BACKGROUND: An unexpected difficult intubation can be very challenging and if it is not managed properly, it may expose the encountered patient to significant risks. The intubation difficulty scale (IDS) has been used as a validated method to evaluate a global degree of intubation difficulty. The aims of this study were to evaluate the prevalence and characteristics of unexpected difficult intubation using the IDS. METHODS: We retrospectively reviewed 951 patients undergoing elective surgery in a single medical center. Patients expected to have a difficult intubation or who had history of difficult intubation were excluded. Each patient was assessed by the IDS scoring system with seven variables. Total prevalence of difficult intubation and the contributing individual factors were further analyzed. RESULTS: For the 951 patients, the difficult intubation cases presenting IDS > 5 was 5.8% of total cases (n = 55). The prevalence of Cormack-Lehane Grade 3 or 4 was 16.2% (n = 154). Most of the difficult intubation cases were managed by simple additional maneuvers and techniques such as stylet application, additional lifting force and laryngeal pressure. CONCLUSIONS: Unexpected difficult airway was present in 5.8% of patients and most was managed effectively. Among the components of IDS, the Cormack-Lehane grade was most sensitive for predicting difficult intubation.
Humans ; Intubation* ; Lifting ; Methods ; Prevalence ; Retrospective Studies

Persistent gestational trophoblastic tumor develops in about 15-25% after evacuation of complete mole, and arises in about 4-5% after removal of partial mole. Especially there is reported that choriocarcinoma after evacuation of partial mole is extremely rare, and it is well responded to systemic chemotherapy. We have experienced that a case of choriocarcinoma which was developed after evacuation of partial mole. So we report this case with a brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Female ; Pregnancy ; Trophoblastic Neoplasms

No abstract available.
Death, Sudden, Cardiac

Vascular access thrombosis is one of the major causes of morbidity in patients maintained on chronic hemodialysis. Thrombophilia has been recognized as a risk factor of vascular access thrombosis. The authors report a case of inherited protein S deficiency associated with vascular access thrombotic events. DNA sequence analysis of the PROS1 gene identified a novel heterozygous nonsense mutation in exon 10 by transition of AAG (lysine) to TAG (stop codon) at codon 473 (c.1417A>T, p.K473X). Results from the study suggest that the inherited protein S deficiency due to a PROS1 gene mutation may cause vascular access thrombosis in hemodialysis patients.
Codon ; Codon, Nonsense ; Exons ; Humans ; Protein S ; Protein S Deficiency ; Renal Dialysis ; Risk Factors ; Sequence Analysis, DNA ; Thrombophilia ; Thrombosis

A 50-year-old woman was admitted for the evaluation of proteinuria and renal biopsy. On the basis of the serum monoclonal protein, marrow plasma cell dyscrasia and end organ damage (nephrotic range proteinuria), multiple myeloma was diagnosed. A renal biopsy showed a membranoproliferative glomerulonephritis pattern of injury and unusual organized deposits of striated structure in the subendothelial space, which were identified as non-amyloid non-immunoglobulin-derived deposits. These deposits contained regularly stacked straight electron-dense bands, which have not been described in the setting of paraproteinemia and/or plasma cell dyscrasia.
Biopsy ; Bone Marrow ; Female ; Glomerulonephritis, Membranoproliferative ; Humans ; Middle Aged ; Multiple Myeloma ; Paraproteinemias ; Proteinuria