No abstract available.
Cesarean Section* ; Female ; Pregnancy

Calcific myonecrosis is a rare late post-traumatic condition in which an entire single muscle is replaced by a fusiform mass with central liquefaction and peripheral calcification. The compartmental syndrome is suggested to be the underlying cause. We report a case of 70 year-old man whose right tibialis anterior and extensor hallucis longus muscle were replaced by calcific myonecrosis and treated with en-bloc resection & tendon reconstruction.
Tendons

No abstract available.

No abstract available.
Animals ; Brain* ; Rats*

Aneurysmal subarachnoid hemorrhage in a pregnant woman is a rare catastrophic situation that places both the mother and fetus at high risk. When this situation arises, numerous relevant issues must be individualized in the effort to reduce hazards threatening both the mother and fetus. A 29 year old woman who was 39 weeks pregnant presented with a subarachnoid hemorrhage, secondary to a ruptured left ophthalmic artery aneurysm. Following initial full recovery, the simultaneous sequence of cesarean section followed by aneurysmal clipping was electively underwent. Successful maternal and perinatal outcome was achieved. The anesthetic management of the case is described and discussed.
Adult ; Anesthesia ; Aneurysm* ; Cesarean Section* ; Female ; Fetus ; Humans ; Intracranial Aneurysm* ; Mothers ; Ophthalmic Artery ; Pregnancy ; Pregnant Women ; Subarachnoid Hemorrhage

BACKGROUND: There are few literatures which show the role of tidal volume on the excretion of nitrous oxide(N2O). The purpose of this study is to pharmacokinetically evaluate the effect of varying oxygen inflow rates and tidal volumes on the excretion of N2O. METHODS: Ten patients undergoing general anesthesia on supine position were selected. Administering N2O 3 L/min and oxygen 2 L/min with enflurane, ventilatory pattern was tidal volume 10 mL/kg and respiratory rate 11/min. Administration of N2O was stopped after 30 minutes, when end-tidal N2O concentration(ETN2O) were near 60% at steady state. Oxygen was given at 4 L/min with tidal volume(VT) 8 mL/kg(treatment 1), 4 L/min with VT 16 mL/kg (treatment 2), 8 L/min with VT 8 mL/kg(treatment 3) and 8 L/min with VT 16 mL/kg(treatment 4). ETN2O was measured every 15 seconds for first 3 minutes and every 1 minute thereafter. The order of 4 treatments were determined with bloc randomization. The time interval between treatments was 30 minutes. Pharmacokinetic parameters were obtained using PKCALC data program. RESULTS: Area under curve and clearance in treatments 1 and 2 were significantly larger than those in treatments 3 and 4. Mean residence time and half-life in treatment 4 were significantly shorter than those in other treatments. CONCLUSIONS: The oxygen inflow rate enhances the excretion of N2O more than the tidal volume does, and the tidal volume does so when the oxygen inflow rate is 8 L/min.
Anesthesia, General ; Anesthetics ; Area Under Curve ; Enflurane ; Half-Life ; Humans ; Nitrous Oxide* ; Oxygen* ; Random Allocation ; Respiratory Rate ; Supine Position ; Tidal Volume*

PURPOSE: To describe the two-phase spiral CT findings of acute cholecystitis. MATERIALS AND METHODS: CTscans of nine patients with surgically-proven acute cholecystitis were retrospectively reviewed for wallthickening, enhancement pattern of the wall, attenuation of the liver adjacent to the gallbladder, gallstones,gallbladder distention, gas collection within the gallbladder, pericholecystic fluid and infiltration ofpericholecystic fat. RESULT: In all cases, wall thickening of the gallbladder was seen, though this was moredistinct on delayed images, Using high-low-high attenuation, one layer was seen in five cases, nd three layers infour. On arterial images, eight cases showed transient focal increased attenuation of the liver adjacent to thegall bladder;four of these showed curvilinear attenuation and four showed subsegmental attenuation. One caseshowed curvilinear decreased attenuation between increased attenuation of the liver and the gallbladder, andduring surgery, severe adhesion between the liver and gallbladder was confirmed. Additional CT findings wereinfiltration of pericholecystic fat (n=9), gallstones (n=7), gallbladder distension (n=6), pericholecystic fluid(n=3), and gas collection within the gallbladder (n=2). CONCLUSION: In patients with acute cholecystisis,two-phase spiral CT revealed wall thickening in one or three layers ; on delayed images this was more distint. Inmany cases, arterial images showed transient focal increased attenuation of the liver adjacent to the gallbladder.
Cholecystitis, Acute* ; Gallbladder ; Gallstones ; Humans ; Liver ; Retrospective Studies ; Tomography, Spiral Computed*

Fibroadenoma is a rare lesion of the vulva. It has been proposed that the origin of the tissue is either ectopic breast tissue or vulvar mammary-like glands (MLG). We report a case of vulvar fibroadenoma in a 33-year-old woman with a right vulvar mass presenting clinically as vulvar cyst. The cut surface of the tumor showed a white and homogenous appearance that was 2.5 cm in maximum dimension. Microscopically, the lesion was well-circumscribed but non-encapsulated. It revealed nodular, glandular and stromal proliferation, consistent with fibroadenoma of breast. Immunohistochemical staining for the estrogen receptor and progesteron receptor revealed nuclear positivity in the epithelium. Smooth muscle actin confirmed the presence of a myoepithelial cell layer. Staining for pancytokeratin showed epithelial cytoplasmic positivity.
Actins ; Adult ; Breast ; Cytoplasm ; Epithelium ; Estrogens ; Female ; Fibroadenoma* ; Humans ; Muscle, Smooth ; Vulva*

BACKGROUND AND OBJECTIVES: A number of studies have documented that the incidence of otitis media with effusion (OME) is greater than 90% in children with cleft palates. The purpose of this study was to evaluate the correlation of OME and mastoid pneumatization in children with cleft palate. SUBJECTS AND METHOD: We studied 175 ears in 95 patients. They were categorized into three groups according to otologic finding:normal children (38 ears), children with OME (89 ears), children with cleft palates (38 ears). The mastoid pnuematization was graded into 5 groups. RESULTS: The masoid pneumatization was relatively good in 76.3% of normal children. The mastoid pneumatization was poor in 40.4% of the children with OME. All children with cleft palate had OME in both ears and their mastoid pneumatizations were very poor, with 16.7% of grade IV and 83.3% of grade V. CONCLUSION: The mastoid pneumatization of children with cleft palate was very poor compared to those without cleft palate. We believe that mastoid pneumatization was influenced by the disease of middle ear and mastoid, environmental factors. Special consideration is needed to deal with otologic problems in children with cleft palate.
Child* ; Cleft Palate* ; Ear ; Ear, Middle ; Humans ; Incidence ; Mastoid ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Temporal Bone*

We report on a case of a 57-year-old male who underwent a curative resection for hepatocellular carcinoma (HCC) with histological confirmation of a spontaneously necrotized tumor. Initial serum AFP level was 4,778 ng/mL. A 3.7 cm hyperechoic mass in segment 6 of the liver was observed on ultrasonography and dynamic contrast-enhanced liver MRI showed a 3.7x3.1 cm sized HCC. He was scheduled to undergo curative surgical resection under the clinical diagnosis of an early stage HCC (Barcelona Clinic Liver Cancer stage A). Without treatment, the serum AFP level declined rapidly to 50 ng/mL over five weeks. He underwent curative wedge resection of segment 6 of the liver. Histology revealed complete necrosis of the mass rimmed by inflamed fibrous capsule on a background of HBV-related cirrhosis with infiltration of lymphoplasma cells. Exact pathophysiology underlying this event is unknown. Among the proposed mechanisms of spontaneous neoplastic remission of HCC, circulatory disturbance and activation of host immune response offer the most scientific explanation for the complete histologic necrosis of HCC in the resected mass seen in our patient.
Carcinoma, Hepatocellular/*diagnosis/diagnostic imaging/pathology ; Hepatitis B/complications/diagnosis ; Humans ; Liver/diagnostic imaging/pathology ; Liver Cirrhosis/etiology ; Liver Neoplasms/*diagnosis/diagnostic imaging/pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Necrosis ; Radiography ; Remission, Spontaneous ; Ultrasonography ; alpha-Fetoproteins/analysis