No abstract available.

A 49 year-old male was scheduled for a cholecystectomy, thereafter a 37 year-old female scheduled for removal of a epidural hematoma in the same operating room. Both of them had no specific medical problems and past medical histories for anesthesia. For those reasons, anesthesia was induced with thiopental sodium and succinylcholine with endotracheal intubation. After induction, vital signs including body temperatures were stable. But moisture dew in the unidirectional valves and corrugated tubes, and color changes of soda lime were discovered. At that time, severe hypercarbia was recognized by arterial blood gas analysis in both cases. In both cases, there were no malfunctions in unidirectional valves, expiratory valves, corrugation tubes, soda lime, ventilators and there connection parts in the anesthetic machines. Also there were no abnormalities of blood pressures, electrocardiograms, pulse oxymeters, temperatures and the pulse in the patient monitoring systems except capnography. At first, we thought that medical signs revealed malignant hyperthermias. But vital signs, air way pressures and functions of all kinds of anesthetic machine components including ventilators were normal. After discontinuing N2O gas deliveries in the operation room, hypercarbias disappeared. Thus, anesthetic gas delivery systems via central piping systems were checked and it was discovered that CO2 gas was in the N2O gas tank instead of N2O.
Adult ; Anesthesia ; Blood Gas Analysis ; Body Temperature ; Capnography ; Carbon Dioxide* ; Carbon* ; Cholecystectomy ; Electrocardiography ; Female ; Hematoma ; Humans ; Intubation, Intratracheal ; Male ; Malignant Hyperthermia ; Middle Aged ; Monitoring, Physiologic ; Nitrous Oxide* ; Operating Rooms ; Succinylcholine ; Thiopental ; Ventilators, Mechanical ; Vital Signs

Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techniques. The basic disciplines of approaching skull base lesions are provide direct vision, minimizing brain retraction, excellent exposure and minimal blood loss. The focus of this report is to review the advantages of skull base approach in our cases and suggest some indications. We experienced 20 cases of skull base surgery by a team approach consisting of a neurosurgeon and plastic surgeon. The surgical approach were supraorbital osteotomy(5 case), orbitozygomatic osteotomy(8 case), orbitozygomaticoglenoid osteotomy (5 case ) and orbitozygomaticoglenoidocondylar osteotomy (2 case). In our experience, these approaches provided excellent exposure of the lesion, direct access to lesions and minimal brain retraction thereby better outcome.
Brain ; Osteotomy ; Skull Base* ; Skull* ; Surgery, Plastic*

No abstract available.
Frontal Sinus*

19 cases of non-pineal intracranial germ cell tumors were reviewed retrospectively with both radiologic andclinical featurses. The results were as follows: 1. The age distribution was 8 to 32 year old (16 year old of meanage) and the sex distribution shows male predominence(15:4). 2. The histopathologic diagnosis included 11 cases ofgeminoma, 2 cases of mixed germ cell tumor, 1 case of embryonal cell carcinoma and 5 cases of unknown. 3. Thelocation of tumors was the suprasellar region in 8 cases, the left basal ganglia and thalamus in 5 cases, and theright frontal lobe in 1 case. Among 11 cases of geminoma, 6 cases involve the suprasellar region and 3 cases theleft basal ganglia and thalamus. 4. In clinical features, there were visual disturbance, diabetes insipidus,increased ICP signs, motor weakness, hormonal disorders, and personal changes in order. 5. In tumor marker studyof 6 cases of geminoma, 5 cases show increase in HCG, titie, but all 6 cases were normal in AFP titer. 6. In brainCT, most of all revealed well-defined homogeneous high density with or without small central low density andhomogenous enhancement at solid portion,and there was calcification in only case with mixed germ cell tumor.
Age Distribution ; Basal Ganglia ; Brain ; Diagnosis ; Frontal Lobe ; Germ Cells ; Humans ; Male ; Neoplasms, Germ Cell and Embryonal ; Retrospective Studies ; Sex Distribution ; Thalamus

No abstract available.
Child* ; Humans ; Infant*

No abstract available.
Ethics, Medical ; Health Communication/ethics ; Humans ; Mass Media/*ethics ; Physicians/*ethics ; Republic of Korea ; Social Support ; Societies, Medical/ethics

Liposarcoma is one of the most common soft tissue sarcomas in adults and its incidence rate is above 10% of all soft tissue sarcoma. The two common sites of liposarcoma are the extremities, particularly the thigh, and the retroperitoneum, but it developes rarely in spermatic cord, testis, chest wall and breast, mediastinum, omentum and mesentery. Primary solid tumors of omentum are exceedingly rare. Most of them are of mesenchymal origin and about one-half of them are malignant. Primary liposarcoma occurring in the omentum has been reported rarely, and especially round cell type liposarcoma, one of the histologic subtype of liposarcoma, has been known to be extremely rare. Recently, we experienced a patient with round cell liposarcoma arising primarily in the omentum. Herein, we report the clinical case with a consideration of the cytopathologic and ultrastructural features and a review of the literature.
Adult ; Breast ; Extremities ; Humans ; Incidence ; Liposarcoma* ; Mediastinum ; Mesentery ; Omentum* ; Sarcoma ; Spermatic Cord ; Testis ; Thigh ; Thoracic Wall

OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. RESULTS: All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. CONCLUSION: Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.
Biliary Atresia ; Child ; Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage* ; Humans ; Liver Transplantation ; Male ; Methods ; Mortality ; Portal Vein* ; Recurrence ; Stents* ; Treatment Outcome ; Varicose Veins*

Disseminated mucormycosis is a rare fungal infectious disease with a high mortality rate and is infrequently diagnosed ante mortem. It is most frequently seen in immunocompromised hosts such as diabetes mellitus, hematologic malignancies, or in the long-term use of steroids or chemotherapeutic agents. Tissue invasion by the hyphae of mucormycosis must be seen microscopically to establish the diagnosis. Treatment consists of correction of the predisposing condition, surgical debridement, and amphotericin-B therapy. A 35-year-old man was admitted through the emergency room due to fever and the right flank pain. He had received an allogenic bone marrow transplantation eight months ago and had been medicated with prednisolone and cyclosporine since the procedure. He was diagnosed with disseminated mucormycosis that involved the spleen, right kidney, and right lung. He is being successfully treated with amphotericin B, flucytosine, and liposomal amphotericin B.
Adult ; Amphotericin B ; Ants ; Bone Marrow Transplantation* ; Bone Marrow* ; Communicable Diseases ; Cyclosporine ; Debridement ; Diabetes Mellitus ; Diagnosis ; Emergency Service, Hospital ; Fever ; Flank Pain ; Flucytosine ; Hematologic Neoplasms ; Humans ; Hyphae ; Immunocompromised Host ; Kidney ; Lung ; Mortality ; Mucormycosis* ; Prednisolone ; Spleen ; Steroids