RESUMO
The biocompatibility of dialysis membranes has significantly reduced adverse responses to dialysis, such that nowadays they are rarely reported. We report the case of a patient diagnosed and subsequently treated for thrombocytopenia caused by a dialysis reaction, as an example of a hemostatic disorder mistaken for an immature arteriovenous fistula. The peridialysis pattern of the platelet count helped to confirm the diagnosis. Further studies of the negative effects of dialysis are needed, including risk factors, predictors, treatment, and prevention.
Assuntos
Humanos , Fístula Arteriovenosa , Diagnóstico , Diálise , Transtornos Hemostáticos , Membranas , Contagem de Plaquetas , Diálise Renal , Fatores de Risco , TrombocitopeniaRESUMO
The biocompatibility of dialysis membranes has significantly reduced adverse responses to dialysis, such that nowadays they are rarely reported. We report the case of a patient diagnosed and subsequently treated for thrombocytopenia caused by a dialysis reaction, as an example of a hemostatic disorder mistaken for an immature arteriovenous fistula. The peridialysis pattern of the platelet count helped to confirm the diagnosis. Further studies of the negative effects of dialysis are needed, including risk factors, predictors, treatment, and prevention.
RESUMO
BACKGROUND: Sedation with propofol during esophagogastroduodenoscopy (EGD) has been increased. However, the use of propofol during EGD may have significant side effects such as hypoxemia and hypotension. We studied the dose of propofol for adequate sedation without side effects during EGD. METHODS: From June to August 2003, 46 healthy persons who visited St. Carollo hospital health management center for diagnostic EGD were enrolled for this study. Twenty four persons (Group A) were given a initial loading dose of propofol 60 mg (in person below 60 kg by body weight) and 80 mg (in person above 60 kg by body weight). Twenty two persons (Group B) were given a initial loading dose of propofol 80 mg and 100 mg at the same way. Additional dose of propofol which was injected once a minute until adequate sedation by 20 mg and maintenance dose during EGD were compared between two groups. Respiration rate, pulse rate, blood pressure, arterial oxygen saturation and ejection fraction of left ventricle were monitored. RESULTS: There were no significant differences between two groups in monitored parameters. Persons in group B were given significantly lower additional dose (p<0.001) and maintenance dose (p<0.05) of propofol. However total amount of propofol during EGD was not significantly different between two groups. CONCLUSION: In relatively young (under 60 years of age) and healthy persons without significant medical problem, 80 mg and 100 mg of propofol (in person below 60 kg and above 60 kg by body weight) as initial loading dose of propofol during EGD are more clinically relevant than 60 mg and 80 mg of propofol (in person below 60 kg and above 60 kg by body weight).
Assuntos
Humanos , Hipóxia , Pressão Arterial , Endoscopia do Sistema Digestório , Endoscopia Gastrointestinal , Frequência Cardíaca , Ventrículos do Coração , Hipotensão , Oxigênio , Propofol , Taxa RespiratóriaRESUMO
It has been reported that myocardial bridging may be associated with myocardial ischemia, myocardial infarction, vasospasm, cardiac arrhythmia and sudden death. However, the mechanism whereby ischemia occur as a consequence of myocardial bridging remains unclear. Recently we experienced a case of myocardial infarction in a patient with myocardial bridging and atrial fibrillation. A 66-year-old man presented with severe chest pain. His ECG showed ST elevation in V3-V5 and atrial fibrillation with rapid ventricular response. He underwent coronary angiography, which revealed a thrombus in the distal portion of the myocardial LAD bridge. He was treated with antiplatelet agents, heparin, tirofiban and amiodarone and beta-blocker without percutaneous coronary intervention. Five days later, his clinical condition was recovered and follow-up coronary angiography revealed markedly improved blood flow of the left anterior descending artery. The previous thrombus had disappeared.
Assuntos
Idoso , Humanos , Amiodarona , Arritmias Cardíacas , Artérias , Fibrilação Atrial , Dor no Peito , Angiografia Coronária , Morte Súbita , Eletrocardiografia , Seguimentos , Heparina , Isquemia , Ponte Miocárdica , Infarto do Miocárdio , Isquemia Miocárdica , Intervenção Coronária Percutânea , Inibidores da Agregação Plaquetária , TromboseRESUMO
Anisakiasis of the gastrointestinal tract is caused by the ingestion of raw fish or uncooked foods infested with Anisakis larvae belonging to the subfamily Anisakidae. With the increasing popularity of Japanese cuisine such as sashimi in Korea, the incidence of anisakiasis is expected to increase. The entire gastrointestinal tract from the esophagus to the rectum can be involved. Colonic anisakiasis is rare in comparison with gastric involvement. We report the anisakiasis concurrently invading the stomach, ileocecal valve and transverse colon treated by endoscopy with a brief review of the relevant literature.
Assuntos
Humanos , Anisaquíase , Anisakis , Povo Asiático , Colo , Colo Transverso , Ingestão de Alimentos , Endoscopia , Esôfago , Trato Gastrointestinal , Valva Ileocecal , Incidência , Coreia (Geográfico) , Larva , Reto , EstômagoRESUMO
Allgrove syndrome, also known as Tripple A syndrome is characterized by ACTH-resistant adrenal insufficiency, achalasia of esophagus and alacrima. Since its first description by Allgrove et al. (1978), more than 60 cases from all over the world have been reported. In Korea, however, there was no report of this Allgrove syndrome. We report studies on a 18-year old male patient with this rare triad. The patient had alacrima from birth; isolated glucocorticoids deficiency had been diagnosed at 6 years of age and achalasia at age 18. We report the case with the review of literature.