INTRODUCTION: Anesthetic approach to patients with myasthenia gravis requires preoperative treatment with anticholinesterase drugs, corticosteroids, plasmapheresis and mechanical ventilation support, either before or immediately after the surgical procedure. MATERIAL AND METHODS: During the period of 10 years, 41 patients with myasthenia gravis (71.42% female and 28.57% male, aged between 9 and 69 years) underwent surgical procedures. All the patients were preoperatively treated with anticholinesterase drugs and corticosteroids and were in remission. Considering the fact that barbiturates and succinylcholine should be avoided during induction of anesthesia, halothane was used. The induction into the surgical stage of anesthesia was pronged. RESULTS: Intubation, as well as the surgical procedure, were successfully completed in all patients. All, except three patients, started breathing spontaneously. Two patients required respiratory support during the immediate postoperative period and one patient died. After the surgical procedure one patient had manifested gastrointestinal bleeding and three patients had pneumothorax (one iatrogenic and two during mechanical ventilation). Mechanical ventilation in postoperative period indicates inadequate respiratory function in patients with myasthenia gravis, whereas thymectomy is a therapy of choice. Volatile inhalation anesthetic with pre and postoperative anticholinesterase drugs and corticosteroids resulted in complete remission.

Adolescent↗

PubMedDate not supplied

[Exogenous lipoid pneumonia with abscess mimicking a lung tumor].

A case of abscessing exogenous lipoid pneumonia is reported. After the onset of respiratory symptoms, 68-year-old male was admitted to our hospital. Physical and X-ray examination suggested malignant lung tumor. After false positive finding of fine needle transthoracic biopsy, the right middle lobectomy was performed. Histological examination showed an unexpected finding of lipoid pneumonia and thereafter information of accidental petroleum aspiration was obtained.

Aged↗

PubMedDate not supplied

[Krukenberg's tumor of the ovary and uterine myoma].

A case of Krukenberg's tumour of the ovary in a 41-year-old patient is described. A year before admission she had mild gastric trouble, repeated short-lasting amenorrhea followed by prolonged bleeding. The menstruations preceding hospitalization were normal and painless. More serious trouble developed suddenly, four days before admission, in the form of intense pain in the lower abdomen and moderate bleeding. The woman had delivered twice and had 6 abortions. Her mother died of intestinal cancer. On examination, the patient was found to have two tumours: one on the right side, the size of a newborn's head, and one on the left side, the size of a female fist, both kidney-shaped and mobile. Also numerous small knots on the small intestine, peritoneum, and omentum, as well as a considerable amount of ascites were observed. An uterine myoma was found as well. Histerectomy and ablation of both adnexa were performed. The therapy was continued by radiation but the patient died 5 months following the operation.

Adult↗

PubMedDate not supplied

[Nodular amyloidosis of the lungs associated with Sjögren's syndrome].

Pulmonary amyloidosis can develop together with both primary or secondary amyloidosis, isolated or associated with amyloidosis of other organs. In the study a case of a 59 year old female with multiple nodules and diffuse amyloid infiltration in pulmonary parenchyma associated with Sjörgen's syndrome is presented. Amyloid deposits were also found in the surgically removed parotid salivary gland, mostly in its blood vessel walls.

Amyloidosis↗

PubMedDate not supplied