RESUMO
Botulinum toxin type A is widely used for functional improvement of muscles and aesthetic plastic surgery. It paralyzes the injected muscle by inhibiting acetylcholine release from synapses of neuromuscular junctions. We herein report a case of progressive respiratory distress after botulinum toxin injection at both the gastrocnemius and soleus muscles. The patient also showed ptosis, dysphonia, dysphagia, and general weakness. Vocal cord dysfunction was observed by laryngoscopy. Other neurologic examination findings, including those of the physical examination, brain MRI, and Jolly's test, were normal. To our knowledge, this is the first report of botulinum toxin injection associated with dyspnea (MRC dyspnea scale, grade 3) in Korea.
Assuntos
Humanos , Acetilcolina , Toxinas Botulínicas , Toxinas Botulínicas Tipo A , Encéfalo , Transtornos de Deglutição , Disfonia , Dispneia , Coreia (Geográfico) , Laringoscopia , Músculos , Exame Neurológico , Junção Neuromuscular , Exame Físico , Cirurgia Plástica , Sinapses , Prega VocalRESUMO
Mucormycosis is a rare fungal disease that holds a fatal opportunistic fungal infection in diabetes mellitus, hematological malignancy, and immunocompromised host. Isolated pulmonary mucormycosis is extremely rare. Optimal therapy is a combined medical-surgical approach and a management of the patient's underlying disease. Herein, we report a case-study of isolated pulmonary mucormycosis which was being presented as multiple lung nodules in a patient with no underlying risk factors. Considering that the patient had poor pulmonary functions, we treated him with only antifungal agent rather than a combined medical-surgical approach. After treatment with antifungal agent for six months, the nodules of pulmonary mucormycosis were improved with the prominent reductions of size on the computed tomography.
Assuntos
Humanos , Diabetes Mellitus , Neoplasias Hematológicas , Imunocompetência , Hospedeiro Imunocomprometido , Pulmão , Mucormicose , Fatores de Risco , TriazóisRESUMO
Von Hippel-Lindau (VHL) disease is an autosomal dominant disease that produces a variety of tumors and cysts in the central nervous system and visceral organs, including renal cell carcinoma (RCC). RCC in patients with VHL disease does not frequently metastasize, therefore, the response to treatment and prognosis of metastatic RCC developed in patients with VHL disease has not been reported. Sunitinib is an oral, multitargeted receptor tyrosine kinase inhibitor with antiangiogenic and antitumor activity. Here, we report on four patients with metastatic RCC in VHL disease who received sunitinib and achieved partial responses that have lasted for a prolonged period of time.