No abstract available.

Primary non-Hodgkin's lymphoma of the cranial vault is very rare. A 55-year-old woman presented with a right parietal subcutaneous scalp lump. Computed tomography(CT) scan showed a right parietal cranial vault lesion with scalp swelling and extradural and intradural involvement. Tumor removal, including portion of involved skull, followed by c ranioplasty with resin were performed. Histologic study revealed the features of a T-cell non-Hodgkin's lymphoma(high grade, large cell, diffuse, immunoblastic type) and there was no systemic involvement. The chemotherapy and radiotherapy were instituted after surgery.
Drug Therapy ; Female ; Humans ; Lymphoma, Non-Hodgkin* ; Middle Aged ; Rabeprazole ; Radiotherapy ; Scalp ; Skull ; T-Lymphocytes

Anterior cervical interbody fusion(ACIF) is an effective method for the treatment of various cervical diseases, but complications from such procedure include non-union, absorption, collapse and displacement of graft bone, kyphosis and pseudoarthrosis. A retrospective study of 67 cases with ACIF with versus without plating system in degenerative cervical disease was performed to compare the arthrodesis level, average admission period, average ambulation period, fusion rate, complications, clinical outcome and reoperation rate for complications and to provide a efficacy and role of internal fixation(IF) after ACIF. Forty-five patients were operated through ACIF without IF and twenty-two patients were operated through ACIF with IF. In the group of ACIF without IF, the average admission period was 20.31 days, postoperative average ambulation period was 6.48 days, fusion rate was 97.7%, the rate of graft related complication was 31.1%, reoperation rate for graft related complications was 8.9%. In the group of ACIF with IF, the average admission period was 17.64 days, postoperative average ambulation period was 3.19 days, fusion rate was 100%, the rate of graft and plate related complications was 13.6%, reoperation rate for plate related complications was 9.1%. There was no reoperation for graft related complication in group of ACIF with IF. In conclusion, ACIF with IF had less chance of serious graft related complications and reoperation for graft related complications.
Absorption ; Arthrodesis ; Humans ; Kyphosis ; Pseudarthrosis ; Reoperation ; Retrospective Studies ; Transplants ; Walking

Atropine, an anticholinergic agent, has bronchodilating effects, so it had been used to treat bronchospasm. But, bronchodilating effects in normal man is controversial. In this study, after anesthetizing patients who did not have any respiratory disease, intravenous injection of atropine to the subjects was done, and then we monitored airway pressures to see the changes in respiratory mechanics indirectly. ASA physical status class 1 or 2 patients were studied. Without premedication, intravenous injection of fentanyl 3 mcg/kg, midazolam 0.1 mg/kg, thiopental 3 mg/kg and vecuronium 0.15 mg/kg was done consecutively. Ventilation was controlled by face mask with O2-N2O(50%)-isoflurane( < 0.5 vo1.%) for 5 minutes with closed circuit anesthetic machine(Physio-Flex) and then intubation was done. After intubation anesthesia was maintained with O2-N2O(50%)-isoflurane( < 0.5 voL%) and ventilation was controlled with tidal volume 9 ml/kg, respiratory rate 11/min and inspiratory tlow rate was maintained constantly for each subject. When airway pressure was stabilized, atropine 0.015 mg/kg was injected intravenously. Thereafter, for 20 minutes peak airway pressure(P), plateau pressure(P(peak)), mean airway pressure(P(plateau)), mean arterial pressure and heart rate were monitored every minute interval. And we calculated dynamic compliance, static compliance and resistance of total respiratory system. Atropine produced significant decrease in P(peak) and increase in dynamic compliance but did not produce significant changes in P(plateau) P(mean) , and static compliance and resistance. In CONCLUSION, atropine has bronchodilating effect in normal subjects anesthetized with isoflurane of low concentration.
Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Atropine* ; Bronchial Spasm ; Compliance* ; Fentanyl ; Heart Rate ; Humans ; Injections, Intravenous* ; Intubation ; Isoflurane ; Masks ; Midazolam ; Premedication ; Respiratory Mechanics ; Respiratory Rate ; Respiratory System ; Thiopental ; Tidal Volume ; Vecuronium Bromide ; Ventilation

PURPOSE: We investigated fecal calprotectin (FC) levels in preterm infants with and without feeding intolerance (FI), and compared the FC levels according to the type of feeding. METHODS: The medical records of 67 premature infants were reviewed retrospectively. The fully enteral-fed infants were classified into two groups; the FI group (29 infants) and the control group (31 infants). Seven infants with necrotizing enterocolitis, sepsis, and perinatal asphyxia were excluded. If breast milk (BM) or preterm formula (PF) could not be tolerated by infants with FI, amino acid-based formula (AAF) was tried temporarily. Once FI improved, AAF was discontinued, and BM or PF was resumed. We investigated the FC levels according to the type of feeding. RESULTS: Significant differences were found in gestational age, birth weight, age when full enteral feeding was achieved, and hospital stay between the FI and control group (p < 0.05). The FC levels in the FI group were significantly higher than those in the control group (p < 0.05). The FC levels in the AAF-fed infants with FI were significantly lower than those in the BM- or PF-fed infants (p < 0.05). The growth velocities (g/d) and z scores were not significantly different between the FI and control group (p>0.05). CONCLUSION: The FC levels in AAF-fed infants with FI showed significantly lower than those in the BM- or PF-fed infants with FI. The mitigation of gut inflammation through the decrease of FC levels in AAF-fed infants with FI could be presumed.
Asphyxia ; Birth Weight ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Gestational Age ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Infant, Premature* ; Inflammation ; Length of Stay ; Leukocyte L1 Antigen Complex* ; Medical Records ; Milk, Human ; Retrospective Studies ; Sepsis

BACKGROUND: Discharge after day-surgery can be delayed for postoperative pain in a video-assisted thoracic sympathicotomy (VATS). However, there seems to be no research about postoperative pain after a VATS. We examined the characteristics of patients and operative factors, and compared the severity of postoperative pain according to different anesthetics. METHODS: We examined the age, sex, obesity index, and pain tolerance in 194 VATS patients of ASA physical status 1 or 2. The patients were randomly divided into two groups each with 97 patients. Group P was anesthetized with propofol, and group E with enflurane. We measured the visual analog scale (VAS) score at 5 minute, 2 hours, and 6 hours after arrival at the recovery room. RESULTS: There was no difference in the VAS score according to age, sex, obesity index, or pain tolerance. The VAS score at coughing was significantly higher than at rest. The VAS score in group P was higher than group E, but there was no significant difference. The patients who had a complication of a pneumothorax had a significantly higher VAS score. CONCLUSIONS: Postoperative pain seems to be aggravated by remaining air within the thorax after VATS.
Anesthetics ; Cough ; Enflurane ; Humans ; Obesity ; Pain, Postoperative ; Pneumothorax ; Propofol ; Recovery Room ; Thoracic Surgery, Video-Assisted ; Thorax ; Visual Analog Scale

Postappendectomy bleeding is a rare and occasionally catastrophic phenomenon. Bleed-ing in the gastrointestinal tract may occur early or late. The cause of late bleeding included ulceration, vascular malformation or granuloma. We experienced a case of delayed appen-diceal stump ulceration and bleeding who underwent an appendectomy 1 year ago. The patient was admitted due to melena. A colonoscopy showed a well-circumscribed deep ulcer containing of silk suture material at the base of appendiceal stump. Biopsy revealed only granulation tissue with nonspecific inflammation. The silk was removed by biopsy forcep and sulfasalazine was tried. A repeat colonoscopy showed the complete ulcer heal-ing 3 months later. We report this case with a review of literatures.
Appendectomy* ; Biopsy ; Colonoscopy ; Gastrointestinal Tract ; Granulation Tissue ; Granuloma ; Hemorrhage* ; Humans ; Inflammation ; Melena ; Silk ; Sulfasalazine ; Surgical Instruments ; Sutures ; Ulcer* ; Vascular Malformations

Von Hippel-Lindau (VHL) disease is an autosomal dominant neoplasia syndrome that result from a germline mutation in the VHL gene. Germline mutation in the VHL gene lead to the development of hemangioblastomas of the central nervous system and retina, cysts and clear cell carcinoma of the kidney, cyst adenomas of other organs, and pheochromocytoma. VHL is a tumor suppressor gene on the short arm of chromosome 3. VHL disease has been classified into two main clinical subtypes depending on the presence (type 2) or absence (type 1) of pheochromocytoma. Type 2 has been subdivided into three categories depending on the presence (type 2B) or absence (type 2A) of renal cell carcinoma, with type 2C being a rare subtype in which pheochromocytoma is the sole manifestation of VHL disease. Recently we experienced a family with VHL type 1 who carry C to T (Q73X) transition in codon 217 nonsense germline mutation in exon 1 of VHL gene. The authors report this case with literature review.
Adenoma ; Arm ; Carcinoma, Renal Cell ; Central Nervous System ; Chromosomes, Human, Pair 3 ; Codon ; Exons ; Genes, Tumor Suppressor ; Germ-Line Mutation* ; Hemangioblastoma ; Humans ; Kidney ; Pheochromocytoma ; Retina ; von Hippel-Lindau Disease

Heparin-induced thrombocytopenia (HIT) is an immunologically mediated complication of heparin therapy resulting in the consumption of platelets and a catastrophic thromboembolism. Both the clinical and laboratory features are important for a diagnosis of HIT. There have been 3 case reports of suspected HIT in Korea. However none have satisfied the laboratory features. We experienced a case of HIT, which satisfied both clinical and laboratory features, in a patient who received heparin during continuous veno-venous hemodiafiltration (CVVHD) used to treat acute renal failure that developed after a total aortic arch replacement with a cardiopulmonary bypass. The decreased platelet count and obstruction of extracorporeal filter of CVVHD by the blood clot was observed while receiving unfractionated heparin. The serum from the patient contained the anti heparin-platelet factor 4 antibody, and the condition was thus diagnosed as HIT. Argatroban, which is a direct thrombin inhibitor, was used to treat the thrombosis.
Acute Kidney Injury ; Aorta, Thoracic* ; Cardiopulmonary Bypass ; Diagnosis ; Hemodiafiltration* ; Heparin ; Humans ; Korea ; Platelet Count ; Thrombin ; Thrombocytopenia* ; Thromboembolism ; Thrombosis

PURPOSE: Hypoxic-ischemic encephalopathy is a significant cause of neonatal morbidity and mortality. Erythropoietin (EPO) is emerging as a therapeutic candidate for neuroprotection. Therefore, this study was designed to determine the neuroprotective role of recombinant human EPO (rHuEPO) and the possible mechanisms by which mitogen-activated protein kinase (MAPK) signaling pathway including extracellular signal-regulated kinase (ERK1/2), JNK, and p38 MAPK is modulated in cultured cortical neuronal cells and astrocytes. METHODS: Primary neuronal cells and astrocytes were prepared from cortices of ICR mouse embryos and divided into the normoxic, hypoxia (H), and hypoxia-pretreated with EPO (H+EPO) groups. The phosphorylation of MAPK pathway was quantified using western blot, and the apoptosis was assessed by caspase-3 measurement and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. RESULTS: All MAPK pathway signals were activated by hypoxia in the neuronal cells and astrocytes (P<0.05). In the neuronal cells, phosphorylation of ERK-1/-2 and apoptosis were significantly decreased in the H+EPO group at 15 hours after hypoxia (P<0.05). In the astrocytes, phosphorylation of ERK-1/-2, p38 MAPK, and apoptosis was reduced in the H+EPO group at 15 hours after hypoxia (P<0.05). CONCLUSION: Pretreatment with rHuEPO exerts neuroprotective effects against hypoxic injury reducing apoptosis by caspase-dependent mechanisms. Pathologic, persistent ERK activation after hypoxic injury may be attenuateed by pretreatment with EPO supporting that EPO may regulate apoptosis by affecting ERK pathways.
Animals ; Anoxia ; Apoptosis* ; Astrocytes ; Blotting, Western ; Caspase 3 ; DNA Nucleotidylexotransferase ; Embryonic Structures ; Erythropoietin* ; Humans ; Hypoxia-Ischemia, Brain ; MAP Kinase Signaling System ; Mice ; Mice, Inbred ICR ; Mitogen-Activated Protein Kinases ; Mortality ; Neurons ; Neuroprotection ; Neuroprotective Agents* ; p38 Mitogen-Activated Protein Kinases ; Phosphorylation ; Phosphotransferases ; Protein Kinases*