Pain and itch are unpleasant sensations that often accompany infections caused by viral, bacterial, parasitic, and fungal pathogens. Recent studies show that sensory neurons are able to directly detect pathogens to mediate pain and itch. Nociceptor and pruriceptor neurons respond to pathogen-associated molecular patterns, including Toll-like receptor ligands, N-formyl peptides, and bacterial toxins. Other pathogens are able to silence neuronal activity to produce analgesia during infection. Pain and itch could lead to neuronal modulation of the immune system or behavioral avoidance of future pathogen exposure. Conversely, pathogens could modulate neuronal signaling to potentiate their pathogenesis and facilitate their spread to other hosts. Defining how pathogens modulate pain and itch has critical implications for sensory neurobiology and our understanding of host-microbe interactions.
Animals ; Humans ; Infection ; complications ; etiology ; pathology ; Neurons ; pathology ; Pain ; etiology ; pathology ; Pruritus ; etiology ; pathology

Infradiaphragmatic extralobar pulmonary sequestration is an extremely rare congenital malformation. It is more frequently diagnosed in the antenatal period due to routine ultrasonic examination of the fetus or in the first 6 months of life, though on rare occasions it is discovered incidentally in adults. A 32-yr-old man presenting with epigastric discomfort and fever was referred. Computed tomographic scanning showed that a 16-cm, multiseptated, dumbbell-shaped, huge cystic tumor was located beneath the diaphragm. On the next day, 850 mL of thick yellowish pus was drained by sonography-guided fine needle aspiration for the purpose of infection control and diagnosis, but no microscopic organisms were found in repeated culture studies. Surgical removal of the cyst was performed through thoracoabdominal incision and most of these pathologic lesions were removed but we could not find the feeding arteries or any fistulous tract to surrounding structures. Histopathologic study revealed that it was extralobar pulmonary sequestration and culture study showed that many WBC and necrotic materials were found but there were no microorganisms in the cystic contents. We report the first case of an infected infradiaphragmatic retroperitoneal extralobar sequestration which was administered a staged management and achieved an excellent clinical course.
Adult ; Bronchopulmonary Sequestration/complications/*pathology/surgery ; Diaphragm/abnormalities ; Humans ; Infection/complications/pathology ; Male ; Retroperitoneal Space/abnormalities

A falciform ligament abscess is a rare type of intra-abdominal abscess. A 2-yr-old male, who had omphalitis two months previously, presented with a fever and right upper quadrant abdominal pain. The ultrasound and CT scan showed an abdominal wall abscess located anterior to the liver, which was refractory to conservative management with percutaneous draninage and antibiotics. On the third recurrence, surgical exploration was performed and revealed an abscess arising from the falciform ligament; the falciform ligament was excised. A follow up ultrasound confirmed complete resolution of the abscess with no further recurrence.
Abdominal Abscess/*etiology/surgery ; Child, Preschool ; Humans ; Infection/*complications ; Ligaments/*pathology/surgery ; Male ; Umbilicus/*pathology

Child, Preschool ; Humans ; Infection ; complications ; Jugular Veins ; pathology ; Male ; Pharynx ; Rupture ; etiology

Most of palatal fistula occur from poor repairation of cleft palate, leaving an abnormal channel between mouth and nose. Palatal fistula can cause a series of complications, such as voice and hearing disorder, poor oral and nasal hygiene, psychological diseases and so on. However, hard palate fistula secondary to Leukemia infection is rarely seen, it hasn't been reported yet. We report one case with hard palate fistula and nasal septum perforation after Leukemia infection.
Fistula ; Humans ; Infection ; complications ; etiology ; Leukemia ; complications ; Nasal Septal Perforation ; etiology ; Nose ; Nose Diseases ; Oral Fistula ; etiology ; Palate, Hard ; pathology ; Postoperative Complications

OBJECTIVETo investigate the clinical pathology of cavernous venous malformations of the body surface.

METHODSTissue samples of cavernous venous malformations from 42 cases were stained with hematoxylin and eosin to observe the pathologic structure. The clinical manifestations and case history were summarized accordingly.

RESULTSThere was no distribution difference of the malformation in sex and body sides, but with obvious difference in anatomic sites. The malformation occurred most frequently at the head and neck, more frequently at extremities and least frequently at the trunk. According to pathologic structure, cavernous venous malformations of the body surface can be divided into three types: the cellular, the canaliform and the mixed.

CONCLUSIONThe cause of distribution difference in anatomic sites remains unclear. Internal hemorrhage and infection may account for the increased growth and ache of the lesion. The different pathologic structure of the malformation may cause different clinical manifestations.

Adolescent ; Adult ; Aged ; Arteriovenous Malformations ; complications ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infection ; etiology ; Male ; Middle Aged ; Pain ; etiology ; Sex Factors ; Skin ; blood supply ; pathology ; Veins ; abnormalities

OBJECTIVE: To evaluate the safety of the incidental appendectomies in women who undergo total abdominal hysterectomies for benign diseases. METHODS: This was a retrospective case-controlled study of patients who did (n=54) or did not (n=70) undergo incidental appendectomies at the time of an total abdominal hysterectomy between January 2002 and December 2003. Data were obtained about operation time, the number of days with nothing by mouth, the length of hospital stay (LOS), postoperative complications and pathology of appendix. Data were analyzed using student t-test. RESULTS: 1) There was no significant difference between two groups in operation time. The mean time was 120.0+/-23.8 in incidental appendectomy group and 112.5+/-23.9 minutes in control group. 2) There was no significant difference between two groups in the days with nothing by mouth. The mean was 1.06+/-0.23 in incidental appendectomy group and 1.03+/-0.17 days in control group. 3) There was no significant difference between two groups in the length of hospital stays. The mean was 7.34+/-0.68 in incidental appendectomy group and 7.14+/-1.15 days in control group. 4) There were no significant differences between two groups with respect to the post operative complications; fever, wound infection, stump disruption, and postoperative bleeding. 5) Seventy-six percent of the histologic specimens were abnormal, with fecalith being most common, and there were three cases of acute appendicitis. CONCLUSION: An incidental appendectomy at the time of hysterectomy does not increase operation time, the days with nothing by mouth, LOS, and postoperative complication rates. The incidental appendectomies during total abdominal hysterectomy may be safe procedures.
Appendectomy* ; Appendicitis ; Appendix ; Case-Control Studies ; Fecal Impaction ; Female ; Fever ; Hemorrhage ; Humans ; Hysterectomy* ; Length of Stay ; Mouth ; Pathology ; Postoperative Complications ; Retrospective Studies ; Wound Infection

BACKGROUND: For complicated appendicitis, in contrast to simple appendicitis, laparoscopic appendectomy (LA) is considered a relative or absolute contraindication because of the higher postoperative complication rate than that of open appendectomy (OA), especially, high incidence of intra-abdominal abscess. The purpose of this article is to assess the feasibility of LA for complicated appendicitis. METHODS: A retrospective review of 35 LA and 128 OA for the cases of gangrenous, perforated appendicitis, and periappendiceal abscess between May 1995 and June 1997 was performed. Patients were identified through the hospital pathology registry. We compared data from both groups with respect to operative times, postoperative pain, duration of ileus, length of hospital stay, and complication rate, with special attention to the incidence of intra-abdominal abscess. RESULTS: 1) The male:female ratio of LA (1:1.2) was significantly lower than that of OA (1:0.45) (p<0.05). There was no significant difference in the age distribution between both groups. 2) The mean operative time of LA (58.3 minutes) was significantly longer than that of OA (51.8 minutes) (p<0.05). 3) The mean number of injections of analgesics and the mean duration of ileus represented an advantage for LA (1.2 times and 1.8 days) than those of OA (1.6 times and 2.0 days). But these differences did not reach statistical significance. 4) The length of hospital stay of LA (6.5 days) was shorter than that of OA (7.8 dyas) (p<0.05). 5) Overall postoperative complication rate was lower in LA (11.4%) compared with OA (11.7) (p>0.05). But LA was associated with higher incidence of postoperative intra-abdominal abscess (3/35, 8.6%) than OA (3/128, 2.3%) (p=0.114). There was one serious intra-abdominal abscess in the LA, which required reoperation. The rest 2 cases in the LA and all 3 cases in the OA were treated conservatively. CONCLUSIONS: LA for complicated appendicitis could afford the merits of shorter hospital stay, reduced incidenceof wound infection, and comparable incidence of overall complication rate. To reduce the incidence of postoperative intra-abdominal abscess, copious irrigation and adequate drainage should be recommended.
Abdominal Abscess ; Abscess ; Age Distribution ; Analgesics ; Appendectomy ; Appendicitis* ; Drainage ; Humans ; Ileus ; Incidence ; Length of Stay ; Operative Time ; Pain, Postoperative ; Pathology ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Wound Infection

OBJECTIVETo study the prevention and treatment on the donor site sequelae after autologous breast reconstruction with extended latissimus dorsi flap.

METHODS88 patients received breast reconstruction with extended latissimus dorsi flap between May 1999 and Nov 2004 were concerned. We analyzed the donor site sequelae by objective and subjective evaluation and we assessed the functional condition. Results Dorsal hematoma developed in 1 patient. There are 7 patients with dorsal seromas and 2 of them developed capsules; 5 patients with mild skin exfoliate and 1 patient with dry skin necrosis, 2 winged shoulders. No infection and no hypertrophic scars appeared in donor site. There is no significant functional limitation and no influence in daily life.

CONCLUSIONSThe main complication after autologous breast reconstruction with extended latissimus dorsi flap was seromas and it can be controlled to decrease. There is no severe complication. It's a worthy method in autologous breast reconstruction in oriental people.

Adult ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Middle Aged ; Muscle, Skeletal ; pathology ; transplantation ; Surgical Flaps ; Surgical Wound Infection ; complications ; Young Adult

Wound sepsis is one of the main causes of death in patients with severe burn and trauma. The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function, poor resistance against infection, and the weakened skin barrier function after burn. The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology, epidemiology, pathogenesis, and diagnostic criteria, in order to improve its early diagnosis and treatment.
Burns ; complications ; prevention & control ; therapy ; Child ; Humans ; Sepsis ; diagnosis ; etiology ; mortality ; therapy ; Skin ; microbiology ; pathology ; Survival Rate ; Wound Infection ; mortality ; prevention & control ; therapy