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PubMed1998

Neonatal Pseudomonas putida infection presenting as staphylococcal scalded skin syndrome.

A case of neonatal Pseudomonas putida sepsis presenting as staphylococcal scalded skin syndrome is described. Staphylococcal scalded skin syndrome is a clinical term used for a spectrum of primarily neonatal blistering skin disorders caused by the exfoliative toxins of Staphylococcus aureus. The disease typically begins with general erythema and fever, followed by the formation of large fluid-filled bullae that coalesce and rupture on slightest pressure to leave extensive areas of denuded skin. The 9-day-old male infant described presented with a generalised non-tender, macular, erythematous rash that later developed into large, flaccid, clear fluid-filled bullae to leave extensive erythematous, weeping, and denuded areas covering over 90% of the total body surface. Despite aggressive antibiotic and symptomatic treatment, he died 11 days after admission. While Pseudomonas infections may present with vesico-bullous eruptions, this is believed to be the first case of neonatal Pseudomonas putida sepsis presenting as staphylococcal scalded skin syndrome.

Ceftazidime↗

PubMed1986

Repair of anal stricture and mucosal ectropion by simple flap procedures.

A technique is described that has proven most effective in correction of postoperative anal stenosis. A modification of this technique also has proven effective in the treatment of symptomatic anal mucosal ectropion--a condition marked by pruritus and perianal soilage from mucosal weeping, usually associated with the Whitehead hemorrhoidectomy. The design of the flap allows primary closure of the donor site and tension-free flap inset with a robust flap blood supply.

Anal Canal↗

PubMed2001

A case of basal cell carcinoma of the nipple and areola with intraductal spread.

We report an 82-year-old Japanese woman with basal cell carcinoma of the left nipple and areola extending into the lactiferous duct. The patient developed a small papular lesion of the left areola about 1 year before admission. The lesion, which had slowly progressed to involve the nipple, had become symptomatic showing weeping and bleeding. Mammography revealed microcalcification in the nipple. Although Paget's disease was suspected from these clinical features, histologically basal cell carcinoma was diagnosed. There was no axillary lymphadenopathy, and no evidence of distant metastasis. The lesion of the nipple and areola was resected with a 2 cm free margin along with the underlying mammary tissue. The patient has remained well without signs of recurrence for 2 years after surgery. We reviewed cases of basal cell carcinoma of the nipple or areola and discuss considerations and problems of this rare tumor.

Aged↗

PubMed1982

Lorazepam and diazepam as adjuncts to epidural anaesthesia for caesarean section.

Lorazepam 0.05 mg X kg-1 and diazepam 0.1 mg X kg-1 administered intravenously were compared as sedatives for 42 patients undergoing Caesarean Section under epidural anaesthesia. After receiving the drug, 15 per cent of the diazepam patients and 32 per cent of the lorazepam patients were still agitated. Ten per cent of the diazepam patients and 36 per cent of the lorazepam patients had severe symptoms of delirium. These included hallucinations, confusion, agitation, restlessness, inappropriate weeping and repetitive hand movements. Memory impairment was greater with lorazepam. Thirty-five per cent of the diazepam patients had pain at the injection site. None of the lorazepam patients had such pain. Respiratory rate, heart rate and mean blood pressure did not change significantly in either group. Half the patients who had been given lorazepam had side effects that were bothersome enough to cause them to complain the following day. Lorazepam and diazepam were both unsatisfactory as sedatives for patients having Caesarean Section.

Adult↗

PubMed1998

[Ficus benjamina--the hidden allergen in the house].

The weeping fig, Ficus benjamina (Fb), is a relatively common indoor allergen. Many cases of perennial allergic rhinoconjunctivitis and allergic asthma caused by Fb hypersensitivity are not detected. These patients typically have proven sensitization to housedust mites and do not improve after avoidance of exposure (encasing) and specific immunotherapy. The number of Fb sensitizations is increasing in Germany, which can partly be explained by the cross-reactivity between Hevea brasiliensis (Hb) latex and Fb and the rapidly increasing number of mostly occupational latex allergies. But Fb itself is a potential sensitizer which is widely spread as ornamental plant in homes and offices. As relevant indoor allergen Fb ranks third after housedust mites and pets but before molds among our allergy patients. For diagnosis, prick-tests with Fb-latex seem to be more sensitive than in vitro-methods (RAST, CAPRAST). Fb plants should not be kept in the homes of atopic individuals or persons with latex (Hb) allergy.

Adult↗

PubMed2006

The potential for phytoremediation of iron cyanide complex by willows.

Hybrid willows (Salix matsudana Koidz x Salix alba L.), weeping willows (Salix babylonica L.) and hankow willows (Salix matsudana Koidz) were exposed to potassium ferrocyanide to determine the potential of these plants to extract, transport and metabolize this iron cyanide complex. Young rooted cuttings were grown in hydroponic solution at 24.0 +/- 0.5 degrees C for 144 h. Ferrocyanide in solution, air, and aerial tissues of plants was analyzed spectrophotometrically. Uptake of ferrocyanide from the aqueous solution by plants was evident for all treatments and varied with plant species, ranging from 8.64 to 15.67% of initial mass. The uptake processes observed from hydroponic solution showed exponential disappearance kinetics. Very little amounts of the applied ferrocyanide were detected in all parts of plant materials, confirming passage of ferrocyanide through the plants. No ferrocyanide in air was found due to plant transpiration. Mass balance analysis showed that a large fraction of the reduction of initial mass in hydroponic solution was metabolized during transport within the plant materials. The difference in the metabolic rate of ferrocyanide between the three plant species was comparably small, indicating transport of ferrocyanide from hydroponic solution to plant materials and further transport within plant materials was a limiting step for assimilating this iron cyanide complex. In conclusion, phytoremediation of ferrocyanide by the plants tested in this study has potential field application.

Biodegradation, Environmental↗

PubMed1994

In vitro measurement of the frictional properties of the temporomandibular joint disc.

The integrity of the articulating surfaces of the temporomandibular joint (TMJ) is likely to be promoted by the control of stresses due to frictional forces between moving joint surfaces. Using a pendulum designed to measure the friction on the surface of the pig TMJ disc, factors such as duration of loading and degree of hydration of the disc were found to influence the amount of friction and the time-dependent changes in friction on the disc surface. The tests provide evidence in support of the hypothesis of 'weeping lubrication' on the surface of the TMJ disc.

Animals↗

PubMed1987

Surgical control of Hailey-Hailey disease.

Hailey-Hailey disease is a benign, chronic genodermatosis manifested by recurrent lesions with a predilection for the intertriginous areas. The malodorous, weeping sores are a source of great discomfort to the patient. Medical therapy controls most lesions adequately; however, some are refractory. Experience with excision of skin involved with Hailey-Hailey disease is reported. The best results were obtained in those patients whose wounds were resurfaced with split skin grafts. Primary suture was associated with recurrent disease and residual morbidity. The findings of other isolated reports in the literature are also summarised. The results show that surgical control of Hailey-Hailey disease is indicated in recalcitrant cases.

Chronic Disease↗

PubMed1990

Emotional facial paresis with striatocapsular infarction.

Emotional facial paresis (EFP) refers to hemifacial paresis of emotionally evoked or spontaneous smiling or weeping with preserved volitional movements of the face. The anatomical location for this phenomenon has been controversial. We report a 15-year-old boy with EFP. Follow-up MRI demonstrated infarction limited to the head of the caudate, putamen and anterior limb of the internal capsule on the contralateral side. This case lends support for selective damage at a striatal or capsular site in the production of EFP.

Adolescent↗

PubMedDate not supplied

Life-threatening erythroderma: diagnosing and treating the "red man".

Exfoliative erythroderma, or diffuse erythema and scaling of the skin, may be the morphologic presentation of a variety of cutaneous and systemic diseases. Establishing the diagnosis of the underlying disease is often difficult and, not uncommonly, erythroderma is classified as idiopathic. Several cases are presented to demonstrate the diversity of presentation of this disease. Laboratory findings are typically unhelpful in establishing the etiology of erythroderma. Clinical data combined with multiple skin biopsies over time are necessary. Systemic complications of erythroderma include infection, fluid and electrolyte imbalances, thermoregulatory disturbance, high output cardiac failure, and acute respiratory distress syndrome. The initial approach to the management of erythroderma of any etiology includes attention to nutrition, fluid and electrolyte replacement, and the institution of gentle local skin care measures. Oatmeal baths and wet dressings to weeping or crusted sites should be followed by application of bland emollients and low-potency topical corticosteroids. Systemic dermatologic therapy may be required to maintain improvement achieved with local measures or to control erythroderma refractory to local measures. The prognosis of erythroderma is dependent on the underlying etiology.

Adult↗

PubMed2005

Gender differences in psychogenic non-epileptic seizures.

PURPOSE: To determine whether male and female populations of patients with psychogenic non-epileptic seizures (PNES) are similar, in terms of demographic and social factors, aetiological factors, the clinical characteristics of events and path to diagnosis. METHODS: Prospective study by semi-structured interview of 160 consecutive patients (117 female and 43 male) with video EEG confirmed diagnosis of PNES + epileptic seizures (ES). RESULTS: Most parameters showed no significant differences. Males were, however, more likely to be unemployed (P = 0.028), and females were six times more likely to self-harm (P = 0.050), though the numbers were small in these categories. Men were more likely to attribute their PNES to a predisposing factor for epilepsy (P = 0.001), and women were over eight times more likely to report sexual abuse (P = 0.001). Event semiology was similar, but women were more likely to weep after events (P = 0.017). The carers and family of men with PNES were three times less likely to accept the diagnosis of PNES (P = 0.017). CONCLUSIONS: Our samples showed few significant gender differences, suggesting that other male and female populations of patients with PNES are likely to be similar also. Some of the differences we found may give insight into causation of PNES.

Adult↗

PubMed2006

Use of equine collagen foil as dura mater substitute in endoscopic endonasal transsphenoidal surgery.

OBJECTIVE: This study describes the use of a novel collagen-based dural substitute in endoscopic endonasal transsphenoidal surgery. METHODS: Operative records were reviewed for a 12-month period for all patients who underwent surgery by means of an endoscopic endonasal transsphenoidal approach since we began using TissuDura (Baxter, Vienna, Austria) collagen-only dural substitute in January 2004. RESULTS: During the 12-month period evaluated, we performed an endoscopic endonasal transsphenoidal operation for a variety of pituitary lesions on 72 consecutive patients. Among these, 15 patients (20.8%) required the implant of the collagen foil. Nine patients (60%) presented an intraoperative CSF leak (3 small weeping of CSF and 6 larger leaks); in these cases, the TissuDura was used against the arachnoid membrane, followed by the other materials used for the repair. In 7 other subjects without any evidence of CSF escape, the collagen foil was used to protect and enforce the arachnoidal membrane descent into the sellar cavity to prevent its possible postoperative rupture and consequent CSF leak. Fibrin glue was used in all cases. A postoperative CSF leak with meningitis occurred in only 1 (6.7%) of the 15 subjects. The patient required a reoperation for CSF fistula repair and intravenous antibiotics. CONCLUSIONS: Even if based on a relatively small patient series, our experience demonstrated that the use of TissuDura in transsphenoidal surgery is safe and biocompatible, as compared with other dural substitutes.

Animals↗

PubMed2006

BioGlue for prevention of postoperative cerebrospinal fluid leaks in transsphenoidal surgery: A case series.

BACKGROUND: The efficacy of BioGlue (CryoLife, Inc, Atlanta, Ga) surgical adhesive in transsphenoidal surgery was assessed as an adjunct in the prevention of postoperative CSF leaks. METHODS: All patients in whom BioGlue was used for an intraoperative skull base reconstruction were retrospectively identified. Intraoperative CSF leaks were graded according to size (grade 1, small weeping leak without obvious diaphragmatic defect; grade 2, moderate leak with a definite diaphragmatic defect; grade 3, large diaphragmatic and/or dural defect). CSF leak repair was tailored to CSF leak grade. BioGlue was applied as a reinforcement over collagen sponge as the last layer of the repair. RESULTS: Over 28 months, a total of 282 patients underwent endonasal surgery. Of these patients, 124 (79 women; age range, 8-84 years), in 128 procedures, had an intraoperative CSF leak repair reinforced with BioGlue. Pathology included 80 pituitary adenomas, 11 craniopharyngiomas, 7 Rathke's cleft cysts, 6 chordomas, 5 meningiomas, 4 spontaneous CSF leaks, 3 arachnoid cysts, and 8 other parasellar pathologies. There were 62 (48.4%) grade 1, 41 (32.0%) grade 2, and 25 (19.5%) grade 3 leak repairs. The overall repair failure rate was 1.6% (2 cases), with the failures occurring in patients with grade 3 leaks, including 1 who developed meningitis; there was no failure of grades 1 and 2 leaks. The 2 failures were attributed largely to technical aspects of the repair rather than to failure of BioGlue per se. CONCLUSIONS: BioGlue appears to be an effective adjunct in preventing postoperative CSF leaks after transsphenoidal surgery. However, careful attention to technical details of the repair is still required to prevent failures, especially when closing large dural and diaphragmatic defects.

Adolescent↗

PubMed1984

A perspective on chest wall resection in patients with breast cancer.

The morbidity from locally recurrent breast cancer or osteoradionecrosis and accompanying infection is substantial. The selective use of surgical resection offers good palliation. Extended full-thickness chest wall resection is facilitated by a variety of techniques available for closure and coverage including use of latissimus dorsi myocutaneous flap, rectus abdominus myocutaneous flap, pectoralis myocutaneous flap, breast flap, and omentum with skin graft. The experience with 43 consecutive chest wall resections in patients with breast cancer affords the opportunity to define indications and contraindications for such palliative procedures. Indications include local symptoms of pain and infection, tumor recurrence refractory to radiation therapy, and infection that precludes chemotherapy. Relative contraindications are pulmonary metastases, bone metastases, hepatic metastases, and malignant pleural effusions. Absolute contraindications are brain metastases, bone marrow involvement, bulky disease in two organs, and breakthrough on multiple chemotherapy regimens. Operative revision was only required in 4 of 43 patients. Minor wound complications occurred in 12 (28%). Three patients who underwent resection for local recurrence have survived 40 months or more free from disease. This procedure provides substantial palliation by relieving pain, controlling infection, removing a weeping wound, and allowing chemotherapy for metastatic disease. In the proper setting, chest wall resection is an important part of the armamentarium for palliation of the patient with breast cancer. It can markedly improve quality of life and occasionally may result in long-term survival.

Abscess↗

PubMed1997

Pathologic laughter after unilateral stroke.

Pathologic laughter which usually occurs after bilateral or diffuse cerebral lesions was rarely reported in patients with unilateral stroke. I describe clinical and radiological findings of 13 patients presenting pathologic laughter due to unilateral stroke. Their laughter was excessive, unmotivated, uncontrollable and most often occurred during conversation especially at the initiation of speaking. There usually was a latent period between the onset of stroke and occurrence of the pathologic laughter. The degree and duration of the pathologic laughter varied, but its severity tended to diminish during the follow up. Some of them also had emotional instability evidenced by easy weeping. Imaging studies showed that 12 patients had infarcts and one had a haemorrhage. The lesions were located in the lenticulocapsular area in 8, pontine base in 3, thalamocapsular area in 1, and cerebral cortical-subcortical area in one. The lenticulocapsular stroke usually involved the upper part of the basal ganglia and a genu or an anterior portion of the posterior limb of the internal capsule/corona radiata. In conclusion, unilateral, usually subcortical, strokes can produce pathologic laughter. Although the neuroradiological data presented here generally support the motor release hypothesis, the delayed onset symptoms suggest that more complex mechanisms may be involved.

Adult↗

PubMed2003

A procedure for identifying regions preferentially activated by attention to semantic and phonological relations using functional magnetic resonance imaging.

A procedure is introduced for using functional magnetic resonance imaging (fMRI) techniques to identify neural regions associated with attention to semantic and phonological aspects of written words within a single group of subjects. Short lists (16 words/list), consisting of visually-presented semantically-related words (bed, rest) or rhyming words (weep, beep) were presented rapidly to subjects, who were asked to attend to the relations among the words. Regions preferentially involved in attention to semantic relations appeared within left anterior/ventral inferior frontal gyrus (IFG, approximate Brodmann Area, BA47), left posterior/dorsal IFG (BA44/45), left superior/middle temporal cortex (BA22/21), left fusiform gyrus (BA37), and right cerebellum. Regions preferentially involved in attention to phonological relations appeared within left inferior frontal cortex (near BA6/44, posterior to the semantic regions within IFG described above) and within bilateral inferior parietal cortex (BA40) and precuneus (BA7). This method is notable in that a comparison of the two tasks within some of the individual subjects revealed activation patterns similar to the group average, especially within left inferior frontal and left superior/middle parietal cortices. This fact combined with the efficiency with which the data can be obtained (here, in about an hour of functional scanning) and the adaptability of the task for many different subject populations suggests a wide range of possibilities for this technique: it could be used to track language development (e.g. in children), compare language organization across subject populations (e.g. for dyslexic or blind subjects), and identify language regions within individuals (e.g. potentially to aid in surgical planning).

Adolescent↗

PubMed2002

Modeling for quantitative non-destructive evaluation.

A quantitative approach to non-destructive evaluation (NDE) must be based on models of the measurement processes. A model's purpose is to predict, from first principles, the measurement system's response to material properties and anomalies in a material or structure. For the ultrasonic case a measurement model should include modeling of the generation, propagation and reception of ultrasonic signals, and the ultrasonic interactions that generate the system's response function. A measurement model has many benefits, which are discussed in the paper. Three examples of the productive use of quantitative modeling in conjunction with measured data are presented: the detection and sizing of fatigue cracks which emanate from weep holes in the risers of wing panels in the interior of an aircraft wing by the use of ultrasound generated on the exterior surface of the wing, the determination of the elastic constants of anisotropic thin films deposited on a substrate, and the detection and sizing of surface-breaking cracks by the use of the laser-source scanning technique for laser generated and detected ultrasound.

Journal Article↗

PubMed2002

Restoration of drastically eroded land using coal fly ash and poultry biosolid.

A 3-year field study was conducted at a 12 ha soil-borrow area adjacent to the Columbia Metropolitan Airport, South Carolina to investigate the restorative effects of co-application of coal fly ash (FA) and a poultry biosolid (PB). FA was applied at 0, 22, 280, 560 and 1120 Mg (tonne) ha(-1), and PB at 5 and 10 Mg ha(-1). The area was seeded with erosion-control species Atlantic Coastal panic grass (Panicum amarum var amarum L.), sericea (Lespedeza cuneata var. appalow [Dumont] G. Don.) and weeping love grass (Eragrostis curvula Wolf.). Plant biomass and elemental composition were analyzed in sequential harvests. Soil and groundwater quality characteristics including pH, EC and elemental composition were also monitored throughout the study. In addition, the effect of amendments on the water holding capacity and bulk density of the soil was investigated. Amendment addition significantly increased plant biomass production by a maximum of 26% using 1120 Mg ha(-1) FA and 10 Mg ha(-1) PB. Application of the highest rate of FA significantly increased the plant tissue concentrations of Mn, As, Se and B. Soil pH was initially increased from 4.6 to 6.1 by amendments. Soil salinity was increased in the initial year only. Amended soils had higher concentrations of Ca, Mg, P and K, higher organic matter content and water holding capacity than unamended soil. Concentrations of plant-essential trace elements (B, Cu and Zn) that were marginally deficient in the unamended eroded soil increased to within typical soil concentrations following amendment with FA and PB. Groundwater quality was unaffected throughout the study. The co-application of FA and PB successfully promoted the revegetation of the eroded borrow area with no apparent adverse environmental side effects.

Animals↗