ABSTRACT
Posterior reversible encephalopathy syndrome (PRES) is an unfamiliar term to anesthesiologists, and this is characterized by neurologic symptoms that include mental change, headache, seizure and visual disturbance and also abnormal neuroimaging finding. A 71-year-old female patient was operated on for posterior decompression and total laminectomy under general anesthesia for the spinal stenosis. After the operation, she developed generalized tonic-clonic seizure and a stuporous mentality in the recovery room. The magnetic resonance imaging (MRI) revealed swelling and increased signal intensity at the deep gray nuclei, cerebral cortex and cerebellum. After one week, she returned to an alert mentality and then she was diagnosed with PRES. She was discharged without any neurologic deficit on postoperative day 20. This report describes our experience with PRES after spinal surgery was performed under general anesthesia on a suspected untreated hypertensive patient.
Subject(s)
Aged , Female , Humans , Anesthesia, General , Brain Edema , Cerebellum , Cerebral Cortex , Decompression , Headache , Hypertension , Laminectomy , Magnetic Resonance Imaging , Neuroimaging , Neurologic Manifestations , Recovery Room , Seizures , Spinal Stenosis , StuporABSTRACT
BACKGROUND: Postoperative nausea and vomiting (PONV) remains a challenge for patients and health professionals despite various newly developed prophylactic interventions. We reviewed the efficacy and safety of ramosetron in randomized controlled trials (RCTs) for the prevention of PONV. METHODS: We reviewed 18 randomized controlled trials investigating the efficacy and safety of ramosetron in comparison with placebo or any other drugs. Relevant studies were searched in the MEDLINE, SCOPUS, and the Cochrane database libraries. Our end points of concern were prevention of PONV and adverse effects as dichotomous data. RESULTS: The prophylactic effect of 0.3 mg ramosetron was observed in early PON (relative risk, RR: 0.4; 95% CI 0.3-0.6), early POV (RR: 0.3; 95% CI 0.1-0.6), late POV (RR: 0.3; 95% CI 0.1-0.6), but not late PON (RR: 0.7; 95% CI 0.5-1.0). Compared with placebo, the efficacy of 0.3 mg ramosetron in adults and 6 microg/kg in children were consistently beneficial in preventing PONV overall (RR: 0.4; 95% CI: 03-0.6). The effects of 0.3 mg ramosetron and 3 mg granisetron were similar. No serious side effects or adverse events resulted from ramosetron and other active drugs, and incidence was similar to those of the placebo group. CONCLUSIONS: Ramosetron is effective and safe in children and adults without serious adverse effects compared with placebo or other active drugs, as shown in pooled data of RCTs, in terms of the prevention of PONV.
Subject(s)
Adult , Child , Humans , Antiemetics , Benzimidazoles , Granisetron , Health Occupations , Incidence , Postoperative Nausea and VomitingABSTRACT
A 68-year-old male patient who was diagnosed as cutaneous mycosis fungoides with plaques, nodules and tumor has been treated with photochemotherapy. Oral methoxsalen followed by ultraviolet light(PUVA) resulted in clinical and histopathologic improvement of skin lesions. Photochemotherapy units consists of boxes with 12 UVA lamps. The initial dose was 8. 4 joules/cm2. The maintenance dose was 10. 5 joules/cm2. The total dose at present time is 1203. 82 joules/cm2. We prppose that PUVA therapy may be a valuable therapeutic regimen for mycosis fungoides.
Subject(s)
Aged , Humans , Male , Methoxsalen , Mycosis Fungoides , Photochemotherapy , PUVA Therapy , SkinABSTRACT
Malignant histiocytosis is a rare, usually fatal malignant neoplasm. We present a case of a 62 year-old female with malignant histiocytosis involving the skin, lymph nodes and bone marrow. The patient achieved a complete remission for 1 year after the completion of COPP chemotherapy (cyclophosphamide, vincristine, procarbazine and prednisone). We propose that COPP chemotherapy is a valuable therapeutic regimen for malignant histiocytosis.
Subject(s)
Female , Humans , Middle Aged , Bone Marrow , Drug Therapy , Drug Therapy, Combination , Histiocytic Sarcoma , Lymph Nodes , Procarbazine , Skin , VincristineABSTRACT
It has been hypothesized, but not yet proven, that T cell dysfunction is operative in the pathogenesis of atopic dermatitis. In order to test this hypothesis. we assessed the nurnbers of T cells, Tm cells, and Tg cells in 15 cases of atopic dermatitis and focontrol purposes in 12 cases of age-matched normal individuals. The results are summarized as follows. 1) The mean percentage of total T cells of atopic dermatitis patients was 54.5+/-6.5% and the mean percentage of total T cells of normal controls was 61.8+/-5.2%. The difference between total T cell values of atopic dermatitis patients and normal controls was statistically significant(p0.05). 3) The mean percentage of Tg cells of atopic dermiatitis patients was 5.4+/-2.0% and the mean percentage of Tg cells of normal controls was 7.2+/-2.0%. The difference between Tg cell values of atopic dermatitis patients and normal controls was statistically significant(p<0.05).
Subject(s)
Humans , Dermatitis, Atopic , T-LymphocytesABSTRACT
We have encountered many patients with dermatologic problems caused by animals, but there are not so many systematized literature about them in Korea. Since these causative animals are different from foreign animals in their distribution and habitat, there have been much difficulties in making diagnosis and in studying them based on foreign literature. We have undertaken this study to get the basic material for the possible causative animals in Korea by comparing with foreign literature, searching out the books of zoological claasification, and through personal contacts. One hundred and five species are found to be identical with the species reported in foreign literature, but 324 species are not, although they could be placed in the same genus.