ABSTRACT
Objective: To summarize clinical features and our experience of the diagnosis and treatment of laryngocele. Methods: Clinical data of 11 laryngocele patients in department of Otorhinolaryngology Head and Neck Surgery of the Second Affiliated Hospital of Shanxi Medical University from January 2012 to December 2021 were retrospectively reviewed, including 9 men and 2 women, aged from 12 to 75 years, with median age of 56 years. Electronic laryngoscope was performed in 10 of all patients, laryngeal CT in 10 and cervical color ultrasound in 5 before operation.All the operations were performed under general anesthesia, and the external cervical approach was used for external and combined laryngocele. The internal laryngocele was resected by low temperature plasma through transoral endoscopy. Patients were followed up regularly after operation to evaluate the effect. Clinical feature, types of lesions, imaging findings, surgical approaches and follow-up results were analyzed through descriptive statistical method. Results: Eleven laryngocele patients were divided into mixed type (n=6), internal type (n=4) and external type (n=1).Nine patients presented with hoarseness or dysphonia, 7 with cervical mass and 1 with airway obstruction. Surgical resections were done through external cervical approach (n=7)or transoral endoscopic approach (n=4). All the operations were successful and no complication occurred. All cases were followed up from 17 to 110 months. No recurrence was encountered. Conclusions: Laryngocele is a rare lesion with atypical clinical presentation. Preoperative imaging including CT scan and electronic laryngoscope is essential to evaluate the location, and extent of the lesion, and to make the surgical plan.Complete surgical excision is required. Surgical resection is the only effective method for the treatment of laryngocele.
Subject(s)
Male , Humans , Female , Middle Aged , Child , Adolescent , Young Adult , Adult , Aged , Laryngocele/pathology , Retrospective Studies , Larynx/pathology , Laryngoscopy/methods , HoarsenessABSTRACT
Rhabditis axei is a free-living nematode, which can occasionally invade into humans through drinking and contacting wastewater. It is usually parasitic in the digestive and urinary systems, causing the disease of rhabditelliasis axei. This paper reports a case of R. axei infection found in the urine routine examination.
ABSTRACT
Rhabditis axei is a free-living nematode, which can occasionally invade into humans through drinking and contacting wastewater. It is usually parasitic in the digestive and urinary systems, causing the disease of rhabditelliasis axei. This paper reports a case of R. axei infection found in the urine routine examination.
ABSTRACT
The author reported a case of a 44-year-old man who developed leukopenia and neutropenia during pharmacological therapy with olanzapine for schizophrenia. He was found to have a significantly decreased WBC level (1.6x109/L, neutrophils 34%) without any signs of medical conditions such as infection, hematologic disorder, or nutritional deficiency. The patient did not use any other neuroleptics or drugs that could induce hematological toxicity. The author concluded that the neutropenia in this case was attributed to the use of olanzapine medication. The author also tried to review current literatures on untoward hematological effects caused by olanzapine therapy. Clinicians may need to be cautious about the potential risk for hematological toxicity caused by olanzapine medication. Patients who were treated with olanzapine should be monitored for WBC level, especially in those patients with previous history of drug-induced neutropenia/agranulocytosis, or those are on high-dose olanzapine.
Subject(s)
Adult , Humans , Antipsychotic Agents , Leukopenia , Malnutrition , Neutropenia , Neutrophils , SchizophreniaABSTRACT
The authors report a case of a 45-year-old man who developed stupor and hyperammonemia during pharmacological therapy with valproate for bipolar affective disorder. He was found to have a significantly elevated ammonia level (>400 microgram/dl) without any signs of hepatic insufficiency such as hepatic failure. The patient showed severely increased serum ammonia level, but the serum valproate level was within the therapeutic range. And he didn't use any other mood stabilizer and have any risk factors for hyperammonemia such as hepatic dysfunction and metabolic abnormality. The authors conclude that the mental change and hyperammonemia in this case are attributable to valproate medication. The authors also reviewed current literatures on hyperammonemia caused by valproate therapy and treatment with carnitine. Clinicians should be cautious about the potential risk for hyperammonemic encephalopathy caused by valproate medication, and patients who are treated with valproate need to be monitored for blood level of ammonia, especially in the case which shows characteristic mental and/or behavioral change.