No abstract available.
Sturge-Weber Syndrome*

The study of bacteriophage began by F.W. Twort in 1915 and the lytic cycle recognized by d'Herellel in 1917. It repeated about the marine bacteriophage containing Vibrio phage by Smith, Spencer and Ju. Authors isolated 2 virulent phages for the pathogenic V. alginolyticus from marine products. These 2 phages were examined their ultrastructure & host-infection by elecron microscopy and in vivo test using skin of rats. V. alginolyticus phages(VAPs) fomed plaques about 0.5 - 0.9mm in diameter and bands 50 - 60% in sucrose density gradient. VAP had 50 - 120nm tail and 40 - 90nm head in diameter. In vivo test, using rat skin, as well as in vitro test VAP had the activity to V. alginolyticus isolated.
Animals ; Bacteriophages* ; Coriolaceae ; Head ; Microscopy ; Rats ; Skin ; Sucrose ; Tail ; Vibrio alginolyticus* ; Vibrio*

No abstract available.
Ectromelia*

No abstract available.
Carcinoma, Basal Cell

No abstract available.
Bowen's Disease ; Vulva

Malignant esophago-bronchial fistula is an incurable and distressing condition. The passage of swallowed saliva and solid or liquid food into the bronchial tree causes coqghing and frequent pulmonary infection and collapse. Most patients are unfit for major surgery, but intubation offers a quick, simple and effective treatment with improved length and quality of life. However, intubation with simple esophageal tubes are liable to result in failure to occlude the fistela, migration of the tube, erosion, and in the case of latex tubes, disintegration. To overcome these problems, the fistula is intubated perorally with a prosthesis surrounded by a foam rubber cuff contained ia silicone sheath, in which vacuum can be created. This cuffed prosthesis is the most satisfactory design for the treatment of malignant esophago-bronchial fistula with effiective and gentle occlusion of the fistula without risk of pressure necrosis. We experienced a case of the endoscopic treatment with a cuffed prosthesis for malignant esophago-bronchial fistula. So we report this case with brief review of the previous literatures.
Bronchial Fistula* ; Esophageal Neoplasms ; Fistula ; Humans ; Intubation ; Latex ; Necrosis ; Prostheses and Implants* ; Quality of Life ; Rubber ; Saliva ; Silicones ; Vacuum

Bone marrow transplantation has become an accepted treatment for malignancy(particulary leukemia and lymphoma), aplastic anemia, and certain inborn errors of metabolism. In addition to the problem of severe, prolonged myelosuppression, bone marrow transplantation is associated with several unusual complications. Among the complications such as GVHD, graft rejection, interstitial pneumonia and veno-occlusive disease, involvement of the gastrointestinal tract by GVHD is associated with high graft failure and mortality. Intestinal GVHD is usually manifest clinically as voluminous secretory diarrhea accompanied by abdominal cramping, ileus, nutritional depletion, and, at times, hemorrhage. We experienced a case of severe intestinal GVHD after allogeneic marrow transplantation for treatment of severe aplastic anemia. He received bone marrow from his elder sister, HLA-matched multiparous woman and suffered from large amount of watery diarrhea with skin rash 34 days after transplantation. 1n spite of prednisolone therapy the symptom was progressed. After sigmoidoscopic mucosal biopsy, intestinal GVHD was confirmed and we tried methylprednisolone pulse therapy. Skin lesion was improved but the amount of diarrhea was increased with intermittent abdominal cramping. We tried ALG(anti-lymphocyte globulin) and conservative management but the patient did not respond the therapy. He succumbed to pneumonia and acute respiratory insufficiency complicated with GVHD, 70days after transplantation.
Anemia, Aplastic* ; Biopsy ; Bone Marrow Transplantation* ; Bone Marrow* ; Colic ; Diarrhea ; Exanthema ; Female ; Gastrointestinal Tract ; Graft Rejection ; Hemorrhage ; Humans ; Ileus ; Leukemia ; Lung Diseases, Interstitial ; Metabolism, Inborn Errors ; Methylprednisolone ; Mortality ; Pneumonia ; Prednisolone ; Respiratory Insufficiency ; Siblings ; Skin ; Transplants

BACKGROUND: Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU. METHODS: We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission. RESULTS: Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001). CONCLUSIONS: Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.
Advance Directives ; Cardiopulmonary Resuscitation ; Consent Forms ; Critical Illness* ; Hospital Mortality ; Humans ; Intensive Care Units ; Resuscitation Orders* ; Retrospective Studies ; Shock, Septic

BACKGROUND: To compare the diagnostic value between Phalen's test and reverse Phalen's test using a morphological change of the median nerve and the carpal tunnel in diabetics and normal controls seen by high-resolution ultrasonography and to research on an ultrasonography as an available tool for the screening and follow up aid-test of the carpal tunnel syndrome(CTS). METHODS: A cross-sectional area and a flattening ratio of the median nerve, and a cross-sectional area of the carpal tunnel were measured in neutral, maximally flexed(Phalen's test), and maximally extended (reverse Phalen's test) positions in 59 wrists of 30 normal controls and 60 wrists of 30 diabetics. RESULTS: 1) In controls and diabetics, the mean cross-sectional area of median nerve at the hamatum were 8.8/10.2 mm2, 8.0/9.5 mm2, 8.3/9.4 mm2, the mean flattening ratio were 3.0/3.0 mm2, 2.4/2.0 mm2, 3.2/3.0 mm2, the mean cross-sectional area of carpal tunnel were 176.5/197.7 mm2, 157.9/187.0 mm2, 170.6/192.5 mm2 in neutral, maximal flexion and maximal extension. 2) In controls, the cross-sectional area of median nerve and carpal tunnel were significantly decreased in maximal flexion(p<0.01), and in maximal extension(p<0.01). 3) In controls, the mean flattening ratio of median nerve was revealed significant change in maximal flexion(p<0.01), and in maximal extension(p<0.01). 4) In diabetics, the flattening ratio was significantly decreased in maximal flexion(p<0.01) with com- paring to neutral position. 5) In diabetics, the cross-sectional area of median nerve and carpal tunnel were significantly increased in all positions(p<0.05), and the mean flattening ratio of median nerve was similar to controls. CONCLUSION: In diabetics, increased cross-sectional area of median nerve can be explained by swelling of median nerve, also increased cross-sectional area of carpal tunnel is can be said to have taken place by the decreasing of the useful space in between the median nerve and carpal tunnel, this show that the diabetics have the high risk of the CTS. Phalen's test reveals higher degree of irritation to median nerve, The high-resolution ultrasonography is suggested as an available tool for the screening and follow up aid-test for the CTS
Carpal Tunnel Syndrome ; Follow-Up Studies ; Mass Screening ; Median Nerve* ; Ultrasonography ; Wrist*

Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.
Adult ; Anesthesia, Local ; Anesthetics ; Cone-Beam Computed Tomography ; Facial Nerve ; Female ; Foreign-Body Migration ; Hemorrhage ; Humans ; Incidence ; Mandibular Nerve ; Needles* ; Paralysis ; Trismus