ABSTRACT
Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.
Subject(s)
Female , Humans , Middle Aged , Anesthesia, General , Dexamethasone , Intubation , Laryngoscopy , Lingual Nerve Injuries , Lingual Nerve , Macroglossia , Radius Fractures , TongueABSTRACT
Adjuvant radiation therapy (RT) after colorectal cancer surgery can prevent local recurrence, but has several side effects. Precise injection of drugs into the affected areas is complicated by radiation-induced fibrosis of soft or connective tissue. A 48-year-old woman experienced severe intractable perineal pain, dysuria, urinary urgency, and frequent urination after rectal cancer surgery and adjuvant RT, and was diagnosed with radiation-induced cystitis and vulvodynia. Her symptoms persisted despite two fluoroscopy-guided ganglion impar blocks. Fluoroscopy revealed atypical needle tip positioning and radiolucent dye distribution, presumably due to radiation-induced fibrosis in the target region. We performed two computed tomography (CT)-guided ganglion impar blocks by using a lateral approach, which allowed more accurate po-sitioning of the needle tip. Her pain visual analog score decreased from 9 to 3, and she recently resumed sexual intimacy. CT guidance is a viable alternative to fluoroscopy guidance when performing ganglion impar blocks in fibrotic areas.
Subject(s)
Female , Humans , Middle Aged , Colorectal Neoplasms , Connective Tissue , Cystitis , Dysuria , Fibrosis , Fluoroscopy , Ganglia, Sympathetic , Ganglion Cysts , Needles , Nerve Block , Radiotherapy , Rectal Neoplasms , Recurrence , Urination , VulvodyniaABSTRACT
Thrombotic complications in iron-deficiency anemia (IDA) are rare. We now report a case of deep vein thrombosis following iron deficiency anemia in cerebral palsy. A 20 year old male was admitted to our hospital? due to a pale appearance. He was diagnosed as having spastic cerebral palsy. On admission, a complete blood cell count showed IDA with thrombocytosis. Prothrombin time and activated partial thromboplastin time were within the normal range. We observed swelling and edema on the left thigh and ankle without tenderness. We performed Doppler sonography and computed tomography. Thrombi were located in the left common iliac vein and left superficial femoral vein with elevated D-dimer levels. We started heparin therapy. We excluded intravascular hemolysis or a hypercoagulable state when we found that Ham's test, anti-cardiolipin antibody, and lupus anticoagulant were negative. The patient died due to hypoxemia and cardiac failure despite ventilator care with anti-coagulant therapy.
Subject(s)
Animals , Humans , Male , Anemia, Iron-Deficiency , Ankle , Hypoxia , Blood Cell Count , Cerebral Palsy , Edema , Femoral Vein , Fibrin Fibrinogen Degradation Products , Heart Failure , Hemolysis , Heparin , Iliac Vein , Iron , Lupus Coagulation Inhibitor , Partial Thromboplastin Time , Prothrombin Time , Reference Values , Thigh , Thrombocytosis , Venous Thrombosis , Ventilators, MechanicalABSTRACT
A 4 years-old girl was diagnosed with aggressive systemic mastocytosis at 2 months after the end of chemotherapy including cisplatin, bleomycin and etoposide for an ovarian germ cell tumor (GCT). She was shown pigmented skin lesion, hepatosplenomegaly, thrombocytopenia and increased mast cells with positive toluidine blue staining on the bone marrow examination. Immunohistochemical staining for c-kit was highly expressed in the bone marrow and skin, but not in the GCT specimen. However, c-kit point mutation was detected in the bone marrow, peripheral blood and GCT tissue when performing PCR via oligonucleotide sequencing. We report here on one case of aggressive systemic mastocytosis following ovarian germ cell tumor with c-kit point mutation.
Subject(s)
Child, Preschool , Female , Humans , Bleomycin , Bone Marrow , Bone Marrow Examination , Cisplatin , Drug Therapy , Etoposide , Germ Cells , Mast Cells , Mastocytosis, Systemic , Neoplasms, Germ Cell and Embryonal , Point Mutation , Polymerase Chain Reaction , Skin , Thrombocytopenia , Tolonium ChlorideABSTRACT
PURPOSE: We investigated to identify factors related to thrombocytosis and clinical data for thrombopoiesis in children with iron deficiency anemia (IDA). METHODS: We retrospectively analyzed clinical and laboratory data for 85 children admitted for acute infection or inflammation. Seventy patients of 85 children were diagnosed as IDA. The others were clinically suspected as IDA but they were not diagnosed. We divided three groups: group 1 included severe anemia below hemoglobin (Hb) 8.0 g/dL, group 2 mild to moderate anemia (Hb: 8.0~10.0 g/dL), and group 3 (control) were clinically suspected but without IDA. RESULTS: There are no differences among groups except age at diagnosis. The age at diagnosis in group 1 are higher than other groups. In control group, there are not any factors correlated with thrombocytosis. In group 1, the white blood cell and lymphocyte counts are significantly related to the platelet counts. However, serum iron level is only correlated with platelets in group 2. In multiple regression analysis, we found significantly correlation between white blood cell counts and serum iron level and thrombocytosis in IDA including group 1 and 2. CONCLUSION: We suggest that white blood cell counts and serum iron level in IDA may be related with increased platelet counts, as a reactive thrombocytosis. We need further study for correlation between acute phase reactants and thrombocytosis in IDA.