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Biomedical subjects

J L Huang

Publications and source records attributed to J L Huang.

At least 37 records · Page 2Linked to original sources

[Developing a scale of self-management behaviors of parents with asthmatic children in Taiwan through triangulation method].

The purposes of this study were to develop a scale of self-management behaviors for parents with asthmatic children by qualitative and quantitative methods. This research included two phases: (1) to explore the self-management behaviors of successfully managing parents with asthmatic children by in-depth interviewing method. (2) To examine the reliability and validity of self-management behaviors by the quantitative survey of 133 outpatient parents with asthmatic children. The results including four categories, 10 items and 23 self-management behaviors units were inducted from the 16 parents. The four categories are named as (1) Preventive behaviors: controlling environmental factors, taking drugs, avoiding the causes of allergy, improving the body's defenses; (2) Managing behaviors: making decision based on the severity, taking pharmacological management for attacks, and selecting non-pharmacological management for attacks; (3) Assessing behaviors: observing and comparing the symptoms/signs themselves; (4) Alternative treatment. The survey research was conducted with 21 self-management behaviors after refinement by 10 experts. Based on the survey of 133 parents with asthmatic children, the reliability of the scale was shown as Cronbach's alpha .88. The construct validity was established by factor analysis by rotation method with Varimax with Kaiser normalization. Three extracting components were named as preventing behaviors, managing behaviors and assessing behaviors. The cumulative percent of variance of 3 factors was 48.2%.

Adolescent↗

High-level expression of recombinant dengue viral NS-1 protein and its potential use as a diagnostic antigen.

The prevalence of NS1 Ab response in patients with dengue viral infection and the potential of using recombinant NS1 protein as a diagnostic antigen for dengue viral infection were investigated. In this study, the full-length and C-terminal half of NS1 proteins (rNS1, rNS1-C) were highly expressed (10-30 mg/l) and further purified and refolded. The good antigenicity of the full-length rNS1 protein was confirmed by interaction with 19 dengue NS1-specific monoclonal antibodies (MAbs) in ELISA; however, the antigenicity of rNS1-C was relatively lower. The full-length rNS1 antigen also differentiated reliably between sera from dengue virus-infected patients and sera from normal controls. When rNS1 was used as an antigen to detect human anti-NS1 IgM and IgG Ab, the anti-NS1 Ab response was found in 15 of 17 patients (88%) with primary dengue infection and all 16 patients (100%) with secondary dengue infection. These results indicated that using the full-length rNS1 whose antigenicity is restored as ELISA antigen, a high anti-NS1 antibody prevalence could be detected in patients with either primary or secondary dengue infection. This finding suggested that the anti-NS1 antibody appeared not only in secondary and severe dengue virus infection and might not correlate the pathogenesis of dengue hemorrhagic fever. The study also verified that our purified rNS1 protein showed similar immunological properties as native dengue viral proteins. Genetic engineering production of recombinant NS1 antigen could provide a safe and valuable resource for dengue virus serodiagnosis.

Animals↗

Clinical characteristics of juvenile rheumatoid arthritis in Taiwan.

This study aimed to investigate the clinical features of juvenile rheumatoid arthritis among Taiwan children. The medical records of 228 children who had juvenile rheumatoid arthritis treated in the Chang Gung Medical Center in Taiwan from 1978 through 1998 were retrospectively reviewed. A total of 146 boys and 82 girls (M:F ratio, 1.8:1) were included in this study. Clinical and laboratory data of these patients were collected from medical charts. Pauciarticular onset (56%) was the most common type of juvenile rheumatoid arthritis, followed by polyarticular (36%) and systemic (8%) type. The positive rate for rheumatoid factor, human leukocyte antigen B27, and antinuclear antibody were 9.2%, 55.2%, and 16.2%, respectively. Uveitis was observed in 5.7% of patients. Compared with previous reports in other regions and populations, remarkably different features of juvenile rheumatoid arthritis were found in this study, which included a higher prevalence among boys than girls, a high positive rate of human leukocyte antigen B27, and a low rate of uveitis.

Adolescent↗

Time trends and seasonal variations in hospital admissions for childhood asthma in Taiwan from 1990 to 1998.

The aim of the study was to determine the trends and seasonal variations in hospital admissions for childhood asthma in a tertiary medical center since 1990. Data were collected according to the age and sex of patients and obtained from hospital registries between 1990 and 1998. Children between 2 and 14 years of age admitted with the diagnosis of asthma, or asthmatic bronchitis (ICD-9 code 493) were included. Age-specific and sex-specific hospital admission rates for asthma were calculated for each calendar year. The asthma admission rates were defined as the number of asthma admissions divided by the total number of all pediatric admissions in a year. Seasonal admission rates were calculated in a similar fashion. In addition, the number of readmissions was also calculated during the study period with comparisons of sex and age differences. The asthma admission rates showed a significant upward trend throughout the period studied, particularly among the 2-4 years of age group (relative risk = 2.08; p = 0.0001). Seasonal admission rates revealed a statistically significant increase during the October-December period, peaking in November or December of each calendar year (relative risk = 1.84; p = 0.0001). There was a male predominance in both age categories during the 9-year period. Comparisons of readmissions for asthma (at least three admissions) disclosed that girls were far more likely to be readmitted than boys among the 5-14 years of age group (p = 0.01). Our results indicate 1) an increased prevalence and severity of childhood asthma in Taiwan; 2) boys and younger children aged 2-4 years with asthma had increased risks of admission for asthma (relative risks were 1.22 and 1.96, respectively) and 3) girls among the older children with asthma tend to present with greater severity than boys owing to higher relative risks of readmission for asthma.

Adolescent↗

[Aedes albopictus: cloning and identification of the acetylcholinesterase gene fragment from the mosquito].

OBJECTIVE: To isolate, clone and identify the acetylcholinesterase (AChE) fragment from the mosquito, Aedes albopictus, in relation to exploring mechanism of insectide resistance. METHODS: The genome DNA extracted from the mosquito was used for degenerate polymerase chain reaction (PCR) and the two pairs of oligonucleotides encoding the highly conserved protein sequences were used as primers. The reaction products were cloned to T-vector and transfected into E. coli JM 109. The replicative form DNA of recombinant vector extracted from E. coli JM 109 through alkalilysis was identified by the methods of digestion with EcoR I and Sal I and PCR. RESULTS: The products of degenerate primers polymerase chain reaction were obtained and the identified clone belongs to the AChE fragment of the mosquito. CONCLUSION: The clone was identified as the AChE fragment of Aedes albopictus.

Acetylcholinesterase↗

Effect of age and sex on plasma total homocysteine in Taiwanese subjects.

Plasma total homocysteine (tHcy) is now established as a clinical risk factor for coronary artery disease, as well as for other arterial and venous occlusive diseases. Therefore, we measured the plasma tHcy concentrations in 385 healthy Chinese subjects in Taiwan and in 40 patients with occluded coronary artery disease or maintenance hemodialysis. The plasma tHcy levels in Taiwanese male and female volunteers were found to increase gradually with age (age group: 20-29, 30-39, 40-49, 50-59, and >60; mean +/- SD 8.22 +/- 2.00, 8.51 +/- 2.67, 8.87 +/- 2.22, 11.41 +/- 2.50 and 13.28 +/- 2.31 microM for male volunteers and 6.49 +/- 1.75, 7.15 +/- 1.20, 7.40 +/- 1.30, 9.57 +/- 3.01 and 10.95 +/- 2.11 microM for female volunteers). At the same age, male volunteers were shown to have higher tHcy levels than female volunteers. In addition, the mean concentrations of plasma tHcy in occluded coronary artery disease (13.62 +/- 5.43 microM) or in maintenance hemodialysis (21.28 +/- 4.32 microM) were statistically higher than in age-matched normal subjects (11.02 +/- 2.85 microM). This study emphasizes the significance of age and sex-associated difference in the plasma tHcy levels, and underlines the importance of the range for plasma homocysteine in normal Taiwanese subjects.

Adult↗

Mice immunized with DNA encoding a modified Pseudomonas aeruginosa exotoxin A develop protective immunity against exotoxin intoxication.

A recombinant plasmid, which contains the Pseudomonas aeruginosa exotoxin A (PE) gene with a C-terminal deletion, was inserted into expression vector pSecTag Xpress. The expression of this bacterial exotoxin in an animal cell was first demonstrated in 3T3 cell by transient transfection and western blot assay. Recombinant plasmid DNA was then injected intramuscularly to BALB/c mice, anti-PE specific antibodies were found in all animals vaccinated with plasmid containing the PE gene and with 'detoxicated' recombinant PE protein. Mice vaccinated with DNA were protected from the intoxication of lethal dosage of P. aeruginosa exotoxin A. Our results indicated that mice vaccinated with DNA encoding the PE gene could express PE protein in vivo, induced specific immune response, and provided sufficient protective immunity that safeguarded mice from the injection of lethal dosage of PE toxin.

ADP Ribose Transferases↗

Magnetic clusters on single-walled carbon nanotubes: the Kondo effect in a one-dimensional host.

Single-walled carbon nanotubes are ideal systems for investigating fundamental properties and applications of one-dimensional electronic systems. The interaction of magnetic impurities with electrons confined in one dimension has been studied by spatially resolving the local electronic density of states of small cobalt clusters on metallic single-walled nanotubes with a low-temperature scanning tunneling microscope. Spectroscopic measurements performed on and near these clusters exhibit a narrow peak near the Fermi level that has been identified as a Kondo resonance. Using the scanning tunneling microscope to fabricate ultrasmall magnetic nanostructures consisting of small cobalt clusters on short nanotube pieces, spectroscopic studies of this quantum box structure exhibited features characteristic of the bulk Kondo resonance, but also new features due to finite size.

Journal Article↗

Changes of serum levels of interleukin-2, intercellular adhesion molecule-1, endothelial leukocyte adhesion molecule-1 and Th1 and Th2 cell in severe atopic dermatitis after intravenous immunoglobulin therapy.

OBJECTIVE: To evaluate the effect of intravenous immunoglobulin (IVIG) in the treatment of severe intractable atopic dermatitis (AD) in children and to investigate the inflammatory markers used to measure their disease activity. MATERIALS AND METHODS: Serum levels of interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (ICAM-1), endothelial leukocyte adhesion molecule (ELAM-1), and eosinophil cationic protein (ECP) were measured in five children with AD (group A) who had a mean age of 9.4 months (range 7 to 12 months) before and after IVIG therapy. Seven age-matched patients with similar severity of AD who only received topical corticosteroid therapy served as the control group (group B). Ten normal control serum samples were collected from well-baby clinic (group C). T helper 1 (Th1) was defined by IFN-gamma/CD4+ and Th2 by IL4/CD4+, using 3-colored flow cytometry. Clinical severity of AD was evaluated with the SCORAD index. Intravenous immunoglobulin (2 g/kg/dose) was administered monthly for a total of 3 doses. RESULTS: The serum levels of ICAM-1, ELAM-1, and IL-2R in patients with AD were significantly higher than normal control infants. After IVIG therapy, the SCORAD index and the inflammatory markers (ICAM-1, ELAM-1, and ECP) in group A were significantly decreased (P = .01 for SCORAD index; .034, .043, and .03 for ICAM-1, ELAM-1 and ECP, respectively). The serum levels of ICAM-1, ELAM-1, ECP and IL-2R in group B did not show a significant reduction after 3 months of topical corticosteroid therapy. In comparison to normal healthy children, patients with AD had decreased Th2 cells (P = .009) and higher ratio of Th1/Th2 (P = .009) in peripheral blood mononuclear cells (PBMC). There was no significant difference of Th1, Th2 cells, and ratio of Th1/Th2 in PBMC before and after IVIG therapy in patients with AD. CONCLUSION: Intravenous immunoglobulin can be safely and effectively given for the treatment of severe intractable AD. The determination of ICAM-1, ELAM-1, and ECP levels may be useful in monitoring disease activity of AD in childhood. The IVIG may play a role in treatment.

Dermatitis, Atopic↗

Significantly higher levels of oxidized LDL autoantibody in coronary artery disease patients.

BACKGROUND: Increasing evidence shows that oxidized low-density lipoprotein (ox-LDL) might play an important role in the pathogenesis of atherosclerosis. Ox-LDL is immunogenic and induces an autoantibody, which we used as a tool for measuring the content of ox-LDL in vivo. METHODS: Patients who were admitted for diagnostic cardiac catheterization for typical or atypical angina pectoris were enrolled in this study. After fasting for 12 hours, a venous blood sample was drawn from the antecubital vein for testing triglyceride, total cholesterol, LDL cholesterol, high-density lipoprotein (HDL) cholesterol, and ox-LDL autoantibody. The ox-LDL autoantibody was quantified using an enzyme linked immunosorbent assay. All patients underwent coronary angiography. Those who had more than 50% angiographic coronary luminal stenosis, were grouped into the coronary artery disease (CAD) group. RESULTS: Sixty-four patients were enrolled in the study (male/female = 46/18; mean +/- standard deviation, age, 64 +/- 9 years). The CAD group had a significantly higher level of ox-LDL autoantibody than the non-CAD group (494.0 +/- 355.0 mU/ml vs 258.1 +/- 196.8 mU/ml, p = 0.004). However, the other lipid profiles including triglyceride, total cholesterol, LDL-cholesterol and HDL-cholesterol were not statistically different between the two groups. Forty-six patients in this study had an arterial blood sample taken from the femoral artery for testing ox-LDL autoantibody. There was no significant difference between the arterial and venous samples of ox-LDL autoantibody (385.2 +/- 333.3 mU/ml vs 399.3 +/- 339.5 mU/ml, n = 46, p = 0.530). CONCLUSIONS: Ox-LDL autoantibody was significantly higher in the CAD group. Ox-LDL may prove to play a key role in the pathogenesis of atherosclerosis. Further study of Ox-LDL and its role in the process of atherosclerosis is warranted.

Adult↗

Catheter-induced coronary spasm--a view of mechanical factors and experience with selective left coronary arteriography.

BACKGROUND: Coronary spasm during cardiac catheterization is not unusual. The mechanism of spasm remains uncertain, but is considered to be multifactorial. Many researchers believe that coronary spasm that develops during catheterization is partly spontaneous and partly catheter-induced. Because catheter-induced spasm results from mechanical irritation, we tried to find the iatrogenic factors that predispose patients to coronary spasm during coronary angiography. METHODS: Retrospectively, we reviewed the records of 7,295 patients who underwent coronary angiography at our hospital from June, 1983 to November, 1997; coronary spasm was documented in 30 patients, who became the study group. We randomly selected 41 patients who had normal coronary arteries as the normal control group. After reviewing cine films of coronary angiography, we compared these two groups for several parameters. These parameters included the length and diameter of the left main coronary artery (LMC), the angle between the LMC and the aorta, the angle between the catheter tip and the LMC, whether the catheter tip came into contact with the vascular wall and whether there was vessel wall bulging, catheter size and catheter/LMC ratio. This angiographic data and the demographic features, including age, sex, history of hypertension, diabetes mellitus, smoking, previous myocardial infarction, family history of coronary artery disease, cholesterol and triglyceride levels and chest pain character (exertional or rest pain) were compared between the study patient group and the control group. RESULTS: The results disclosed that larger catheter size (7.1 +/- 0.6 mm vs 6.4 +/- 0.7 mm, p < 0.001), smaller LMC diameter (4.2 +/- 0.9 mm vs 4.9 +/- 1.0 mm, p = 0.004), larger catheter/LMC ratio (0.07 +/- 0.05 vs 0.05 +/- 0.03, p = 0.022), catheter contact with the vessel wall (27/30 vs 20/41, p < 0.001) and vessel bulging (18/30 vs 5/41, p < 0.001) were related to catheter-induced coronary spasm. We found that the catheter tip coming into contact with the vessel wall, vessel wall bulging and catheter/LMC ratio (odds ratio 8.92 x 10(14)) were statistically significant factors predisposing patients to catheter-induced coronary spasm. CONCLUSIONS: Multiple factors contribute to coronary spasm. Of those, mechanical or iatrogenic factors might predispose patients to spasm during coronary catheterization. These facts deserve our attention, because iatrogenically induced spasms may be avoided by meticulously selecting catheters and manipulating them gently.

Adult↗

Randomized, double-blind comparison of irbesartan and enalapril for treatment of mild to moderate hypertension.

BACKGROUND: Irbesartan is a newly developed angiotensin II receptor antagonist. Its antihypertensive efficacy and safety in Taiwanese patients with mild to moderate hypertension remains to be determined. METHODS: This was a multicenter, double-blind, randomized, parallel group study. One hundred and sixteen patients from three centers were enrolled. After a placebo lead-in period of 14 days, 55 patients (24-75 years-of-age) who had a mean seated diastolic blood pressure of 95 to 110 mmHg were randomized to once-daily treatment with irbesartan 150 mg or enalapril 10 mg. Doses were doubled at week 4 if trough seated diastolic blood pressure was 90 mmHg or more. Trough blood pressure was measured at zero, two, four and eight weeks of treatment. RESULTS: Both treatments lowered blood pressure with no significant difference in efficacy between treatment groups. Irbesartan 150 mg to 300 mg provided reductions in trough seated systolic and diastolic blood pressures at week 8 of -16.5 mmHg and -7.2 mmHg, respectively, with 36% of patients having a favorable response. Similarly, enalapril 10 mg to 20 mg reduced systolic and diastolic blood pressure by -10.6 mmHg and -5.0 mmHg, respectively, with a response rate of 43%. Headache, malaise and dizziness were the major adverse reactions observed in both groups. The incidence of drug-related cough was significantly higher with enalapril (18%) than with irbesartan (0%). CONCLUSIONS: Irbesartan 150 mg to 300 mg once daily was as effective in lowering blood pressure as enalapril 10 mg to 20 mg once daily. Both irbesartan and enalapril were well tolerated, while there was a significantly lower incidence of cough with irbesartan compared with enalapril.

Adult↗

Effect of interleukin-15 and Flt3-ligand on natural killer cell expansion and activation: umbilical cord vs. adult peripheral blood mononuclear cells.

Expansion and activation of cord blood (CB) natural killer (NK) cells by cytokines might greatly benefit patients undergoing stem cell transplantation by increasing resistance against viral infections and providing graft-vs.-leukemia (GVL) effects through enhanced cytolytic abilities. We tested the ability of a recently cloned stem cell factor, Flt3-ligand (Flt3L), in combination with interleukin-15 (IL-15), to stimulate CB mononuclear cells (MNCs) to proliferate and differentiate into NK cells, in comparison with adult peripheral blood (APB) MNCs. Unstimulated CB MNCs had low NK and lymphokine-activated killer (LAK) activity compared with APB MNCs. A similar dose-dependent increase in NK and LAK activity and CD16/56 expression was found with IL-15 in CB and APB MNCs after 10 days of culture. The NK cytotoxicity (against K562 cells) of IL-15-treated CB MNCs was lower than that of corresponding APB MNCs, while IL-15-induced LAK activity (against Daudi cells) of CB MNCs was comparable to that of corresponding APB MNCs. IL-15 resulted in greater CD16/56 expression in CB MNCs compared with APB MNCs after 10 days of culture. Flt3L, alone or in combination with IL-15, had little effect on CD16/56 expression and cytotoxicity. Cytotoxic activities and CD16/56 expression did not alter after CD34 depletion of CB MNCs. We therefore concluded that CB NK cells could be greatly activated and expanded with IL-15, but not with Flt3L. The greater expression of CD16/56 induced by IL-15 in CB MNCs may originate from non-CD34+ NK progenitor cells.

Adult↗

Atopic cataracts in a child with atopic dermatitis: a case report and review of the literature.

Cataracts induced by atopic dermatitis rarely occur in adolescent and young adult patients suffering from this problem. Lenticular opacity is an important ocular complication in atopic dermatitis. Although the cause of atopic dermatitis and its ocular complications are unknown, cataracts have been observed to develop and progress during periods of exacerbation of the dermatitis. We report the case of a 16-year-old boy with atopic dermatitis who abruptly developed cataracts in both eyes while suffering from severe skin itching which began 2 months before the initial examination. His peroxidation test result was very high, and we postulate the retinal peroxidation might play a key role in cataractogenesis. Lens aspiration and intraocular artificial lens implantation were performed smoothly with restoration of visual acuity in both eyes.

Adolescent↗

Gastrointestinal manifestation and outcome of Henoch-Schonlein purpura in children.

BACKGROUND: We reviewed the clinical and laboratory manifestations and analyzed the outcome in children with Henoch-Schönlein purpura (HSP) and gastrointestinal involvement. METHODS: The medical records of 158 children who had Henoch-Schönlein purpura with gastrointestinal (GI) involvement admitted to our institution from June 1987 to December 1998 were reviewed. We retrospectively analyzed their demographic features, clinical manifestations, and outcome. RESULTS: Totally 104 boys and 54 girls (male: female = 1.9:1) were enrolled in this study, with a mean age of diagnosis of 5.8+/-4.8 years (range: 2 to 13 years). Sixty-three (40%) of our patients had preceding upper respiratory tract infection. The main GI manifestations included abdominal pain (88%); GI bleeding (75%), and vomiting (25%). Bowel edema was found in 71% of examined patients. Upper GI endoscopy provided supportive evidence of HSP in 58% of patients examined. Five patients were found to have marked jejunal edema with bowel collapse leading to severe intestinal obstruction. Thirteen patients (8.2%) had emergent complications including massive blood loss from GI tract in 4, seizure in 2, severe hypoalbuminemia in 2, and emergent surgical condition in 6. Twenty-one patients (13%) experienced prolonged hospitalization (> or =10 days). Bilious vomiting, hematemesis, leukocytosis (>20000/cmm), high C-reactive protein (>50 mg/l), and hemorrhagic erosive duodenitis were found to correlate with prolonged hospitalization. Fourteen (20%) of 70 patients who received follow-up for more than 5 years experienced GI recurrence of HSP. CONCLUSION: Despite severe and protracted GI symptoms in some HSP patients, the overall prognosis of GI involvement in children with HSP remains good.

Child↗

PFAPA syndrome (Periodic Fever, Aphthous stomatitis, Pharyngitis, Adenitis).

This paper aims to remind paediatric clinicians to suspect and confirm 'PFAPA' syndrome (Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis syndrome). We report two cases of PFAPA syndrome: a 3-year-old healthy boy with atopic rhinitis and a boy aged 8 years 5 months who simultaneously had lymphocytic vasculitis syndrome treated with immunosuppressive drugs. Both met Marshall's criteria. The literature regarding PFAPA syndrome was complied using a Medline search for articles published between 1963 and 1998 and we then reviewed the reference lists of the articles. The Medline search revealed 28 cases with available clinical manifestations, management and prognosis. Our study describes two additional cases. We divided the cases into typical (28 cases) and atypical (two cases) PFAPA syndrome. In typical PFAPA, the age of onset was less than 5 years in most cases and the patients presented 4.9 +/- 1.4 days of fever (100%), pharyngitis (89.3%), cervical adenitis (72.1%), stomatitis (71.4%), malaise (64.3%), headache (60.7%), abdominal pain (53.6%) and nausea/vomiting (17.9%). Afebrile intervals were 3.2 +/- 2.4 months and increased with age. The time from initial onset to final episode was 3 years 7 months +/- 3 years 6 months. The total number of episodes was 8.3 +/- 2.5 (range 6-14). Effective treatment included steroids, tonsillectomy/adenoidectomy and cimetidine. The general outcome was good. In atypical PFAPF, the clinical manifestations were similar to those of typical PFAPA except that the age of onset was more than 5 years, and life-threatening intestinal perforation happened once in a patient with underlying Fanconi's anaemia. It was concluded that typical PFAPA syndrome is benign and can be diagnosed by detailed history-taking and from physical findings during repeated febrile episodes with tests to rule out other periodic fever syndromes. A review of the literatures since the first report in 1987 has shown that typical PFAPA syndrome is not associated with significant long-term sequelae and has a good response to steroids. One patient with atypical PFAPA, who received low-dose steroids for over 1 year, developed intestinal perforation after an increment of the 7-day steroid dose. If an underlying problem requires long-term immunosuppressive medication, it is wiser to choose cimetidine rather than increasing the steroid dosage to resolve atypical PFAPA.

Azathioprine↗

Esophageal reconstruction by jejunal transfer.

Forty-five esophageal reconstructions were carried out using a free or pedicled transfer of jejunal segments. Thirty were performed for benign stenosis or atresia, and 13 were performed for malignancy. The remaining two were used to repair anastomotic leakage or fistulization resulting from prior esophagogastrostomy. Average anastomotic arterial and venous diameters were 1.2 mm and 3.0 mm respectively. Of the 45 reconstructions, 44 were successful; the single failure was the result of tearing of the mesenteric arcade. There were four fatalities. Jejunal transfer is an effective method of esophageal reconstruction.

Adolescent↗

Cervical necrotizing fasciitis: a case report.

Necrotizing fasciitis is a severe soft tissue infection characterized by cutaneous necrosis, suppurative fasciitis, vascular thrombosis and extreme systemic toxicity. Involvement of head and neck structures is rare, but occur most frequently in patients with diabetes and chronic alcoholism. Once initiated, the disease progresses rapidly and diffusely, involving adjacent fascial spaces. Necrotizing fasciitis may also extend to the cervical viscera, mediastinum and anterior chest wall. A 65-year-old chronic alcoholic man, with long-standing diabetes and liver cirrhosis under irregular treatment is described. The patient developed a deep neck infection from a buccal abscess after a local incision. The infection then extended to an orocutaneous fistula and deep neck superficial and middle layer fascias, with necrotizing fasciitis. Management requires early recognition, high doses of appropriate antimicrobial therapy, early surgical drainage and radical debridement of necrotic tissue. The disease carries a high rate of morbidity and mortality, especially in the elderly.

Aged↗