ABSTRACT
BACKGROUND: Sevoflurane anesthesia is a high-risk factor for postoperative cognitive dysfunction (POCD) in elderly patients. Recently, some studies demonstrated that dexmedetomidine (DEX) could reduce the incidence of POCD caused by sevoflurane anesthesia. We hypothesized that DEX could reduce the incidence of POCD caused by sevoflurane anesthesia through decreasing plasma interleukin (IL-6) and tumor necrosis factor (TNF)-α concentrations. MATERIALS AND METHODS: A total of 120 patients aged 65-75 years scheduled for esophageal carcinoma resection were randomly assigned to four groups. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to measure patients' cognitive function the day before operation and the 1st, 3rd, and 7th postoperative days. The plasma TNF-α, IL-6, and S100 ß protein concentrations were measured by ELISA 10 min before anesthesia administration and the 1st, 3rd, and 7th postoperative days. RESULTS: There were no significant differences in the demographic or clinical characteristics or perioperative hemodynamic status in all groups. Compared with Group M + P, the MMSE and MoCA scores were significantly lower and the plasma TNF-α, IL-6, and S100 ß protein concentrations were significantly higher in Group M + S at the 1st, 3rd, and 7th postoperative days (P < 0.05). Compared with Group M + S, the MMSE and MoCA scores were significantly higher and the plasma TNF-α, IL-6, and S100 ß protein concentrations were significantly lower in Group D + S at the 1st, 3rd, and 7th postoperative days (P < 0.05). CONCLUSION: The POCD incidence was higher in elderly patients receiving sevoflurane anesthesia and DEX could alleviate POCD in these patients through decreasing plasma TNF-α and IL-6 concentrations.
Subject(s)
Analgesics, Non-Narcotic/administration & dosage , Cognitive Dysfunction/etiology , Dexmedetomidine/administration & dosage , Esophageal Neoplasms/congenital , Postoperative Complications , Sevoflurane/adverse effects , Age Factors , Aged , Aged, 80 and over , Analgesics, Non-Narcotic/adverse effects , Anesthesia, General/adverse effects , Anesthesia, General/methods , Anesthetics, Inhalation/adverse effects , Biomarkers , Cognitive Dysfunction/blood , Cognitive Dysfunction/diagnosis , Cytokines/blood , Dexmedetomidine/adverse effects , Esophageal Neoplasms/surgery , Female , Humans , Inflammation Mediators/blood , Male , S100 Calcium Binding Protein beta Subunit/bloodABSTRACT
Congenital hyperpigmentation in the acro-genital area and simultaneous occurrence of ganglioneuroma in the esophagus have yet to be reported. Herein, we report a 4-month-old girl presenting with feeding difficulty by esophageal ganglioneuroma and symmetrically distributed brown pigmented patches on the lips, axillae, dorsa of fingers and toes, and genital area. Although the esophageal stricture was resolved by surgical removal of ganglioneuroma, her skin manifestations remained for over 2 years.
Subject(s)
Esophageal Neoplasms/congenital , Esophageal Neoplasms/complications , Esophageal Stenosis/congenital , Esophageal Stenosis/etiology , Ganglioneuroma/congenital , Ganglioneuroma/complications , Hyperpigmentation/congenital , Hyperpigmentation/complications , Axilla/pathology , Female , Fingers/pathology , Groin/pathology , Humans , Hyperpigmentation/pathology , Infant , Lip/pathology , Toes/pathologyABSTRACT
Alport's syndrome comprises hereditary deafness, nephritis and ocular abnormalities. The features of Alport's syndrome are illustrated by a family with Alport's syndrome and hereditary oesophageal leiomyomatosis. The evidence that Alport's syndrome is due to a widespread basement membrane disorder is noted. Treatment of anterior lenticonus, the principal ocular abnormality, by lensectomy and intraocular lens insertion is recommended.
Subject(s)
Esophageal Neoplasms/congenital , Leiomyoma/congenital , Lens, Crystalline/abnormalities , Nephritis, Hereditary/pathology , Adult , Humans , Lens, Crystalline/surgery , Lenses, Intraocular , Male , Nephritis, Hereditary/geneticsABSTRACT
A 30-yr-old white female with a history of focal dermal hypoplasia (Goltz syndrome), chronic gastroesophageal reflux, and dysphagia was found to have, by barium esophagram and esophagogastroduodenoscopy, multiple 2- to 3-mm papillary projections in the distal esophagus and an esophageal stricture. Biopsy of these lesions revealed squamous papillomas and a benign stricture. Although chronic irritation from gastroesophageal reflux has been suggested as a possible etiology of acquired esophageal papillomas, the previous association of congenital papillomas of the oral mucosa in Goltz syndrome suggests that the multiple papillomas in this patient are congenital in origin.
Subject(s)
Ectodermal Dysplasia/congenital , Esophageal Neoplasms/congenital , Focal Dermal Hypoplasia/congenital , Neoplasms, Multiple Primary/congenital , Papilloma/congenital , Adult , Esophageal Neoplasms/therapy , Esophageal Stenosis/therapy , Female , Humans , Papilloma/therapyABSTRACT
A review with a classification of congenital defects involving the stomach is presented. Owing to the fact that in certain lesions there are so few case reports available for study, the etiology and true nature of these defects remains unknown. It is incumbent upon the surgical community to continue to document congenital anomalies of the stomach and report them accordingly.
Subject(s)
Stomach/abnormalities , Choristoma/congenital , Diverticulum, Stomach/congenital , Esophageal Neoplasms/congenital , Esophagus/abnormalities , Gastric Mucosa , Humans , Hypertrophy , Ileum/abnormalities , Muscle, Smooth/abnormalities , Pancreas , Pyloric Antrum/abnormalities , Pyloric Stenosis/congenital , Pylorus/abnormalities , Stomach Neoplasms/congenital , Teratoma/congenitalABSTRACT
This communication describes one case treated by the authors and reviews 27 reports of congenital esophageal stenosis caused by tracheobronchial remnants. Histologic examination of the case showed respiratory mucous glands with respiratory epithelium and hyaline cartilage. The anomalies presumably result from failure of normal embryonic separation of the respiratory tract from the primitive esophagus. Primary resection is recommended as definitive treatment. Dilatation of the stenosis affords only temporary relief.
