The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation

Hemangioma of the testis is an extremely rare lesion, more or less than 10 cases having been reported in infancy or early childhood in the world. We have experienced one case of capillary hemangioma of the left testis in 6 year old Korean male, which was suspicious to be a malignant tumor.
Capillaries* ; Child ; Hemangioma ; Hemangioma, Capillary* ; Humans ; Male ; Testis*

PURPOSE: Gastrointestinal stromal tumors (GIST) are a heterogenous group of mesenchymal neoplasms of the gastrointestinal tract. This study was performed to determine the clinical characteristics and prognostic factors of GIST. METHODS: We studied 24 cases of GIST collected over a 9 year period. This retrospective review analyzed the clinical presentation, pathologic examination, and long-term follow-up of patients with GIST. The clinicopathological features were evaluated to identify the predictors of survival. RESULTS: The most common clinical presentation was pain or discomfort (37.5%). GISTs were found to be typically present in older individuals and be most common in the stomach (41.7%). All patients underwent surgical resection with curative intent. The follow-up period ranged from 3 to 110 months. Recurrence occurred in 11 (45.8%) of 24 patients. According to multivariate analysis, survival was inversely correlated with size (P=0.032) and the number of mitoses (P=0.030). Patients younger than 50 had an independent value for prognostic prediction (P=0.058). CONCLUSION: Tumor size, mitotic index and patient's age can be used as prognostic factors for GIST according to the results of our study. But, better pathological and immunohistochemical methods are still required to improve GIST prognosis.
Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Humans ; Mitosis ; Mitotic Index ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach

PURPOSE: The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. RESULTS: DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. CONCLUSION: CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.
Cone-Beam Computed Tomography ; Crowns ; Dentigerous Cyst ; Displacement (Psychology) ; Mandible ; Maxilla ; Odontogenic Cysts ; Retrospective Studies ; Root Resorption ; Tooth ; Tooth, Unerupted

A 63-year-old Korean man presented with generalized, asymptomatic, discrete papules and coalescent annular plaques for one year. Interestingly, the patient complained of conjunctival congestion, concurrently with aggravation of the skin lesion. Histopathologic findings of the skin lesion and conjunctiva revealed giant cells engulfing fragmented elastic fibers, and a diagnosis of actinic granuloma with ocular involvement was made. Ten months later, the patient revisited with a two-week history of bilateral temporal headache, neck pain, intermittent jaw claudication, and blurred vision. Biopsy of the temporal artery confirmed the clinical diagnosis of temporal arteritis. Both actinic granuloma and temporal arteritis show similar pathologic process, and this case supports the hypothesis that actinically degenerated elastic tissue is likely to be the antigenic basis of actinic granuloma of the skin and temporal arteritis.
Actins* ; Biopsy ; Conjunctiva ; Diagnosis ; Elastic Tissue ; Estrogens, Conjugated (USP) ; Giant Cell Arteritis* ; Giant Cells ; Granuloma* ; Headache ; Humans ; Jaw ; Middle Aged ; Neck Pain ; Skin ; Temporal Arteries

Postoperative hyphema following cataract extraction surgery is not usually a serious complication and clears quickly in the most cases. Sutureless cataract surgery was reported to have less incidence of postoperative hyphema than conventional cataract surgery. We analyzed the incidence of postoperative hyphema in each group according to the depth and the length of scleral pocket incision in 500 eyes with the sutureless cataract surgery via superior incision during two years. One day after surgery, 90 cases(18.0%) had hyphema and most of them(74.4%) showed grade 1 severity. The incidence of hyphema was 23.0% in the deep incision group and only 11.9% in the superficial incision group(p<0.01). The percentage of grade 1 hyphema was 66.6% in the deep group and 92.6% in the superficial group, then severity was greatly reduced in the superficial incision group(p<0.01). The incidence of hyphema in the group of 7.0 mm in length was highest among the 6.0, 6.5, 7.0 mm groups(p<0.01), and the shorter the incision length, the milder the serverity of hyphema(p<0.01). The incidence of hyphuma was the lowest(6.2%) in the group of 6.0 mm in length and superficial incision, and it was the highest(28.5%) in the 7.0 mm in length and deep incisional group(p<0.01).
Cataract Extraction ; Cataract* ; Hyphema* ; Incidence*

PURPOSE: This study investigated the expression of three isoforms of nitric oxide synthase (NOS): neuronal (nNOS), inducible (iNOS), and endothelial (eNOS) in an experimental rat model of chronic glaucoma. The aim was to research the role of nitric oxide (NO) as a neurotoxic molecule in connection with damage to and the degeneration of retinal ganglion cells in glaucoma. METHODS: Retinal tissues were obtained after inducing chronic elevation of intraocular pressure by cauterization of episcleral vessels. We then performed quantification and localization of NOS isoforms through western blot and immuno-fluorescence staining of the tissues. RESULTS: The expression of nNOS and iNOS increased significantly but that of eNOS did not. nNOS expressed in the amacrine and displaced amacrine cell of the normal retinal tissue, as well as in retinal ganglion cells in the experimental group. iNOS that expressed in the microglia of the normal retinal tissue was also expressed in the cell thought to be an astrocyte or Muller cell end-feet in the experimental group. Administration of L-NAME (NG-nitro-L-arginine-methyl-esther), a non-specific NOS inhibitor, tended to reduce retinal ganglion cell loss, but this result was without statistical significance. CONCLUSIONS: These results showed that the cytotoxicity of excessive NO took part in retinal ganglion cell loss in glaucoma, and the expression of nNOS in retinal ganglion cells suggests that it may play an important role in the selective death of the retinal ganglion cell.
Amacrine Cells ; Animals ; Astrocytes ; Blotting, Western ; Cautery ; Glaucoma* ; Intraocular Pressure ; Microglia ; Models, Animal* ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Protein Isoforms ; Rats* ; Retinal Ganglion Cells ; Retinaldehyde

No abstract available.
Adrenocortical Carcinoma* ; Stomach Neoplasms*

Osteoporosis is a disease characterized by excessive bone loss or osteopenia particulary in the axial skeleton at the site of fracture, such as the spine and proximal femur. Since the strength of both spine and femur is directly proportional to the bone mass, this osteoporosis always increases the risk of fracture. In this study, to evaluate whether a simple measurement of femoral geometry and BMD value are related with hip fracture, we obtained DEXA Scan (Lunar Expert-XL) of hip by retrospective study. DEXA scan was measured on 70 control people and 17 hip fracture patients aged 50 or older. The result is I. The mean Ward BMD value of hip fracture group is significantly lower than control group (Hip fracture group: 0.52g/cm2, Control group: 0.67g/cm2 P=0.0001) 2. The mean L-spine BMD value of hip fracture group is significantly lower than control group (Hip fracture group: 0.81g/cm, Control group: 0.97g/cm2 P=0.0002) 3. The mean femur axis length of hip fracture group is longer than control group (Hip fracture group: 6.77g/cm2, Control group: 6.57g/cm2 P=0.006) As a conclusion, the measurement of BMD and hip axis length in DEXA scan is an effective method for screening the hip fracture risk patient and BMD value of femur, hip axis length and L- spine BMD value are strongly associated with hip fracture.
Absorptiometry, Photon ; Axis, Cervical Vertebra* ; Bone Density* ; Bone Diseases, Metabolic ; Femur ; Hip* ; Humans ; Mass Screening ; Osteoporosis ; Retrospective Studies ; Skeleton ; Spine