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Atsushi Tanikawa Satoshi Seki Takuya Yasuda Eiju Hasegawa 《The American journal of emergency medicine》2019,37(9):1809.e1-1809.e3
Half-life of the antipsychotic vegetamin is very long, partially due to the presence of phenobarbital, and mortality due to phenobarbital poisoning is high. Here, we present the case of a 22-year-old female admitted to the emergency department with disturbed consciousness due to vegetamin overdose. Her blood phenobarbital level was elevated to 123 μg/ml. Phenobarbital undergoes enterohepatic circulation, and its retention in the intestine causes its blood levels to remain sustained. The utility of hemodialysis for drug poisoning has been previously reported; however, its efficiency is not yet established and its efficacy is low for drugs with long half-lives such as phenobarbital. Therefore, we performed a two-tube approach to adsorb phenobarbital in the intestines with activated charcoal delivered via a gastric tube and to remove the phenobarbital-adsorbed activated charcoal using whole bowel irrigation via an ileus tube 2 h later. The patient successfully eliminated the charcoal via stool, the blood phenobarbital level decreased drastically without hemodialysis, and the clinical course improved. We propose that this two-tube approach is suitable for treatment of poisoning with drugs that undergo enterohepatic circulation and have long half-lives. 相似文献
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Kiyotaka Nemoto Tetsuya Shimokawa Masaki Fukunaga Fumio Yamashita Masashi Tamura Hidenaga Yamamori Yuka Yasuda Hirotsugu Azechi Noriko Kudo Yoshiyuki Watanabe Mikio Kido Tsutomu Takahashi Shinsuke Koike Naohiro Okada Yoji Hirano Toshiaki Onitsuka Hidenori Yamasue Michio Suzuki Kiyoto Kasai Ryota Hashimoto Tetsuaki Arai 《Psychiatry and clinical neurosciences》2020,74(1):56-63
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Primary cutaneous localized/clearly-outlined true histiocytic sarcoma: Two long-term follow-up cases
Naoko Sato Eiichi Arai Yasuhiro Nakamura Yasuo Yazawa Masanori Yasuda 《The Journal of dermatology》2020,47(6):651-653
Histiocytic sarcoma (HS) is a rare hematopoietic tumor that mainly involves extranodal sites, including the intestinal tract, skin, soft tissues and other organs. It is well known as an aggressive neoplasm that shows a poor response to therapy. However, a subset of patients with resectable disease has shown a favorable outcome with surgical treatment. Primary cutaneous HS is exceedingly rare and, to date, its long-term prognosis has thus not been well described. Here, we highlight two cases of primary cutaneous HS that showed long-term survival. Case 1 was a healthy 47-year-old woman who found a 12-mm tumor on her forehead. Case 2 was a 66-year-old woman, under follow up of a myxoid liposarcoma in her leg, who presented with a 25-mm tumor in her hypothenar eminence. Histologically, the tumors in both cases had a smooth outline with proliferating atypical tumor cells that showed histiocytic differentiation as revealed by immunohistochemistry with antibodies to CD68 (KP-1) and lysozyme in case 1; and CD68, lysozyme and CD163 in case 2. Tumor cells in case 1 had a monotonous appearance. After complete resection, cases 1 and 2 have survived for 10 and 4 years, respectively, without recurrence. To date, such patients are relatively long follow-up cases of survival from HS and highlight how a clear outline of the primary cutaneous HS tumor may be associated with its resectability and be an important factor in the assessment of its curability. 相似文献
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