1/25. Bilateral fat necrosis of the scrotum.The typical patient with fat necrosis of the scrotum is a prepuberal heavy set male subject who has extratesticular scrotal masses, usually bilateral, with mild to moderate pain but no systemic complaints or symptons related to voiding. The masses are firm, tender and do not transmit light. With a firm diagnosis expectant treatment will allow spontaneous resolution of the lesions. If doubt exists appropriate surgical intervention is advocated. Hypothermic injury, such as swimming in frigid water, is the most probable etiologic agent.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
2/25. Differences in water diffusion and lactate production in two different types of postinfectious encephalopathy.We compared two different types of postinfectious encephalopathy using magnetic resonance imaging (MRI), including diffusion-weighted images and MR spectroscopy. Acute disseminated encephalomyelitis (ADEM) and acute necrotizing encephalopathy (ANE) showed different distribution of abnormal intensity areas and different diffusion of water measured by diffusion-weighted imaging (DWI). Proton MR spectroscopy (MRS) showed lactate production in both cases, which returned to a normal range; the rate of increased lactate production was much lower in the ANE case. water diffusion showed a difference in pathophysiological background between the two encephalopathies, but the lactate elevation observed by proton MRS did not correlate with clinical severity.- - - - - - - - - - ranking = 5keywords = water (Clic here for more details about this article) |
3/25. Repair of a late-onset filtering bleb leak using a corneal graft shaped with an excimer laser.A new method for repairing an area of late scleral necrosis and bleb leak after glaucoma-filtering surgery using mitomycin C (MMC) is described. In a 33-year-old female patient diagnosed with bilateral juvenile glaucoma, a bleb leak occurred 41 months after trabeculectomy with MMC in the left eye. A corneal stromal patch-graft shaped to the desired size using an excimer laser (Excimer-Laser-Corneal-Shaping-System, ELCS-S) was used to cover the scleral defect. This step was followed by water-tight closure of the conjunctiva. During the follow-up period of 12 months the leak remained successfully repaired and the intraocular pressure stayed between 8 and 14 mm Hg without medication. This technique that uses lamellar grafts of very large size should be considered when a surgical repair of a large leaking bleb is required, especially in cases with scleral tissue necrosis.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
4/25. Symmetrical necrosis of the solitary tract nuclei as a contributory cause of death.A 64-year-old man died in spite of surgery 4 days after attempting suicide. He first tried to hang himself with a rope and when the hanging did not succeed, he cut his throat with a knife. The autopsy showed four sutured cervical wounds with laryngeal wounds but without associated important vascular injury. The neuropathological study revealed two watershed-type haemorrhagic infarcts, involving the left occipital lobe and the left cerebellum. It also showed a symmetrical necrosis of solitary tract nuclei in the medullary tegmentum. Such a lesion is likely to result from sudden acute transient circulatory failure and might have played a role in the secondary autonomous cardiac and respiratory dysfunctions following a non-lethal trauma.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
5/25. Hot tub-associated necrotizing pneumonia due to pseudomonas aeruginosa.We describe a case of severe necrotizing pneumonia due to community-acquired pseudomonas aeruginosa. Cultures of fluid obtained from the filter of the patient's hot tub grew the same P. aeruginosa strain as that grown from culture of the patient's sputum. Centers for disease Control and Prevention guidelines should be strictly followed for hot tub maintenance to prevent P. aeruginosa overgrowth: the range of free chlorine levels in the water should be kept at 1-3 mg/L, and the pH should be kept at 7.2-7.8.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
6/25. A case of generalized hypoxic brain damage following traumatic brain damage.In forensic autopsy cases, transient brain hypoxia can be induced by cardiac arrest, hypovolemic shock, and other conditions with severe circulatory failure. Although cortical laminar necrosis in watershed areas between territories of the major cerebral arteries is occasionally seen, cases with global hypoxic damage to the brain is rare, because patients with irreversible severe brain damage rarely survive for more than a few days. In this report we describe autopsy results for an injury victim who survived unconscious for approximately 4 weeks after admission. Macroscopic thinning of the gray matter and uniformly cheesecake-like cloudy changes in white matter were observed. Microscopically, cortical laminar necrosis was observed in all lobes of the cerebrum, and massive gliosis was diffused throughout the white matter. We speculate that traumatic brain damage, continuous hypoxemia, and many other factors induced these characteristic pathological changes during the long time interval from brain damage to death.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
7/25. Case report: subcutaneous elemental mercury injection--clinical observations and implications for tissue disposal from the histopathology laboratory.A 31-yr-old man presented to his general physician complaining of pain and swelling in the soft tissue of both hips. He initially denied knowledge of the etiology, but after elemental mercury droplets were expressed from the skin wounds by manual manipulation, he admitted that the source was self-administered sc injections. He did not provide a reason for this or give the time-frame of the injections. The areas of skin discoloration and soft tissue induration were completely excised and the wounds healed uneventfully. blood levels of mercury declined gradually after excision. Examination of the resected skin and subcutis revealed subcutaneous abscesses containing droplets of elemental mercury, released easily when the abscesses were sectioned. Sections showed dark droplets of metallic mercury associated with necrosis and microabscess formation, with areas of foreign body giant cell reaction. Disposal of the residual tissues and mercury by incineration would release the volatile elemental mercury into the atmosphere, where it would subsequently be returned to earth in rain water, be converted to methyl mercury by microorganisms, and enter the food chain. The US Environmental Protection Agency has recommended caution in consuming foods containing methyl mercury and has provided guidelines for consuming foods believed to contain increased amounts of mercury. mercury is readily available in the united states by over-the-counter sales to consumers, and in some cultures elemental mercury is used in ritualistic practices. skin injection cases are infrequent, but histopathology laboratories should recognize this phenomenon and be prepared to dispose of Hg-contaminated tissues in an environmentally sound manner.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
8/25. Complication of a Portuguese man-of-war envenomation to the foot: a case report.Jellyfish stings have become more prevalent on account of larger commercial presence along coastal waterways. Stings are referred to as envenomations, due to the process of a neurotoxic venom being injected into the victim at the site of the sting. These events are usually mild, and for the most part, confined to local hypersensitivity reactions at the site of the injury. Certain species of jellyfish, however, have been associated with more severe, systemic insults including muscle cramping, respiratory distress, hypotension, circulatory collapse and death. One such example of a more potent venom is the Portuguese man-of-war. Most case reports of Portuguese man-of-war envenomations do not involve local soft tissue necrosis. The purpose of this case report is to present such a consequence after a jellyfish sting to the dorsum of the foot. A large area of skin necrosis developed after an envenomation that required extensive debridement and skin grafting.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
9/25. A unique waterskiing injury leading to a necrotizing foot infection in an insulin-dependent diabetic.Reports of waterskiing-related injuries are limited in the medical literature. The authors report a case of a unique waterskiing injury that progressed into a necrotizing foot infection in a well-controlled insulin-dependent diabetic. This case shows that with aggressive therapy, including hyperbaric oxygen treatments and use of a wound vacuum-assisted closure system, limbs can be saved.- - - - - - - - - - ranking = 6keywords = water (Clic here for more details about this article) |
10/25. MRI demonstration of cortical laminar necrosis and delayed white matter injury in anoxic encephalopathy.We performed serial radiological examinations on a patient with anoxic encephalopathy. In the early term after the anoxic insult, T1-weighted MRI revealed high signal intensity areas distributed laminarly in the cerebral cortex and diffusely in the putamen, which were thought to reflect the cortical necrosis and necrosis in the putamen. Single photon emission computed tomography using I-123 isopropylamphetamine showed persistent hypoperfusion in the arterial watershed zones. T2-weighted MRI performed several months after the anoxic episode revealed diffuse high-intensity lesions in the arterial water-shed zones. These delayed-onset white matter lesions continued to extend over several months.- - - - - - - - - - ranking = 2keywords = water (Clic here for more details about this article) |
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