High-dose steroid therapy is known as effective adjuvant therapy for refractory bone pain due to metastasis of solid cancer. However, the standard dose and duration have not been established to date. Long term maintenance with steroid therapy is not encouraged due to its potential adverse effects. Here, we report a case of a terminal cancer patient who maintained high dose steroid therapy to alleviate refractory bone pain with complication of systemic fungal infection.
Candida ; Humans ; Neoplasm Metastasis ; Steroids

No abstract available.
Aneurysm* ; Neck* ; Rupture*

Porphyrias are inherited metabolic disorders resulting from a specific enzyme defect in the heme biosynthetic pathway. Porphyrias are induced by various precipitants. Clinical features include abdominal pain, neurologic manifestations, autonomic neuropathy, and mental disturbance. Diagnosis may be delayed because of variable symptoms that mimic other diseases and because of the rarity of of porphyrias. Although most patients with known porphyria can complete anesthesia and surgery safely, undiagnosed porphyric patients are in danger of porphyric crisis due to inadvertent exposure to precipitating drugs and environment. We report a case of a patient who experienced delayed emergence with neurological disturbance after general anesthesia, ultimately diagnosed as acute intermittent porphyria.
Abdominal Pain ; Anesthesia ; Anesthesia, General* ; Biosynthetic Pathways ; Delayed Emergence from Anesthesia ; Diagnosis ; Guillain-Barre Syndrome ; Heme ; Humans ; Neurologic Manifestations* ; Porphyria, Acute Intermittent* ; Porphyrias ; Spine* ; Wernicke Encephalopathy

No abstract available.
Humans ; Prone Position* ; Respiratory Mechanics*

No abstract available.
Humans ; Prone Position* ; Respiratory Mechanics*

No abstract available.
Cholecystectomy, Laparoscopic* ; Humans ; Mosaicism* ; Myelodysplastic Syndromes* ; Trisomy*

Although fentanyl-induced cough is generally transient and benign, it can give rise to serious problems in patients to whom increasing intracranial, intraocular or intraabdominal pressures may create dangerous situations. This case demonstrates aspiration pneumonia as a complication, exhibiting severe cough induced by intravenous injection of fentanyl.
Cough ; Fentanyl ; Humans ; Injections, Intravenous ; Pneumonia ; Pneumonia, Aspiration ; Vomiting

Tapia's syndrome is the palsy of the 10th and 12th cranial nerves, resulting in ipsilateral paralysis of the vocal cord and tongue. It is a rare complication which is related to the anesthetic airway management and positioning of the patient's head during the surgery. We describe a patient with a postoperative unilateral Tapia's syndrome, after general anesthesia, with uncomplicated endotracheal intubation. The patient's symptoms improved gradually for three months.
Airway Management ; Anesthesia, General ; Cranial Nerves ; Head ; Humans ; Intubation, Intratracheal ; Paralysis ; Tongue ; Vocal Cords

No abstract available.
Child* ; Facies* ; Humans

We report a case of an erroneously elevated bispectral index (BIS) during robot assisted thyroidectomy using an electromyographic endotracheal tube (EMG tube), which is safe and useful for laryngeal electromyographic monitoring. Ten minutes after start of the operation, a sudden increase of BIS value up to 98 was noticed. The BIS values were not decreased to < 65 with supplemental anesthetics. The anesthetic method was changed from total intravenous anesthesia to balanced anesthesia. The BIS sensor and monitor were changed and other models were used. These interventions did not alter BIS values. BIS levels remained between 60 and 70 throughout the main procedure and intermittently increased to the mid-90s without any trace of poor signal quality. At the end of the surgery, the BIS values returned to normal range. The patient did not complain of intraoperative recall. Knowledge of potential interference from the use of an EMG tube must be considered when interpreting BIS.
Anesthesia, Intravenous ; Anesthetics ; Balanced Anesthesia ; Humans ; Organothiophosphorus Compounds ; Reference Values ; Thyroidectomy