RESUMO
Methylene blue (MB) based chromoendoscopy has been used for more than a decade to increase detection rates of specialized intestinal metaplasia, dysplasia, and esophageal adenocarcinoma. It is also used to detect anastomotic leakage after an operation. A 67-year-old man with no previous medical problems had complaints of jaundice and weight loss for 2 months. He was diagnosed with a Klatskin tumor and was referred to our hospital. An initial esophagogastroduodenoscopy (EGD) was performed before the operation. No abnormality was observed in the esophagus. MB solution was infused via an L-tube to check for leakage in the anastomosis. Subepithelial hemorrhagic and edematous mucosal changes with friability and a bluish mucosal discoloration were noted 2 days later from the mid to lower esophagus on EGD. Nine months later, an EGD revealed an unremarkable esophageal mucosa. MB solution is considered safe; however, a large volume or high concentration of MB solution might be harmful.
Assuntos
Idoso , Humanos , Adenocarcinoma , Fístula Anastomótica , Endoscopia do Sistema Digestório , Esôfago , Icterícia , Tumor de Klatskin , Metaplasia , Azul de Metileno , Mucosa , Redução de PesoRESUMO
Hereditary angioedema is a rare genetic disease transmitted with a autosomal dominant trait result of a quantitative or functional defect of Cl inhibitor. We report three cases of heriditary angioedema from the same famly respectively the 35-year-old sister, the younger bn)ther of 32, and the younger sister of 20 The older sister died due to her airway being obstructel by acute laryngeal edema, and her you igirbrother and sister experienced recurrent episodes oswelling on the hand and forearm. The ore we examined the two patients serum complement levils to confirm diagnosis. In both, the r;ults showed decreased levels of Cl inhibitor and C4 which are the evidence of hereditary a giedema. The younger sister has been administered danazol (600mg/day) to prevent angioedem or 8 weeks, and we have not yet found a recurrenc of he symptoms. However, well cont ol the dosage of danazol because amenorchea has developec.
Assuntos
Adulto , Humanos , Angioedema , Angioedemas Hereditários , Proteínas do Sistema Complemento , Danazol , Diagnóstico , Antebraço , Mãos , Edema Laríngeo , IrmãosRESUMO
BACKGROUND: Hydrofluoric acid(HF) is one of the strong stirritating, corrosive and poisonous inorganic acid, The HF burns are occuring with ever-increa firifrequency due to the wide use of this acid in industrial fields, such as electronics and semicor tor industries. OBJECTIVE: The purpie of this study is to quantiate theound depths produced by varying concentrations of HF aiud to suggest the treatment guideline. METHODS: Uarious cinicentrations of HF(5%, 25%, 50%),were applied to two pairs of test sites on a guinea pig's back in a uniform fashion with cotton-tip applicators and then the histopathologic changes of guinea pig skin were observed. RESULTS: 1, In the 5% HF applied group, intracellular edema vaobserved in the epidermis after 12 hours. After 3days, epidermal cell necrosis was observed. 2. In the 25% HF applied group, intraepidermal vesice was observed after 6hours. After 12hours, inflammatory cell infiltrations were observed in the apper dermis and then after 3days, dermal necrosis was oberved. 3. In the 50% HF applied group, epidermal cell necros After 6hours, liquefaction degeneration in the epidermis an was observed focally after 3hours. iflhmmatory cell infiltrations in the upper dermis were observed. After 2days, dermalar.ecrosis was observed and then after days, the reaction was at its peak and subcutaneous tissuc. necrosis was observed. CONCLUSION: This study showed that a higher concentrator HF exposure enhances The penetration of HF. For treatmi not alcohloic solution of a quarternary ammonium for avintralesional injection of calcium gluconate within 24 hours of HF and a longer period after we suggest wet dressing with an concentration of HF burn and high concentration of HF burn.
Assuntos
Animais , Compostos de Amônio , Bandagens , Queimaduras , Gluconato de Cálcio , Derme , Edema , Epiderme , Cobaias , Guiné , Ácido Fluorídrico , Necrose , PeleRESUMO
Hyperkeratosis of the nipple and areola is a rare skin disordr characterized clinically by thickening and discoloration of the skin of the areola and/or nipple and pathoiog cally by papillomaosis or acanthosis-nigricans like changes. We report a case of hyperkeratosis of the nipple and areola occuring in a woman with no underlying endocrinopathy and no other additional hyperkeratotic conditions. Ttie iresent case seems to be the nevoid form by the Levy-Franckel classification. Treatment with topical medications including steroids and keratolytic agents produced no improvement. Therefore we recommeneded surgical excision because the paient was greatly disturbed by the appearance of the lesions. Surgical excision and full thickness skin graft were performed sucessfully.