RESUMO
Aconite, derived from the roots of certain aconitum species (Racunculaceae), is widely distributed in Korea. Aconitine, an extremely toxic substance present in aconite, has pharmacological effects, including anti-inflammatory, analgesic, and positive inotropic actions. Due to its relatively low safe dose, we sometimes encounter cases of serious aconite intoxication. The toxic compound mainly affects the CNS, heart, and muscle tissues, resulting primarily in cardiovascular complications. Aconite poisoning presents with a combination of neurological, cardiovascular, and gastrointestinal features. The main cause of death is severe cardiotoxicity causing refractory ventricular tachyarrhythmias and asystole. As there is no specific antidote, management of aconite poisoning is supportive. All patients require close monitoring of blood pressure and cardiac rhythm since ventricular arrhythmias may occur during the first 24 hours of poisoning, resulting in sudden deterioration in the patient's clinical condition. Extracorporeal membrane oxygenation (ECMO) has traditionally been utilized for perioperative cardiac failure and cardiomyopathies. More recently, the indications for ECMO have expanded to patients with acute cardiovascular decompression including intractable arrhythmias. We report on a patient who developed life threatening ventricular tachyarrhythmia after ingestion of herbal tablets containing aconite alkaloids. Our patient was resuscitated with intravenous infusion of amiodarone, repeated cardioversion/defibrillation, and mechanical circulatory support with ECMO.
Assuntos
Humanos , Aconitina , Aconitum , Alcaloides , Amiodarona , Arritmias Cardíacas , Pressão Sanguínea , Cardiomiopatias , Causas de Morte , Descompressão , Ingestão de Alimentos , Oxigenação por Membrana Extracorpórea , Coração , Parada Cardíaca , Insuficiência Cardíaca , Infusões Intravenosas , Coreia (Geográfico) , Intoxicação , Comprimidos , Taquicardia , Taquicardia VentricularRESUMO
A 29-year-old man with nodular gastritis diagnosed by previous gastroscopy was referred to our hospital for an evaluation of laryngeal discomport and soreness. The patient had no previous history of eradication for Helicobacter pylori-associated gastritis. Gastroscopy demonstrated the presence of gooseflesh-like nodularities on antrum and whitish discoloring lesion with depression on lesser curvature of lower body. The whitish discoloring lesion with depression was histologically diagnosed a signet ring cell carcinoma by endoscopic biopsy. We report this case of a patient with nodular gastritis who received no eradication therapy and was diagnosed with signet ring cell carcinoma with a review of the literature.
Assuntos
Adulto , Humanos , Adulto Jovem , Biópsia , Carcinoma de Células em Anel de Sinete , Depressão , Seguimentos , Gastrite , Gastroscopia , Helicobacter , Helicobacter pyloriRESUMO
A 29-year-old man with nodular gastritis diagnosed by previous gastroscopy was referred to our hospital for an evaluation of laryngeal discomport and soreness. The patient had no previous history of eradication for Helicobacter pylori-associated gastritis. Gastroscopy demonstrated the presence of gooseflesh-like nodularities on antrum and whitish discoloring lesion with depression on lesser curvature of lower body. The whitish discoloring lesion with depression was histologically diagnosed a signet ring cell carcinoma by endoscopic biopsy. We report this case of a patient with nodular gastritis who received no eradication therapy and was diagnosed with signet ring cell carcinoma with a review of the literature.
Assuntos
Adulto , Humanos , Adulto Jovem , Biópsia , Carcinoma de Células em Anel de Sinete , Depressão , Seguimentos , Gastrite , Gastroscopia , Helicobacter , Helicobacter pyloriRESUMO
Malignant mesothelioma is a rare aggressive tumor and arises from mesothelial cells in the pleural, peritoneal and pericardial cavities. Median survival is -1 year and the incidence is approximately 0.7 per million persons, and is increasing annually in Korea. It is difficult to diagnose malignant mesothelioma because of nonspecific symptoms, signs and laboratory findings. It needs to be confirmed by histological examination and immunohistochemistry. There is no case report of malignant mesothelioma of the peritoneum and pleura in Korea. We report a rare case of malignant mesothelioma with simultaneous involvement of the peritoneum and pleura in a 75-year-old man without evidence of asbestos exposure.