon Lee,3 Sang Nam Lee,4 Jane J Abanes,5 Bong Hyo Lee6 1Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, 2Chims-Saengvit Oriental Medicine Clinic, Seoul, 3Department of Preventive Korean Medicine, 4Department of Qigong, College of Korean Medicine, Daegu Haany University, Gyeongsangbuk-do, South Korea; 5Daniel K Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; 6Department of Acupuncture, Moxibustion and Acupoint, College of Korean Medicine, Daegu Haany University, Daegu, South Korea *These authors contributed equally to this work Introduction: Despite improved research in the treatment, depression remains difficult to treat. Till date, successful treatment of depression using taping therapy has not been known yet. We report cases where patients with severe depressive symptoms were successfully treated by taping therapy, a new approach.Methods: In case 1, a patient was taking several psychiatric medications for 10 years and admitted often to the psychiatric hospital with a leaning head, flexible legs, and nearly closed eyes; in case 2, a patient after a hysterectomy complained with heart palpitations, depressive- and anxiety-like behaviors, insomnia, and gastrointestinal problems; and in case 3, a patient with complaints of adverse effects from antidepressant medications had suicidal thoughts frequently. The medical tapes were placed on acupoints, trigger points, and pain points found by finger pressing examination in the chest, sides, and upper back of the patients.Results: In case 1, the patient started weeping immediately after the first treatment. He discontinued psychiatric drugs and returned to baseline functioning after 2 months. In case 2, the patient felt at ease showing decreased palpitation immediately after the first treatment, and after 1 week, she quit medications. In case 3, the patient experienced a

  4. A case of treatment refractory hyperemesis gravidarum in a patient with comorbid anxiety, treated successfully with adjunctive gabapentin: a review and the potential role of neurogastroentereology in understanding its pathogenesis and treatment.

    Science.gov (United States)

    Spiegel, David R; Webb, Kathryn

    2012-11-01

    Hyperemesis gravidarum occurs in 0.3 to 10 percent of pregnant women, with a 0.8 percent hospital admission rate. While older theories supported the psychosocial model as a cause for hyperemesis gravidarum, more recent studies have shown significant data to support a biological etiology. Hyperemesis gravidarum has serious complications including include increased risk for miscarriage, low birth weight infants, dehydration, Wernicke's encephalopathy, secondary depression, and negative attitudes toward a consecutive pregnancy. Because of these life-threatening complications and complexity of the disease, it is important to treat both somatic and psychosocial causes of hyperemesis gravidarum to provide the best care for the patient. This paper presents a case of a woman with anxiety symptoms who was experiencing severe nausea and vomiting since Week 2 of pregnancy, with minimal reduction of these symptoms on standard medications utilized in hyperemesis gravidarum. The patient had marked reduction of nausea and vomiting with adjunctive gabapentin. After a brief review of relevant neurogastroenterology, we discuss a possible mechanism for the added gabapentin.

  5. Recurrent spontaneous hemarthrosis after total knee arthroplasty successfully treated with synoviorthesis.

    Science.gov (United States)

    Kapetanos, George A; Papavasiliou, Kyriakos A; Makris, Vassilios; Nikolaides, Anastasios P; Kirkos, John M; Symeonides, Panayotis P

    2008-09-01

    A case of spontaneous recurrent hemarthrosis--due to developed hypertrophied synovium--after total knee arthroplasty is reported. The patient was successfully treated with radiosynovectomy. The first hemorrhage occurred 18 months after the total knee arthroplasty. Several similar episodes followed over a period of 4 years. Because conservative treatment failed to control the bleeding, an arthroscopic lavage was performed, which revealed the existence of proliferative synovium. A significant part of the hypertrophic tissue was excised with the use of a thermocoagulator. However, 1 month later, another episode of hemarthrosis occurred. As a final step before reoperation, the patient was treated with intra-articular injection of ytrium 90. Eighteen months later, she remains symptom-free, is very satisfied with the result, and reports no new episode of hemarthrosis.

  6. Secondary pouchitis in a post-operative patient with ulcerative colitis, successfully treated by salvage surgery

    Institute of Scientific and Technical Information of China (English)

    Yuji Toiyama; Toshimitsu Araki; Shigeyuki Yoshiyama; Chikao Miki; Masato Kusunoki

    2005-01-01

    We report a case of secondary pouchitis, defined as a mucosal inflammatory lesion in the ileal reservoir provoked by pouch-related complication following total colectomy and pouch anal anastomosis, which was successfully treated by salvage surgery. A 20-year-old woman with ulcerative colitis developed acute severe bloody diarrhea following proctocolectomy, ileal pouchanal anastomosis and diverting ileostomy. She was diagnosed as having a secondary pouchitis mainly caused by a peripouch abscess and partly concerned with the abnormal pouch formation. The remnantrectum and ileal pouch were excised and ileal pouch-anal anastomosis and diverting ileostomy were constructed.The postoperative course was uneventful with no sign of pouchitis. Salvage surgery may be indicated to treat secondary pouchitis when caused by surgery-related complications.

  7. Adolescent Catatonia Successfully Treated with Lorazepam and Aripiprazole

    OpenAIRE

    Roberto, Aaron J.; Subhash Pinnaka; Abhishek Mohan; Hiejin Yoon; Kyle A. B. Lapidus

    2014-01-01

    Catatonia is especially concerning in children and adolescents. It leads to significant impairment, including emotional distress, difficulty communicating, and other debilitating symptoms. In this case report, we discuss a patient with no previous history of neuroleptic medication or psychotic symptoms, presenting with first-episode catatonia in the presence of disorganized, psychotic thoughts. We then review the catatonia syndrome, citing examples in the literature supporting its underdiagno...

  8. Symptomatic subserosal gastric lipoma successfully treated with enucleation

    OpenAIRE

    2008-01-01

    Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptom...

  9. Successfully treated unstable angina pectoris in a young Japanese female.

    Science.gov (United States)

    Umetani, K; Nakagawa, K; Oagawa, R; Iida, T; Kohno, I; Osada, M; Sawanobori, T; Ijiri, H; Komori, S; Tamura, K

    2001-05-01

    A 25-year-old Japanese female complaining chest oppression and palpitation was admitted to hospital under the presumptive diagnosis of ischemic heart disease (IHD), although no obvious underlying disease associated with IHD was detected. Coronary angiography showed stenosis at the proximal site of left anterior descending artery (LAD), with dilatation and tortuosity at the bifurcation of the first and the second septal branches. Intravascular ultrasound imaging of the LAD showed intimal thickness without calcification at the site of stenosis. The stenosis was successfully and smoothly dilated by percutaneous transluminal angioplasty. Even with precise evaluation, the cause of the coronary artery disease in this young female patient was not clarified. Further careful follow-up is needed.

  10. Second Primary Pancreatic Adenocarcinoma Three Years After Successfully Treated Index Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Nina Nandy

    2014-01-01

    Full Text Available Context Development of a second primary malignancy after an index esophageal cancer is a rare event, primarily due to short survival of patients with esophageal cancer. However, the number of long-term esophageal cancer survivors has been increasing due to advances in early detection and therapy. Case report We report herein a case of pancreatic adenocarcinoma that developed three years after a successfully treated early-stage adenocarcinoma of the esophagus. A 70-year-old Caucasian male presented with vague complaints of nausea, vomiting and abdominal distention, with subsequent development of jaundice. A computed tomography scan of abdomen revealed a 2.9 cm soft tissue mass in the head of the pancreas and the patient underwent a Whipple’s procedure, with pathology confirming the diagnosis of pancreatic adenocarcinoma. Three years previously, the patient was successfully treated for adenocarcinoma of the esophagus via minimally invasive esophagogastrectomy. Despite chemoradiotherapy for localized disease and subsequent systemic chemotherapy for metastatic pancreatic cancer, the patient eventually succumbed to his illness. Conclusion We discuss the association between esophageal cancer and subsequent second malignancies, along with implications for surveillance and therapy.

  11. Patient with intractable delirium successfully treated with electroconvulsive therapy

    DEFF Research Database (Denmark)

    Lindgren, Eske; Hageman, Ida

    2014-01-01

    Delirium is a frequent and serious condition often seen in hospitalized patients, especially the elderly. Treatment of the somatic illness causing the delirium, and antipsychotic medication will usually resolve the condition. Sometimes, however, the condition is refractory towards medical treatment...... and in this situation electroconvulsive therapy (ECT) can be a quick and efficient treatment. In this case report of a 26-year-old man a post-operative intractable delirium persisting for three weeks was efficiently and swiftly relieved by three consecutive ECTs. The patient was discharged without need for further...

  12. Intestinal Anisakiasis Treated Successfully with Prednisolone and Olopatadine Hydrochloride

    Directory of Open Access Journals (Sweden)

    Hideki Toyoda

    2016-02-01

    Full Text Available The clinical characteristic of gastrointestinal anisakiasis is severe abdominal pain after eating raw fish. Intestinal anisakiasis is more uncommon than gastric anisakiasis. Most patients with intestinal anisakiasis need hospitalization because anisakiasis can cause intestinal obstruction, ileus, peritonitis or intestinal perforation. We report a case of intestinal anisakiasis. A 43-year-old woman presented with symptoms of intermittent abdominal pain 2 days after eating raw fish. Her brother had eaten the same food and had been suffering from gastric anisakiasis. Abdominal ultrasonography in this patient showed localized jejunal wall thickening with dilated lumen of proximal jejunum and ascites. According to the clinical course and examinations, she was diagnosed with intestinal anisakiasis. Administration of prednisolone 5 mg/day and olopatadine hydrochloride 10 mg/day improved her symptoms quickly without hospitalization. Prednisolone was administered for 10 days, and olopatadine hydrochloride was administered for a total of 6 weeks according to ultrasonographic findings. Six months after the treatment, the abdominal ultrasonography demonstrated normal findings. This case demonstrates that ultrasonography was quite useful for the diagnosis and surveillance of intestinal anisakiasis. Furthermore, treatment with corticosteroid and an antiallergic agent could be an option for patients with intestinal anisakiasis.

  13. Linear porokeratosis with multiple squamous cell carcinomas successfully treated by electrochemotherapy.

    Science.gov (United States)

    Sommerlad, M; Lock, A; Moir, G; McGregor, J; Bull, R; Cerio, R; Harwood, C

    2016-12-01

    Porokeratosis is a clonal epidermal disorder of keratinization characterized by annular lesions with an atrophic centre and a hyperkeratotic edge. The cornoid lamella is the histopathological hallmark. Six clinical variants are recognized: porokeratosis of Mibelli; disseminated superficial porokeratosis; disseminated superficial actinic porokeratosis (DSAP); porokeratosis plantaris et palmaris disseminata; punctate porokeratosis and linear porokeratosis. Linear porokeratosis is the type most frequently associated with malignant transformation into squamous cell carcinoma (SCC). It is thought to represent a mosaic form of DSAP and has an incidence of less than 1 in 200 000; treatment options are limited. We describe a patient with systematized linear porokeratosis and multiple SCCs who was successfully treated with bleomycin electrochemotherapy (ECT), a form of intralesional chemotherapy. In view of their large number, the individual SCCs were treated with bleomycin ECT. One year post-treatment the patient remains tumour free. To our knowledge, this is the first case of multiple SCCs treated by ECT in the context of systematized linear porokeratosis. Our case highlights the challenges associated with diagnosing and managing this unusual form of porokeratosis.

  14. Allergic bronchopulmonary aspergillosis treated successfully for one year with omalizumab

    Directory of Open Access Journals (Sweden)

    Collins J

    2012-11-01

    Full Text Available Jennifer Collins,1 Gabriele deVos,2 Golda Hudes,2 David Rosenstreich21New York Eye and Ear Infirmary, New York, NY, 2Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USABackground: Current therapy for allergic bronchopulmonary aspergillosis (ABPA uses oral corticosteroids, exposing patients to the adverse effects of these agents. There are reports of the steroid-sparing effect of anti-IgE therapy with omalizumab for ABPA in patients with cystic fibrosis (CF, but there is little information on its efficacy against ABPA in patients with bronchial asthma without CF.Objective: To examine the effects of omalizumab, measured by asthma control, blood eosinophilia, total serum immunoglobulin E (IgE, oral corticosteroid requirements, and forced expiratory volume spirometry in patients with ABPA and bronchial asthma.Methods: A retrospective review of charts from 2004–2006 of patients treated with omalizumab at an academic allergy and immunology practice in the Bronx, New York were examined for systemic steroid and rescue inhaler usage, serum immunoglobulin E levels, blood eosinophil counts, and asthma symptoms, as measured by the Asthma Control Test (ACT.Results: A total of 21 charts were screened for the diagnosis of ABPA and bronchial asthma. Four patients with ABPA were identified; two of these patients were male. The median monthly systemic corticosteroid use at 6 months and 12 months decreased from baseline usage. Total serum IgE decreased in all patients at 12 months of therapy. Pre-bronchodilator forced expiratory vital capacity at one second (FEV1 was variable at 1 year of treatment. There was an improvement in Asthma Control Test (ACT symptom scores for both daytime and nighttime symptoms.Conclusions: Treatment with omalizumab creates a steroid-sparing effect, reduces systemic inflammatory markers, and results in improvement in ACT scores in patients with ABPA.Keywords: allergic bronchopulmonary aspergillosis

  15. Acute Fibrinous and Organizing Pneumonia Associated With Allogenic Hematopoietic Stem Cell Transplant Successfully Treated With Corticosteroids

    Directory of Open Access Journals (Sweden)

    Lam-Phuong Nguyen DO

    2016-04-01

    Full Text Available Acute fibrinous and organizing pneumonia (AFOP is an extremely rare, relatively new, and distinct histological pattern of acute lung injury characterized predominately by the presence of intra-alveolar fibrin and associated organizing pneumonia. AFOP may be idiopathic or associated with a wide spectrum of clinical conditions. It has a variable clinical presentation from mild respiratory symptoms to that similar to the acute respiratory distress syndrome. Currently there is no consensus on treatment, and corticosteroids previously were of unclear benefit. To date, there are less than 40 cases of AFOP reported in the literature and only one has been linked to hematopoietic stem cell transplantation. Here we report the first case series of 2 patients who developed AFOP following allogenic stem cell transplant that were successfully treated with high-dose corticosteroids.

  16. Abdominal compartment syndrome successfully treated with neuromuscular blockade

    Directory of Open Access Journals (Sweden)

    Kris T Chiles

    2011-01-01

    Full Text Available A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention.

  17. Successful displacement of a traumatic submacular hemorrhage in a 13-year-old boy treated by vitrectomy, subretinal injection of tissue plasminogen activator and intravitreal air tamponade: a case report

    OpenAIRE

    Doi, Shinichiro; Kimura, Shuhei; Morizane, Yuki; Shiode, Yusuke; Hosokawa, Mio; Hirano, Masayuki; Hosogi, Mika; Fujiwara, Atsushi; Miyamoto, Kazuhisa; Shiraga, Fumio

    2015-01-01

    Background The natural course of submacular hemorrhage resulting from traumatic choroidal rupture generally has a poor outcome unless treated. The intravitreal injection of gas only or gas with recombinant tissue plasminogen activator (rt-PA) has been reported to be effective, but has also been reported to induce severe complications such as retinal detachment and vitreous hemorrhage. Recently, we reported a safe and effective procedure for treating submacular hemorrhage due to polypoidal cho...

  18. Spondylodiscitis (Andersson lesion in psoriatic spondyloarthritis: a rare event successfully treated with an anti-TNF therapy.

    Directory of Open Access Journals (Sweden)

    Vincenzo Bruzzese

    2016-04-01

    Full Text Available Spondylodiscitis (Andersson lesion is an infrequent and late complication of advanced ankilosing arthritis. Scanty data on the efficacy of anti-TNF therapy for these lesions are available. To our knowledge, only few cases of spondylodiscitis occurring in patients with psoriatic arthritis were reported in literature. We describe the case of a patient with psoriatic arthritis who early developed Andersson lesions successfully treated with infliximab plus methotrexate therapy.

  19. Refractory Scedosporium apiospermum Keratitis Successfully Treated with Combination of Amphotericin B and Voriconazole

    Directory of Open Access Journals (Sweden)

    Mohd-Tahir Fadzillah

    2013-01-01

    Full Text Available Aim. To report a case of refractory fungal keratitis caused by Scedosporium apiospermum. Methods. Interventional case report. Results. A 47-year-old Malay housewife presented with left eye cornea ulcer as her first presentation of diabetes mellitus. There was no history of ocular trauma, contact lens used, or cornea foreign body. Scedosporium apiospermum was isolated from the cornea scrapping. Her cornea ulcer initially responded well to topical Amphotericin B within 3 days but subsequently worsened. Repeat cornea scrapping also yields Scedosporium apiospermum. This refractory keratitis was successfully treated with a combination of topical Amphotericin B and Voriconazole over 6 weeks. Conclusion. Scedosporium apiospermum keratitis is an opportunistic infection, which is difficult to treat despite tight control of diabetes mellitus and intensive antifungal treatment. The infection appeared to have very quick onset but needed long duration of treatment to completely heal. Surgical debridement always plays an important role as a therapeutic procedure as well as establishes the diagnosis through repeat scrapping.

  20. Combined Thenar and Hypothenar Hammer Syndromes and Raynaud's Phenomenon Successfully Treated with Iloprost.

    Science.gov (United States)

    Ciapetti, Alessandro; Carotti, Marina; Di Carlo, Marco; Salaffi, Fausto

    2016-01-01

    Thenar and hypothenar hammer syndromes are uncommon conditions characterised by digital ischemia of the hand as a result of repetitive trauma at level of the thenar and/or hypothenar eminence and damage to the radial and/or ulnar arteries, respectively. The symptoms are related to the mechanism of the trauma and a Raynaud's phenomenon can be predominant for a long time. The angiography is the "gold standard" imaging technique which allows to confirm the diagnosis. Therapeutic strategy depends on the type of the lesion and severity of symptoms and includes pharmacological (antithrombotic and thrombolytic drugs) and surgical treatments. The authors present a case of a 53-year-old man, carpenter by profession, with combined thenar and hypothenar hammer syndromes and Raynaud's phenomenon, successfully treated with a short course of intravenous infusion of iloprost.

  1. Exophiala dermatitidis pneumonia successfully treated with long-term itraconazole therapy.

    Science.gov (United States)

    Mukai, Yutaka; Nureki, Shin-ichi; Hata, Masahiro; Shigenaga, Takehiko; Tokimatsu, Issei; Miyazaki, Eishi; Kadota, Jun-ichi; Yarita, Kyoko; Kamei, Katsuhiko

    2014-07-01

    Exophiala dermatitidis pneumonia is extremely rare. Here we report a case of E. dermatitidis pneumonia successfully treated with long-term itraconazole therapy. A 63-year-old woman without a remarkable medical history developed a dry and chest pain. Chest radiographs revealed consolidation in the middle lobe of the lung. Cytologic examination by bronchoscopy showed filamentous fungi and E. dermatitidis was detected in the bronchoalveolar lavage fluid. After 5 months of itraconazole therapy, her symptoms improved and the area of consolidation diminished. Two weeks after discontinuing the itraconazole therapy, the area of consolidation reappeared. Itraconazole therapy was restarted and continued for 7 months. The abnormal shadow observed on the chest X-ray gradually diminished. Over a 27-month follow-up with periodic examination, there was no relapse and the patient had a favorable clinical course.

  2. Hepatic Encephalopathy due to Congenital Multiple Intrahepatic Portosystemic Venous Shunts Successfully Treated by Percutaneous Transhepatic Obliteration

    Directory of Open Access Journals (Sweden)

    Shinsuke Takenaga

    2016-11-01

    Full Text Available Hepatic encephalopathy due to intrahepatic portosystemic venous shunts (IPSVS in a non-cirrhotic condition is rare. Here we report a rare case of a patient with congenital multiple IPSVS successfully treated by percutaneous transhepatic obliteration. The patient was a 67-year-old woman who presented to our hospital with progressive episodes of consciousness disorder and vomiting. Laboratory tests revealed hyperammonemia (192.0 μg/dL, and computed tomography revealed multiple IPSVS in both lobes. There was no evidence of underlying liver disease or hepatic trauma. Transcatheter embolization for IPSVS was performed because conservative therapy was not sufficiently effective. After endovascular shunt closure, hepatic encephalopathy improved. The serum ammonia level normalized during the 5-year follow-up period. Thus, transcatheter embolization may be an effective therapy for patients with symptomatic and refractory IPSVS. Careful follow-up is necessary for portal hypertension-related complications after transcatheter embolization for IPSVS.

  3. Acne fulminans successfully treated with prednisone and dapsone Acne fulminans tratada com prednisona associada à dapsona

    Directory of Open Access Journals (Sweden)

    Rafael Bandeira Lages

    2012-08-01

    Full Text Available Acne fulminans is a rare condition and the most severe form of acne. It involves the sudden onset of febrile and multisystemic symptoms, with poor response to ordinary therapy in patients who previously had mild to moderate acne. It is characterized by hemorrhagic ulcerative crusting lesions on the face, chest and upper back. The authors report a case of acne fulminans that was successfully treated with oral prednisone and dapsone.A acne fulminans é uma condição rara e a mais severa forma de acne. Manifesta-se com um quadro agudo, febril e multissistêmico, resistente à terapêutica convencional em doentes com antecedente de acne leve ou moderada. As lesões são caracteristicamente úlcero-hemorrágicas e acometem preferencialmente tórax e face. Os autores relatam um caso de acne fulminans com excelente resposta terapêutica ao tratamento empregado.

  4. Post-transplant lymphoproliferative disorder in the pelvis successfully treated with consolidative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Habibeh, Omar; Elsayad, Khaled; Kriz, Jan; Haverkamp, Uwe; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiation Oncology, Muenster (Germany)

    2017-01-15

    Post-transplant lymphoproliferative disorders (PTLDs) are aggressive malignancies which represent one of the major post-transplant complications. However, treatment options vary significantly and localized disease may be curatively treated with radiotherapy (RT) or surgery. We report a case of recurrent rectal PTLD, which was successfully treated by chemoimmunotherapy followed by RT. We describe a patient who developed a rectal lymphoproliferative lesion 11 years after kidney transplant, which was successfully treated with consolidative RT using 25.4 Gy sequential to chemoimmunotherapy (R-CHOP). RT was well tolerated and the patient showed no signs of grade 3 or 4 toxicity. This patient is free of recurrence 52 months after RT, with an overall survival of 62 months since diagnosis. Conventionally fractionated moderate-dose RT appears to be a tolerable and effective treatment option for localized PTLD if a sufficient systemic treatment cannot be applied. (orig.) [German] Posttransplantationslymphoproliferative Erkrankungen (PTLDs) sind eine haeufige Komplikation nach einer Organtransplantation. Nichtdestotrotz unterscheiden sich die Behandlungsmoeglichkeiten signifikant und vor allem lokalisierte Stadien koennen kurativ entweder mit Strahlentherapie (RT) und/oder Operation behandelt werden. Wir berichten ueber einen Fall einer rezidivierten rektalen PTLD, die erfolgreich mit einer Chemoimmuntherapie mit anschliessender RT behandelt wurde. Wir beschreiben einen Patienten der 11 Jahre nach einer Nierentransplantation eine PTLD entwickelte. Diese wurde erfolgreich mit konsolidierender RT (25,4 Gy) im Anschluss an eine Chemoimmuntherapie (R-CHOP) behandelt. Die RT wurde komplikationslos vertragen und es zeigten sich keine Nebenwirkungen. Das rezidivfreie Ueberleben betrug zum Zeitpunkt der letzten Nachsorgeuntersuchung 52 Monate mit einer Gesamtueberlebenszeit von 62 Monaten seit der Diagnose. Die konventionelle fraktionierte moderat dosierte RT scheint eine gut

  5. Rotterdam Navel Gazing as Success Factor… (case)

    NARCIS (Netherlands)

    Star, G.J. Van der; Maas, A.

    2016-01-01

    Case about Henk, sector manager Cleantech at Rotterdam Partners. His responsibility is to stimulate the Circular Economy of Rotterdam, this in cooperation with the “government” of Rotterdam. Of course he knows a lot about what a Circular Economy theoretically is and should be, but to put in the day

  6. Refractory Uveitis in Patient with Castleman Disease Successfully Treated with Tocilizumab

    Directory of Open Access Journals (Sweden)

    Toshiyuki Oshitari

    2012-01-01

    Full Text Available Although multicentric Castleman disease is a rare but life-threatening disease, eye complications are extremely uncommon. We present a case of refractory uveitis accompanied with Castleman disease successfully treated with tocilizumab. A 58-year-old man with Castleman disease was introduced for refractory uveitis to Chiba University Hospital. Large cells were detected in the anterior chamber and increased vascular permeability of retinal vessels has been found in both eyes. Although the patient was treated with oral and eye drop steroid treatment, the uveitis symptoms had not decreased. The serum levels of CRP and IL-6 were increased. The level of IL-6 concentration in the anterior chamber was the same as the serum level of IL-6. The humanized anti-IL-6 receptor-antibody (tocilizumab was administrated for the patient because of poor general condition. After tocilizumab treatment, large cells in the anterior chamber were undetectable and vascular permeability was improved in FA. The serum levels of CRP and IL-6 decreased and the general condition improved. The side effect of tocilizumab was not observed during the treatment. Tocilizumab treatment was significantly effective for uveitis accompanied with Castleman disease. Although it is extremely rare, uveitis accompanied with Castleman disease may be one of the hallmarks to consider tocilizumab treatment.

  7. Steroid unresponsive anti-NMDA receptor encephalitis during pregnancy successfully treated with plasmapheresis.

    Science.gov (United States)

    Shahani, Lokesh

    2015-04-29

    Anti-N-methyl-d-aspartate (NMDA) receptor encephalitis is an autoimmune disorder resulting in neurological and psychiatric symptoms. It is rare during pregnancy and treatment is extremely challenging as little data exist to guide management. A 26-year-old woman presented at 22 weeks of gestation with intermittent headache and an acute episode of bizarre behaviour and grandiose delusions resulting in hospitalisation. The patient was worked up for encephalitis and was found to have anti-NMDA receptor antibody in cerebrospinal fluid as well as in serum. She was initially treated with high-dose steroids but failed to improve clinically and serologically. She was then treated with plasmapheresis and showed clinical and serological response. She had a successful delivery at 37 weeks and the baby did not show serological evidence of disease. This case adds to the sparse literature of anti-NMDA receptor encephalitis during pregnancy and adds to the differential diagnosis of new onset psychiatric symptoms during pregnancy.

  8. Giant bilateral renal angiomyolipomas and lymphangioleiomyomatosis presenting after two successive pregnancies successfully treated with surgery and rapamycin.

    Science.gov (United States)

    Peces, Ramón; Cuesta-López, Emilio; Peces, Carlos; Selgas, Rafael

    2011-01-01

    We report the case of a 25-year-old woman who presented with abdominal and flank pain with two successive pregnancies and was diagnosed of giant bilateral renal AMLs and pulmonary LAM associated with TSC in the post-partum of her second pregnancy. This case illustrates that in women with TSC rapid growth from renal AMLs and development of LAM may occur with successive pregnancies. It also stresses the potential for preservation of renal function despite successive bilateral renal surgery of giant AMLs. Moreover, the treatment with a low-dose rapamycin may be an option for LAM treatment. Finally, a low-dose rapamycin may be considered as an adjuvant treatment together to kidney-sparing conservative surgery for renal AMLs.

  9. Giant Bilateral Renal Angiomyolipomas and Lymphangioleiomyomatosis Presenting after Two Successive Pregnancies Successfully Treated with Surgery and Rapamycin

    Directory of Open Access Journals (Sweden)

    Ramón Peces

    2011-01-01

    Full Text Available We report the case of a 25-year-old woman who presented with abdominal and flank pain with two successive pregnancies and was diagnosed of giant bilateral renal AMLs and pulmonary LAM associated with TSC in the post-partum of her second pregnancy. This case illustrates that in women with TSC rapid growth from renal AMLs and development of LAM may occur with successive pregnancies. It also stresses the potential for preservation of renal function despite successive bilateral renal surgery of giant AMLs. Moreover, the treatment with a low-dose rapamycin may be an option for LAM treatment. Finally, a low-dose rapamycin may be considered as an adjuvant treatment together to kidney-sparing conservative surgery for renal AMLs.

  10. Severe digital ischemia due to systemic sclerosis successfully treated with bosentan: case report Tratamento de isquemia digital severa em paciente com esclerose sistêmica utilizando bosentana: relato de caso

    Directory of Open Access Journals (Sweden)

    Cesar José Guimarães Soares

    2007-09-01

    Full Text Available Systemic sclerosis (SSc is an autoimmune connective tissue disease characterized by cutaneous and visceral fibrosis and widespread vascular pathology. Raynaud's phenomenon is one of the most common manifestations of SSc. It may lead to complications such as digital ulceration and infarction and its treatment remains elusive. We present the case of a female patient with severe digital ischemia secondary to SSc. Treatment using vasodilators and prostacyclin analogues was ineffective, but the patient experienced a remarkable response to bosentan, a dual endothelin receptor antagonist. This report suggests that endothelin antagonists may benefit patients with SSc and vasculopathy as a major feature of the disease, including limb ischemia.Esclerose sistêmica (SSc é uma doença auto-imune do tecido conjuntivo caracterizada por fibrose cutânea e visceral, além de vasculopatia difusa.Ofenômeno deRaynaud é uma das manifestações mais comuns da SSc, que pode levar a complicações como úlceras digitais e infarto. Seu tratamento ainda é indefinido. Apresentamos o caso de uma paciente com isquemia digital grave secundária a SSc. O tratamento incluindo vasodilatadores e análogos de prostaciclina foi ineficaz, mas a paciente apresentou excelente resposta ao bosentan, um antagonista de receptores de endotelina. Este relato sugere que antagonistas de endotelina podem beneficiar pacientes com SSc e vasculopatia como principal característica da doença, incluindo isquemia de extremidades.

  11. Refractory linear IgA bullous dermatosis successfully treated with mycophenolate sodium.

    Science.gov (United States)

    Marzano, Angelo V; Ramoni, Stefano; Spinelli, Diana; Alessi, Elvio; Berti, Emilio

    2008-01-01

    Linear IgA bullous dermatosis (LABD) is a rare, blistering autoimmune disease characterized by linear deposits of IgA at the basement membrane zone (BMZ), with the possible presence of circulating IgA anti-BMZ antibodies. LABD of childhood is usually self-healing, while in adults it follows a more prolonged course and refractory cases may rarely occur. The first-line treatment for LABD is dapsone in monotherapy or in combination with systemic corticosteroids, but various therapeutic approaches have been used in non-responder patients. We report two adult patients with refractory LABD successfully treated with enteric-coated mycophenolate sodium (EC-MPS), a recently introduced formulation of mycophenolic acid (MPA). MPA is an immunosuppressive agent that acts by inhibiting monophosphate dehydrogenase, a key enzyme in the novo synthesis of purines. Based on the present cases, we indicate EC-MPS as being a safe and effective adjuvant therapy in the treatment of LABD when dapsone or the other steroid-sparing drugs fail. It seems to offer an improved gastric side effect profile in comparison with the classic formulation of MPA, namely its ester mycophenolate mofetil (MMF).

  12. Spontaneous Hemoperitoneum due to Rupture of Uterine Varicose Veins during Labor Successfully Treated by Percutaneous Embolization

    Directory of Open Access Journals (Sweden)

    Rebeca Díaz-Murillo

    2014-01-01

    Full Text Available Hemoperitoneum during pregnancy is a rare but potentially lethal clinical condition. Improvements in antenatal and intrapartum care, especially in surgical and anesthetic techniques, have reduced maternal mortality; perinatal mortality remains very high (31%. Treatment is based on the systemic correction of hypovolemia and immediate surgery via laparotomy or laparoscopy in cases in the first trimester of pregnancy for hemostatic purposes. Sometimes, hysterectomy is needed. A 35-year-old Asiatic primigravid woman at 37 weeks’ gestation with otherwise uneventful pregnancy came to the hospital referring abrupt-onset lumbar and abdominal pain. A bleeding uterine superficial varicocele of about 7 cm was found on the left uterine horn during Caesarean section. Interventional radiologic embolization of both uterine arteries was successfully performed. Posterior evolution of the patient was favorable. Percutaneous vascular embolization of the uterine arteries is an effective alternative treatment for many obstetrical and gynecological causes of bleeding. The main advantage of this technique is the low rate of serious complications and the preservation of reproductive function. To our knowledge, this is the first case of spontaneous intrapartum hemoperitoneum treated with this technique. An early diagnosis and a rapid indication of this therapeutic option are essential. Hemodynamic stability is needed to decide this conservative management.

  13. Central nervous system paracoccidioidomycosis. Report of a case successfully treated with Itraconazol Paracoccidioidomicose do sistema nervoso central. Apresentação de um caso tratado com êxito com itraconazole

    Directory of Open Access Journals (Sweden)

    Luis A. VILLA

    2000-08-01

    Full Text Available Paracoccidioidomycosis (PCM is a primary pulmonary infection that often disseminates to other organs and systems. Involvement of the central nervous system (CNS is rare and due to the fact that both clinical alertness and establishment of the diagnosis are delayed, the disease progresses causing serious problems. We report here a case of neuroparacoccidioidomycosis (NPCM, observed in a 55 year-old male, who consulted due to neurological symptoms (left hemiparesis, paresthesias, right palpebral ptosis, headache, vomiting and tonic clonic seizures of a month duration. Upon physical examination, an ulcerated granulomatous lesion was observed in the abdomen. To confirm the diagnosis a stereotactic biopsy was taken; additionally, mycological tests from the ulcerated lesion and a bronchoalveolar lavage were performed. In the latter specimens, P. brasiliensis yeast cells were visualized and later on, the brain biopsy revealed the presence of the fungus. Treatment with itraconazole (ITZ was initiated but clinical improvement was unremarkable; due to the fact that the patient was taking sodium valproate for seizure control, drug interactions were suspected and confirmed by absence of ITZ plasma levels. The latter medication was changed to clonazepam and after several weeks, clinical improvement began to be noticed and was accompanied by diminishing P. brasiliensis antigen and antibody titers. In the PCM endemic areas, CNS involvement should be considered more often and the efficacy of itraconazole therapy should also be taken into consideration.A paracoccidioidomicose (PCM é infecção pulmonar primária que algumas vezes pode se disseminar a outros órgãos e sistemas. O envolvimento do sistema nervoso central (SNC é raro e devido ao fato que a alerta clínica e o estabelecimento do diagnóstico são tardios, a doença progride e o paciente piora. Aquí apresentamos caso de neuroparacoccidioidomicose (NPCM observada em homem de 55 anos de idade que

  14. 卡泊芬净成功治愈奥默柯达真菌血症1例%A case of 75 -year -old woman patient with Kodamaea ohmeri fungemia treated by Caspofungin successfully

    Institute of Scientific and Technical Information of China (English)

    张春玲; 徐德祥; 王立生; 孙荣丽; 李黎

    2011-01-01

    1 例确诊为奥默柯达(毕赤)真菌血症的75 岁女性患者经卡泊芬净治疗后痊愈.该患者既往有冠状动脉粥样硬化性心脏病、高血压病、糖尿病及糖尿病肾病,近期因脑出血行脑内血肿置管引流术,术后因肺炎及呼吸衰竭行气管切开及机械通气,因消化道出血行全胃肠外营养.此后多次血液及静脉导管头培养均提示为奥默柯达真菌感染,先后给予氟康唑、伏立康唑、卡泊芬净及移除深静脉导管后血培养转阴,续用卡泊芬净21 d 并连续6 次血培养阴性考虑真菌血症治愈.目前报道的所有奥默毕赤真菌血症患者都存在免疫功能低下,卡泊芬净适合于肾功能不全患者,移除深静脉导管和停止静脉营养是治疗该病的重要措施,为避免复发抗真菌药物的疗程应在血培养阴性后维持2 周以上.%A case of 75-year-old woman patient diagnosed as Kodamaea (Pichia) ohmeri fungemia was recovered through the treatment of Caspofungin. The patient suffered coronary atherosclerotic heart disease, hypertensive disease, diabetes and diabetic nephropathy in the past, and was performed percutaneous catheter drainage in the intracerebral hematoma because of cerebral hemorrhage recently, and was taken incision of tracheal and mechanical ventilation after the operation because of the complication of pneumonia and respiratory failure, and was given total parenteral nutrition because of the severe ali -mentary tract hemorrhage. After that, multiple blood culture and culture of the tip of central venous catheter (CVC) all showed that there was Kodamaea ohmeri infection. The patient was cured after the treatment of Fluconazole, Voriconazole and the removal of CVC. Caspofungin was kept on for 21days and the blood culture showed 6 consecutive negative results, with the results, we considered that fungemia was cured. In recent reports, all patients with Kodamaea ohmeri fungemia had low immunity. Caspofungin was

  15. Life-threatening ACE inhibitor-induced angio-oedema successfully treated with icatibant

    DEFF Research Database (Denmark)

    Ostenfeld, Sarah; Bygum, Anette; Rasmussen, Eva Rye

    2015-01-01

    We present a case of a 75-year-old woman treated with an ACE inhibitor, who presented with angio-oedema of the tongue and had difficulty speaking. No symptoms of anaphylaxis or urticaria were present. The patient was treated intravenously with antihistamine and glucocorticoid in combination with ...... of choice instead of antiallergic medications, which have no proven efficacy in this condition....

  16. Success factors affecting E-business:case Taobao

    OpenAIRE

    2015-01-01

    E-business has aroused great concern and become a hot topic in both information technology and business field. With many companies’ success in doing e-business, there are also abundant of failure cases. Therefore, the purpose of this study was to investigate the success factors that can affect e-business so as to provide beneficial guidance to companies. Virtually, many researchers have also studied e-business relating to its success from different perspectives and in various areas. However, ...

  17. A case of bilateral rheumatoid pleuritis successfully treated with tocilizumab.

    Science.gov (United States)

    Ohtsuka, Keiko; Takeuchi, Kimihiko; Matsushita, Masatoshi; Aramaki, Tetsuo

    2014-11-01

    The patient was a 77-year-old woman diagnosed as having rheumatoid arthritis (RA) in 1973. She was initiated on infliximab therapy in addition to methotrexate administration in 2009. The therapeutic response decreased after the fifth dose of infliximab, and the patient developed rheumatoid pleuritis due to increased RA disease activity. The therapy was switched from infliximab to tocilizumab, which resulted in amelioration of the arthralgias well as pleuritis. Our results suggest that tocilizumab is an effective treatment alternative for the treatment of rheumatoid pleuritis.

  18. Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide

    DEFF Research Database (Denmark)

    Holm, Jakob; Eiken, Pia; Hyldstrup, Lars;

    2014-01-01

    OBJECTIVE: We report a case of a successfully healed atypical femoral fracture (AFF) following treatment with teriparatide in a patient with osteogenesis imperfecta (OI). To our knowledge, no successful treatment of AFFs with teriparatide in this subpopulation has ever been described. METHODS...

  19. Candida albicans septicemia in a premature infant successfully treated with oral fluconazole

    DEFF Research Database (Denmark)

    Bodé, S; Pedersen-Bjergaard, Lars; Hjelt, K

    1992-01-01

    A premature male infant, birth-weight 1460 g, was treated successfully for a Candida albicans septicemia with orally administered fluconazole for 20 days. Dosage was 5 mg/kg/day. No side effects were seen. Fluconazole may present a major progress in treatment of invasive C. albicans infections in...... in neonatology....

  20. Establishment and Early Succession of Bacterial Communities in Monochloramine-treated Drinking Water Biofilms

    Science.gov (United States)

    The use of monochloramine as drinking water disinfectant is increasing because it forms lower levels of traditional disinfection by-products compared to free-chlorine. However, little is known about the bacterial succession within biofilms in monochloramine-treated systems. The d...

  1. Success case studies contribute to evaluation of complex research infrastructure.

    Science.gov (United States)

    Hogle, Janice A; Moberg, D Paul

    2014-03-01

    The success case studies approach examines in depth what works well in a program by describing cases and examining factors leading to successful outcomes. In this article, we describe the use of success case studies as part of an evaluation of the transformation of a health sciences research support infrastructure. Using project-specific descriptions and the researchers' perceptions of the impact of improved research infrastructure, we added depth of understanding to the quantitative data required by funding agencies. Each case study included an interview with the lead researcher, along with review of documents about the research, the investigator, and their collaborators. Our analyses elucidated themes regarding contributions of the Clinical and Translational Science Awards program of the National Institutes of Health to scientific achievements and career advancement of investigators in one academic institution.

  2. Acute respiratory distress syndrome (ARDS) treated successfully by veno-venous extracorporeal membrane oxygenation (ECMO) in a nearly drowned patient.

    Science.gov (United States)

    Sonoo, Tomohiro; Ohshima, Kazuma; Kobayashi, Hiroaki; Asada, Toshifumi; Hiruma, Takahiro; Doi, Kento; Gunshin, Masataka; Murakawa, Tomohiro; Anraku, Masaki; Nakajima, Susumu; Nakajima, Jun; Yahagi, Naoki

    2014-09-01

    This report highlights about one acute respiratory distress syndrome (ARDS) case after near-drowning resuscitated using extracorporeal membrane oxygenation (ECMO). Few cases have been reported about ECMO use for near-drowning and in most of these cases, ECMO was initiated within the first week. However, in our report, we would like to emphasize that seemingly irreversible secondary worsening of ARDS after nearly drowned patient was successfully treated by ECMO use more than 1 week after near-drowning followed by discharge without home oxygen therapy, social support, or any complication. This is probably due to sufficient lung rest for ventilator-associated lung injury during ECMO use. Based on our case's clinical course, intensive care unit physicians must consider ECMO even in the late phase of worsened ARDS after near-drowning.

  3. Esthesioneuroblastoma treated with external radiotherapy. Case report.

    Science.gov (United States)

    Tramacere, F; Bambace, S; De Luca, M C; Castagna, R; Francavilla, M C; Leone, A; Monastero, S; Fucilli, F; Pili, G; Portaluri, M

    2008-08-01

    Esthesioneuroblastoma is a rare tumour arising from the olfactory epithelium of the nasal vault which frequently invades the cranial base and orbit. Esthesioneuroblastoma has a bimodal age distribution between 11 and 20 years and between 51 and 60 years. Esthesioneuroblastoma accounts for approximately 1-5% of intranasal cancers. The case is reported of a 79-year-old female patient with a Kadish stage C tumour with a one-year history of headache, nasal obstruction, anosmia, rhinorrhoea and epistaxis. Aim of this study is to analyse the natural history, treatment and prognosis of this tumour, based on a review of the literature.

  4. Body hair transplantation: Case report of successful outcome

    Directory of Open Access Journals (Sweden)

    Venkataram Mysore

    2013-01-01

    Full Text Available Transplantation of body hair in to scalp has been suggested as an option to treat extensive cases of baldness with poor donor scalp. However, evidence about its long-term efficacy is yet lacking, with very few published reports and the routine use of the technique is still controversial. We report the satisfactory outcome in a case of extensive baldness in whom hairs from different donor areas such as chest, abdomen, arms, thighs were transplanted on to scalp.

  5. Mucosal varicosities: case report treated with monoethanolamine oleate.

    Science.gov (United States)

    Gomes, Carolina Cavalieri; Gomez, Ricardo Santiago; do Carmo, Maria Auxiliadora Vieira; Castro, Wagner Henriques; Gala-García, Alfonso; Mesquita, Ricardo Alves

    2006-01-01

    We reported a case of varicosities in the buccal mucosa treated with sclerotherapy. The sclerosant agent used was the monoethanolamine oleate. After three sessions the lesions disappeared and the patient is follow-up.

  6. Acute Lymphangitis Treated by Moxibustion with Garlic in 118 Cases

    Institute of Scientific and Technical Information of China (English)

    周韦

    2003-01-01

    @@ In recent years, the author has treated 118 cases of acute lymphangitis (usually called red-thread furuncle in TCM) by moxibustion with garlic and achieved good therapeutic results. It is briefly introduced as follows.

  7. Purely cutaneous Langerhans cell histiocytosis presenting as an ulcer on the chin in an elderly man successfully treated with thalidomide

    Science.gov (United States)

    Subramaniyan, Radhakrishnan; Ramachandran, Rajagopal; Rajangam, Gnanasekaran; Donaparthi, Navya

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare, clonal proliferative disorder of Langerhans’ cells of unknown etiology. Although the clinical presentation and therapeutic approach to the disease in children have been well established; limited data is available about the disease in adults. Purely cutaneous involvement of LCH in a man older than 70 years has rarely been described. Herein we report the case of a 71-year-old man with cutaneous LCH confined to the perioral region, scalp, and flexures successfully treated with thalidomide. PMID:26753141

  8. Refractory vasculitic ulcer of the toe in adolescent suffering from Systemic Lupus Erythematosus treated successfully with hyperbaric oxygen therapy

    Directory of Open Access Journals (Sweden)

    Mauro Angela

    2010-10-01

    Full Text Available Abstract Skin ulcers are a dangerous and uncommon complication of vasculitis. We describe the case of a teenager suffering from Systemic Lupus Erythematosus with digital ulcer resistant to conventional therapy, treated successfully with Hyperbaric Oxygen Therapy. The application of hyperbaric oxygen, which is used for the treatment of ischemic ulcers, is an effective and safe therapeutic option in patients with ischemic vasculitic ulcers in combination with immunosuppressive drugs. Further studies are needed to evaluate its role as primary therapy for this group of patients.

  9. Use of combination therapy to successfully treat breakthrough Trichosporon asahii infection in an acute leukemia patient receiving voriconazole

    Directory of Open Access Journals (Sweden)

    Jia Chen

    2014-10-01

    Full Text Available Trichosporon species is an important life-threatening opportunistic systemic pathogen, especially in leukemia patients. Voriconazole is proved to be a promising agent in past decade. However, recently we observed a case of breakthrough Trichosporon asahii infection while receiving voriconazole, which calls for an alternative treatment strategy. A combination therapy of liposomal amphotericin B (AmB plus caspofungin – in which liposomal AmB dose was reduced due to renal toxicity – was administered to successfully treat this patient.

  10. Successful treatment of poison oak dermatitis treated with Grindelia spp. (Gumweed).

    Science.gov (United States)

    Canavan, Don; Yarnell, Eric

    2005-08-01

    Poison oak and related hypersensitivity dermatitides are age-old problems that have historically been treated with herbal medicines before the availability of corticosteroids. Few of these historical therapies have been rigorously investigated. The case presented here provides some insight into the potential efficacy of certain herbs for relieving mild-to-moderate poison ivy dermatitis.

  11. Successful Minority Pedagogy in Mathematics: US and Japanese Case Studies

    Science.gov (United States)

    Ahn, Ruth; Catbagan, Paula; Tamayo, Kristin; I, Ji Yeong; Lopez, Mario; Walker, Pamela

    2015-01-01

    This study examines best practices in teaching mathematics to minority students through two case studies conducted at high-minority junior high schools in the USA and Japan. Observations, interviews, and conversations with the teachers in both countries focused on the research question: how do teachers successfully teach mathematics to minority…

  12. A Case Report of Telangiectatic Rosacea Treated with Long Pulsed Nd-YAG Laser

    Directory of Open Access Journals (Sweden)

    Can Ergin

    2016-02-01

    Full Text Available Rosacea is a chronic enflammatory skin disease characterized by facial erythema, telangiectasia, papules and pustules. A variety of topical and systemic medications are used in the treatment of the disease. Recently, erythema and telangiectasia in rosacea patients have been frequently treated with laser applications. Herein, we present a case of rosacea whose telangiectasia were successfully treated with Nd-YAG laser treatment. 

  13. Post-transfusion purpura treated with plasma exchange by haemonetics cell separator. A case report

    DEFF Research Database (Denmark)

    Laursen, B; Morling, N; Rosenkvist, J;

    1978-01-01

    A case of post-transfusion purpura in a 61-year-old, multiparous female with a platelet alloantibody (anti-Zwa) in her serum is reported. The patient was successfully treated with plasma exchange by means of a Haemonetics 30 cell separator and corticosteroids. Compared with other therapeutic meas...

  14. Two Cases of Accidental Injection of Epinephrine into a Digit Treated with Subcutaneous Phentolamine Injections

    Directory of Open Access Journals (Sweden)

    Ryan P. Bodkin

    2013-01-01

    Full Text Available Accidental injection into the digit from an epinephrine autoinjection device can cause discoloration, pain, and paresthesias. Although loss of digit is rare, treatment in the emergency department is commonly aimed at vasodilation of the affected tissue. We report two cases of accidental injection of epinephrine into the digits that were successfully treated with subcutaneous phentolamine injection with no adverse events.

  15. Severe acute cholestatic hepatitis of unknown etiology successfully treated with the Chinese herbal medicine Inchinko-to (TJ-135)

    Institute of Scientific and Technical Information of China (English)

    Susumu Ohwada; Isao Kobayashi; Nobuo Harasawa; Kyoichiro Tsuda; Yosikatsu Inui

    2009-01-01

    Severe acute hepatitis of unknown etiology is difficult to treat and often progresses to subacute fulminant hepatitis or late-onset hepatic failure. A 45-year-old wellnourished, healthy man had progressive fatigue and his liver function tests showed severe liver dysfunction. The etiology of sever acute cholestatic hepatitis was unknown. The liver function tests normalized gradually, which excluded high persistent total bilirubin after starting on predonine. A liver biopsy showed chronic active hepatitis with mild fibrosis (A2, F1). Oral Inchinko-to, a Chinese herbal medicine, at 7.5 g daily was prescribed. The treatment was effective with no adverse effects. We present a successfully treated case and discuss hepatoprotective and choleretic effects of Inchinko-to.

  16. Use of CBCT in the Successful Management of Endodontic Cases

    OpenAIRE

    Dax Abraham; Nikhil Bahuguna; Rishi Manan

    2012-01-01

    The purpose of this article is to emphasize the use of Cone Beam Computed Tomography (CBCT) for root canal treatment. Two case reports are presented where CBCT has been used to locate and eventually treat extra canals in maxillary first molars. Dental clinicians should be aware of the anatomical variations in maxillary molars. CBCT should be an essential part of the diagnosis prior to initiating root canal treatment.

  17. Successful endoscopic removal of a swallowed toothbrush: case report.

    Science.gov (United States)

    Tonkic, Ante; Bogdanovic, Zoran; Grandić, Leo

    2011-04-06

    Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.

  18. Successful Endoscopic Removal of a Swallowed Toothbrush: Case Report

    Directory of Open Access Journals (Sweden)

    Ante Tonkic

    2011-04-01

    Full Text Available Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.

  19. Recurrent pancreatitis in a patient with familial hypocalciuric hypercalcaemia treated successfully with cinacalcet

    Science.gov (United States)

    Grossman, Ashley; Druce, Maralyn

    2014-01-01

    Summary A 22-year-old female student presented with a history of recurrent pancreatitis. The commonest causes of pancreatitis, including drugs, gallstones, corticosteroids, excess alcohol and hypertriglyceridaemia, were excluded. She was found to have an elevated serum calcium level that was considered to be the cause of her pancreatitis, with a detectable serum parathyroid hormone (PTH). An initial diagnosis of primary hyperparathyroidism was made. However, two neck explorations failed to reveal a parathyroid adenoma. She was referred to our unit three years later as her episodes of pancreatitis were becoming more frequent and her calcium level remained persistently elevated. Her investigations were as follows: elevated adjusted calcium level of 2.79 mmol/l (2.2–2.58), PTH level of 4.2 pmol/l (0.6–6.0), low 24 h urine calcium of 0.3 mmol/l and a urine calcium:creatinine ratio of A mutation in the calcium-sensing receptor gene. Although the hypercalcaemia of FHH is usually without sequelae due to the generalised changes in calcium sensing, in the presence of this complication she was started on cinacalcet 30 mg daily. She had one further episode of pancreatitis with calcium levels ranging between 2.53 and 2.66 mmol/l. Her cinacalcet was gradually increased to 30 mg three times daily, maintaining her calcium levels in the range of 2.15–2.20 mmol/l. She has not had a further episode of pancreatitis for more than 2 years. FHH is usually a benign condition with minimal complications from hypercalcaemia. Pancreatitis has been reported rarely, and no clear management strategy has been defined in these cases. Cinacalcet was successfully used in treating recurrent pancreatitis in a patient with FHH by maintaining calcium levels in the lower part of the reference range. Whether or not this is an effective long-term treatment remains yet to be seen. Learning points FHH is an important differential diagnosis for hypercalcaemia.FHH can rarely cause

  20. Acute Respiratory Failure due to Neuromyelitis Optica Treated Successfully with Plasmapheresis

    Directory of Open Access Journals (Sweden)

    Massa Zantah

    2016-01-01

    Full Text Available Neuromyelitis Optica (NMO is a demyelinating autoimmune disease involving the central nervous system. Acute respiratory failure from cervical myelitis due to NMO is known to occur but is uncommon in monophasic disease and is treated with high dose steroids. We report a case of a patient with NMO who developed acute respiratory failure related to cervical spinal cord involvement, refractory to pulse dose steroid therapy, which resolved with plasmapheresis.

  1. A successful case of dose reduction in etizolam dependence using fine granules: a case report

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    Nishii S

    2014-08-01

    Full Text Available Shigeki Nishii,1 Hikaru Hori,1 Toshifumi Kishimoto,2 Jun Nakamura1 1Department of Psychiatry, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan; 2Department of Psychiatry, Nara Medical University, Shijocho, Kashihara, Nara, Japan Abstract: The prevalence of benzodiazepine consumption in Japan is one of the highest worldwide. Etizolam is the most abused drug of the benzodiazepine class. The treatment of benzodiazepine dependence is difficult. We report a case of successful dosage reduction in a 24-year-old female patient with etizolam dependence. She was diagnosed with etizolam dependence at the age of 22 years old. We proposed a benzodiazepine dependence treatment that involved replacing etizolam with a long-acting benzodiazepine class drug in conjunction with a long-term weaning plan. However, the patient refused the treatment and insisted that reducing the number of tablets would increase her anxiety. After providing a detailed explanation and receiving consent from the patient, a treatment regimen consisting of fine granules of etizolam mixed with lactose granules was begun with the aim of reducing the percentage of etizolam at a rate of 0.3 mg/week. The treatment of etizolam dependence in this patient was successful. This treatment strategy may be an effective option for patients who are difficult to treat with conventional methods, or who have anxiety regarding the reduction of the amount of the drug itself. Keywords: benzodiazepine, Japan, dependence, etizolam

  2. Lung abscess combined with chronic osteomyelitis of the mandible successfully treated with video-assisted thoracoscopic surgery.

    Science.gov (United States)

    Arai, Hiromasa; Inui, Kenji; Watanabe, Keisuke; Watanuki, Kei; Okudela, Koji; Tsuboi, Masahiro; Masuda, Munetaka

    2015-04-01

    With the progress of antibiotic therapy, the mortality of lung abscess has been improved, and surgical intervention has declined. However, surgery is still required in selected cases that are intractable to antibiotic treatment. Video-assisted thoracoscopic surgery (VATS) is beneficial for treatment and/or diagnosis of pulmonary disease as it provides a less invasive surgical technique and reduces prolongation of post-operative recovery. However, the indication of VATS lobectomy for lung abscess is controversial as a result of particular complications, i.e. wet lung, intrapleural adhesion and ease of bleeding. We herein report a rare combination of lung abscess and osteomyelitis of mandible resulting from the same pathogen successfully treated with VATS lobectomy. We propose VATS lobectomy for lung abscess. This procedure might be the best treatment candidate for selected cases of lung abscess.

  3. Plasma cell cheilitis, successfully treated with topical 0.03% tacrolimus ointment.

    Science.gov (United States)

    Jin, Seon Pil; Cho, Kwang Hyun; Huh, Chang Hun

    2010-05-01

    Plasma cell cheilitis is a rare, idiopathic mucosal condition. The treatment of plasma cell cheilitis is often disappointing. It is often resistant to various topical treatments. We present a 65-year-old woman who had a painful, eroded area on her lower lip, which responded poorly to various topical treatments. A biopsy revealed a band-like infiltration composed mainly of plasma cells in the dermis. She was diagnosed as having plasma cell cheilitis, and was successfully treated with 0.03% topical tacrolimus ointment.

  4. "Half-half" blisters in bullous pemphigoid successfully treated with adjuvant high-dose intravenous immunoglobulin.

    Science.gov (United States)

    Pacheco, David; Lopes, Leonor; Soares-Almeida, Luis; Marques, Manuel Sacramento; Filipe, Paulo

    2012-09-01

    Bullous pemphigoid is a rare, autoimmune blistering disease. Its clinical presentation is tense blisters that may arise on normal-appearing or erythematous skin. Bullous pemphigoid refractory to systemic corticosteroids in combination with immunosuppressants such as azathioprine and mycophenolate mofetil may benefit from adjuvant high-dose intravenous immunoglobulin (IVIg). We describe a particular case with an unusual clinical presentation unresponsive to systemic corticosteroids plus azathioprine, in which the addition of high-dose IVIg was successful. The combined therapy of systemic corticosteroids and azathioprine plus high-dose IVIg can be an option in refractory cases due to its efficiency and tolerability.

  5. Delayed Descemet's membrane detachment after successful cataract surgery: a case report

    Directory of Open Access Journals (Sweden)

    Aileen Walsh

    2012-10-01

    Full Text Available The detachment of Descemet's membrane can be a serious complication following cataract surgery, leading to severe corneal edema and reduced visual acuity. This report describes an unusual case of Descemet's membrane detachment 6 months after successful phacoemulsification, documented by anterior segment optic coherence tomography (OCT; RTVue, Optovue. The eye was treated successfully with pneumatic descemetopexy and transcorneal suturing, with reattachment of Descemet's membrane. This report should alert physicians that delayed corneal edema can be related to late-onset Descemet's membrane detachment, which requires proper treatment to avoid permanent corneal decompensation.

  6. Cytomegalovirus Retinitis in an ALL Child during Maintenance Therapy Treated Successfully with Intravenous Ganciclovir

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    Hande Celiker

    2014-01-01

    Full Text Available Purpose. In here we described cytomegalovirus retinitis (CMVR in 12-year-old male patient with acute lymphoblastic leukemia (ALL who was on maintenance phase therapy. Methods. He was referred to our clinic for seeing of spots with the right eye for 3 days. At presentation, his best corrected visual acuity was 20/20 in the right eye and 20/20 in the left eye. Slit-lamp biomicroscopic examination of the anterior chamber of the left eye was within normal limits, whereas we observed 3+ anterior chamber cellular reaction in the right eye. On retinal examination, we found active retinitis lesions (cream-colored lesions associated with hemorrhages and perivascular cuffing in the retinal periphery in the right eye. Left eye was normal. Results. On the basis of clinical picture, we made the diagnosis of CMVR in the right eye. Vitreous aspiration was performed and 23096 copies/mL of CMV DNA was detected by polymerase chain reaction (PCR technique. The patient was successfully treated with intravenous ganciclovir for two weeks and discharged with oral valganciclovir prophylaxis. Conclusion. CMVR should be in mind in children with ALL on maintenance phase therapy even in those without hematopoietic stem cell transplantation. These patients can be treated successfully by intravenous ganciclovir alone.

  7. Chemical and microbiological attributes of an oxisol treated with successive applications of sewage sludge¹

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    José Rafael Pires Bueno

    2011-08-01

    Full Text Available Studies on sewage sludge (SS have confirmed the possibilities of using this waste as fertilizer and/or soil conditioner in crop production areas. Despite restrictions with regard to the levels of potentially toxic elements (PTE and pathogens, it is believed that properly treated SS with low PTE levels, applied to soil at adequate rates, may improve the soil chemical and microbiological properties. This study consisted of a long-term field experiment conducted on a Typic Haplorthox (eutroferric Red Latosol treated with SS for seven successive years for maize production, to evaluate changes in the soil chemical and microbiological properties. The treatments consisted of two SS rates (single and double dose of the crop N requirement and a mineral fertilizer treatment. Soil was sampled in the 0-0.20 m layer and analyzed for chemical properties (organic C, pH, P, K, Ca, Mg, CEC, B, Cu, Fe, Mn, Zn, Cd, Ni, and Pb and microbiological properties (basal respiration, microbial biomass activity, microbial biomass C, metabolic quotient, microbial quotient, and protease and dehydrogenase enzyme activities. Successive SS applications to soil increased the macro- and micronutrient availability, but the highest SS dose reduced the soil pH significantly, indicating a need for periodic corrections. The SS treatments also affected soil microbial activity and biomass negatively. There were no significant differences among treatments for maize grain yield. After seven annual applications of the recommended sludge rate, the heavy metal levels in the soil had not reached toxic levels.

  8. Successive failure, repeat entrepreneurship and no learning: A case study

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    Marius Pretorius

    2011-02-01

    Full Text Available Orientation: Current theories of repeat entrepreneurship provide little explanation for the effect of failure as a ‘trigger’ for creating successive ventures or learning from repeated failures. Research purpose: This study attempts to establish the role of previous failures on the ventures that follow them and to determine the process of learning from successive failures.Motivation for the study: Successive failures offer potentially valuable insights into the relationship between failures on the ventures that follow and the process of learning from failure.Research design, approach and method: The researchers investigated a single case study of one entrepreneur’s successive failures over 20 years.Main findings: Although the causes varied, all the failures had fundamental similarities. This suggested that the entrepreneur had not learnt from them. The previous failures did not trigger the subsequent ventures. Instead, they played a role in causing the failures. Learning from failure does not happen immediately but requires deliberate reflection. Deliberate reflection is a prerequisite for learning from failure as the entrepreneur repeated similar mistakes time after time until he reflected on each failure.Practical/managerial implications: It confirms that failure is a part of entrepreneurial endeavours. However, learning from it requires deliberate reflection. Failure does not ‘trigger’ the next venture and educators should note this.Contribution/value-add: Knowing the effect of failure on consecutive ventures may help us to understand the development of prototypes (mental frameworks and expand the theory about entrepreneurial prototype categories.

  9. Recurrent hemorrhagic pericardial effusion and tamponade due to filariasis successfully treated with ivermectin and albendazole

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    Santosh Kumar Sinha

    2015-01-01

    Full Text Available Filariasis presenting with pericardial effusion with tamponade is rare. We report a case of a 30-year-old female who was admitted with severe dyspnea and chest pain since 2 days. Echocardiogram showed massive pericardial effusion with tamponade. Pericardial fluid aspiration drained 1.2 L of hemorrhagic fluid. Cytology examination revealed microfilaria of Wuchereria bancrofti. She was treated with diethyl carbamazine and discharged. Six weeks later, she presented again with massive pericardial effusion with cardiac tamponade. Pericardiocentesis was done. Cytology examination revealed microfilaria of W. bancrofti. This time she was treated with ivermectin and albendazole and cured. Hemorrhagic effusion resolved completely. Though relatively uncommon, tropical diseases must always be considered in the etiological diagnosis of recurrent pericardial effusion.

  10. Recurrent Hemorrhagic Pericardial Effusion and Tamponade due to Filariasis Successfully Treated with Ivermectin and Albendazole.

    Science.gov (United States)

    Sinha, Santosh Kumar; Goel, Amit; Sachan, Mohit; Saraf, Sameer; Verma, Chandra Mohan

    2015-01-01

    Filariasis presenting with pericardial effusion with tamponade is rare. We report a case of a 30-year-old female who was admitted with severe dyspnea and chest pain since 2 days. Echocardiogram showed massive pericardial effusion with tamponade. Pericardial fluid aspiration drained 1.2 L of hemorrhagic fluid. Cytology examination revealed microfilaria of Wuchereria bancrofti. She was treated with diethyl carbamazine and discharged. Six weeks later, she presented again with massive pericardial effusion with cardiac tamponade. Pericardiocentesis was done. Cytology examination revealed microfilaria of W. bancrofti. This time she was treated with ivermectin and albendazole and cured. Hemorrhagic effusion resolved completely. Though relatively uncommon, tropical diseases must always be considered in the etiological diagnosis of recurrent pericardial effusion.

  11. Successful treatment of spindle cell sarcoma of the sella turcica. Case report.

    Science.gov (United States)

    Alpert, Tracy E; Hahn, Seung S; Chung, Chung T; Bogart, Jeffrey A; Hodge, Charles J; Montgomery, Craig

    2002-12-01

    A primary spindle cell sarcoma of the sella turcica in a patient without a history of radiation treatment is a very rare occurrence. Only one other case has been reported to date, with local recurrence 7 months after the patient underwent subtotal resection and stereotactic radiosurgery of the tumor. The authors present a case of spindle cell sarcoma of the sella turcica successfully treated by surgery, external-beam radiotherapy, and gamma knife radiosurgery. After 24 months of follow up, the patient continues to show no evidence of disease.

  12. Cardiac metastasis from renal cell carcinoma successfully treated with pazopanib: impact of TKIs' antiangiogenic activity.

    Science.gov (United States)

    Schinzari, Giovanni; Monterisi, Santa; Signorelli, Diego; Cona, Silvia; Cassano, Alessandra; Danza, Francesco; Barone, Carlo

    2014-01-01

    Cardiac metastasis from renal cell carcinoma, especially without neoplastic thrombosis of the vena cava, is extremely rare. The prognosis of patients with metastatic renal cell carcinoma has been radically influenced by the introduction of tyrosine kinase inhibitors, but very few reports in the literature have described their activity in heart metastasis. We report the case of a woman with a left ventricle metastasis from kidney cancer without renal vein involvement, who was treated with pazopanib. The patient achieved a prolonged partial response, with clear signs of metastasis devascularization and a favorable toxicity profile.

  13. Smile esthetics: a methodology for success in a complex case.

    Science.gov (United States)

    Paris, Jean-Christophe; Ortet, Stéphanie; Larmy, Annick; Brouillet, Jean-Louis; Faucher, André-Jean

    2011-01-01

    The clinical case presented is the demonstration of a multidisciplinary approach to a complex treatment. A precise methodology is important to ensure that the treatment objectives are clear to all the teams. The aim of the treatment is to restore dentofacial harmony to a young, 22-year-old, female patient showing severe attrition of the anterior teeth. The direct effect of this is an ageing of the smile. This type of multidisciplinary treatment, which seems complicated at first, is greatly simplified once time has been spent on the diagnosis and treatment plan: it thereby becomes a succession of clinical stages.

  14. 58 CASES OF PROSTATIC HYPERTROPHY TREATED BY ELECTROACUPUNCTURE

    Institute of Scientific and Technical Information of China (English)

    李兰敏; 欧阳颀; 张立夫

    2001-01-01

    In the present paper, 58 prostatic hypertrophy patients were treated with electroacupuncture (EA) therapy. Their ages ranged from 50 to above 70 years in 38 cases and above 80 years in 20 cases. Main acupoints were Qugu (CV 2), Henggu (KI 11), Shuidao (ST 28) and Guanyuan (CV 4) in combination with auxiliary acupoints Zhonglushu (BL 29), Huiyang (BL 35) and Sanyinjiao (SP 6) which were stimulated with EA Therapeutic Apparatus for 30min. After treatment, of the 58 cases, 36 were cured, accounting for 62 %, 20 had marked effect, accounting for 34%, and 2 had no any effectiveness, accounting for 3%. The total effective rate was 96%.

  15. Successful 4th kidney transplantation: a case report from Iran.

    Science.gov (United States)

    Nourbala, Mohammad Hossein; Ghadian, Alireza; Einollahi, Behzad; Azarabadi, Mehdi

    2013-05-21

    Kidney transplantation is generally considered the best option for most patients with end-stage renal disease requiring renal replacement therapy, even for patients with graft failure. Here, we describe a case of a 49-year-old man who received his 1st kidney transplant the United Kingdom from his brother when he was 18 years old in. Thirty-one year after the first transplant, he underwent successful 4th living-unrelated kidney transplantation with no serious complications at our transplant center. He continued to have excellent allograft function and his latest serum creatinine 33 months after his 4th transplant was 1.2 mg/dL. To our knowledge, this is the first case of 4th kidney transplantation from Iran.

  16. Self-Mapping in Treating Suicide Ideation: A Case Study

    Science.gov (United States)

    Robertson, Lloyd Hawkeye

    2011-01-01

    This case study traces the development and use of a self-mapping exercise in the treatment of a youth who had been at risk for re-attempting suicide. A life skills exercise was modified to identify units of culture called "memes" from which a map of the youth's self was prepared. A successful treatment plan followed the mapping exercise. The…

  17. Successful Use of Posaconazole to Treat Invasive Cutaneous Fungal Infection in a Liver Transplant Patient on Sirolimus

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    Randah Dahlan

    2012-01-01

    Full Text Available Fungi are an important and common cause of cutaneous infections affecting solid organ transplant recipients. These infections can represent a primary site of infection with the potential for dissemination, or a manifestation of metastatic infection. The high morbidity and mortality associated with these infections necessitates urgent therapy with antifungal drugs; however, the interaction between these drugs and immunosuppressive therapies can be a major limitation because of drug toxicity. A case of soft tissue infection of the toe caused by Fusarium chlamydosporum and Candida guilliermondii in a liver transplant patient on sirolimus, who was successfully treated with the new antifungal agent posaconazole, is described. The pharmacokinetic interactions of sirolimus and the new triazoles, and their impact on treatment choices are briefly discussed.

  18. Success Factors in Offset Deals: A Case Study Based Examination

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    Heinz Kirchwehm

    2014-04-01

    Full Text Available The requests for offset obligations occurs primarily in the area of arms imports and covers the full range of industrial and commercial benefits that companies provide to foreign governments as inducements or conditions for the purchase of military goods and services. Increasingly, all major contracts ask for offset obligations. They are now key differentiators in major contracts and it is a fast growing market. For the suppliers, offsets are a key differentiator in earning new business and therefore should be accepted that much accurateness is put on the successful execution of the offset projects. Nevertheless, it comes to problems during the project phase and sometimes we’ve the situation that a offset project failed. The aim of this paper is to exam which success- giving factors are exists in the offset related interaction between buyer, seller and participating industry. The data for this investigation were obtained from secondary sources which were mainly accessible via internet. After data collection, an analysis was performed which was based on the context of this paper and also in connection with the chosen case study: Saudi Arabia. As a result of this analysis can be derived several success factors, which could be also seen as the foundation for an optimized execution of offset obligations. The paper concludes with a reflection of the investigation approach and as well with a classification of the subject offset. Furthermore the results of the analyzes are summarized and an outlook for further researches is given.

  19. Commercializing Government-sponsored Innovations: Twelve Successful Buildings Case Studies

    Science.gov (United States)

    Brown, M. A.; Berry, L. G.; Goel, R. K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies.

  20. A case of retinopathy of prematurity treated by pattern scan laser photocoagulation

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    Ota S

    2014-07-01

    Full Text Available Satoshi Ota, Miho Nozaki, Shuichiro Hirahara, Tomoaki Hattori, Munenori Yoshida, Yuichiro Ogura Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan Abstract: We experienced a case of retinopathy of prematurity that was successfully treated with pattern scan laser. Pattern scan laser treatment should be considered as one treatment option for Retinopathy of Prematurity. Keywords: retinopathy of prematurity, PASCAL, slit-lamp delivery

  1. Confluence at distal end of multiple coronary artery fistulae: two cases treated with interventional approach

    Institute of Scientific and Technical Information of China (English)

    SHEN Xiang-qian; HU Xin-qun; LI Jiang; ZHOU Tao; FANG Zhen-fei; ZHOU Sheng-hua; TANG Jian-jun; QI Shu-shan; L(U) Xiao-ling

    2008-01-01

    @@ Coronarv artery fistula(CAF), an uncommon congenital heart disease,often results in myocardial ischemia.1-3 In the last two decades,there are some reports about interventional treatment of CAF,4-6but few on transcatheter treatment of multiple CAFS.With different interventional procedures, we treated successfully two cases of percutaneous closure of two multiple CAFs which were confluent at the distal ends.

  2. Successful management of oral ranula: a rare case in an infant.

    Science.gov (United States)

    Alves, Thais Pintos; Pinheiro, Raquel Santos; Braga, David Nascimento; Monteiro, Leonardo Pinto; Castro, Gloria Fernando de Aaujo

    2013-01-01

    An oral ranula is a retention cyst that arises from the sublingual gland as a result of ductal obstruction and fluid retention. This report describes the successful management of a rare case of oral ranula in an infant. A 4-month-old male infant was referred for emergency treatment due to a 2-month history of a swelling in the right sublingual region. The examination revealed a lesion of approximately 3.5 cm in diameter, which was jeopardizing the infant's breastfeeding. The lesion's dimensions suggested a ranula. Surgical specimens were sent for histopathological analysis to confirm the diagnosis. Although there are many different ways to treat an oral ranula, the marsupialization method was followed in this case due to the serious consequences of the infant's restricted access to nourishment. The treatment proved to be successful and after 18 months of follow-up, there was no sign of recurrence.

  3. Advanced adult esthesioneuroblastoma successfully treated with cisplatin and etoposide alternated with doxorubicin, ifosfamide and vincristine.

    Science.gov (United States)

    Turano, Salvatore; Mastroianni, Candida; Manfredi, Caterina; Biamonte, Rosalbino; Ceniti, Silvia; Liguori, Virginia; De Simone, Rosanna; Conforti, Serafino; Filice, Aldo; Rovito, Antonio; Viscomi, Caterina; Patitucci, Giuseppe; Palazzo, Salvatore

    2010-05-01

    The esthesioneuroblastoma is a rare neuroendocrine tumor that derives from the olfactory cells. In the last 20 years, around 1,000 cases have been described, with an overall survival rate of 60-70% at 5 years. The most common symptoms are nasal bleeding, nasal clogging and, in locally advanced cases, signs/symptoms of intracranic hypertension such as papilla edema, cefalea, and vomiting. The standard treatments are surgery and radiotherapy. Chemotherapy can be used in an adjuvant/neoadjuvant setting and in the metastatic phase, even if its role is still not established with certainty. Here, the case is reported of a young man (38 years old) with a locally advanced esthesioneuroblastoma. Two months before coming to our clinic, he had been treated elsewhere with debulking surgery through bilateral frontal craniotomy. After surgery, MRI showed residual disease in the nasal cavities and in the medial wall of the orbits responsible for blindness and bilateral exophthalmos within a month: a very short time. Octreoscan and whole body CT scan confirmed a locally advanced disease, in the absence of metastases. Chemotherapy was begun with cisplatin and etoposide alternated with doxorubicin, ifosfamide and vincristine with granulocyte colony-stimulating factor (G-CSF) support after every cycle. Soon after the first cycle, an important reduction of pain and decrease of the exophthalmos and vertigos was observed. No improvement in blindness was seen. The patient is still stable after 24 months of follow up.

  4. Successful treatment of catatonic syndrome in bipolar I disorder adding aripiprazole to ECT: A case report

    Directory of Open Access Journals (Sweden)

    Diego Hidalgo, MD

    2012-09-01

    Full Text Available Background and Objectives: Catatonic syndrome is a condition presenting in multiple ways, sharing many of them with the neuroleptic malignant syndrome and other diseases. This diagnostic challenge is the main cause of keep treating catatonic syndromes without neuroleptics. Methods: Review of the literature and a case report. Results: We present the case of a 19 years old bipolar I patient with a severe catatonic syndrome, with a torpid clinical evolution, partial response to benzodiazepines and ECT, which successfully resolved with intramuscular aripiprazole. We found through a systematic review (PubMed 2005-2010 that there are few but significant case reports of catatonic syndromes treated with new second generation antipsychotics for different reasons with good outcomes as ours. The pharmacological profile of aripiprazole and the low incidence of NMS reported make it a suitable option in treating this syndrome. Conclusions: We think that this case report could contribute to add more evidence for aripiprazole to be considered a good third-line option in the treatment of catatonic syndrome. However, this would require randomized controlled trials to confirm its effectiveness and safety.

  5. Commercializing government-sponsored innovations: Twelve successful buildings case studies

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Berry, L.G.; Goel, R.K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies. 27 refs., 21 figs., 4 tabs.

  6. A Selective Mutism Arising from First Language Attrition, Successfully Treated with Paroxetine-CBT Combination Treatment.

    Science.gov (United States)

    Serra, Agostino; Di Mauro, Paola; Andaloro, Claudio; Maiolino, Luigi; Pavone, Piero; Cocuzza, Salvatore

    2015-10-01

    After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment.

  7. Severe gastric variceal bleeding successfully treated by emergency splenic artery embolization.

    Science.gov (United States)

    Sankararaman, Senthilkumar; Velayuthan, Sujithra; Vea, Romulo; Herbst, John

    2013-06-01

    Bleeding from gastric varices due to splenic vein obstruction is extremely rare in children, but it can be catastrophic. Reported herein is the case of a teenager with splenic vein thrombosis and chronic decompensated liver disease from autoimmune hepatitis who presented with massive gastric variceal bleeding. Standard medical management did not control the bleeding. Due to decompensated liver disease and continuous active bleeding, emergency partial splenic artery embolization was preferred over splenectomy or a shunt procedure. Bleeding was successfully controlled by partial splenic artery embolization by decreasing the inflow of blood into the portal system. It is concluded that emergency partial splenic artery embolization is a safer alternative life-saving procedure to manage severe gastric variceal bleeding due to splenic vein obstruction in a patient with high surgical risk. To our knowledge, only one other patient with similar management has been reported in the pediatric age group.

  8. LMCA thrombosis presenting as inferior wall myocardial infarction successfully treated with intracoronary tenecteplase

    Directory of Open Access Journals (Sweden)

    Tom Devasia

    2016-01-01

    Full Text Available Received: 23/10/15, Reviewed: 9/11/15, Accepted: 8/12/15 Keywords: DOI: ABSTRACT We report a case of 40 year old male who presented with chest pain and diaphoresis. General and systemic examination was unremarkable. Electrocardiogram was suggestive of inferior wall myocardial infarction. Coronary angiogram revealed large thrombus in left main coronary artery. In view of risk of distal embolisation with thrombectomy, intracoronary tenecteplase was administered following which there was complete resolution of thrombus in left main system. A thorough workup of the cause including thrombotic panel (Protein C, Protein S was carried out and was negative. Patient made a successful recovery and is doing well on follow-up.

  9. Successful Peripheral Blood Stem Cells Collection in Imatinib Pretreated and Nilotinib-Treated Chronic Myeloid Leukemia Patient

    Directory of Open Access Journals (Sweden)

    Samuel Vokurka

    2010-01-01

    Full Text Available We report a case of a successful mobilization and harvest of the peripheral blood stem cells (PBSCs in imatinib-pretreated and nilotinib treated 52-year-old woman diagnosed with Philadelphia chromosome-positive and BCR-ABL (b2a2 positive chronic phase CML in 2/2002. She failed interferon-alfa and imatinib treatment. She achieved her first complete molecular remission after 16 months of nilotinib treatment and later on was mobilized with filgrastim at a dose of 10 ug/kg/day applied subcutaneously once daily. The total number of 2.98×106 CD34+ cells/kg was harvested on the fourth day of the mobilization. The autologous graft of the stem cells was cryopreserved and tested for the residual disease: the FISH revealed negative results and the RT-PCR was positive (BCR-ABL/ABL ratio 0,0017 in RQ-PCR. To our knowledge, this is the first report of successful PBSC harvest in a patient significantly pretreated with imatinib and nilotinib.

  10. An SLE patient with prolactinoma and recurrent granulomatous mastitis successfully treated with hydroxychloroquine and bromocriptine.

    Science.gov (United States)

    Zhang, L-N; Shi, T-Y; Yang, Y-J; Zhang, F-C

    2014-04-01

    Granulomatous mastitis (GM) is a rare benign mammary lesion in which autoimmunity and hyperprolactinemia are considered possible etiological factors. GM has a high frequency of relapse and may lead to chronic ulceration and fistula if not treated properly. Here we report a case of a 22-year-old systemic lupus erythematosus (SLE) patient with three years' disease duration, stable on prednisone and hydroxychloroquine, who was found to have prolactinoma and recurrent GM after she discontinued medication on her own accord. The patient subsequently recovered and remained free of GM relapse under treatment of prednisone, hydroxychloroquine and bromocriptine. Though autoimmune disorders and prolactinoma were reported in GM, a coexisting condition of SLE, prolactinoma, and granulomatous mastitis has rarely been observed in one patient. We suggest our case as an illustrative example of the complex interaction between autoimmunity, neuroendocrine dysfunction, and manifestations in the breast: Immunological disturbances in the background of SLE, coupled with elevated prolactin levels secondary to a prolactinoma, may have predisposed the patient to the development of GM. The mammary lesion recovered and maintained free of relapse under immunosuppressive and antiprolactinemic therapy.

  11. Case Report of Successful Childbearing after Conservative Surgery for Cervical Mullerian Adenosarcoma

    Science.gov (United States)

    Nakamura, Masako; Oi, Hidekazu; Sugimoto, Sumire; Sasaki, Yoshikazu; Uchiyama, Tomoko; Ohbayashi, Chiho; Kobayashi, Hiroshi

    2017-01-01

    Mullerian adenosarcoma (MA) is a rare tumor variant with low malignancy potential and is reported to account for 8% of all uterine sarcomas. Cervical MAs are reported to occur in relatively younger patients with the mean age of 27 years, while those in the uterine corpus generally present in postmenopausal women. Due to the rarity of cervical MAs, optimal management for these patients (especially younger women) is still under exploration. Here, we describe a case of cervical MA in a woman of reproductive age who was treated by fertility-preserving surgery and successfully delivered a child 18 months later.

  12. Segmental omental infarction in childhood: a typical case diagnosed by CT allowing successful conservative treatment

    Energy Technology Data Exchange (ETDEWEB)

    Coulier, Bruno [Clinique St. Luc, Department of Diagnostic Radiology, Bouge (Belgium)

    2006-02-01

    Segmental omental infarction (SOI) is an uncommon cause of right lower quadrant pain in children that is often misdiagnosed as appendicitis. During the last decade, imaging findings of SOI have proved to be sufficiently typical to avoid unnecessary surgery in the majority of reported adult patients. The condition has a spontaneous favourable evolution under medical treatment. In children the surgical option remains controversial. We report a typical case of SOI in a 10-year-old boy. The diagnosis was suspected by sonography, unambiguously confirmed by multidetector CT and successfully treated conservatively. This report emphasizes the use of CT in selected acute abdominal situations, peculiarly in obese children, to avoid unnecessary surgery. (orig.)

  13. Successful treatment of MRSA native valve endocarditis with oral linezolid therapy: a case report.

    Science.gov (United States)

    Nathani, N; Iles, P; Elliott, T S J

    2005-11-01

    Staphylococcal endocarditis is potentially fatal and is now the most common cause of infective endocarditis with a mortality rate of 25-47% [Hecht SR, Berger M. Right-sided endocarditis in intravenous drug users: prognostic features in 102 episodes. Ann Intern Med 1992;117:560-6]. Its treatment requires maintenance of bactericidal level of antibiotics for prolonged periods to attain a culture-negative state. Although intravenous vancomycin is currently the drug of choice for methicillin resistant Staphylococcus aureus (MRSA) endocarditis, we present a case treated successfully with oral linezolid for 4 weeks due to a lack of venous access.

  14. What is the potential of oligodendrocyte progenitor cells to successfully treat human spinal cord injury?

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    Yeung Trevor M

    2011-09-01

    Full Text Available Abstract Background Spinal cord injury is a serious and debilitating condition, affecting millions of people worldwide. Long seen as a permanent injury, recent advances in stem cell research have brought closer the possibility of repairing the spinal cord. One such approach involves injecting oligodendrocyte progenitor cells, derived from human embryonic stem cells, into the injured spinal cord in the hope that they will initiate repair. A phase I clinical trial of this therapy was started in mid 2010 and is currently underway. Discussion The theory underlying this approach is that these myelinating progenitors will phenotypically replace myelin lost during injury whilst helping to promote a repair environment in the lesion. However, the importance of demyelination in the pathogenesis of human spinal cord injury is a contentious issue and a body of literature suggests that it is only a minor factor in the overall injury process. Summary This review examines the validity of the theory underpinning the on-going clinical trial as well as analysing published data from animal models and finally discussing issues surrounding safety and purity in order to assess the potential of this approach to successfully treat acute human spinal cord injury.

  15. [Cryptococcal meningitis successfully treated with liposomal amphotericin B and voriconazole in an elderly patient].

    Science.gov (United States)

    Ogaki, Kotaro; Noda, Kazuyuki; Fukae, Jiro; Furuya, Tsuyoshi; Hirayama, Takashi; Fujishima, Kenji; Hattori, Nobutaka; Okuma, Yasuyuki

    2010-12-01

    Abstract An 81-year-old woman who had microscopic polyangiitis that was being treated with corticosteroids for 2 months was admitted to our department because of fever and clouding of consciousness. Neurological examination showed disturbance of consciousness and nuchal stiffness. Analysis of cerebrospinal fluid (CSF) revealed pleocytosis, low glucose level, and elevated protein levels. On the basis of the presence of Cryptococcus neoformans in CSF, the patient was diagnosed with cryptococcal meningitis. On the basis of established practice guidelines, liposomal amphotericin B (L-AMB) was administered to avoid the possible nephrotoxicity of amphotericin B. After the treatment was started, the patient's condition gradually improved. The results of CSF analysis also showed a gradual recovery. Because the cryptococcal antigen in CSF did not disappear completely, voriconazole (VRCZ) was administered orally; subsequently, the CSF cryptococcal antigen titer gradually decreased. During the course of the treatment with L-AMB and VRCZ, there were no severe side effects that required a change in treatment. To the best of our knowledge, in Japan, the combination of L-AMB and VRCZ has rarely been reported to be effective for the treatment of cryptococcal meningitis. The recovery of our patient indicates that the administration of L-AMB and VRCZ to elderly patients with cryptococcal meningitis and renal insufficiency is safe and leads to a successful outcome.

  16. Successful Treatment in a Case of Massive Hepatocellular Carcinoma with Paraneoplastic Syndrome

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    Atsunori Tsuchiya

    2009-04-01

    Full Text Available Paraneoplastic syndromes of hepatocellular carcinoma (HCC are not uncommon. However, the prognosis is poor and follow-up and improvement of paraneoplastic syndromes with treatment have been reported rarely. We report a successful case in an aged man of a massive HCC with paraneoplastic syndrome, treated by combined intraarterial chemotherapy and hepatic resection. Paraneoplastic syndrome (erythrocytosis and hyperlipidemia was monitored throughout the treatment and erythropoietin (EPO mRNA also was analyzed in the resected liver. The hemoglobin level and serum levels of EPO and total cholesterol (T-cho decreased dramatically with treatment, along with a decrease in serum levels of α-fetoprotein and protein induced by vitamin vitamin K absence II (PIVKA-II. Semiquantitative reverse transcription polymerase chain reaction (RT-PCR revealed that the residual cancer expressed EPO RNA but the nontumor tissue did not. This was a rare case of paraneoplastic syndrome of HCC that was treated successfully. This case indicates that paraneoplastic syndrome reflected tumor progression and that serum levels of both EPO and T-cho might be used as tumor markers.

  17. A rare case of chronic endometritis treated with hysteroscopy

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    Neena Gupta

    2013-08-01

    Full Text Available We present a case of 32 year old woman complaining of menometrorrhagia with chronic pelvic pain of following second trimester abortion. Her transabdominal ultrasound revealed chronic endometritis. She was treated with dilatation and curettage, on histopathological examination diagnosis of chronic endometritis was confirmed. Her menorrhagia was revealed but chronic pelvic pain persisted for which diagnostic hysteroscopy was planned. It revealed presence of tiny bony chips which were removed in the same setting. Intrauterine retained foetal bony chips due to previous medical termination of pregnancy were identified to be the cause of menometrorrhagia with chronic pelvic pain in the present case. Our case reiterates the importance of hysteroscopy in evaluation of such patients who are not responding to conventional medical management of abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 726-727

  18. Pseudobulbar Paralysis Treated by Acupuncture - Clinical Observation in 36 Cases

    Institute of Scientific and Technical Information of China (English)

    杜琳

    2001-01-01

    @@Pseudobulbar paralysis is a kind of common clinical syndromes of cerebral vascular diseases, which is manifested as dyslalia, dysphagia and choking. By several-year clinical observations, 36 cases were treated with satisfactory therapeutic effects as reported in the following. Clinical Data Of 36 in-patients, there were 24 males and 12 females, aged from 44 to 81 years, averaging 64.92 years. Of 36 cases, 24 were at the acute stage and 12 at the recovery stage. All the cases were diagnosed as cerebral vascular diseases by cranial CT scan and MRI, of which, 4 were cerebral infarction, 26 lacunar cerebral infarction, 5 cerebral hemorrhage and 1 mixed type. Of 36 cases, 15 were the first attack of wind-stroke, 15 the second attack, 5 the third attack and 1 the forth attack. There were 26 patients with hypertension among 36 cases, of which, 8 patients suffered from hypertension within 10 years, 6 for more than 10 years, 9 for more than 20 years and 3 for more than 30 years. All the 36 cases were associated with dysphagia and agreeable to Standard on Diagnosis and Evaluation of Therapeutic Effects of Wind-stroke issued by the State Scientific Committee 85-919-01-01, 1995.

  19. A patient presenting with cholangitis due to Stenotrophomonas maltophilia and Pseudomonas aeruginosa successfully treated with intrabiliary colistine

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    Pablo N. Pérez

    2014-05-01

    Full Text Available Anatomical barriers for antibiotic penetration can pose a particular challenge in the clinical setting. Stenotrophomonas maltophilia (SM and Pseudomonas aeruginosa (PA are two pathogens capable of developing multiple drug-resistance (MDR mechanisms. We report the case of a 56-year-old female patient with a permanent percutaneous transhepatic biliary drainage (PTBD, who was admitted to our hospital with a cholangitis due to a MDR Escherichia coli strain. Upon admission, culture-guided antimicrobial therapy was conducted and the biliary catheter was replaced, with poor clinical response. Subsequently, SM and PA were detected. Treatment with fosfomycin and colistine was initiated, again without adequate response. Systemic colistine and tigecycline along with an intrabiliary infusion of colistine for 5 days was then used, followed by parenteral fosfomycin and tigecycline for 7 days. The patient was then successfully discharged. This is the first case report we are aware of on the use of intrabiliary colistine. It describes a new approach to treating cholangitis by MDR bacteria in patients with a PTBD.

  20. Scleroderma en coup de sabre treated with polymethylmethacrylate - Case report*

    Science.gov (United States)

    Franco, Joanna Pimenta de Araujo; Serra, Márcio Soares; Lima, Ricardo Barbosa; D’Acri, Antônio Macedo; Martins, Carlos José

    2016-01-01

    The scleroderma en coup de sabre is a variant of localized scleroderma that occurs preferentially in children. The disease progresses with a proliferative and inflammatory phase and later atrophy and residual deformity, which are treated with surgical techniques such as injectable fillers, transplanted or autologous fat grafting and resection of the lesion. Among the most widely used fillers is hyaluronic acid. However, there are limitations that motivate the search for alternatives, such as polymethylmethacrylate, a permanent filler that is biocompatible, non-toxic, non-mutagenic and immunologically inert. In order to illustrate its application, a case of scleroderma en coup de sabre in a 17-year-old patient, who was treated with polymethylmethacrylate with excellent aesthetic results, is reported. PMID:27192521

  1. Successful Management of a Neglected Case of Nephropathic Cystinosis

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    Mohamed A. El-Naggari

    2014-05-01

    Full Text Available Cystinosis is a rare metabolic disorder characterised by lysosomal cystine accumulation leading to multi-organ damage; clinically, the kidneys are the first organ affected. Respiratory insufficiency caused by overall respiratory muscle myopathy is a life-threatening complication. Treatment with cysteamine should be initiated rapidly and continued lifelong to prolong renal function and protect the extra-renal organs. We report the case of a four-year-old Omani girl, diagnosed with infantile nephropathic cystinosis at 21 months. Cysteamine was prescribed but with no compliance to medications. She presented to the Child Health Department of Sultan Qaboos University Hospital, Oman, two years later with severe failure to thrive, electrolyte disturbance and respiratory failure. The hypoventilation and early respiratory dysfunction, due to intercostal and diaphragm myopathy, was treated by non-invasive positive-pressure ventilation. The patient was discharged after four months of intensive rehabilitation with no ventilator support. No standard treatment options have yet been established for respiratory dysfunction in cystinosis.

  2. Successful Treatment of Cerebral Toxoplasmosis with Clindamycin: A Case Report

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    Deepak Madi

    2012-09-01

    Full Text Available Toxoplasmosis is caused by infection with the obligate intracellular parasite Toxoplasma gondii. Toxoplasmosis is generally a late complication of HIV infection and usually occurs in patients with CD4 + T-cell counts below 200/μl. Co-trimoxazole (trimethoprim plus sulfamethoxazole is the most common drug used in India for the treatment of AIDS-associated cerebral toxoplasmosis. Other alternative drugs used for the treatment of cerebral toxoplasmosis are clindamycin plus pyrimethamine and clarithromycin with pyrimethamine.A 30-year-old male known case of retroviral disease presented to Kasturba Medical College, India, with complaints of fever, headache and vomiting. Computed tomography scan of his brain showed irregular ring enhancing lesion in the right basal ganglia. Toxoplasma serology revealed raised IgG antibody levels. Based on the CT features and serology, diagnosis of cerebral toxoplasmosis was made. He was treated with clindamycin alone as he had historyof sulfonamide allergy. The patient was symptomatically better after 48 hours. After 21 days, repeat CT of brain was done which was normal. The patient showed good clinical improvement within 48 hours and the lesion resolved completely within 3 weeks. The authors recommend using clindamycin without pyrimethamine in resource poor settings and in patients who do not tolerate sulfa drugs.

  3. Herpes zoster infection: Report of a treated case

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    Kotya Naik Maloth

    2015-01-01

    Full Text Available Herpes zoster (HZ is an acute infectious viral disease result from reactivation of the DNA varicella-zoster virus, which occurs more frequently among older adults and immunocompromised persons. The most common complication of HZ is postherpetic neuralgia, a chronic often debilitating pain condition that can last months or even years. Deaths attributable to zoster are common among immunocompromised persons. Prompt treatment with the antiviral drugs, corticosteroids and analgesics decrease the severity and duration of acute pain from HZ. Here, we report a treated case of HZ in 35-year-old male involving all three branches of the trigeminal nerve without any complication.

  4. A strange case of ingrown toenail treated with phenol

    OpenAIRE

    Sugamata, A; Yoshizawa, N.

    2011-01-01

    We experienced a strange case of ingrown toenail, which had developed as a huge mass and enveloped the nail of the left first toe. The patient had self-treated his ingrown toenail for a period of one year with an ointment available over the counter. However, the granulation tissue on both sides of the nail had increased gradually and advanced over the nail plate in the medial direction. Finally, the granulation tissue on both sides had adhered to the nail and epithelial cells advanced over th...

  5. AESTHETIC MANAGEMENT OF FRACTURED ENDODONTICALLY TREATED TOOTH- CASE REPORT

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    Hada Singh

    2012-12-01

    Full Text Available ABSTRACT: Title – Aesthetic management of fractured endodonti cally treated teeth- Case report Healthy oral cavity is primary requisite for beautif ul looks. Aesthetic requirement of severely mutilated teeth has been a challenge to de ntist. This paper presents endodontic treatment of grossly decayed tooth followed by the placement of a fibre-reinforced composite resin post. The crown reconstruction was done with f ull ceramic crown. Resin fibre post has best properties in elasticity, translucency, adaptabil ity and resistance to traction

  6. Elderly patient refractory to multiple pain medications successfully treated with integrative East–West medicine

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    Bill Tu

    2008-07-01

    Full Text Available Bill Tu, Michael Johnston, Ka-Kit HuiUCLA Center for East–West Medicine, Department of Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USABackground: Polypharmacy is a common and serious problem in the elderly today. Few solutions have been effective in reducing its incidence.Case summary: An 87-year-old female with a history of osteoarthritis and spinal stenosis presented with a five month history of severe right hip pain. She had been seen by multiple specialists and hospitalized many times. During these encounters, she was prescribed a long list of pain medications. However, these medications did not improve her pain and added to her risk of adverse drug events. After exhausting traditional Western medical therapies, she received a referral to the UCLA Center for East–West Medicine. There, clinicians treated her with a nonpharmacological integrative East-West medicine approach that included acupuncture, dry needling of trigger points, and education on self-acupressure. Her pain began improving and she was able to cut back on analgesic use under physician supervision. Ultimately, she improved to the point where she was able to discontinue all of her pain medications. Symptomatic relief was evidenced by improvement in health-related quality of life (HRQOL.Conclusions: This case study suggests that integrative East–West medicine may have the potential to reduce the incidence of polypharmacy in elderly patients presenting with pain conditions and improve their quality of life.Keywords: polypharmacy, pain, osteoarthritis, acupuncture, complementary and alternative medicine, integrative medicine, adverse drug reaction, elderly

  7. Severe multiorganic flare of systemic lupus erythematosus successfully treated with rituximab and cyclophosphamide avoiding high doses of prednisone.

    Science.gov (United States)

    Gonzalez-Echavarri, C; Pernas, B; Ugarte, A; Ruiz-Irastorza, G

    2014-03-01

    Both acute pancreatitis and diffuse alveolar haemorrhage are rare conditions associated with systemic lupus erythematosus (SLE). In this case report, a 23-year-old female with SLE was diagnosed with lupus-associated pancreatitis and, within a few days and despite initial therapy with pulse methyl-prednisolone, subsequently suffered an acute respiratory failure due to a diffuse alveolar haemorrhage. The patient was admitted to the intensive care unit and treatment was intensified with cyclophosphamide and rituximab, which shortly induced the complete remission of SLE with resolution of both clinical conditions. She completed treatment with six pulses of cyclophosphamide followed by azathioprine, hydroxychloroquine and prednisone at initial doses of 20 mg/d with rapid tapering to 5 mg/d, without relapse of the disease during the following year. This case can illustrate that, even in severe, life-threatening SLE flares, it is possible to avoid high-dose prednisone, which has been associated with severe side effects, including infections. Acute pancreatitis and diffuse alveolar haemorrhage are rare conditions caused by SLE. DAH can be a life-threatening complication, with an early mortality of at least 50%. When facing such severe SLE activity, there is a general tendency to use high doses of prednisone as the initial therapy, maintaining such high doses for long periods of time, even after the clinical situation has subsided. We report a case of a young woman with SLE, suffering from acute pancreatitis and diffuse alveolar haemorrhage, who was successfully treated with pulse methyl-prednisolone, hydroxychloroquine, cyclophosphamide and rituximab, combined with medium doses of prednisone.

  8. 糖皮质激素联合硫唑嘌呤治疗复发性淋巴细胞性垂体炎三例报道%Recurrent lymphocytic hypophysitis successfully treated with glucocorticoids plus azathioprine: three cases report

    Institute of Scientific and Technical Information of China (English)

    杨国庆; 陆菊明; 吕朝晖; 谷伟军; 杜锦; 郭清华; 王先令; 巴建明; 窦京涛; 母义明

    2011-01-01

    报道3例复发性淋巴细胞性垂体炎(LYH)患者均为女性,其中病例2为老年女性.病例1主要累及垂体前叶,并侵犯海绵窦和视交叉,病例2则主要累及下丘脑和漏斗部,病例3则是垂体前叶和垂体柄均受累.病例1手术后4个月第一次复发,给予大剂量甲基泼尼龙治疗(HDMPT)有效,但停药后14个月再次复发;病例2中等剂量强的松治疗停药16个月后复发,而病例3则在HDMPT治疗,糖皮质激素减量的过程中复发.3例患者复发后均以糖皮质激素联合硫唑嘌呤治疗16周,疗效良好,停药后随访3例患者,MRI显示LYH均无复发,而且病例1和3垂体功能正常.%All three cases of recurrent lymphocytic hypophysitis were female, one of them being 70-yearold postmenopausal woman.Adenohypophysis, cavernous sinus, and optic chiasm were involved in case 1,hypothalamus and neurohypophysis were invaded in case 2, and adenohypophysis and hypophyseal stalk were involved in case 3.Relapse occured 4 months after operation in case 1, then high dosage methylprednisolone pulse therapy (HDMPT) brought about a remission lasting for 14 months before second relapse set in.Relapse occurred in case 2 at 16 months after prednisone treatment was discontinued, and case 3 recurred during the period of dose reduction.All three patients were then treated with glucocorticoid plus azathioprine for 16 weeks, and good response was seen in 3 cases.During follow-up, the symptoms were relieved and significant reduction of lesion was revealed by MRI in all thee patients, and the pituitary function was resumed in case1and 3.

  9. Fifty Cases of Vertebrobasilar Ischemic Vertigo Treated by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    HUANG Qiong

    2009-01-01

    Objective:To observe the therapeutic effects of filiform needle acupuncture combined with dermal needle tapping for vertebrobasilar ischemic vertigo. Methods: Based on the etiopathogenesis of TCM, the disease is caused by turbid phlegm clouding the heart orifice combined with wind, leading to insufficient nourishment of the brain due to deficiency of blood. Fenglong (ST 40) was punctured with filiform needle to resolve phlegm; Fengchi (GB 20) to dispel wind; Baihui (GV 20) to stop dizziness; and Lieque (LU 7) to widen the inner diameter of the vertebral arteries and increase peak systolic velocity and minute blood flow volume, so as to improve blood supply to the vertebral arteries. Dazhui (GV 14) was stimulated by tapping with a dermal needle to improve blood supply to the head. Results: Of 50 patients in this series, 39 cases (78%) were cured,6 cases (12%) relieved, 4 cases (8%) improved, and 1 case (2%) failed, with a total effective rate of 98%.Conclusion: Acupuncture combined with dermal needle tapping is an effective therapy for treating vertebrobasilar ischemic vertigo.

  10. Platypnea-orthodeoxia syndrome in a patient with a pre-existing patent foramen ovale successfully treated with an atrial septal occluder

    Institute of Scientific and Technical Information of China (English)

    Ting-Ting ZHANG; Ge-Sheng CHENG; Jun WANG; Xing-Ye WANG; Xue-Gang XIE; Ya-Juan DU; Yu-Shun ZHANG

    2015-01-01

    Platypnea orthodeoxia syndrome is associated with dyspnea and arterial oxygen desaturation accentuated by an upright posture. It can be secondary to an intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome (POS) in a 58-year old male patient who had a pre-existing patent foramen ovale (PFO) and substantial pulmonary pathologies. He was successfully treated by percutaneous transcatheter closure of the PFO. Our case highlights the importance of recognition of this rare syndrome in patients who present with unexplained hy-poxia for whom transcatheter closure of the interatrial shunt can be safely carried out.

  11. Successful Treatment of Brittle Diabetes Following Total Pancreatectomy by Islet Allotransplantation: A Case Report

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    Angela Koh

    2013-07-01

    Full Text Available Context Allotransplantation of islets can successfully treat subjects with type 1 diabetes complicated by severehypoglycemia and erratic glycemic control. Insulin independence is often lost over time due to several factors, includingrecurrent autoimmunity. Brittle diabetes (frequent hypoglycemia and labile glycemic control is common afterpancreatectomy. This is ameliorated by auto-islet transplantation in pancreatectomized patients who have better glycemiccontrol, even without insulin independence. Case report We herein report a case where islet allotransplantation was carriedout in a patient who had undergone total pancreatectomy. Following two islet infusions, he became insulin independent withexcellent glycemic control and remains so currently, more than four years after his second islet infusion. Side effects fromimmunosuppressive therapy were minimal. Discussion Islet allotransplantation can be considered in selected individualspost-pancreatectomy. The absence of autoimmunity may be advantageous for long term graft function relative to isletallotransplantation in type 1 diabetic recipients.

  12. Unusual case of successful hand replantation with bad functional outcome: A case report

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    Milenković Saša

    2012-01-01

    Full Text Available Introduction. Traumatic hand amputation is a very severe and rare injury. Replantation and revascularization surgery requires the existence of specialized centres and well-educated teams of microsurgeons. In places where there are no such specialized centres for this kind of surgery, traumatic hand amputation is a major concern and quite a challenge, and a successfully performed replantation is a great accomplishment. Case Outline. We report a case of a successfully survived replanted hand in a 35-year-old male patient with unfortunately bad end result of the treatment. The patient with the amputated left hand (disarticulation had a surgery 4 hours after injury. The urgent surgical procedure required a debridement, the excision of the first row of the carpal bones, external fixation of the wrist, vascular anastomoses, nerve repair, tenorrhaphy, skin sutures and decompression skin incisions. The successful operation did not have a successful post-operative course due to the patient’s psychiatric problems and lack of rehabilitation at the psychiatric institution where the treatment was continued. Conclusion. Successful surgical performance can unfortunately be ruined due to inadequate further treatment course or the wrong selection for such a demanding surgery. The survival of the amputated hand can be achieved surgically, but achieving refunctioning does not always depend on surgery. It also depends on the very patient, his motivation, rehabilitation, as well as on the proper selection for such a demanding and complex surgical procedure.

  13. Children successfully treated for moderate acute malnutrition remain at risk for malnutrition and death in the subsequent year after recovery.

    Science.gov (United States)

    Chang, Cindy Y; Trehan, Indi; Wang, Richard J; Thakwalakwa, Chrissie; Maleta, Ken; Deitchler, Megan; Manary, Mark J

    2013-02-01

    Moderate acute malnutrition (MAM) affects 11% of children risk for morbidity and mortality. It is assumed that successful treatment of MAM reduces these risks. A total of 1967 children aged 6-59 mo successfully treated for MAM in rural Malawi following randomized treatment with corn-soy blend plus milk and oil (CSB++), soy ready-to-use supplementary food (RUSF), or soy/whey RUSF were followed for 12 mo. The initial supplementary food was given until the child reached a weight-for-height Z-score (WHZ) >-2. The median duration of feeding was 2 wk, with a maximum of 12 wk. The hypothesis tested was that children treated with either RUSF would be more likely to remain well-nourished than those treated with CSB++. The primary outcome, remaining well-nourished, was defined as mid-upper arm circumference ≥12.5 cm or WHZ ≥-2 for the entire duration of follow-up. During the 12-mo follow-up period, only 1230 (63%) children remained well-nourished, 334 (17%) relapsed to MAM, 190 (10%) developed severe acute malnutrition, 74 (4%) died, and 139 (7%) were lost to follow-up. Children who were treated with soy/whey RUSF were more likely to remain well-nourished (67%) than those treated with CSB++ (62%) or soy RUSF (59%) (P = 0.01). A seasonal pattern of food insecurity and adverse clinical outcomes was observed. This study demonstrates that children successfully treated for MAM with soy/whey RUSF are more likely to remain well-nourished; however, all children successfully treated for MAM remain vulnerable.

  14. Successful use of camelid (alpaca) antivenom to treat a potentially lethal tiger snake (Notechis scutatus) envenomation in a dog.

    Science.gov (United States)

    Padula, Andrew M; Winkel, Kenneth D

    2016-05-01

    This report describes a confirmed clinical case of tiger snake (Notechis scutatus) envenomation in a domestic dog that was successfully treated with a novel polyvalent camelid (alpaca; Llama pacos) antivenom. Samples collected from the dog were assayed for tiger snake venom (TSV) using a highly sensitive and specific ELISA. The TSV concentration in serum and urine at initial presentation was 365 ng/mL and 11,640 ng/mL respectively. At the time of initial presentation whole blood collected from the dog did not clot and the Prothrombin Time was abnormally increased (>300 s). Serum was also visibly hemolysed. The dog was administered antihistamine, dexamethasone and 4000 Units (sufficient to neutralise 40 mg of TSV) of a novel polyvalent alpaca antivenom diluted in 0.9% NaCl. At 4 h post-antivenom treatment the dog's clinical condition had improved markedly with serum TSV concentrations below the limit of detection (improve by 4 h and had fully normalised by 16 h post-antivenom. Venom concentrations in both serum and urine remained undetectable at 16 h post-antivenom. The dog made a complete recovery, without complications, suggesting that the alpaca-based antivenom is both clinically safe and effective.

  15. Pheochromocytoma-Induced Inverted Takotsubo-Like Cardiomyopathy Leading to Cardiogenic Shock Successfully Treated With Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Flam, Benjamin; Broomé, Michael; Frenckner, Björn; Bränström, Robert; Bell, Max

    2015-09-01

    Pheochromocytoma classically displays a variety of rather benign symptoms, such as headache, palpitations, and sweating, although severe cardiac manifestations have been described. We report a case of pheochromocytoma-induced inverted takotsubo-like cardiomyopathy leading to shock and cardiac arrest successfully treated with extracorporeal membrane oxygenation (ECMO) as a bridge to pharmacological therapy and curative adrenalectomy. A previously healthy 46-year-old woman presented to the emergency department with abdominal pain, dyspnea, nausea, and vomiting. Clinical evaluation revealed cardiorespiratory failure with hypoxia and severe metabolic acidosis. Computed tomography (CT) scan showed pulmonary edema and a left adrenal mass. Transthoracic echocardiography (TTE) displayed severe left ventricular dysfunction with inverted takotsubo contractile pattern. Despite mechanical ventilation and inotropic and vasopressor support, asystolic cardiac arrest ensued. The patient was resuscitated using manual chest compressions followed by venoarterial ECMO. Repeated TTEs demonstrated resolution of the cardiomyopathy within a few days. Laboratory results indicated transient renal and hepatic dysfunction, and CT scan of the brain displayed occipital infarctions. Biochemical testing and radionuclide scintigraphy confirmed a pheochromocytoma. Pharmacological adrenergic blockade was instituted prior to delayed adrenalectomy after which the diagnosis was histopathologically verified. The patient recovered after rehabilitation. We conclude that pheochromocytoma should be considered in patients presenting with unexplained cardiovascular compromise, especially if they display (inverted) takotsubo contractile pattern. Timely, adequate management might involve ECMO as a bridge to pharmacological therapy and curative surgery.

  16. Popliteal lymphadenectomy for treating metastatic melanoma: case report

    Directory of Open Access Journals (Sweden)

    Sergio Renato Pais Costa

    Full Text Available CONTEXT: Regional lymph node involvement in patients with malignant melanomas has been associated with poor prognosis. In-transit metastases also lead to poor long-term survival. Whereas for nodal disease only regional lymphadenectomy offers adequate locoregional control, for in-transit metastasis both local excision and isolated limb perfusion with chemotherapy plus tumor necrosis factor-alpha can be used for disease control. In cases of tumors located in the distal region of the legs, the lymphatic dissemination most commonly observed is to the inguinal chain. Consequently, therapeutic inguinal lymphadenectomy or even selective lymphadenectomy (sentinel lymph node biopsy have been recommended. On the other hand, involvement of the popliteal chain is very rare. When this occurs, popliteal lymphadenectomy should be indicated. Local excision may be the logical approach for a few small in-transit metastases because of the low morbidity in this procedure, when compared with isolated limb perfusion. CASE REPORT: A case of melanoma of the heel with popliteal chain involvement and in-transit metastases is presented. This was treated by means of regional lymphadenectomy plus in-transit metastases excision, with a good postoperative course.

  17. Bilateral Temporal Triangular Alopecia Associated with Phakomatosis Pigmentovascularis Type IV Successfully Treated with Follicular Unit Transplantation

    Directory of Open Access Journals (Sweden)

    Robin Unger

    2011-01-01

    Full Text Available Temporal triangular alopecia (TTA, also known as congenital triangular alopecia, is a nonscarring, noninflammatroy, circumscribed form of alopecia. TTA has been associated with several disorders, such as Phakomatosis Pigmentovascularis. Hair restoration surgery using follicular unit transplantation has been a successful treatment modality for TTA. Herein we report such a success that was sustained for over six years.

  18. Post-transplant lymphoproliferative disorder treated with rituximab: case report

    Institute of Scientific and Technical Information of China (English)

    MENG Hai-tao; LI Ying; LIU Jian-hua; XU Gai-xiang; TENG Xiao-dong

    2007-01-01

    @@ Post-transplant lymphoproliferative disorder (PTLD), a rare disease, is characterized by an abnormal proliferation of lymphoid cells after solid organ transplantation.1 This complication is usually caused by the immunosuppressive therapy following transplantation.Though the techniques of early detection and diagnosis of the disease are well established, treatment is not so straightforward and poses a real challenge. At this time,options include anti-viral therapy, cytotoxic chemotherapy, cellular immunotherapy, and reduction of immunosuppression. But the effects of these therapies are not satisfying. Rituximab, a chimeric monoclonal anti-CD20 antibody used for the treatment of B cell lymphoma with a good effect, is rarely, especially in combination with chemotherapy, used for PTLD. In this report, we describe a case of PTLD treated with rituximab and chemotherapy resulting in complete remission.

  19. A strange case of ingrown toenail treated with phenol.

    Science.gov (United States)

    Sugamata, A; Yoshizawa, N

    2011-07-01

    We experienced a strange case of ingrown toenail, which had developed as a huge mass and enveloped the nail of the left first toe. The patient had self-treated his ingrown toenail for a period of one year with an ointment available over the counter. However, the granulation tissue on both sides of the nail had increased gradually and advanced over the nail plate in the medial direction. Finally, the granulation tissue on both sides had adhered to the nail and epithelial cells advanced over the granulation tissue completely. During surgery, the epithelized granulation tissue was excised at the bilateral terminal base point, and the posterior nail fold and the nail matrix were cauterized completely with phenol. Eighteen months after the operation there was no recurrence of the ingrown toenail.

  20. A case of progeria syndrome treated as VIP patient

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    Seema Mahant, Mahant PD, C.M. Reddy

    2014-11-01

    Full Text Available Progeria is rare autosomal recessive genetic disease with an incidence of about one in eight million. He was 16 years old boy lying on the couch. He was short stature thin with minimal subcutaneous tissue, skin was thin and fragile with loss of hair over scalp, eyebrows and eyelashes, and his face was dismorphic with prominent eyes, beaked nose, small jaw and large cranium with visible veins over it. His voice was thin and high pitched. Overall, this gives them an extremely aged nearly 70 -80 years old man look. The patient was a known case of progeria syndrome and he was treated as a VIP patient by all faculty members and staff, though he belongs low socioeconomic status, no political issue with them. But still he was a VIP.

  1. How to build successful city brands? -Case Munich, Berlin & Hamburg

    OpenAIRE

    Järvisalo, Susanna

    2012-01-01

    This thesis examines the success factors of branding a city. The objective is to find out required organizational and managerial competences and best practices in successful city branding. The thesis consists of theory section and an empirical section. The theory section rep-resents the concept of a brand and discusses the characteristics of brand management and place marketing on the basis of relevant literature and Internet sources. Brand management and place marketing sections focus o...

  2. [Osteoid osteoma in children: 5 cases treated with electrocoagulation].

    Science.gov (United States)

    Gilliaux, O; de Wispelaere, J-F; Charlier, H; Bodart, E

    2012-11-01

    Osteoid osteoma is a benign bone tumor. Its diagnosis is often delayed despite typical symptoms: severe pain mainly situated on the lower limbs and characteristically worse at night. Once diagnosed, an antalgic treatment by aspirin is well known to be very effective in relieving pain. Osteoid osteoma will resolve spontaneously. If symptoms persist despite the use of aspirin, surgery can be performed to remove the tumor. Percutaneous electrocoagulation can be performed instead of surgical resection as a less invasive procedure. The success rate of surgery and percutaneous electrocoagulation is comparable. We reviewed the cases of 5 patients who were hospitalized in our institution for percutaneous electrocoagulation of an osteoid osteoma. We compared them to the literature.

  3. 成功治疗儿童罕见髓系/自然杀伤细胞祖细胞急性白血病1例%An Unusual Child Case of Myeloid/Natural Killer Cell Precursor Acute Leukemia Treated Successfully with Acute Myeloid Leukemia-Oriented Chemotherapy

    Institute of Scientific and Technical Information of China (English)

    陈玉梅; 刘芳; 邹尧; 阮敏; 刘晓明; 刘天峰; 竺晓凡

    2012-01-01

    This study was aimed to identify the characteristics of childhood myeloid/'natural killer cell precursor acute leukemia (M/NKPAL), and to summarize the therapeutical experiences of this rare hematologic malignancy. A child case of M/NKPAL accompanied by CNS leukemia was enrolled in this study, the therapeutic regiments and the results of long time following up were analysed and evaluated. The results showed that the unusual child case of M/NKPAL with CNS infiltration was diagnosed, showing immunophenotype of CD7+, CD33+, CD3case was treated with daunorubicin and cytarabine, and achieved complete remission. Then, S coures of acute myeloid leukemia-oriented chemotherapy were given as consolidation chemotherapy, all of the 5 courses contained high dose cytarabine. This child case was given 9 times of lumbar puncture and intrathecal injection, besides these, this case was also given cranial radiotherapy with a dose of 36 Gy. After treated with these methods, the child case achieved long-term complete remission. It is concluded that the M/NKPAL is a rare disease with distinctive immunophenotypic characteristics, acute myeloid leukemia-oriented chemotherapy regimen with high dose of cytarabine may be able to induce long-term remission.%本文总结儿童髓系/自然杀伤细胞祖细胞急性白血病(M/NKPAL)的治疗经验以提高对该病的认识.对1例罕见的3岁8个月女童M/NKPAL合并中枢神经系统白血病进行了确诊分析,并对其治疗经过及长期随访结果进行了总结.结果表明,女童M/NKPAL合并中枢神经系统浸润得到了确诊,其免疫表型特征为CD7,CD33,CD34,CD56和HLA-DR共表达,MPO阴性,其他NK细胞和T、B细胞分化抗原阴性,染色体核型有+8和12p -.采用柔红霉素+阿糖胞苷化疗后达完全缓解,随后应用急

  4. Ventricular arrhythmias in patients of atrial fibrillation treated with Flecainide: A case report

    Directory of Open Access Journals (Sweden)

    Barman M, Djamel B

    2014-07-01

    Full Text Available Purpose: Flecainide is a class 1C antiarrhythmic drug, especially used for the management of supraventricular arrhythmia. Flecainide also has a recognized proarrhythmic effect in all age groups of adult patients treated for ventricular tachycardia. It is used to treat a variety of cardiac arrhythmias including paroxysmal fibrillation, Paroxysmal Supraventricular tachycardia and ventricular tachycardia. Flecainide works by regulating the flow of sodium in the heart, causing prolongation of the cardiac action potential. The proarrhythmic effects however noted are not widely reported. Case report: We report a case of paroxysmal atrial fibrillation with structurally normal heart who was treated with oral Flecainide. Despite subjective improvement and no adverse events [QTc prolongation] a repeat holter detected him to have multiple short non sustained ventricular arrhythmias. Results: Development of ventricular arrhythmias, salvos &non sustained ventricular tachycardia after a month of initiation of oral Flecainide detected by 24 hours ECG holter lead to discontinuation of Flecainide and subsequent early electro physiological studies and successful ablation. Conclusion: Initiation of oral Flecainide in a case of atrial fibrillation with subjective improvement and regular ECG monitoring, no QTc prolongation can still lead to development of dangerous ventricular arrhythmias. A cautious approach and thorough investigations and follow up are recommended.

  5. Successful immunological treatment of gallbladder cancer in India-Case report

    Institute of Scientific and Technical Information of China (English)

    KHAN Jamal A.; YAQIN Sharmin

    2006-01-01

    Gallbladder cancer has a poor outcome because of its anatomy and location. Often, the diagnosis is made very late due to its silent course. Post-operated cases do respond to chemotherapy but the survival is counted in months and the quality of life is further hampered due to toxicity of drugs. Immunotherapy holds good promise in non-responding cancers treated by conventional chemotherapeutic agents. Among various therapies, dendritic cell therapy is growing at rapid pace due to its acceptable rationale.It has been utilized in treating successfully resected stage Ⅲ (T2, N1, M0) gallbladder cancer in one of our patients. A 48 years old lady treated with this therapy is free of metastasis with ten doses of autologous dendritic cell vaccine constructed by utilizing resected tumor lysate antigen. She has received ten doses of therapy in 14 months of her treatment. This therapy has proven to be safe and without apparent side effects. The positive clinical response obtained supports that autologous dendritic cell-based immunotherapy is a promising therapeutic approach for refractory gallbladder cancers.

  6. Building Action Research Teams: A Case of Struggles and Successes

    Science.gov (United States)

    Du, Fengning

    2009-01-01

    Teaching teams can hold the promise of being an ideal vehicle in which collaborative action research is conducted. This case documents the mixed results of a team leader's efforts to improve teaching and introduce inquiry-based professional development through action research in a community college. This case paints a realistic and…

  7. Treating the untreatable: a single case study of a psychopathic inpatient treated with schema therapy.

    Science.gov (United States)

    Chakhssi, Farid; Kersten, Truus; de Ruiter, Corine; Bernstein, David P

    2014-09-01

    From its first conceptualization in modern psychiatry, psychopathy has been considered difficult if not impossible to treat. Schema Therapy (ST) is a psychotherapeutic approach that has shown efficacy in patients with borderline personality disorder. ST has recently been adapted for personality disordered forensic patients, including patients with high levels of psychopathy. The present case study examined the process of individual ST, combined with movement therapy and milieu therapy by the nursing staff, with a forensic inpatient with psychopathic features (Psychopathy Checklist-Revised total score = 28.4). The patient had been sentenced to a mandatory treatment order in relation to a sexual assault. We assessed change using independent assessments of psychopathic traits, cognitive schemas, and risk-related behaviors over the 4-year treatment period and a 3-year follow-up. We also assessed the quality of the working alliance. Reliable change analyses showed significant improvements in psychopathic traits, cognitive schemas, and risk-related outcomes. At 3 years posttreatment, the patient was living independently outside of the forensic institution without judicial supervision and he had not reoffended. While many questions remain about the effectiveness of psychotherapeutic treatment for psychopathic patients, our study challenges the view that they are untreatable.

  8. Successful treatment of plasma cell cheilitis with topical tacrolimus: report of two cases.

    Science.gov (United States)

    Hanami, Yuka; Motoki, Yoshikazu; Yamamoto, Toshiyuki

    2011-02-15

    Plasma cell cheilitis is an uncommon chronic inflammatory dermatitis that presents with flat to slightly elevated erosive erythematous plaques. It is histologically characterized by plasma cell infiltrates into the mucosa. Other than the lip, genital areas are often involved, which is called plasma cell balanitis or vulvitis. Plasma cell cheilitis is sometimes resistant to conventional topical corticosteroid therapy. Other choices include oral griseofulvin, topical cyclosporine, and intralesional corticosteroid injection, all of which occasionally fail to produce satisfactory results. Recent reports show that topical calcineurin inhibitors are effective for plasma cell cheilitis, balanitis, and vulvitis. However, there are so far only 2 reports of plasma cell cheilitis successfully treated with topical pimecrolimus and tacrolimus. We present herein two cases of plasma cell cheilitis, in which topical tacrolimus showed beneficial effects, suggesting that this immunomodulatory agent is a promising option for plasma cell cheilitis.

  9. Establishment and Early Succession of Bacterial Communities in Monochloramine-Treated Drinking Water Biofilms

    Science.gov (United States)

    Monochloramine is increasingly used as a drinking water disinfectant because it forms lower levels of regulated disinfection by-products. While its use has been shown to increase nitrifying bacteria, little is known about the bacterial succession within biofilms in monochloramin...

  10. A Case of Successful Remission of Extensive Primary Gastric Diffuse Large B Cell Lymphoma: Radiologic, Endoscopic and Pathologic Evidence

    Directory of Open Access Journals (Sweden)

    Mike M. Bismar

    2014-04-01

    Full Text Available Though rare amongst stomach neoplasms, primary gastric diffuse large B cell lymphoma is one of the commonest extranodal non-Hodgkin lymphomas. If left untreated, it can have a devastating progression and life-threatening consequences. We present the case of a successfully treated large antral ulcer confirmed to be large B cell lymphoma as evidenced by radiologic, endoscopic and histopathologic findings. A brief discussion about the types of gastric lymphoma, their Helicobacter pylori relation and therapeutic modalities follows.

  11. Drivers of cultural success: The case of sensory metaphors.

    Science.gov (United States)

    Akpinar, Ezgi; Berger, Jonah

    2015-07-01

    Why do some cultural items catch on and become more popular than others? Language is one of the basic foundations of culture. But what leads some phrases to become more culturally successful? There are multiple ways to convey the same thing and phrases with similar meanings often act as substitutes, competing for usage. A not so friendly person, for example, can be described as unfriendly or cold. We study how the senses shape cultural success, suggesting that compared with their semantic equivalents (e.g., unfriendly person), phrases which relate to senses in metaphoric ways (e.g., cold person) should be more culturally successful. Data from 5 million books over 200 years support this prediction: Sensory metaphors are used more frequently over time than are their semantic equivalents. Experimental evidence demonstrates that sensory metaphors are more memorable because they relate more to the senses and have more associative cues. These findings shed light on how senses shape language and the psychological foundations of culture more broadly.

  12. Acute severe organophosphate poisoning in a child who was successfully treated with therapeutic plasma exchange, high-volume hemodiafiltration, and lipid infusion.

    Science.gov (United States)

    Yesilbas, Osman; Kihtir, Hasan S; Altiti, Mohammad; Petmezci, Mey Talip; Balkaya, Seda; Bursal Duramaz, Burcu; Ersoy, Melike; Sevketoglu, Esra

    2016-10-01

    Acute severe organophosphate poisoning is a serious complication seen in developing and agricultural countries. Pralidoxime and high dose atropine are the standard treatments. There is no consensus about acute severe organophosphate poisonings that are unresponsive to pralidoxime, atropine, and supportive therapies. We report a case of acute severe organophosphate poisoning that was unresponsive to standard treatments and successfully treated with high-volume continuous venovenous hemodiafiltration and therapeutic plasma exchange combined with lipid infusion. J. Clin. Apheresis 31:467-469, 2016. © 2015 Wiley Periodicals, Inc.

  13. Acute intermittent porphyria with syndrome of inappropriate antidiuretic hormone secretion (SIADH and neurological crisis, successfully treated with haemodialysis

    Directory of Open Access Journals (Sweden)

    P. S. Singh

    2014-04-01

    Full Text Available We report a 35 years old male, a case of Acute Intermittent Porphyria (AIP with Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH and neurological crisis for its rarity. Since specific parenteral medication (hemin was not available, patient was empirically treated with haemodialysis with satisfactory outcome. [Int J Res Med Sci 2014; 2(2.000: 795-797

  14. Toothpick impaction with sigmoid colon pseudodiverticulum formation successfully treated with colonoscopy

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Foreign bodies in the colon are encountered with increasing frequency,but only sporadic reports concerning their management have appeared in the literature.While most ingested foreign bodies usually pass through the gastrointestinal tract uneventfully,sharp foreign bodies such as toothpicks infrequently cause intestinal perforation and may even result in death.We report our experience with a patient with a sigmoid colon pseudodiverticulum formation,a complication of accidental ingestion of a toothpick that was diagnosed and successfully managed colonoscopically.

  15. A near-miss case of obstetric haemorrhage managed successfully

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    Meena N. Satia

    2016-12-01

    Full Text Available Functioning of health systems with respect to maternal health were previously audited using indicators like maternal mortality ratio. However, maternal morbidity as a consequence of pregnancy-related complications is not accounted for in these indicators. Thus, the World Health Organization (WHO has formulated a maternal near-miss approach to pregnancy complications for a more thorough evaluation of health care systems across the world. In practical terms, women are said to be maternal near-miss cases when they survive lethal conditions during pregnancy or in the postpartum period. We report one such case of traumatic variety of postpartum haemorrhage subsequent to a lower segment caesarean section with immediate post-operative removal of cervical cerclage threads that resulted in a maternal near-miss case.

  16. Lumbar hernia treated with lightweight partially absorbable mesh: report of a case.

    Science.gov (United States)

    Yamaguchi, Shohei; Tsutsumi, Norifumi; Kusumoto, Eiji; Endo, Kazuya; Ikejiri, Koji; Yamashita, Yo-ichi; Uchiyama, Hideaki; Saeki, Hiroshi; Oki, Eiji; Kawanaka, Hirofumi; Morita, Masaru; Ikeda, Tetsuo; Maehara, Yoshihiko

    2013-12-01

    Superior lumbar hernia, also known as Grynfeltt-Lesshaft hernia, is an uncommon abdominal wall defect. We report a case of superior lumbar hernia, which was successfully treated with a lightweight partially absorbable mesh. A 73-year-old man visited our department with complaints of lumbar pain and a feeling of pressure associated with a right lumbar mass. A CT scan of the abdomen demonstrated a defect in the aponeurosis of the transversus abdominis muscle and a protrusion of the small intestine through the defect. The diagnosis of a right superior lumbar hernia was made. The lumbar hernia was surgically treated with a lightweight large-pore polypropylene mesh containing an absorbable component consisting of poliglecaprone (ULTRAPRO Plug). The patient had no evidence of recurrence after 4 years of follow-up without any sense of discomfort. This is the first case report of a lumbar hernia treated with a lightweight partially absorbable mesh. This partially absorbable mesh can be considered to be suitable for the treatment of a lumbar hernia.

  17. Two cases of valproic acid poisoning treated with L-carnitine.

    Science.gov (United States)

    Chan, Y C; Tse, M L; Lau, F L

    2007-12-01

    Two cases of acute valproic acid poisoning with central nervous system depression and raised ammonia level without hepatotoxicity were reported. They were treated successfully with the use of the antidotes: L-carnitine and other supportive measures. Clinical manifestation and progress was described, and discussion is focused on the use of L-carnitine in valproic acid-induced hyperammonemia, from its mechanism to the clinical experiences in the literature. Based on the favorable response of our two cases and the literature review, we recommend the administration of intravenous L-carnitine in patients of valproic acid overdose with hyperammonemia or valproic acid-induced hyperammonemic encephalopathy and hepatotoxicity at a dose of 50 mg/kg every 8 h for the first initial 24 h with further individual assessment.

  18. [Carpentier's procedure for Ebstein's anomaly: successful and failed cases].

    Science.gov (United States)

    Ogawa, K; Yuasa, T; Fujita, K; Yano, Y; Hayase, S; Kidokoro, H; Hattori, T; Koike, A

    1992-06-01

    Two adult cases of Ebstein's anomaly underwent Carpentier's procedure. In the first case longitudinal plication limited to free wall of atrialized ventricle was performed and postoperative course was uneventful. In the second case preoperative echocardiography showed apparently restricted movement of anterior leaflet of the tricuspid valve which was compatible with intraoperative findings. That is, inferior edge of anterior leaflet was partly adherent to ventricular wall and systolic bulging of leaflet was significantly impaired which was left untouched but should be repaired by additional procedure. Six days after operation the tricuspid valve replacement was required for persistent right heart failure due to residual tricuspid regurgitation. In the same case longitudinal plication of atrialized ventricle reported by Carpentier and colleagues resulted in excessively small annulus. Therefore we had to reduce the plication and did not perform following atrial plication to avoid direct injury to conduction system or disturbing coronary venous return. In conclusion exact preoperative evaluation of anterior leaflet of the tricuspid valve especially subvalvular anatomy is essential to Carpentier's procedure, as Carpentier and colleagues emphasized, and conservative longitudinal plication of the atrialized ventricle limited to free wall is favorable when excessively small annulus might be concerned.

  19. Successful use of right unilateral ECT for catatonia: a case series.

    Science.gov (United States)

    Cristancho, Pilar; Jewkes, Delaina; Mon, Thetsu; Conway, Charles

    2014-03-01

    Catatonia is a neuropsychiatric syndrome involving motor signs in association with disorders of mood, behavior, or thought. Bitemporal electrode placement electroconvulsive therapy (ECT) is a proven effective treatment for catatonia, and this mode of ECT delivery is the preferred method of treatment in this condition. Studies in major depressive disorder have demonstrated that suprathreshold, nondominant (right) hemisphere, unilateral electrode placement ECT has fewer adverse effects, especially cognitive adverse effects, than bitemporal ECT. This case series describes the use of right unilateral (RUL) ECT in 5 patients with catatonia. Before ECT, all 5 patients in this series initially failed therapy with benzodiazepines and psychotropic medications. Each catatonic patient received a series of 8 to 12 RUL ECT in an every-other-day series. After ECT, 4 of the 5 patients had a full recovery from catatonia. One patient achieved only partial response to RUL ECT, and no additional benefit was obtained with bitemporal ECT. All patients in this case series tolerated RUL ECT without major adverse effects. This case series illustrates successful use of RUL ECT in patients with catatonia and adds to the early literature demonstrating its effective use in treating this complex condition.

  20. Severe Leptospirosis with Multiple Organ Failure Successfully Treated by Plasma Exchange and High-Volume Hemofiltration

    Directory of Open Access Journals (Sweden)

    Vincent Bourquin

    2011-01-01

    Full Text Available Background. Leptospirosis is a spirochetal zoonosis with complex clinical features including renal and liver failure. Case report. We report the case of a Swiss fisherman presenting with leptospirosis. After initial improvement, refractory septic shock and severe liver and kidney failure developed. The expected mortality was estimated at 90% with clinical scores. The patient underwent plasma exchanges and high-volume hemofiltration (HVHF with complete recovery of hepatic and kidney functions. Discussion. Plasma exchanges and HVHF may confer survival benefit on patients with severe leptospirosis, refractory septic shock, and multiple-organ failure.

  1. Clinical Observation of 46 Cases of Scapulohumeral Periarthritis Treated by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    PAN Feng-qin; KUAI Le

    2003-01-01

    Forty-six cases of scapulohumeral periarthritis were treated by selecting the acupoints far from the affected part plus acupuncture differentiation of symptoms and signs, in comparison with 34 cases treated by simple acupuncture differentiation of symptoms and signs. The result showed that cure occurred in 21 cases,marked effectiveness in 19 cases, improvement in 3 cases and ineffectiveness in 1 case in the treatment group. In control group, cure occurred in 10 cases, marked effectiveness in 15 cases, improvement in 8 cases and ineffectiveness in 3 cases. There was a significant difference in the therapeutic effect between the two groups (P<0.05).

  2. [The achievements of medical embryology and the successes in treating infertility].

    Science.gov (United States)

    Nikitin, A I

    1996-01-01

    In connection with the decade of the first test-tube children appearance in Russia a contribution of medical embryology to the working out of auxiliary reproduction method is discussed. The significance of close interaction and mutual understanding between embryologists and representatives of other professions (gynaecologists, endocrinologists and geneticists) in successful solving of the problem is emphasized Main stages of the modern reproductive technology forming were followed up so as the role of medical embryology in sterility treatment. Certain ethic and lawful problems concerning reproduction including the limits of research on human embryos were discussed.

  3. The Hospital Course of a Successfully Treated Patient with Respiratory Failure: Beginning to End!

    Science.gov (United States)

    Callister, T Brian

    The successful treatment of a patient with acute respiratory failure is a complex undertaking that requires clinical competence, evidence-based interventions, seamless coordination of care transitions, and transparent open communication among all members of the health care team. Many of the processes of care in these critically ill patients are reassuringly consistent across services, across hospitals, across health systems, and even across the country. Although the clinical course of such complicated patients can be extremely unpredictable, we are fortunate that the professional, technical, and psychosocial aspects of care for these patients can be relatively orderly, evidence-based, and transparent.

  4. Recurrent impetigo herpetiformis with diabetes and hypoalbuminemia successfully treated with cyclosporine, albumin, insulin and metformin

    Directory of Open Access Journals (Sweden)

    Lakshmi Chembolli

    2010-01-01

    Full Text Available We report the case of a patient with recurrent impetigo herpetiformis associated with diabetes mellitus, hypoalbuminemia, and hypocalcaemia; who was refractory to corticosteroids. Cyclosporine along with other supportive measures proved to be life-saving with maintenance of pregnancy.

  5. Spontaneous successful pregnancy in posthypophysectomy hypopituitarism: A rare case report

    Directory of Open Access Journals (Sweden)

    Indu Lata

    2014-01-01

    Full Text Available Pregnancy in patients with pan-hypopituitarism following surgery of pituitary adenoma is rare and considered high risk. Hormonal dysfunction in these patients involves more than one axis (gonadotrophic, thyroidal, and adrenal. However, advance in infertility treatment have led to the increased pregnancy rate in hypopituitarism women. We present a case of nonfunctioning pituitary macroadenoma, who after pituitary surgery (hypophysectomy developed hypopituitarism followed by multiple tuberculoma brain with hydrocephalus with arachnoiditis. She conceived spontaneously after 9 years of pituitary surgery and carried her pregnancy to the term. Elective caesarean section was done at 38 weeks and both infant and mother are well. The case highlights the rarity of the phenomenon and the safe outcome of the pregnancy with proper replacement.

  6. Successful Management of a Recurrent Supralevator Abscess: A Case Report

    Directory of Open Access Journals (Sweden)

    S. Sanyal

    2012-01-01

    Full Text Available Anorectal abscesses are commonly encountered in clinical surgical practice. These abscesses require surgical management. Supralevator abscesses are thought to originate either from an ischiorectal or intersphincteric abscess extension or from an intraperitoneal source. These abscesses are quite uncommon and present a difficult surgical problem. We present a case here of a 42-year-old female with a recurrent supralevator abscess requiring multiple surgical procedures for adequate drainage and care of her abscess.

  7. The Experiences of Single Fathers Who Have Reared Academically Successful Children: A Collective Case Study

    Science.gov (United States)

    Long, Cheri Gentry

    2014-01-01

    This qualitative collective case study explored single fathers' experiences in rearing academically successful children. Academic success was defined as the completion of high school or college, entering college, or attending college. A purposeful maximal sampling of five bounded systems of single fathers and their academically successful children…

  8. Strategic planning ensures surgical success in cases of proliferative vitreoretinopathy.

    Science.gov (United States)

    Lakhanpal, R Ross; Hariprasad, Seenu M

    2015-02-01

    For this Practical Retina column, Dr. Ross Lakhanpal from Baltimore was asked to comment on the current state of thinking and management options for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery.We are all aware that PVR continues to be an important cause of recurrent RD after successful repair. This feared complication has been reported to occur in up to 8% of patients after undergoing RD repair. Despite the historic progress made in managing various vitreoretinal diseases over the past decade, most retina specialists will agree that an unmet need remains in this landscape. Fortunately, advances in various surgical technologies such as instrumentation, lighting, and visualization have improved the outcomes after PVR management.Dr. Lakhanpal discusses causes of PVR, management goals, surgical techniques, and pearls to avoid complications after managing PVR. His experience working in an urban tertiary surgical retina practice enables him to offer insights that will be highly valued by our community.

  9. Successful pregnancy in pulmonary arterial hypertension associated with systemic lupus erythematosus: a case report

    Directory of Open Access Journals (Sweden)

    Streit Michael

    2009-06-01

    Full Text Available Abstract Introduction Pulmonary arterial hypertension is a complication of systemic lupus erythematosus. Mortality in pregnant patients with pulmonary arterial hypertension related to connective tissue disease is as high as 56%. The authors report the first case of a successful maternal-fetal outcome in a pregnant patient with systemic lupus erythematosus-associated pulmonary arterial hypertension treated with sildenafil and inhaled iloprost during pregnancy and until several weeks after caesarean section. Case presentation The case presented is of a 29-year-old woman with systemic lupus erythematosus and associated severe pulmonary arterial hypertension. Vasodilator therapy with bosentan and sildenafil, immunosuppressive therapy with prednisone, hydroxychloroquine and azathioprine and oral anticoagulation (phenprocoumon had normalized her right ventricular over right atrial pressure when she was diagnosed in her 5th week of pregnancy. The teratogenic drugs bosentan and phenprocoumon were stopped, the latter replaced by low molecular weight heparin. During the 35th week, a slight increase in pulmonary pressure was found. Therapy with inhaled iloprost was established. A caesarean section was performed in the 37th week and a healthy baby was delivered. The patient remained stable until 11 weeks after delivery, when an increase in right ventricular over right atrial pressure was noted. Bosentan was reintroduced and prednisone and azathioprine doses were increased. The patient has remained stable until the present time. Conclusion Pulmonary arterial hypertension has been considered a contraindication for pregnancy. Novel vasodilator therapy, combined with immunosuppressants in this patient with systemic lupus erythematosus, may "cure" pulmonary arterial hypertension and permit pregnancy with successful outcome. However, postpartum exacerbation of systemic lupus erythematosus and pulmonary arterial hypertension have to be considered.

  10. Online Tutor 2.0: Methodologies and Case Studies for Successful Learning

    Science.gov (United States)

    García-Peñalvo, Francisco José, Ed.; Seoane-Pardo, Antonio Miguel, Ed.

    2014-01-01

    After centuries of rethinking education and learning, the current theory is based on technology's approach to and affect on the planned interaction between knowledge trainers and trainees. "Online Tutor 2.0: Methodologies and Case Studies for Successful Learning" demonstrates, through the exposure of successful cases in online education…

  11. Angiotensin-converting enzyme inhibitors-induced angioedema treated by C1 esterase inhibitor concentrate (Berinert®): about one case and review of the therapeutic arsenal.

    Science.gov (United States)

    Lipski, Samuel Michael; Casimir, Georges; Vanlommel, Martine; Jeanmaire, Mathieu; Dolhen, Pierre

    2015-02-01

    C1 esterase inhibitor (Berinert®) is generally used to treat severe attack of hereditary angioedema. We describe here the case of a patient who presented with a severe angioedema induced by angiotensin-converting enzyme inhibitors (ACEIs) endangering her life. It could be successfully treated with that medicine.

  12. Refractory ulcerative colitis complicated by cytomegalovirus infection successfully treated with valganciclovir

    Directory of Open Access Journals (Sweden)

    Tiziana Larussa

    2012-11-01

    Full Text Available Cytomegalovirus (CMV infection is widespread in the general population. In patients with severe and/or steroid-refractory ulcerative colitis (UC, local reactivation of CMV can be detected in actively inflamed colonic tissue in approximately 30% of cases. However, the role of CMV in patients with UC is not clearly understood. There is evidence to show a possible role in exacerbating a colitis flare, whereas other studies describe CMV as an innocent bystander. We report the case of a patient with severe UC complicated by CMV infection who did not respond to conventional therapy. A complete diagnostic panel for CMV diagnosis, including tissue polymerase chain reaction and immunohistochemistry, was carried out. Three-week therapy with oral valganciclovir resulted in dramatic clinical and endoscopic improvement. Timing of diagnosis and treatment of CMV infection complicating UC is crucial in order to recognize the organ-disease and plan appropriate treatment.

  13. Empyema Secondary to Actinomyces meyeri Treated Successfully with Ceftriaxone Followed by Doxycycline

    Science.gov (United States)

    Piscopo, Tonio; Cassar, Karen

    2016-01-01

    Actinomycosis is a relatively rare infection caused by Gram-positive bacteria. We present the case of a 54-year-old, previously healthy, male patient with a history of severe penicillin allergy who developed severe pneumonia and empyema caused by Actinomyces meyeri. Presenting symptoms included productive cough, right upper quadrant pain, and chills and rigors. He required drainage of the empyema via tube and prolonged antibiotic treatment with intravenous ceftriaxone for 2 weeks followed by oral doxycycline for 6 months. PMID:27752374

  14. Severe Refractory Immune Thrombocytopenia Successfully Treated with High-Dose Pulse Cyclophosphamide and Eltrombopag

    Directory of Open Access Journals (Sweden)

    Faiz Anwer

    2015-01-01

    Full Text Available Severe refractory ITP is clinically challenging and a variety of single or combination chemotherapies have been tried with limited outcome. We report a case of ITP that was unresponsive to multiple agents including high-dose steroid, IVIG, Rho(D immune globulin, rituximab, cyclosporine, azathioprine, vincristine, mycophenolate mofetil, romiplostim, and eltrombopag; however, it achieved complete remission with combination treatment of cyclophosphamide and eltrombopag.

  15. Monoclonal gammopathy-associated pauci-immune extracapillary-proliferative glomerulonephritis successfully treated with bortezomib

    OpenAIRE

    2013-01-01

    Extracapillary-proliferative glomerulonephritis is a rare complication of multiple myeloma. Partial remission of kidney involvement with cyclophosphamide therapy has previously been described. We report the case of a 60-year-old male patient diagnosed with rapidly progressive glomerulonephritis associated with IgG kappa monoclonal gammopathy. His kidney biopsy revealed pauci-immune extracapillary-proliferative glomerulonephritis without cryoglobulinaemia. Treatment with the proteasome inhibit...

  16. Cutaneous and gastrointestinal symptoms in two patients with systemic mastocytosis successfully treated with omalizumab

    DEFF Research Database (Denmark)

    Lieberoth, Sofie; Thomsen, Simon Francis

    2015-01-01

    The pathogenesis of mastocytosis is not well defined and thus treatment remains challenging and remains on a palliative basis. We present two cases (a 48-year-old woman and a 57-year-old man) with indolent systemic mastocytosis in whom omalizumab (anti-IgE) reduced gastrointestinal and cutaneous...... symptoms significantly. This observation provides additional insight into the effects of omalizumab on systemic mastocytosis....

  17. [Atypical preeclampsia and perinatal success: a case report].

    Science.gov (United States)

    Castelazo-Morales, Ernesto; Monzalbo-Núñez, Diana Elena; López-Rioja, Miguel de Jesus; Castelazo-Alatorre, Santiago

    2014-01-01

    Preeclampsia is a multi systemic syndrome of variable severity, pregnancy specific, consequence of an abnormal vascular response to placentation, with increase in peripheral vascular resistance, stimulation of platelet aggregation, activation of the coagulation cascade, and endothelial dysfunction. In the majority of cases, it will present with gestational hypertension and proteinuria, after 20 weeks, nevertheless, in other cases, it has presented as an atypical form (with absence of hypertension and/or proteinuria) behaving like severe preeclampsia. We report the case of a patient, 32 year old primigravida, with a 26.6 weeks gestation, that comes to the office with postprandial projectile vomiting. At the time of admission, she presents with sudden headache, phosphenes, and tinnitus, associated to epigastric pain, with a blood pressure of 110/70 mmHg; fetal heart rate of 146 bpm, normal lower limbs and reflexes. The Complete Blood Count and liver function tests are within normal values, urinalysis with proteinuria. Normal hepatic ultrasound. Obstetric ultrasound; with fetal measurements of 2.6 weeks below, with flattening of the growth curve, Doppler flowmetry with an increase in placental resistance and oligohydramnios. Given the clinical manifestations compatible with severe preeclampsia, magnesium sulfate, and antenatal corticosteroid therapy are initiated, and abdominal termination of pregnancy is decided. A female newborn is obtained, of 595 g, Apgar 4/7. On immediate puerperium, she presents with an increase in blood pressure of 150/90 mmHg, discharged with normal blood pressure 96 hours later. The newborn girl was discharged when she reached a weight of 2000 g. Today, she is neurologically unimpaired.

  18. Clinical Observation on Intractable Insomnia Treated by Point Pressure in 42 Cases

    Institute of Scientific and Technical Information of China (English)

    张庆萍

    2002-01-01

    @@ The author have in recent years treated 42 cases of intractable insomnia (with a history of over 2 years) by point pressure, yielding quite satisfactory results when compared with those treated with clonazepam. This is reported as follows.

  19. Single coronary artery; extremely rare coronary anomaly successfully treated surgically in young adult male.

    LENUS (Irish Health Repository)

    Shah, A R

    2010-05-01

    Single coronary artery arising from aortic root, is a rare congenital anomaly. A 30-year-old male presented with acute myocardial infarction (MI) complaining of chest pain and raised troponin levels. Emergency angiography showed no coronary lesions but both left and right coronary arteries arising from single ostium. Patient was operated electively and perioperative findings confirmed the diagnosis of single coronary artery, as left coronary artery after taking origin from right sinus of valsalva runs through the septum, before dividing into left anterior descending and circumflex branches. The single coronary ostium opened with a slit like incision over the course of left main coronary, making the size of ostium three to four times bigger than the native one. In addition left internal mammary artery was harvested and grafted to the left anterior descending branch distally. Patient made successful recovery. Four months follow up dobutamine stress echo showed no inducible ischemia.

  20. Successful reimplantation of extruded long bone segments in open fractures of lower limb--a report of 3 cases.

    Science.gov (United States)

    Shanmuganathan, Rajasekaran; Chandra Mohan, Arun Kamal; Agraharam, Devendra; Perumal, Ramesh; Jayaramaraju, Dheenadhayalan; Kulkarni, Sunil

    2015-07-01

    Extruded bone segments are rare complication of high energy open fractures. Routinely these fractures are treated by debridement followed by bone loss management in the form of either bone transport or free fibula transfer. There are very few reports in the literature about reimplantation of extruded segments of bone and there are no clear guidelines regarding timing of reimplantation, bone stabilisation and sterilisation techniques. Reimplantation of extruded bone is a risky procedure due to high chances of infection which determines the final outcome and can result in secondary amputations. We present two cases of successful reimplantation of extruded diaphyseal segment of femur and one case of reimplantation of extruded segment of tibia.

  1. Depression with psychotic features in a child with SLE: successful therapy with psychotropic medications--case report.

    Science.gov (United States)

    Milovancevic, Milica Pejovic; Miletic, Vladimir; Deusic, Smiljka Popovic; Gajic, Saveta Draganic; Tosevski, Dusica Lecic

    2013-04-01

    Systemic lupus erythematosus (SLE) is a multisystemic, autoimmune disease of unknown etiology, which affects multiple organ systems, including the central nervous system (CNS). Neuropsychiatric manifestations are seen in 13-75% of all SLE patients, with equal frequency in children and adults. Despite a high prevalence of psychiatric manifestations, there is no consensus on the proper treatment of such cases. We report here a case of an 11-year-old girl diagnosed with a severe depressive episode with psychotic features, treated successfully with risperidone and sertraline as an adjunct to immunosuppressive therapy.

  2. Uterocutaneous Fistula Following Cesarean Section: Successful Management of a Case

    Directory of Open Access Journals (Sweden)

    Ghodratollah Maddah

    2016-03-01

    Full Text Available A uterocutaneous fistula is a rare clinical presentation that occurs following Cesarean section and other pelvic operations. There are only a few reports discussing the treatments. We describe a patient with successful surgical management and review the literature. A 25-year-old woman referred to our department 13 months after her first Cesarean section. She had a history of an abdominal mass and collection 2 months after surgery and some fistula opening with discharge from her previous incision. She had a previous surgical operation and antibiotic therapy without complete response. We performed fistulography to evaluate the tracts. In the operation — she had fistula tracts, one of which was between the uterus and skin. We debrided the necrotic tissue in the uterus, excised the fistula tracts, and drained the uterine cavity. At 8 months’ postoperative follow-up, she had no recurrence. A uterocutaneous fistula is a rare condition with many causes and needs proper investigation and timely medical and surgical management.

  3. Keys to success: Ten case studies of effective weatherization programs

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Berry, L.G.; Kolb, J.O.; White, D.L. [Oak Ridge National Lab., TN (United States); Kinney, L.F.; Wilson, T. [Synertech Systems Corp., Syracuse, NY (United States)

    1993-11-01

    In 1990, DOE initiated a nationwide evaluation of its Weatherization Program, with assistance from Oak Ridge National Laboratory and an advisory group of 40 weatherization professionals, program managers, and researchers. The evaluation is comprised of three impact studies covering the Program`s major market segments: Single-family homes, mobile homes, and dwellings in small (2 to 4-unit) multifamily buildings (the Single-Family Study), Single-family homes heated primarily with fuel oil (the Fuel-Oil Study), and Dwellings in buildings with five or more units (the Multifamily Study). The Single-Family Study, the subject of this report, is a critical part of this coordinated evaluation effort. Its focus on single-family dwellings, mobile homes, and dwellings in small multifamily buildings covers 83% of the income-eligible population and 96% of the dwellings weatherized during Program Year 1989. The first phase of the Single-Family Study involved the analysis of a massive data base of information collected from 368 local weatherization agencies and 543 electric and gas utilities. This analysis resulted in energy-saving and cost-effectiveness estimates for the Weatherization Program and the identification of a set of ten high-performing agencies located throughout the country. The second phase, which is the subject of this report, involves a ``process`` evaluation of these ten high performers, aimed at identifying those weatherization practices that explain their documented success.

  4. CASE REPORT OF SUCCESSFUL RESUSCITATION OF A CASE O F SUICIDAL HANGING

    Directory of Open Access Journals (Sweden)

    Yanki D.

    2013-05-01

    Full Text Available ABSTRACT: In Sikkim, the rate of suicide has been on the rise since the last 10 years. Suicidal hanging as method of ending life is a major concern among school children. It is very rare that the victims are brought on time for successful resuscit ation in Sikkim. Suicide by hanging is probably the most easy way to go about taking one’s own life , as the means to do it are easily available and uncomplicated and, brutally efficient in most case s . This is a case report of a young female who was brought to the emergency room of our hospital a s a case of suicidal hanging. On admission her GCS was 6; she was unconscious with deteriorating v ital parameters and the breathing was laboured with SpO2 of 40% in room air. Early interv ention with intubation with ventilatory and circulatory support was given and she walked home a fter 7 days without any neurological deficit. KEY WORDS: Near hanging suicide, early intervention

  5. Refractory pseudomembranous colitis that was treated successfully with colonoscopic fecal microbial transplantation.

    Science.gov (United States)

    Shin, Jun Young; Ko, Eun Jung; Lee, Seung Ho; Shin, Jong Bum; Kim, Shin Il; Kwon, Kye Sook; Kim, Hyung Gil; Shin, Yong Woon; Bang, Byoung Wook

    2016-01-01

    Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%-30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.

  6. Serratus muscle stimulation effectively treats notalgia paresthetica caused by long thoracic nerve dysfunction: a case series

    Directory of Open Access Journals (Sweden)

    Barad Meredith

    2009-09-01

    Full Text Available Abstract Currently, notalgia paresthetica (NP is a poorly-understood condition diagnosed on the basis of pruritus, pain, or both, in the area medial to the scapula and lateral to the thoracic spine. It has been proposed that NP is caused by degenerative changes to the T2-T6 vertebrae, genetic disposition, or nerve entrapment of the posterior rami of spinal nerves arising at T2-T6. Despite considerable research, the etiology of NP remains unclear, and a multitude of different treatment modalities have correspondingly met with varying degrees of success. Here we demonstrate that NP can be caused by long thoracic nerve injury leading to serratus anterior dysfunction, and that electrical muscle stimulation (EMS of the serratus anterior can successfully and conservatively treat NP. In four cases of NP with known injury to the long thoracic nerve we performed transcutaneous EMS to the serratus anterior in an area far lateral to the site of pain and pruritus, resulting in significant and rapid pain relief. These findings are the first to identify long thoracic nerve injury as a cause for notalgia paresthetica and electrical muscle stimulation of the serratus anterior as a possible treatment, and we discuss the implications of these findings on better diagnosing and treating notalgia paresthetica.

  7. Reflex seizures induced by micturition and defecation, successfully treated with clobazam and phenytoin.

    Science.gov (United States)

    Higuchi, Tsukasa; Fukuyama, Tetsuhiro; Misawa, Yuka; Inaba, Yuji; Ichikawa, Motoki; Koike, Kenichi

    2011-06-01

    We report a six-year-old girl with seizures induced by both micturition and defecation. Several days after unprovoked generalised tonic-clonic seizures, she developed reflex seizures characterised by the extension of both arms and rhythmic jerking of her upper body. No abnormal findings were noted on brain magnetic resonance imaging. Interictal electroencephalography (EEG) showed spike-and-wave activity on central electrode recording, and rhythmic fast activity was recorded by central electrodes during the ictal EEG upon micturition. The combination of clobazam and phenytoin was effective for both unprovoked and reflex seizures. Although some previous reports have described reflex seizures triggered by either micturition or defecation, this is the first case report of reflex seizures induced by both micturition and defecation in the same patient. Based on a comparison with previous cases of reflex seizures induced either by micturition or defecation, the neuronal pathway from the pelvic base musculature to the supplementary motor area may be responsible for the condition in our patient.

  8. Beyond successful ISR: case-by-case investigations for unmatched reassay results when ISR passed.

    Science.gov (United States)

    Tan, Aimin; Gagnon-Carignan, Sofi; Lachance, Sylvain; Boudreau, Nadine; Lévesque, Ann; Massé, Robert

    2011-05-01

    Incurred sample reanalysis (ISR) is now commonly practiced in regulated bioanalytical laboratories. With an average ISR success rate of 95% or higher and an increasing number of ISR tests being conducted, more and more situations deserve scientific evaluation or investigation for the unmatched reassay results revealed in ISR tests even though they meet the acceptance criteria. First, should an investigation be initiated when an ISR test is acceptable? How large a discrepancy or what situation would warrant an investigation? What would be the impact on a study? How would investigations regarding unmatched reassay results be conducted? What are the main root causes identified? Can normal random errors cause a large discrepancy in unfavorable combinations? How could the timeline and cost be affected? All these questions are addressed in this paper with five real case examples.

  9. Minority nursing student success: A grounded theory case study

    Science.gov (United States)

    Mister, Brenda J.

    theory proposes that when the minority nursing student bridges his or her personal attributes of self-efficacy with some or all identified support systems, this may be a conduit to fostering success in obtaining their educational goals as long as the resources are available, and a caring environment is present.

  10. Penile calciphylaxis: a life-threatening condition successfully treated with sodium thiosulfate.

    Science.gov (United States)

    Sandhu, Gagangeet; Gini, Marcelo Barrios; Ranade, Aditi; Djebali, David; Smith, Steven

    2012-01-01

    Calciphylaxis or calcific uremic arteriolopathy is a life-threatening condition that predominantly affects patients with end-stage renal disease on hemodialysis. A prevalence of up to 4% and a 6-month mortality rate of up to 80% have been reported in those with proximal disease (thighs, abdomen wall, and buttocks). Penile calciphylaxis is very rare but has a mortality rate of 69% within 6 months. Its treatment is controversial. For small lesions, conservative treatment with local wound care and debridement may suffice. Partial or complete penectomy may be needed for more extensive lesions, and especially those associated with signs of local infection. In addition to surgical intervention, as with any other case of calcific uremic arteriolopathy, the cornerstones of therapy should be to keep serum phosphorus sodium thiosulfate was used in addition to the standard medical and surgical therapy. Two months after surgery, the patient's wound completely healed and he has experienced no new lesions over the past 11 months.

  11. Antiepiligrin cicatricial pemphigoid of the larynx successfully treated with a combination of tetracycline and niacinamide.

    Science.gov (United States)

    Sakamoto, Kikuo; Mori, Kazunori; Hashimoto, Takashi; Yancey, Kim B; Nakashima, Tadashi

    2002-12-01

    A case of antiepiligrin cicatricial pemphigoid that primarily involved the larynx and required a tracheostomy was studied. The diagnosis was based on the direct immunofluorescence findings of a biopsy specimen from the glottis, immunofluorescence using normal and 1M sodium chloride-split normal human skin as substrates, and immunoprecipitation. A dramatic clinical improvement was observed after the combined administration of tetracycline hydrochloride and niacinamide. The tracheal stoma could be shut after the narrow segment was cut by means of carbon dioxide laser therapy. The patient showed no respiratory difficulty during the 2-year follow-up period. The combined therapy of tetracycline and niacinamide is thus considered to be an effective treatment for various types of cicatricial pemphigoid.

  12. Monoclonal gammopathy-associated pauci-immune extracapillary-proliferative glomerulonephritis successfully treated with bortezomib.

    Science.gov (United States)

    Grundmann, Franziska; Witthus, Marco; Göbel, Heike; Kisner, Tuelay; Siewert, Rainer; Benzing, Thomas; Kurschat, Christine E

    2013-06-01

    Extracapillary-proliferative glomerulonephritis is a rare complication of multiple myeloma. Partial remission of kidney involvement with cyclophosphamide therapy has previously been described. We report the case of a 60-year-old male patient diagnosed with rapidly progressive glomerulonephritis associated with IgG kappa monoclonal gammopathy. His kidney biopsy revealed pauci-immune extracapillary-proliferative glomerulonephritis without cryoglobulinaemia. Treatment with the proteasome inhibitor bortezomib induced rapid clinical and histological remission of his kidney disease. The patient's renal function remained stable on bortezomib maintenance therapy. Our findings suggest that bortezomib is a promising therapeutic approach to ameliorate severe kidney damage in monoclonal gammopathy- and myeloma-associated pauci-immune extracapillary-proliferative glomerulonephritis.

  13. All Eyes on Nepal - A Success Case for Integrated Observations

    Science.gov (United States)

    Cox, E. L., Jr.

    2015-12-01

    When hazards are known it is not a question of if but when the disaster shock will happen and it is critical that all relevant observational data, tools and technologies be accessible and integrated by experts and volunteers to provide reliable, timely and actionable information. In this talk NASA's coordinated response to the recent Nepal "Gorkha" will be presented as a case study to highlight the opportunities and challenges. Triggered by a global seismic network and the interpretation by operational, research and response agencies, all available assets were quickly mobilized, charters activated to share data, and information gathered to assess impacts. This included assessing available data from optical and radar-based satellites and global positioning systems to baseline pre-event conditions and distinguish immediate and ongoing changes. Models and maps were generated to identify land deformation and damage proxies for communities, resources and infrastructure. Technologies facilitated national and international collaboration among public and private sector institutions to task satellites and optimize integration and processing of data from vital airborne platforms or ingest relevant new data streams. Crowd-sourced data added to the mix and provided a critical source of ground truth that blended with reports from field teams and those in communities. New levels of situational awareness were achieved through integrated data products and the reliance on relationships and new technologies that allowed for volunteers to analyze results in an unprecedented fashion. The results demonstrated how science aided by emerging technologies is changing our implementation of disaster response.

  14. [Neuroleptic malignant syndrome: presentation of a case treated with sulpiride].

    Science.gov (United States)

    Brescia, A; Zocchi, M

    1991-01-01

    The authors, in this case, stress the importance that cases of N.M.S. can arise as possible complication of sulpiride treatment, a drug of large use and with less unwished extrapyramidal effects that other neuroleptics.

  15. Macrophage Activation Syndrome Associated with Adult-Onset Still’s Disease Successfully Treated with Anakinra

    Directory of Open Access Journals (Sweden)

    Aswini Kumar

    2016-01-01

    Full Text Available Macrophage activation syndrome (MAS is a potentially fatal complication of Adult-Onset Still’s disease (Still’s disease. Whereas an increasing body of evidence supports interleukin-1 (IL-1 blockade as a promising treatment for Still’s disease, whether it is therapeutic for MAS associated with Still’s disease remains unclear. We report a 34-year-old Caucasian man with one-decade history of TNF-blockade-responsive seronegative arthritis who presented with abrupt onset of fever, serositis, bicytopenia, splenomegaly, hepatitis, and disseminated intravascular coagulation. Striking hyperferritinemia was noted without evidence of infection, malignancy, or hemophagocytosis on bone marrow biopsy. NK cells were undetectable in the peripheral blood, whereas soluble IL-2 receptor was elevated. His multiorgan disease resolved in association with methylprednisolone pulse therapy, Anakinra, and a tapering course of prednisone. This case reinforces the notion that Still’s disease is inherently poised to manifest MAS as one of the clinical phenotypes by shedding light on the role of IL-1 underlying both Still’s disease and related MAS.

  16. A woman with diabetes presenting with pyomyoma and treated with subtotal hysterectomy: a case report

    Directory of Open Access Journals (Sweden)

    Fletcher Horace

    2009-09-01

    Full Text Available Abstract Introduction Pyomyoma (suppurative leiomyoma of the uterus is a rare condition resulting from infarction and infection of a leiomyoma. It is more usual in pregnant women or postmenopausal women who have vascular disease. The condition is usually fatal unless treated with appropriate antibiotics and surgical intervention. Case presentation We report a case of a 44-year-old Afro-Caribbean woman with diabetes who presented with recurrent episodes of abdominal pain and fever over a period of five months. Her problem proved to be a diagnostic dilemma mimicking cholecystitis, pyelonephritis and ovarian cancer. Her blood cultures were positive on one occasion for methicillin-resistant Staphylococcus epidermidis. An ultrasound scan suggested uterine fibroids but a computed tomography scan suggested an ovarian malignancy because the mass appeared heterogeneous with fluid filled areas. She was treated with several courses of antibiotics and eventually at laparotomy, she was found to have a large pyomyoma which was successfully removed by subtotal hysterectomy with immediate and complete resolution of her symptoms. Conclusion The diagnosis of pyomyoma should be considered in perimenopausal women with large fibroids and pyrexia of unknown origin.

  17. A Case of Medication-Resistant Acanthamoeba Keratitis Treated by Corneal Crosslinking in Turkey

    Directory of Open Access Journals (Sweden)

    Goktug Demirci

    2013-01-01

    Full Text Available Purpose. To report a case of medication-resistant acanthamoeba keratitis (AK treated successfully by corneal crosslinking (CXL. Methods. A 26-year-old male with medication-resistant AK underwent a standard CXL procedure with local anesthesia, followed by central corneal epithelial debridement, application of riboflavin 0.1%, and UV-A irradiation. Results. The patient experienced a dramatic symptomatic improvement within 24 hours. At two months, keratitis was healed with a semitransparent paracentral scar that did not affect visual acuity. Conclusions. Our experience, considered in the context of recent studies, suggests that CXL may be an option for selected patients with medication-resistant AK and corneal melting. CXL allows patients to avoid emergency keratoplasty and experience rapid symptomatic relief.

  18. Case Report of Nasal Polyp Treated by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    蒋传义

    2007-01-01

    @@ A Patient, female, student, nineteen years old.She was diagnosed with rhinitis and nasal polyps at the age of 17, and was treated with many methods,but the disease was not cured. The patient and her parents were fearful of surgical treatment, so she came for acupuncture therapy.

  19. A Rare Case of an Osteoid Osteoma of the Rib Treated under Computed Tomography Guidance: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sakiko Mizuno

    2015-11-01

    Full Text Available Osteoid osteoma (OO usually occurs in the extremities of young adults. The tumor can arise in any part of the skeletal tissue; however, it is rarely found in the rib, with limited reports to date. In this report, we present a rare case of OO arising in the rib, which was successfully treated under computed tomography guidance with minimal invasiveness. At the final follow-up after 4 years, no local recurrence was observed.

  20. Laparoscopic oviductal artificial insemination improves pregnancy success in exogenous gonadotropin-treated domestic cats as a model for endangered felids.

    Science.gov (United States)

    Conforti, Valéria A; Bateman, Helen L; Schook, Mandi W; Newsom, Jackie; Lyons, Leslie A; Grahn, Robert A; Deddens, James A; Swanson, William F

    2013-07-01

    Artificial insemination (AI) in cats traditionally uses equine chorionic gonadotropin (eCG) and human chorionic gonadotropin (hCG) to induce follicular development and ovulation, with subsequent bilateral laparoscopic intrauterine insemination. However, long-acting hCG generates undesirable secondary ovulations in cats. Uterine AI also requires relatively high numbers of spermatozoa for fertilization (~8 × 10(6) sperm), and unfortunately, sperm recovery from felids is frequently poor. Using short-acting porcine luteinizing hormone (pLH) instead of hCG, and using the oviduct as the site of sperm deposition, could improve fertilization success while requiring fewer spermatozoa. Our objectives were to compare pregnancy and fertilization success between 1) uterine and oviductal inseminations and 2) eCG/hCG and eCG/pLH regimens in domestic cats. Sixteen females received either eCG (100 IU)/hCG (75 IU) or eCG (100 IU)/pLH (1000 IU). All females ovulated and were inseminated in one uterine horn and the contralateral oviduct using fresh semen (1 × 10(6) motile sperm/site) from a different male for each site. Pregnant females (11/16; 69%) were spayed approximately 20 days post-AI, and fetal paternity was genetically determined. The number of corpora lutea (CL) at AI was similar between hormone regimens, but hCG increased the number of CL at 20 days post-AI. Numbers of pregnancies and normal fetuses were similar between regimens. Implantation abnormalities were observed in the hCG group only. Finally, oviductal AI produced more fetuses than uterine AI. In summary, laparoscopic oviductal AI with low sperm numbers in eCG/hCG- or eCG/pLH-treated females resulted in high pregnancy and fertilization percentages in domestic cats. Our subsequent successes with oviductal AI in eCG/pLH-treated nondomestic felids to produce healthy offspring supports cross-species applicability.

  1. Sixty-eight Cases of Child Chronic Cough Treated by Moxibustion

    Institute of Scientific and Technical Information of China (English)

    CUI Xia; WANG Su-mei; WU Li-qun

    2009-01-01

    To observe the therapeutic effects of moxibustion for chronic cough in children. Methods: 68 child cases of chronic cough were treated by moxibustion. Results: 54 cases were cured, 13 cases improved, and one case failed. The cure rate was 79.2%, with a total effective rate of 98.5%. Conclusion: The moxibustion therapy has definite therapeutic effect for children chronic cough.

  2. Dance Talent Development: Case Studies of Successful Dancers in Finland and Singapore

    Science.gov (United States)

    Chua, Joey

    2014-01-01

    Though anchored in cross-cultural comparisons, this study aims to identify the key factors that impacted the talent development of successful dancers from childhood through adulthood. Case studies of eight Finnish and Singaporean ballet and contemporary dancers exemplify the qualities of successful dancers in terms of their career achievements and…

  3. Acupuncture plus TDP Treated 34 Cases of Radial Nerve Paralysis

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gui-xiang; HUANG Guo-qi

    2003-01-01

    In the treatment of 34 cases of radial nerve paralysisby puncturing the acupoints in Yangming meridians of the hand and foot, plus TDP radiation in the local areas after acupuncture, the total effective rate is 97.1%.

  4. Radical Nephrectomy Using a Chevron Incision to Treat Complicated Renal Carcinoma: a Report of 15 Cases

    Institute of Scientific and Technical Information of China (English)

    Ning Kang; Junhui Zhang; Yinong Niu; Nianzeng Xing

    2008-01-01

    OBJECTIVE To investigate the outcome and indications for radical nephrectomy with a Chevron incision to treat complicated renal carcinoma.METHODS Large renal carcinomas were found in 15 patients during a preoperative CT and/or MRI examination. A tumor thrombus in the renal vein or inferior vena cava was found in 5 cases, and a complication of metastasis in the contralateral adrenalgl and was found in 2 patients. All of the 15 patients underwent a radical nephrectomy by a chevron incision and the postoperative pathological results noted.RESULTS Of the 15 patients who underwent a radical nephrectomy and lymphadenectomy, 5 also received a thrombectomy, and 2 a contralateral adrenalectomy. All surgical operations were safe and successful. The mean operation time was (4.45±0.83) h, and the intraoperative blood loss was (785±910) ml. All patients recovered well after the surgery. Multimodal therapy was conducted in these cases, with rigorous follow-up.CONCLUSION In determining the type of incision for surgery of renal carcinoma, a chevron incision is suitable for cases with a large tumor, local nodal metastasis, thrombus of the renal vein or inferior vena cava and complicated metastasis to the contralateral adrenal gland. The incision produces a clear operating field with less intra- and post-operative complications.

  5. Successful salvage of the upper limb after crush injury requiring nine operations: a case report.

    Science.gov (United States)

    Zeng, Qingmin; Cai, Guoping; Liu, Dechang; Wang, Kun; Zhang, Xinchao

    2015-03-01

    Emergency treatment of amputation is one of the most frequently used therapeutic methods for patients with severe upper limb crush injury with a mangled extremity severity score (MESS) of more than 7. With the development of advanced surgical repair techniques and reconstructive technology, cases that once required amputation can now be salvaged with appropriate management, and some limb functions may also be reserved. A patient with a severe upper limb crush injury with a MESS score of 10 was treated in our hospital. The limb was salvaged after 9 surgeries over 10 months. The follow-up visits over the next 18 months post-injury showed that the shoulder joint functions were rated as "excellent" (90) according to the Neer score, the Harris hip evaluation (HHS) for elbow joint functions was "good" (80), and the patient was very satisfied with the overall therapeutic outcome. We conclude from the successful outcome of this extreme injury that salvage attempts should be the first management choice for upper limbs with complex injuries to save as much function as possible. Amputation should only be adopted when the injury is life-threatening or no more function can be saved. The level of evidence was V.

  6. Successful treatment of post-traumatic narcolepsy with methylphenidate: a case report.

    Science.gov (United States)

    Francisco, G E; Ivanhoe, C B

    1996-01-01

    Narcolepsy is a rare sequela of brain injury. We report the case of a 27-yr-old male with post-traumatic narcolepsy who was successfully treated with methylphenidate. This patient sustained moderate brain injury from a motorcycle accident. Subsequently, he manifested the classic tetrad of narcolepsy: cataplexy, excessive daytime sleepiness, sleep paralysis, and hypnogogic hallucinations. There was no premorbid seizure or sleep disorder. There was no family history of sleep disorders. Polysomnography and Multiple Sleep Latency Test confirmed the diagnosis of narcolepsy. Sleep latency (time to sleep onset), rapid eye movement sleep latency (time from sleep onset to rapid eye movement sleep onset), and mean multiple sleep latency were all pathologically shortened (2.5, 66, and 1.2 min, respectively). Twenty-four hour electroencephalographic monitoring and magnetic resonance imaging of the brain were normal, as were serum chemistries. Treatment with caffeine was unsuccessful. He was then started on methylphenidate, 10 mg twice daily, which was increased to 30 mg twice daily over a 4-mo period. Cataplexy and excessive daytime sleepiness started to improve 1 mo after adjustments in methylphenidate dosing. Six months after the initiation of methylphenidate therapy, the patient is completely asymptomatic.

  7. Multiple successful desensitizations to brentuximab vedotin: a case report and literature review.

    Science.gov (United States)

    DeVita, Michael D; Evens, Andrew M; Rosen, Steven T; Greenberger, Paul A; Petrich, Adam M

    2014-04-01

    Brentuximab vedotin is an antibody-drug conjugate FDA-approved for the treatment of systemic anaplastic large-cell lymphoma (ALCL) that has relapsed after multiagent chemotherapy. At least 2 cases of hypersensitivity reactions to brentuximab vedotin have been reported, without attempted desensitization. This report describes a morbidly obese 32-year-old woman with ALCL that relapsed after autologous stem cell transplantation, who was treated on a phase II clinical study with brentuximab vedotin. After 1 dose, she experienced near-complete remission, but therapy was stopped because of severe drug-related toxicity. She then received 5 cytotoxic treatments and radiation, and ultimately experienced disease progression. The patient was rechallenged with brentuximab vedotin approximately 28 months after initial exposure and tolerated the dose well, but experienced a significant allergic reaction with the next dose. High-dose steroid and antihistamine prophylaxis administered 50 minutes before the subsequent brentuximab vedotin infusion was unsuccessful in mitigating this reaction. Brentuximab vedotin was successfully infused according to a rapid desensitization protocol. With progressive dose titration and supportive care, the patient tolerated this therapy. She received 11 doses through a rapid desensitization protocol and experienced a durable disease remission.

  8. Successful treatment of infundibulofolliculitis with topical tretinoin. Report of a case

    Directory of Open Access Journals (Sweden)

    Seema Srinivasa

    2012-07-01

    Full Text Available First described in 1968 by Hitch and Lund. Disseminated and Recurrent infundibulofolliculitis (DRIF is an uncommon eruption characterized by recurrent, pruritic follicular papules commonly seen on the trunk and proximal extremities. Rarely limited to the neck. It is much more common in black population but has also been reported in other ethnicities including Caucasians. Its etiology has constantly been debated with a few authors describing it as a variant of atopic dermatitis while others have refuted the same as a family history of atopy is not present. Various others have classified DRIF as variants of follicular eczema, along with lichen spinulosus and juxtaclavicular beaded lines. Its treatment also varies with different authors claiming response to steroids, isotretinoin, UVA therapy, keratolytics and tetracyclines. We describe a case of localized infundibulofolliculitis of the neck diagnosed in a 21 year old female who was successfully treated with a course of topical tretinoin 0.025%. The presenting history, clinical findings, biopsy results and available literature are reviewed.

  9. Exercise Induced Left Bundle Branch Block Treated with Cardiac Rehabilitation: A Case Report and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Nathan S. Anderson

    2014-01-01

    Full Text Available Exercise induced bundle branch block is a rare observation in exercise testing, accounting for 0.5 percent of exercise tests. The best treatment of this condition and its association with coronary disease remain unclear. We describe a case associated with normal coronary arteries which was successfully treated with exercise training. While this treatment has been used previously, our case has a longer followup than previously reported and demonstrates that the treatment is not durable in the absence of continued exercise.

  10. Monitoring success of remediation: seven case studies of moisture and mold damaged buildings.

    Science.gov (United States)

    Haverinen-Shaughnessy, Ulla; Hyvärinen, Anne; Putus, Tuula; Nevalainen, Aino

    2008-07-25

    Based on seven case studies of buildings that underwent different degrees of moisture and mold damage remediation, we aimed to develop methodology for assessment of the success of the remediation process. Methods used in gauging the success included technical monitoring of performance of building structures and heating, ventilation and air conditioning (HVAC) systems, microbial monitoring of indoor air quality (IAQ), and health effects studies of building occupants. The assessment was based on measurable change in the situations before and after remediation. Based on technical monitoring, remediation was successful in three cases, with partial improvement noted in three cases, whereas no remediation was conducted in one case. Based on microbial monitoring, improvement was detected in one, partial improvement in two and no improvement in two cases, whereas no follow-up was conducted in two cases. Health effect studies (mainly self-reported health status) showed improvement in one case, partial improvement in two cases, and no improvement in two cases, whereas no follow-up was conducted in one case, and in one case, follow-up failed due to low response rate. The results illustrate that it is possible to monitor the effects of remediation using various metrics. However, in some cases, no improvement could be observed in IAQ or occupant health, even if the remediation was considered technically successful, i.e. the remediation was fully completed as recommended. This could be due to many reasons, including: 1) all damage may not have been addressed adequately; 2) IAQ or health may not have been perceived improved regardless of remediation; and/or 3) the methods used may not have been sensitive/specific enough to detect such improvement within the 6-12 months follow-up periods after completion of the remediation. There is a need to further develop tools for monitoring and assessment of the success of moisture damage remediation in buildings.

  11. Treating Schizophrenia With the Diuretic Bumetanide: A Case Report.

    Science.gov (United States)

    Lemonnier, Eric; Lazartigues, Alain; Ben-Ari, Yehezkel

    2016-01-01

    Administration of the diuretic and NKCC1 chloride cotransporter antagonist bumetanide reduces the severity of autism spectrum disorders in children, and this effect is mediated by a reduction of the elevated intracellular chloride concentrations and a reinforcement of GABAergic inhibition (Lemonnier et al Transl Psychiatry. 2012;2:e202; Tyzio et al Science. 2014;343:675-679). Here, we report that this treatment also reduces the severity of symptoms in an adolescent with schizophrenia. Long-term treatment reduced hallucinations significantly, suggesting that this treatment may also be useful to treat schizophrenia. Further clinical trials and experimental studies are warranted to test this hypothesis.

  12. One case treated bladder cancer with Immunity-herbal acupuncture

    Directory of Open Access Journals (Sweden)

    Dong-Suk Kim

    2002-02-01

    Full Text Available In oriental medicine bladder cancer had been called '溺血(Hematuria', 血淋(Blood Stranguria', 濕熱河注(Downward Flow of Damp-heat' and so on. The symptoms are Hematuria, Oliguria, Lower abdomen pain, febrile sensation and Anemia etc. These are similar to the symptoms of bladder cancer by modem medicine. I have experienced a bladder cancer patient who was diagnosed as stage Ⅲ. She has been treated bladder cancer with Immunity herbal acupuncture and Her clinical and objective symptoms have been better. Therefore I report this results.

  13. One case treated bladder cancer with Immunity-herbal acupuncture

    OpenAIRE

    2002-01-01

    In oriental medicine bladder cancer had been called '溺血(Hematuria)', 血淋(Blood Stranguria)', 濕熱河注(Downward Flow of Damp-heat)' and so on. The symptoms are Hematuria, Oliguria, Lower abdomen pain, febrile sensation and Anemia etc. These are similar to the symptoms of bladder cancer by modem medicine. I have experienced a bladder cancer patient who was diagnosed as stage Ⅲ. She has been treated bladder cancer with Immunity herbal acupuncture and Her clinical and objective symptoms have been bett...

  14. Prophylaxis of hemicrania continua: three cases effectively treated with acemethacin.

    Science.gov (United States)

    Nicpoń, Krzysztof J; Nicpoń, Krzysztof W; Jaroszuk-Nicpoń, Joanna

    2011-04-01

    Hemicrania continua is a daily headache disorder that is characterized by unilateral, constant pain with exacerbations of intensity accompanied by autonomic symptoms. Response to indomethacin is the diagnostic criterion for hemicrania continua, but efficacy of indomethacin in therapy is restricted because of gastrointestinal adverse events. Therefore, many patients are disqualified from treatment with indomethacin, creating a need to search for alternative therapy. In comparison with indomethacin, acemethacin seems to have a better therapeutic profile. It is associated with fewer gastrointestinal adverse events while having a good therapeutic effect. We present three patients effectively treated with acemethacin without adverse events of the gastrointestinal tract.

  15. A Case of Successful Ablation of a Gastrophrenic Fistula with n-Butyl-2-Cyanoacrylate

    Directory of Open Access Journals (Sweden)

    Ashish Mahajan

    2008-01-01

    Full Text Available A 79-year-old woman with a fistula between a subphrenic abscess and the fundus of the stomach was successfully treated with n-Butyl-2-Cyanoacrylate. Conservative management had failed. Clinical presentation, treatment progress and imaging findings by computed tomography scan, ultrasound, gastroscopy and fluoroscopy are presented, along with a brief review of the relevant literature.

  16. The successful use of amphotericin B followed by oral posaconazole in a rare case of invasive fungal sinusitis caused by co-infection with mucormycosis and aspergillus

    Directory of Open Access Journals (Sweden)

    Sharana Mahomed

    2015-01-01

    Full Text Available We report on an unusual case of oro-rhinocerebral disease caused by mucormycosis and aspergillus co-infection in a 54-year-old insulin dependent diabetic patient. Although she was successfully treated with parenteral amphotericin B followed by oral posaconazole, she was left with irreversible blindness of the right eye and multiple cranial nerve palsies.

  17. A Case of Dentinogenesis Imperfecta Treated with Submerged Root Technique.

    Science.gov (United States)

    Uday, Ginjupally; Chandar, Bhanu; Srilakshmi, J; Khaitan, Tanya; Babu, B Balaji

    2015-09-01

    Dentinogenesis imperfecta (DGI), an autosomal dominant trait, is one of the most common hereditary disorders affecting both the formation and mineralization of dentin. Either or both primary and permanent dentition is affected by it. Here, we present a case report of a 13-year-old female patient affected with DGI who had undergone prosthetic rehabilitation with submerged root technique.

  18. Burr-hole craniotomy treating chronic subdural hematoma:a report of 398 cases

    Institute of Scientific and Technical Information of China (English)

    LIU Yuan; XIA Jun-zhe; WU An-hua; WANG Yun-jie

    2010-01-01

    Objective: To investigate the treatment of chronic subdural hematoma (CSDH) with burr-hole craniotomy in our hospital.Methods: From January 2004 to December 2009, 398patients with CSDH, 338 males and 60 females (male/female=5.63/1 ), received burr-hole craniotomy in our hospital.The median age was 60 years with the mean age of (58. 1± 18. 1 )years, (65.0±14.5) years for females and (57.0±18.2) years for males. Trauma history was determined in 275 patients (69. 1%).Burr-hole craniotomy was performed under local anesthesia in 368 patients and general anesthesia in 30 patients.CSDH was classified into 3 groups according to the density on CT scan. Clinical data concerning etiologies, symptoms and signs, concomitant diseases, diagnosis, therapies and outcomes were investigated retrospectively. Patients' neurological status on admission and at discharge was also classified to judge the outcomes.Results: Generally, trauma history showed few differences between those over 60 years old and under 60 years old, but showed obvious differences when gender was taken into account. Totally 123 male patients (60.0% of 204 cases) suffering from head injuries were under 60 years,whereas 35 female patients (85.4% of 41 cases) with trauma histories were over 60 years. The duration from trauma to appearance of clinical symptoms was (84.0±61.7) days (range,0-1493 days). Traumatic accident was the leading etiology,other accompanying diseases such as cerebral vascular disease, hypertension, etc, were also predisposing factors.Commonly, the elderly presented with hemiplegia/hemidysesthesia/hemiataxia and the young with headache.Most CSDH patients (95.6%) treated with burr-hole craniotomy successfully recovered. However, postoperative complications occurred in 17 cases, including recurrence of CSDH in 15 cases, subdural abscess in 1 case and pneumonia in 3 cases.Conclusion: Burr-hole craniotomy is an easy, efficient and reliable way to treat CSDH.

  19. Costs, Benefits and Value Distribution – Ingredients for Successful Cross-Organizational ES Business Cases

    NARCIS (Netherlands)

    Eckartz, Silja M.

    2009-01-01

    This paper introduces my PhD research project on developing guidelines for creating successful business cases for Enterprise System implementations in network settings. Three important aspects that were found to be important in such business cases are: the costs, benefits and the value distribution

  20. Are You Leaving? A Case of Succession in the Willow Tree Charter School

    Science.gov (United States)

    Gawlik, Marytza A.

    2015-01-01

    This case study asks readers to contemplate what leadership practices may facilitate leadership succession at charter schools. The case narrative is followed by an activity designed for students in principal preparation programs. In this activity, students develop an exit strategy for the departing leader, a hiring plan for the charter school…

  1. Promoting Physical Activity in Girls: A Case Study of One School's Success.

    Science.gov (United States)

    Felton, Gwen; Saunders, Ruth P.; Ward, Dianne S.; Dishman, Rod K.; Dowda, Marsha; Pate, Russell R.

    2005-01-01

    This case study profiles one of 24 high schools that participated in a school-based, NIH-funded study to increase physical activity among high school girls. The case study school was one of 12 randomly assigned to the intervention group. The study intervention was based on the premise that a successful intervention is developed and tailored by…

  2. Bumetanide to Treat Parkinson Disease: A Report of 4 Cases.

    Science.gov (United States)

    Damier, Philippe; Hammond, Constance; Ben-Ari, Yeheskel

    2016-01-01

    Relying on recent experimental data in 2 animal models of Parkinson disease (PD), we have tested the effects of the loop diuretic bumetanide as an add-on treatment to dopaminergic drugs in 4 volunteered patients with PD using the Unified Parkinson's Disease Rating Scale. Bumetanide is a specific antagonist of the chloride importer NKCC1 (sodium/potassium/chloride cotransporter isoform 1) that ameliorates neuronal inhibition by reducing intracellular chloride levels in a variety of pathological conditions. Bumetanide is however not labeled for use in PD. We report an improvement of PD motor symptoms in the 4 patients treated with bumetanide (5 mg/d for 2 months). Bumetanide also improved gait and freezing in 2 of these patients. Our results suggest that bumetanide is well tolerated and call for double-blind, placebo-controlled, randomized trials to confirm the therapeutic efficacy of bumetanide.

  3. Clinical Observation of 40 Cases of Acne Treated by Acupuncture plus Herbal Drugs

    Institute of Scientific and Technical Information of China (English)

    CAI An-he; DAI Xi-ping; ZHANG Hai-bo; HUANG Guo-qi

    2003-01-01

    Acne is divided into the patterns of wind and heat in the lung meridian and accumulation of dampness and heat. Forty cases of acne were treated by acupuncture plus herbal drugs (acupuncture and drug group, A) and 30 cases were treated by simple acupuncture as the control group (acupuncture group, B). The results showed basic cure in 31 cases, remarkable effect in 5 cases, effect in 3 cases, failure in 1 case and the total effective rate of 97.5% in Group A, and basic cure in 16 cases, remarkable effect in 6 cases, effect in 3 cases, failure in 5 cases and the total effective rate of 83.3% in Group B. There was no significant difference ( P > 0.05 ) in the therapeutic effect and there was a significant difference (P < 0. 01 ) in the curative rate in the two groups. The therapeutic effect was obviously better in Group A than in Group B.

  4. Gamma-knife for treating pituitary adenomas in 501 cases: Retrospective case analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Gamma-knife is characterized by low risk and low death rate, without trauma, bleeding or infection. MRI has replaced CT as a method of location, and provides a good choice for treating pituitary tumors.OBJECTIVE: To analyze the effectiveness and complications of 501 cases with pituitary adenoma by using gamma-knife retrospectively.DESIGN: Case-analysis.SETTING: Gamma-knife Center, the 363 Hospital of Chinese PLA.PARTICIPANTS: A total of 501 cases were selected from Gamma-knife Center, the 363 Hospital of Chinese PLA from January 1997 to December 2002. All patients were certainly diagnosed with CT and MRI scanning. There were 186 males and 315 females. Their ages ranged from 15 to 84 years with the mean age of 39 years. All patients provided confirmed consent.METHODS: All 501 cases with pituitary adenomas were treated by gamma-knife or combined with operations: The average iso-dose curve was 50% (30% - 65%), peri-dose was 14 Gy and the average target number was 5.17. ① At 35 months after treatment, patients received follow-up including clinical symptoms,imaging symptoms and endocrine symptoms. ② Patients who received second gamma-knife treatment were analyzed and their complications were observed after operation.MAIN OUTCOME MEASURES: ① Follow-up results of clinical symptoms, image and endocrine indexes; ② second gamma-knife treatment; ③ postoperative complications.RESULTS: Among 501 accepted patients, 275 cases were involved in the follow up of clinical symptoms,154 in image symptoms and 98 in endocrine symptoms. ① Follow-up results of clinical symptoms, image and endocrine indexes: Follow up of clinical symptoms demonstrated that clinical symptoms of 169 cases were relieved, of 68 disappeared, and of 38 deteriorated. Follow-up of image symptoms indicated that pituitary tumor of 25 cases disappeared, of 84 shortened, of 42 not changed, and of 3 enlarged. Follow-up of endocrine symptoms suggested that endocrine of 50 cases was abnormal, of 29

  5. Treating and management in acute Laugier's fracture: a case report

    Directory of Open Access Journals (Sweden)

    Predrag Grubor

    2014-01-01

    Full Text Available Laugier's fractures are rare because they are located deep in the elbow joint and are thus protected from any direct trauma. Laugier's fractures have been insufficiently described in the literature. Surgical treatment does not have an alternative, and timely diagnosis and surgical and physical therapy. We presented a case report of a 23 years' old man, sustained a Laugier's fracture in June 2012 after falling from motocycle (low energy trauma and hit with his flexed elbow against the street.

  6. Phobic postural vertigo treated with autogenic training: a case report

    OpenAIRE

    GOTO, FUMIYUKI; Nakai, Kimiko; Kunihiro, Takanobu; Ogawa, Kaoru

    2008-01-01

    Background Patients suffering from dizziness due to vertigo are commonly encountered in the department of otolaryngology. If various clinical examinations do not reveal any objective findings, then the patients are referred to the department of internal medicine or psychiatry. In many cases, the diagnosis is psychological dizziness. Phobic postural vertigo, which was first reported by Brandt T et al in 1994, is supposed to be a type of psychological dizziness. The diagnosis is based on 6 char...

  7. Postpartum catatonia treated with electroconvulsive therapy: a case report.

    Science.gov (United States)

    Strain, Angela Katherine; Meltzer-Brody, Samantha; Bullard, Elizabeth; Gaynes, Bradley N

    2012-01-01

    Catatonia is a rare syndrome that occurs in mood and psychotic disorders, and general medical conditions. Postpartum depression affects 10%-15% of women within 6 months after delivery. Postpartum psychosis affects 0.1%-0.5% of women within weeks after delivery, though it can occur within hours; it carries risk for suicide and infanticide. There is limited evidence available to guide treatment. We review a case of postpartum psychosis that presented with catatonia and was resistant to medications, but responded to electroconvulsive therapy.

  8. Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

    Directory of Open Access Journals (Sweden)

    Psarros Constantin

    2006-09-01

    Full Text Available Abstract Background The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. Case presentation A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg. Conclusion The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient.

  9. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    Directory of Open Access Journals (Sweden)

    Elmedina Dautovic

    2016-07-01

    Full Text Available Purpose: To examine the potential effects of eye movement desensitization and reprocessing (EMDR in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods: Five children (aged 8–18 with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results: Before EMDR, overall or subscale scores indicated that all children had (subclinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session. Conclusions: In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy.

  10. The case for immunomodulatory approaches in treating HSV encephalitis.

    Science.gov (United States)

    Ramakrishna, Chandran; Openshaw, Harry; Cantin, Edouard M

    2013-03-01

    HSV encephalitis (HSE) is the most prevalent sporadic viral encephalitis. Although safe and effective antiviral therapies and greatly improved noninvasive diagnostic procedures have significantly improved outcomes, mortality (~20%) and debilitating neurological sequelae in survivors remain unacceptably high. An encouraging new development is that the focus is now shifting away from the virus exclusively, to include consideration of the host immune response to infection in the pathology underlying development of HSE. In this article, the authors discuss results from recent studies in experimental mouse models, as well as clinical reports that demonstrate a role for exaggerated host inflammatory responses in the brain in the development of HSE that is motivating researchers and clinicians to consider new therapeutic approaches for treating HSE. The authors also discuss results from a few studies that have shown that immunomodulatory drugs can be highly protective against HSE, which supports a role for deleterious host inflammatory responses in HSE. The impressive outcomes of some immunomodulatory approaches in mouse models of HSE emphasize the urgent need for clinical trials to rigorously evaluate combination antiviral and immunomodulatory therapy in comparison with standard antiviral therapy for treatment of HSE, and support for such an initiative is gaining momentum.

  11. Human case of fasciolosis in Serbia treated with triclabendazole

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    Pavlović Milorad

    2014-01-01

    Full Text Available Introduction. The number of humans infected by Fasciola hepatica is increasing worldwide. Humans can become accidental hosts by ingesting drinking water or plants contaminated with metacercariae. Case report. We reported a case of a 68-year-old Serbian woman, in which the diagnosis of acute fasciolosis had been established after serious diagnostic concerns. Based on clinical picture (episodic right upper quadrant abdominal pain, febrility and generalized body pain and biochemical analyses (high eosinophilia and high activity of alkaline phosphatase, she was appointed as suspected to the acute fasciolosis. Stool and duodenal aspirate exams were negative for Fasciola ova. In the absence of adequate serologic diagnostic for fasciolosis in Serbia, the diagnosis was confirmed using enzyme immunoassays and immunoblot at the Institute for Tropical Diseases in Hamburg, Germany. Soon after triclabendazole was administered, the symptoms disappeared and biochemical values returned to normal. Conclusion. The diagnosis of human fasciolosis may be problematic and delayed, especially in non endemic areas, because physicians rarely encounter this disease and a long list of other diseases must be considered in the differential diagnosis. The syndrome of eosinophilia, fever, and right upper quadrant abdominal pain suggest acute fasciolosis. Unclear source does not rule out fasciolosis.

  12. Catheter-related septic thrombophlebitis of the great central veins successfully treated with low-dose streptokinase thrombolysis and antimicrobials

    Directory of Open Access Journals (Sweden)

    Baltazares-Lipp Enrique

    2005-08-01

    Full Text Available Abstract Background Septic thrombophlebitis is an iatrogenic life-threatening disease associated with use of central venous devices and intravenous (IV therapy. In cancer patients receiving chemotherapy, vein resection or surgical thrombectomy in large central venous lines is time-consuming, can delay administration of chemotherapy, and therefore can compromise tumor control. Experience with thrombolysis has been published for catheter-related thrombosis but for septic thrombosis, this experience is scarce. Results We describe three patients with cancer and septic thrombophlebitis of central veins caused by Staphylococcus aureus treated with catheter removal, thrombolysis, and intravenous (IV antibiotics. In our reported cases, an initial bolus of 250,000 international units (IU of streptokinase administered during the first h followed by an infusion of 20,000–40,000 IU/h for 24–36 h through a proximal peripheral vein was sufficient to dissolve the thrombus. After thrombolyisis and parenteral antibiotic for 4–6 weeks the septic thrombosis due to Staphylococcus aureus solved in all cases. No surgical procedure was needed, and potential placement of a catheter in the same vein was permitted. Conclusion Thrombolysis with streptokinase solved symptoms, cured infection, prevented embolus, and in all cases achieved complete thrombus lysis, avoiding permanent central-vein occlusion.

  13. Successful coil embolization of a ruptured basilar artery aneurysm in a child with leukemia: a case report.

    Science.gov (United States)

    Hayashi, Shihori; Maehara, Taketoshi; Mukawa, Maki; Aoyagi, Masaru; Yoshino, Yoshikazu; Nemoto, Shigeru; Ono, Toshiaki; Ohno, Kikuo

    2014-01-01

    Ruptured intracranial aneurysms are rare in the pediatric population compared to adults. This has incited considerable discussion on how to treat children with this condition. Here, we report a child with a ruptured saccular basilar artery aneurysm that was successfully treated with coil embolization. A 12-year-old boy with acute lymphoblastic leukemia and accompanying abdominal candidiasis after chemotherapy suddenly complained of a severe headache and suffered consciousness disturbance moments later. Computed tomography scans and cerebral angiography demonstrated acute hydrocephalus and subarachnoid hemorrhage caused by saccular basilar artery aneurysm rupture. External ventricular drainage was performed immediately. Because the patient was in severe condition and did not show remarkable signs of central nervous system infection in cerebrospinal fluid studies, we applied endovascular treatment for the ruptured saccular basilar artery aneurysm, which was successfully occluded with coils. The patient recovered without new neurological deficits after ventriculoperitoneal shunting. Recent reports indicate that both endovascular and microsurgical techniques can be used to effectively treat ruptured cerebral aneurysms in pediatric patients. A minimally invasive endovascular treatment was effective in the present case, but long-term follow-up will be necessary to confirm the efficiency of endovascular treatment for children with ruptured saccular basilar artery aneurysms.

  14. Modified Exposure and Response Prevention to Treat the Repetitive Behaviors of a Child with Autism: A Case Report

    Directory of Open Access Journals (Sweden)

    Brian A. Boyd

    2011-01-01

    Full Text Available We report the case study of a school-aged child with autism whose repetitive behaviors were treated with a modified version of a technique routinely used in cognitive behavior therapy (i.e., exposure response prevention to treat obsessive-compulsive disorder. A trained behavioral therapist administered the modified ERP treatment over the course of an intensive two-week treatment period with two therapy sessions occurring daily. The treatment was successful at decreasing the amount of child distress and cooccurring problem behavior displayed; however, the child's interest in the repetitive behavior eliciting stimulus (i.e., puzzles remained. The case study demonstrates specific ways that exposure response prevention strategies can be adapted to the unique kinds of repetitive behaviors that present clinically in autism. A larger clinical trial is needed to substantiate these findings.

  15. Forty Cases of Simple Obesity Treated by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Obesity, a dystrophic disease most frequently seen in modern society, has become one of the worldwide health concerns. Obesity not only affects the body shape, but also has close relations to angiocardiopathy, diabetes, hypertension,hyperlipemia and fatty liver. Therefore, the prevention and treatment of obesity have become a major problem facing the medical workers. At present, there are a lot of therapies for obesity,including pharmacotherapy, acupuncture therapy,dietary therapy, exercise therapy, and surgical therapy. Acupuncture therapy, with its unique advantages of safety, effectiveness, simplicity, less expense and no toxic side-effects, becomes more and more popular among the patients. In this study,40 cases of simple obesity were chosen to clinically observe the curative effect of acupuncturetherapy for simple obesity.

  16. Forty Cases of Gastrointestinal Neurosis Treated by Acupunture

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective: To compare the therapeutic effect of acupuncture for gastrointestinal neurosis with that of oral remedy. Methods: Eighty cases were randomly divided into the following 2 groups. In the treatment group, acupuncture was given for one month at the main points of Zhongwan (CV 12), Zusanli (ST 36), Taichong (LR 3) and Shenmen (HT 7), with the auxiliary points selected according to TCM differentiation. In the control group, Domperidone was orally administered for one month. Results: The total effective rate was 92.5% in the treatment group and 75.0% in the control group, with a significant difference between the 2 groups (χ2=4.423, P<0.05). Acupuncture was superior to the oral remedy in therapeutic effects. Conclusions: Acupuncture may show better results for gastrointestinal neurosis and with less toxic side effects.

  17. Coblation cryptolysis to treat tonsil stones: a retrospective case series.

    Science.gov (United States)

    Chang, Christopher Y; Thrasher, Richard

    2012-06-01

    We introduce a novel and potentially effective approach in the treatment of tonsil stones using Coblation technology. A retrospective pilot case series was performed demonstrating the effectiveness of a technique that we call Coblation tonsil cryptolysis. This technique is unique in that it can be performed in adult patients without sedation using only local anesthesia, much like laser tonsil cryptolysis. As with laser cryptolysis, pain is significant for only a few days and most adults can resume normal diet and activity within 1 week. In contrast, tonsillectomy entails significant morbidity for several weeks. However, Coblation avoids the significant disadvantages of laser use, including the potential for airway fire, retinal damage from reflected scatter, dealing with plume from vaporized tissues, oral/facial burns, and the high cost of purchasing and maintaining laser equipment. After a single session of Coblation tonsil cryptolysis, a significant decrease and even elimination of tonsil stones can potentially be achieved.

  18. Ustekinumab successfully treated a patient with severe psoriasis vulgaris with primary failure to infliximab and secondary failure to adalimumab

    Directory of Open Access Journals (Sweden)

    Chiharu Tateishi,

    2015-07-01

    Full Text Available Biologic drugs have been recently used to treat psoriasis. However, some patients do not respond or lose therapeutic benefit with first-line use of tumor necrosis factor (TNF antagonists. We report a case of psoriasis vulgaris, that failed to respond to TNF antagonists, infliximab and adalimumab, completely disappeared after treatment with ustekinumab, a therapeutic agent for biologically blocking p40 protein of interleukin (IL 12 and 23. This report highlights anti-TNF agents only inhibited the TNF-α/inducible nitric oxide synthase (iNOS-producing dendritic cells (TIP-DCs, but the plasmacytoid-DC-derived psoriatic response was re-initiated. On the other hand, ustekinumab may inhibit both the TIP-DCs and the plasmacytoid-DC-derived inflammatory response.

  19. Investigating Barriers to Knowledge Management Success: A Conceptual Model and a Comparative Case Analysis

    OpenAIRE

    Chihab BenMoussa

    2010-01-01

    What barriers obstruct the success of knowledge management programs? This paper has integrated studies on the barriers to knowledge management (KM) into a theoretical framework. Based on this framework, five cases documenting failed KM initiatives were analysed. The analysis gives a clear picture about why certain KM projects fail. The high failure rate of KM can be explained by the supply-IT based approach many organisations adopt when it comes to their KM programs. To increase the success r...

  20. How to build successful city brands? : Case Cities: San Francisco and Los Angeles

    OpenAIRE

    2014-01-01

    The idea of place branding has received a wide attention in the recent years and has now grown beyond slogans and ad campaigns. This thesis aims at finding the key competences for successful place branding and the factors affecting the success of place branding. This thesis is a part of an international research conducted by Dr. Teemu Moilanen which includes 25 different cities from 5 different continents. The thesis contains two sections theoretical section and the case studies of cities....

  1. 76 Cases of Hypomenorrhea Treated by Acupuncture to Regulate the Menstrual Cycle

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hai-jie

    2009-01-01

    @@ Between August 2006 to September 2008, the author treated 76 cases of hypomenorrhea by using acupuncture to regulate the menstrual cycle, and achieved good therapeutic results as reported in the following:

  2. FORTY CASES OF INSOMNIA TREATED WITH ACUPUNCTURE, MASSAGE AND MUSIC THERAPY

    Institute of Scientific and Technical Information of China (English)

    WANG Lin-yu

    2005-01-01

    @@ Insomnia is a commonly encountered sleep disorder in clinical practice. The author of the present paper treated 40 cases of insomnia with acupuncture and massage combined with music therapy and achieved satisfied outcomes. Following is the report.

  3. [Abdominal aortic aneurysm treated by endovascular surgery: a case report].

    Science.gov (United States)

    Alconero-Camarero, Ana Rosa; Cobo-Sánchez, José Luis; Casaus-Pérez, María; García-Campo, María Elena; García-Zarrabeitia, María José; Calvo-Diez, Marta; Mirones-Valdeolivas, Luz Elena

    2008-01-01

    An aneurysm is an abnormal dilation or irreversible convex of a portion of an artery. The most common site of aneurysms is the abdominal aorta and their appearance is often due to degeneration of the arterial wall, associated with atherosclerosis and favored by risk factors such as smoking and hypertension, among others. Left untreated, aneurysm of the abdominal aorta usually leads to rupture. Treatment is surgical, consisting of the introduction of a prosthesis, composed basically of a stent and an introducer, into the aorta. We report the case of a person diagnosed with abdominal aortic aneurysm in a routine examination who was admitted for ambulatory surgical treatment. We designed a nursing care plan, following Virginia Henderson's conceptual model. The care plan was divided into 2 parts, a first preoperative phase and a second postimplantation or monitoring phase. The care plan contained the principal nursing diagnoses, based on the taxonomies of the North American Nursing Diagnosis Association (NANDA), nursing interventions classification (NIC) and nursing outcomes classifications (NOC), and collaboration problems/potential complications. The patient was discharged to home after contact was made with his reference nurse in the primary health center, since during the hospital phase, some NOC indicators remained unresolved.

  4. Complicated distal femoral epiphyseolysis treated by Ilizarov method: Case report

    Directory of Open Access Journals (Sweden)

    Jovanović Vesna

    2010-01-01

    Full Text Available Introduction Injuries of the distal femur are rare in children; however, they are frequently associated with complications. They are almost always physeal, most frequently Salter-Harris type II epiphyseolysis. The treatment of such injuries is similar in all physeal injuries. It is intended to provide growth plate recovery by gentle reduction and stable fixation thus preventing secondary complications, and also to provide decompression of the segment to solve the compartment syndrome and recover the neurovascular structures. Case Outline A seven-year old boy presented with a right knee injury while sleigh riding. He was admitted three weeks following the injury with distal femoral epiphysiolysis associated with peroneal palsy. A day after admission to our Institute the reduction was performed using the Ilizarov device. Physical therapy was started immediately after surgery, as well as walking with weight bearing on the operated leg. Five months after surgery the patient was anatomically and functionally recovered. Conclusion The presented method is recommended in the treatment of such injuries because of several reasons; reposition is simple and complete, there is no need to open the fracture site, fixation is stable, the growth plate is preserved, there is no need for additional external immobilisation, and physical therapy involving walking with weight bearing on the operated leg may be started immediately after surgery. .

  5. A Case Study Using Child-Centered Play Therapy Approach to Treat Enuresis and Encopresis.

    Science.gov (United States)

    Cuddy-Casey, Maria

    1997-01-01

    Demonstrates an alternative method (nondirective child-centered therapy) in treating enuresis and encopresis resulting from emotional disturbances. Examines various etiologies and approaches to treating these conditions. Provides a case study example. Claims that professionals must differentiate between primary and secondary occurrences of these…

  6. Two cases of tracheal disease misdiagnosed as difficult-to-treat asthma.

    Science.gov (United States)

    Alici, Ibrahim Onur; Kar Kurt, Ozlem; Dursun, Adile Berna; Yilmaz, Aydin; Erkekol, Ferda Oner

    2013-11-01

    Initial management of patients with difficult-to-treat asthma must begin with confirmation of the diagnosis. We present 2 cases of tracheal disease misdiagnosed as difficult-to-treat asthma. After systemic evaluation, tracheomalacia and tracheobronchial narrowing due to diffuse calcification of the cartilaginous rings were found as mimicking asthma.

  7. Successful treatment of severe pouchitis with rebamipide refractory to antibiotics and corticosteroids: A case report

    Institute of Scientific and Technical Information of China (English)

    Mitsuki Miyata; Toshihiro Konagaya; Shiniti Kakumu; Takeshi Mori

    2006-01-01

    The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report,we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide,known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea,and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema (3.95 mg/dose). However,despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema (150 mg/dose) twice a day for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation.The effect of rebamipide enema was dramatic and was maintained throughout the 11-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period.The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions.

  8. A case of adult Langerhans cell histiocytosis showing successfully regenerated osseous tissue of the skull after chemotherapy.

    Science.gov (United States)

    Suzuki, Takahiro; Izutsu, Koji; Kako, Shinichi; Ohta, Satoshi; Hangaishi, Akira; Kanda, Yoshinobu; Motokura, Toru; Chiba, Shigeru; Kurokawa, Mineo

    2008-04-01

    Langerhans cell histiocytosis (LCH) is a proliferative disorder of Langerhans cells and extremely rare in adults. Adult LCH is often associated with osteolytic bone lesions, but large bone-defective lesions have been rarely reported. We report an adult case of LCH accompanied by large osteolytic lesions in the skull that successfully responded to chemotherapy. A 47-year-old woman with LCH who had multiple, large osteolytic areas of more than 3 cm in diameter in the skull was admitted to our hospital. She was treated with systemic chemotherapy consisting of prednisolone, vinblastine, and 6-mercaptopurine. Twelve months later, when she completed the treatment, osteolytic areas were covered with hard osseous tissue, and X-ray examination confirmed regeneration of the bone. This case indicates that chemotherapy can be effective even for the treatment of large osteolytic lesions in adult LCH patients.

  9. Evaluation of the inhibition of egg laying, larvicidal effects, and bloodfeeding success of Aedes aegypti exposed to permethrin- and bifenthrin-treated military tent fabric.

    Science.gov (United States)

    Frances, S P; Huggins, R L; Cooper, R D

    2008-12-01

    Laboratory studies were conducted to evaluate the effects of treating military canvas tent fabric with bifenthrin and permethrin on the survival of the eggs and larvae of Aedes aegypti. Gravid female Ae. aegypti were able to oviposit on tent canvas treated with either bifenthrin or permethrin. However, none of the eggs laid on treated canvas hatched, and no larvae added to water in treated trays survived. Low residual concentrations of bifenthrin and permethrin on treated canvas prevented the development of eggs and larvae of Ae. aegypti. Inhibition of bloodfeeding was shown when Ae. aegypti adults were exposed to lower concentrations (10-50% of operational concentrations) of bifenthrin- and permethrin-treated canvas tent fabric. These experiments have shown that military tent canvas treated with either bifenthrin or permethrin can reduce the development of Ae. aegypti eggs and larvae and reduce bloodfeeding success of adults.

  10. A Case of Successful Use of Hypnosis in the Treatment of Parasomnia Overlap Disorder.

    Science.gov (United States)

    Kohler, William C; Kurz, Peter J; Kohler, Elizabeth A

    2015-01-01

    A young male patient was successfully treated for parasomnia overlap disorder (POD) using hypnosis. In 2006, this 16-year-old patient underwent a clinical evaluation for episodes of sleep talking, sleepwalking, and dream enactment. This initial assessment was followed by polysomnographic evaluation, a brain MRI, and three sessions of treatment using hypnosis. From the beginning, until the last contact in December 2011, benefits from the hypnotic suggestions were noted and documented.

  11. Successful treatment of lower urinary tract infections with oral fosfomycin: a report of three cases

    Directory of Open Access Journals (Sweden)

    Juliana Oliveira da Silva

    2015-06-01

    Full Text Available Infections due to multidrug-resistant organisms continue to increase, and therapeutic options remain scarce. Given this challenge, it has become necessary to use older antimicrobials for treatment of these pathogens. We report three patients with lower urinary tract infections caused by Klebsiella pneumoniae carbapenemase (KPC-producing Klebsiella pneumoniae who were successfully treated with a seven-day course of oral fosfomycin monotherapy.

  12. Rectal laterally spreading tumors successfully treated in two steps by endoscopic submucosal dissection and endoscopic mucosal resection

    Directory of Open Access Journals (Sweden)

    Palmieri Giovanni

    2010-11-01

    Full Text Available Abstract Background Endoscopic submucosal dissection (ESD is an advanced technique of therapeutic endoscopy alternative to endoscopic mucosal resection (EMR for superficial gastrointestinal neoplasms >2 cm. ESD allows for the direct dissection of the submucosa and large lesions can be resected en bloc. ESD is not limited by resection size, increases histologically complete resection rates and may reduce the local recurrence. Nevertheless, the technique is time-consuming, technically demanding and associated with a high complication rate. To reduce the risk of complications, different devices and technical advances have been proposed with conflicting results and, still, ESD en bloc resections of huge lesions are associated with increased complications. Case Presentation We successfully used a combined ESD/EMR technique for huge rectal laterally spreading tumors (LSTs. ESD was used for circumferential resection of 2/3 of the lesion followed by piecemeal resection (2-3 pieces of the central part of the tumour. In all three patients we obtained the complete dissection of the polyp and the complete histological evaluation in absence of complications and recurrence at 6 months' follow up. Conclusions In the treatment of rectal LSTs, the combined treatment - ESD/EMR resection may be considered a suitable therapeutic option, indicated in selected cases as an alternative to surgery, in which the two techniques are neither reliable nor safe separately. However, to confirm our results, larger trials with longer follow up are required together with improvement of the technique and of the technical devices.

  13. Fibrillary glomerulonephritis with small fibrils in a patient with the antiphospholipid antibody syndrome successfully treated with immunosuppressive therapy

    Directory of Open Access Journals (Sweden)

    Tagboto Senyo

    2007-05-01

    Full Text Available Abstract Background Fibrillary glomerulonephritis is a rare cause of progressive renal dysfunction, often leading to the need for dialysis within a few years. The role of immunosuppressive treatment is still uncertain although this has been tried with variable success. Case presentation A 56 year old woman with the antiphospholipid antibody syndrome (IgM anticardiolipin antibodies was seen in the nephrology clinic with haematuria, proteinuria, and worsening renal function. A renal biopsy demonstrated a mesangial proliferative glomerulonephritis on light microscopy and smaller fibrils (10.6–13.8 nm in diameter than is usual for fibrillary glomerulonephritis (typically 18–22 nm on electron microscopy. Amyloidosis was excluded following detailed evaluation. On account of rapidly worsening renal failure she was started on cyclophosphamide and prednisolone which led to the partial recovery and stabilization of her renal function. Conclusion This case highlights the need for routine electron microscopy in native renal biopsies, where the differential diagnosis is wide and varied and the light and immunofluorescence microscopic findings may be non specific.

  14. Strategies of Successful Poverty Reduction: Case Studies of Tanzania and Zambia

    Science.gov (United States)

    2015-03-01

    SUCCESSFUL POVERTY REDUCTION: CASE STUDIES OF TANZANIA AND ZAMBIA by Jacqueline A. Natter March 2015 Thesis Co-Advisors: Robert E. Looney...March 2015 Master’s Thesis 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS S1RA 1EGIES OF SUCCESSF1JL POVERTY REDUCTION: CASE STUDIES OF TANZANIA AND...growth in the 21st century, Tanzania has been able to translate that growth into poverty reduction while Zambia has not. A contextual picture of the two

  15. Severe hypocalcemia secondary to hypomagnesaemia, successfully treated by self-administered subcutaneous magnesium Hipocalcemia severa, secundaria a hipomagnesemia, tratada con éxito mediante auto-administración subcutánea de magnesio

    OpenAIRE

    2009-01-01

    We report the case of a patient with recurrent severe hypocalcemia, secondary to hypomagnesaemia, and prerenal renal failure, due to ileostomy losses after a colectomy, who needed several admissions to the hospital through more than one year. Finally, he was successfully treated by self-administered subcutaneous magnesium: he reached and maintained normal levels of serum calcium, magnesium and PTH, no more hospital admission were needed and he resumed a normal life.Se trata de un paciente con...

  16. Successful management of peri-implantitis with a regenerative approach: a consecutive series of 51 treated implants with 3- to 7.5-year follow-up.

    Science.gov (United States)

    Froum, Stuart J; Froum, Scott H; Rosen, Paul S

    2012-02-01

    The results of a case series of 51 consecutively treated, peri-implantitis-affected implants in 38 patients with follow-up measurements from 3 to 7.5 years are presented. Each implant displayed bleeding on probing, probing depths ≥ 6 mm, and bone loss ≥ 4 mm prior to surgery. A successful regenerative approach including surface decontamination, use of enamel matrix derivative, a combination of platelet-derived growth factor with anorganic bovine bone or mineralized freeze-dried bone, and coverage with a collagen membrane or a subepithelial connective tissue graft was employed in all cases. Patients were divided into two groups. Group 1 included patients in which the greatest defect depth was visible on radiographs; group 2 included patients in which the greatest loss of bone was on the facial or oral aspect of the implant. Bone level changes in patients in group 2 were determined by probe sounding under local anesthesia. Probing depth reductions at 3 to 7.5 years of follow-up were 5.4 and 5.1 mm in groups 1 and 2, respectively. Concomitant bone level gain was 3.75 mm in group 1 and 3.0 mm in group 2. No implant in either group lost bone throughout the duration of the study. The results to date with this regenerative approach for the treatment of peri-implantitis appear to be encouraging.

  17. Understanding a Father-Daughter Succession Case: Applying the 5+5+5 Bernelli Model

    Directory of Open Access Journals (Sweden)

    Leann Mischel

    2011-01-01

    Full Text Available Problem statement: Research on father-daughter succession in family businesses has only recently begun to get some traction. Still, examples of these situations often elude researchers. Futhermore, there has not been adequate attention paid to how children are raised in family businesses and how they learn to be entrepreneurial. Approach: This study outlines a father-daughter succession case in this unique American setting-the Appalachian Mountains of West Virginia. West Virginia offers an opportunity to examine family businesses embedded in the Appalachian culture-one where much of the popular and scholarly literature contend that deficiencies have contributed to, or reinforced, economic poverty and backwardness. These ideals are now being challenged and this case offers evidence of reversal. We also use the Bernelli 5+5+5 Model as a lens through which to examine the daughter’s entrepreneurial growth in this case. Results: The Bernelli 5+5+5 Model allowed us to structure the daughter’s experiences and better understand how she got to be such a successful successor. Conclusion/Recommendations: We recommend that the Bernelli 5+5+5 Model be used as a framework to view succession in family businesses. The Model also serves as a lens through which to view and better understand how children raised in family businesses become more successful entrepreneurs as adults.

  18. Critical Success Factors for Enterprise Resource Planning System Implementation: A Case Study in Malaysian SME

    Directory of Open Access Journals (Sweden)

    Feybi Ariani Goni

    2011-01-01

    Full Text Available Implementing Enterprise Resource Planning (ERP system for Malaysian Small to Medium Enterprises (SMEs is not just a technological challenge. It is a socio-technological endeavour which mandates modifying existing applications and redesigning business processes to facilitate ERP system implementation. Most Malaysian SMEs cannot afford to adopt an existing ERP system due to the extremely high cost and complex implementation. The ERP system implementation literature contains many case studies of organizations that have implemented ERP system successfully. However, many Malaysian SMEs do not achieve success in their ERP system implementation. There are very few studies have represented and developed critical success factors of ERP system implementation projects highlighted for SMEs. This research seeks to explore the critical success factors for successful ERP system implementation in Malaysian SMEs. The research method is based on a case study within Malaysian SME to perform a critical success factors model of ERP system implementation adoption which has validated by a number of SMEs in Malaysia. The proposed model will help outline the critical factors that should be considered by Malaysian SMEs in uccessfully adopting ERP system.

  19. Successful treatment of Rh alloimmunization in a twin pregnancy: case report

    Directory of Open Access Journals (Sweden)

    Rahimi Sharbaf F

    2008-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Background: The prevalence of Rh alloimmunization has decreased following the use of anti-D immunoglobulin. With serial amniocentesis, Doppler sonography of the middle cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal mortality has declined. However, Rh alloimmunization in twin pregnancies poses a diagnostic and therapeutic challenge."n"n Case report: We are reporting, for the first time in Iran, the successful treatment of severe Rh alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the live births of both neonates. Before treatment, the fetal hemoglobin levels were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were treated with several IUTs."n"n Results: After treatment, the neonates were delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational age of 34 weeks. "n"n Conclusion: 10% of population in Iran is Rh-negative, although Prophylaxis for Rh alloimmunization is universal, as other part of the world it cannot irrigated. For the best management of these cases, we need a well-equipped referral center."n"n Keywords: Twin, pregnancy, Rh alloimmunization, intrauterine blood transfusion, Doppler, middle cerebral

  20. A CASE OF SUCCESSFUL TREATMENT OF PRIMARY MULTIPLE CANCER OF THE OROPHARYNX AND THYROID

    Directory of Open Access Journals (Sweden)

    M. G. Madzhidov

    2013-01-01

    Full Text Available The paper describes the author’s practice case of successful radiotherapy (gamma-teletherapy using the radio modifier 5-fluorouracil for squamous cell carcinoma of the palatine tonsils and surgery for metachronous papillary thyroid cancer occurring 15 years later.

  1. Transformation in Higher Education: A Case Study of Successful Organization Change and Rebirth

    Science.gov (United States)

    Kirby, Janet A.

    2011-01-01

    This history and case study of the transformation of a private Catholic junior college to a branch campus of a private Catholic university system is one of successful organization change achieved through entrepreneurial leadership, resilient culture, teleological change processes, and sound business strategies. The use of the term "transformation"…

  2. Exploring Predictors of Graduate School and Career Success: A Case Study in Sport Management

    Science.gov (United States)

    LeCrom, Carrie; Rufer, Lisa; Slavich, Mark; Dwyer, Brendan; Greenhalgh, Gregory

    2016-01-01

    The following case study attempted to assess what factors contribute to graduate school and early-career success among sport management graduate students. As faculty members charged with admitting the next generation of leaders in the sport industry, how should admissions decisions be made and what factors should be considered? The authors…

  3. The Power of Teacher Teams: With Cases, Analyses, and Strategies for Success

    Science.gov (United States)

    Troen, Vivian; Boles, Katherine C.

    2012-01-01

    While most educators believe working in teams is valuable, not all team efforts lead to instructional improvement. Through richly detailed case studies, "The Power of Teacher Teams" demonstrates how schools can transform their teams into more effective learning communities that foster teacher leadership. The benefits of successful teacher teams…

  4. Hydroxychloroquine as Treatment for Inflammatory Subglottic Stenosis: A Second Successful Case

    Directory of Open Access Journals (Sweden)

    G. Desuter

    2012-01-01

    Full Text Available Inflammatory sub-glottic stenosis is a life threatening condition that represents a therapeutic challenge. Recently, hydroxychloroquine has been suggested as one efficient medical treatment option. This report describes the second case of successful treatment of inflammatory sub-glottic stenosis using hydroxychloroquine.

  5. Success Despite Socioeconomics: A Case Study of a High-Achieving, High-Poverty School

    Science.gov (United States)

    Tilley, Thomas Brent; Smith, Samuel J.; Claxton, Russell L.

    2012-01-01

    This case study of a high-achieving, high-poverty school describes the school's leadership, culture, and programs that contributed to its success. Data were collected from two surveys (the School Culture Survey and the Vanderbilt Assessment of Leadership in Education), observations at the school site, and interviews with school personnel. The…

  6. The Impact of Management Decision-Making on Student Success in Community Colleges: A Case Study

    Science.gov (United States)

    Alt, Albert G.

    2012-01-01

    This case study examined a multi-college community college district in northern California in a primarily rural area, to understand how their practices compared to management best practices designed to improve student success, barriers that may exist in implementing best practices, and how the institution may improve its own practices. The problem…

  7. Cross-organizational ERP Management: How to Create a Successful Business Case?

    NARCIS (Netherlands)

    Eckartz, S.M.; Daneva, M.; Wieringa, R.J.; Hillegersberg, van J.

    2009-01-01

    This paper deals with the development and use of business cases in support of cross-organizational enterprise resource planning (ERP)-enabled e-business integration initiatives. In order to ensure that such a project starts successfully, we will focus on pre-implementation activities. We propose a s

  8. Hepatocellular carcinoma with gastric metastasis treated by simultaneous hepatic and gastric resection: report of a case.

    Science.gov (United States)

    Haruki, Koichiro; Misawa, Takeyuki; Gocho, Takeshi; Saito, Ryota; Shiba, Hiroaki; Akiba, Tadashi; Yanaga, Katsuhiko

    2016-10-01

    Hepatocellular carcinoma (HCC) with gastric metastasis is extremely rare. There have been few reports on curative surgical resection for gastric metastasis of HCC. We herein report such a case successfully treated by simultaneous surgical resection. A 73-year-old male was admitted for evaluation and treatment of a liver tumor. Computed tomography showed an exophytic tumor of 170 mm in diameter located in the left lobe of the liver with poor delineation to the gastric wall. Upper gastrointestinal endoscopy revealed a submucosal tumor with ulceration in the antrum of the stomach. With a diagnosis of HCC with invasion to the gastric wall, an en bloc resection was planned, and the patient underwent laparotomy. The patients underwent left hemihepatectomy with partial resection of the stomach for adhesion and distal gastrectomy for the tumor. Pathological examination of the liver tumor revealed poorly differentiated HCC, and pathological diagnosis of the tumor in the submucosal and muscular layer of the stomach was compatible with metastasis from HCC, which was separate from the liver tumor. Therefore, we diagnosed the tumor as HCC with hematogenous gastric metastasis. The patient remains well with no evidence of tumor recurrence as of 13 months after resection.

  9. Case report and review of esophageal lichen planus treated with fluticasone.

    Science.gov (United States)

    Ynson, Marie Lourdes; Forouhar, Faripour; Vaziri, Haleh

    2013-03-14

    Lichen planus is a fairly common chronic idiopathic disorder of the skin, nails and mucosal surfaces. Esophageal involvement of this disease on the other hand is rare and only about 50 cases have been reported in literature. Given its rarity, it can be difficult to diagnose and may be easily misdiagnosed as reflux esophagitis. Currently, there are no clear recommendations on the optimal management of this disease and little is known about the best treatment approach. Systemic steroids are usually the first line treatment and offer a favorable response. In this report, we would like to present a novel approach in the management of esophageal lichen planus in a middle-aged woman treated successfully with swallowed fluticasone propionate 220 mcg twice a day for 6 wk, as evidenced by objective clinical findings. Based on our review of related literature and experience in this patient, we feel that a trial of swallowed fluticasone may be a prudent approach in the management of these patients since it has a more favorable side effect profile than systemic treatment.

  10. [Thyroid cancer metastasis to the lumbar spine successfully treated by embolization and radioiodine. A case report].

    Science.gov (United States)

    Sumimura, J; Nakagawa, K; Kawamura, J; Tayama, M; Takahashi, E; Moritomo, T; Miyata, M

    1990-07-01

    A 82-year-old woman suffered from a metastatic lesion of follicular carcinoma of the thyroid to the fourth lumbar spine, which compressed the spinal nerves and caused lumbar pain and paresthesis of the lower limb. External irradiation, 5200 RAD, was carried out. Total thyroidectomy was done for the preparation of radioiodine(131I) therapy. Two weeks later, embolization of lumbar arteries was performed to prevent the progression of the spinal cord damage during a period waiting for 131I administration. The size of the lumbar lesion decreased, and lumbal pain and spinal cord symptoms disappeared. After administration of 131I, the metastatic lesion became further smaller.

  11. Chronic 'speech catatonia' with constant logorrhea, verbigeration and echolalia successfully treated with lorazepam: a case report.

    Science.gov (United States)

    Lee, Joseph W Y

    2004-12-01

    Logorrhea, verbigeration and echolalia persisted unremittingly for 3 years, with occasional short periods of motoric excitement, in a patient with mild intellectual handicap suffering from chronic schizophrenia. The speech catatonic symptoms, previously refractory to various antipsychotics, responded promptly to lorazepam, a benzodiazepine with documented efficacy in the treatment of acute catatonia but not chronic catatonia. It is suggested that pathways in speech production were selectively involved in the genesis of the chronic speech catatonic syndrome, possibly a rare form of chronic catatonia not previously described.

  12. Neuromyelitis optica spectrum disorder complicated with Sjogren syndrome successfully treated with tocilizumab: A case report.

    Science.gov (United States)

    Komai, Toshihiko; Shoda, Hirofumi; Yamaguchi, Kenichi; Sakurai, Keiichi; Shibuya, Mihoko; Kubo, Kanae; Takahashi, Toshiyuki; Fujio, Keishi; Yamamoto, Kazuhiko

    2016-01-01

    A 38-year-old woman with relapsing longitudinal extensive transverse myelitis and Sjogren's syndrome (SS) was admitted with lower extremity muscle weakness. Studies showed high serum titer of anti-aquaporin4 antibody and gadolinium-enhanced-MRI T1-weighted lesions within thoracic cord. Clinical findings suggested neuromyelitis optica-spectrum disorder (NMO-SD). High-dose corticosteroids, plasma exchange and cyclophosphamide were not effective. After starting tocilizumab, her neurological findings gradually improved. This report describes the first evidence to show tocilizumab could be effective for NMO-SD with SS.

  13. A successfully treated case of necrotizing fasciitis with complicated sepsis due to intramuscular steroid injection

    Directory of Open Access Journals (Sweden)

    Ahmet Karakas

    2016-12-01

    Full Text Available Necrotising fasciitis is a devastating soft tissue infection which characterised by rapidly progressing necrosis involving mainly fascia and subcutaneous tissues. A 66-year old male patient with chronic obstructive pulmonary disease admitted to our hospital with fever, pain and swelling in the right thigh and right leg, difficulty in walking, dry mouth and weakness. There was a single dose intramuscular steroid injection story in his anamnesis. Physical examination revealed swelling, hyperemia and pain in the right gluteal region spreading through the right femur and popliteal fossa. He was diagnosed necrotizing fasciitis complicated with sepsis. We administered the supportive therapy and broad-spectrum antibiotic therapy in addition to the surgical debridement, vacuum assisted closure and hyperbaric oxygen therapy. The patient was discharged after six months of the follow-up period in hospital. In conclusion, Health-care personnel should be careful when the intramuscular injections planned for patients at the risk of development of necrotizing fasciitis reason of their chronic illnesses or immunosuppressive conditions. In patients who developed necrotizing fasciitis despite everything, we want to strongly emphasise the advantageous hyperbaric oxygen therapy as an additional therapy to the broad spectrum antibiotherapy and surgical debridement [Cukurova Med J 2016; 41(4.000: 787-791

  14. [Haemorrhagic pineal cysts: two clinical cases successfully treated by means of microsurgery].

    Science.gov (United States)

    Arevalo, A; Pulido-Rivas, P; Gilo-Arrojo, F; Sola, R G

    2016-09-01

    Introduccion. Los quistes pineales son un hallazgo incidental relativamente frecuente en las pruebas de imagen; sin embargo, la apoplejia pineal se considera rara y se asocia a sintomas graves. Casos clinicos. Varon de 25 a˜os y mujer de 15 a˜os, que acudieron a urgencias con clinica de hipertension intracraneal; mediante pruebas de imagen se confirmo la existencia de una hemorragia pineal. Se les trato con exito mediante microcirugia. Conclusion. En nuestra experiencia, y avalado por la bibliografia, creemos que el mejor tratamiento de esta infrecuente patologia es el abordaje microquirurgico. Sin embargo, no se excluye la posibilidad de que, en un futuro, las tecnicas endoscopicas puedan tener un lugar importante en el tratamiento de la apoplejia pineal.

  15. A successful case on traditional Chinese fumigation-soaking therapy in treating diabetic peripheral neuropathy

    Institute of Scientific and Technical Information of China (English)

    Hongfang Liu; Huayang Wu; Lizhong Zhang; Jinxi Zhao

    2006-01-01

    AIM: To investigate the scheme of inducing the diabetic peripheral neuropathy (DNP) symptoms by combine Chinese traditional medicine with modern medicine. METHODS: Patient hospitalized on April 1, 2005. Main symptoms in hospitalization: His bilateral fingers and toe tips felt stabbing pain, numb, cold, assuming a type of sock set which alleviated after he had a rest and aggravated after exercise. He had also got the symptom of dizziness, asthenia, eating little food, very thin bowel and body pain which had influence on his sleeping. Physical examination in hospital: The bilateral lower limbs which got a hyperpathia did not swell. The bilateral dorsum pedis artery pulsation was atlenuarive. The skin temperature was not high. Other nerve system examination had been discovered abnormal. Diagnosis: Traditional Chinese medical diagnosis: Xiaokebing (blood stasis for insufficiency of qi, blockage of meridian and collaterals). Modern medical diagnosis: Diabetes type 2, DNP, diabetic lower limbs artery obliteration, diabetic foot (0 level), diabetic retinopathy, coronary atherosclerotic heart disease, hypertension, chronic bronchitis, chronic obstructive pulmonary emphysema. Carried on the former therapy plan that continued to use insulin to control blood glucose, depressed blood pressure and total plasma lipoprotein etc. Meanwhile used the therapy of bilateral feet medicinal bath (Sanling 30 g, Ezhu 30 g, Ruxiang 30 g, Moyao 30 g, Zhichuanwu 30 g, Zhicaowu 30 g, Weilingxian 30 g, Mugua 30 g, Sangzhi 30 g), boiled in water, 1 dose everyday, soak feet twice a day, 20-30 minutes once, < 37 ℃. RESULTS: Seven days later, the pain of bilateral feet alleviated obviously, and the bilateral dorsum pedis artery pulsation enhanced. Blood glucose and total plasma lipoprotein had no changes. CONCLUSION: The symptoms of DNP such as pain, coldness, numbness of the lower limbs can be induced by combining feet medicinal bath (fumigation-soaking) treatment with modern medicine.

  16. A case of lupus vulgaris successfully treated with antituberculous therapy despite negative PCR and culture.

    Science.gov (United States)

    Akoglu, Gulsen; Karaduman, Aysen; Boztepe, Gonca; Ozkaya, Ozay; Sahin, Sedef; Erkin, Gul; Kolemen, Fikret

    2005-01-01

    A 14-year-old boy presented with a pink firm plaque with well-defined borders in the right infra-orbital skin area. On diascopy, the infiltrate exhibited a typical apple-jelly appearance. No acid-fast bacilli could be demonstrated. A polymerase chain reaction (PCR) assay did not reveal the presence of mycobacteria in a lesional biopsy sample. Culture of biopsied tissue on Loewenstein-Jensen medium was negative. Although the tuberculosis culture and PCR did not confirm tuberculosis, a diagnosis of lupus vulgaris was made considering the clinical and histopathological findings. After a 9-month antituberculous therapy, the lesion disappeared. We believe that a diagnosis of lupus vulgaris still depends more on clinical and histopathological findings than on tuberculosis culture or PCR.

  17. A Case of Acquired Pulmonary Alveolar Proteinosis Successfully Treated with Whole Lung Lavage

    Science.gov (United States)

    2016-05-18

    of your presentation. It is important to update this information so that we can provide quality support for you, your department, and the Medical...within the alveoli . Surfactant phospholipids and proteins are produced by type II alveolar epithelial cells, and subsequently cleared by the

  18. [A case of advanced esophageal cancer with direct bronchial invasion successfully treated by multidisciplinary therapy].

    Science.gov (United States)

    Haba, Yusuke; Okamoto, Koichi; Watanabe, Toshifumi; Tsukada, Tomoya; Kinoshita, Jun; Makino, Isamu; Nakamura, Keishi; Oyama, Katsunobu; Ninomiya, Itasu; Fushida, Sachio; Fujimura, Takashi; Ohta, Tetsuo

    2014-11-01

    A 66-year-old man with advanced esophageal cancer (staging Mt, 6.0 cm, cT3N0M0, cStage II) was administered neoadjuvant chemotherapy (NAC: 5-fluorouracil and cisplatin). As the tumor continued to grow after one course of NAC, video-assisted thoracoscopic surgery(VATS) was used to perform an esophagectomy along with 3-field lymph node dissection and retrosternal route reconstruction using a gastric tube. The second course of NAC was not administered. Intraoperative findings showed the direct invasion of the primary esophageal cancer into the membranous portion of the left bronchus. The maximum possible tumor tissue was resected and removed. The tumor tissue was exposed extensively to the surface of the esophageal adventitia and a residual tumor at the surface of the left bronchus was suspected. It was diagnosed as CT-pT4 (left bronchus), N0, M0, CT-pStage III. Subsequently, we administered chemoradiotherapy consisting of weekly low-dose docetaxel with radiation for the residual tumor (60 Gy/30 Fr). The patient is still alive 40 months after surgery without any signs of recurrence.

  19. A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone

    Institute of Scientific and Technical Information of China (English)

    Soichi Sano; Katsunobu Yoshioka; Keiko Yamagami; Ayako Tanaka; Minako Nishio; Tomoyuki Nakamura; Yuki Kubo; Takeshi Inoue; Wataru Ueda; Kiyotaka Okawa

    2008-01-01

    A 76-year-old woman with a 5-mo history of recurrent diarrhea and generalized edema was admitted to our hospital. Colonoscopy revealed edematous mucosa, and histopathological examination was compatible with collagenous colitis. Protein leakage from the colon, particularly in the ascending portion, was identified on 99mTc-human serum albumin scintigraphy. Collagenous colitis associated with protein-losing enteropathy (PLE) without small bowel disease was diagnosed. Prednisolone treatment ameliorated diarrhea and hypoproteinemia. Collagenous colitis should be included in the differential diagnosis of chronic diarrhea with hypoproteinemia for appropriate management.

  20. [Surgical treatment of myopathic ptosis. Apropos of 20 surgically treated cases].

    Science.gov (United States)

    Morax, S; Longueville, E; Hurbli, T

    1992-08-01

    Twenty cases of severe progressive ophthalmoplegia (Myopathic ptosis) with significant ptosis were treated by various procedures, including levator resection with blepharoplasty or frontalis suspension using temporalis fascia. Surgical indications were generally limited to cases with poor or absent levator function. The results are analysed after an average follow-up of 6 months. The particular problems concerning surgery of myopathic ptosis are discussed.

  1. Clear-Cell Adenocarcinoma of Vesical Origin: A Case Study of Metastatic Disease Treated with Chemotherapy

    Directory of Open Access Journals (Sweden)

    Carolina Pena Álvarez

    2010-01-01

    Full Text Available Vesical clear cell adenocarcinoma is an uncommon tumour. The description of nearly all published cases focuses on histological issues, providing few clinical particulars and limited followup. The treatment choice is resection. No publications have been found regarding systemic treatments for advanced disease. We present a case of metastatic clear cell adenocarcinoma of the bladder treated with chemotherapy.

  2. Primary spinal glioblastoma treated with adjuvant radiation and temozolomide: Report of two cases

    Directory of Open Access Journals (Sweden)

    Supriya Mallick

    2015-01-01

    Full Text Available Primary spinal glioblastoma multiforme (GBM is a rare entity, which is invariably associated with poor outcome. Standard treatment is surgery followed by post-operative radiotherapy. Due to paucity of cases role of chemotherapy is investigational. We intend to report two cases of primary spinal GBM treated with radiation and adjuvant temozolomide.

  3. Mesonephroid adenocarcinoma in urethral diverticulum treated with diverticulectomy. Case report and review of the literature

    DEFF Research Database (Denmark)

    Jacobsen, F; Sørensen, Flemming Brandt; Nielsen, J B;

    1989-01-01

    A case of mesonephroid adenocarcinoma in an urethral diverticulum treated with diverticulectomy in a 53 year old female is reported. To our knowledge 26 cases of similar tumours have been reported in the literature. A review of symptoms, management and possible relationship to nephroid metaplasia...

  4. Integrative Analysis of Immunological Data to Explore Chronic Immune T-Cell Activation in Successfully Treated HIV Patients

    Science.gov (United States)

    Picat, Marie-Quitterie; Pellegrin, Isabelle; Bitard, Juliette; Wittkop, Linda; Proust-Lima, Cécile; Liquet, Benoît; Moreau, Jean-François; Bonnet, Fabrice; Blanco, Patrick; Thiébaut, Rodolphe

    2017-01-01

    Objectives To unravel the complex relationships between cytomegalovirus-induced-, autoimmune-induced responses, microbial translocation and chronic immune activation (CIA) in successfully treated HIV-infected patients and to explore the mediating role of alpha-interferon in these processes. Design Cross-sectional study nested in the ANRS CO3 Aquitaine Cohort, a prospective hospital-based cohort of HIV-1-infected patients in South-Western France. Methods Patients initiated antiretroviral therapy between 2005 and 2008 and were treated with sustained virological suppression for at least two years. CIA was defined by the percentage of HLA-DR+/CD38+ among CD8+T-cells. Integrative analyses were performed using structural equation modelling (SEM). Results The main analysis was performed in 57 HLA-A*0201 positive patients, due to availability of percentages of actin-, vimentin-, lamin-specific CD8+T-cells (HLA-A2-restricted tests) to further characterize autoimmune response. Cytomegalovirus-induced response was assessed by Quantiferon and pp-65 ELISPOT. SEM revealed a direct effect of cytomegalovirus-induced response on CIA (standardized estimate βstd = 0.56, p-value = 0.0004). The effect of autoimmune-induced response on CIA was indirect through alpha-interferon pathway, assessed by expression levels of 5 alpha-interferon-stimulated genes ADAR, ISG15, IFIT1, Mx1 and OAS1 (effect of autoimmune response on alpha-interferon: βstd = 0.36, p-value = 0.0401; effect of alpha-interferon on CIA: βstd = 0.39, p-value = 0.0044). There was no direct effect of autoimmune-induced response on CIA (p-value = 0.3169). Microbial translocation as measured by 16SrDNA and sCD14 in plasma was not associated with CIA. Results were consistent in 142 patients in whom cytomegalovirus and auto-immunity responses were measured by Quantiferon and anti-nuclear antibodies, respectively. All analyses performed in HLA-A*0201 positive patients and in the overall population revealed a significant effect

  5. How to Ask for a Favor: A Case Study on the Success of Altruistic Requests

    CERN Document Server

    Althoff, Tim; Jurafsky, Dan

    2014-01-01

    Requests are at the core of many social media systems such as question & answer sites and online philanthropy communities. While the success of such requests is critical to the success of the community, the factors that lead community members to satisfy a request are largely unknown. Success of a request depends on factors like who is asking, how they are asking, when are they asking, and most critically what is being requested, ranging from small favors to substantial monetary donations. We present a case study of altruistic requests in an online community where all requests ask for the very same contribution and do not offer anything tangible in return, allowing us to disentangle what is requested from textual and social factors. Drawing from social psychology literature, we extract high-level social features from text that operationalize social relations between recipient and donor and demonstrate that these extracted relations are predictive of success. More specifically, we find that clearly communic...

  6. Forty Cases of Insomnia Treated by Suspended Moxibustion at Baihui (GV 20)

    Institute of Scientific and Technical Information of China (English)

    JU Yan-li; CHI Xu; LIU Jian-xin

    2009-01-01

    Objective:To observe the therapeutic effect of suspended moxibustion at Baihui (GV 20) for insomnia.Methods: 75 cases were divided randomly into two groups, with 40 cases in the treatment group treated by suspended moxibustion over Baihui (GV 20) and 35 cases in the control group treated by oral administration of Estazolam. Results: The difference in therapeutic effect between the two groups was not statistically significant (P>0.1). Conclusion: It was concluded that suspended moxibustion at Baihui (GV 20) is as effective as Estazolam for insomnia.

  7. Fifty Cases of Chloasma Treated by Acupuncture plus Intensive Pulse Light Irradiation

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To observe the clinical therapeutic effect of acupuncture plus intensive pulse light irradiation on chloasma. Methods: Ninety-six cases of chloasma were randomly divided into two groups, the control group of 46 cases treated by simple acupuncture and the treatment group of 50 cases treated by acupuncture and intensive pulse light irradiation. Results: The total effective rate was 89.1% and 98.0% in the control group and treatment group respectively, with a significant difference between the two groups (P<0.05). Conclusion: For chloasma, the effect of treatment with acupuncture plus intensive pulse light irradiation is superior to that with simple acupuncture.

  8. Supporting clinical management of the difficult-to-treat TB cases: the ERS-WHO TB Consilium.

    Science.gov (United States)

    D'Ambrosio, Lia; Tadolini, Marina; Centis, Rosella; Duarte, Raquel; Sotgiu, Giovanni; Aliberti, Stefano; Dara, Masoud; Migliori, Giovanni Battista

    2015-03-01

    Multi-drug and extensively drug-resistant tuberculosis (MDR/XDR-TB) are considered a serious threat for TB control and elimination. The outcome of these patients is still largely unsatisfactory as of today, with treatment success rates being consistently below 50% at global level. The World Health Organization (WHO) recommends that management of MDR-TB cases is supported by a specialized team, including complementary medical professionals able to cover several perspectives (clinical, both for adults and children; surgical; radiological; public health; psychological; nursing, among others). Implementation of such a body (known as Consilium in most of the former Soviet Union countries) is often a pre-requisite to apply for international TB control funding and concessionally priced medicines to treat M/XDR-TB cases. The primary objective of the ERS/WHO TB Consilium is to provide clinical consultation for drug-resistant TB and other difficult-to-treat TB cases, including co-infection with HIV and paediatric cases. Through technical guidance to clinicians managing complex TB cases, the main contribution and outcome of the initiative will be a public health response aimed at achieving correct treatment of affected patients and preventing further development of drug resistance. The Consilum's secondary objective is to ensure monitoring and evaluation of clinical practices on the ground (diagnosis, treatment and prevention).

  9. Lessons for public health campaigns from analysing commercial food marketing success factors: a case study

    Science.gov (United States)

    2012-01-01

    Background Commercial food marketing has considerably shaped consumer food choice behaviour. Meanwhile, public health campaigns for healthier eating have had limited impact to date. Social marketing suggests that successful commercial food marketing campaigns can provide useful lessons for public sector activities. The aim of the present study was to empirically identify food marketing success factors that, using the social marketing approach, could help improve public health campaigns to promote healthy eating. Methods In this case-study analysis, 27 recent and successful commercial food and beverage marketing cases were purposively sampled from different European countries. The cases involved different consumer target groups, product categories, company sizes and marketing techniques. The analysis focused on cases of relatively healthy food types, and nutrition and health-related aspects in the communication related to the food. Visual as well as written material was gathered, complemented by semi-structured interviews with 12 food market trend experts and 19 representatives of food companies and advertising agencies. Success factors were identified by a group of experts who reached consensus through discussion structured by a card sorting method. Results Six clusters of success factors emerged from the analysis and were labelled as "data and knowledge", "emotions", "endorsement", "media", "community" and "why and how". Each cluster subsumes two or three success factors and is illustrated by examples. In total, 16 factors were identified. It is argued that the factors "nutritional evidence", "trend awareness", "vertical endorsement", "simple naturalness" and "common values" are of particular importance in the communication of health with regard to food. Conclusions The present study identified critical factors for the success of commercial food marketing campaigns related to the issue of nutrition and health, which are possibly transferable to the public health

  10. Lessons for public health campaigns from analysing commercial food marketing success factors: a case study

    Directory of Open Access Journals (Sweden)

    Aschemann-Witzel Jessica

    2012-02-01

    Full Text Available Abstract Background Commercial food marketing has considerably shaped consumer food choice behaviour. Meanwhile, public health campaigns for healthier eating have had limited impact to date. Social marketing suggests that successful commercial food marketing campaigns can provide useful lessons for public sector activities. The aim of the present study was to empirically identify food marketing success factors that, using the social marketing approach, could help improve public health campaigns to promote healthy eating. Methods In this case-study analysis, 27 recent and successful commercial food and beverage marketing cases were purposively sampled from different European countries. The cases involved different consumer target groups, product categories, company sizes and marketing techniques. The analysis focused on cases of relatively healthy food types, and nutrition and health-related aspects in the communication related to the food. Visual as well as written material was gathered, complemented by semi-structured interviews with 12 food market trend experts and 19 representatives of food companies and advertising agencies. Success factors were identified by a group of experts who reached consensus through discussion structured by a card sorting method. Results Six clusters of success factors emerged from the analysis and were labelled as "data and knowledge", "emotions", "endorsement", "media", "community" and "why and how". Each cluster subsumes two or three success factors and is illustrated by examples. In total, 16 factors were identified. It is argued that the factors "nutritional evidence", "trend awareness", "vertical endorsement", "simple naturalness" and "common values" are of particular importance in the communication of health with regard to food. Conclusions The present study identified critical factors for the success of commercial food marketing campaigns related to the issue of nutrition and health, which are possibly

  11. Pediatric seizure-related posttraumatic stress and anxiety symptoms treated with EMDR: a case series

    Science.gov (United States)

    Dautovic, Elmedina; de Roos, Carlijn; van Rood, Yanda; Dommerholt, Agnes; Rodenburg, Roos

    2016-01-01

    Purpose To examine the potential effects of eye movement desensitization and reprocessing (EMDR) in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods Five children (aged 8–18) with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED) pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results Before EMDR, overall or subscale scores indicated that all children had (sub)clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session). Conclusions In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy. Highlights of the article The first study to examine the potential effects of EMDR to reduce clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms in children with epilepsy. After 1–3 EMDR (45 min) sessions, positive treatment effects were found on a range of seizure-related PTSD symptoms and/or anxiety symptoms. During treatment, no seizures, absences, or any other adverse events were observed; the seizure diaries showed that none of the children experienced more seizures (or an unusual pattern) after treatment. At the reevaluation of EMDR, all children and parents

  12. Three cases of immune-mediated adnexal skin disease treated with cyclosporin.

    Science.gov (United States)

    Noli, Chiara; Toma, Stefano

    2006-02-01

    Cyclosporin is currently considered a new and interesting drug in veterinary dermatology for the treatment of immune-mediated skin diseases, and a safe and effective alternative to immunosuppressive therapy with glucocorticoids. The authors report a case of granulomatous folliculitis and furunculosis and of sebaceous adenitis in two cats and a case of alopecia areata in a dog, successfully controlled with cyclosporin.

  13. Case report: a case of intractable Meniere's disease treated with autogenic training

    Directory of Open Access Journals (Sweden)

    Nakai Kimiko

    2008-01-01

    Full Text Available Abstract Background Psychological stress plays an important role in the onset and course of Meniere's disease. Surgical therapy and intratympanic gentamicin treatment are options for cases that are intractable to conventional medical therapy. Psychotherapy, however, including autogenic training (AT, which can be used for general relaxation, is not widely accepted. This paper describes the successful administration of AT in a subject suffering from intractable Meniere's disease. Case presentation A 51-year-old male patient has suffered from fluctuating right sensorineural hearing loss with vertigo since 1994. In May 2002, he was first admitted to our hospital due to a severe vertigo attack accompanied by right sensorineural hearing loss. Spontaneous nystagmus toward the right side was observed. Since April 2004, he has experienced vertigo spells with right-sided tinnitus a few times per month that are intractable to conventional medical therapy. After four months, tympanic tube insertion was preformed in the right tympanic membrane. Intratympanic injection of dexamethasone was ineffective. He refused Meniett therapy and intratympanic gentamicin injection. In addition to his vertigo spells, he suffered from insomnia, tinnitus, and anxiety. Tranquilizers such as benzodiazepines and antidepressants such as serotonin selective re-uptake inhibitors (SSRIs failed to stop the vertigo and only slightly improved his insomnia. In December 2006, the patient began psychological counseling with a psychotherapist. After brief psychological counseling along with cognitive behavior therapy (CBT, he began AT. He diligently and regularly continued his AT training in his home according to a written timetable. His insomnia, tinnitus, and vertigo spells disappeared within a few weeks after only four psychotherapy sessions. In order to master the six standard formulas of AT, he underwent two more sessions. Thereafter, he underwent follow-up for 9 months with no

  14. Seventy Cases of External Humeral Epicondylitis Treated by Local Blocking and Massotherapy

    Institute of Scientific and Technical Information of China (English)

    王兴峰

    2001-01-01

    @@External humeral epicondylitis or tennis elbow, is a commonly encountered disease in orthopaedics and traumatology. The curative effect is not satisfactory as far as its treatment by western and traditional Chinese medicine is concerned, which has a long course of treatment and a high recurrent rate. 70 cases of external humeral epicondylitis were treated by massotherapy after local blocking from August 1995 to October 1997 at this hospital with satisfactory therapeutic effects. Clinical Data Of the 70 cases in this series treated by massotherapy after local blocking, 30 were males and 40 females, ranging in age from 19 to 65 years. 55 cases were 30 to 50 years old, 20 had the left elbow affected and 50 the right elbow. 7 cases had a history of trauma, 50 a history of chronic strain, and 13 the cause unknown. The shortest duration of disease was 15 days and the longest 24 months. Among 50 cases in the control group treated by massotherapy, 20 cases were males and 30 females, ranging in age from 16 to 58 years. 40 cases were 30 to 50 years old. 15 cases were affected on the left elbow and 35 on the right elbow. 6 cases had a history of trauma, 32 a history of chronic strain, and 12 the cause unknown. The shortest duration of diseases was 7 days and the longest 22 months.

  15. The Chang Management Strategies and Processes for Successful ERP Implementation-A Case Study of MADAR

    Directory of Open Access Journals (Sweden)

    Hala M Al-Shamlan

    2011-03-01

    Full Text Available Top management usually faces an unexpected attitude from potential users during implementing an enterprise resource planning (ERP system. For one reason or another, they resist the implementation process and may cause the failure of ERP system. Therefore, top management should be deal with this problem using effective change management strategies and processes. In this paper, we discuss the successful change management strategies and processes in literature. A case study of MADAR has been presented to discover the strategies and processes used for the successful enterprise system.

  16. Successful Ziprasidone Monotherapy in a Case of Delusional Parasitosis: A One-Year Followup

    Directory of Open Access Journals (Sweden)

    Domenico De Berardis

    2013-01-01

    Full Text Available Delusional parasitosis is characterized by the false idea that own body is infested by invisible mites, insects, or other parasites. This case report describes a 24-year-old woman with delusional parasitosis who was treated with ziprasidone monotherapy (120 mg/day with a complete remission of delusion and followed for one year without symptom recurrences. These findings, although preliminary, indicate that further investigation of ziprasidone monotherapy for the treatment of delusional parasitosis is warranted in further trials.

  17. Successful treatment of SAPHO syndrome with severe spinal disorder using entercept: a case study.

    Science.gov (United States)

    Zhang, L L; Zhao, J X; Liu, X Y

    2012-07-01

    SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare disease. Presently, there is no treatment guideline for this illness. Several studies suggested entercept, a novel biological agent against tumor necrosis factor-alpha, is effective in treating SAPHO syndrome. We report a case in which the clinical conditions of a middle-aged female patient diagnosed with SAPHO syndrome, with noted spinal disorder, improved significantly after receiving entercept treatment. The patient remained stable after 3-month follow-up.

  18. Granulomatous Cheilitis: Successful Treatment of Two Recalcitrant Cases with Combination Drug Therapy

    Directory of Open Access Journals (Sweden)

    Ambika Gupta

    2014-01-01

    Full Text Available Granulomatous cheilitis is a rare, idiopathic, inflammatory disorder which usually affects young adults. It is characterized by persistent, diffuse, nontender, soft-to-firm swelling of one or both lips. Various treatment modalities have been suggested. In spite of the best treatment, recurrence of the disease is very common. We report two cases of granulomatous cheilitis treated with a combination of steroids, metronidazole, and minocycline with no signs of relapse at one-year follow-up.

  19. Granulomatous Cheilitis: Successful Treatment of Two Recalcitrant Cases with Combination Drug Therapy

    OpenAIRE

    Ambika Gupta; Harneet Singh

    2014-01-01

    Granulomatous cheilitis is a rare, idiopathic, inflammatory disorder which usually affects young adults. It is characterized by persistent, diffuse, nontender, soft-to-firm swelling of one or both lips. Various treatment modalities have been suggested. In spite of the best treatment, recurrence of the disease is very common. We report two cases of granulomatous cheilitis treated with a combination of steroids, metronidazole, and minocycline with no signs of relapse at one-year follow-up.

  20. Successful Treatment of a Large Pelvic Abscess Using Intraluminal VAC: A Case Report.

    Science.gov (United States)

    Aras, Abbas; Celik, Sebahattin; Kiziltan, Remzi; Yilmaz, Özkan; Kotan, Çetin

    2016-04-01

    The most feared complication of the surgical treatment of rectal cancer is anastomotic leakage, which is related to high rates of mortality and morbidity. Here, we present a patient who could not be treated with surgical drainage but treated by intraluminal Vacuum Associated Closure (VAC). A 34-year-old male patient was treated for rectal cancer by low anterior resection, colorectal anastomosis, and diverting ileostomy following neoadjuvant CRT. The patient reported with a postoperative anastomotic disruption and a large pelvic abscess. Due to the continuation of foul-smell drainage inspite of perianal incision and drainage, intraluminal VAC was applied and the pelvic abscess and the foul-smell were successfully treated. The presence of an adequate anal sphincter tonus is a disadvantage in anastomotic leakage, since it prevents the emptying of the intestinal content and also precludes the drainage of the pelvic abscess. The endoluminal application of VAC, similar to the results of application of VAC in open wounds, has been demonstrated to decrease fibrin and necrotic tissue in the pelvic cavity and increase granulation tissue. VAC, which has long been used in the treatment of open wounds, is a promising method in the treatment of large pelvic abscesses due to anastomotic leakage following rectum resection.

  1. The Clinical Report on the 3 Cases of Sciatica treated on Direct Moxibustion

    Directory of Open Access Journals (Sweden)

    Jun-Hyuk Kang

    2007-06-01

    Full Text Available Objectives : The purpose of this report is to examine the effects of direct moxibustion on the Low back pain and Lowerlimb radiating pain. Methods : The patients were hospitalized in Daejeon Univ. Oriental Hospital and treated with acupuncture treatment, physical treatment and direct moxibustion. After treatments, we measured the Results & Conclusions : VAS(Visual Analogue Scale and PRS(Pain Rating Scale. VAS(Visual Analogue Scale and PRS(Pain Rating Scale scores were improved in 3 cases of Low back pain and Lowerlimb radiating pain treated with direct moxibustion. So it is suggested that direct moxibution have the possibility to treat on sciatica

  2. Sofosbuvir and Ribavirin to Treat Hepatitis C Virus Genotype 4 Infection in a 65-Year-Old Patient With Diabetes and Low Platelet: A Case Report

    Directory of Open Access Journals (Sweden)

    Hussein

    2016-08-01

    Full Text Available Introduction Hepatitis C virus (HCV is a major public health problem especially in the elderly. The classical interferon/ribavirin regimen was unfavorable for elderly patents due to intolerability and adverse effects. More studies are needed about the safety profile of new direct-acting antiviral (DAA in the elderly. Case Presentation Here, a case of chronic HCV was described in a 65-year-old female with diabetes and low platelet count. The patient was treated successfully by a combination of sofosbuvir+ ribavirin without major side effects. Conclusions This report highlighted the importance and the safety of this regimen to treat HCV in the elderly.

  3. Successful treatment of two cases of urorectal septum malformation sequence with oligohydramnios and severe respiratory failure

    Directory of Open Access Journals (Sweden)

    Sekiguchi K

    2013-03-01

    Full Text Available Kazuhito Sekiguchi, Daijiro Takahashi, Takehiko Hiroma, Tomohiko Nakamura Division of Neonatology, Nagano Children's Hospital, Nagano, Japan Abstract: Urorectal septum malformation sequence can be diagnosed prenatally. We report herein the successful treatment of severe respiratory failure in two patients with urorectal septum malformation sequence and prenatally diagnosed oligohydramnios. The patients showed significant hypoxic deterioration and persistent pulmonary artery hypertension soon after birth. We used high-frequency ventilation (HFO, nitric oxide (NO, and extracorporeal membrane oxygenation (ECMO. The patients were successfully weaned from ECMO and artificial ventilation and discharged to home. Although termination of the pregnancy has often been selected for fetuses with oligohydramnios-related urorectal septum malformation sequence, our results suggest the opportunity for these fetuses to be treated using respiratory supports including HFO, NO, and ECMO after birth. Keywords: urorectal septum malformation sequence, oligohydramnios, pulmonary hypoplasia

  4. Successful laparoscopic bipolar coagulation of a large arteriovenous malformation due to invasive trophoblastic disease: a case report.

    Science.gov (United States)

    Corusic, Ante; Barisic, Dubravko; Lovric, Helena; Despot, Albert; Planinic, Pavao

    2009-01-01

    We report the case of an acquired large arteriovenous malformation due to invasive gestational trophoblastic tumor that was treated successfully with laparoscopic surgery. After 4 cycles of methotrexate chemotherapy, a vascular tangle (volume, 28 cm(3)) was noted that emerged from the right uterine horn, invading the broad ligament adjacent to the uterine artery. Doppler ultrasonography along with magnetic resonance arteriography confirmed the diagnosis. The location, size and relation of this arteriovenous malformation to the uterine vasculature demanded urgent intervention. Laparoscopy was performed, and bipolar coagulation of the ovarian and uterine artery feeding branches was achieved after surgical resection of the tumor. The defect in the uterine wall with an intact uterine cavity was reconstructed using sutures. There were no intraoperative or postoperative complications. The patient underwent chemotherapy, and at 2-month follow-up was cured and has since had regular menstrual cycles.

  5. Successful palliative approach with high-intensity focused ultrasound in a patient with metastatic anaplastic pancreatic carcinoma: a case report

    Science.gov (United States)

    Ungaro, Antonio; Orsi, Franco; Casadio, Chiara; Galdy, Salvatore; Spada, Francesca; Cella, Chiara Alessandra; Tonno, Clementina Di; Bonomo, Guido; Vigna, Paolo Della; Murgioni, Sabina; Frezza, Anna Maria; Fazio, Nicola

    2016-01-01

    We report a case of a 74-year-old man with a metastatic anaplastic pancreatic carcinoma (APC). After an early tumour progression on first-line chemotherapy with cisplatin and gemcitabine, even though it was badly tolerated, he was treated with a combination of systemic modified FOLFIRI and high-intensity focused ultrasound (HIFU) on the pancreatic mass. A tumour showing partial response with a clinical benefit was obtained. HIFU was preferred to radiotherapy because of its shorter course and minimal side effects, in order to improve the patient’s clinical conditions. The patient is currently on chemotherapy, asymptomatic with a good performance status. In referral centres, with specific expertise, HIFU could be safely and successfully combined with systemic chemotherapy for treatment of metastatic pancreatic carcinoma. PMID:27170835

  6. Sustaining Innovative Success: A Case Study on Consumer-Centric Innovation in the ICT Industry

    Directory of Open Access Journals (Sweden)

    Minkyung Choy

    2016-09-01

    Full Text Available The phenomenon of innovation growing rapidly and having a shorter lifespan is a structural change due to the development of ICT (Information and Communications Technology, diverse investment methods, and reduced pattern of innovation adoption. For ICT companies to survive and maintain their success in this ever-changing environment, they need to succeed in fulfilling both productivity and accuracy of innovation. To sustain their innovative success, ICT companies should consistently maintain the direction of innovation towards consumers. The present study analyzes various cases of ICT companies which succeeded or failed to maintain their prior innovative success, and suggests consumer-centric innovation as a solution. To create consumer-centric innovations, companies have to (1 predict the dynamically evolving demand of consumers and continuously transform; (2 proactively employ observation method and big data analysis to discover hidden demands; and (3 identify hassles such as wastes, inconveniences, and anxieties, and put effort in solving these hassles.

  7. Successful salvage therapy of Fusarium endophthalmitis secondary to keratitis: an interventional case series

    Directory of Open Access Journals (Sweden)

    Comer GM

    2012-05-01

    Full Text Available Grant M Comer, Maxwell S Stem, Stephen J SaxeUniversity of Michigan, Department of Ophthalmology and Visual Sciences, Ann Arbor, MI, USAPurpose: To describe a combination of treatment modalities used for the successful eradication of Fusarium endophthalmitis.Design: Interventional case series.Participants: Three consecutive patients with keratitis-associated Fusarium endophthalmitis.Methods: After failure of traditional management options, a combination of intravitreal and long-term, high-dose systemic voriconazole, topical antifungal medications, and surgical intervention, with penetrating keratoplasty, lensectomy, and endoscopic-guided pars plana vitrectomy, was administered to each patient.Results: All three cases achieved full resolution of the infection, with a final Snellen visual acuity score of 20/50 to 20/70.Conclusions: An aggressive combination of therapeutic modalities, including the removal of subiris abscesses, might be needed for the successful resolution of Fusarium endophthalmitis.Keywords: endophthalmitis, fungal, Fusarium, keratitis, keratoplasty, voriconazole 

  8. Successful pregnancy after excision of cesarean scar endometriosis with uterovesicocutaneous fistula: A rare case report

    Science.gov (United States)

    Juneja, Sunil Kumar; Tandon, Pooja; Chopra, Isha

    2016-01-01

    Scar endometriosis is an infrequent type of extrapelvic endometriosis. The most common extrapelvic form of endometriosis is cutaneous endometriosis, involving scar tissues occurring after obstetric or gynecologic procedures such as episiotomy, hysterotomy, cesarean section, and even laparoscopic surgery. The clinical presentation of scar endometriosis, i.e., tender swellings, mimics other dermatological and/or surgical conditions and delays the diagnosis. Scar endometriosis very rarely can get complicated with uterocutaneous fistula with a reported incidence of very few cases in world literature. We report a case of a 36-year-old woman presenting with scar endometriosis with complicated uterocutaneous fistula 11 years after her last lower segment cesarean section, managed successfully with laparotomy-fistulectomy and sleeve resection of the bladder with repair followed by successful subsequent spontaneous conception and pregnancy terminated by lower segment cesarean section. PMID:27857904

  9. Assessment of Health Status of Successfully Treated Category I Patients under RNTCP Program, Five Years After Treatment Completion and ndash; A Retrospective Cohort Study from A Coastal District of India

    Directory of Open Access Journals (Sweden)

    Kirthinath Ballal

    2016-05-01

    Full Text Available "Background: Tuberculosis remains a major public health problem worldwide and also in India. Inspite of RNTCP being a comprehensive programme for effective management and control of tuberculosis, efficacy of DOTS regimen is questioned by private practitioners. Methods: A retrospective cohort study was carried out in a coastal district of India to assess the health status of successfully treated Category I patients under RNTCP program, five years after treatment completion. An interview was conducted with all the available subjects at their residence using a semi-structured pre-tested interview. Results: Out of 224 registered new sputum positive patients, 177 cases were successfully treated during the recruiting year, accounting for a success rate of 79%. Of the 177 treated patients, 118 were traceable during the study period, out of which 100 subjects had survived after 5 years and were available for the interview. Recurrence of TB was reported in 2 patients during the follow up period. Conclusion: This five years follow up study shows a good long term success rate of TB patient's treatment. Hence, it reaffirms the scientific basis of RNTCP policy of DOTS regimen to be the right strategy for TB control. [Natl J Community Med 2016; 7(5.000: 425-429

  10. Fifty Cases of Parkinson's Disease Treated by Acupuncture Combined with Madopar

    Institute of Scientific and Technical Information of China (English)

    REN Xiao-ming

    2008-01-01

    objective;To search for an effective therapy for trealing motor disorder due to Parkinson's disease(PD).Methods;Fifty cases in a treatrnent group were treated by acupuncture combined with madopar,and 30 cases in a control group treated by madopar only.Results;A total effective rate of 92%was achieved with obvious alleviation of motor disorder in the treatment group,which was significantly higher than that in the control group(P<0.05).Conclusion;Acupuncture can enhance therapeutic effects of western medicine and lessen the dose of the medicine needed.

  11. [Two cases of phytobezoars treated by adminsitration of Coca-Cola by oral route].

    Science.gov (United States)

    Lee, Hyun Jai; Kang, Hyoun Goo; Park, Se Young; Yi, Chea Yong; Na, Gyoung Jun; Lee, Tae Yeong; Kim, Sang Hyun; Song, Chul Soo

    2006-12-01

    Bezoars are concretions of foreign bodies found in the gastrointestinal tract. In the past, most common method for the treatment of bezoar was surgical management. However, the current treatment methods include chemical dissolution and endoscopic mechanical lithotripsy. There were few reports on the treatment of phytobezoars by nasogastric Cola lavage. However, there was no report succeeded by oral route alone. In our two cases, phytobezoars were treated by oral administration of Coca-Cola. Our patients drank 700-800 mL of Coca-Cola daily, and after two months, complete dissolutions of bezoars were achieved. We report two cases of phytobezoars completely treated by drinking Coca-Cola.

  12. Forty-five Cases of Apoplexy Treated by Electroacupuncture at the Points of Yin Meridians

    Institute of Scientific and Technical Information of China (English)

    李静铭

    2001-01-01

    Forty-five cases of apoplexy were treated by electroacupuncture only at the points of Yin Meridians (i.e. the Hand- and Foot-Taiyin Meridians), and the other 30 cases as the controls were treated only at the points of Yang Meridians (i.e. the Hand- and Foot-Yangming Meridians). The total effective rate was 91.1% in the former and 86.7% in the latter, with no statistically significant difference between the two groups, indicating that acupuncture only at the points of Yin-Meridians is also an effective therapy for apoplexy.

  13. CASES ON GLOBAL E-LEARNING PRACTICES:Successes and Pitfalls

    OpenAIRE

    Yavuz Akbulut

    2007-01-01

    Cases on Global E-Learning Practices: Successes and Pitfalls” look into the global practices of e-learning which has assumed a considerable role in the education sector recently. It is edited by Ramesh C. Sharma and Sanjaya Mishra from Indira Gandhi National Open University in New Delhi, India. It is published by Information Science Publishing, which is an imprint of Idea Group, an international publishing company specializing in research publications in the fields of technology, management ...

  14. Periocular necrotizing fasciitis associated with kerato-conjunctivitis and treated with medical management: A case report

    Directory of Open Access Journals (Sweden)

    Shome Debraj

    2008-01-01

    Full Text Available We report a 25-year-old systemically healthy male who presented with periocular necrotizing fasciitis (NF in the left eyelid. This was associated with the presence of immunologically mediated marginal kerato-conjunctivitis, in the same eye. This potentially dangerous lid infection and the associated ocular surface infection resolved successfully, with medical management. We report this case to highlight the successful conservative management of periocular NF and the hitherto unreported anterior segment involvement.

  15. Successful Pregnancy Outcome in an Operated Case of Lipomeningomyocele: A Rare Case

    Science.gov (United States)

    Nanda, Sakshi; Aggarwal, Rohina; Tanvir

    2016-01-01

    Lipomeningomyocele is one of the types of occult spinal dysraphism associated with tethered cord syndrome, which is characterised by neurodeficit symptomatology due to stretch- induced functional disorder of the spinal cord with its caudal part attached by an in elastic tissue. There is stretching of conus medullaris and nerve roots due to disproportionate growth between vertebral column and spinal cord, resulting in various neurological deficits. Its incidence is approximately 1 in 4000 births in the USA, with a slightly higher female preponderance, although its true incidence is not known. There are very few studies on pregnancy outcome in these patients and the management dilemma in this group has prompted us to report this case. PMID:27790529

  16. An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate.

    LENUS (Irish Health Repository)

    Coleman, E

    2010-03-01

    Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac-arrested patient was successfully resuscitated using extracorporeal circulation (ECC).

  17. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid

    OpenAIRE

    Hideki Yasui; Koshi Yokomura; Takafumi Suda

    2016-01-01

    Acute exogenous lipoid pneumonia is a rare disorder in adults. A treatment of choice for lipoid pneumonia has not been established, and systemic corticosteroid use remains controversial. We report the case of a 32-year-old man with schizophrenia who presented with kerosene-induced acute exogenous lipoid pneumonia that was treated with a systemic corticosteroid. In this case, supportive therapy did not improve the patient's condition, so systemic corticosteroid therapy was commenced four days ...

  18. Case Study in RefractoryNon-Hodgkin’s Lymphoma: Successful Treatment with Plerixafor

    Directory of Open Access Journals (Sweden)

    Hamdy Abdel Azim

    2011-09-01

    Full Text Available The present case study describes our experience in treating a young woman diagnosed with a relapsing case of diffuse large cell lymphoma, who was heavily pre-treated with chemotherapy and radiotherapy. Our only chance to improve her survival was by using high-dose chemotherapy, followed by peripheral stem cell rescue. Unfortunately, in this patient, collecting sufficient stem cells for bone marrow transplantation proved to be very difficult since she had already been heavily treated with chemotherapy and radiotherapy. Currently, granulocyte colony-stimulating factor (G-CSF alone or G-CSF plus chemotherapy are the most commonly used treatments for stem cell mobilization. However, 5–30% of patients do not respond to these agents. Plerixafor is a new hematopoietic stem cell-mobilizing drug that antagonizes the binding of chemokine stromal cell-derived factor-1α to CXC chemokine receptor 4. It is indicated in combination with G-CSF to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with non-Hodgkin’s lymphoma and multiple myeloma [Kessans et al.: Pharmacotherapy 2010;30:485–492; Jantunen: Expert Opin Biol Ther 2011;11:1241–1248]. Based on our findings, we consider plerixafor to be a very efficient and practical solution to mobilize and collect stem cells among all patients in such a situation, enabling us to proceed to autologous bone marrow transplantation and peripheral stem cell rescue in order to improve the patients’ overall survival.

  19. A CASE OF CHRONIC RENAL VEIN THROMBOSIS TREATED WITH THROMBOLYTIC DRUGS

    Directory of Open Access Journals (Sweden)

    S. H. Mousavi Bahar

    2006-05-01

    Full Text Available Renal vein thrombosis (RVT is the most frequent vascular abnormality in newborns, but rarely seen in adults. RVT is an acute problem, and diagnostic and therapeutic approaches should be done immediately. Surgical thrombectomy is not a rational approach and the treatment of choice is conservative management and thrombolytic therapy. We present a 45 years old male patient with chronic renal vein thrombosis who was treated with thrombolytic therapy successfully.

  20. Two Cases of Carcinoma with Tracheobronchial Stenosis Treated by Self-expanding Nitinol Stents(Sens)

    OpenAIRE

    山本,夏男; 宮下,義啓; 千葉,成宏

    1999-01-01

    Two cases with tracheobronchial stenosis due to tumors(lung and esophageal cancer) were treated by Self-expanding nitinol stent(Ultraflex). Severe dyspnea and stridor were markedly impromed after placement of nitinol stents. Insertion of Ultraflex is easy and useful for prevention and improvement of airway obstruction.

  1. Forty Cases of Insomnia Treated by Multi-output Electric Pulsation and Auricular Plaster Therapy

    Institute of Scientific and Technical Information of China (English)

    Liu Weizhe

    2007-01-01

    @@ The writer has treated 40 cases of insomnia by the method of multi-output electric pulsation in combination with auricular plaster therapy (with a seed of Vaccariae segetalis 王不留行 taped tightly to a particular ear point and pressed) and received satisfactory therapeutic effects. A report follows.

  2. Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples

    Science.gov (United States)

    Peterson, Brennan D.; Eifert, Georg H.; Feingold, Tal; Davidson, Sarah

    2009-01-01

    Although the field of couple therapy has made significant strides in recent years, there continues to be a need for theoretically sound and empirically supported treatments. The current case study examines whether Acceptance and Commitment Therapy (ACT), an experiential acceptance-based behavior therapy, can be effective in treating distressed…

  3. Variation in case-mix between hospitals treating colorectal cancer patients in the Netherlands

    NARCIS (Netherlands)

    Kolfschoten, N.E.; Marang van de Mheen, P.J.; Gooiker, G.A.; Eddes, E.H.; Kievit, J.; Tollenaar, R.A.E.M.; Wouters, M.W.; Bemelman, W.A.; Busch, O.R.; Dam, R.M. van; Harst, E. van der; Jansen-Landheer, M.L.E.A; Karsten, T.M.; Krieken, J.H.J.M. van; Kuijpers, W.G.T.; Lemmens, V.E.; Manusama, E.R.; Meijerink, W.J.H.J.; Rutten, H.J.; Wiggers, T.; Velde, C.J. van de

    2011-01-01

    AIMS: The purpose of this study was to determine how expected mortality based on case-mix varies between colorectal cancer patients treated in non-teaching, teaching and university hospitals, or high, intermediate and low-volume hospitals in the Netherlands. MATERIAL AND METHODS: We used the databas

  4. Fifty-Six Cases of Acne Treated by Auricular Needle-Embedding

    Institute of Scientific and Technical Information of China (English)

    侯慧先; 吴童

    2002-01-01

    @@ Acne is an inflammatory disease often affecting the boys and girls at the pubescent age, with a tendency of affecting the females aged 30-45 years. We have treated 56 cases of acne by auricular needle-embedding with satisfactory therapeutic results as reported in the following.

  5. 60 CASES OF BONE BI OF LUMBAR VERTEBRAE TREATED WITH LONG-ROUND NEEDLE

    Institute of Scientific and Technical Information of China (English)

    XueLigong; ZhangHairong

    2000-01-01

    Bone bi of the lumbar vertebrae is a common and frequently encountered disease in the middle-aged and old people. The autbor of the article treated 60 cases of bone bi of the lumbar vertebrae complicated with lumbocrural pain with the "long-round" needle which was made

  6. Thirty-six Cases of Pseudobulbar Palsy Treated by Needling with Prompt and Deep Insertion

    Institute of Scientific and Technical Information of China (English)

    Chen Hong

    2006-01-01

    @@ Pseudobulbar palsy refers to bulbar paralysis due to the upper motor neuron injury, which is one of the severe complications of cerebrovascular diseases.The author has treated 36 cases of the disease with acupuncture by a prompt and deep insertion technique, and achieved satisfactory therapeutic results. A report follows.

  7. Clinical Observation of Combined Acupuncture and Medications in Treating 90 Cases of Facial Palsy

    Institute of Scientific and Technical Information of China (English)

    WU Chun-huan; XIAO Yuan-chun

    2008-01-01

    @@ Peripheral facial palsy, namely Bell palsy, is one ofthe common diseases in the department ofacupuncture. Facial palsy, popularly called wry mouthand eye, is primarily manifested by the motormalfunction of the muscles of the expression on theaffected side. The author adopted combinedacupuncture and medications to treat 90 cases offacial palsy from June 2005 to June 2007, andattained good effects. It is now reported as follows.

  8. A research related with pseudoarthrosis and correction loss in idiopatic scoliosis cases treated with Harrington rods

    OpenAIRE

    Hamzaoglu, Azmi; Domanic, Unsal; Cakmak, Mehmet; Temucin, Bahattin Oguz; Taser, Omer; Karamehmetoglu, M.

    2004-01-01

    Attempts have been made to investigate the rate of correction loss, rate of pseudoarthrosis and its causes in 25 cases treated by Harrington procedure and whose last controls were made in the Department of Orthopaedics and Traumatology in the Medical School in Istanbul University during 1970-1978.

  9. Stress-induced hemorrhagic gastric ulcer after successful Helicobacter pylori eradication: two case reports

    Directory of Open Access Journals (Sweden)

    Miyamoto Mitsuaki

    2011-06-01

    Full Text Available Abstract Introduction Helicobacter pylori infection is a major cause of gastric ulcers, and Helicobacter pylori eradication drastically reduces ulcer recurrence. It has been reported, however, that severe physical stress is closely associated with gastric ulceration even in Helicobacter pylori -negative patients. Case presentation We report the cases of a 47-year-old Japanese man and a 69-year-old Japanese man who developed psychological stress-induced hemorrhagic gastric ulcers, in both of whom Helicobacter pylori had been successfully eradicated. Conclusion Our cases strongly suggest that not only physical but also psychological stress is still an important pathogenic factor for peptic ulceration and accordingly that physicians should pay attention to the possible presence of psychological stress in the management of patients with peptic ulcers.

  10. Successful use of dydrogesterone as maintenance therapy in recurrent endometrial stromal sarcoma: a case report.

    Science.gov (United States)

    Akashi, Daisuke; Todo, Yukiharu; Shimada, Chisa; Okamoto, Kazuhira; Minobe, Shinichiro; Kato, Hidenori

    2013-11-01

    Endometrial stromal sarcoma is known to be a hormone-dependent tumor. Efficacy of hormonal therapy including high-dose progestins, aromatase inhibitors or gonadotropin-releasing hormone analogs has been reported. We report a case of recurrent endometrial stromal sarcoma, the tumor cells of which were strongly positive for CD10, estrogen and progesterone receptors. Although almost all of the pelvic tumors infiltrating the rectum or pelvic side wall remained, the patient is alive with slight disease 9 years and 6 months after the initial failure. During the treatment period of 4 years and 3 months, the patient was treated exclusively with dydrogesterone at a daily dose of 10 mg and the tumor clinically disappeared. Dydrogesterone at a daily dose of 10 mg may be effective in treating low-grade endometrial stromal sarcoma.

  11. Clinical Observation of Tuina Therapy in Treating 47 Cases of Vertigo

    Institute of Scientific and Technical Information of China (English)

    耿中文

    2008-01-01

    In order to observe the clinical effect of Tuina therapy for vertigo, 47 cases of the patients with vertigo were treated by massaging Triple Energizer Meridian and Gallbladder Meridian on the head, and the results showed cure in 36 cases, improvement in 11 cases and the total effective rate was 100%.%为观察推拿治疗眩晕的临床疗效,以推拿头部三焦经及胆经为主,治疗眩晕患者47例,结果痊愈36例,好转11例,总有效率100%.

  12. Forty-two Cases of Greater Occipital Neuralgia Treated by Acupuncture plus Acupoint-Injection

    Institute of Scientific and Technical Information of China (English)

    Pan Changqing; Tan Guangbo

    2008-01-01

    Objective:To observe the therapeutic effect of acupuncture plus acupoint-injection on greater occipital neuralgia.Methods:The 84 cases of greater occipital neuralgia were randomly divided into two groups,with 42 cases in the treatment group treated bv acupuncture plus acupoint-injection.and 42 cases in the control group treated with oral administration of carbamazepine.Results:The total effective rate was 92.8% in the treatment group and 71.4% in the control group.The difrerence in the tohal effective rate was significant (P<0.05)between the two groups.Conclusions:Acupuncture plus acupoint-injection is eriective for greater occipital neuralgia,better than the routine western medication.

  13. Acute duodenal Crohn's disease successfully managed with low-speed elemental diet infusion via nasogastric tube: A case report

    Institute of Scientific and Technical Information of China (English)

    Takayuki Yamamoto; Maki Nakahigashi; Satoru Umegae; Tatsushi Kitagawa; Koichi Matsumoto

    2006-01-01

    Duodenal Crohn's disease is rare, and patients without obstruction are treated medically. We herein report one case whose duodenal Crohn's disease was successfully managed with low-speed elemental diet infusion through a nasogastric tube. A 28-year-old female developed acute duodenal Crohn's disease. Upper GI radiologic and endoscopic examinations showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens,mucosal cytokine levels were measured; interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-α levels were remarkably elevated. For initial 2 wk, powdered mesalazine was orally given but it was not effective. For the next 2 wk, she was treated with low-speed elemental diet therapy using a commercially available ElentalTM,which was infused continuously through a nasogastric tube using an infusion pump. The tip of the nasogastric tube was placed at an immediate oral side of the pylorus.The infusion speed was 10 mL/h (usual speed, 100 mL/h).After the 2-wk treatment, her symptoms were very much improved, and endoscopically, the duodenal stricture and inflammation improved. The duodenal mucosal cytokine levels remarkably decreased compared with those before the treatment. Although our experience was limited, lowspeed elemental diet infusion through a nasogastric tube may be a useful treatment for acute duodenal Crohn's disease.

  14. Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 杨红明

    2000-01-01

    Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients' vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged;②The major cause related to burn wound sepsis was extensive burn injuries, with large areas of deep burn remaining open; ③Although wound swabs taken on admission revealed the presence of colonization by many pathogenic bacteria, Pseudomonas aeruginosa was one of the most frequent bacteria isolated from the subeschar tissue; ④The plasma concentrations of IL-6, IL-8, TNF and LPS before surgical intervention were significantly higher than that after surgical intervention (P<0.05) ;⑤The lowest level of the inflammatory mediators was observed when the patients' conditions became stable, as compared with before surgical intervention (P<0. 001).These findings suggest that the clinical characteristics of burn wound sepsis are abrupt deterioration of the general condition and prominent septic symptoms, often complicated by MODS. The main cause of burn wound sepsis is the presence of a large area of open deep burn wounds, which should be excised and covered early. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn wound sepsis. Although success in treating these patients is the result of appropriate application of multiple treatments, early, aggressive and thorough surgical excision of invasive burn infectious tissue and closure of wound play a crucial role in the successful treatment of patients complicated by burn wound sepsis. Other treatments are adjuvant but also important.

  15. Twelve Cases of Malignant Hematopathy Treated by Combined Therapy of Hematopoietic Stem Cell Transplantation andChinese Herbal Medicine

    Institute of Scientific and Technical Information of China (English)

    虞荣喜; 周郁鸿; 朱宁希; 沈建平; 胡致平; 罗秀素; 林圣云; 沈一平; 陈均法; 孙洁

    2002-01-01

    Objective:To evaluate the effect of hematopoietic stem cell transplantation combined with Chinese herbal medicine in treating malignant hematopathy.Methods: Allo-bone marrow transplantation (allo-BMT) or allo-peripheral blood stem cell transplantation (allo-PBSCT), with conditioning regimen of 60  Co total body irradiation + Cyclophosphamide (TBI+Cy) or busulfan + cyclophosphamide (Bu+Cy), was used to treat 4 cases of chronic granu locytic leukemia (CGL, 3 of chronic phase and 1 of accelerating phase) and one case of acute non-lymphocytic leukemia (ANLL). And auto-BMT or auto-PBSCT, with conditioning regimen of my leran + cytosino arabinoside +cyclophosphamide (MAC) or MAC+VP16, was used to tr eat 7 cases of hematopathy, including 5 cases of ANLL (3 of CR 1 and 2 of CR 2) and 2 cases of malignant lymphoma (1 of the first occurrence and 1 of relapse). Chinese herbal medicine was given orally to all the 12 patients after transplantation according to TCM Syndrome Differentiation. Results: All patients were successfully engrafted. Within the median follow-up period of 18 (4-70) months, 1 patient (8.3%) died a transplantation-related death, 3 ( 25.0% ) relapsed and 8 (66.7%) survived free of original disease. Conclusion: Auto-BMT or auto-PBSCT in CR 1 stage of acute leukemia could reduce the relapse rate, when there was no matched bone marow donor; allo-BMT or allo-PBSCT in chronic stage could result in long-term disease-free survival of patients; Chinese herbal medicine administration in patients of malignant hematopathy after transplantation might reduce the complications and plays certain rol e in promoting recovery of hematopoietic function.

  16. Persistent sciatica induced by quadratus femoris muscle tear and treated by surgical decompression: a case report

    Directory of Open Access Journals (Sweden)

    Tzanakakis George

    2010-08-01

    Full Text Available Abstract Introduction Quadratus femoris tear is an uncommon injury, which is only rarely reported in the literature. In the majority of cases the correct diagnosis is delayed due to non-specific symptoms and signs. A magnetic resonance imaging scan is crucial in the differential diagnosis since injuries to contiguous soft tissues may present with similar symptoms. Presentation with sciatica is not reported in the few cases existing in the English literature and the reported treatment has always been conservative. Case presentation We report here on a case of quadratus femoris tear in a 22-year-old Greek woman who presented with persistent sciatica. She was unresponsive to conservative measures and so was treated with surgical decompression. Conclusion The correct diagnosis of quadratus muscle tear is a challenge for physicians. The treatment is usually conservative, but in cases of persistent sciatica surgical decompression is an alternative option.

  17. Successful Management of Phaeochromocytoma using Preoperative Oral Labetalol and Intraoperative Magnesium Sulphate; Report of four cases

    Directory of Open Access Journals (Sweden)

    Sanath Kumar B. S.

    2014-05-01

    Full Text Available Phaeochromocytoma is a rare neuroendocrine catecholamine-secreting tumour. This type of tumour poses multidimensional anaesthetic challenges as it has an unpredictable clinical course during surgical resection. The alpha-blocking agent phenoxybenzamine remained the mainstay in preoperative preparation before the introduction of beta-blocking agents. We report four cases operated between 2009–2012 at Sultan Qaboos University Hospital, Muscat, Oman. The cases were prepared with oral labetalol, as the alpha-blocking drug phenoxybenzamine was not immediately available. Responses to simulated stress were tested in the theatre before surgery. Anaesthesia was induced under invasive arterial pressure monitoring and magnesium sulphate infusion. Rare intraoperative surges in blood pressure during tumour manipulation were treated with sodium nitroprusside infusions and phentolamine boluses. All of the patients had an uneventful postoperative recovery. Preoperative treatment with labetalol has rarely been reported and can be considered as a potential therapeutic option with optimal patient monitoring if phenoxybenzamine is unavailable.

  18. [Use of hypnosis in treating a patient with dental anxiety: A case study].

    Science.gov (United States)

    Meyerson, J; Ratson, T

    2015-10-01

    Dental anxiety is quite common and may lead to dental neglect due to lack of regular visits to the dental clinic. The difficulties in managing anxious patients are characterized by prolonged visits, a tendency to cancel appointments and a tense atmo- sphere during treatment. The use of hypnosis while treating an anxious patient can help create a posi- tive environment and shorten the duration of dental appointments as well. The article describes a case in which hypnosis was used while treating a patient who had suffered from dental anxiety for over 20 years.

  19. Successful treatment of a case of acute myeloid leukemia following Langerhans cell histiocytosis in an adolescent: a case report and review of the literature

    Science.gov (United States)

    Xu, Gaixiang; Yang, Min; Huang, Jian; Jin, Jie

    2015-01-01

    Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder of unknown etiopathogenesis. Its clinical presentation is variable and ranges from isolated skin or bone disease to a life-threatening multisystem condition. LCH can occur at any age but is more frequent in the pediatric population. The diagnosis depends on clinical, histopathological and radiographic examination and should be confirmed by immunohistochemical study with CD1a, S100 protein and langerin, three markers used widely for identifying Langerhans cells. Herein, we report an adolescent with acute myeloid leukemia (AML-M2) who was treated just with surgical management alone for LCH. As far as we know, this is the first case that the LCH patient without chemotherapy evolved into AML and was successfully cured. Cooperative studies of large numbers of LCH patients are needed to evaluate a possible association between LCH and acute leukemia, and to identify common risk factors or predisposing agents if such be present. The previously reported cases of LCH concomitant with other hematological disorders are also summarized and described compared with the present case. PMID:25932277

  20. Succession Planning in Malaysian Family Owned Business– Case Studies in Malaysian Chinese Owned Business

    OpenAIRE

    Jade Li, Chong

    2009-01-01

    Transferring a business to the next generation can pose serious challenges, especially in the SMEs sector. In many cases, the owner of the SMEs is the pillar of the company and he/she is responsible for most of the functions in the business. Some are near irreplaceable, thus, making succession even more difficult. According to research, about two-thirds of all family businesses fail to make it from the first generation to the second, and even less make it to the third. Researchers believe tha...

  1. A case study of desired attributes for success within the ICT sector

    Directory of Open Access Journals (Sweden)

    Mehdi Asgarkhani

    Full Text Available This paper examines attributes (soft skills that are perceived as being critical to success within the ICT sector. The required attributes as identified by a study of 205 randomly selected ICT positions are compared with students\\' perception (based on a pilot study of a focus group of students. Overall, it is not possible to draw clear conclusions from the outcome of one case study only. However, we were able to identify some preliminary trends and identify a number of key factors for future studies.

  2. Successful Treatment of a Patient With Complicated Diabetic Foot Wound: A Case Report.

    Science.gov (United States)

    Zheng, Yurong; Wang, Xingang; Zhang, Liping; You, Chuangang; Feng, Zhanzeng; Han, Chunmao

    2014-06-01

    Foot ulceration is one of the most serious complications of diabetes mellitus and may lead to amputation of the lower extremity. Timely prophylaxis and treatment of diabetic foot ulceration are important to maintain a good quality of life. This article reports a complicated diabetic patient with severe limb-threatening necrotizing infection. We successfully applied endovascular stent insertion, digit amputation, negative pressure wound therapy, and advanced dressings in different wound phases to achieve definitive wound healing after 12 months of treatment. Based on this case report, we would like to emphasize the importance of combined multiple therapies and patient compliance for severe diabetic foot ulcers.

  3. A Case Report of Successful Treatment of Recalcitrant Childhood Localized Scleroderma with Infliximab and Leflunomide.

    Science.gov (United States)

    Ferguson, Ian D; Weiser, Peter; Torok, Kathryn S

    2015-01-01

    Herein we report successful treatment of an adolescent Caucasian female with severe progressive localized scleroderma (mixed subtype, including generalized morphea and linear scleroderma of the trunk/limb) using infliximab and leflunomide. The patient demonstrated improvement after the first 9 months of therapy based on her clinical examination, objective measures, and patient and parent global assessments. Infliximab is a potential treatment option for pediatric localized scleroderma patients who have progression of disease or who are unable to tolerate the side effect profile of more standard systemic therapy. Larger longitudinal studies or case series are needed to confirm and further investigate infliximab's role in localized scleroderma.

  4. A successful double-layer facial nerve repair: A case presentation

    Directory of Open Access Journals (Sweden)

    Mehmet Dadaci

    2015-04-01

    Full Text Available The best method to repair the facial nerve is to perform the primary repair soon after the injury, without any tension in the nerve ends. We present a case of patient who had a full-thickness facial nerve cut at two different levels. The patient underwent primary repair, recovered almost completely in the fourth postoperative month, and had full movement in mimic muscles. Despite lower success rates in double-level cuts, performing appropriate primary repair at an appropriate time can reverse functional losses at early stages, and lead to recovery without any complications. [Hand Microsurg 2015; 4(1.000: 24-27

  5. Clinical Observation on 930 Child Epilepsy Cases Treated with Anti-epilepsy Capsules

    Institute of Scientific and Technical Information of China (English)

    马融; 李少川; 李新民; 胡思源; 孙希焕; 刘玉珍; 张喜莲; 李向农; 马秀华

    2003-01-01

    1090 cases of child epilepsy were divided randomly into two groups: the treatment group (930 cases treated with anti-epilepsy capsules) and the control group (160 cases treated with luminal). The results showed that in the treatment group, 534 cases were markedly effective, 241 effective, 96 improved, 46 ineffective, and 13 aggravated, with a total effective rate of 83.33%; while in the control group, 64 cases were markedly effective, 19 effective, 38 improved, 29 ineffective, and 10 aggravated, with a total effective rate of 51.88%. The treatment group showed an obviously higher total effective rate than that in the control group (P<0.01). After treatment, cases in the two groups all had lower frequency of epilepsy attacks and shorter duration of each attack as compared with that before treatment (P<0.01), but the situation was obviously better in the treatment group. The anti-epilepsy capsules had very good effect on various types of epilepsy, especially on autonomic epilepsy and on epilepsies due to wind, phlegm, or terror as differentiated in TCM. After treatment, the recovery rate shown by EEG examination was 54.3% in the treatment group, while 38.4% in the control group, the former being obviously higher than the latter (P<0.01).

  6. Case Studies of Multilingual/Multicultural Asian Deaf Adults: Strategies for Success.

    Science.gov (United States)

    Wang, Qiuying; Andrews, Jean; Liu, Hsiu Tan; Liu, Chun Jung

    2016-01-01

    Case studies of adult d/Deaf or Hard of Hearing Multilingual Learners (DMLs) are few, especially studies of DMLs who learn more than one sign language and read logographic and alphabetic scripts. To reduce this paucity, two descriptive case studies are presented. Written questionnaires, face-to-face interviews, and self-appraisals of language-use rubrics were used to explore (a) the language and literacy histories of two adult Asian DMLs who had learned multiple languages: Chinese (spoken/written), English (written), Chinese Sign Language, and American Sign Language; and (b) how each language was used in different cultural communities with diverse conversational partners. Home literacy environment, family support, visual access to languages, peer and sibling support, role models, encouragement, perseverance, and Deaf identity all played vital roles in the participants' academic success. The findings provide insights into the acquisition of multiple languages and bi-literacy through social communication and academic content.

  7. Successful Pregnancy Following Assisted Reproduction in Woman With Systemic Lupus Erythematosus and Hypertension: A Case Report.

    Science.gov (United States)

    de Macedo, José Fernando; de Macedo, Gustavo Capinzaiki; Campos, Luciana Aparecida; Baltatu, Ovidiu Constantin

    2015-09-01

    Patients with systemic lupus erythematosus have a poor prognosis of pregnancy, since it is associated with significant maternal and fetal morbidity, including spontaneous miscarriage, pre-eclampsia, intrauterine growth restriction, fetal death and pre-term delivery. We report a case with successful pregnancy in a patient with systemic lupus erythematosus and hypertension. A 39-year-old nulliparous woman presented with systemic lupus erythematosus with antinuclear and antiphospholipid antibodies, hypertension and recurrent pregnancy loss presented for assisted reproduction. The patient responded well to enoxaparin and prednisone during both assisted reproduction and prenatal treatment. This case report indicates that prescription of immunosuppressant and blood thinners can be safely recommended throughout the whole prenatal period in patients with systemic lupus erythematosus. Enoxaparin and prednisone may be prescribed concurrently during pregnancy.

  8. Successful pregnancy outcome in a case of Swyer Syndrome with hypertension and morbid obesity

    Directory of Open Access Journals (Sweden)

    Aradhana Kalra

    2016-06-01

    Full Text Available To report a case of Swyer syndrome with hypertension and morbid obesity with successful pregnancy and live birth after assisted reproductive technology. 27 year old morbidly obese female with essential hypertension who had been on HRT for 10 years with well-developed secondary sexual characters with primary infertility. After adequate development of the uterus and the endometrial preparation, Patients with Swyer syndrome conceive with oocyte donation and ICSI. Caesarean section rate is high due to multiple pregnancies and other obstetric complications. Early detection of these cases would help in timely development of their secondary sexual characters and restoration of menses and gonadectomy for prevention of malignancy as its propensity is high. Multidisciplinary approach is required including counseling and management of long term health problems. Pregnancy is feasible but caesarean rate is high. [Int J Reprod Contracept Obstet Gynecol 2016; 5(6.000: 2061-2064

  9. A patient with Pfeifer-Weber-Christian Disease - Successful Therapy with Cyclosporin A: case report

    Directory of Open Access Journals (Sweden)

    Schölmerich Jürgen

    2010-01-01

    Full Text Available Abstract Background Pfeifer-Weber-Christian disease (PWCD is a rare inflammatory disorder of the subcutaneous fatty tissue. The diagnosis and therapy of this rare type of panniculitis is still controversial and will be discussed in this article. Case presentation We here report the rare case of a 64-year old male patient, with PWCD. The patient suffered from rheumatoid arthritis for several years, but then developed relapsing fever and recently occurring painful subcutaneous nodules predominantly at the inner part of his left upper limb with no signs of synovitis. Finally, a biopsy from one of the nodules revealed lobular panniculitis with mixed cell infiltrate, which was conformable only with PWCD, after excluding several differential diagnoses. In our patient PWCD developed despite immunosuppressive therapy with steroids and different disease modifying drugs, which the patient received to treat his underlying rheumatoid arthritis. However, when DMARD therapy was switched to Ciclosporin A the patient's symptoms resolved. Conclusion Our observation supports the hypothesis that T cells are involved in the pathogenesis of PWCD. Thus, T cell modifying drugs should be primarily used to treat patients with this rare disorder.

  10. Adrenergic Inhibition with Dexmedetomidine to Treat Stress Cardiomyopathy during Alcohol Withdrawal: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Zachary M. Harris

    2016-01-01

    Full Text Available Stress (Takotsubo cardiomyopathy is a form of reversible left ventricular dysfunction with a heightened risk of ventricular arrhythmia thought to be caused by high circulating catecholamines. We report a case of stress cardiomyopathy that developed during severe alcohol withdrawal successfully treated with dexmedetomidine. The case involves a 53-year-old man with a significant history of alcohol abuse who presented to a teaching hospital with new-onset seizures. His symptoms of acute alcohol withdrawal were initially treated with benzodiazepines, but the patient later developed hypotension, and stress cardiomyopathy was suspected based on ECG and echocardiographic findings. Adjunctive treatment with the alpha-2-adrenergic agonist, dexmedetomidine, was initiated to curtail excessive sympathetic outflow of the withdrawal syndrome, thereby targeting the presumed pathophysiology of the cardiomyopathy. Significant clinical improvement was observed within one day of initiation of dexmedetomidine. These findings are consistent with other reports suggesting that sympathetic dysregulation during alcohol withdrawal produces ideal pathobiology for stress cardiomyopathy and leads to ventricular arrhythmogenicity. Stress cardiomyopathy should be recognized as a complication of alcohol withdrawal that significantly increases cardiac-related mortality. By helping to correct autonomic dysregulation of the withdrawal syndrome, dexmedetomidine may be useful in the treatment of stress-induced cardiomyopathy.

  11. Adrenergic Inhibition with Dexmedetomidine to Treat Stress Cardiomyopathy during Alcohol Withdrawal: A Case Report and Literature Review.

    Science.gov (United States)

    Harris, Zachary M; Alonso, Alvaro; Kennedy, Thomas P

    2016-01-01

    Stress (Takotsubo) cardiomyopathy is a form of reversible left ventricular dysfunction with a heightened risk of ventricular arrhythmia thought to be caused by high circulating catecholamines. We report a case of stress cardiomyopathy that developed during severe alcohol withdrawal successfully treated with dexmedetomidine. The case involves a 53-year-old man with a significant history of alcohol abuse who presented to a teaching hospital with new-onset seizures. His symptoms of acute alcohol withdrawal were initially treated with benzodiazepines, but the patient later developed hypotension, and stress cardiomyopathy was suspected based on ECG and echocardiographic findings. Adjunctive treatment with the alpha-2-adrenergic agonist, dexmedetomidine, was initiated to curtail excessive sympathetic outflow of the withdrawal syndrome, thereby targeting the presumed pathophysiology of the cardiomyopathy. Significant clinical improvement was observed within one day of initiation of dexmedetomidine. These findings are consistent with other reports suggesting that sympathetic dysregulation during alcohol withdrawal produces ideal pathobiology for stress cardiomyopathy and leads to ventricular arrhythmogenicity. Stress cardiomyopathy should be recognized as a complication of alcohol withdrawal that significantly increases cardiac-related mortality. By helping to correct autonomic dysregulation of the withdrawal syndrome, dexmedetomidine may be useful in the treatment of stress-induced cardiomyopathy.

  12. Successful treatment of Chlamydophila pneumoniae acute respiratory distress syndrome with extracorporeal membrane oxygenator: a case report and diagnostic review

    Directory of Open Access Journals (Sweden)

    De Bels David

    2012-01-01

    Full Text Available Abstract Introduction Chlamydophila pneumoniae is a respiratory pathogen known to infect the upper and lower respiratory tracts. Infection severity can range from sub-clinical pulmonary infection to acute respiratory distress syndrome. Case presentation A previously healthy 62-year-old Caucasian man was admitted to our hospital for acute respiratory failure. Serum samples obtained every week starting from the day of admission showed clear-cut seroconversion for C. pneumoniae antibodies. All other cultures obtained during the first days of hospitalization were negative. Despite maximal ventilatory support (high positive end expiratory pressure, fraction of inspired oxygen of 1.0, nitric oxide inhalation, neuromuscular blocking agents and prone positioning, our patient remained severely hypoxemic, which led us to initiate an extracorporeal membrane oxygenation treatment. Extracorporeal membrane oxygenation and hemodiafiltration were withdrawn on day 12. Our patient was extubated on day 18 and discharged from our Intensive Care Unit on day 20. He went home a month later. Conclusion We describe the first published case of acute respiratory distress syndrome due to C. pneumoniae infection successfully treated by extracorporeal membrane oxygenation, a very useful tool in this syndrome. A quick and specific method for the definite diagnosis of Chlamydophila infection should be developed.

  13. Severe Aplastic Anemia following Acute Hepatitis from Toxic Liver Injury: Literature Review and Case Report of a Successful Outcome

    Directory of Open Access Journals (Sweden)

    Kamran Qureshi

    2014-01-01

    Full Text Available Hepatitis associated aplastic anemia (HAAA is a rare syndrome in which severe aplastic anemia (SAA complicates the recovery of acute hepatitis (AH. HAAA is described to occur with AH caused by viral infections and also with idiopathic cases of AH and no clear etiology of liver injury. Clinically, AH can be mild to fulminant and transient to persistent and precedes the onset SAA. It is assumed that immunologic dysregulation following AH leads to the development of SAA. Several observations have been made to elucidate the immune mediated injury mechanisms, ensuing from liver injury and progressing to trigger bone marrow failure with the involvement of activated lymphocytes and severe T-cell imbalance. HAAA has a very poor outcome and often requires bone marrow transplant (BMT. The findings of immune related myeloid injury implied the use of immunosuppressive therapy (IST and led to improved survival from HAAA. We report a case of young male who presented with AH resulting from the intake of muscle building protein supplements and anabolic steroids. The liver injury slowly resolved with supportive care and after 4 months of attack of AH, he developed SAA. He was treated with IST with successful outcome without the need for a BMT.

  14. PROBLEMS EXPERIENCED IN EVALUATING SUCCESS AND PERFORMANCE IN DISTANCE EDUCATION: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ramazan YILMAZ

    2017-01-01

    Full Text Available The need for distance education is increasing due to such reasons as keeping up with the changing social conditions, meeting the learning needs of the individuals and enabling them to be lifelong learners. In addition to many advantages distance education provides, it also has certain restrictions. One of these restrictions is the problems encountered in evaluating students’ success and performance. The purpose of this study is to examine the viewpoints of lecturers regarding the evaluation process of academic success and performance of those students who are attending to online distance education program and to compare lecturers’ views on assessment and evaluation practices carried out in face-to-face classroom environment with those online assessment and evaluation practices. The study was a case study and the data of the study were collected from the lecturers who lectured in a distant education program of a state university. Based on the findings of the study, the problems that lecturers have in evaluating the success and performance of the students in online distance education and possible solution suggestions for these problems are presented.

  15. Successful treatment of chronic recurrent multifocal osteomyelitis with indomethacin: a preliminary report of five cases.

    Science.gov (United States)

    Abril, Juan Carlos; Ramirez, Ana

    2007-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is a disease of children and young adults. Clinically, the disease is characterized by the insidious onset of local pain and swelling in affected bones. Its course is one of intermittent periods of exacerbation and remission with successive bones affected. The pathogenesis of CRMO remains unknown, although an autoinflammatory disorder may be the cause, with inflammation of bone. This lesion is radiologically characterized as multiple lucencies surrounded by defined zones of patchy but dense sclerosis, cortical thickening from periosteal new bone formation, and increased bone size with different bones involved. Multiple therapeutic regimens had shown only a partial or temporary response. Because indomethacin has been successfully applied in inhibition of ossification and inflammatory processes, we initiated therapy with indomethacin in patients with CRMO. We report on the cases of 5 patients who responded dramatically to treatment with indomethacin. All underwent progressive clinical improvement (mean, 2.8 months). Radiological lesions disappeared after a mean period of 10.5 months. In 1 case where treatment was started late, small osteolytic zones persisted but with no clinical consequences. There were no additional recurrences or new bones affected during follow-up period (mean, 4 years). Our observation indicates that indomethacin may be an effective treatment for CRMO.

  16. Combination of Rapamycin and Imatinib in Treating Refractory Chronic Myeloid Leukemia Myeloid Blast Crisis: a Case Report

    Institute of Scientific and Technical Information of China (English)

    Jing Xie; Xiang Zhang; Bao-zhi Fang; Guang-sheng He; Yun Zhao; De-pei Wu

    2013-01-01

    CHRONIC myeloid leukemia (CML) is character-ized by the presence of the BCR/ABL fusiongene, which is the resultof a reciprocal translo-cation betweenchromosomes 9 and 22, calledPhiladelphia (Ph) chromosome. Imatinib mesylate (imatinib), a specific small molecularinhibitor of BCR/ABL,couldimprove the prognosis of CML and is now the standard drugapplied in all phases of this disease.1 Despite the efficacy ofimatinib,the development of resistance and the persistence of minimal residual disease haveseriously impaired the efficiency of this medicine. Resistance may developthrough several differentmechanisms, such asmutations in the Abl kinase domain, BCR/ABL overexpression, or compensatory phosphatidylinositol 3 kinase (PI3K)/Akt/mammalian targetof rapamycin (mTOR) activation.2,3Rapamycin, with mTOR asapotential therapeutic target, has been studied in patients with hematologic malignancies. Herewe report a case ofrefractory CML myeloid blast crisis successfully treated by the combination of rapamycin and imatinib.

  17. Korean Herbal Medicine for Treating Henoch-Schonlein Purpura with Yin Deficiency: Five Case Reports

    Directory of Open Access Journals (Sweden)

    Sung-Kyung Kim

    2014-12-01

    Full Text Available Objectives: The purpose of this study is to report the clinical effect of Korean medicine (KM treatment for Henoch-Schonlein purpura (HSP. Methods: Five HSP patients who demonstrated a Yin deficiency and who had a history of a previous upper respiratory tract infection were included in this study. Four patients had arthritis and three had severe stomachache. One of them appeared to have proteinuria and hematuria before starting KM treatment. Results: All patients were improved with only herbal medicine, Jarotang (JRT. Purpura in the lower extremities and abdominal pain, which were not treated by using a corticosteroid, disappeared and had not recurred after 6 months. Conclusion: These cases indicate that JRT may be effective in treating HSP in patients who demonstrate Yin deficiency, even though the number of cases was limited to five.

  18. [Self-amputation of the penis treated immediately: Case report and review of the literature].

    Science.gov (United States)

    Odzébé, A W S; Bouya, P A; Otiobanda, G F; Banga Mouss, R; Nzaka Moukala, C; Ondongo Atipo, A M; Ondziel Opara, A S

    2015-12-01

    Self-amputation of the penis treated immediately: case report and review of the literature. Self-amputation of the penis is rare in urological practice. It occurs more often in a context psychotic disease. It can also be secondary to alcohol or drugs abuse. Treatment and care vary according on the severity of the injury, the delay of consultation and the patient's mental state. The authors report a case of self-amputation of the penis in an alcoholic context. The authors analyze the etiological and urological aspects of this trauma.

  19. Thirty-Two Cases of Trigeminal Neuralgia Treated with Acupuncture plus Chinese Traditional Drugs

    Institute of Scientific and Technical Information of China (English)

    Zheng Xiangmei; Suo Yunxi; Chen Zhengqiu

    2006-01-01

    @@ Trigeminal neuralgia refers to the kind of pain occurring in the distribution areas of the trigeminal nerves. The pain attacking periodically is so intense like either knife-cutting or electric stroke. However,no abnormality is found in the patients when the attack ceases. By means of acupuncture plus Chinese traditional drugs, the authors had treated 32cases of the disease from March of 1999 to March of 2003, and its effect is compared with that of carbamazepine in 29 cases. A report follows.

  20. Chronic idiopathic intestinal pseudo-obstruction treated with jejunostomy: case report and literature review

    Directory of Open Access Journals (Sweden)

    Carlos Renato dos Reis Lemos

    Full Text Available CONTEXT: Chronic idiopathic intestinal pseudo-obstruction is a very rare condition. CASE REPORT: This study describes a male patient who had presented obstructive symptoms for 24 years. He had been treated clinically and had undergone two previous operations in different services, with no clinical improvement or correct diagnosis. He was diagnosed with intestinal obstruction without mechanical factors in our service and underwent jejunostomy, which had a significant decompressive effect. The patient was able to gain weight and presented improvements in laboratory tests. Jejunostomy is a relatively simple surgical procedure that is considered palliative but, in this case, it was resolutive.

  1. A rare case of solitary trichoepithelioma treated with carbon dioxide laser

    OpenAIRE

    2016-01-01

    Trichoepithelioma (TE) is a benign skin neoplasm derived from the hair follicle. It is commonly located on the face and hairy skin. We report a rare and interesting case of a solitary trichoepithelioma (sTE) treated with a carbon dioxide laser. This report shows a positive therapeutic effect of a carbon dioxide laser on a patient with sTE located on the medial angle of the eye region. The carbon dioxide laser may be one of the therapeutic options in the case of sTE.

  2. Treating bipolar disorder in patients with renal failure having haemodialysis: two case reports

    Directory of Open Access Journals (Sweden)

    Annadatha Srinivas

    2008-07-01

    Full Text Available Abstract Background There is little published guideline or evidence on treating bipolar affective disorder in patients with renal failure having haemodialysis. Case We present two patients with bipolar affective disorder with renal failure having haemodialysis. We used lorazepam in one patient to manage the immediate risk of non-engagement with dialysis. Risperidone was added in the second patient for managing psychotic symptoms. Valproate was started as a mood stabiliser and titrated upwards for long-term management of the illness. Conclusion We discuss the similarities in the two cases and the care plan we used to manage them.

  3. Complete Response of Liver Metastasis of Gastric Cancer Treated by S-1 Chemoradiotherapy: A Case Report

    Directory of Open Access Journals (Sweden)

    Tomonori Miyazawa

    2012-01-01

    Full Text Available This paper presents a case of suspected liver metastasis of gastric cancer and a virtual complete response to S-1 chemoradiotherapy. A 69-year-old man underwent distal gastrectomy for gastric cancer in 2008. Multiple liver metastases occurred in 2009. He underwent 15 courses of S-1 therapy and radiation therapy (37.5 Gy. Abdominal computed tomography showed virtual complete disappearance of liver metastasis after chemoradiotherapy. Hence, this case was interpreted as a complete response. No sign of recurrence was noted 18 months after complete response was confirmed. S-1 chemoradiotherapy is likely to be effective in treating patients with liver metastases of gastric cancer.

  4. Complete response of liver metastasis of gastric cancer treated by s-1 chemoradiotherapy: a case report.

    Science.gov (United States)

    Miyazawa, Tomonori; Ebe, Kazuyu; Koide, Norihiko; Fujita, Nobuhiro

    2012-01-01

    This paper presents a case of suspected liver metastasis of gastric cancer and a virtual complete response to S-1 chemoradiotherapy. A 69-year-old man underwent distal gastrectomy for gastric cancer in 2008. Multiple liver metastases occurred in 2009. He underwent 15 courses of S-1 therapy and radiation therapy (37.5 Gy). Abdominal computed tomography showed virtual complete disappearance of liver metastasis after chemoradiotherapy. Hence, this case was interpreted as a complete response. No sign of recurrence was noted 18 months after complete response was confirmed. S-1 chemoradiotherapy is likely to be effective in treating patients with liver metastases of gastric cancer.

  5. Primary Hyperparathyroidism-A Review of this Disorder and an Interesting Case Treated with Cinacalcet

    Directory of Open Access Journals (Sweden)

    Abdul Rafi Mohammed

    2009-06-01

    Full Text Available Primary hyperparathyroidism is not an uncommon disorder and there can be a delay in the diagnosis as it remains mostly asymptomatic. We discuss about this disorder and review the literature. Treatment options which include both surgical and medical therapy are also discussed. We also report an interesting case of primary hyperparathyroidism which was treated with Cinacalcet. Turk Jem 2009; 13: 37-9

  6. Thirty-six Cases of Infantile Proctoptosis Treated by Extremely Shallow Puncture

    Institute of Scientific and Technical Information of China (English)

    张曼

    2002-01-01

    @@ Proctoptosis, a disease of downward displacement of the anal canal, rectal mucosa, rectum or partial sigmoid colon, is known as prolapse of the rectum in TCM, which is frequently seen in the weak and thin babies or children of 2-4 years old. The author treated 36 cases of infantile proctoptosis by using extremely shallow puncture in the acupuncture techniques from Aug. 1995 to Dec. 1998 and obtained satisfactory results as reported in the following.

  7. Thirty-six Cases of Hyperglycemia Treated by Promoting Blood Circulation to Remove Stasis

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Thirty-six cases with hyperglycemia were treated with the method of promoting blood circulation and removing stasis in a course of 4 weeks. The treatment was significantly effective in correcting the abnormal viscosity of the blood by reducing the contents of total plasmic cholesterol (TC), triglyceride (TG) and apoprotein B (apoB), while the level of the apoprotein A (apoA) was elevated.

  8. A Rare case of Guillain-Barré syndrome in pregnancy treated with plasma exchange

    Directory of Open Access Journals (Sweden)

    Rahul Vasudev

    2014-01-01

    Full Text Available Guillain-Barre syndromé (GBS is an autoimmune disorder. It is rare in pregnancy as there is a decrease in cell-mediated immunity. A case of 28-year-old pregnant woman who presented with acute flaccid quadriplegia suffering from GBS is discussed in this study. She was treated with plasma exchange in her immediate post-partum period. The management of GBS in pregnancy has been discussed.

  9. Spontaneous pseudoaneurysm of the uterine artery during pregnancy treated by direct thrombin injection: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Jung Hee; Kim, See Hyung; Kim, Young Hwan [Dept. Radiology, Keimyung University School of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of)

    2016-04-15

    Pseudoaneurysm of uterine artery during pregnancy is a very rare disease. It is mostly associated with uterine artery injury, usually occurring after proceeding conditions such as history of gynecologic operation and infection. However, the best treatment modality has not been established yet. Herein, we reported a case of spontaneous formation of uterine artery pseudoaneurysm during pregnancy treated by direct thrombin injection without any complication or recurrence.

  10. Sixty-seven Cases of Abnormal Movement of the Cardiac Apex Treated with Bu Xin Tang

    Institute of Scientific and Technical Information of China (English)

    王平; 耿世钊

    2002-01-01

    @@ Bu Xin Tang (heart-reinforcement decoction) was used to treat 67 cases of abnormal movement of the cardiac apex based on differentiation of symptoms and signs. The results showed that, in most patients, there were remarkable improvement notonly for the symptoms but also for the abnormal movement of the cardiac apex. The cured plus remarkably effective rate was 87%, suggesting that it can postponeor prevent coronary heart attacks for the patient of prophase coronary heart disease.

  11. NINETY-THREE CASES OF GASTROPTOSIS TREATED BY ACUPUNCTURE COMBINED WITH CHINESE HERBAL MEDICINE

    Institute of Scientific and Technical Information of China (English)

    HAN Xin-qiang; HAN Bao-ru; HAN Yan-ru

    2006-01-01

    @@ Gastroptosis refers to prolapse of the stomach to an abnormal position manifested clinically by distending pain below the xiphoid process, hypochondriac fullness, chest stuffiness, abdominal distention and straining sensation,which is mainly caused by reduced tensity, lack of fat of the abdominal wall, relaxed muscles and decreased abdominal pressure. The authors have treated 93 cases of gastroptosis by applying acupuncture combined with Chinese herbal medicine and achieved quite satisfactory therapeutic results reported as follows.

  12. A case of toxic megacolon caused by clostridium difficile infection and treated with fecal microbiota transplantation.

    Science.gov (United States)

    Gweon, Tae Geun; Lee, Kyung Jin; Kang, Dong Hoon; Park, Sung Soo; Kim, Kyung Hoon; Seong, Hyeon Jin; Ban, Tae Hyun; Moon, Sung Jin; Kim, Jin Su; Kim, Sang Woo

    2015-03-01

    Clostridium difficile infection. The mortality rate of fulminant C. difficile infection is reported to be as high as 50%. Fecal microbiota transplantation is a highly effective treatment in patients with recurrent or refractory C. difficile infection. However, there are few published articles on the use of such transplantation for fulminant C. difficile infection. Here, we report on a patient with toxic megacolon complicated by C. difficile infection who was treated successfully with fecal mi-crobiota transplantation. (Gut Liver, 2015;9:247-250).

  13. A Case of Microstomia Subsequent to Toxic Epidermal Necrolysis Surgically Treated by Simple Technique

    Directory of Open Access Journals (Sweden)

    Takanobu Mashiko, MD

    2013-06-01

    Full Text Available Summary: Toxic epidermal necrolysis (TEN is a rare but severe adverse dermatitis that is an autoimmune reaction to drugs such as nonsteroidal anti-inflammatory drugs. TEN most severely affects the mucous membranes including the mouth and could develop into microstomia; however, microstomia in relation to TEN has rarely been reported in the literature. We describe an adult female patient who developed microstomia due to scar contracture of the bilateral oral commissures subsequent to TEN and was successfully treated by a simple surgical technique consisting solely of transverse incision of the commissure and longitudinal closure.

  14. Successful treatment of methemoglobinemia in an elderly couple with severe cyanosis: two case reports

    Directory of Open Access Journals (Sweden)

    Su Ying-Fu

    2012-09-01

    Full Text Available Abstract Introduction Methemoglobinemia should be considered in all cyanotic patients who remain unresponsive to oxygen therapy. Rapid diagnosis is very important in emergency cases. Here, we present the cases of two patients, a married couple, admitted to our hospital with methemoglobinemia after exposure to sodium nitrite. Case presentation Two patients, a married couple, presented with methemoglobinemia. The 72-year-old Taiwanese man and 68-year-old Taiwanese woman were referred to our hospital with dizziness and tachypnea. On examination, their mucous membranes were cyanotic, and their blood samples showed the classic ‘chocolate brown’ appearance. The man also reported having experienced twitching of his right arm for a few minutes before arrival at the hospital. The symptoms of both patients failed to improve in response to supplemental oxygen delivered via oxygen masks, although the arterial blood gas data of these patients were normal and their pulse oximetry showed oxyhemoglobin levels of approximately 85%. A carbon monoxide-oximeter showed that the man’s methemoglobin concentration was 48.3%, and the woman’s was 36.4%. Methylene blue (100mg was administered intravenously to both patients, and their symptoms improved dramatically. They were admitted to the intensive care unit and discharged three days later, without neurological sequelae. Conclusion Severe methemoglobinemia is a life-threatening condition and, if untreated, may result in death. Early diagnosis and appropriate antidotal treatment are crucial in treating this emergency situation.

  15. Succession of microbial community and enhanced mechanism of a ZVI-based anaerobic granular sludge process treating chloronitrobenzenes wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Liang, E-mail: felix79cn@hotmail.com [Department of Environmental Engineering, Zhejiang University, Hangzhou 310058 (China); Zhejiang Province Key Laboratory for Water Pollution Control and Environmental Safety, Hangzhou 310058 (China); Jin, Jie [Department of Environmental Engineering, Zhejiang University, Hangzhou 310058 (China); Lin, Haizhuan [Department of Environmental Engineering, Zhejiang University, Hangzhou 310058 (China); Wenzhou Environmental Protection Design Scientific Institute, Wenzhou 325000 (China); Gao, Kaituo [Department of Environmental Engineering, Zhejiang University, Hangzhou 310058 (China); Xu, Xiangyang, E-mail: xuxy@zju.edu.cn [Department of Environmental Engineering, Zhejiang University, Hangzhou 310058 (China); Zhejiang Province Key Laboratory for Water Pollution Control and Environmental Safety, Hangzhou 310058 (China)

    2015-03-21

    Highlights: • The combined ZVI–UASB process was established for the degradation of chloronitrobenzenes. • There were the better shock resistance and buffering capacity for anaerobic acidification in the combined process. • Novel ZVI-based anaerobic granular sludge (ZVI–AGS) was successfully developed. • Adaptive shift of microbial community was significant in ZVI-based anaerobic granular sludge system. - Abstract: The combined zero-valent iron (ZVI) and upflow anaerobic sludge blanket (UASB) process is established for the treatment of chloronitrobenzenes (ClNBs) wastewater, and the succession of microbial community and its enhanced mechanism are investigated in the study. Results showed that compared with the control UASB (R1), the stable COD removal, ClNBs transformation, and dechlorination occurred in the combined system (R2) when operated at influent COD and 3,4-Dichloronitrobenzene (3,4-DClNB) loading rates of 4200–7700 g m{sup −3} d{sup −1} and 6.0–70.0 g m{sup −3} d{sup −1}, and R2 had the better shock resistance and buffering capacity for the anaerobic acidification. The dechlorination for the intermediate products of p-chloroanaline (p-ClAn) to analine (AN) occurred in R2 reactor after 45 days, whereas it did not occur in R1 after a long-term operation. The novel ZVI-based anaerobic granular sludge (ZVI–AGS) was successfully developed in the combined system, and higher microbial activities including ClNB transformation and H{sub 2}/CH{sub 4} production were achieved simultaneously. The dominant bacteria were closely related to the groups of Megasphaera, Chloroflexi, and Clostridium, and the majority of archaea were correlated with the groups of Methanosarcinalesarchaeon, Methanosaetaconcilii, and Methanothrixsoehngenii, which are capable of reductively dechlorinating PCB, HCB, and TCE in anaerobic niche and EPS secretion.

  16. A case of CTO treated with minimum use of contrast media.

    Science.gov (United States)

    Uehara, Yoshiki; Shimizu, Mitsuyuki; Yoshimura, Michihiro

    2013-12-01

    The retrograde approach is a novel technique for improving the success rate of guidewire passage through chronic total occlusion (CTO). In addition, this technique, especially when intravascular ultrasound-guided reverse controlled antegrade and retrograde subintimal tracking is employed, may help the operator to save on the contrast media used. In the case reported here, only 10 ml of contrast media was used in percutaneous coronary intervention for CTO.

  17. Treatment of 65 Cases of Cervical Vertigo Treated by Acupuncture plus Medication

    Institute of Scientific and Technical Information of China (English)

    张旭霞; 黄国琪

    2006-01-01

    To investigate the efficacy of acupuncture plus puerarin and glucose injection for treating cervical vertigo. Method:110 cases of cervical vertigo were divided into the treatment group and control group. 65 cases in the treatment group were treated by acupuncture plus puerarin and glucose injection and 45 cases in the control group were treated with Western medications. Results:In the treatment group,the results showed cure in 33 cases,effect in 29 cases and failure in 3 cases,and the total effective rate in 95.38%. In the control group,the results showed cure in 12 cases,effect in 23 cases and failure in 10 cases,and the total effective rate in 77.87%. In comparison of the total effective rate between the two groups,the treatment group was better than the control group (P<0.01). Conclusion:The therapeutic effect is better in the treatment of cervical vertigo by acupuncture plus herbal medicine than that by Western medications.%目的:观察针灸配合葛根素治疗颈性眩晕的疗效.方法:将110例颈性眩晕患者分为治疗组和对照组.治疗组65例以针灸配合葛根素治疗,对照组45例采用西药治疗.结果:治疗组痊愈33例,有效29例,无效3例,总有效率95.38%.对照组痊愈12例,有效23例,无效10例,总有效率为77.87%,两组总有效率比较,治疗组疗效优于对照组(P<0.01).结论:针灸中药并用治疗颈性眩晕疗效优于西药治疗.

  18. Fifty Cases of Child Restless Syndrome Treated with the Integrated Method of Chinese Herbal Drugs and Auricular-Plaster Therapy

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Fifty cases of child restless syndrome were treated with oral administration of Chinese traditional herbal drugs plus auricular-plaster therapy from December 1998 to November 2001, and another 47 cases were treated with oral administration of methylphenidate as controls. The result is reported as follows.

  19. Successful treatment of three cases of generalized pustular psoriasis with granulocyte and monocyte adsorption apheresis.

    Science.gov (United States)

    Suzuki, Akiko; Haruna, Kunitaka; Mizuno, Yuki; Kuwae, Yoshiyuki; Ono, Yuka; Okumura, Kazuko; Negi, Osamu; Kon, Yasuko; Takeuchi, Kaori; Takamori, Kenji; Ikeda, Shigaku; Suga, Yasushi

    2012-10-01

    Generalized pustular psoriasis (GPP) is a rare form of psoriasis characterized by the presence of variable numbers of sterile pustules appearing in erythematous and scaly lesions, which are associated with moderate to severe constitutional symptoms. It can be life-threatening especially in the elderly; therefore, medical care must be performed in rapid succession of treatment especially in refractory cases. We have performed granulocyte and monocyte adsorption apheresis (GCAP) on three GPP cases associated with several systemic and laboratory findings. As a result, the edema, erythema and numbers of sterile pustules on the skin lesions were reduced dramatically in all three patients after the first sessions of GCAP therapy. The sizes of the psoriatic lesions were reduced in all three patients following a weekly GCAP treatment for 5 consecutive weeks. Psoriasis area and severity index on discharge had improved in all three patients. No serious adverse effects were observed for up to at least 8 months after treatment. We therefore considered GCAP as one effective alternative to currently existing therapies, especially for recalcitrant cases of GPP.

  20. Controlling water pollution in developing and transition countries--lessons from three successful cases.

    Science.gov (United States)

    Kathuria, Vinish

    2006-03-01

    The policy prescription for solving environmental problems of developing countries and countries-in-transition (CIT) is slowly getting polarized into two viewpoints. One group of researchers and policy advocates including multilateral organizations upholds extensive use of market based instruments (MBIs) in these countries. The other group argues that institutions need to be built first or the policy makers should select the incremental or tiered approach taking into account the existing capabilities. The group also insists that the financial, institutional and political constraints make environmental regulation in these countries more problematic than in industrialized countries. In the short-run, the immediate needs of the developing countries can be addressed effectively by learning lessons from the difficulties encountered by a few successful cases and accordingly evolving an appropriate policy instrument. In this paper an attempt has been made to highlight three such cases from three different parts of the world--Malaysia (Asia-pacific), Poland (Eastern Europe) and Colombia (Latin America). The paper looks into what policy instruments led to a fall in water pollution levels in these countries and what role did MBIs play in this pollution mitigation? The case studies suggest that it is a combination of instruments--license fee, standards, charge and subsidies--reinforced by active enforcement that led to an overall improvement in environment compliance.

  1. SUCCESSFUL PREGNANCY OUTCOME IN SUB-MUCOUS MYOMA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Susmita

    2014-07-01

    Full Text Available Myomas are the most common benign tumors of the female genital tract and are associated with numerous clinical problems including a negative impact on fertility. Myomas that compress the uterine cavity like submucous myomas significantly reduce pregnancy rates. CASE: A 29 year old primi-gravida woman with term pregnancy (39 weeks 2days came to the out-patient department, of the department of Obstetrics and Gynecology with pain abdomen on 26th July, 2013 and got admitted. On per vaginal examination cephalo- pelvic disproportion was detected and emergency lower segment caesarean section was done under spinal anesthesia. A single live male baby weighing 3.9 kg was delivered by cephalic presentation. Interestingly, a retro-placental submucous myoma was found intra-operatively in the right fundal area measuring 5 cm * 5 cm. There was no intra-operative or post-operative complication. Patient got discharged on the 5th post-operative day with routine post-operative advice. CONCLUSION: Sub-mucous myomas prevent implantation and growth of the embryo and thereby cause infertility in most of the cases. Chance of progressing to term pregnancy with successful outcome is very rare. This type of cases should be managed with expertise obstetric guidance and care.

  2. Choroidal metastases in testicular choriocarcinoma, successful treatment with chemo- and radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Guber Ivo

    2011-12-01

    Full Text Available Abstract Background Choriocarcinoma is a very rare cause of ocular metastasis. Only 18 male patients have been reported on, 4 of whom survived, but with significant loss of vision. Case presentation A 26-year-old Caucasian man, suffering from testicular choriocarcinoma with pulmonary, cerebral, renal, hepatic and osseous metastases, underwent left radical orchiectomy. While being treated with chemotherapy, he presented with loss of vision in the left eye. Ophthalmoscopy revealed bilateral non-pigmented, hemorrhagic choroidal tumours, compatible with secondary lesions. Continued chemotherapy and stereotactic radiotherapy of the skull and spine lead to full remission with excellent vision, after more than 4 years of follow up. Conclusion Testicular choriocarcinoma is an exceptional cause of choroidal metastasis, potentially asymptomatic and with specific clinical features. Radiotherapy can complement radical orchiectomy and chemotherapy, to achieve full remission and maintain good vision.

  3. 300 CASES OF HYPERPLASIA OF MAMMARY GLANDS TREATED WITH RED-HOT NEEDLE PLUS FILIFORM NEEDLE

    Institute of Scientific and Technical Information of China (English)

    蔡志红; 吴英; 付波; 贺普仁

    2003-01-01

    Clinical observations on 300 cases of hyperplasia of mammary glands (group A) treated by red-hot needle plus filiform needle are reported in the present study. "Ashi" points were used as the main acupoints. For comparison, other 300 cases (group B) were treated with routine acupuncture method, and Rugen (ST 18) was used as the main acupoint. In addition, other auxiliary acupoints were supplemented in the light of the concrete syndromes in these two groups. The treatment was given once daily, with 10 sessions being a therapeutic course. Of the 300 cases in group A, 240 were clinically cured, amounting to 80%; 58 were effective, amounting to 19.3%; 2 were failed, with a total effective rate of 99.3%. Of the 300 cases in group B, 113 were clinically cured, 165 effective, 22 were failed, with a total effective rate of 92.7%. The therapeutic effect of group A is significantly superior to that of group B (P<0.05).

  4. 36-Year-Old Female with Catastrophic Antiphospholipid Syndrome Treated with Eculizumab: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Marianna Strakhan

    2014-01-01

    Full Text Available Catastrophic antiphospholipid syndrome (CAPS is a rare but potentially life-threatening condition characterized by diffuse vascular thrombosis, leading to multiple organ failure developing over a short period of time in the presence of positive antiphospholipid antibodies (aPL. CAPS is a severe form of antiphospholipid syndrome, developing in about 1% of cases of classic antiphospholipid syndrome, manifesting as microangiopathy, affecting small vessels of multiple organs. It is acute in onset, with majority of cases developing thrombocytopenia and less frequently hemolytic anemia and disseminated intravascular coagulation. Lupus anticoagulant and anticardiolipin antibodies have been reported as predominant antibodies associated with CAPS. Treatment options often utilized in CAPS include anticoagulation, steroids, plasma exchange, cyclophosphamide therapy, and intravenous immunoglobulin therapy. Even though the reported incidence of this condition is considered to be low, the mortality rate is approaching 50%. The high rate of mortality should warrant greater awareness among clinicians for timely diagnosis and treatment of this life-threatening condition. Studies have shown that complement activation plays a key role in the pathogenesis of aPL mediated thrombosis in CAPS. We report a case of a 36-year-old female admitted with clinical and laboratory findings consistent with CAPS successfully treated with eculizumab, a terminal complement inhibitor.

  5. Impact of Leadership Styles on Project Success – The Case of a Multinational Company

    Directory of Open Access Journals (Sweden)

    Bálint Blaskovics

    2014-11-01

    Full Text Available Literature on project success mainly focused on identifying and analyzing success criteria and critical success factors. Success criteria are used for evaluating the success of a project and critical success factors are those factors which increase the potential for achieving project success. However, the interrelationships among them were rarely analyzed, although researchers highlighted the importance of these interrelationships. The aim of the paper is to identify a leadership style, of which project managers can maximize the potential for achieving project success. Project success is analyzed from the point of view of success criteria. This approach manages the shortcoming mentioned above, the lack of analyzing interrelationships among critical success factors and success criteria. This outcome is drawn from qualitative field research at a subsidiary of a Scandinavian-based multinational company.

  6. Self-management support interventions that are clinically linked and technology enabled: can they successfully prevent and treat diabetes?

    Science.gov (United States)

    Kaufman, Neal D; Woodley, Paula D Patnoe

    2011-05-01

    Patients with diabetes need a complex set of services and supports. The challenge of integrating these services into the diabetes regimen can be successfully overcome through self-management support interventions that are clinically linked and technology enabled: self-management support because patients need help mastering the knowledge, attitudes, skills, and behaviors so necessary for good outcomes; interventions because comprehensive theory-based, evidence-proven, long-term, longitudinal interventions work better than direct-to-consumer or nonplanned health promotion approaches; clinically linked because patients are more likely to adopt new behaviors when the approach is in the context of a trusted therapeutic relationship and within an effective medical care system; and technology enabled because capitalizing on the amazing power of information technology leads to the delivery of cost-effective, scalable, engaging solutions that prevent and manage diabetes.

  7. Successful Vaginal Delivery despite a Huge Ovarian Mucinous Cystadenoma Complicating Pregnancy: A Case Report

    Directory of Open Access Journals (Sweden)

    Dipak Mandi

    2013-12-01

    Full Text Available A 22-year-old patient with 9 months of amenorrhea and a huge abdominal swelling was admitted to our institution with an ultrasonography report of a multiloculated cystic space-occupying lesion, almost taking up the whole abdomen (probably of ovarian origin, along with a single live intrauterine fetus. She delivered vaginally a boy baby within 4 hours of admission without any maternal complication, but the baby had features of intrauterine growth restriction along with low birth weight. On the 8th postpartum day, the multiloculated cystic mass, which arose from the right ovary and weighed about 11 kg, was removed via laparotomy. A mucinous cystadenoma with no malignant cells in peritoneal washing was detected in histopathology examination. This report describes a rare case of a successful vaginal delivery despite a huge cystadenoma of the right ovary complicating the pregnancy.

  8. People's participation in rural electrification - a successful case

    Energy Technology Data Exchange (ETDEWEB)

    Kamalapur, G.D. [National Institute of Technology Karnataka, Surathkal (India); Udaykumar, R.Y. [National Institute of Technology Karnataka, Department of Electrical Engineering, Surathkal (India)

    2012-06-15

    Rural electrification is an integral component of poverty alleviation and rural growth of a nation. A developing nation, like India has 72.2 percent people living in rural areas. Still, electricity has not played an effective role in the socio-economic growth of villages. The Government of India has an ambitious target of providing electricity to all villages by 2008 and all rural households by 2012. Steps are already initiated with Rural Electric Corporation, Rural Electricity Supply Technology Mission, State Electricity Boards led reforms, Reforms in Power Sector, Electricity Act 2003, Rajiv Gandhi Grameen Vidyutikaran Yojana etc. An attempt has been made in this paper to assess the present status of rural electrification in India and the major factors contributing to rural electrical distribution. Steps initiated by the Government of India through Rural Electric Corporation (REC) and a successful case study of the people's participation model is presented. (orig.)

  9. Actors’ Competencies or Methods? A Case Study of Successful Information Systems Development

    DEFF Research Database (Denmark)

    Omland, Hans Olav; Nielsen, Peter Axel

    2009-01-01

    and methods are exercised. Emphasising the intertwining of competencies and methods, we discuss the character of the intertwining process, how different actors relate to different methods, and how methods may be part of the problem rather than part of the solution to challenges in information systems......Research on information systems development methods has by and large acknowledged a significant difference between a method and its use and that the use depends on the situation and the developers, as well as other contingencies. We extend this research and focus in particular on the relationship...... between actors’ competencies and their deployment of methods, arguing that this relationship is described over-simplistically and needs a better explanation. Through a case study of a successful information systems development project we identify some central situations where a variety of competencies...

  10. [Successful pregnancy in a patient with idiopathic pulmonary arterial hypertension. Case report].

    Science.gov (United States)

    Szenczi, Orsolya; Karlócai, Kristóf; Bucsek, László; Rigó, János

    2016-04-10

    Idiopathic pulmonary arterial hypertension is characterized by progressive increase in pulmonary arterial pressure and pulmonary vascular resistance which lead to right ventricular failure and death. Pregnancy in patients with idiopathic pulmonary arterial hypertension is contraindicated because of the high maternal and fetal mortality. The authors present a case of successful pregnancy and delivery of a patient with idiopathic pulmonary arterial hypertension in Hungary for the first time. The aim of the report was to demonstrate that management and treatment of idiopathic pulmonary arterial hypertension in a pregnant woman is a complex and multidisciplinary task that should involve obstetrician, cardiologist and anesthesiologist. Those patients who become pregnant and do not wish to terminate the pregnancy must be referred to obstetric centers where a multidiciplinary approach is taken.

  11. Two cases of Chest Heating Sensation treated by Hwangryunhaedok-tang Herbal-Acupuncture

    Directory of Open Access Journals (Sweden)

    Gwon-Il Cho

    2003-06-01

    Full Text Available The purpose of this study is to evaluate the clinical effect of Hwangryunhaedok-tang Herbal-Acupuncture. Hwangryunhaedok-tang is used in all heating diseases. Chest Heating Sensation is a unique concept in Oriental Medicine. So we applied Hwangryunhaedok-tang Herbal-Acupuncture to treat the Chest Heating Sensation. We used DITI(Digital Infrared Thermographic Imaging to estimate the temperatures of chest surface for the outcome assessment. We came to know that the chest surface temperatures were all reduced in both cases after Herbal-Acupuncture treatment. The reduced average temperature was 1.5℃ in case 1 and 0.9℃ in case 2. The above result indicates that Hwangryunhaedok-tang Herbal-Acupuncture treatment has an effect on Chest Heating Sensation, thus continuous Hwangryunhaedok-tang Herbal-Acupuncture study will be needed for more clinical applications.

  12. Can establishment success be determined through demographic parameters? A case study on five introduced bird species.

    Directory of Open Access Journals (Sweden)

    Ana Sanz-Aguilar

    Full Text Available The dominant criterion to determine when an introduced species is established relies on the maintenance of a self-sustaining population in the area of introduction, i.e. on the viability of the population from a demographic perspective. There is however a paucity of demographic studies on introduced species, and establishment success is thus generally determined by expert opinion without undertaking population viability analyses (PVAs. By means of an intensive five year capture-recapture monitoring program (involving >12,000 marked individuals we studied the demography of five introduced passerine bird species in southern Spain which are established and have undergone a fast expansion over the last decades. We obtained useful estimates of demographic parameters (survival and reproduction for one colonial species (Ploceus melanocephalus, confirming the long-term viability of its local population through PVAs. However, extremely low recapture rates prevented the estimation of survival parameters and population growth rates for widely distributed species with low local densities (Estrilda troglodytes and Amandava amandava but also for highly abundant yet non-colonial species (Estrilda astrild and Euplectes afer. Therefore, determining the establishment success of introduced passerine species by demographic criteria alone may often be troublesome even when devoting much effort to field-work. Alternative quantitative methodologies such as the analysis of spatio-temporal species distributions complemented with expert opinion deserve thus their role in the assessment of establishment success of introduced species when estimates of demographic parameters are difficult to obtain, as is generally the case for non-colonial, highly mobile passerines.

  13. Can establishment success be determined through demographic parameters? A case study on five introduced bird species.

    Science.gov (United States)

    Sanz-Aguilar, Ana; Anadón, José D; Edelaar, Pim; Carrete, Martina; Tella, José Luis

    2014-01-01

    The dominant criterion to determine when an introduced species is established relies on the maintenance of a self-sustaining population in the area of introduction, i.e. on the viability of the population from a demographic perspective. There is however a paucity of demographic studies on introduced species, and establishment success is thus generally determined by expert opinion without undertaking population viability analyses (PVAs). By means of an intensive five year capture-recapture monitoring program (involving >12,000 marked individuals) we studied the demography of five introduced passerine bird species in southern Spain which are established and have undergone a fast expansion over the last decades. We obtained useful estimates of demographic parameters (survival and reproduction) for one colonial species (Ploceus melanocephalus), confirming the long-term viability of its local population through PVAs. However, extremely low recapture rates prevented the estimation of survival parameters and population growth rates for widely distributed species with low local densities (Estrilda troglodytes and Amandava amandava) but also for highly abundant yet non-colonial species (Estrilda astrild and Euplectes afer). Therefore, determining the establishment success of introduced passerine species by demographic criteria alone may often be troublesome even when devoting much effort to field-work. Alternative quantitative methodologies such as the analysis of spatio-temporal species distributions complemented with expert opinion deserve thus their role in the assessment of establishment success of introduced species when estimates of demographic parameters are difficult to obtain, as is generally the case for non-colonial, highly mobile passerines.

  14. Do the urolithiasis scoring systems predict the success of percutaneous nephrolithotomy in cases with anatomical abnormalities?

    Science.gov (United States)

    Kocaaslan, Ramazan; Tepeler, Abdulkadir; Buldu, Ibrahim; Tosun, Muhammed; Utangac, Mehmet Mazhar; Karakan, Tolga; Ozyuvali, Ekrem; Hatipoglu, Namik Kemal; Unsal, Ali; Sarica, Kemal

    2016-07-12

    The objective of this study is to assess the utility of the Guy, S.T.O.N.E., and CROES nephrolithometry scoring systems (SS), and compare the capability of each system to predict percutaneous nephrolithotomy (PNL) outcome in patients with anatomical abnormalities. We retrospectively collected medical records of patients with anatomical abnormalities who underwent PNL for the treatment of renal calculi by experienced surgical teams in four referral centers. All of the patients were graded by a single observer from each department based on preoperative computed tomography images using each SS. Patient demographics and outcomes were compared according to the complexity of the procedure as graded by each scoring system. A total of 137 cases with anatomical abnormalities [horseshoe kidney (n = 46), malrotation (n = 33), kypho and/or scoliosis (n = 31) and ectopic kidney (n = 27)] were assessed retrospectively. The mean stone burden, number, and density were 708.5 mm(2), 1.7, and 791.8 HU, respectively. The mean procedure, fluoroscopy, and hospitalization times were 75.2 ± 35.3 min, 133.4 ± 92.3 s, and 3.5 ± 2.1 days, respectively. Stone-free status was achieved in 106 cases (77.4 %). A total of 17 (13.6 %) complications occurred postoperatively. The mean scores were 2.7, 7.2, and 219.1, for the Guy, S.T.O.N.E., and CROES systems, respectively. CROES score was the independent predictor of PNL success in cases with anatomical abnormalities [p: 0.001, OR 1.01, (95 % CI 1005-1021)]. The CROES scoring system is well correlated with the success of PNL in cases with anatomical abnormalities; the S.T.O.N.E. and Guy scoring systems failed to predict the outcomes of PNL in this specific patient population.

  15. Three cases of affections of the hip treated with Korean Bee-Venom therapy

    Directory of Open Access Journals (Sweden)

    Kim Tae-Hee

    2001-12-01

    Full Text Available Objectives:In this study, we have discovered that Korean Bee-Venom therapy is effective in treating various hip joint diseases. For example, Avacular Necrosis, Degenerative Arthritis and Rheumatoid Arthritis. Methods and Results:We have treated three cases of affections of the hip(eg. Degenerative arthritis, Rheumatoid arthritis and Avascular Necrosis of Femoral Head with Korean Bee-Venom therapy and herbal acupuncture treatments. For acupuncture, Korean Bee-Venom therapy was observed for its pain relieving effects. Korean Bee-Venom therapy was treated on the following acupuncture points: GB29(Koryo:(居髎, GB30(Hwando:(環跳, ST36(Chok-samni:(足三里. As the results of these treatments, a little change of inflammation around the hip joint on X-ray scan study was observed, but the degree of pain and range of motion were improved, in addition to general conditions of the patients. Conclusions:Based on the clinical results, Korean Bee-Venom therapy is believed to be effective for treating Avascular Necrosis of Femoral Head, Degenerative arthritis and Rheumatoid arthritis of hip joint. However, it is expected that further studies should be conducted to provide more objective information.

  16. Acute necrotizing eosinophilic myocarditis in a patient taking Garcinia cambogia extract successfully treated with high-dose corticosteroids.

    Science.gov (United States)

    Allen, Scott F; Godley, Robert W; Evron, Joshua M; Heider, Amer; Nicklas, John M; Thomas, Michael P

    2014-12-01

    A previously healthy 48-year-old woman was evaluated for lightheadedness and chest heaviness 2 weeks after starting the herbal supplement Garcinia cambogia. She was found to be hypotensive and had an elevated serum troponin level. The patient had a progressive clinical decline, ultimately experiencing fulminant heart failure and sustained ventricular arrhythmias, which required extracorporeal membrane oxygenation support. Endomyocardial biopsy results were consistent with acute necrotizing eosinophilic myocarditis (ANEM). High-dose corticosteroids were initiated promptly and her condition rapidly improved, with almost complete cardiac recovery 1 week later. In conclusion, we have described a case of ANEM associated with the use of Garcinia cambogia extract.

  17. Two unusual cases with Wilson's disease: hepatoma and fulminant hepatitis treated with plasma exchange.

    Science.gov (United States)

    Aydinli, Musa; Harmanci, Ozgur; Ersoy, Osman; Iskit, Arzu T.; Ozcebe, Osman; Abbasoglu, Osman; Bayraktar, Yusuf

    2006-01-01

    We report two atypical cases of Wilson's disease. The first case is a 22-year-old male patient with a history of disease for 15 years and diagnosed as Wilson's disease upon investigations. Alpha-fetoprotein level was found elevated and computed tomography showed a 3.5-cm liver mass. Hepatocellular carcinoma was diagnosed. Radiofrequency ablation and liver transplantation were performed successfully. The second case is a 24-year-old female patient who presented with fulminant hepatitis. Urinary copper excretion and ceruloplasmin levels were suggestive of Wilson's disease. Despite chelation therapy, no improvement was observed. Plasma exchange therapy was performed for seven days. Her clinical status improved, and transplantation was no longer needed. To conclude, although hepatoma is rarely seen in Wilson's disease, patients should be examined regularly to diagnose it in a treatable stage. Removal of copper and toxic metabolites with plasma exchange therapy may be a way of treatment for fulminant hepatitis associated with Wilson's disease. PMID:17225847

  18. Infliximab- and Immunosuppressant-Resistant Crohn’s Disease Successfully Treated with Adsorptive Granulocyte Apheresis Combined with Prednisolone

    Directory of Open Access Journals (Sweden)

    Munenori Itagaki

    2012-02-01

    Full Text Available Activated granulocytes, monocytes, and platelets appear to be closely involved in active Crohn’s disease (CD. Adsorptive granulocyte apheresis (GCAP is a new treatment for inflammatory bowel disease. GCAP was used to treat a 23-year-old female patient with CD resistant to both infliximab (IFX and azathioprine (AZA. At 16 years of age, the patient underwent a partial ileal resection for peritonitis caused by perforative ileitis. On pathological examination of the resected specimen, the diagnosis was CD. Mesalazine was started, but the patient did not comply with therapy. She was admitted to our hospital again in 2007 due to an acute exacerbation. IFX induction therapy was started. The combination of both AZA daily and IFX every 8 weeks was continued as maintenance therapy. However, she developed severe abdominal pain in September 2009. Computed tomography revealed ileitis and ascending colitis, and blood tests showed high inflammatory response marker levels. She was considered to have IFX- and AZA-resistant CD. Initial intravenous steroid therapy did not result in any improvement. Therefore, weekly GCAP therapy was given for 5 weeks, which immediately improved the inflammatory response markers. GCAP combined with prednisolone could be effective for IFX- and AZA-refractory CD.

  19. Severe neuroleptic malignant syndrome: successful treatment with high-dose lorazepam and diazepam: a case report.

    Science.gov (United States)

    Tsai, Meng-Chang; Huang, Tiao-Lai

    2010-01-01

    Neuroleptic malignant syndrome (NMS) is an idiosyncratic and potentially fatal adverse complication of antipsychotic medications and other dopamine-modulating agents. It is characterized by hyperthermia, muscle rigidity, autonomic dysfunction and alteration in mental status. Here, we report a patient with severe NMS who was successfully treated with highdose lorazepam and diazepam. A 61-year-old man with bipolar I disorder was admitted to the hospital because of manic episodes. Fever, muscle rigidity, tachycardia, diaphoresis, elevated blood pressure and delirium occurred following intramuscular injection of haloperidol and NMS was diagnosed. Supportive treatment included hydration, alkalinized fluids and correction of abnormal electrolytes without the use of dantrolene, dopaminergic agents or electroconvulsive therapy. The Francis-Yacoub NMS rating scale was employed for evaluation of clinical improvement, and scores were 55 on the first day and 0 at discharge. The patient was followed up for 6 months and was free of NMS. In conclusion, this is the first report of rapid relief of NMS with high-dose lorazepam and diazepam in a Taiwanese patient.

  20. Complication of Salmonella Bacteremia in a Case of Treated Fungal Endophthalmitis

    Directory of Open Access Journals (Sweden)

    J. Malathi

    2012-01-01

    Full Text Available This is to report a case of bacteremia caused by Salmonella typhi in a treated unilateral fungal endogenous endophthalmitis in an 18-year-old male from one of the South Asian countries. Microbiological and molecular investigations were carried out on the eviscerated material and routine blood culture was carried out. Direct examination of eviscerated material revealed the presence of fungal filaments. However, Salmonella typhi was isolated from both specimens, which was confirmed by Polymerase chain reaction targeting the 16SrRNA gene, sequencing, and random amplification of polymorphic DNA showed that they belonged to the same clone. The presence of Salmonella bacteremia in a treated unilateral fungal endophthalmitis, among young adult patients is rare and systemic symptoms should be investigated.