Convincing evidence suggests that females and males are different in regard to susceptibility to both infectious and non-infectious diseases. Sex and gender influences the severity and outcome of several infectious diseases, including leptospirosis, tuberculosis, listeriosis, Q fever, avian influenza and SARS.

Nevus lipomatosus superficialis is an uncommon form of connective tissue nevus and is manifest principally by the deposition of fatty tissue in the dermis. In this disease two clinical types are distinguished. The classic type consists of asymptomatic linear, soft, flesh-colored to yellowish papules or nodules that often coalesce into plaque. It is usually located in the pelvic girdle and lumbar area. The solitary form usually appears later in life and can occur at any site. Clinically, it may be confused with neurofibroma and acrochordon. The solitary form has been described as a pedunculated lipofibroma. There is no sexual predilection or hereditary trend. The authors experienced two cases of solitary nevus lipomatosus superficialis. The first case was a 57-year-old male who had a solitary, 1 cm-diametered, flesh-colored, polypoid nodule on the buttock for 4 years. The second case was a 32-year-old female who had a 1.5 cm-diametered, flesh-colored and light brown, polypoid nodule on the right flank for 10 years. Diagnosis was confirmed by clinical and histopathologic findings.
Adipose Tissue ; Adult ; Buttocks ; Connective Tissue ; Dermis ; Female ; Humans ; Light ; Male ; Middle Aged ; Neurofibroma ; Nevus

PURPOSE: The purpose of this project was to explore the parental experience of making a "do not resuscitate" (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. METHODS: A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. RESULTS: Three major themes were identified: (a) "convincing points to sign", (b) "feelings immediately after signing", and (c) "postsigning relief or regret". Feelings following signing the DNR form were mixed and included "frustration", "guilt", and "conflicting hope". Parents adjusted their attitudes to thoughts such as "I have done my best," and "the child's life is beyond my control." Some parents whose child had died before the time of the interview expressed among other things "regret not having enough time to be with and talk to my child". CONCLUSION: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child's end of life process.
Adolescent ; Adult ; Child ; Child, Preschool ; *Decision Making ; Female ; Humans ; Infant ; Intensive Care Units, Pediatric ; Male ; Middle Aged ; Palliative Care/*psychology ; Parents/*psychology ; *Professional-Family Relations ; Qualitative Research ; Resuscitation Orders/*psychology ; Taiwan ; Young Adult

No abstract available.
Carcinoma, Squamous Cell*

Mantle cell lymphoma (MCL) is an uncommon and aggressive form of non-Hodgkin lymphoma and this typically involves lymph nodes. Extranodal involvement is frequent and especially in the bone marrow, spleen, gastrointestinal tract and Waldeyer's ring. MCL is not well represented in the dermatology literature because the skin is rarely involved. We describe here a case of relapse of MCL that was diagnosed by skin metastasis of the face. A 71 year-old male patient presented with erythematous nodules that had been on the Rt. forehead for 6 months. The patient was initially diagnosed as having MCL and he had undergone chemotherapy. A year after complete remission, multiple nodules developed on the forehead. Biopsy of the nodule revealed skin metastasis of MCL.
Biopsy ; Bone Marrow ; Dermatology ; Forehead ; Gastrointestinal Tract ; Humans ; Lymph Nodes ; Lymphoma, Mantle-Cell ; Lymphoma, Non-Hodgkin ; Male ; Neoplasm Metastasis ; Recurrence ; Skin ; Spleen

As our population ages and the rate of spine surgery continues to rise, the use epidural lysis of adhesions (LOA) has emerged as a popular treatment to treat spinal stenosis and failed back surgery syndrome. There is moderate evidence that percutaneous LOA is more effective than conventional ESI for both failed back surgery syndrome, spinal stenosis, and lumbar radiculopathy. For cervical HNP, cervical stenosis and mechanical pain not associated with nerve root involvement, the evidence is anecdotal. The benefits of LOA stem from a combination of factors to include the high volumes administered and the use of hypertonic saline. Hyaluronidase has been shown in most, but not all studies to improve treatment outcomes. Although infrequent, complications are more likely to occur after epidural LOA than after conventional epidural steroid injections.
Constriction, Pathologic ; Failed Back Surgery Syndrome ; Hyaluronoglucosaminidase ; Loa ; Radiculopathy ; Spinal Stenosis ; Spine

OBJECTIVETo prepare and characterize the heavy metal reference material of radix salvia planted in Zhongjiang, Sichuan province under the good agricultural procedure (GAP).

METHODAfter being prepared, the reference material was digested with 65% HNO3 and H2O2 by microwave-assisted oven systems, and the heavy metals in Radix salvia reference material were accurately determined by inductively coupled plasma mass spectrometry (ICP-MS).

RESULTThe measuring method was validated by running certificated reference materials, including bush twigs and leaves (GBW07602) and tea twigs and leaves (GBW07605) under the same conditions. The recoveries of the elements mostly ranged from 90% to 110%, and the RSD was within 5%. The measurement of radix salvia reference material was carried out by different laboratories with ICP-MS and by several time intervals in one year for the stability. The results showed that the concentration of the heavy metals provided were accurate and the reference material was stable.

CONCLUSIONThe reference material is suitable to be the criterions of heavy metals for radix salvia in the qualities controlling, and is also suitable to be the criterion of poisonous heavy metals of other herbs in the administration of GAP.

Agriculture ; standards ; Arsenic ; analysis ; Cadmium ; analysis ; Drug Stability ; Lead ; analysis ; Metals, Heavy ; analysis ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; growth & development ; Quality Control ; Salvia miltiorrhiza ; chemistry ; growth & development

No abstract available.
Lipoma*

STUDY DESIGN: Retrospective comparative study and technical note. PURPOSE: To determine if there is a difference in clinical and radiographic parameters between unilateral and bilateral kyphoplasty in a uniform cancer population and to stress the importance of preoperative planning. OVERVIEW OF LITERATURE: While unipedicular kyphoplasty is gaining popularity, a few comparative studies have reported on superior kyphotic reduction with the bipedicular approach. METHODS: We reviewed 69 myeloma patients with 105 operated levels (51 levels were done bilaterally vs. 54 unilaterally). Pain reduction, height restoration, cement volume and complications were recorded up to three months postoperatively. A technical note to identify the skin entry point on the basis of the magnetic resonance imaging and fluoroscopy (lateral view) is being described. RESULTS: Both procedures resulted in significant pain reduction (5.4-5.6/10 points, p=0.8). There was significant height restoration after the operation (p<0.001), while there was no sustained difference between the procedures (p=0.5) up to three months postoperatively. More cement was injected in the bilateral group (4.1 mL vs. 4.9 mL, p=0.002); no difference in cement extravasation in the spinal canal was observed (p=0.5). CONCLUSIONS: There was no difference in the clinical or radiological outcomes between the unilateral and bilateral approaches. Therefore, unilateral kyphoplasty may be performed whenever it is technically feasible and this may be determined preoperatively.
Fluoroscopy ; Fractures, Compression ; Humans ; Kyphoplasty* ; Magnetic Resonance Imaging ; Multiple Myeloma* ; Retrospective Studies ; Skin ; Spinal Canal

Purpose: The aim of this study was to retrospectively evaluate contrast-enhanced ultrasound (CEUS) findings in patients with peliosis hepatis (PH). Methods: A retrospective analysis was conducted of CEUS features in 24 patients with histopathologically confirmed PH (11 men and 13 women; mean age, 32.4±7.1 years; range, 28 to 41 years). All lesions were histologically proven, either by core needle biopsy (n=10) or by hepatic surgery (n=14). Results: The mean size was 36.8±12.4 mm (range, 10 to 80 mm). On B-mode ultrasonography (BMUS), all PH lesions were heterogeneously hypoechoic, with well-defined margins but irregular shapes. No mass effect was observed. During the arterial phase of CEUS, all lesions displayed mild heterogeneous hyperenhancement (83.3%, 20/24) or isoenhancement (16.7%, 4/24). Furthermore, 87.5% of the PH lesions showed mild washout after 1 minute in the portal venous phase (30-120 seconds) and mild washout in the late phase (>120 seconds). Conclusion The lack of a mass effect on BMUS, mild heterogeneous arterial hyperenhancement, and washout in the very late portal venous phase (after 1 minute) on CEUS are characteristic of PH. Although it is a histological diagnosis, PH should be considered in the differential diagnosis when the clinical context does not favor a malignancy or infection.