1/79. Short-bowel syndrome associated with subtotal necrosis of small intestine after rectal trauma.We report on a 4-year-old girl who experienced rectal trauma during swimming, sitting on an uncovered draining valve in the swimming pool. This resulted in a powerful suction effect on her rectum, followed by rupture of the sigmoid colon and evisceration of the small intestine. laparotomy showed a near complete necrosis of the small bowel because of thrombotic lesions and wall lacerations of the superior mesenteric artery (SMA). A subtotal bowel removal associated with a jejuno-ileostoma was carried out, a total length of about 35 cm of the small intestine could be left in situ. parenteral nutrition was stopped after eight months. At the moment defecation takes place 2-3 times a day, growth and weight gain are quite normal.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/79. Postanesthetic necrotic defect.An unusual defect was noted in a 10-year-old girl near the usual site of administration for an inferior nerve block. It was interpreted to be the result of a local anesthetic having been administered 2 months previously.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/79. Necroqizing enterocolitis with pneumatosis intestinalis in systemic lupus erythematosus and polyarteritis.Pneumatosis intestinalis was encountered in association with fatal necrotizing enterocolitis in systemic lupus erythematosus (SLE) and polyarteritis nodosa. The radiologic identification of mottled, bubbly, and linear collections of intramural intestinal gas distinguish this ominous complication from benign pneumatosis cystoides intestinalis. In the setting of intestinal vasculitis due to SLE or polyarteritis nodosa, these characteristic radiologic features indicate necrotizing enterocolitis. Since corticosteroids may mask clinical progression of the intestinal lesion, radiologic evaluation is essential in the overall management of the patient with intestinal vasculitis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/79. McArdle's disease in childhood: report of a new case.McArdle's disease (glycogenosis type V) is an inherited glycogen storage disease characterized clinically by myalgia, cramps and sometimes myoglobinuria, triggered by exercise. The onset of exercise intolerance is usually in late childhood or adolescence and diagnosis is exceptionally established during infancy. We report the case of a 6-year-old girl who had been complaining of aching muscles for a long time, and who presented after a near-drowning incident, with extensive muscle necrosis, probably secondary to myophosphorylase deficiency-induced cramps. These unusual manifestations led to the diagnosis of this rare disorder. We compare the clinical findings of this case to nine previous reports. This highlights the heterogeneous spectrum of this disease in childhood and supports the distinction of three clinical pictures in childhood: a neonatal form rapidly fatal, a milder form with congenital myopathic symptoms and a benign classical form with myalgia, cramps and pigmenturia.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/79. Leukocyte adhesion deficiency.Leukocyte adhesion deficiency is a rare syndrome with autosomal recessive pattern of inheritance. An eleven-month-old boy, whose parents were first degree relatives, was referred to clinic with recurrent episodes of pneumonia, otitis and extensive necrotic wounds of perianal area since neonatal period. His umbilical cord had separated 30 days after birth. Laboratory findings included marked leukocytosis, chemotaxis abnormality, and very low levels of CD 11 (0.5%) and CD 18 (2%). Leukocyte Adhesion Defect (LAD) is rare genetic defect of a group of leukocyte membrane glycoproteins. LAD affects nearly one out of every million individuals and is characterized by recurrent bacterial and fungal infections of skin and mucous membranes, diminished pus formation, delayed umbilical cord separation, granulocytosis, poor wound healing and progressive periodontitis. This is the first report of a case of LAD in Isfahan of iran.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/79. High-resolution magnetic resonance imaging reveals symmetric bitemporal cortical necrosis after carbon monoxide intoxication.High-resolution magnetic resonance images obtained in a patient several months after carbon monoxide (CO) intoxication revealed nearly symmetric regional atrophy of both lateral temporal lobes. This pattern of cortical lesions after CO exposure has not been reported before. The patient suffered from severe cognitive deficits including a transient Kluver-Bucy-like behavior. This report underlines the value of high-resolution magnetic resonance imaging in chronic stages of CO intoxication in the attempt to understand the neuroanatomical bases of the observed behavior.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
7/79. heparin-induced skin necrosis in a patient with end-stage renal failure and functional protein s deficiency.skin ulceration is a well-characterized thrombotic complication of the heparin-induced thrombocytopenia (HIT) syndrome. We present the case of a 73-year-old diabetic woman nearing end-stage renal failure who developed extensive upper thigh, abdominal and buttock ulceration following initiation of subcutaneous heparin for prophylaxis against deep vein thrombosis. A preliminary diagnosis of calciphylaxis was made based on the classical distribution and macroscopic appearance of the ulceration in a patient with end-stage renal failure and secondary hyperparathyroidism. However skin biopsy showed complete absence of calcium deposits in the dermal microvasculature. The presence of extensive microthrombi within dermal vessels prompted serologic testing to detect a prothrombotic state. We identified the combined presence of heparin-dependent platelet activating (HIT) antibodies and functional protein s deficiency. To our knowledge this is the first reported case of a dialysis patient presenting with skin ulceration induced by heparin and protein s deficiency. This case highlights the importance of a skin biopsy and testing for a hypercoaguable state in patients with end-stage renal disease and skin ulceration. We suggest that HIT antibodies should be requested in all dialysis patients presenting with skin ulceration.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
8/79. Acute necrotizing eosinophilic myocarditis successfully treated by high dose methylprednisolone.Acute necrotizing eosinophilic myocarditis is the most severe form of eosinophilic myocarditis, or hypersensitivity myocarditis, and is characterized by rapidly progressive congestive heart failure followed by fulminant clinical deterioration that is nearly always fatal. A 55-year-old previously healthy patient with acute necrotizing eosinophilic myocarditis was diagnosed by early myocardial biopsy and successfully treated with corticosteroids. Throughout his hospitalization, the eosinophil count in the peripheral blood remained normal (56-201/mm3). Early stage corticosteroid therapy can have dramatic effects in acute necrotizing eosinophilic myocarditis and early diagnosis by endomyocardial biopsy is recommended.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
9/79. Hyperbaric oxygen therapy for mitomycin C-induced scleral necrosis.Intraoperative or postoperative use of mitomycin C is one of the treatment options to reduce the recurrence of pterygia. Scleral necrosis, a potentially blinding complication after mitomycin C use, has been among great concern in ophthalmic practice. A patient is presented in whom scleral necrosis developed 20 days after a pterygiectomy with bare sclera technique was performed, followed by the application of 0.4 mg/mL of topical mitomycin C eye drops for 3 weeks. After conjunctival flap failures the patient was treated with hyperbaric oxygen therapy. The sclera revascularized and returned to near normal thickness after 24 sessions of hyperbaric oxygen therapy. This case demonstrates that it is an effective, novel treatment. [Ophthalmic- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
10/79. A study on pathogenicity of hepatitis G virus.AIM: To study the pathogenicity of hepatitis G virus (HGV) and observe the genesis and pathological process of hepatitis G. methods: HGV-rna in serum was detected by RT-PCR assay. The immunohistochemical assays of liver tissue were performed with HGV monocoloned antibody (McAb) expressed from the region of HGV NS5 nucleic acid sequence. The clinical and pathological data of 52 patients with hepatitis G were discussed. In animal experiment, the Chinese Rhesus monkeys were infected with the serum of a patient with HGV infection. And the dynamic changes in serology and liver histology of animals were observed. RESULTS: One hundred and fifty-four patients with HGV-rna positive were selected from 1552 patients with various kinds of hepatitis. Of 154 patients with HGV infection, 52 were infected with HGV only, which accounted for 33.8 (52/154) and 102 with positive HGV-rna were super-infected with other hepatitis viruses, which accounted for 66.2 (102/154). The clinical and pathological observation showed that the acute and chronic hepatitis could be induced by HGV. The slight abnormality of transaminases ALT and AST in serum of monkeys lasted nearly 12 months and histological results showed a series of pathological changes. CONCLUSION: HGV is a hepatotropic virus and has pathogenicty.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
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