No abstract available.
Facial Paralysis* ; Humans

A series of 58 verified various sellar and parasellar lesions exclusive of aneurysms and inflammatory lesions was reviewed as to history, development and progression of the neurological features, spontaneous and steroid induced remission, endocrine disturbances, other laboratory findings, reontgenograms, differential diagnosis, operative methods and findings, and pathologic findings of the lesion. The author has only emphasized some interesting points illustrated in our cases because other results do not differ greatly from previous authors' reports. 1. No direct correlation was found to exist between the amount of the sellar destruction and the occurrence of endocrine disturbances. However, it was likely that marked endocrine changes were due to cystic formation in pituitary adenomas. 2. On angiograms of sellar and parasellar lesions, opening of the siphon and lateral displacement of the supraclinoid portion of the internal carotid artery were important in the diagnosis, and the event of nonvisualization of the posterior communicating and posterior cerebral arteries was observed in the majority of pituitary tumors. 3. In pituitary cystic adenomas, intracapsular bleeding was very hard to control on occasions because of rupturing vascular network or trabeculae in the cyst. 4. Definition of the empty sella was always obscure in intracranial exploration under the diagnosis of pituitary tumor when no definite lesion was found. 5. In a hydrocephalic patient with raised intracranial pressure and a markedly enlarged third ventricle extending into the sella turcica, third ventriculostomy still seems to be the choice of treatment.
Adenoma ; Aneurysm ; Carotid Artery, Internal ; Diagnosis ; Diagnosis, Differential ; Hemorrhage ; Humans ; Intracranial Pressure ; Pituitary Neoplasms ; Posterior Cerebral Artery ; Sella Turcica ; Third Ventricle ; Ventriculostomy

We report two cases of post-extubation negative pressure pulmonary edema in otherwise healthy patients. The patients underwent laparoscopic appendectomy under general anesthesia and developed negative pressure pulmonary edema immediately after extubation. All cases fully resolved within 24 hours with supplementary oxygen. The literature suggests that post-extubation pulmonary edema occurs more frequently than is generally thought, with a frequency of 0.05-0.1% in all anesthesia, and is often unrecognized or misdiagnosed. Most cases occur in the early post-operative period, and this is potentially life-threatening condition. Therefore, anesthesiologist and surgeon are well placed to witness, investigate and manage this condition.
Anesthesia ; Anesthesia, General ; Appendectomy ; Humans ; Oxygen ; Pulmonary Edema ; Wit and Humor as Topic

Intra-epidermal epithelioma is a rare cutaneous neoplasm and generally used as a histologic description for superficial tumors in which nests are found in well-defined islands within the epidermis. The intra-epidermal nests are composed of keratinocytes, and basaloid or squamoid or pleomorphic cells. Some authors reported that this tumor may be considered an invasion of the epidermis from a malignant tumor and it has the potential of carcinomatous invasion. Herein, we report a case of intra-epidermal epithelioma that showed clonal seborrheic keratosis and intra-epidermal eccrine poroma differentiation on the right thigh areaof a 77-year-old female. Although intra-epidermal epithelioma shows benign features, it may be predisposed to other tumoral changes, such as eccrine poroma, eccrine porocarcinoma, and Bowen's disease. We suggest that individuals with intra-epidermal epithelioma require continuous monitoring of skin changes, including enlargement of size, inflammation, ulceration, and hemorrhages.
Aged ; Bowen's Disease ; Carcinoma ; Eccrine Porocarcinoma ; Epidermis ; Female ; Hemorrhage ; Humans ; Inflammation ; Islands ; Keratinocytes ; Keratosis, Seborrheic ; Poroma ; Skin ; Thigh ; Ulcer

No abstract available.
Biopsy, Fine-Needle*

Neurilemmoma is the most frequent solitary tumor of the peripheral nerves. It is a tumor from Schwann cells, and it is usually solitary and benign. Treatment of this benign lesion is usually by excisional biopsy. This report concerns a rare case of neurilemmoma developed in the penis in a 51 years old male and the relevant literature has been reviewed.
Biopsy ; Humans ; Male ; Middle Aged ; Neurilemmoma* ; Penis* ; Peripheral Nerves ; Schwann Cells

Erlotinib (Tarceva(R)) is a new anti-cancer agent that acts by inhibiting epidermal growth factor receptor (EGFR) signal transduction. It is currently used in the treatment of advanced stage non-small cell lung cancer and pancreatic cancer. A patient consulted our clinic and she had erythematous patches and vesicles on the submandibular area. She had taken erlotinib for the treatment of recurred lung cancer for 2 weeks. We report here on a case of radiation recall dermatitis that was induced by erlotinib in a 69-year-old woman who was previously irradiated on her submandibular area.
Aged ; Carcinoma, Non-Small-Cell Lung ; Female ; Humans ; Lung Neoplasms ; Pancreatic Neoplasms ; Quinazolines ; Radiodermatitis ; Receptor, Epidermal Growth Factor ; Signal Transduction ; Erlotinib Hydrochloride

The Marcus ankle arthrodesis was carried out in 16 patients at department of orthopaedic surgery of Korea Veterans Hospital from January 1989 to December 1993. All of patients were reviewed and evaluated with subjective and functional rating scales according to the Mazur scoring system. The average follow up was 23 months, ranging from 12 months to 60 months. The Marcus ankle arthrodesis involves a chevron osteotomy, tibial onlay graft medially, internal fixation with staples and screws. According to the Mazur score, the results were 6 cases of Excellent, 7 cases of Good. The average Mazur score was 75.1. There were 4 cases of complication, a non-union, a superficial wound infection, a bursitis, and a tendon injury. In summary the Marcus ankle arthrodesis by chevron osteotomy seems to be a good procedure, which gives solid bony union with short duration, relief of pain, normal looking ankle configuration without leg length discrepancy and good function with few complications.
Ankle ; Arthrodesis ; Bursitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Inlays ; Korea ; Leg ; Osteotomy ; Tendon Injuries ; Transplants ; Weights and Measures ; Wound Infection

OBJECTIVE: We investigated the association between lactate clearance or serum lactate levels and neurologic outcomes or in-hospital mortality in cardiac arrest survivors who were treated with targeted temperature management (TTM). METHODS: A retrospective analysis of data from cardiac arrest survivors treated with TTM between 2012 and 2015 was conducted. Serum lactate levels were measured on admission and at 12, 24, and 48 hours following admission. Lactate clearance at 12, 24, and 48 hours was also calculated. The primary outcome was neurologic outcome at discharge. The secondary outcome was in-hospital mortality. RESULTS: The study included 282 patients; 184 (65.2%) were discharged with a poor neurologic outcome, and 62 (22.0%) died. Higher serum lactate levels at 12 hours (odds ratio [OR], 1.157; 95% confidence interval [CI], 1.006 to 1.331), 24 hours (OR, 1.320; 95% CI, 1.084 to 1.607), and 48 hours (OR, 2.474; 95% CI, 1.459 to 4.195) after admission were associated with a poor neurologic outcome. Furthermore, a higher serum lactate level at 48 hours (OR, 1.459; 95% CI, 1.181 to 1.803) following admission was associated with in-hospital mortality. Lactate clearance was not associated with neurologic outcome or in-hospital mortality at any time point after adjusting for confounders. CONCLUSION: Increased serum lactate levels after admission are associated with a poor neurologic outcome at discharge and in-hospital mortality in cardiac arrest survivors treated with TTM. Conversely, lactate clearance is not a robust surrogate marker of neurologic outcome or in-hospital mortality.
Biomarkers ; Heart Arrest* ; Hospital Mortality ; Humans ; Hypothermia, Induced ; Lactic Acid* ; Prognosis ; Retrospective Studies ; Survivors*

We have seen a primitive glioma which can be regarded as ependymoblastoma arising at the left frontal lobe of four-year-old boy. He has complained of excitement, hyperesthesia, mild incomplete paralysis of the left lower extremity for 1 1/2 months, and also incontinence of urine and stool was complained. The signs of increased intracranial pressure such as papilledema and separation of suture line were noted. Brain scanning showed tumor mass at the left frontal lobe, and which was revealed to be vascular tumor on carotid angiogram and delta wave was found at those area by electroencephalogram. Operative findings were that the tumor was hemorrhagic vascular mass showing partly cystic and necrotic in appearance, not bulged above outer surface and not connected with ventricle. The tumor mass measured 6x5x4cm which cut surface was pinkish white and focal necrotic areas were also seen. On microscopic examination the tumor was composed of relatively uniform primitive glial cells and the tumor cells arranged in perivascular area forming multiple layers while other region showed well formed tubules. Fibrillated cytoplasmic process between central vessel and glial cells that could be seen in matured ependymoma was not identified.
Brain ; Cytoplasm ; Electroencephalography ; Ependymoma ; Frontal Lobe ; Glioma ; Humans ; Hyperesthesia ; Intracranial Pressure ; Lower Extremity ; Male ; Neuroectodermal Tumors, Primitive* ; Neuroglia ; Papilledema ; Paralysis ; Sutures