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Myocardial infarction with ST-segment elevation in old patient with history of takotsubo syndrome

Journal of Geriatric Cardiology 2018年第5期15卷 376-378页

作者： Momka Budnik janusz Kochanowski Radoslaw Piatkowski Robert Kowalikl janusz kochman Grzegorz Opolski First Chair and Department of Cardiology Medical University of Warsaw 1a Banacha Street 02-097 Warsaw Poland Department of Noninvasive Cardiology and Hypertension Central Clinical Hospital of the Ministry of the Interior and Administration Wotoska 137 02-507 Warsaw Poland

Takotsubo syndrome （TTS） is a rare condition that af- fects mainly aging women. TTS was first reported in 1990r and is characterized by clinical symptoms, ECG changes and regional wall motion abnormalities without changes in the coronary arteries. However, some reports admit the pos- sibility of coexistence of TTS and coronary artery disease. We present a patient who had not had any changes in coro- nary arteries until four years later when she had myocardial infarction associated with right coronary artery narrowing, despite the fact that the risk factors of coronary heart disease were closely monitored.

关键词： Myocardial infarction Recurrence of disease Takotsubo syndrome

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Acute coalescent mastoiditis in a 16-month-old child due to Streptococcus pneumoniae infection

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Journal of Acute Disease 2024年第1期13卷 36-39页

作者： Magdalena Pszczołowska Monika Morawska-kochman Katarzyna Resler Katarzyna Pękalska Tomasz Zatoński Department and Clinic of Otolaryngology Head and Neck SurgeryWrocław Medical UniversityBorowska 213WrocławPoland Department of General Radiology Interventional Radiology and NeuroradiologyWrocław Medical UniversityBorowska 213WrocławPoland

Rationale:Acute otitis media is a common disease in early childhood,and is usually caused by Streptococcus pneumoniae(***).Acute mastoiditis is a complication of acute otitis media and can involve not only the mucoperiosteum of the middle ear but can also spread to the periosteum by destroying the mastoid bone(acute coalescent mastoiditis).In addition,the infection can extend through the surrounding bones or the emissary veins beyond the mastoid’s air cells,leading to subperiosteal ***’s Concern:A 16-month-old female patient was hospitalized due to the purulent discharge of the left ear and the symptoms of right mastoiditis(swelling and redness of the skin).Diagnosis:Bilateral acute coalescent mastoiditis caused by *** *** computer tomography revealed bilateral bone destruction of the mastoid and abscesses found behind the auricle on both ***:The patient underwent intravenous antibiotic therapy and surgical ***:The patient was discharged 14 days after hospitalization with an improved ***:Improperly treated acute coalescent mastoiditis can lead to extracranial and intracranial complications,sometimes serious and even *** are prevalent in children under 2 years,in whom the disease progresses more rapidly and *** vaccination with a 13-valent vaccine may not result in sufficient immunity against ***,a predominant pathogen in children affected by acute coalescent mastoiditis.

关键词： Acute otitis media Acute coalescent mastoiditis Streptococcus pneumoniae Children Case report

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False contouring effect of the uterine wall during hysteroscopy a lesson from immediate hydrosonography

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Open Journal of Obstetrics and Gynecology 2013年第5期3卷 1-4页

作者： Yaron Hamani Ernst Voss Asher Shushan Ronit Haimov-kochman Department of Obstetrics and Gynecology Hadassah Medical Center Mt. Scopus Jerusalem

A 42 years old woman suffering from repeated events of intensive vaginal bleeding during the week off birth control pills was referred for diagnostic hysteroscopy. The patient underwent hysterohy drosonoscopy, a 3-step procedure, including a transvaginal ultrasound scan, a diagnostic hysteroscopy and immediate hydrosonography. A3 cmintramural myoma was detected by the ultrasound scan without impinging onto the uterine cavity as visualized by diagnostic hysteroscopy. However, continuous hydrosonographic evaluation of the uterus, performed immediately afterwards, unveiled a fibroid with a significant intracavitary portion. A falsely normal cavity could be appreciated by high pressured hysteroscopy, while during the gradual fall of the intracavitary pressure a significant lesion could be revealed encroaching into the lumen. In the absence of an agreed distention pressure range during hysteroscopy, an immediate hydrosonography may serve as an auxiliary tool to follow the uterine wall contour as distention pressure declines during the eventual escape of the distention fluid from the lumen. Uterine wall contour is heavily dependent on the distension pressure and guidelines for intrcavitary pressure during hysteroscopy are evidently needed.

关键词： Distension Fibroid Hydrosonography Hysteroscopy Pressure

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结肠镜检中丙泊酚和瑞芬太尼与咪达唑仑和芬太尼镇静的随机对照双盲研究

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麻醉与镇痛 2009年第1期5卷 63-67页

作者： Jeff E. Mandel Jonathan W. Tanner Gary K Lichtenstein David C. Metz David A. Katzka Gregory G. Ginsberg Michael L. kochman 肖玮(译) 王天龙(校) Departments of Anesthesiology and Critical Care Departments of Medicine University of Pennsylvania School of Medicine Philadelphia Pennsylvania 不详

背景丙泊酚用于患者自控镇静（patient-controlled sedation，PCS）可解决中度镇静治疗窗窄的问题，但之前的研究存在方法学的不足。本研究中，我们使用瑞芬太尼＋丙泊酚经PCS给予，我们发现与芬太尼＋咪达唑仑相比，瑞芬太尼＋丙泊酚... 详细信息

背景丙泊酚用于患者自控镇静（patient-controlled sedation，PCS）可解决中度镇静治疗窗窄的问题，但之前的研究存在方法学的不足。本研究中，我们使用瑞芬太尼＋丙泊酚经PCS给予，我们发现与芬太尼＋咪达唑仑相比，瑞芬太尼＋丙泊酚更方便使用。方法将50例择期结肠镜检的患者随机（使用盲法）分为咪达唑仑＋芬太尼组（MF组）或丙泊酚＋瑞芬太尼组（PR组），药物均经PCS给予。研究中评估项目有：镇静起效时间、恢复时间、患者满意度、护士满意度、镜检医师满意度、是否需要麻醉医师干预。结果与MF组相比，PR组患者进入镇静状态与恢复明显较快（P〈0．0001）。在PR组中，恢复时间短于操作时间。两组间患者满意度、护士满意度、镜检医师满意度相同。PR组中，有2例患者因为动脉氧饱和度低于设置的安全终点而需要麻醉医师干预。结论在适当的监护条件下，丙泊酚＋瑞芬太尼用于PCS比咪达唑仑＋芬太尼更有优势。

关键词：患者自控镇静瑞芬太尼咪达唑仑结肠镜检随机对照丙泊酚双盲研究患者满意度

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对ERCP术中应用导丝固定改良的十二指肠镜的初始评价

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世界核心医学期刊文摘（胃肠病学分册） 2005年第2期1卷 33-33页

作者： Beilstein M.C. Ahmad N.A. kochman M.L. G.G.Ginsberg 赵丽娜 Division of G astroenterology Department of Medicine University of Pennsylvania Philadelphi a PAUnited StatesDr.

Background Catheter/guidewire exchanges during ERCP require the coordinated ef forts of an endoscopist and endoscopy assistant. Aprototype duodenoscopewas deve loped to improve the control of catheter/guidewire exchange by enabling fixation of guidewires at the elevator lever. MethodsAn initial prototype duodenoscope a nd a subsequent modification of this instrument were used to perform ERCP in 7 a nd 10 patients, *** following were recorded: total procedure time, fluoroscopy time, catheter/guidewire exchange time, guidewire repositioning,loss of guidewire access, success or failure of fixation,and endoscopist satisfactio n. Observations The initial and the modified prototype duodenoscopes were used i n a variety of catheter/guidewire exchanges (n=46). Guidewire fixation was achie ved in 75%of catheter/guidewire exchanges with the initial prototype and in 93 %with the modified prototype and was reflected in shorter exchange times. Acces s to the desired duct was not lost during any exchange, and the need for reposit ioning was eliminated. Conclusions A new prototype duodenoscope with an elevator lever that enables guidewire fixation will improve the ease and efficiency of c atheter/guidewire exchange during ERCP. Modifications made to the original proto type improved reliability of guidewire fixation.

关键词：十二指肠镜 ERCP术内镜医生操作时间透视检查意度

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