Résumé
Left ventricular aneurysm (LVA) and false aneurysm are complications of acute myocardial infarction, trauma, and cardiac surgery. Left ventricular false aneurysm (LVFA) is a particularly catastrophic complication owing to its high propensity for rupture. Surgical resection should be considered for LVFA occurring within three months after myocardial infarction or development of congestive heart failure. In this report, we describe a case of acute heart failure with LVA and LVFA occurring in stage as a complication of myocardial infarction in a 55-year-old man. The patient was also at risk of brain ischemia due to abnormal vessel status and a previous cerebrovascular accident with left-sided weakness. Successful perioperative anesthetic management was achieved by focusing on maintaining marginal upper normal blood pressure to ensure cerebral perfusion and to reduce the risk of false aneurysm rupture.
Sujets)
Humains , Adulte d'âge moyen , Anévrysme , Faux anévrisme , Pression sanguine , Encéphalopathie ischémique , Défaillance cardiaque , Infarctus du myocarde , Perfusion , Rupture , Accident vasculaire cérébral , Chirurgie thoraciqueRésumé
We experienced anaphylaxis during general anesthesia twice in the same patient. After the first incidence of anaphylaxis at the induction of anesthesia, we speculated that the allergen was rocuronium. Thus, we administered sugammadex as well as a vasopressor to treat the anaphylaxis and the vital signs gradually recovered to nearly normal. Thereafter, we could not avoid the administration of another muscle relaxant, cisatracurium, since the patient moved uncontrollably after the surgery was restarted. A second anaphylactic event then occurred. We speculated that the second allergen was cisatracurium and stopped using it. The results of the investigation after the surgery showed that the allergens were indeed rocuronium and cisatracurium. When we encounter anaphylaxis during general anesthesia, it is necessary to suspect all administered medicines as the cause, with the potential of two or more causes, especially with muscle relaxants.
Sujets)
Humains , Allergènes , Anaphylaxie , Anesthésie , Anesthésie générale , Incidence , Tests intradermiques , Signes vitauxRésumé
PURPOSE: The androgen receptor (AR) plays a central role in prostate cancer. Evidence from several groups indicates that epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) may enhance AR activity in prostate cancer cell lines. This study was designed to investigate the protein expression of AR, EGFR, and HER2 and to determine whether the EGFR and HER2 genes are amplified in prostate cancer tissues. MATERIALS AND METHODS: The protein expression levels of AR, EGFR, and HER2 in a tissue microarray block of 66 prostate cancer samples were investigated by immunohistochemical analysis and chromogenic in situ hybridization was used to determine whether the EGFR and HER2 genes were amplified in these tissues. RESULTS: The AR and EGFR proteins were expressed in 59.1% and 40.9% of prostate cancers, respectively, but their expression levels were not significantly associated with clinicopathologic factors. Of the cases in which tissues were negative for EGFR protein expression, 69.2% were positive for AR protein expression; however, AR protein expression was significantly reduced (44.4%) in tissues in which EGFR protein was expressed. HER2 expression was detected in only 1 case (1.5%). No amplification of the EGFR or HER2 genes was found in prostate cancer specimens. CONCLUSION: This study was limited by small number of subjects, but it can still be inferred that the expression levels of the AR and EGFR proteins are inversely correlated in prostate cancer patients. The potential utility of EGFR and HER2 as prognostic factors or therapeutic targets warrants further study.
Sujets)
Humains , Lignée cellulaire , Gènes erbB-2 , Hybridation in situ , Prostate , Tumeurs de la prostate , Protéines , Récepteurs ErbB , Récepteur ErbB-2 , Récepteurs aux androgènesRésumé
Sturge-Weber syndrome is a rare congenital anomaly characterized by angiomatosis of face, eye and leptomeninges and nevus flammeus is distributed along the trigminal nerve in face, often accompanying congenital glaucoma. We experienced a case of Sturge-Weber syndrome in an 11-year-old Korean girl of bilateral facial nevus flammeus with bilateral glaucoma treated by trabeculectomy and laser trabeculoplasty previously, but glaucomatous optic neuropathy progressed due to inadequate intraocular pressure control, and we could obtain successful result after trabeculectomy with mitomycin-C.
Sujets)
Enfant , Femelle , Humains , Angiomatose , Glaucome , Pression intraoculaire , Mitomycine , Atteintes du nerf optique , Tache lie de vin , Syndrome de Sturge-Weber , TrabéculectomieRésumé
We investigated the conjunctival sensitivity of bleb area after successful trabeculectomy for 3 to 6 months in 19 eyes of 16 patients using Cochet-Bonnet aesthesiometer(diameter=0.12mm). The conjunctival sensitivity of bleb area was decreased significantly from 68.78mg/S to 171.05mg/S compared to the preoperative values. This decrement was maintained during the follow-up period and not related to the type, height and vascularity of the bleb. This results shows that the conjunctival sensitivity of bleb area after successful trabeculectomy is significantly decreased and maintained at least 3 months after operation. Therefore the conjunctival sensitivity of bleb area might be considered possible indicator of success or failure during follow-up period after trabeculectomy.