scholarly journals Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction after Ingestion of a Naphazoline-Containing Antiseptic

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Yuko Ono ◽  
Nozomi Ono ◽  
Kazuaki Shinohara
Keyword(s):  
Liver Dysfunction ◽  
Laboratory Data ◽  
Japanese Woman ◽  
Over The Counter ◽  
Tissue Hypoperfusion ◽  
First Case ◽  
Old Japanese ◽  
History Of ◽  
History Of Depression ◽  
Adrenergic Receptor Agonist

Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express α2-adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.

Cochlear fistula found in a naturally healed tympanic cavity

1991 ◽  
Vol 105 (8) ◽  
pp. 656-658 ◽  
Author(s):  
Mamoru Suzuki ◽  
Isao Nishida ◽  
Katsuhiro Hirakawa ◽  
Masafumi Nikaido ◽  
Yasuo Harada
Keyword(s):  
Semicircular Canal ◽  
Posterior Wall ◽  
Japanese Woman ◽  
Mastoid Cavity ◽  
Tympanic Cavity ◽  
Ear Canal ◽  
Horizontal Semicircular Canal ◽  
Old Japanese ◽  
History Of ◽  
Exploratory Surgery

AbstractA cochlear fistula found in a naturally healed mastoid cavity is reported. The patient is a 53-year-old Japanese woman who was complaining of unsteadiness. She hada long history of otorrhoea in childhood. Her tympanic and mastoid cavities were widely open and were covered by thin epithelium. The posterior wall of the ear canal was missing. She had no hearing in the ear but responded to electrical promontory testing. Exploratory surgery was indicated at which fistulae of the basal turn of the cochlea and the horizontal semicircular canal were found. These fistulae were sealed by pieces of bone andmuscle.

scholarly journals Neuroleptic malignant syndrome as part of an akinetic crisis associated with sepsis in a patient with Lewy body disease

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-227216 ◽  
Author(s):  
Saki Manabe ◽  
Hidetaka Yanagi ◽  
Hideki Ozawa ◽  
Atsushi Takagi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Lewy Body ◽  
Cardiopulmonary Arrest ◽  
Lewy Body Disease ◽  
Kidney Injury ◽  
Spontaneous Circulation ◽  
Japanese Woman ◽  
Old Japanese ◽  
History Of ◽  
Tentative Diagnosis

A 65-year-old Japanese woman with Parkinson’s disease, later diagnosed with Lewy body disease, presented with a 2-day history of systemic tremors. She also had fever without rigidity or creatine kinase (CK) elevation. She was diagnosed with sepsis caused by pyelonephritis with acute kidney injury and parkinsonism exacerbation. Although antibiotic and fluid therapy improved her pyuria and renal function, her fever and tremors persisted. On the fourth day, her symptoms worsened and resulted in cardiopulmonary arrest; however, quick resuscitation allowed the return of spontaneous circulation. Simultaneously, hyperthermia, altered consciousness, extrapyramidal symptoms, dysautonomia and CK elevation were noted. Thus, dantrolene administration was initiated with a tentative diagnosis of neuroleptic malignant syndrome (NMS). This caused her fever to subside, and her symptoms gradually improved. It was difficult to distinguish between parkinsonism exacerbation associated with sepsis and NMS. Physicians should consider NMS early on, even if the patient does not fulfil the diagnostic criteria.

Severe Pre-Eclampsia in Multiparous Women: Indication of an Environmental Triggering Agent?

1987 ◽  
Vol 32 (1) ◽  
pp. 8-10 ◽  
Author(s):  
D.C. Kilpatrick ◽  
E.C. Jazwinska ◽  
W.A. Liston ◽  
G.E. Smart
Keyword(s):  
Laboratory Data ◽  
Infectious Agent ◽  
Clinical Syndrome ◽  
Case Histories ◽  
First Case ◽  
Multiparous Women ◽  
History Of ◽  
Maternal Immune Response ◽  
First Time ◽  
Normotensive Pregnancy

Two case histories are described with conflicting implications for the etiopathogenesis of pre-eclampsia. In both, typical proteinuric pre-eclampsia developed despite a history of previous normotensive pregnancy. In the first case, the disease was associated with a change of husband, consistent with the view that pre-eclampsia arises from an inadequate maternal immune response to paternal antigens inherited by the fetus. The second case, however, concerned a woman who developed pre-eclampsia for the first time in her third pregnancy by the same reproductive partner. We conclude that either more than one underlying cause can result in the clinical syndrome of pre-eclampsia, or that pre-eclampsia is caused by an environmental factor. The possibility that pre-eclampsia may be initiated by an infectious agent is briefly explored in the light of the clinical histories described and well-established epidemiological, clinical and laboratory data.

scholarly journals Sub-Tenon Injections of Triamcinolone Acetonide Had Limited Effect on Cystoid Macular Edema Secondary to Nanoparticle Albumin-Bound-Paclitaxel (Abraxane)

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Naoki Matsuoka ◽  
Hiruma Hasebe ◽  
Tetsuji Mayama ◽  
Takeo Fukuchi
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Cystoid Macular Edema ◽  
Treatment Options ◽  
Time Lag ◽  
Japanese Woman ◽  
First Case ◽  
Old Japanese ◽  
Long Term Follow Up ◽  
Near Future

Purpose. To report the first case of cystoid macular edema (CME) induced by nanoparticle albumin-bound- (nab-) paclitaxel treated with sub-Tenon injections of triamcinolone acetonide (STTA) with detailed long-term follow-up.Case. A 39-year-old Japanese woman with breast cancer presents with decreased vision in both eyes while receiving nab-paclitaxel. Two STTA treatments were administered for persistent CME in her right eye. Central retinal thickness (CRT) of the treated eye decreased after the first STTA, but there was no change after the second STTA. CRT of the other eye and bilateral visual acuity (VA) showed no change after each treatment. However, this patient experienced gradual recovery of visual function after nab-paclitaxel treatment was completed, 3 months after the second STTA. Improvements in VA and CRT did not overlap in time. Moreover, there was a big improvement time lag in VA between the eyes.Conclusion. Cessation of nab-paclitaxel could lead to resolution of CME more than STTA, although STTA had some effect. Since nab-paclitaxel has been recently approved for treating more types of malignancies, the number of the patients with this CME is expected to increase in the near future. Patients and physicians should understand this side effect and prepare for other treatment options.

scholarly journals Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Takayuki Inoue ◽  
Ken Kobayashi ◽  
Mizuki Sawada ◽  
Sumiko Ishizaki ◽  
Haruo Ito ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Skin Lesions ◽  
Japanese Woman ◽  
Bowen’S Disease ◽  
Seborrheic Keratosis ◽  
Bowen's Disease ◽  
Pathologic Features ◽  
Old Japanese ◽  
History Of ◽  
Pigmented Skin Lesions

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD.

scholarly journals Obstructive Pneumonia With Bronchial Foreign Body: A Case Report

2021 ◽  
Author(s):  
Hitomi Tanaka ◽  
Takatoshi Anno ◽  
Haruka Takenouchi ◽  
Hideaki Kaneto ◽  
Toru Oga ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Laboratory Data ◽  
Vital Signs ◽  
Fish Bone ◽  
Case Presentation ◽  
Bronchial Foreign Body ◽  
Old Japanese ◽  
History Of ◽  
Normal Chest

Abstract Background: Bronchial foreign bodies are relatively uncommon in adults. There are a variety of symptoms induced by airway foreign bodies, although the typical symptoms of some bronchial foreign bodies are cough, wheezing, chest pain, hemoptysis and fever up. Case presentation: An 80-year-old Japanese man was referred to our hospital with symptom of 7-month history of cough and pneumonia. His chest radiograph showed a slight increase in opacity. His vital signs and his laboratory data were almost normal. Chest computed tomography revealed obstructive pneumonia and a bronchial foreign body. We performed bronchoscopy and detected a fish bone as an intrabronchial foreign body and finally removed it from the bronchi.Conclusions:It is very important to carefully perform medical consultation about the current and past medical history. People in some countries and regions such as Japan have a habit of eating fish. It is necessary to more carefully consider the possibility of some bronchial foreign body such as a fish bone, when we observe symptoms of persistent cough.

Disseminated neurenteric cyst

2008 ◽  
Vol 9 (4) ◽  
pp. 382-386 ◽  
Author(s):  
Muneyoshi Yasuda ◽  
Hiroshi Nakagawa ◽  
Hiroaki Ozawa ◽  
Chikage Inukai ◽  
Takeya Watabe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Japanese Woman ◽  
Neurenteric Cyst ◽  
Cerebrospinal Fluid Circulation ◽  
Unsteady Gait ◽  
Old Japanese ◽  
History Of ◽  
Cyst Membrane ◽  
Upper Thoracic ◽  
Cyst Fenestration

This case report presents the unusual holospinal dissemination of a neurenteric cyst, which was successfully treated by fenestration and placement of a subarachnoid-peritoneal (SP) shunt. The patient was a 46-year-old Japanese woman with a history of fourth ventricle neurenteric cysts, which were managed with cyst fenestration in 1996 and 2005. She had been doing well until January 2006, when she developed dizziness and an unsteady gait. A neurological examination revealed a disturbance in the deep sensation of the feet. A neuroimaging evaluation demonstrated multiple cystic lesions in the whole spinal canal, which significantly distorted the spinal cord. Because the spinal cord distortion was the most severe in the lower cervical to upper thoracic areas, a unilateral osteoplastic laminotomy with an endoscopic cyst fenestration was performed in these areas, followed by placement of an SP shunt. The pathological diagnosis was a disseminated neurenteric cyst. There was no malignancy, and the patient has been well, with an improved gait and no signs of peritoneal dissemination, for > 1 year. The present case showed a unique extent of dissemination, which was most likely a secondary characteristic. Neurenteric cysts are well known for their tendency to recur, and total removal is usually difficult because of adhesion of the cyst membrane to important structures. The lesion also compromises cerebrospinal fluid circulation. Cyst fenestration combined with SP shunt placement might be a treatment option in such a case.

scholarly journals Membranous Nephropathy With Monoclonal IgM Lambda Deposits in a Patient With IgM Monoclonal Gammopathy: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Go Hirose ◽  
Takahiro Uchida ◽  
Aki Kojima ◽  
Kentaro Sugisaki ◽  
Muneharu Yamada ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Membranous Nephropathy ◽  
Monoclonal Gammopathy ◽  
Rare Condition ◽  
Japanese Woman ◽  
Immunofluorescence Staining ◽  
First Case ◽  
Old Japanese ◽  
Repeat Renal Biopsy ◽  
Igm Deposits

We report a case of membranous nephropathy with monoclonal immunoglobulin (Ig)M lambda deposits in a patient with IgM monoclonal gammopathy, in whom histological changes were observed on repeat renal biopsy. A 72-year-old Japanese woman was referred to our hospital because of massive proteinuria. A prominent increase in monoclonal IgM lambda level was identified, and she was diagnosed as having IgM monoclonal gammopathy of undetermined significance. Renal biopsy showed glomerular subepithelial electron-dense deposits that were found to be granular deposits of IgM lambda but not kappa or IgG by immunofluorescence staining, resulting in a diagnosis of membranous nephropathy with monoclonal IgM deposits. The second biopsy, which was performed 2 years later because of exacerbation of her nephrotic syndrome, demonstrated less immunofluorescence staining of IgM, and dominant IgG2 deposition without light chain restriction. Interestingly, immunostaining for thrombospondin-type-1-domain-containing-7A was positive in both renal biopsy tissues, although the second biopsy showed clearly stronger immunoreactivity. The effect of steroid therapy was limited; however, rituximab treatment improved both the hematological and renal abnormalities. Solitary deposition of IgM in membranous nephropathy is a quite rare condition. To our knowledge, this is the first case of monoclonal gammopathy of renal significance presenting as membranous nephropathy with monoclonal IgM deposits, in which chronological immunohistochemical changes were observed and rituximab therapy was effective.

scholarly journals Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

2021 ◽  
pp. 73-76
Author(s):  
Shinjiro Kono ◽  
Patricia Ann L. Lee ◽  
Hirohiko Kakizaki ◽  
Yasuhiro Takahashi
Keyword(s):  
Differential Diagnosis ◽  
Japanese Woman ◽  
Soft Tissue Lesion ◽  
Palpebral Conjunctiva ◽  
Biopsy Specimens ◽  
Body Sensation ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
Conjunctival Lesion

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.

scholarly journals Coincidence of Large Adrenal Cyst and Prominent Hyporeninemic Hyperaldosteronism

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Takaaki Sakaue ◽  
Yosuke Okuno ◽  
Kosuke Mukai ◽  
Shingo Fujita ◽  
Junji Kozawa ◽  
...  
Keyword(s):  
Japanese Woman ◽  
Vascular Endothelial ◽  
Abdominal Ct ◽  
Adrenal Cyst ◽  
Old Japanese ◽  
Resected Tumor ◽  
History Of ◽  
Endothelial Cyst ◽  
Stage Renal Disease ◽  
End Stage

A 67-year-old Japanese woman who had end-stage renal disease was referred to our hospital for kidney transplantation. Abdominal CT revealed a large adrenal mass with inhomogeneity. She had a history of hospitalization for stroke and heart failure and exhibited prominent hyporeninemic hyperaldosteronism. Histological examination of the resected tumor with anti-CYP11B2 antibody indicated that she had a vascular endothelial cyst with primary aldosteronism (PA) due to multiple adrenocortical micronodules. This report implicates the pathological interaction between adrenal vascular cysts and PA-mediated vascular damage of the adrenal vein.

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