RESUMO
This report describes the case of a patient with cricopharyngeal dysfunction with significant piriform sinus expansion. An 80-year-old man presented with a three-year history of dysphagia. Palsy of the cricopharyngeal chalasis was identified by electromyography under both videofluorography and manofluorography. Although a widening procedure was performed in the cricopharyngeal region using a bougie, the patient gained only minor relief from his dysphagia. After the patient had had adequate time to recover spontaneously (six months), a cricopharyngeal myotomy was performed. As a result, his dysphagia resolved and the post-operative course was uneventful. The clinical and histopathological findings in this case suggested that significant piriform sinus expansion had resulted from the cricopharyngeal dysfunction, due to cricopharyngeal myopathy.
Assuntos
Cartilagem Cricoide/cirurgia , Transtornos de Deglutição/cirurgia , Faringe/cirurgia , Idoso de 80 Anos ou mais , Transtornos de Deglutição/fisiopatologia , Fluoroscopia/métodos , Humanos , Masculino , Resultado do Tratamento , Gravação de VideoteipeRESUMO
To evaluate the function of the reticuloendothelial system and macrophage-monocyte system, blood samples from Thorotrast patients and age-matched healthy controls were used to determine the titer of plasma antibodies to lipid A and the numbers of several lymphocyte subclasses in peripheral blood and for an autoradiographic study of peripheral blood monocytes. The titer of plasma IgM class antibodies to lipid A was significantly elevated in the Thorotrast patients. Counts of CD 11-positive lymphocytes and CD 57-positive lymphocytes, which correspond to monocytes and natural killer cells, respectively, were significantly increased in the Thorotrast patients. Autoradiography showed that alpha-particle tracks were emitted from the monocytes isolated from the peripheral blood of Thorotrast patients. Thus the depressed function of the reticuloendothelial system resulted in the activation of the macrophage-monocyte system in the Thorotrast patients.
Assuntos
Macrófagos/efeitos da radiação , Monócitos/efeitos da radiação , Sistema Fagocitário Mononuclear/efeitos da radiação , Dióxido de Tório/efeitos adversos , Idoso , Autorradiografia , Antígenos CD11/análise , Antígenos CD57/análise , Humanos , Lipídeo A/imunologia , Subpopulações de Linfócitos/imunologia , Pessoa de Meia-IdadeRESUMO
A 6-year-old girl underwent allogeneic BMT from a matched sibling donor for the treatment of Kostmann syndrome. She suddenly became drowsy on day 30 after BMT, and lost consciousness 2 days later. Cranial CT scan showed symmetrical lesions suggesting bilateral necrosis in the basal ganglia. Clinical and laboratory investigations failed to reveal any evidence of neurometabolic disease.
