No abstract available.
Facial Paralysis* ; Fascia Lata* ; Fascia*

Drowning is a leading cause of accidental deaths worldwide, but its pathological diagnosis remains a challenge for forensic pathologists owing to a lack of pathognomonic findings in drowning deaths and inconclusive autopsy findings caused by postmortem changes. The aim of the present study was to investigate the pathway taken by inhaled drowning medium through the airway after death in a variety of experimental conditions, including underwater pressurization. We used methylene blue dye to monitor the spread of drowning medium to the lungs. Results of theses experiments demonstrated that it is possible for a significant amount of downing medium to enter the airway during immersion after death. Our results suggest that autopsies of immersed bodies and interpretation of these findings should be performed with special care.
Animal Experimentation* ; Animals* ; Autopsy ; Diagnosis ; Drowning* ; Immersion ; Inhalation* ; Lung ; Methylene Blue* ; Postmortem Changes

No abstract available.
Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Neurofibromatosis is a syndrome of multiple neurofibromas, abnormal skin pigmentation and certain bony abnormalities. Sometimes the growth of plexiform neurofibromatosis on the face or trunk is centripetal and usually involves the mediastinum and skull base. However, it is very rare that neurofibromatosis involves the trigeminal ganglion. Its encroachment around the foramina of the skull base may induce facial palsy or conductive hearing loss. The guiding principle in the treatment of generalized neurofibromatosis is a radical excision with preservation of vital structures and an immediate reconstruction of the bony skeleton and soft tissue defect. The authors experienced 4 cases of neurofibromatosis involving the trigeminal ganglion. All had trigeminal symptoms for 3 to 4 years. These were severe headache and intractable trigeminal neuralgia. Tumors in all 4 cases were spread in the centripetal type from extracranial neurofibromatosis. The facial nerve was affected in 4 cases. Malignat Schwannoma occurred in 1 case. Accurate diagnosis and assessments were necessary with CT, MRI art oomputer-aided simulation design. Intraoperative bleeding was minimal with hypotensive anesthesia. Surgical approach to the middle cranial fossa involved temporary removal of the zygomatic arch and TMJ disarticulation with downward traction of the mandible. Satisfactory results have been obtained far 3 to 7 years(mean 5 years) follow-up.
Anesthesia ; Cranial Fossa, Middle ; Diagnosis ; Disarticulation ; Facial Nerve ; Facial Paralysis ; Follow-Up Studies ; Headache ; Hearing Loss, Conductive ; Hemorrhage ; Magnetic Resonance Imaging ; Mandible ; Mediastinum ; Neurilemmoma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Skeleton ; Skin Pigmentation ; Skull Base ; Temporomandibular Joint ; Traction ; Trigeminal Ganglion* ; Trigeminal Neuralgia ; Zygoma

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

No abstract available.
Hyperbilirubinemia, Neonatal*

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

This study was undertaken to investigate the efficacy of 5% PABA cream using mouse ear swelling reaction(ESR). Mice were exposed to 100mJ/cm of UVB, five times a week for four weeks, on the both ventral aspect of the ear, with application of 5% PABA cream on the right ear. The results were as follows : 1. The intensity of ear swelling reaction of 5% PABA protected group was reduced greater than unproteeted group after the first 3 days of UUR. 2. The intensity of ear swelling reached at peak after 1 week of the ultraviolet radiation. Thereafter it has decreased gradually the following 4 weeks. The difference of ear swelling between the two groups was the greatest after 1 week, and the sunscreening efficacy of 5% PABA cream has remained persisted for 4 weeks. 3. The number of mice which have shown severe inflarnmatory response after ultravioiet radiation was more in unprotected group than that in 5% PABA protected group. 4. Determination of mouse ESR is considered a good method for the evaluation of longterm efficacy of sunscreen preparation.
4-Aminobenzoic Acid ; Animals ; Ear* ; Mice*

BACKGROUND: Many studies document the presence of abnormalities in amino acids metabolism in chronic uremia. These abnormalities have been attributed to low protein intake, deficiency of excretory and metabolic functions of the diseased kidneys, toxic effects of uremia on the intermediary metabolism of amino acids and in dialysis patients, loss of protein and amino acids by the dialytic procedure. METHODS: This study was designed to compare anthropometric measurement, biochemical characteristics and plasma amino acid concentration between patients with end stage renal disease on maintenance hemodialysis (HD) and normal controls. A cross sectional study of overnight fasting plasma amino acids and plasma albumin, prealbumin, triglyceride (TG), cholesterol, transferrin concentration were performed on 20 hemodialysis patients and 20 normal controls, matched by age and sex. RESULTS: The concentrations of prealbumin (25.60+/-7.05 mg/dL vs 35.08+/-8.11 mg/dL, p<0.005), transferrin (158.30+/-39.66 mg/dL vs 275.50+/-55.46 mg/dL, p<0.001) were found to be lower in HD patients. No differences in albumin, cholesterol and TG were observed between the two groups. Several amino acids (taurine, cystine, phosphoserine) were found to be higher in the HD patients, while the concentrations of other five amino acids (serine, alanine, valine, leucine, tyrosine) were lowered in HD patients. No differences in nine amino acids (asparagine, glutamine, proline, glycine, methionine, isoleucine, lysine, histidine, arginine) were observed between the two groups. CONCLUSION: Our results suggest that chronic renal failure patients have malnutrition and amino acids abnormalities. To correct the amino acids abnormalities and improve nitrogen utilization in hemodialysis patients, correction of acidosis and supplementation of the diet with serine should be considered.
Acidosis ; Alanine ; Amino Acids ; Cholesterol ; Cystine ; Dialysis ; Diet ; Fasting ; Glutamine ; Glycine ; Histidine ; Humans ; Isoleucine ; Kidney ; Kidney Failure, Chronic ; Leucine ; Lysine ; Malnutrition ; Metabolism ; Methionine ; Nitrogen ; Nutritional Status* ; Plasma* ; Prealbumin ; Proline ; Renal Dialysis* ; Serine ; Serum Albumin ; Transferrin ; Triglycerides ; Uremia ; Valine

BACKGROUND: Most studies on the incidence rate (IR) and post-exposure reporting rate (RR) of needle-stick injuries (NSIs) were performed using retrospective surveillance, which is vulnerable to recall bias. This study aimed to identify the agreement between IRs and RRs obtained from prospective and retrospective surveillance. METHODS: The prospective surveillance was performed with 716 nurses working at 3 hospitals from August to September in 2012. They prospectively reported when they experienced the NSIs, and the investigator retrospectively calculated the RR from records in the infection control unit or health care unit during the same periods when they reported the number of NSIs. The retrospective surveillance was carried out with 312 nurses who participated in the prospective surveillance. They retrospectively answered the question on the number of NSIs and post-exposure reporting after recalling the experienced NSI from August to September in 2012. RESULTS: The IR of NSIs was 9.8 per 100 nurses by the prospective surveillance and 36.4 per 100 nurses by the retrospective surveillance, which was statistically significantly different (P<0.001). The RR of NSIs was 14.3% by the prospective surveillance and 8.5% by the retrospective surveillance, which was not statistically significantly different. CONCLUSION: We recommend using a prospective approach for calculating the IR of NSIs to reduce the risk of recall bias. However, the RR of NSIs can be calculated using both prospective and retrospective approaches.
Bias (Epidemiology) ; Delivery of Health Care ; Humans ; Incidence* ; Infection Control ; Memory ; Needlestick Injuries* ; Prospective Studies* ; Research Personnel ; Retrospective Studies*