RESUMO
Continuous arteriovenous hemofiltration(CAVH) is used to treat hemodynamically unstable patients with renal failure, refractory ascites and edema, sepsis, or ARDS patients. Patients received CAVH during a 3-year-period from March 1994 to February 1997. Their clinical findings were analyzed retrospectively, and the results were as follows; They were 6 men and 3 women from 28 to 62 years. 3 patients had ARDS, 2 patients had CHF. The remainder had SLE, liver cirrhosis, septic shock with cholangitis, diabetic ketoacidosis with pulmonary edema. The duration of treatment ranged from 30 to 50 hours, with a mean of 41.6+/-6.9 hours. The total fluid repalcement was 22.4+/-1.7L and the mean fluid loss was 3.9+/-2.6L. Changes in serum BUN, creatinine, sodium, potasium before and after treatment were not significantly diffrent. The complication of CAVH is clotting of hemofilter, hypotension, bleeding, and mild thrombocytopenia. 2 of 3 ARDS patients expired during CAVH, liver cirrhosis patient expired later due to hepatic encephalopathy, and, finally 6 patients discharged with improved conditions. In conclusion, CAVH, a safe and effective therapy in hemodynamically unstable patients with renal failure, refractory ascites and edema, sepsis, or ARDS patients.
Assuntos
Feminino , Humanos , Masculino , Ascite , Colangite , Creatinina , Cetoacidose Diabética , Edema , Hemofiltração , Hemorragia , Encefalopatia Hepática , Hipotensão , Cirrose Hepática , Edema Pulmonar , Insuficiência Renal , Estudos Retrospectivos , Sepse , Choque Séptico , Sódio , TrombocitopeniaRESUMO
Gastric bezoar has been known to occur occasionally in the gastrointestinal tract, as a result of foreign material accumulating in the stomach. Most case have been managed by surgical methods. Currently, the endoscopic mathod is after used for the gastrointestinal disease, and therefore we treated two cases of huge bezoars using the endoscopic polypectomy snare and lithotriptor. Subsequently, we are reporting these cases and have incorporated relevant literature which was reviewed for our report for the subject case.
Assuntos
Bezoares , Gastroenteropatias , Trato Gastrointestinal , Proteínas SNARE , EstômagoRESUMO
Biliary cystadenoma is a rare biliary ductal neoplasm that usually arises in the liver and less frequently in the extrahepatic bile ducts. Clinical manifestations are non-specific; hence preoperative diagnosis depends heavily on imaging. Computed tomography, ultrasonography, angiography and cholangiogram are useful diagnostic procedures in biliary cystic tumor, but definite diagnosis depends on histologic diagnosis. Surgical resection often yields excellent results. Surgical procedures used to treat cystadenomas include: aspiration, drainage, marsupialization, and excision. If there is no evidence of metastasis, complete resection of these tumors is necessary for a complete cure. We experienced an 80-year-old man who complained of jaundice and RUQ pain. He was diagnosed as biliary mucinous cystadenoma, We confirmed our diagnosis by cholangioscopic biopsy, and performed endoscopic sphincterotomy(EST). So, we report this case and have reviewed the relevant literature as a part of our report for the subject case.
Assuntos
Idoso de 80 Anos ou mais , Humanos , Angiografia , Ductos Biliares Extra-Hepáticos , Sistema Biliar , Biópsia , Cistadenoma , Cistadenoma Mucinoso , Diagnóstico , Drenagem , Icterícia , Fígado , Mucinas , Metástase Neoplásica , Pâncreas , UltrassonografiaRESUMO
OBJECTIVES: A prospective study was performed to find out the correlation between neutrophil, eosinophil and eosinophilic cationic protein (ECP)-the granular protein in eosinophil- and smoking history and pulmonary function change, METHODS: In this study there were seventy smokers and seventy lifetime nonsmokers. None of them had the history of atopy, or the evidence of parasitic infestation. Smoking history, spirometric pulmonary function test and blood samples for CBC, serum ECP were analyzed. RESULTS: 1) Eosinophil and neutophil count was elevated in the smokers compared with the nonsmokers. 2) Serum ECP was elevated in smokers and the magnitude of this increase was greater than that of eosinophil count. 3) In the smokers, there was a direct proportional correlation between serum ECP and FEV1, but inverse proportional correlation between neutophil count and FEV. 4) In the smokers, neutrophil count was elevated regardless of FEV value. 5) The level of serum ECP well correlated with the daily tobacco consumption but not with the duration of smoking or pack-year consumption. CONCLUSION: Incresed neutrophil count, decreased eosinophil count and decreased serum ECP level could be useful in the understanding of pathophysiology of lung parenchymal destruction in smokers.