Moser Straarup (walltoe05)

However, this study shows that this is not the case and that after the end of radiotherapy patients started using new CAM methods or increased the number of methods used. CAM use is mainly reported to be a static phenomenon. However, this study shows that this is not the case and that after the end of radiotherapy patients started using new CAM methods or increased the number of methods used. Post-pump chorea (PPC), defined as the development of chorea after major cardiac surgery utilizing cardiopulmonary bypass (CPB), has been rarely reported in adults. We compared 17 patients with adult-onset PPC to controls who did not develop chorea after cardiac surgery with CPB. Two patients were enrolled using hospital based data and 15 were collected by a systematic literature review. The controls without chorea after CPB (n=4208) were collected using hospital based data. We described the clinical and surgical features of adult-onset PPC and compared them with those of the controls. Ten of 17 PPC patients were male, the mean age was 46.8years, and the mean onset latency was 6.0days. The adult-onset PPC patients were younger (46.8±16.7 vs. 59.1±15.0, p=0.001), had a lower minimum body temperature (23.3±5.5 vs. 29.7±3.7, p<0.001) and a longer total circulatory arrest time (63.7±7.5 vs. 21.0±14.6, p<0.001) than controls. Forty-three percentage of patients with adult-onset PPC had persistent chorea on follow-up, and these patients showed a higher rate of abnormal initial brain MRI compared with the patients with good clinical outcomes (p=0.041). The onset age, onset latency, underlying disease, treatment response, and surgical features were variable among PPC patients, while abnormal initial brain MRI was associated with persistent chorea. Pooling more cases through multicenter efforts will hopefully provide more knowledge on the underlying pathophysiology, prevention, and management of PPC. The onset age, onset latency, underlying disease, treatment response, and surgical features were variable among PPC patients, while abnormal initial brain MRI was associated with persistent chorea. Pooling more cases through multicenter efforts will hopefully provide more knowledge on the underlying pathophysiology, prevention, and management of PPC. Concurrent bladder neoplasm and giant bladder stone are rare in contemporary urological practice. Squamous cell carcinoma (SCC) is rare histologic diagnosis of bladder cancer. A 45 y.o. male, with lower abdominal pain when urinating, that comes and goes in the last 35 years. He had gross hematuria a year ago. The patient comes from a rural region, which undiagnosed for years. Physical examination showed a suprapubic abdominal solid mass, sized 20 × 10 cm, without tenderness. On plain radiography, showed radiopaque lesion which fully occupies the bladder. The ultrasound showed bilateral hydronephrosis. The patient underwent vesicolithotomy, and a giant bladder stone (size of 14 × 9 cm) was found, with incidental finding of suspicious malignant mass. The patient refuses radical cystectomy. Due to mass characteristics that are manageable for complete excision and the need for histopathological studies, bladder preservative therapy was applied with complete tumor excision and biopsy. The mass pathological diagnosis is grade 2 squamous cell carcinoma with lamina muscularis invasion, staged pT3bN0M0. The patient underwent cisplatin-based chemotherapy, with regular evaluation. The possibility of future radical cystectomy remains open. By diameter, the stones found in our patient is perhaps one of the largest that ever reported being associated with bladder SCC. The bladder stones causing chronic mucosal injury, lead to the development of SCC. In limited situation, bladder preservation therapy may be considered for muscle-invasive bladder cancer. Despite its rarity, SCC along with the chronic bladder stone is poss