RESUMO
There are many possible causes of esophageal ulcer, such as reflux esophagitis, pill-induced esophagitis, infectious esophagitis, tuberculosis, syphilis, Behcet's disease, radiation injury, caustic injury, foreign body-induced injury, esophageal cancer, and so on. However, there are only a few cases of esophageal ulcer by thermal injury from food, and most of these were caused by liquids; few are related to ingestion of solid food. We experienced a case of a large symmetrical esophageal ulcer caused by thermal and compressive injury from a hot solid foodstuff known as 'Song-pyen', a traditional Korean food, and report the natural course of healing by conservative treatment, with a review of the few available reports regarding such injuries.
Assuntos
Ingestão de Alimentos , Neoplasias Esofágicas , Esofagite , Esofagite Péptica , Lesões por Radiação , Sífilis , Tuberculose , ÚlceraRESUMO
BACKGROUND AND OBJECTIVES: It was reported that atorvastatin co-administered with clopidogrel for 8 months did not affect the anti-platelet potency of clopidogrel in Korean patients with acute coronary syndrome, but not in patients with stable angina. We investigated whether co-administration of statins with clopidogrel affected the anti-platelet efficacy of clopidogrel in Korean patients with stable angina. SUBJECTS AND METHODS: This was a randomized, open-label and two-period crossover design study conducted at two centers. Two hundreds thirty three patients with stable angina scheduled for coronary stenting were randomized into two groups. In Group A, 119 patients first received atorvastatin (10 mg) followed by fluvastatin (80 mg) for 12 weeks per treatment. In Group B, 114 patients received the same treatments in reverse order. RESULTS: Baseline adenosine diphosphate (ADP, 10 micromol/L)-induced platelet aggregation was 54.4+/-9.1% in Group A and 53.8+/-9.0% in Group B (p=0.44), and significant differences were noted after each treatment period (p<0.001). Inhibition of platelet aggregation was similar between Group A and Group B at 24 hours following clopidogrel loading (29.2+/-11.0% vs. 30.4+/-12.7%; p=0.42). The two treatment least square means of 12-week ADP (10 mol/L)-induced platelet aggregation [29.50+/-0.79 {standard error (SE)}% on the atorvastatin treatment group vs. 28.16+/-0.70 (SE)% in the fluvastatin treatment group] in a 2x2 cross-over study were not significantly different (p=0.204). CONCLUSION: Statin and clopidogrel co-administration for 12 weeks is not associated with attenuated anti-platelet activity of clopidogrel in Korean patients with stable angina after coronary stenting, in support of the findings of similar studies conducted in Caucasian populations.
Assuntos
Humanos , Síndrome Coronariana Aguda , Difosfato de Adenosina , Angina Estável , Doenças Cardiovasculares , Estudos Cross-Over , Citocromo P-450 CYP3A , Ácidos Graxos Monoinsaturados , Ácidos Heptanoicos , Inibidores de Hidroximetilglutaril-CoA Redutases , Indóis , Agregação Plaquetária , Pirróis , Stents , Ticlopidina , AtorvastatinaRESUMO
Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Assuntos
Idoso , Humanos , Masculino , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Colorretais/tratamento farmacológico , Fluoruracila/efeitos adversos , Leucovorina/efeitos adversos , Doenças Pulmonares Intersticiais/induzido quimicamente , Compostos Organoplatínicos/efeitos adversosRESUMO
Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here.
Assuntos
Idoso , Humanos , Masculino , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Colorretais/tratamento farmacológico , Fluoruracila/efeitos adversos , Leucovorina/efeitos adversos , Doenças Pulmonares Intersticiais/induzido quimicamente , Compostos Organoplatínicos/efeitos adversosRESUMO
PURPOSE: We aimed to evaluate whether cancer detection rates could vary with prostate size using a systematic sextant biopsy. MATERIALS AND METHODS: We performed a systematic sextant biopsy in 225 consecutive men from January 1997 to August 2002. Indications for biopsy included an elevated prostate specific antigen(PSA) level(more than 4.0ng/ml), or the hypoechoic lesion on TRUS. Prostate volume was calculated using the following fomula: volume=0.52 x length x width x height. We examined biopsy yield according to gland-volume intervals of 10cc. RESULTS: Adenocarcinoma was detected in 68 out of 225 patients(30.22%). The mean volume of prostate in all patients was 51.5cc. The highest biopsy rate(65.7%) was recorded among men with prostates between 20 to 29.9cc. The lowest biopsy rate (17.2%) was recorded among men with prostates larger than 80cc. Decreasing yield of sextant biopsy was strongly associated with increasing gland volume(p or =30cc)(62.63% and 22.09%, respectively, p or =30cc) prostate groups. CONCLUSION: Our cancer detection rate using a systematic sextant biopsy was higher in men with prostates less than 30cc. Our results suggest that significant sampling error may occur in men with large glands, and more biopsies may be needed under these circumstances.
Assuntos
Humanos , Masculino , Adenocarcinoma , Biópsia , Próstata , Neoplasias da Próstata , Viés de SeleçãoRESUMO
The authors have experienced a case of general anesthesia for a patient of congenital esophageal atresia with tracheo-esophageal fistula. Paramount importance of particular attention to the maintenance of patent airway and the removal of secretions whenever necessary for the patient's safety throughout anesthetic and postonesthetic period has been stressed. General anesthetics which irritate the respiratory tract and increase secretions must be avoided. Keeping the patient in an incubator with oxygen and humidity after anesthesia is recommended. In case of respiratory distress due to gastric dilatation, gastrostomy under local anesthesia before operation may be helpful.
Assuntos
Humanos , Anestesia , Anestesia Geral , Anestesia Local , Anestésicos Gerais , Atresia Esofágica , Fístula , Dilatação Gástrica , Gastrostomia , Umidade , Incubadoras , Oxigênio , Sistema RespiratórioRESUMO
Two cases of upper extremity paralysis following general anesthesia due to malposition paralysis are reported. The one case is brachial plexus paralysis following general anesthesia for hemicoleetomys and the other case is radial nerve paralysis following general anesthesia for radical hysterectomy. In the above two cases, there was not any neurological disease and no trauma history before operation. There was no specific finding in the labaratory test and X-rays. Other authors reported that most of postoperative nerve damage was due to irritating drugs, trauma, hypotension, hypoxia, hypothermia, diabetus mellitus. and malposition. But in the above two cases, we believed that there was no causative factors except malposition.
Assuntos
Anestesia Geral , Hipóxia , Plexo Braquial , Hipotensão , Hipotermia , Histerectomia , Paralisia , Nervo Radial , Extremidade SuperiorRESUMO
A 4 years old Korean male child was presented with delay of regaining consciousness after general anesthesia for the correction of the right hand deformity and limitation of motion. In 1961 Frederich described the failure to regain consciousness after general anesthesia. 1.Hypoxia. 2. Excess of CO2.3. Anesthetic overdose, surgical shock, hypotension. 4. Miscellaneous factors: cerebro-vascular accidents, metabolic acidosis, hypoglycemia, uremia, hemorrhage, cerebral thrombosis, electrolyte imbalance. In this case, we believed that hypoxia was responsible for this complication.