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A 65-year-old Japanese male, who was treated for Fournier's gangrene, developed an enlarged erythema over the right thigh and right lower quadrant. The area was surgically debrided, and he was given antibiotics. However, he complained of abdominal swelling with a metallic bowel sound, pain, and vomiting and was then treated for paralytic ileus. Although his symptoms initially improved, he complained again of the same symptoms and underwent surgery for mechanical ileus occurring at the site of a surgical scar from an appendectomy 43 years earlier. This is a very rare case of Fournier's gangrene which caused mechanical ileus of the small intestine and adherence to a peritoneal scar after paralytic ileus due to inflammation of the abdominal fascia following scrotal gangrene. 相似文献
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Nagano Y Nojiri K Matsuo K Tanaka K Togo S Ike H Shimada H 《Journal of the American College of Surgeons》2005,201(4):511-516
BACKGROUND: The aim of this study was to evaluate the impact of patient age on surgical therapy for colorectal liver metastases. STUDY DESIGN: Between 1992 and 2004, 212 consecutive patients underwent potentially curative hepatic resection. Sixty-two patients were 70 years or older at the time of resection (older group) and 150 patients were less than 70 years at the time of resection (younger group). RESULTS: A proportion of older patients had a history of severe cardiopulmonary disease (32.3%) and respiratory insufficiency (6.5%). Intraoperative variables, such as resected liver volume, operation time, estimated blood loss, and blood transfusion, were not notably different between older and younger patients. Postoperative complications after resection occurred in 19.7% of older patients and at a similar rate (23.3%) in the younger group. Resection mortality was 0% in older patients and 0.49% in younger patients. The 5-year survival rates of older and younger patients were 34.1% and 53.1%, respectively. Compared with younger patients, the overall survival rate of older patients was markedly lower (p<0.01). CONCLUSIONS: Advanced chronologic age cannot be regarded as a medical contraindication for hepatic resection of colorectal liver metastases in patients who are more than 70 years of age. 相似文献
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Yoshikatsu Saiki Masaki Hata Junetsu Akasaka Takeshi Saito Koichi Tabayashi 《General thoracic and cardiovascular surgery》2005,53(12):638-640
A 77-year-old man developed deep sternal wound infection withEnterobacter cloacae 4 days after total aortic arch replacement for distal aortic arch aneurysm. Reexploration and open drainage of the mediastinum was carried out for 4 days, and the vacuum-assisted closure system was applied and continued for 10 days. During the treatment, granulation formation and neovascularization was apparently enhanced which lead us to perform omental transfer and chest closure on the 18th postoperative day. The patient has been free from recurrent sign of mediastinal infection or graft infection for the 19 months of the follow-up period. 相似文献
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An ingenious design for peptide vaccines 总被引:8,自引:0,他引:8
For humoral immunization, it may be possible to make effective and safe peptide vaccines for various diseases by selection of proper B-cell epitopes. However, a lack of T-cell epitopes on short peptides, such as those associated with major histocompatibility complex (MHC)-restriction, is a major problem for peptide vaccine development. We propose a solution for the design of peptide vaccines that involves induction of broadly reactive T-cell epitopes via agretopes. The strategy involves positioning multi-agretope type peptides on the N-terminal side of a di-lysine linker and B-cell epitopes on the C-terminal side. The addition of the arginine-glysine-aspartate (RGD)-motif to the N terminus of the peptide enhances its immunogenicity, and enables nasal immunization without adjuvants. 相似文献