Rabies is a fetal viral encephalitis to which all mammals, including man are susceptible. This virus, the genus of Rhabdovirus, is usually present in the saliva of infected animals and is transmitted by their bite. As a rule the virus enter the CNS by ascending along peripheral nervous system and extremely variable in extent. Negri bodies are appear in about 75% of cases. These bodies are eosinophilic, usually rounded inclusions and is located in the cystoplasm of the neurons, most frequently in the pyramidal neurons of the Hippocampus and the Purkinje cells of the cerebellum. We have experienced a case of canine rabies that showed Negri bodies in the Purkinje cells along with diffuse degenerative encephalitis and perivascular mononuclear cells infiltration. The Negri bodies were best demonstrated by Negri body staining although routine H-E staind was also useful. There inclusion bodies were located exclusively in the cytoplasm, and were found occasionally. Electron microscopic findings of the Negri bodies showed aggregates of bulletshaped nucleocapsids. We report a Negri body found in the brain of rabid dog with the light and electron microscopic findings.
Male ; Humans ; Dogs ; Animals

No abstract available.
MELAS Syndrome*

The management of penetrating injuries of zone II of the neck presents a difficult problem. The difficulties are due to the close anatomical relationships between the many vital structures in the neck and to the insidious nature in which some of the injuries may present themselves, for example, esophageal lacerations. If a significant injury is overlooked, the consequences may be dire with severe complication and mortality. Two management strategies have been developed for coping with these difficult injuries : (1) mandatory exploration of all injuries penetrating the platysma, and (2) a selective approach with neck exploration being performed based on clinical and investigative findings. The aim of this study was to review the clinical characteristics of and the various treatment protocols for II penetrating injuries of the neck. We reviewed retrospectively the medical records of 38 patients who were admitted to and treated at Yongdong Severance Hospital, College of Medicine, Yonsei University, due to penetraing injuries of the neck from Jan. 1990 to Dec. 1996. Twenty-three of the 38 patients (60.5%) underwent immediate operative exploration. In 13 of these patients, the exploration produced positive findings (56.5%), and in 10, the exploration produced negative findings (43.5%). Following neck exploration, 13 patients presenting acutely were found to have 21 injuries. The predominant injuries were vascular followed by neurologic and then respiratory. Eight of the 11 patients (73%) with positive clinical findings were found to have injuries at exploration, and 5 of the 12 patients (42%) with no clinical signs were found to have injuries (p=0.0432). Three of 4 patients (75%) with positive CT scan findings were found to have injuries at exploration and 4 of the 8 patients (50%) with no CT scan findings were found to have injuries (p=0.0455). The complication rate and the performance rate of CT scan were not statistically different between patients with a negative neck exploration and patients with conservative management. The duration of hospitalization was an average of 6.2 days for those patients with a negative neck exploration and 4.1 days for those patients with conservative management (p=0.0022). There was no mortality. In conclusion, it is possible, by careful physical examination and CT scan, it will be possible to reduce the rate of negative neck exploration without risk to those patients who need immediate surgery.
Clinical Protocols ; Hospitalization ; Humans ; Lacerations ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Physical Examination ; Retrospective Studies ; Tomography, X-Ray Computed ; Wounds, Penetrating

No abstract available.
Female* ; Humans

We report a case of epidermolysis bullosa simplex occurred in a 12-year-old girl, who presented with intractable bullous lesions of the hands and feet after minor traumas ever since her early neonatal period. The bullous lesions were noted on the 2nd and 4th webs of the fingers and dorsum of the hands as well as on the skin of the ankle. The lesions were healed without scar formation. Family history was not contributary and seasonal pattern was not noted. Histologic sections revealed intraepidermal bullae just above the well preserved basement membrane. Electron microscopic findings revealed cytolysis of basal cells with preservation of the basement membrane, indicating the epidermal type of epidermolysis bullosa simplex.
Infant, Newborn ; Humans

Auricular arterio-venous malformation(AVM) is relatively rare and few have been reported in the literature. Two cases, presented here showed pulsating lesions of anterior and posterior auricular or even retroauricular mastoid area. They caused irregular macro and prominent ear compared with the opposite normal ear. After embolization of feeding arteries to the arteriovenous malformations, skin and subcutaneous masses were completely removed and grafted with full thickness skin: one was removed one stage and the other underwent a two stage operations. There were no evidence of recurrence for more than 2 years follow up and esthetic results were promising.
Arteries ; Arteriovenous Malformations ; Ear ; Follow-Up Studies ; Mastoid ; Recurrence ; Skin ; Transplants

BACKGROUND: The management of penetrating neck injuries presents a difficult problem. Although many authors have stated that surgical exploration should be mandatory for all neck injuries that penetrate platysma, recent reports from many centers now claim selective exploration. The aim of this study was to review a policy of selective neck exploration based on clinical presentation, anatomic location, and the result of diagnostic studies. METHOD: We reviewed retrospectively medical records of 66 patients who were admitted and managed at Yongdong Severance hospital, Yonsei university college of medicine due to penetrating neck injuries from Jan. 1990 to Dec. 1996. RESULTS: Forty-one patients(62%) were underwent immediate neck exploration, while the remaining 25 patients(38%) were admitted and observed. Three had esophagoscopy, four had esophagogram, and three had direct laryngoscopy, all of which revealed normal result except one patient had blood tinged larynx on laryngoscopy. Results of 12 neck explorations(29%) were negative. There was no delayed diagnosis during conservative treatment. There was no mortality. CONCLUSION: We concluded that selective exploration of penetrating neck injuries is both safe and resonable.
Delayed Diagnosis ; Esophagoscopy ; Humans ; Laryngoscopy ; Larynx ; Medical Records ; Mortality ; Neck Injuries* ; Neck* ; Retrospective Studies ; Tolnaftate

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed by overproduction of plasminogen activator inhibitor-1 (PAI-1). Intermittent sequential pneumatic compression (ISPC) is an effective method to prevent deep vein thrombosis. Its action is explained by the mechanical effect on blood flow, as well as by the enhancement of fibrinolysis by the reduction of PAI-1. The aim of this study was to determine the effects of ISPC on coagulation and fibrinolysis after multiple trauma. METHODS: Thirty-nine trauma patients were either treated with ISPC (ISPC group, 20 patients) or without ISPC (control group, 19 patients). We measured the plasma levels of the thrombin antithrombin III complex (TAT), the plasmin alpha 2 plasmin inhibitor complex (PIC), the tissue plasminogen activator (t-PA), and the plasminogen activator inhibitor-1 (PAI-1) on admission and at 1, 2, 3, 6, 12, and 24 hours after admission. RESULTS: The TAT was higher than normal in both groups, with no significant difference between the two groups throughout the study period. The PIC level of ISPC group was significantly higher than that of the control group. In the ISPC group, the PIC level increased gradually, reaching a peak at 3 hours and decreasing thereafter. In the control group, the PIC level increased to a peak level at 2 hours. The TAT/PIC ratio dropped in the first two hours and increased at 3 hours, dropping again thereafter. In the ISPC group, the ratio dropped gradually without an intermittent fluctuation. At 3 and 6 hours, the control group showed a significantly greater ratio compared to the ISPC group. PAI-1 was higher than normal in bothgroups, with a significantly lower level in the ISPC group from 2 hours to 24 hours. For the t-PA level, no difference was noted between the two groups, with the peak level occurring at 1 hour. The PAI-1/t-PA ratio was significantly greater in the control group from 2 hours to 12 hours than in the ISPC group, but the difference was not significant at 24 hours. CONCLUSIONS: In multiple trauma patients, ISPC does not seem to affect coagulation, but enhances fibrinolysis through suppressed PAI-1 production. This effect of ISPC may be maintained for 12 hours.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Thrombin ; Tissue Plasminogen Activator ; Venous Thrombosis

No abstract available.
Esophagus* ; Transplants*

Condyloma acuminatum, a benign disease caused by a filtrable virus, occurs predominantly in the perianal andgenital areas. The lesions are noninvasive but are subject to recurrence. In rare instances, a more aggresive formof this disease, known as "giant condlyloma acuminatum" or "Buschke-Lownestein tumor", occures. In this form,infiltration of the lesion into surrounding structures takes place. This tumor has been reported to occurprincipally in the genitourinary tract. The authors experienced a cases of giant condyloma acuminatum originatingfrom rectum in 67 years old male patient which recurred 3 months after electrofulguration.
Buschke-Lowenstein Tumor ; Humans ; Male ; Rectum ; Recurrence