A 25-year-old-woman with four years history of pancolonic ulcerative colitis (UC) underwent laparoscopy-assisted restorative proctocolectomy. She developed postoperatively abdominal pain, high fever, ...bloody diarrhea. Computed tomography showed thickening of duodenal and small intestinal wall, and endoscopic examination revealed diffuse mucosal edema, redness, erosion and ulceration involving duodenum, small intestine and ileal pouch that was similar in appearance to UC. She experienced massive melena five times and was successfully treated by transcatheter arterial embolization. Some antibiotics and predonisolone failed to decrease activity of the lesion but the symptoms and endoscopic findings improved since intravenous dexamethasone injection.
Reducing pressure is one of the most important factors in preventing decubitus. One way to reduce pressure is to redistribute pressure over as large an area as possible. Soft polyurethane mattresses ...are good for redistributing pressure, however this type of mattress does not provide sufficient back support. So in order to reduce pressure and provide sufficient support, we have developed a silicone gel layered mattress. Silicone gel is frequently used as a shock absorber in various types of machines and our tests showed that silicone gel was superior to standard polyurethane mattress materials in reducing interface pressure. The silicone gel layered mattress was also preferred by volunteers over a standard hard mattress and a standard soft mattress.
We have proposed a new syndrome, HANS(human papilloma virus HPV vaccination-associated neuro-immunopathicsyndrome). The most critical question concerning the adverse reactions following HPV ...vaccination is whether or notthey are psychogenic rather than organic in origin. We made an extensive study of 35 patients diagnosed with HANS to objectively determine the nature of their disorders by means of single photon emission computed tomography(SPECT), endocrine function tests and electroencephalography (EEG). We observed (1) autonomic, endocrine and inflammatory symptoms, (2) emotional and cognitive syrnptoms, (3) environlnental hypersensitivity and pain symptoms, and (4) locomotion and motor symptoms. Clinical symptoms associated with the four domains not oIlly overlapped within single patients but were also observed across patients. Theophylline, a blocker of central A1 adenosine receptor activation was effective for symptomatic relief in some patients. SPECT images were compared between 29 HANS patients and 19 normal controls. Two-tail view images in three-dimensional stereotactic surface projection (3D-SSP) indicated profound hypo-activity in the thalamus. Relative hypo-perfusion in 3D-SSP with stereotactic extraction estimation analysis wasmost prominent in the anterior cingulate cortex. The 35 patients consisted of 27 patients vaccinated with Cervarix(R) and 8 vaccinated with Gardasil(R). We noted different adverse reactions between the two groups concerning fatigue, sleep disorder, HDS-R score and SPECT images. Endocrine function tests in 9 HANS patients indicated the presence ofhypothalamic dysfunction. EEG showed generalized paroxysmal bursts of large sharp waves or spikes in 5 among 13 HANS patients. We conclude that the symptoms presented by HANS patients are not of psychogenic origin but derive from neuro-endocrinological disorders of the hypothalamus and its limbic networks.
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