Surgery today
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An 80-year-old woman presented to our outpatient center with abdominal pain and blood-stained stools. She underwent a colonoscopy, which showed a 4-cm type II tumor in the rectum. About 2 h after the colonoscopy, mild facial edema and subcutaneous emphysema developed around her neck. ⋯ The air seemed to have leaked from a 2-cm inflamed diverticulum in the sigmoid colon. The mesosigmoid was also expanded by air. We discuss the anatomical mechanism of the various clinical presentations of extraluminal air following colonoscopy.
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Review Case Reports
Primary cutaneous mucormycosis in an immunocompetent host: report of a case.
Cutaneous mucormycosis is an uncommon disease and it usually affects immunocompromised, diabetic, and trauma patients with contaminated wounds or patients with underlying malignancies. It is very rare to find this disease in immunocompetent, nondiabetic patients. We herein report a case of primary cutaneous mucormycosis in an immunocompetent and nondiabetic patient. ⋯ He was diagnosed to have cutaneous mucormycosis of the anterior abdominal wall, and was treated with multiple debridements of the wound and intravenous amphotericin B therapy. He received a total of 1000 mg of amphotericin B. A high index of clinical suspicion and early institution of therapy in the form of surgical debridements and antifungal drugs are required to achieve a successful outcome.
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Review Case Reports
Synchronous bilateral breast cancer with Paget's disease and invasive ductal carcinoma: report of a case.
We report a case of synchronous bilateral breast cancer with Paget's disease and invasive ductal carcinoma. A 60-year-old Japanese woman presented with an 8-month history of discharge from the left nipple with eczema and itching. Mammography showed grouped fine calcification in the right breast, which was highly suggestive of right breast carcinoma with an intraductal component. ⋯ There was no metastasis in any of the 24 left axillary lymph nodes resected. We also gave her postoperative adjuvant chemoendocrine therapy, comprised of tamoxifen (20 mg) and UFT (uracil/tegafur) (400 mg)daily. The patient has been disease-free for 4 years since her operation.
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Comparative Study
An evaluation of histomorphometric properties of coronary arteries, saphenous vein, and various arterial conduits for coronary artery bypass grafting.
We evaluated the histomorphological properties of the coronary arteries, saphenous vein, and five arterial conduits for coronary artery bypass grafting, and compared them with each other. ⋯ These findings emphasize the justification of continued use of the ideally matching internal mammary artery, either as an in situ or free graft, in coronary artery bypass grafting, although other arterial grafts can be used in coronary artery bypass grafting. In addition, the intercostal artery was found to have relatively favorable properties regarding its potential suitability as a coronary bypass conduit.
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This report describes a giant peritoneal loose body in the pelvic cavity. A 63-year-old man who was asymptomatic underwent a routine medical examination, which revealed a tumor in the pelvic space. ⋯ Histological examination revealed that this peritoneal loose body was made up of thick layers of fibrous tissue with a few cellular components, and necrotic fat tissue in the central position. Small peritoneal loose bodies are occasionally found during laparotomy or autopsy, but such a large one is very unusual.