The isolated dissection of the splanchnic artery is relatively rare and there is no consensus on the optimal treatment strategy. We report 4 cases of isolated splanchnic dissection. The mean patient ...age was 54 years (range, 47-64), and all were treated with conservative therapy during the period of observation. In all 4 cases, conservative management successfully resolved the isolated dissection of a splanchnic artery, with a benign clinical course and no evidence of progression of the dissection on multidetector computed tomography following the therapeutic periods. It is considered common that isolated splanchnic dissection progression is limited during the period of observation and furthermore, develops little 6 months after onset. Multidetector computed tomography is useful not only for accurate diagnosis in isolated splanchnic artery dissection, but also when considering its treatment. Based on our experience, cases without acute intestinal ischemia or aneurysmal changes can be treated conservatively.
Purpose: Human fibroblast growth factor (bFGF, Fibrast^○!R Spray 500, Kaken Pharmaceutical, Tokyo) has been used clinically as a new wound healing accelerator in the treatment of burns and bedsores. ...The use of bFGF for the treatment of infant perianal abscess, a potential new application, was investigated. Methods: The subjects were 9 boys with infant perianal abscess who underwent therapy at the department after October 2007 (average age at the time of therapy, 5.1 months). Results: The first patient had intractable infant perianal abscess, and although the patient was treated on an outpatient basis for 9 months to drain out pus, the patient did not respond. However, bFGF quickly eliminated inflammation and purulent discharge in 5 days. The patient was then monitored without any treatment, and bFGF was used again when mild recurrence occurred in one location 7 months later; no recurrence has been seen in the 6 months since that time. In the subsequent 8 patients, bFGF was used as initial therapy, and in all cases, bFGF quickly eliminated purulent discharge and inflammation (mean±SD; 7.3±1.9 days), as in the first patient. In 1 of the 8 patients, a mild purulent discharge was seen at another location, but it disappeared after bFGF was used twice, and it has not recurred. Conclusions: The results suggest that bFGF quickly suppresses inflammation in infant perianal abscess (anal infection), and when compared to conventional techniques, such as squeezing and drainage, bFGF is a convenient and useful treatment.
Zusammenfassung
Hintergrund
Der Großteil der Wachstumsstörungen der Wirbelsäule ist erworben und deren Ätiologie noch immer unbekannt. Sowohl bei den Skoliosen als auch bei den sagittalen ...Profilstörungen kommen die idiopathischen Formen am häufigsten vor.
Ätiologie
Die Ätiologie ist multifaktoriell und neben genetischen, hormonellen und mechanischen Faktoren scheinen auch Stoffwechselkomponenten mitbeteiligt zu sein. Das Progressionsrisiko einer bestehenden Deformität ist während des pubertären Wachstumsschubs besonders hoch. Entsprechend sollten in dieser vulnerablen Phase regelmäßige klinisch-radiologische Kontrollen erfolgen. Neuerdings werden unter Berücksichtigung der in den letzten Jahren gewonnenen Erkenntnisse über den Zusammenhang von Wirbelsäulen- und Thoraxwachstum und der damit verbundenen Lungenreifung die Deformitäten weniger nach ihrer Ätiologie, als vielmehr nach dem Zeitpunkt der Diagnosestellung eingeteilt. Unter dem Begriff Early-Onset-Skoliosen werden dementsprechend alle Deformitäten der Wirbelsäule subsumiert, welche vor dem 10. Lebensjahr nachgewiesen werden.
Therapie
Bei Versagen der so lange wie möglich einzusetzenden konservativen Therapien sollten definitive Fusionen durch Verwendung wachstumslenkender operativer Techniken hinausgezögert und damit eine den Umständen entsprechend optimale Lungenfunktion angestrebt werden.
The treatment of clinically locally advanced prostate cancer (cT3-4) is subject to controversies. Patients with lymph node metastases as well as patients with overstaged localized and thus curable ...disease fall into this category. Radical prostatectomy, external beam radiotherapy and early or deferred hormonal therapy are possible treatment options. Multimodal treatment (i.e., a combination of these options) is frequently used. After radical prostatectomy, Gleason score-adjusted disease-specific survival does not differ meaningfully between the tumor stages pT2 and pT3-4. In the case of lymph node metastases after radical prostatectomy, but not in node-negative disease, adjuvant hormonal treatment seems to improve survival. Adjuvant radiotherapy may improve biochemical and local control in locally advanced prostate cancer, a survival benefit has, however, not yet been proven. External beam radiotherapy alone provides unfavourable survival rates in locally advanced prostate cancer. Adjuvant hormonal treatment may improve outcome in this setting. When no curative treatment is chosen, early hormonal treatment seems to provide modest benefit compared with deferred therapy.
We report a 52-year-old female with end-stage osteoarthritis of the hip accompanied by acetabular dysplasia in whom quality of life (QOL) was improved by Kampo treatment. When she was 42 years old, ...she developed pain in the left hip joint, and early-stage OA of the hip was diagnosed by hip joint x-ray. Therefore, she took NSAIDs, and received conservative therapies such as diet and muscle training. However, pain in the hip joint increased and her activity of daily life (ADL) decreased at the age of 50, although she continued to receive the conservative therapies. At the age of 52, she consulted our department requesting Japanese Oriental (Kampo) Medicine. Kampo formulae; Keishikaryojutsubuto (12Tab/day: Kuracie Co. Ltd. Japan), and Boiougito (7.5 g/day: Kuracie Co. Ltd. Japan), were administered. Treatment for 3 months resulted in a decrease in the left hip joint pain using visual analogue scale (VAS) and improvement of her ADL. One year later, her joint symptoms have not increased, and both the Harris hip score and the clinical evaluation criteria of osteoarthritis of the hip have improved.
The course of this disease varies depending on the lifestyle of the patient, and Kampo formulations may offer safe, potent supplemental treatment.
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