Total severance of renal pedicle by blunt trauma to the abdomen is relatively rare and mainly leads to a fatal result by hypovolemic shock. We report the two cases of a 35 and a 20-year-old men with survival. They had blunt trauma on their right flank area by fall down from a driving cultivater and a steep hill 3 meters high in drunken state, respectively. We identified totally severed renal artery and vein to have been hemostatic by thrombosis at explorative laparatomy.
Abdomen ; Hemostasis* ; Humans ; Male ; Renal Artery ; Shock ; Thrombosis* ; Veins ; Young Adult

We operated on a 41-year-old man using venous bypass shunt for superior vena cava (SVC) syndrome caused by mediastinal fibrosis. The patient had substantially high venous pressure and high risk of postoperative neurologic deficits. The collateral veins were deemed to be interrupted during the surgical reconstruction of SVC. Treatment included resection of the obstructed SVC and innominate vein and reconstruction with an autologous pericardial tube graft. During the operation, venous drainage from upper body was maintained with an extraluminal bypass shunt. The shunt was effective at prompt relief of venous hypertension, eliminating the time constraints, and preventing the postoperative complications.
Adult ; Brachiocephalic Veins ; Drainage ; Fibrosis ; Humans ; Hypertension ; Neurologic Manifestations ; Pericardium ; Postoperative Complications ; Superior Vena Cava Syndrome ; Transplants ; Veins ; Vena Cava, Superior* ; Venous Pressure

As the mean life expectancy increases, the incidence of hepatocellular carcinoma (HCC) in superelderly patients (>85 years old) is expected to increase in Korea. However, their clinical features, treatments, and treatment outcomes are unclear. Herein, we present a case of a large single HCC and its natural course in an 86-year-old man who refused any treatment following histologic diagnosis.
Aged, 80 and over ; Carcinoma, Hepatocellular ; Diagnosis ; Humans ; Incidence ; Korea ; Life Expectancy

We encountered a rare case of diffuse idiopathic skeletal hyperostosis (DISH) associated with dysphonia and dysphagia. An 80 year-old man developed progressive dysphonia and dysphagia. The radiology study, esophagogram and nasopharyngoscopic exam revealed the esophagus and the posterior wall of the nasopharynx to be severely compressed by the unfused osteophyte of the 3rd and 4th cervical intervertebral space. It was thought that the osteophyte formation was caused by not merely DISH but degenerative changes due to a concentration of stress around the unfused hyperostosis. A resection of the osteophyte was performed, which resolved the clinical symptoms. The follow-up radiology study, esophagogram and nasopharyngoscopic exam showed that the osteophyte had disappeared.
Aged, 80 and over ; Deglutition Disorders* ; Dysphonia* ; Esophagus ; Follow-Up Studies ; Humans ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Nasopharynx ; Osteophyte

A thyroid storm is a potentially fatal complication of hyperthyroidism. Early diagnosis and treatment is essential for reducing morbidity and mortality. Older patients with hyperthyroidism tend to have fewer hypermetabolic signs and increased signs of weight loss, depression, lethargy, cardiac arrhythmia, and apathetic mood. Additionally, comorbid diseases and drug history can affect thyroid function and symptoms. Here, we report an older patient with a thyroid storm and accompanied features of Parkinson's disease. She presented with generalized weakness, delirium, and anxiety. Laboratory findings were consistent with hyperthyroidism. She became drowsy with no precipitating factors. High fever, meningism, and atrial fibrilation occurred with no obvious sources. Suspecting a diagnosis of a thyroid storm, she was treated with an antithyroid drug, Lugol's solution, hydrocortisone, and supportive management. After these treatments, her clinical condition recovered and the neurological signs resolved.
Aged ; Anxiety ; Arrhythmias, Cardiac ; Delayed Diagnosis ; Delirium ; Depression ; Early Diagnosis ; Fever ; Humans ; Hydrocortisone ; Hyperthyroidism ; Iodides ; Lethargy ; Meningism ; Parkinson Disease ; Precipitating Factors ; Thyroid Crisis ; Thyroid Gland ; Weight Loss