Cyclic vomiting syndrome (CVS) is a disorder characterized by recurrent episodes of incapacitating nausea and vomiting interspersed with symptom free periods. Common triggers of cyclic vomiting include noxious stress, excitement, fatigue and menstrual period. Here, we report a case of cyclic vomiting syndrome in adult patient characterized by stereotypical vomiting attack, occurring in every menstruation period. Recurrent vomiting episodes began 6 years ago and we treated this patient with subcutaneous injection of goserelin, a gonadotropin-releasing hormone analogue (GnRHa) and oral estrogen. After 4 months of therapy, she was symptom free for the following 5 years, even with the resumed normal menstruation. Recurrence of vomiting attack with same pattern occurred 1 month before readmission. Treatment with intravenous lorazepam aborted vomiting, but could not prevent recurrences of vomiting and epigastric pain. We treated the patient with GnRHa and oral estradiol again which effectively prevented recurrence of the symptoms.
Gossypiboma refers to a mass resulting from a retained gauze pad accidentally left within the body after surgery. Although the clinical features are diverse, it is often found incidentally as a mass having an internal cystic change and adhesion to adjacent organs. Abdominal computed tomography (CT) is helpful, yet the initial diagnosis can be misleading in cases with atypical findings. We report a case of gossypiboma in a 78-year-old woman that we suspected was a gastrointestinal stromal tumor according to abdominal CT and endoscopic ultrasound, yet was diagnosed as a gossypiboma postoperatively.
This work presented the highly controlled drug delivery system to achieve the suppression of the burst release at initial time and long term release of drug with cancellous bone mimetic nanoporous structures. The materials were prepared by the integration of synthesized inorganic hydroxyapatite (HA) and the hybrid gels of bicontinuous sponge-phased L 3 silicate and thermo-responsive poly(Nisopropylacrylamide) (L 3 -PNIPAm gels). The materials were designed to have the three dimensionally interconnected heterogeneous porosity of macro-and mesoporosity, in which the HA has the macroporosity of 150 to be impregnated the drug into the pores and the L 3 -PNIPAm gels have mesoporosity of 5 nm to regulate the temperature sensitive drug-release through the pore channels and polymeric network, respectively. Consequently, these bone-mimetic system gave the highly long term drug release over the 60 days with suppressing the burst release and was able to control the releasing rate per time by the change of the HA and PNIPAm composition ratios.
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