Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have high mortality rates. Disseminated intravascular coagulation has been reported in SJS/TEN patients. The influence of ...this lethal complication in patients with SJS/TEN is not well known.
This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN.
We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019.
We analyzed 150 patients with SJS/TEN (75 with SJS, 22 with overlapping SJS/TEN, and 53 with TEN) and their complete disseminated intravascular coagulation profiles. Disseminated intravascular coagulation was diagnosed in 32 patients (21.3%), primarily those with TEN. It was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with disseminated intravascular coagulation had elevated procalcitonin levels. Among patients with SJS/TEN, disseminated intravascular coagulation was associated with a greater than 10-fold increase in mortality (78.1% vs 7%).
The study limitations include small sample size and a single hospital system.
Disseminated intravascular coagulation is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN.
We simulate the injection-locking performance of a 1% antireflection coated Fabry-Perot laser amplifier (AR-FPLA) and demonstrate the 2.5-Gbit/s DWDM-PON application with the directly modulated ...AR-FPLA based ONU transmitter under side-mode injection-locking condition. The effect of the AR-FPLA front-facet reflectivity on the injection locking range detuning and the Q-factor are interpreted from theoretical simulations and are experimentally characterized. A 25-channel locking capacity is reported for such a side-mode injection-locked AR-FPLA with corresponding wavelength locking range of 30 nm, the minimal requested power of -7 dBm and gain extinction ratio of <;7 dB by reducing its front-facet reflectivity to 1%. At bit rate of 2.5 Gbit/s, the BER of 10 -12 is achievable for the nearest 17 channels of AR-FPLA at receiving power of -21 dBm, and all of the 25 injection-locked channels with SMSR of > 35 dB can guarantee the BER of <; 10 -9 with their worst receiving sensitivity degrading to -19 dBm.
To investigate the impact of a positive family history of high myopia on the level and onset of myopia and its ocular components.
A cross-sectional study was conducted. The participants (aged 17 to ...45 years) were categorized into four groups: normal, mild, moderate, and high myopia. The age of first glasses for myopia was used as the onset of myopia. The impact of the family history on the level and the onset of myopia was quantified. Parental effect on corneal curvature (CC), anterior chamber depth (ACD), and axial length (AXL) was analyzed.
The study included 185 normal subjects, 170 mild, 140 moderate, and 392 high myopes. Family history was strongly associated with the probands' status (P < 6 x 10(-12)). When there was >or=1 highly myopic parent, the odds ratios (ORs) of developing mild or moderate myopia were between 2.5 and 3.7 (95% CI: 1.1-6.5) and the ORs of having high myopia were > 5.5 (95% CI: 3.2-12.6). A strong association (P = 2 x 10(-6)) between parental myopic state and the AXL in the subjects was also found, but there was no statistical relationship for ACD or CC. There was an association between high myopia in parents and the onset of myopia in children. Siblings had a weaker association with the level of myopia and had no effect on the onset of myopia.
This study found strong familial effects on the level and onset of myopia even after adjusting for environmental factors. The parental effect on ocular components in their offspring was primarily on AXL.
Abstract Inhalation injuries contribute significantly to morbidity and mortality in both children and adults with burns. Pneumonia is a major compromising factor in these patients. The purpose of ...this article was to evaluate the characteristics, impact factors, incidence, morbidity, and mortality of pneumonia in inhalation injuries. Furthermore, a severity score has been formulated to help predict the probability of developing pneumonia following inhalation injuries. A retrospective study was performed of 214 patients, treated for inhalation injuries from 1999 to 2009 at the Burn Center in Chang Gung Memorial Hospital, Linkou, Taiwan. Patients’ characteristics, length of hospitalization, total burn surface area, initial PaO2 :FiO2 ratio, number of intubated days, bronchoscope grade, initial carboxyhemoglobin level (COHb) and mortality rate were recorded. A Student's t -test was used for comparison of inhalation injury patients with and without pneumonia and was also used for comparing a TBSA of >20% to those with a TBSA of ≤20% in patients with inhalation injury and pneumonia. Logistic regression analyses were utilized to create a severity score related to pneumonia. 129 patients with inhalation injury were included in the analysis. Overall, 38% (49/129) patients developed pneumonia. Pneumonia associated with inhalation injury occurred more often in patients with a TBSA>20% ( P < 0.05). The intubation days, bronchoscope grade and COHb level of pneumonia patients were significantly longer ( P < 0.05). Initial PaO2 :FiO2 ratio (PaO2 /FiO2 ) was significantly lower in patients with pneumonia ( P < 0.05). Mortality following pneumonia was increased sevenfold ( P < 0.05). Hospitalization days and intubation days were significantly longer in TBSA > 20%. Logistic regression analysis was performed to find out the impact factors of pneumonia in inhalation injury patients and to set a severity score. Patients age >60 years, TBSA >20%, bronchoscope grade is 3 or 4, initial PaO2 /FiO2 ≦ 300 and initial COHb level>10% showed a significant difference ( P < 0.05). The total severity scale was set at 5 points. Each impact factor was given one point and when the score ≥2 it means patients have high risk of development of pneumonia. This study had identified the significant risk factors for potential development of pneumonia in a group of inhalation injury patients. The impact of these risk factors should be validated in further prospective trials to improve outcome or at least reduce the incidence of the surrogate diagnosis of pneumonia.
In this paper, a field‐sequential‐color liquid crystal display (FSC LCD) based on new polymer stabilized vertical alignment (N‐PSVA) liquid crystal display mode and photo alignment technology have ...been developed. An excellent response time of the device can be obtained by the developed of N‐PSVA LC and the optimizing of process, with the operating voltage keep in 10V. By this work, the 32 inch large size FSC TV panels were presented
Theory and experiments on the side-mode-suppression-ratio (SMSR) enhancement and the linewidth reduction of a Fabry-Perot laser diode (FPLD) side-mode-injection-locked by using another FPLD are ...demonstrated to realize its potential application as a DWDM transmitter source. The SMSR, the spectral linewidth and the linewidth enhancement factor are simulated to realize the limitation of the FPLD-FPLD link under side-mode injection-locking condition. A degradation of the linewidth enhancement factor from 1.5 to 2.1 is observed due to the slave FPLD injection-locked at principle- and side-mode conditions. Up to 22-channel selectability of the 2.5 Gbit/s directly modulated FPLD based transmitter under side-mode injection-locking is demonstrated with a SMSR >35 dB, a Q-factor 6.8-9.2, a locking range of 24 nm, a power penalty of -0.7 dB, and a BER of 10(-10) at -17 dBm. The side-mode injection-locked FPLD shows high-quality transmission performance and meet the demand for cost-effective and high-capability 2.5 Gbit/s WDM systems.
Abstract
Introduction: Since Jean-Nicolas Marjolin reported carcinoma arising in post-traumatic scars in 1828, the term 'Marjolin ulcer' has been applied to malignant changes in burn scars. Although ...many papers have been published already in this field, there are few reports from Oriental people. Methods: From 1989 to 2008, there were 11 cases noted as burn scar carcinoma in Chang Gung Memorial Hospital. Ten were reported as squamous cell carcinoma (SCC) and the one was verrucous carcinoma. Most of the cases occurred in the extremities (10/11). Results: Ten cases underwent an operation initially with wide excision and skin graft or local flap for coverage. Forefoot amputation was performed in one patient. One patient received above-knee amputation and adjuvant therapy because recurrent verrucous carcinoma occurred 2 years later. One patient suffered from a new lesion 8 years later and another case had inguinal lymph node metastasis 8 months later. Five patients were lost to follow-up and six cases were tumor-free during the follow-up period. Most scar malignancies are SCC while other cell types are rarer. Conclusion: The casual association between burn injuries and a later risk of basal cell carcinoma is questionable. Owing to poor prognosis in advanced scar cancer, the best treatment for scar carcinoma is to prevent the scar from developing repeated ulceration by performing aggressive initial burn wound care: early grafting by surgeons and daily scar care with regular follow-up for patients. This may be why a lower incidence has been noted in recent years.
Abstract Introduction Dynamic and static complex scar contractures after burn commonly cause tendon adhesion, deep adipose tissue stiffness and further limitation of major joints motion. Skin ...autografting or locoregional flaps are not adequate reconstructive options, because of the easy recurrence and limitation of donor sites. Therefore, free perforator flaps are playing increasing role in reconstruction of complex scar contractures. Patients and methods The free medial thigh perforator (MTP) flap is an addition to the reconstructive armamentarium and is particularly useful since the medial thigh is commonly spared in burn injury. Between December 2001 and October 2005, eight patients with severe post-burn scar contractures received free MTP flaps treatment in the Linkou Burn Center. The free MTP flap harvest was modified to enhance its reliability and versatility. Flap sizes ranged from 5 × 15 cm to 8 × 24 cm. The follow-up period was from 12 to 26 months. Flap harvest is rapid, averaging 37.8 min. Results The significantly improved range of motion of the contracture joints approximated to normal activity at 6–22-month follow-up ( p < 0.05). No free major MTP flap complication was noted, except for mild marginal necrosis in one case. Conclusion The free MTP flap with new modified harvest is a good choice for dynamic an static complex scar contractures of major joints, due to short harvesting time and few variations of the pedicle. However, thick skin paddle was considered in secondary hand reconstruction.
PDF
