No abstract available.
Adrenocorticotropic Hormone* ; Humans ; Infant ; Infant, Newborn ; Spasms, Infantile*

Uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are very rare tumors that occur mainly in the uterine fundus of women in reproductive age. These tumors can be classified into group 1 and group 2 by histological results. In group 1, epithelial-like differentiation is partially observed in the tumors. In group 2, sex-cord elements are predominant in uterine mural mass. We experienced UTROSCT group 1 in a 29-year-old woman who complained of severe abdominal pain that started one week after delivery and UTROSCT group 2 case in a 49-year-old woman who complained of dysfunctional uterine bleeding. We report two different types of UTROSCT cases that we experienced.
Abdominal Pain ; Adult ; Female ; Humans ; Metrorrhagia ; Middle Aged ; Sex Cord-Gonadal Stromal Tumors ; Uterine Diseases ; Uterine Neoplasms

Purpose: We explored the relationship between dry eye syndrome (DES) and parity in women over 20 years of age. Methods: We retrieved data from the Fifth Korean National Health and Nutrition Examination Survey. Of women over 20 years of age, 7,573 diagnosed with DES by ophthalmologists and 7,347 who self-diagnosed DES were included. We used logistic regression to explore the relationship between DES prevalence and parity, and the chi-squared test to compare differences in DES prevalence by someo children. Results: On univariate logistic regression, the DES incidence was significantly affected by residential status, educational level, hours of sleep, and hyperlipidemia, osteoarthritis, thyroid disorder, and menopause status. We subjected these parameters (and age) to multivariate logistic regression. We found no significant relationship between the doctor-diagnosed DES rate and the number of children. Subjectively, the number of children significantly reduced the prevalence of self-diagnosed DES but not that diagnosed by ophthalmologists. The self-diagnosed DES prevalence was significantly lower in women with than without children. Conclusions The KNHANES-V data showed that the prevalence of self-diagnosed DES decreased with the number of children in women aged over 20 years. The prevalence of self-diagnosed DES in women with children was significantly less than that in women without children. However, we found no significant correlation between the number of children and DES status, because DES does not simply reflect poor tear secretion, being rather multifactorial.

The transurethral resection of the prostate (TURP) syndrome is caused by intravascular absorption of an electrolyte-free irrigating fluid during TURP for benign prostatic hypertrophy or prostatic carcinoma. The clinical symptoms and signs include hypertension, bradycardia, respiratory distress, hypotension, nausea, vomiting, confusion, blindness, seizure, coma, hyponatremina, and hypoosmolality. In this case, we incidentally detected very severe dilutional hyponatremia (99 mmol/L) without any symptoms during TURP and immediately took measures to treat TURP syndrome. On the third postoperative day, the hyponatremia had resolved within the normal range.
Absorption ; Blindness ; Bradycardia ; Coma ; Hypertension ; Hyponatremia* ; Hypotension ; Nausea ; Prostate* ; Prostatic Hyperplasia ; Reference Values ; Seizures ; Transurethral Resection of Prostate ; Vomiting

Intraoperative pulmonary embolism can result in severe hemodynamic instability, including cardiac arrest. Therefore, immediate diagnosis and proper treatment are required. We report a case of the acute cardiac and pulmonary embolisms during radical nephrectomy and inferior vena cava (IVC) thrombectomy in a patient with renal cell carcinoma with thrombus in the IVC. We diagnosed the cardiac embolism intraoperatively using the transesophageal echocardiogram, and performed emergent cardiac and pulmonary embolectomies immediately. After the surgery, the patient was discharged without any complication.
Carcinoma, Renal Cell ; Diagnosis ; Embolectomy ; Embolism ; Heart Arrest ; Hemodynamics ; Humans ; Nephrectomy* ; Pulmonary Embolism* ; Thrombectomy* ; Thrombosis ; Vena Cava, Inferior*

Lesch-Nyhan syndrome (LNS) is a rare, X-linked recessive inherited disorder caused by a deficiency of the enzyme hypoxanthine-guanine-phophoribosyltransferase, leading to excessive purine production and elevation of uric acid. Clinical manifestations include mental retardation, spasticity, choreathetosis, compulsive self-mutilation, renal calculi followed by obstructive nephropathy, and arthritis. Patient with LNS may have increased risk of aspiration pneumonia, acute renal failure and unexpected sudden death. We accomplished successful general anesthesia in a case of LNS requiring percutaneous nephrolithotomy due to renal calculi.
Acute Kidney Injury ; Anesthesia, General ; Arthritis ; Death, Sudden ; Humans ; Intellectual Disability ; Kidney Calculi* ; Lesch-Nyhan Syndrome* ; Muscle Spasticity ; Nephrostomy, Percutaneous* ; Pneumonia, Aspiration ; Uric Acid

Obturator nerve block is occasionally performed during transurethral resection of lateral bladder wall tumors to prevent the violent contraction of the adductor muscle of the thigh. Rare complications including intravascular injection of the local anesthetics and hematoma formation may occur during the obturator nerve block. We report a case of the unintentional breakage of the spinal needle during the obturator nerve block with successful removal of the broken spinal needle by an orthopedic surgeon.
Anesthetics, Local ; Hematoma ; Needles* ; Obturator Nerve* ; Orthopedics ; Thigh ; Urinary Bladder Neoplasms* ; Urinary Bladder*

OBJECTIVE: We retrospectively assessed the efficacy of stereotactic radiosurgery (SRS) for dural arteriovenous fistulas (DAVFs) involving the transverse-sigmoid sinus and analyzed the angiographic and clinical results with our 8-year experience.METHODS: Nine patients with intracranial DAVFs involving the transverse-sigmoid sinus underwent SRS using a Gamma Knife® (Elekta Inc., Atlanta, GA, USA) between 2009 and 2016. Five patients underwent SRS for residual DAVFs after embolization and four patients were treated with SRS alone. The median target volume was 1.9 cm3 (range, 0.8–14.2) and the median radiation dose of the target was 17 Gy (range, 16–20). The median follow-up period was 37 months (range, 7–81).RESULTS: Pulsating tinnitus (33%) was the most common symptom. DAVFs were completely obliterated in four patients (44%) and subtotally obliterated in five (56%). Six patients (67%) showed complete recovery of symptoms or signs, and three (33%) showed incomplete recovery. One patient experienced a recurrent seizure. Adverse radiation effects after SRS occurred in one patient (11%). The total obliteration rates after SRS were 16.7%, 37.5%, and 68.7% at 1, 2, and 3 years, respectively. The median interval from SRS to total obliteration of the fistula was 31 months (range, 12–38). The rates at which the symptoms started to improve were 40% at 1 month and 80% at 2 months after SRS. Symptoms started to improve at a median of 5 weeks after SRS (range, 3–21).CONCLUSION: SRS with or without embolization is a safe and effective treatment to relieve symptoms and obliterate DAVFs on the transverse-sigmoid sinus.
Central Nervous System Vascular Malformations ; Fistula ; Follow-Up Studies ; Humans ; Radiation Effects ; Radiosurgery ; Retrospective Studies ; Seizures ; Tinnitus ; Transverse Sinuses

BACKGROUND: Several factors affect the end-tidal carbon dioxide pressure (PETCO2) and increase the arterial to end-tidal carbon dioxide pressure gradient (Pa-ETCO2) during general anesthesia. We evaluated the relationship between age and Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). METHODS: Ninety-two consecutive patients undergoing RALP were divided by age into a middle-aged (45-65 years) and an elderly (> 65 years) group. Anesthesia was standardized. Heart rate, mean arterial pressure, peak inspiratory pressure, lung compliance, minute ventilation, PaO2, PETCO2, PaCO2, and Pa-ETCO2 were measured 10 min after intubation in the supine position without pneumoperitoneum (T0); and 10 (T1), 60 (T2), and 120 (T3) min after pneumoperitoneum in the Trendelenburg position. RESULTS: Although PETCO2 did not change significantly during surgery, PaCO2 and Pa-ETCO2 increased gradually with time during pneumoperitoneum in the Trendelenburg position, and both parameters showed greater increases in the elderly than in the middle-aged group. Simple linear regression analyses revealed significant correlations between age and Pa-ETCO2 at T0 (P = 0.018), T1 (P = 0.006), T2 (P < 0.001), and T3 (P = 0.001). Linear mixed model analysis showed that Pa-ETCO2 was associated statistically significantly with age and duration of pneumoperitoneum in the Trendelenburg position, but age and duration of pneumoperitoneum in the Trendelenburg position were not associated (P = 0.090). CONCLUSIONS: The magnitude of Pa-ETCO2 during pneumoperitoneum in the steep Trendelenburg position increased with age, which could be attributed to age-related respiratory physiological changes.
Aged ; Anesthesia ; Anesthesia, General ; Arterial Pressure ; Carbon ; Carbon Dioxide ; Head-Down Tilt ; Heart Rate ; Humans ; Intubation ; Linear Models ; Lung Compliance ; Pneumoperitoneum ; Prostatectomy ; Supine Position ; Ventilation

No abstract available.
Coronary Vessels* ; Pulmonary Artery*