ABSTRACT
Angiosarcoma is a malignant endothelial cell tumor of lymphatic or vascular origin and is most commonly found in the skin and soft tissue. Primary mesenteric angiosarcoma has rarely been reported. Here, we present a case of primary mesenteric angiosarcoma manifesting as a gradually enhancing mass along with necrosis and hemorrhage.
ABSTRACT
BACKGROUND/AIMS: Mucosal immunoglobulin A (IgA) may prevent the entrance of allergens. This study examined the relationship between serum IgA levels (within the normal range) and sensitization to house dust mites (HDM) or airway hyper-responsiveness (AHR). METHODS: The clinical records of 1,136 adult patients with suspected asthma, for whom test data for serum IgA level and methacholine-AHR were available, were reviewed retrospectively. The AHR/allergy indices were compared among patient groups with low (<140 mg/dL, group I), intermediate (140 to 280 mg/dL, group II), or high (≥280 mg/dL, group III) IgA levels in serum. RESULTS: The HDM skin sensitization rate progressively decreased from 30.0% in group I (n = 139) to 26.8% and 18.5% in groups II (n = 684) and III (n = 313), respectively (p = 0.003). Although both the HDM sensitization degree and the IgA level were significantly related to age, the adjusted odds ratio (OR) of association of a high IgA level (≥ 280 mg/dL) with HDM sensitization was significant (0.617; 95% confidence interval [CI], 0.415 to 0.916; p = 0.017). Among younger subjects (≤ 45 years of age) with AHR, the prevalence of moderate/severe AHR progressively decreased (70.6%, 52.3%, and 47.1% in groups I, II, and III [n = 34, 149, and 51]), respectively (p = 0.045). The IgA < 140 mg/dL was a significant risk factor for moderate/severe AHR (OR, 2.306; 95% CI, 1.049 to 5.071; p = 0.038). CONCLUSIONS: Sensitization to HDM and methacholine-AHR were significantly associated with serum IgA levels in suspected asthmatics, even when those levels were normal.
Subject(s)
Asthma/blood , Bronchial Hyperreactivity/blood , Hypersensitivity/blood , Immunoglobulin A/blood , Pyroglyphidae/immunology , Adult , Animals , Asthma/diagnosis , Asthma/immunology , Biomarkers/blood , Bronchial Hyperreactivity/diagnosis , Bronchial Hyperreactivity/immunology , Bronchial Provocation Tests , Chi-Square Distribution , Female , Humans , Hypersensitivity/diagnosis , Hypersensitivity/immunology , Intradermal Tests , Linear Models , Logistic Models , Male , Middle Aged , Odds Ratio , Predictive Value of Tests , Retrospective Studies , Risk Factors , Severity of Illness IndexABSTRACT
Oxycodone is a µ-opioid receptor agonist and is generally indicated for the relief of moderate to severe pain. The aim of this study was to compare the analgesic efficacy of patient-controlled oxycodone and fentanyl for postoperative pain in patients undergoing colorectal surgery. Patients scheduled to undergo elective colorectal surgery (n=82) were allocated to receive oxycodone (n=41, concentration of 1 mg/mL) or fentanyl (n=41, concentration of 15 µg/mL) for postoperative pain management. After the operation, pain using a numerical rating scale (NRS), delivery to demand ratio, infused dose of patient-controlled analgesia (PCA), side effects, and sedation levels were evaluated. Median (25%-75%) cumulative PCA dose of oxycodone group at 48 hours (66.9, 58.4-83.7 mL) was significantly less than that of fentanyl group (80.0, 63.4-103.3 mL, P=.037). Six hours after surgery, the mean (SD) NRS scores of the oxycodone and fentanyl groups were 6.2 (2.4) and 6.8 (1.9), respectively (P=.216). The mean equianalgesic potency ratio of oxycodone to fentanyl was 55:1. The groups did not differ in postoperative nausea, vomiting, and level of sedation. Patient-controlled oxycodone provides similar effects for pain relief compared to patient-controlled fentanyl in spite of less cumulative PCA dose. Based on these results, oxycodone can be a useful alternative to fentanyl for PCA in patients after colorectal surgery.