Low-grade endometrial stromal sarcoma (LGESS) with intravascular extension is very rare, with only 26 cases having been reported. We experienced a case of LGESS with inferior vena cava (IVC) extension. A 60-year-old female presented with left leg edema. She had a history of total hysterectomy, and was diagnosed of leiomyoma at that time. On imaging study, tumor masses were located around both common iliac veins (CIV), and within the CIV and IVC. The pelvic masses on both side and IVC mass were resected, and then the patient received adjuvant hormonal therapy and radiotherapy over the remnant pelvic masses. LGESS with IVC extension is difficult to distinguish from intravascular leiomyomatosis. LGESS is a malignant disease and commonly recurs, even in early stages. Accurate diagnosis, complete resection, proper adjuvant therapy and close follow-up are very important.
Diagnosis ; Edema ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Iliac Vein ; Korea ; Leg ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Radiotherapy ; Sarcoma, Endometrial Stromal* ; Vena Cava, Inferior*

BACKGROUND: Sore throat is one of the most common complications of intubation. There are many factors that affect the incidence of sore throat and the succinylcholine-induced myalgia. Our study is to reveal the influences of these factors on the postoperative sore throat and the succinylcholine-induced myalgia. METHODS: One thousand and seven patients in ASA class I or II undergoing elective surgery under general anesthesia were studied, except patients undergoing brain surgery, open heart surgery, operation in oro-, naso-pharynx and larynx, and uncooperated psychiatric. We checked age, sex, patient controlled analgesia and nasogastric tube, size and kind of tube, operation position, duration of intubation and anesthetic agent. At 24~38 hours after operation, the patients were questioned about pre- and postoperative sore throat, or myalgia. RESULTS: Sore throat after endotracheal intubation developed more frequently in woman (32.8%) than man (25.9%). The older the patients, the lower the incidence of sore throat (p<0.05). The longer the anesthesia duration, the lower the incidence of sore throat (p<0.05). Succinylcholine, patient controlled analgesia, nasogastric tube, endotracheal tube, operation position, maintenance anesthetic agents and the amount of smoking did not affect the incidence of sore throat. The incidence of succinylcholine-induced myalgia was lower in elderly or patients who were administered nondepolarizing muscle relaxant. CONCLUSIONS: The incidences of sore throat and myalgia were 29% and 15%, respectively. There were significant differences in incidence of sore throat and myalgia depending on the gender, age, duration of operation, but the controllable factors which reduce the incidence of sore throat were not found. Nondepolarizing muscle relaxants could reduce the occurrence of postoperative myalgia.
Aged ; Analgesia, Patient-Controlled ; Anesthesia ; Anesthesia, General ; Anesthetics ; Brain ; Female ; Humans ; Incidence* ; Intubation* ; Intubation, Intratracheal ; Larynx ; Myalgia ; Pharyngitis* ; Smoke ; Smoking ; Succinylcholine ; Thoracic Surgery

The appropriate plot effectively conveys the author's conclusions to the readers. The Journal of Korean Medical Science provides a series of special articles to show you how to make consistent and excellent plots easier. In the second article, drawing receiver operating characteristic (ROC) curve is introduced. A ROC curve is a graphic plot that illustrates the diagnostic ability as its discrimination threshold is varied. It is widely used as logistic regression analysis as machine learning becomes widespread. It has great visual effect in comparing various diagnostic tools.

No abstract available.
Leiomyosarcoma* ; Uterus*

BACKGROUND: The purpose of this study was to evaluate the safety and efficacy of low-flow anesthesia with a semi-closed circle anesthesia system in infants. METHODS: Twenty, ASA physical status 1 or 2, infants were randomly assigned into two groups: high-flow anesthesia (HFA) or low-flow anesthesia (LFA). An identical semi-closed Dr ger circle anesthesia system (Cato) was used to all patients. Initial fresh gas flow (FGF) was N2O 1.5 L/min and O2 1.5 L/min in both groups. This FGF of 3 L/min was maintained in the HFA group. After 10 min of HFA, the FGF was reduced to 500 ml/min (N2O 250 ml/min and O2 250 ml/min) in the LFA group. RESULTS: Hypoxic or hypercarbic gas concentrations were not observed in all patients. Enflurane consumption during LFA was about 1/3 of that during HFA (6.8 +/- 1.3 ml vs. 19.5 +/- 5.8 ml). The mean highest esophageal temperature was similar in both groups. The mean highest inspiratory gas and soda lime temperatures were significantly higher in the LFA group than in the HFA group. CONCLUSIONS: Low-flow anesthesia in a circle system with a fresh gas flow of N2O 250 ml/min and O2 250 ml/min could be performed safely and economically for infants.
Anesthesia* ; Enflurane* ; Humans ; Infant*

BACKGROUND/AIMS: Mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach is an uncommon disease. Bone marrow involvement is reported even in patients with only a mucosal lesion. We evaluated the prevalence and risk factors of marrow involvement and its implications for diagnosis and treatment. METHODS: In total, 132 patients who were diagnosed with gastric MALT lymphoma at the National Cancer Center in Korea between January 2001 and December 2016 were enrolled in the study. The patient data were collected and analyzed retrospectively. RESULTS: Of the 132 patients, 47 (35.6%) were male, with a median age of 52 years (range, 17 to 81 years). The median follow-up duration was 48.8 months (range, 0.5 to 169.9 months). Helicobacter pylori infection was detected in 82 patients (62.1%). Most patients (80.3%) had stage IE1 according to the modified Ann Arbor staging system. Ninety-two patients underwent bone marrow evaluation, and four patients (4.3%) had marrow involvement. Of these patients, one presented with abdominal lymph node involvement, while the other three had stage IE1 disease if marrow involvement was disregarded. All three patients had no significant symptoms and were monitored after local treatment without evidence of disease aggravation. CONCLUSIONS: Bone marrow involvement was found in 4.3% of the patients with gastric MALT lymphoma. Bone marrow examination may be deferred because marrow involvement does not change the treatment options or outcome in gastric MALT lymphoma confined to the stomach wall.
Bone Marrow Examination ; Bone Marrow* ; Diagnosis ; Follow-Up Studies ; Helicobacter pylori ; Humans ; Korea ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Male ; Prevalence* ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach

The number of wild animal species is gradually decreasing due to poaching, hunting and habitat loss. While several endangered animal species have been successfully preserved at the zoo, assisted reproductive technology (ART) must be applied to restore wild animals. In the case of critically endangered animals, somatic cell cloning is considered the most appropriate method of ART. Somatic cell cloning can be beneficial for the reproduction of endangered species with limited female populations. However, gene and cell banks, and understanding of reproductive physiology and optimization of ART for wild animals are urgently required for further activation of artificial reproduction of endangered species, which enlarges its application and maintains biodiversity. Care should also be taken to consider ethical and legal issues associated with somatic cell cloning for conservation of endangered animals.
Animals ; Animals, Wild ; Biodiversity ; Clone Cells ; Cloning, Organism ; Ecosystem ; Endangered Species* ; Female ; Humans ; Physiology ; Reproduction ; Reproductive Techniques, Assisted

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*

Endometrial stromal sarcoma (ESS) is a mesenchymal neoplasm that usually occurs as a primary tumor of the uterine corpus, but rarely arises in other sites, such as the ovary, pelvic cavity, mesentery, omentum and intestine. Herein, we present a rare case of low-grade ESS presented as prevesical mass. A 60-yr-old woman who had undergone total hysterectomy for endometriosis eleven years ago was presented with incidentally detected prevesical pelvic mass. Since malignant transformation of urachal remnants was possible, the mass was suspected to be a urachal tumor. Extraction of the mass was performed, and the histopathologic diagnosis was low-grade ESS. In summary, prevesical tumor is rare but in patients with endometriosis, we suggest endometriosis and its possible malignant changes should be taken into account in the differential diagnosis of prevesical mass.
Diagnosis, Differential ; Endometrial Neoplasms/*diagnosis/pathology/ultrasonography ; Endometriosis/diagnosis ; Female ; Humans ; Hysterectomy ; Middle Aged ; Sarcoma, Endometrial Stromal/*diagnosis/pathology/ultrasonography ; Urachus/abnormalities ; Urinary Bladder Neoplasms/diagnosis

Transient myeloproliferative disorder (TMD), which may mimic acute leukemia, occurs in neonates with Down syndrome along with hepatic fibrosis. TMD is recognized shortly after birth or in the neonatal period and is characterized by leukocytosis and thrombocytopenia, which resolve spontaneously in four to six weeks. And hepatic fibrosis is characterized by diffuse intralobular sinusoidal fibrosis, extramedullary hematopoiesis and hemochromatosis. A newborn male infant with Down syndrome, atrial septal defect and ventricular septal defect is reported. He showed abnormal myelopoiesis accompanying characteristic hepatic sinusoidal fibrosis. Knowing the cellular mechanism of hepatic fibrosis and its modulation by growth factors, a pathogenetic link between transient myeloproliferative disorder and the development of liver fibrosis in Down syndrome neonates, association of this triad no longer appears to be accidental.
Down Syndrome* ; Fibrosis* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hematopoiesis, Extramedullary ; Hemochromatosis* ; Humans ; Infant ; Infant, Newborn ; Intercellular Signaling Peptides and Proteins ; Leukemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Myelopoiesis ; Myeloproliferative Disorders* ; Parturition ; Thrombocytopenia