This study was undertaken to compare the effects of furosemide on the serum concentration of sodium and osmolality after transurethral prostatic resection(TURP) using cytal solution, and to determine the adequate time of administration of frurosemide. At the end of prostatic resection, 15 patients were allocated randomly to receive furosemide (furosemide group) and were compared with 15 patients without administration of furosemide (control group). There was no difference in mean serum concentation of sodium between two groups. Serum osmolality in furosemide group was significantly increased as compared with control group one hour after operation. So cytal solution used during staged TURP and short operation within one hour do not affect serum corcentration of sodium and administration of furosemide is not associated with a change in serum concentration of sodium. But furosemide meaningfully increases the serum osmolality and it is more effective to administer it with administration at the end of prostatic reseetion.
Furosemide* ; Humans ; Hyponatremia ; Osmolar Concentration* ; Sodium* ; Transurethral Resection of Prostate*

Thirteen patients with visceroatrial situs abnormalities were evaluated by magnetic resonance(MR) imaging. Eleven patients were confirmed surgically. Two patitnts were diagnosed by MRI and cardiac catheterization. Right isomerism was found in seven patients, left isomerism in two, and situs inversus in four. For the determination of situs, we evaluated the morphology of atrial appendages and main bronchi, the relationship between abdominal aorta and inferior vena cava(IVC), and the status of upper abdominal viscera. The bilateral atrial morphology was differentiated in 8 of 12 patients. The bronchial situs was determined in 11 of 12 patients. Juxtaposition of abdominal aorta and IVC was found in 6 of 7 with right isomerism. IVC interruption with azygos continuation was found in all two with left isomerism. Incidentally three cases of short pancreas were found. MR imaging showed all structures relevant for the assessment of situs, thus obvrating the need for performing additional diagnostic procedures. MR imaging, therefore, is a valuable tool in the clinical management of patients who are suspected of having a situs abnormality.
Aorta, Abdominal ; Atrial Appendage ; Bronchi ; Cardiac Catheterization ; Cardiac Catheters ; Humans ; Isomerism ; Magnetic Resonance Imaging ; Pancreas ; Situs Inversus ; Viscera

Ascites is a rare complication of multiple myeloma. When it develops, it is usually associated with extensive liver infiltration with plasma cells, infectious peritonitis or myelomatous peritoneal infiltration. Ascites caused by peritoneal infiltration is even less frequent than others. The majority of previously reported cases were characterized by an IgA paraprotein and lack of skeletal lesions. This rare extramedullary complication of myeloma has been unresponsive to therapy and rapidly fatal. Therefore, it is important to recognize myeloma as a cause of ascites and the presence of ascites heralds a poor prognosis of myeloma. We recently experienced a case of myeloma with ascites and reviewed the relevant literature of human myeloma presenting with the triad of ascites, relative or absolute sparing of the skeleton, and an IgA paraprotein. A 76-year-old man was presented with ascites early in the course of myeloma. He had no evidence of intra-abdominal plasmacytoma and skeletal lesions. Myelomatous ascites was demonstrated by the monoclonal immunoglobulin of IgA type in ascitic fluid. He was treated by plasmapheresis due to hyperviscosity syndrome and VAD combination chemotherapy. He was discharged with the improved clinical condition.
Aged ; Ascites* ; Ascitic Fluid ; Drug Therapy, Combination ; Humans ; Immunoglobulin A ; Immunoglobulins ; Liver ; Multiple Myeloma* ; Paraproteins ; Peritonitis ; Plasma Cells ; Plasmacytoma ; Plasmapheresis ; Prognosis ; Skeleton

Intracranial germinomas are malignant neoplasms arising from remnants of primitive germ cells that have failed to migrate to the genital crest during embryonic life. They are usually solid tumors, but focal cysts may occasionally be found within them and are thought to represent proteinaceous fluid. Cystic degeneration of the whole tumor, however, that is caused by intratumoral hemorrhage, has not yet been reported. We present a case of cystic degeneration of solid suprasellar germinoma. During surgery, cyst content was shown to be liquefied hematoma, and bleeding of the tumor had occurred. The exact time of intratumoral hemorrhage in the presented case is unknown, but since there had been no episode of apoplexy, we believe that degeneration occurred chronically. The patient's postoperative course was uneventful. On the basis of our findings we suggest that in diagnosing suprasellar cystic tumors, the possibility of germinomas must be taken into consideration and that spontaneous cystic degeneration of suprasellar germinoma can occur as a result of tumor bleeding.
Central Nervous System Cysts ; Germ Cells ; Germinoma* ; Hematoma ; Hemorrhage ; Stroke

BACKGROUND AND OBJECTIVES: Various surgical approaches have been employed to treat fractures of the medial orbital wall. Among them, the transnasal endoscopic approach provides the chance to avoid external scars and to observe the fracture site clearly. These approaches mostly require the use of grafts or splints. Authors carried out a retrospective study on the blowout fractures repaired by bulla ethmoidalis osteomucosal flap (BOMF) and compared them with the groups that were treated with silastic sheet only and with Med-pore(R) registered to investigate the merits of BOMF with respect to results and complications. SUBJECTS AND METHOD: We reviewed 62 cases (64 sides) of medial wall fractures that were treated surgically. They were diagnosed with 3 mm facial CT scans and treated according to the authors' indications from February 1998 to March 2004 at Namgwang Hospital, Seonam University. The surgical treatment consisted of the reconstruction of the fractures and the repair of the remaining bone defects by graft and splint, and the type of graft was selected according to the size of the defect. For minor defects, silastic sheet was used alone, whereas major defects were repaired with BOMF or Med-pore(R) registered. All patients were evaluated regularly for at least six months postoperatively. RESULTS: There were no differences in the aspects of the final treatment results of diplopia and enopthalmos. But in the aspects of postoperative crust formation and granulation, the cases that were repaired with BOMF showed better results as well as the economic merits. In the BOMF cases, the average duration of silastic sheet stenting was 12.5 days and it could reduce the follow up period. CONCLUSION: BOMF demonstrated better results in the respects of duration of silastic sheet stenting, postope-rative crust formation, granulation and economic cost.
Cicatrix ; Diplopia ; Follow-Up Studies ; Humans ; Orbit* ; Retrospective Studies ; Splints ; Stents ; Tomography, X-Ray Computed ; Transplants