Atypical fibroxanthoma(AFX) occurs most on sun-exposed area of the head and neck of elderly person. It has an excellent prognosis after conservative, but complete, excision. However, because of its potential, albeit small, for metastasis, it is widely regarded as a low-grade sarcoma. We present herein two cases of atypical fibroxanthoma. The case 1 was a 86-year-old female who had a small egg-sized, dome shaped nodule with eroive surface on the left cheek. The other case was a 60-year-old male who had solitry bean-sized, nodulo-ulcerative lesion on the vertex. Immunohistochemical studies revealed positive reaction for vimntin and a-antichymo trypsin. These patients have received completely total surgical ecis on and remained free of recurrence for a period of about, 2 years follow up.
Aged ; Aged, 80 and over ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Sarcoma ; Skin* ; Trypsin

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.

Heel cord advancement(HCA), which has been applied for the correction of equinus deformity in spastic cerebral palsy, has some theoretical advantages. However, HCA has also theoretical disadvantage that the procedure remove the tensile force exerting to the calcaneal apophysis. In order to evaluate the effect of HCA on the calcaneal growth, we compared the changes of calcaneal and foot lengths between the operated feet and non-operated feet after HCA. Among the 54 patients who had been treated with HCA at Seoul National University Childrens Hospital from March 1990 to August 1995, we excluded the cases who had been treated bilaterally, and also excluded hemiplegic patients in whom the ipsilateral feet were already shortened and the growth rates are different between the ipsilateral and contralateral foot. Seven patients who met the criterior of this study were included for the evaluation. There were 3 diplegics and 4 paraplegics, and average age at operation was 10 years and 6 months(range; 7 year 8 months-16 year 5 months). Average follow-up period was 3 years and 5 months(range; 2 years-4 years 9 mos). Total calcaneal lengths, anterior and posterior part of calcaneal lengths were measured on the standing lateral radiographs of the foot and ankle. Ratios of the operated limb over the non-operated limb were calculated for the three parameters. Ratios of posterior part of calcaneal lengths decreased significantly(P=0.031). Ratios of total calcaneal lengths decreased and ratios of anterior part of calcaneal lengths increased. However, the changes of two ratios were not significant. Ratios of posterior part calcaeal lengths over total calcaneal length decreases significantly(P=0.016). In conclusion, HCA can cause calcaneal growth retardation, especially posterior part of calcaneus, due to removal of physiologic tensile force of Achilles tendon.
Achilles Tendon ; Ankle ; Calcaneus ; Cerebral Palsy* ; Child ; Equinus Deformity ; Extremities ; Follow-Up Studies ; Foot ; Heel* ; Humans ; Muscle Spasticity* ; Seoul

Here we report an autopsy case of diabetic ketoacidosis (DKA) with severe hypertriglyceridemia (12,900 mg/dl). A 29-year-old woman with a history of type 1 diabetes was found dead at a motel. There was no injury on external inspection, but a lump of cheese-like material was noted in the heart at autopsy and peripheral blood plasma had a creamy appearance. After postmortem biochemical analysis, we made a diagnosis of DKA with severe hypertriglyceridemia and concluded that these unusual autopsy findings were caused by DKA and postmortem change. Uncontrolled diabetes often causes DKA and hypertriglyceridemia. To the best of our knowledge, this is the first report in Korea of DKA with severe hypertriglyceridemia diagnosed by autopsy.
Adult ; Autopsy* ; Diabetic Ketoacidosis* ; Diagnosis ; Female ; Heart* ; Humans ; Hypertriglyceridemia* ; Korea ; Plasma ; Postmortem Changes

BACKGROUND/AIMS: Benzodiazepine is generally used when sedation is required for endoscopy, while propofol, a phenol-derived intravenous anesthetic agent, appears to have a more suitable phamacokinetic profile. The aim of this study was to evaluate the effectiveness and safety of propofol as premedication for upper gastrointestinal endoscopy. METHODS: Between July 1998 and October 1998, 44 male patients and 70 female patients were involved in this study. The relative ease of upper gastrointestinal endoscopy, patient's tolerance, and amnestic effects on 64 patients with propofol was compared with 50 patients with non-sedation. Pulse rate and arterial oxygen saturation was monitored. The endoscopist and patients replied to a questionnaire. RESULTS: Patients receiving propofol tolerated endoscopy much more than patients with non-sedation (p<0.01). The change in pulse rate was less variable but arterial oxygen saturation showed a statistically significant decrease in patients receiving propofol (p<0.01). Propofol induced complete amnesia in 93.7% of the patients and partial anesthesia in 4.7%. Most of the patients receiving propofol accepted the same sedative methods in their next endoscopy (p<0.01). CONCLUSIONS: Propofol is highly effective, with a short recovery time and satisfaction of the patients, but careful monitoring is recommended because of its untoward effect of hypoxia. It is recommended that propofol be used as a premedication especially in patients who are apprehensive about a repeated endoscopy.
Amnesia ; Anesthesia ; Anoxia ; Benzodiazepines ; Endoscopy ; Endoscopy, Gastrointestinal* ; Female ; Heart Rate ; Humans ; Male ; Oxygen ; Premedication* ; Propofol* ; Surveys and Questionnaires

Complications of tracheal intubation are well documented. However, iatrogenic aspiration of a broken metallic stylet following tracheal intubation has been infrequently reported. A 60-year-old woman, 10 days after shoulder arthroscopic surgery under endotracheal general anesthesia, was admitted to our hospital because of right chest pain. Chest radiographs showed a 8 cm length of metallic foreign body in the lower lobe of the right lung. Attempts at retrieval, including thoracoscopy, were unsuccessful. Open thoracostomy was performed. The removed foreign body was a part of metallic stylet. We report a case of iatrogenic aspiration of a broken metallic stylet.
Anesthesia, General ; Arthroscopy ; Chest Pain ; Female ; Foreign Bodies ; Humans ; Intubation ; Lung ; Middle Aged ; Radiography, Thoracic ; Shoulder ; Thoracoscopy ; Thoracostomy

To evaluate trends, if any, anesthetic experiences of 10,000 cases in the total performed at the department of Anesthesiology, Han Kang Sung Shim Hospital, Choong Ang University, School of Medicine from Dec. 197I through Nov. 1976 were analyzed statistically according to anesthetic method, age, sex, department, anesthetic agent, anesthetic duration, physical status and cause of death. The results are as follows; 1. About forty-five percent of all surgical patients were emergency cases. 2. The spinal and regional blocks tended to increase compared with inhalation anesthesia. 3. The patients under 1 year and over 60-years of age also tended to increase. 4. In almost all cases, post-operative and post-anesthetic cause of death was due to the severity of preexisting disease itself and overall death rate of surgical patients who received anesthesia was 0.16% 5. Through this statistical study, we can perform anesthesia with more safety and ease, and also eliminate post-operative and post-anesthetic complications, with further study of new agents and techniques.
Anesthesia ; Anesthesia, Inhalation ; Anesthesiology ; Cause of Death ; Emergencies ; Humans ; Methods ; Mortality ; Preexisting Condition Coverage ; Statistics as Topic

No abstract available.
Fistula*