oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Moyamoya Disease in Pregnancy: Management after Intracranial Bypass Grafting  [PDF]
A. C. Gimovsky,C. J. Macri,S. L. Bathgate,D. E. Ross
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/638471
Abstract: Moyamoya disease (MD) is a chronic, progressive cerebrovascular disease distinguished by bilateral stenosis or occlusion of the arteries around the circle of Willis with resulting prominent arterial collateral circulation. We describe a pregnant woman in whom this diagnosis was confirmed by cerebral angiogram and treated with bilateral superficial temporal artery-middle cerebral artery (STA-MCA) bypass grafting prior to conception. The patient was managed with strict blood pressure monitoring and low-dose aspirin antepartum, intrapartum, and postpartum. The patient presented in spontaneous labor at term and underwent a spontaneous vaginal delivery without complications. 1. Introduction MD is a progressive cerebrovascular disease distinguished by bilateral stenosis or occlusion of the arteries supplying the circle of Willis and resulting in a prominent arterial collateral circulation. The disease is characterized by intimal thickening in the walls of the internal carotid arteries bilaterally. Intraventricular, subarachnoid, and intracerebral hemorrhage has been described with MD. There is a paucity of the literature regarding management during pregnancy. We present a case of a woman with MD who underwent intracranial bypass grafting prior to conception and subsequently underwent a successful vaginal delivery. 2. Case A 30-year-old right-handed African American presented for prenatal care at 10 weeks of gestation. The patient had a past medical history that was significant for a “stroke” in 1999. In 2008, the patient presented to the emergency department (ED) with difficulty using her right hand and transient left-sided weakness and numbness. A preliminary diagnosis of transient ischemic attack (TIA) was made. Her evaluation at that time included an MRI which demonstrated encephalomalacia in the right frontal cortex; MRA at that time demonstrated “irregular vessels” but was otherwise interpreted as unremarkable. A follow-up evaluation by a neurosurgeon confirmed the diagnosis of MD based upon findings at a cerebral angiogram. Please see Figures 1(a) and 1(b) for images from her cerebral angiogram. The patient underwent bilateral STA-MCA bypass grafting. One month following the second procedure the patient presented to the ED with aphasia and right hemiplegia. Evaluation revealed a left basal ganglia hemorrhage. Her symptoms subsequently resolved. Figure 1: The attached pictures are digitally subtracted images from a cerebral angiogram of our patient. (a) Right vertebral injection showing irregular, serpiginous ill-defined vessels. (b) Left vertebral
Moyamoya Disease in Pregnancy: Management after Intracranial Bypass Grafting
A. C. Gimovsky,C. J. Macri,S. L. Bathgate,D. E. Ross
Case Reports in Obstetrics and Gynecology , 2012, DOI: 10.1155/2012/638471
Abstract: Moyamoya disease (MD) is a chronic, progressive cerebrovascular disease distinguished by bilateral stenosis or occlusion of the arteries around the circle of Willis with resulting prominent arterial collateral circulation. We describe a pregnant woman in whom this diagnosis was confirmed by cerebral angiogram and treated with bilateral superficial temporal artery-middle cerebral artery (STA-MCA) bypass grafting prior to conception. The patient was managed with strict blood pressure monitoring and low-dose aspirin antepartum, intrapartum, and postpartum. The patient presented in spontaneous labor at term and underwent a spontaneous vaginal delivery without complications.
Outcome of Glansectomy and Skin Grafting in the Management of Penile Cancer  [PDF]
Hugh F. O'Kane,Ajay Pahuja,K. J. Ho,Ali Thwaini,Thaigarajan Nambirajan,Patrick Keane
Advances in Urology , 2011, DOI: 10.1155/2011/240824
Abstract: Purpose. To report outcome data for patients with penile cancer treated surgically with glansectomy and skin grafting. Materials and Methods. We retrospectively reviewed data on all patients undergoing surgical management of penile cancer by a single surgeon between 1998 and 2008. Outcomes in patients who underwent glansectomy and skin grafting were analysed. Results. Between 1998 and 2008 a total of 25 patients with a mean age 60 (39–83) underwent glansectomy and skin grafting. Six patients had carcinoma in situ (CIS); the stage in the remaining patients ranged from T1G1 to T3G3. Mean followup for patients was 28 months (range 6–66). Disease specific survival was 92% with 2 patients who had positive nodes at lymph node dissection developing groin recurrence. One patient developed a local recurrence requiring a partial penectomy. Conclusions. Penile preserving surgery with glansectomy and skin grafting is a successful technique with minimal complications for local control of penile carcinoma arising on the glans. Careful followup to exclude local recurrence is required. 1. Introduction Penile cancer is an uncommon malignancy in the industrialized world, particularly in Europe and in the USA with an incidence of less than 1 per 100?000 of the male adult population. In contrast to this, the incidence in some parts of the developing world is as high as 19 per 100?000 per year [1]. More than 95% of penile cancers are primary squamous cell carcinomas with other uncommon histological types including melanoma, sarcoma, and basal cell carcinomas. Historically, the surgical management of the primary lesion in penile carcinoma has meant either partial or radical penectomy. Oncologically, radical surgical excision has stood the test of time, with excellent local control. These operations are however often mutilating and associated with urinary and sexual dysfunction as well as significant psychological morbidity [2]. In an attempt to reduce the negative impact of radical surgery and retain functional penile length, a variety of therapeutic strategies have been developed particularly for the management of more distal lower-grade cancers. The obvious risk is always that there will be compromise of local oncological control. Oncological outcomes of “penile preserving” surgical techniques should always, if possible, be measured against the gold standard of radical excision. Randomised trials are next to impossible in such an uncommon disease and although widely practiced and results are encouraging, only a small number of centres have published their outcome data on
Results of Dermal Patch Graft in the Treatment of Peyronie’s Disease  [cached]
Darioush Irani,Shahriyar Zeighami,A A Khezri
Urology Journal , 2004,
Abstract: Purpose: To investigate the efficacy of “dermal patch graft” in surgical management of Peyronie’s. Materials and Methods: eighteen of Peyronie’s disease cases, with a mean age of 49 and a history of penile curvature and painful erection were enrolled in this study. Diagnosis was made clinically by plaque palpation. All of them were in the chronic stage of disease with symptom duration of at least 6 months. We also evaluate their potency through Brief Sexual Function Inventory (BSFI) questionnaire before and after the operation, meanwhile the degree of penile curvature was measured with goniometry while artificial erection status was induced. Results: Mean penile curvature, before and after the operation (58 and 5 degrees respectively), showed significant improvement (P < 0.001). The improvement of curvature was irrespective of the plaque size. All of our patients suffered from inability to intercourse due to significant penile curvature but after the procedure 11 of them (66.1%) could do so. Also the BSFI score improved significantly in this subgroup (P < 0.05). The remaining 7 cases (39%) already suffered from erectile dysfunction despite of operation; however, the penile curvature improved significantly in them. Six of this latter group had a plaque size greater than 4 cm2 and BSFI score was not significantly improved.Conclusion: Dermal patch graft as a cost effective method in the management of Peyronie’s disease significantly corrects the curvature irrespective of plaque size and curvature severity. We found that if the fibrous plaque is less than 4 cm2 and the patient has no severe erectile dysfunction, this procedure will significantly improve his potency; however, if the patient suffers from a plaque sized greater than 4 cm2 and/or severe erectile dysfunction, to reach satisfactory erection, implantation of penile prosthesis or applying other methods of artificial erection in addition to dermal patch graft is suggested.
Applying collateral disease theory to treat chronic dermal ulcer
Hua-fa QUE
Zhong Xi Yi Jie He Xue Bao , 2008,
Abstract: Collateral disease theory has been applied to investigate the pathogenesis of chronic dermal ulcer in traditional Chinese medicine. It is suggested that deficiency of vital qi is the pathological basis of chronic dermal ulcer with collaterals stagnation as the major pathological factor, and collaterals impairment by toxin evil is the main pathological change. The important principle in treatment of chronic dermal ulcer is established as strengthening the body resistance, dredging collaterals and removing toxins, and this enriched the theory of wound healing in traditional Chinese medicine, and has practical value.
Characterization and evolution of dermal filaments from patients with Morgellons disease  [cached]
Middelveen MJ,Mayne PJ,Kahn DG,Stricker RB
Clinical, Cosmetic and Investigational Dermatology , 2013,
Abstract: Marianne J Middelveen,1 Peter J Mayne,1 Douglas G Kahn,2 Raphael B Stricker11International Lyme and Associated Diseases Society, Bethesda, MD, USA; 2Department of Pathology, Olive View–UCLA Medical Center, Sylmar, CA, USAAbstract: Morgellons disease is an emerging skin disease characterized by formation of dermal filaments associated with multisystemic symptoms and tick-borne illness. Some clinicians hypothesize that these often colorful dermal filaments are textile fibers, either self-implanted by patients or accidentally adhering to lesions, and conclude that patients with this disease have delusions of infestation. We present histological observations and electron microscopic imaging from representative Morgellons disease samples revealing that dermal filaments in these cases are keratin and collagen in composition and result from proliferation and activation of keratinocytes and fibroblasts in the epidermis. Spirochetes were detected in the dermatological specimens from our study patients, providing evidence that Morgellons disease is associated with an infectious process.Keywords: Morgellons disease, digital dermatitis, Lyme disease, Borrelia burgdorferi, spirochetes, keratin, keratinocytes, collagen, fibroblasts
Characterization and evolution of dermal filaments from patients with Morgellons disease
Middelveen MJ, Mayne PJ, Kahn DG, Stricker RB
Clinical, Cosmetic and Investigational Dermatology , 2013, DOI: http://dx.doi.org/10.2147/CCID.S39017
Abstract: racterization and evolution of dermal filaments from patients with Morgellons disease Original Research (6113) Total Article Views Authors: Middelveen MJ, Mayne PJ, Kahn DG, Stricker RB Video abstract presented by Raphael B Stricker Views: 1031 Published Date January 2013 Volume 2013:6 Pages 1 - 21 DOI: http://dx.doi.org/10.2147/CCID.S39017 Received: 10 October 2012 Accepted: 28 November 2012 Published: 08 January 2013 Marianne J Middelveen,1 Peter J Mayne,1 Douglas G Kahn,2 Raphael B Stricker1 1International Lyme and Associated Diseases Society, Bethesda, MD, USA; 2Department of Pathology, Olive View–UCLA Medical Center, Sylmar, CA, USA Abstract: Morgellons disease is an emerging skin disease characterized by formation of dermal filaments associated with multisystemic symptoms and tick-borne illness. Some clinicians hypothesize that these often colorful dermal filaments are textile fibers, either self-implanted by patients or accidentally adhering to lesions, and conclude that patients with this disease have delusions of infestation. We present histological observations and electron microscopic imaging from representative Morgellons disease samples revealing that dermal filaments in these cases are keratin and collagen in composition and result from proliferation and activation of keratinocytes and fibroblasts in the epidermis. Spirochetes were detected in the dermatological specimens from our study patients, providing evidence that Morgellons disease is associated with an infectious process.
Lifa Disease: Frictional Dermal Melanosis over Bony Prominences (Clinicopathological Study)  [PDF]
Khalifa E. Sharquie, Muhsin A. Al-Dhalimi, Adil A. Noaimi, Hussein A. Al-Sultany
Journal of Cosmetics, Dermatological Sciences and Applications (JCDSA) , 2012, DOI: 10.4236/jcdsa.2012.23036
Abstract: Background: Lifa disease (Frictional dermal melanosis over bony prominences) has been described in Iraq for the first time in 1993, as a new distinctive pigmentary skin condition that followed chronic friction with a body washing agent (lifa) during bathing. Objective: To assess this increasingly common problem where still many doctors unaware about its presence especially in other Middle East countries. Patients and Methods: A case series descriptive study done in Departments of Dermatology-Najaf and Baghdad Teaching Hospitals, between March 2007- Oct.2008. Full history and clinical examination were done for all patients including Wood's light examination. Biopsies were taken from 21 patients and sent for hematoxylin-eosin and Congo red stains. Results: Fifty two (49 female and 3 male) patients with typical clinical features of lifa disease were studied. The mean age of presentation was 27.92 ± 7.58 years. All patients were slim with prominent bones and low body mass index, used lifa vigorously during bathing.Pigmentation was distributed bilaterally and symmetrically over bony prominences. The most common affected sites were: clavicular areas (67.3%) and upper back (42%). Wood's light and histopathological examinations revealed dermal melanosis. No amyloid deposit was detected by using Congo red stain in any patient. Conclusions: Lifa disease is a common distinctive pigmentary disfiguring problem especially among females. The histopathology showed dermal melanosis, and might be confused with other pigmentary problems like macular amyloidosis.
Dementia and Depression with Ischemic Heart Disease: A Population-Based Longitudinal Study Comparing Interventional Approaches to Medical Management  [PDF]
W. Alan C. Mutch,Randall R. Fransoo,Barry I. Campbell,Dan G. Chateau,Monica Sirski,R. Keith Warrian
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0017457
Abstract: We compared the proportion of ischemic heart disease (IHD) patients newly diagnosed with dementia and depression across three treatment groups: percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical management alone (IHD-medical).
Evaluation of an Amniotic Membrane-Collagen Dermal Substitute in the Management of Full-Thickness Skin Defects in a Pig  [PDF]
Hyunji Kim,Daegu Son,Tae Hyun Choi,Samhyun Jung
Archives of Plastic Surgery , 2013, DOI: http://dx.doi.org/10.5999/aps.2013.40.1.11
Abstract: Background To minimize the inflammatory reaction and improve healing, a new modifieddermal substitute composed of an atelocollagen, chondroitin-6-sulfate, and amnioticmembrane (AM) was applied to full-thickness skin defects in a pig. Atelocollagen was extractedfrom bovine skin, and two modified dermal substitutes were generated according to the crosslinkingtype.Methods The AM-collagen dermal substitutes were characterized and compared withcurrently used dermal substitutes in a pig skin defect model. There were five experimentalgroups: dehydrothermal (DHT) cross-linking atelocollagen with the AM on the top (AM-DHT),DHT and chemical cross-linking atelocollagen with the AM on the top (AM-DHT/chemical),Terudermis, Integra, and AlloDerm. After 3×3 cm full-thickness skin defects on the back ofa pig were created, each dermal substitutes dermal substitutes was randomly grafted on thedefects. Two weeks after grafting, autologous partial-thickness skin was over-grafted on theneodermis. The take rate of the dermal substitutes, skin, and histological sections were allassessed at 1, 2, and 4 weeks postoperatively.Results More rapid healing and a higher take rate were evident in the AM-DHT and Terudermisgroups. Histological examination revealed fewer inflammatory cells and more fibroblasthyperplasia in these two groups. Four weeks after surgery, the amount of newly formedcollagen was significantly more appropriate in the AM-DHT group.Conclusions These observations provide supporting evidence that a newly developed amnioticcollagendermal substitute may inhibit inflammatory reactions and promote wound healing.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.