THE incidence of gastroesophageal reflux disease （GERD） is high in Western nations. Its extraesophageal manifestations such as asthma, paroxysmal laryngospasm, and excessive throat phlegm,
Primary splenic epithelial cyst is an unusual event in everyday surgical practice with about 800 cases reported until date in the English literature. Splenic cysts may be parasitic or non-parasitic in origin. Nonparas...Primary splenic epithelial cyst is an unusual event in everyday surgical practice with about 800 cases reported until date in the English literature. Splenic cysts may be parasitic or non-parasitic in origin. Nonparasitic cysts are either primary or secondary. Primary cysts are also called true,congenital,epidermoid or epithelial cysts. Primary splenic cysts account for 10% of all benign non-parasitic splenic cysts and are the most frequent type of splenic cysts in children. Usually,splenic cysts are asymptomatic and can be found incidentally during imaging techniques or on laprotomy. The symptoms are related to the size of cysts. When they assume large sizes,they may present with fullness in the left abdomen,local or referred pain,symptoms due to compression of adjacent structures(like nausea,vomiting,flatulence,diarrhoea) or rarely thrombocytopenia,and occasionally complications such as infection,rupture and/or haemorrhage. The preoperative diagnosis of primary splenic cysts can be ascertained by ultrasonography(USG),computed tomography or magnetic resonance imaging,although the wide use of USG today has led to an increase in the incidence of splenic cysts by 1%. However,careful histopathological evaluation along with immunostaining for presence of epithelial lining is mandatory to arrive at the diagnosis. The treatment has changed drastically from total splenectomy in the past to splenic preservation methods recently.展开更多
Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth musc...Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction,edema of the mucosa,and mucus in the lumen of the bronchi and bronchioles.The stimuli vary widely and include antigens,infection,air pollutants,respiratory tract irritants,exercise,and emotional factors.This condition is completely different from distress breathing because of laryngotracheal spasm.One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease(GERD),in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis.A patient suffered from GERD without esophageal symptoms,which was diagnosed and treated as bronchial asthma during his five emergency admissions.The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening.The patient was being treated for as long as two years.After the correct diagnosis was made and treatment of laporascopic fundaplication was performed,the longstanding“bronchial asthma”,after all,completely disappeared.The concept of“not asthma,but GERD”seems undervalued,unappreciated,even misunderstood among patients with intractable asthma.Therefore,such a case is reported in detail,similar cases are mentioned briefly as well,and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.展开更多
文摘THE incidence of gastroesophageal reflux disease （GERD） is high in Western nations. Its extraesophageal manifestations such as asthma, paroxysmal laryngospasm, and excessive throat phlegm,
文摘Primary splenic epithelial cyst is an unusual event in everyday surgical practice with about 800 cases reported until date in the English literature. Splenic cysts may be parasitic or non-parasitic in origin. Nonparasitic cysts are either primary or secondary. Primary cysts are also called true,congenital,epidermoid or epithelial cysts. Primary splenic cysts account for 10% of all benign non-parasitic splenic cysts and are the most frequent type of splenic cysts in children. Usually,splenic cysts are asymptomatic and can be found incidentally during imaging techniques or on laprotomy. The symptoms are related to the size of cysts. When they assume large sizes,they may present with fullness in the left abdomen,local or referred pain,symptoms due to compression of adjacent structures(like nausea,vomiting,flatulence,diarrhoea) or rarely thrombocytopenia,and occasionally complications such as infection,rupture and/or haemorrhage. The preoperative diagnosis of primary splenic cysts can be ascertained by ultrasonography(USG),computed tomography or magnetic resonance imaging,although the wide use of USG today has led to an increase in the incidence of splenic cysts by 1%. However,careful histopathological evaluation along with immunostaining for presence of epithelial lining is mandatory to arrive at the diagnosis. The treatment has changed drastically from total splenectomy in the past to splenic preservation methods recently.
文摘Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction,edema of the mucosa,and mucus in the lumen of the bronchi and bronchioles.The stimuli vary widely and include antigens,infection,air pollutants,respiratory tract irritants,exercise,and emotional factors.This condition is completely different from distress breathing because of laryngotracheal spasm.One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease(GERD),in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis.A patient suffered from GERD without esophageal symptoms,which was diagnosed and treated as bronchial asthma during his five emergency admissions.The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening.The patient was being treated for as long as two years.After the correct diagnosis was made and treatment of laporascopic fundaplication was performed,the longstanding“bronchial asthma”,after all,completely disappeared.The concept of“not asthma,but GERD”seems undervalued,unappreciated,even misunderstood among patients with intractable asthma.Therefore,such a case is reported in detail,similar cases are mentioned briefly as well,and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.
