No abstract available.
Prostate* ; Testis*

Livedo vasculitis is thought to be a thrombogenic disorder that is related to the autoimmune disease. It clinically shows purplish mottling and recurrent painful ulcers in the lower extremities, leaving atrophie blanche after healing of the ulcers. Histopathologic finding are thrombotic occlusion in the mid-dermal vessels without necrotizing vasculitis. The therapeutic approach has largely been made by the use of drugs that stimulate endogenous fibrinolytic activitiy, that inhibit thrombus formation, or that cause vasodilation, but surgical intervention by excision and skin graftion has rarely been reported as a primary treatment.In our experience, two patients with livedo vasculitis, who had been unresponsive to various medications, were treated with wide excision and several times of skin grafting. And they experienced complete healing without recurrence.
Autoimmune Diseases ; Humans ; Lower Extremity ; Recurrence ; Skin ; Skin Transplantation ; Thrombosis ; Ulcer ; Vasculitis* ; Vasodilation

Background: Esmolol as a drug for induced hypotension can, not only avoid many drawbacks of nitroprusside, but reduce the amount of intraoperative bleeding and make better operative field. This study was performed to evalute cardiovascular changes during esmolol-induced controlled hypotension. Methods: Induced hypotension using esmolol was applied to 18 adult patients receiving spinal surgery under the diagnosis of spinal stenosis or scoliosis. After prehydraion of 2,000 ml of crystalloid solution, 0.5 mg/kg esmolol was used as loading dose once, twice or three times until mean blood pressure (MBP) fell below 70 mmHg, followed by continuous infusion (50~300 microg/kg/min) of esmolol. MBP and heart rate (HR) were measured before, 5, 10, 15, 30, 60 and 90 min after esmolol administration, and 5, 10 and 15 minutes after discontinuation of esmolol. In 8 patients, cardiac output (CO) and mixed venous oxygen tension and saturation were measured before, during and after esmolol use. Results: MBP was decreased from 91+/-12 mmHg to 67+/-7 mmHg after 15 min (P<0.05). HR(BPM) was decreased from 76+/-17 to about 60 after 15 min (P<0.05). CO was decreased about 30% during induced hypotension but recoverd to initial level 15 min after esmolol discontinuation. While oxygen transport was reduced significantly during induced hypotension (P<0.05), oxygen consumption was maintained all the time. Conclusion: With the use of esmolol, stable hypotension could be achieved. Although oxygen transport decreased possibly due to reduction of CO, but oxygen consumption was maintained.
Adult ; Blood Pressure ; Cardiac Output ; Diagnosis ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Hypotension, Controlled ; Nitroprusside ; Oxygen ; Oxygen Consumption ; Scoliosis ; Spinal Stenosis

BACKGROUND: The purpose of this study was to measure and compare the optimum depth of the internal jugular venous catheterization between the right and left side. METHODS: Forty-four patients were enrolled for this study and divided into two groups (22 patients each). The optimum depth of the catheterization was calculated using the sum of two component (A and B); the advanced length of the catheter from the level of the cricoid cartilage (A) and the distance from the catheter tip to the junction of the superier vena cava and right atrium (B). RESULT: The optimum depths of the internal jugular venous catheterization were 16.0 1.0 cm (right) and 18.4 1.5 cm (left) respectively. Left side was significantly longer than right side (p<0.05). In this study, we experienced some complications; arterial punctures (5 cases) and migration of the catheter to the opposite subclavian vein (1 case). Five complications were associated with left internal jugular venous cannulation and one was associated with the right side cannulation. CONCLUSION: We concluded that the optimum depth of the internal jugular venous catheterization was longer in the left side than in the right side.
Catheterization* ; Catheters* ; Cricoid Cartilage ; Heart Atria ; Humans ; Punctures ; Subclavian Vein

Gangiogliomas are rare tumors, primarily seen in patients under the age of 30 years. They occure least commonly in the spinal cord. We present a 17-year-old girl who harbored an intramedullary conus ganglioglioma.
Adolescent ; Conus Snail* ; Female ; Ganglioglioma* ; Humans ; Spinal Cord

No abstract available.
Typhlitis*

Mesoblastic nephroma is an uncommon congenital tumor of infancy that rarely occurs in adults. We report an adult case of mesoblastic nephroma. A 38- year-old man was incidentally found to have a right renal mass by abdominal ultrasonography. Computerized tomography revealed a relatively homogeneous tumor with hypervascularity. Radical nephrectomy was performed. The tumor was an encapsulated whitish- yellow and myxoid solid mass. Microscopically, the tumor was composed of spindle cell proliferation. Atypia and mitosis were not identified. Among the tumor cells, there were tubular arranged epithelial components. Mesoblatic nephroma is benign, so that survival following nephrectomy alone is excellent but local recurrence and metastases have been reported. Regular postoperative follow-up is mandatory.
Adult ; Cell Proliferation ; Follow-Up Studies ; Humans ; Mitosis ; Neoplasm Metastasis ; Nephrectomy ; Nephroma, Mesoblastic* ; Recurrence ; Ultrasonography

One of the most common mechanisms of failure of epidural anesthesia is the misplacement of a catheter. We present two cases of transforaminal escape of catheter which occurred accidentally during lumbar epidural anesthesia. Epidural catheter was inserted to a depth of 4.5 cm and 3.5 cm respectively, then 2% lidocaine 25 ml were injected slowly into the catheter. No analgesia was found except anterior knee area, so Iohexol dye was injected through the catheter for X-ray determination. The epidurogram showed the catheter, which passed through the intervertebral foramen, was to lie outside the epidural space in the paravertebral tissue. Because of the random direction and migration of epidural catheter, we suggest an epidural catheter should be inserted 3cm into the epidural space. Epidurogram with a small dose of contrast material is advisable in the cases of unsatisfactory effect of epidural block, or when some adverse reactions are noted after block.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Catheters* ; Epidural Space ; Iohexol ; Knee ; Lidocaine ; United Nations*

To evaluate the clinical utility of Tc-99m MIBI scan in the detection of residual thyroid tissue or metastatic lesion in postoperative thyroid cancer patients, we compared Tc-99m MIBI scan with I-131 diagnostic and therapeutic scan in 30 postoperative well-differentiated thyroid cancer patients. Thyroglobulin levels of both on and off thyroid hormone medication and antithyroglobulin antibody were tested [Tg(on), Tg(off)l Positive rates for I-131 diagnostic and Tc-99m MIBI scan were 81% and 68% respectively. Concordance between I-131 diagnostic and Tc-99m MIBI scan was observed in 15 cases; 12 positive and 3 negative respectively Among the 6 cases with negative I-131 diagnostic scan and positive Tc-99m MIBI scan, 4 were positive in the therapeutic I-131 scan. We concluded that Tc-99m MIBI scan maybe a useful complementary modality to the currently established method of I131 scan and serum thyroglobulin level in the detection of recurrent or metastatic thyroid cancer, especially in the case of negative I-131 diagnostic scan.
Follow-Up Studies* ; Humans ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

Fungal peritonitis is a serious complication of continuous ambulatory peritoneal dialysis (CAPD). It has been reported with increasing frequency and has been estimated that 1- 10% of peritonitis associated with CAPD is reported to be caused by the fungus. Most cases of fungal peritonitis involve candida species, however, other oppotunistic pathogens including encapsulated yeast named Rhodotorula species have been reported. Reports of infection due to Rhodotorula species, rarely being a pathogenic organism. include septicemia, endocarditis, meningitis, ventriculitis and peritonitis. We report a case of serious fungal peritonitis caused by Rhodotorula mucilaginosa in a neonate with history of neonatal asphyxia undergoing CAPD.
Acute Kidney Injury* ; Asphyxia ; Candida ; Endocarditis ; Fungi ; Humans ; Infant, Newborn* ; Meningitis ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Rhodotorula* ; Sepsis ; Yeasts