A. The North Dakota Institutional Ethics Committee Network

Lymphedema is a chronic edema that sometimes occurs after treatment of gynecologic cancer, and cellulitis often occurs concomitantly with lymphedema. On the other hand, necrotizing fasciitis (NF) is a relatively rare, but life-threatening disease. The symptoms in cellulitis and NF are very similar. In this case report, we describe a case in which the diagnosis of NF in a lymphedematous limb was difficult. A 70-year-old woman had secondary lymphedema in bilateral legs and consulted our department. On the first day of lymphedema therapy, the patient complained of vomiting, diarrhea, and fever (37.7 °C) without local fever in the legs. She was diagnosed with acute gastroenteritis. On the next day, swelling and pain in her left leg occurred and her blood pressure was 59/44 mmHg. She was diagnosed with cellulitis accompanied by lower limb lymphedema and septic shock. On the second day, blisters appeared on the left leg, and computed tomography showed NF. We performed debridement under general anesthesia and her vital signs improved postoperatively. Streptococcus agalactiae (B) was detected in blood culture, and we administered bixillin and clindamycin. Postoperatively, necrosis in the skin and fat around the left ankle gradually spread, and it took 5 months to complete epithelialization. The diagnosis was more difficult than usual NF because patients with lymphedema often experience cellulitis. Clinicians should always think of NF to avoid mortality due to delayed treatment. This case report was approved by the institutional ethics committee.

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Different profiles for the institutional ethics committee in the Netherlands

HEC Forum ◽

10.1007/bf01463647 ◽

1994 ◽

Vol 6 (3) ◽

pp. 139-156 ◽

Cited By ~ 1

Author(s):

Herman H. van der Kloot Meijburg

Keyword(s):

The Netherlands ◽

Ethics Committee ◽

Institutional Ethics

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Bison Ecology In The Northern Plains And A Reconstruction Of Bison Patterns For The North Dakota Region

Plains Anthropologist ◽

10.1080/2052546.1984.11909225 ◽

1984 ◽

Vol 29 (104) ◽

pp. 93-113 ◽

Cited By ~ 17

Author(s):

Jeffery R. Hanson

Keyword(s):

North Dakota ◽

Northern Plains ◽

The North

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Relation of algal biovolume to chlorophyll a in selected lakes and wetlands in the north-central United States

Canadian Journal of Fisheries and Aquatic Sciences ◽

10.1139/f95-043 ◽

1995 ◽

Vol 52 (2) ◽

pp. 416-424 ◽

Cited By ~ 12

Author(s):

James W. LaBaugh

Keyword(s):

United States ◽

North Dakota ◽

Chlorophyll A ◽

Linear Relation ◽

Algal Biomass ◽

Open Water ◽

Light Penetration ◽

North Central ◽

The North ◽

Central United States

Algal chlorophyll a is commonly used as a surrogate for algal biomass. Data from three lakes in western Nebraska, five wetlands in north-central North Dakota, and two lakes in north-central Minnesota represented a range in algal biovolume of over four orders of magnitude and a range in chlorophyll a from less than 1 to 380 mg∙m−3. Analysis of these data revealed that there was a linear relation, log10 algal biovolume = 5.99 + 0.09 chlorophyll a (r2 = 0.72), for cases in which median values of chlorophyll a for open-water periods were less than 20 mg∙m−3. There was no linear relation in cases in which median chlorophyll a concentrations were larger than 20 mg∙m−3 for open-water periods, an occurrence found only in shallow prairies lakes and wetlands for years in which light penetration was the least.

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