- MeSH
- Electrocoagulation methods MeSH
- Epistaxis * classification therapy MeSH
- Humans MeSH
- Therapeutics * classification methods MeSH
- Endotamponade methods adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Electrocoagulation * classification methods adverse effects MeSH
- Epistaxis * pathology therapy MeSH
- Humans MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Úvod: Cílem sdělení je referovat o neobvyklém výskytu symptomů při komplikaci terapeutické koloskopie. Kazuistika: 70letá polymorbidní pacientka v chronickém dialyzačním programu podstoupila ošetření sáknoucích angiektázií v céku a colon ascendens argon plazma koagulací. Krátce po výkonu se u ní objevila dušnost a podkožní emfyzém na krku, který byl mylně hodnocen jako otok. Dalším vyšetřením bylo zjištěno pneumoperitoneum, podkožní emfyzém a pneumomediastinum. S ohledem na rizikovost nemocné (komorbidity, obezita) byla indikována laparoskopie, při které nebyla nalezena perforace střevní ani peritonitis. Při další komplexní léčbě se pacientka zahojila bez dalších komplikací. Závěr: Dušnost a podkožní emfyzém nejsou typickými prvními příznaky koloskopické perforace. Náš případ potvrzuje, že na tuto komplikaci je potřeba především myslet a při podezření na ni rychle zahájit diagnostický a léčebný proces.
Introduction: The paper presents unusual symptoms as a complication of therapeutic colonoscopy. Case report: A 70-year-old polymorbid female patient in chronic dialysis program underwent argon plasma coagulation treatment of leaking angioectasias in the cecum and ascending colon. Shortly after the procedure she presented with shortness of breath and subcutaneous emphysema of the neck which was initially misdiagnosed as swelling. Further tests revealed pneumoperitoneum, subcutaneous emphysema and pneumomediastinum. Considering the high risks for our patient (comorbidities, obesity), a laparoscopic approach was indicated. During laparoscopy neither peritonitis nor intestinal perforation were found. The patient recovered without complications after further complex treatment. Conclusion: Shortness of breath and subcutaneous emphysema are not typically among the first symptoms of colonoscopic perforation. Our case confirms that we should bear this complication in mind and when suspected, the diagnostic process should be started without delay.
- MeSH
- Argon Plasma Coagulation * adverse effects MeSH
- Blood Vessels diagnostic imaging pathology MeSH
- Dilatation, Pathologic surgery diagnostic imaging therapy MeSH
- Iatrogenic Disease MeSH
- Colonoscopy adverse effects MeSH
- Humans MeSH
- Mediastinal Emphysema diagnostic imaging etiology MeSH
- Intestinal Perforation etiology therapy MeSH
- Pneumoperitoneum * surgery diagnostic imaging etiology MeSH
- Tomography, X-Ray Computed MeSH
- Aged MeSH
- Subcutaneous Emphysema diagnostic imaging etiology MeSH
- Intestine, Large surgery diagnostic imaging pathology MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Centrifugation is the most commonly used method for harvesting autotrophically produced microalgae, but it is expensive due to high energy demands. With the aim of reducing these costs, we tested electrocoagulation with iron electrodes for harvesting Chlorella vulgaris. During extensive lab-scale experiments, the following factors were studied to achieve a high harvesting efficiency and a low iron content in the harvested biomass: electric charge, initial biomass concentration, pH, temperature, agitation intensity, residual salt content and electrolysis time. A harvesting efficiency greater than 95% was achieved over a broad range of conditions and the residual iron content in the biomass complied with legislative requirements for food. Using electrocoagulation as the pre-concentration step prior to centrifugation, total energy costs were reduced to 0.136 kWh/kg of dry biomass, which is less than 14% of that for centrifugation alone. Our data show that electrocoagulation is a suitable and cost-effective method for harvesting microalgae.
- MeSH
- Biomass MeSH
- Chlorella vulgaris * MeSH
- Electrocoagulation MeSH
- Electrolysis MeSH
- Flocculation MeSH
- Microalgae * MeSH
- Publication type
- Journal Article MeSH
Fibroepiteliální polypy jsou benigní nádory vycházející z pojivové tkáně. Jsou mezodermálního původu, kryté obvykle dlaždicovým epitelem, nejčastěji se nacházejí na kůži, v urogenitálním traktu nebo v oblasti dolních cest dýchacích. Mohou být ojedinělé nebo vícečetné. Jejich rozměry obvykle nepřesahují 1-2 milimetry. Zcela výjimečně mohou dosahovat obrovských rozměrů. V literatuře byl popsán obří fibroepiteliální polyp o velikosti 42 centimetrů. Přestože etiologie a faktory způsobující nadměrný růst nebyly objasněny, uvádí se, že růst může vyvolat především chronické mechanické dráždění, obezita a inzulinová rezistence, lymfatická stagnace a chronický zánět. Možnosti odstranění těchto projevů jsou chirurgické snesení, laserové ablace, elektrokauterizace, kryodestrukce a další. Existují i možnosti domácího ošetření. Vždy je však nutná pečlivá diagnostika.
Fibroepithelial polyps are benign tumors arising from connective tissue. They are of mesodermal origin and are usually covered with squamous epithelium and come from the skin, genitourinary tract or lower respiratory tract. On the skin, they occur mainly in the skin folds. They can be isolated or multiple. They are usually no larger than 1-2 millimeters. In rare cases, they can reach enormous dimensions. A giant fibroepithelial polyp 42 centimeters in size has been described in the literature. Although the etiology and factors causing overgrowth are not known, an association with chronic mechanical irritation, obesity, insulin resistance, as well as prolonged lymphatic stagnation and chronic inflammation has been reported. Types of removal of these symptoms are surgical excision, laser ablation, electrocauter destruction, cryodestruction and more. There are also home treatment options. However, careful diagnosis is always necessary.
- MeSH
- Birt-Hogg-Dube Syndrome therapy MeSH
- Dermatologic Surgical Procedures MeSH
- Electrocoagulation MeSH
- Neoplasms, Fibroepithelial * diagnosis therapy MeSH
- Fibroma therapy MeSH
- Hamartoma therapy MeSH
- Cryotherapy methods MeSH
- Laser Therapy MeSH
- Humans MeSH
- Mesoderm pathology MeSH
- Polyps * therapy MeSH
- Hamartoma Syndrome, Multiple therapy MeSH
- Check Tag
- Humans MeSH
Cévní ektázie žaludečního antra (GAVE – gastric antral vascular ectasia) je vzácná diagnóza, která může vést ke chronické sideropenické anemii v důsledku okultního nebo zjevného krvácení do gastrointestinálního traktu. Za základ léčby GAVE jsou považovány endoskopické termické metody – z nichž nejužívanější je argon-plazma koagulace, dále radiofrekvenční ablace nebo kryoterapie. Příznivé výsledky jsou publikovány také v souvislosti s používáním endoskopické ligace. V případě GAVE refrakterní na předchozí endoskopickou léčbu lze použít farmakoterapii, jejíž podstatou je redukce tvorby cévních malformací a krevního průtoku v nich. Prezentujeme přehled dostupných endoskopických a neendoskopických metod pro léčbu GAVE a naše zkušenosti s léčbou refrakterní GAVE kombinací endoskopických metod a thalidomidu formou kazuistik. Navrhujeme možný algoritmus pro terapii GAVE.
Gastric antral vascular ectasia (GAVE) is an uncommon diagnosis leading to chronic iron deficiency anaemia caused by occult or overt gastrointestinal bleeding. The mainstay of the therapy is based on endoscopic therapy using endoscopic thermal methods – particularly argon plasma coagulation and others – radiofrequency ablation, coagulation or cryotherapy. Endoscopic band ligation presents satisfying results as well. Pharmacotherapy aiming at reduction of the development of new vascular lesions and reduction of blood flow in them could be considered in patients refractory to endoscopic treatment. We present a review of available endoscopic and non-endoscopic methods for GAVE therapy and our experience with the therapy of refractory GAVE using a combination of endoscopic methods and thalidomide on case series. The algorithm for GAVE therapy is proposed.
- Keywords
- endoskopická ligace,
- MeSH
- Gastric Antral Vascular Ectasia * therapy MeSH
- Argon Plasma Coagulation methods MeSH
- Gastrointestinal Hemorrhage etiology therapy MeSH
- Humans MeSH
- Ligation methods MeSH
- Aged MeSH
- Thalidomide therapeutic use MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
- MeSH
- Argon Plasma Coagulation MeSH
- Fecal Incontinence etiology complications therapy MeSH
- Hyperbaric Oxygenation MeSH
- Humans MeSH
- Proctitis * diagnosis etiology therapy MeSH
- Proton Therapy MeSH
- Radiation Injuries * diagnosis epidemiology therapy MeSH
- Radiotherapy adverse effects MeSH
- Rectum radiation effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND: The authors present a series of 5 patients with anterior epistaxis in which a transcaruncular endoscopic approach was used for the anterior ethmoidal artery coagulation (AEA). METHODS: Six AEA coagulations (5 unilateral, 1 bilateral) using the transcaruncular endoscopic approach were performed in 5 patients with anterior epistaxis resistant to conservative measures. An incision was made between the plica semilunaris of conjunctiva and the lacrimal caruncle. Using a rigid endoscope, tissues were dissected lateral to the lacrimal sac, to the posterior lacrimal crest. The periorbit was incised and pulled aside. Hereafter, the technique was the same as that involving a frontoethmoidal incision. After bipolar coagulation of the AEA, the conjunctiva was sutured. RESULTS: Bleeding was resolved in all patients. One patient experienced early postoperative temporary diplopia. CONCLUSIONS: The transcaruncular endoscopic approach is a promising technique with no outer scarring. It is convenient in patients with difficult orientation in the nasal cavity, relatively safe, and faster than the transnasal endoscopic approach.
- MeSH
- Arteries surgery MeSH
- Adult MeSH
- Electrocoagulation MeSH
- Epistaxis surgery MeSH
- Hemostasis, Endoscopic methods MeSH
- Conjunctiva surgery MeSH
- Middle Aged MeSH
- Humans MeSH
- Nasal Cavity blood supply MeSH
- Orbit surgery MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- MeSH
- Electrocoagulation methods MeSH
- Hematoma * diagnosis etiology surgery MeSH
- Neck blood supply pathology MeSH
- Humans MeSH
- Tomography, X-Ray Computed methods MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Warfarin adverse effects MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
