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*

A dissociative anesthetic agent, ketamine has bronchodilating property and its bronchodilating effects in asthmatic patients have been apparent since earlier clinical studies. In this study, after anesthetizing patients who did not have any respiratory disease, we administered ketamine to the patients intravenously, and then monitored airway pressure to see the changes in respiratory mechanics indirectly. ASA physical status class 1 and 2 surgical patients who didn't have any respiratory disease were studied. Without premedication, fentanyl 3 mcg/kg, midazolam 0.1 mg/kg, thiopental 3 mg/kg and vecuronium 0.15 mg/kg were injected intravenously 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). After intubation, anesthesia was maintained with O2-N2O(50%)-isoflurane(<0.5 vol.%) and controlled ventilation was done with tidal volume 9 ml/kg, respiratory rate 11/min and inspiratory flow was constant for each subject. When airway pressure was stabilized, ketamine 4 mg/kg was administered intravenously, Thereafter, for 20 minutes P(peak), P(plateau), P(mean), mean arterial pressure and heart rate were monitored every minute interval. Dynamic compliance, static compliance and resistance of the total respiratory system were calculated by inspiratory pressure method. The result is that ketamine does not produce significant changes in airway pressure, resistance and compliance of total respiratory system. In conclusion, ketamine does not have bronchodilating effect in normal pntients anesthetized with isoflurane of low concentration.
Administration, Intravenous* ; Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Compliance* ; Fentanyl ; Heart Rate ; Humans ; Intubation ; Isoflurane ; Ketamine* ; Masks ; Midazolam ; Premedication ; Respiratory Mechanics ; Respiratory Rate ; Respiratory System ; Thiopental ; Tidal Volume ; Vecuronium Bromide ; Ventilation

Kidney transplantation, particularly from a living donor, is the treatment of choice for most patients with end-stage renal disease. The superior results achieved with kidney transplantation from living donor. We report a case of transplantation using a kidney with renal arterial aneurysm from a 49-year-old living donor to her 51-year-old brother. A preoperative CT angiogram in a donor candidate showed the right kidney with 6 mm sized saccular aneurysm involves the proximal portion of anterior segmental artery. The kidney was removed by a hand-assisted laparoscopic nephrectomy. After ex vivo aneurysmectomy, the graft was transplanted into the right iliac fossa. The total ischemic time was 62 minutes, and the urine flow was started immediately after declamping. If there are multiple donor candidates of same condition, donor with unilateral renal artery aneurysm should be chosen for transplant. The use of those grafts is safe for both recipients and donors.
Aneurysm ; Arteries ; Humans ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Living Donors ; Middle Aged ; Nephrectomy ; Renal Artery ; Siblings ; Tissue Donors ; Transplants

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

Tufted hair folliculitis is an inflammatory disorder of the scalp characterized by a peculiar tufting of hair within areas of scarring alopecia. Histopathological studies reveal perifollicular inflammation around the upper portions of the follicles sparing the hair root level. Within areas of inflammation, several follicles converge toward a common follicular duct with a widely dilated opening. The cause of tufted hair folliculitis is unknown, and the therapeutic approach is problematic. We present herein a patient with a 28-year history of recurrent and progressive tufted hair folliculitis. A 33-year-old man was referred to our department for the treatment of chronic and relapsing inflammatory lesions of the scalp. The clinical examination revealed a circumscribed area of 15cm length and 10cm width on the occipital area of the scalp which was characterized by hair tufting and exudates. Histopathologic findings were typical for tufted hair folliculitis. We believe that hair tufting is a secondary phenomenon which may occur in several inflammatory diseases of the scalp.
Adult ; Alopecia ; Cicatrix ; Exudates and Transudates ; Folliculitis* ; Hair* ; Humans ; Inflammation ; Scalp

BACKGROUND: It is well known that kidney transplant recipients in Western countries are at high risk for development of lower extremity (LE) deep vein thrombosis (DVT). The aim of this study was to establish the frequency of symptomatic LE DVT, the time until their occurrence, and to define risk factors for them following kidney transplantation (KT) in Korea. METHODS: We performed a retrospective analysis of LE DVT among 1695 patients who were kidney transplant recipients between 1969 and 2009. All patients were symptomatic with objective diagnostic modalities. Results were compared with those for a cohort of kidney transplant recipients from the same center without DVT. RESULTS: During follow-up, 21 symptomatic LE DVTs (1.2%) occurred in 18 patients (1.1%). The mean interval between transplantation and a first episode of DVT was 77.1+/-76.6 months. No DVT episode developed within one month after KT. There were no significant differences in body mass index, graft function, donor age and sex, recipient sex, type of preoperative renal replacement therapy, immunosuppressive agents, and malignancy between the two groups. Patients who developed LE DVT had a significantly different recipient age, presence of diabetes mellitus, presence of acute rejection episodes, and type of donor (P<0.05). CONCLUSIONS: Our retrospective study showed that the incidence of LE symptomatic DVT after KT is lower than after other surgeries performed in Korean hospitals and after KT performed in Western countries. There were no cases of symptomatic DVT within 1 month after KT. Our findings suggest that aggressive DVT prevention is not necessary for KT recipients in Korea.
Body Mass Index ; Cohort Studies ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Korea ; Lower Extremity ; Rejection (Psychology) ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplants ; Venous Thrombosis

Aortic Rupture ; diagnostic imaging ; microbiology ; surgery ; Blood Pressure ; physiology ; Humans ; Klebsiella pneumoniae ; pathogenicity ; Male ; Middle Aged

Background: Physical activity is known to prevent several diseases and positively affect mental health. Previous studies have shown that smartphone addiction negatively affects the physical activity of children and adolescents. This study aimed to investigate the relationship between problematic smartphone use and physical activity among adolescents and the related factors using path analysis. Methods: Using data from the 16th Youth Risk Behavior Web-based Survey from 2020, scores on the Smartphone Addiction Scale—Short Version for Adolescents, physical activity, sex, socioeconomic status (SES), academic performance, depression, smoking, drinking, and sitting time were assessed. Complex sampling and path analyses were performed. Results: Of the total 54,948 students, 25.5% were smartphone risk users, including potential and high-risk users. The direct path coefficients of each factor indicated that female sex (-0.14 for male), low SES (-0.062), high academic performance (0.056), low sitting time for studying purposes (-0.033), high sitting time for non-studying purposes (0.071), and depressive mood (0.130) were related to problematic smartphone use (all P<0.001). Each factor affected problematic smartphone use, and subsequently had a negative effect on the amount of physical activity, with a direct path coefficient of -0.115 (P<0.001). Conclusion In this study, we confirmed that problematic smartphone use among adolescents was negatively associated with performing an adequate amount of physical activity and that various factors, such as sex, SES, academic performance, and sitting time, directly and indirectly affected this relationship.

PURPOSE: The aim of the present study was to investigate the protective effects of ischemic preconditioning for different periods of time and to elucidate the optimal safe ischemic preconditioning time for renal ischemia-reperfusion (I/R) injury in mice. METHODS: A total of 25 male C57BL/6 mice were randomly divided into 5 groups (sham, I/R, ischemic preconditioning [IP]-3, IP-5, and IP-7 groups), in which the kidney was preconditioned with IP of various durations and then subjected to I/R injury (the last 3 groups). To induce renal ischemia, the left renal pedicle was occluded with a nontraumatic microaneurysm clamp for 30 minutes followed by reperfusion for 24 hours. The effects of IP on renal I/R injury were evaluated in terms of renal function, tubular necrosis, apoptotic cell death and inflammatory cytokines. RESULTS: Results indicated that BUN and creatinine (Cr) levels increased significantly in the I/R group, but the elevations were significantly lower in IP groups, especially in the IP-5 group. Histological analysis revealed that kidney injury was markedly decreased in the IP-5 group compared with the I/R group, as evidenced by reduced renal necrosis/apoptosis. In addition, IP significantly inhibited gene expression of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) and chemokines (monocyte chemoattractant protein-1). Western blot analysis indicated that the expression levels of Toll-like receptor 4 (TLR4) and nuclear factor-kappa B (NF-κB) were upregulated in the I/R group, while expression was inhibited in the IP groups. CONCLUSION: Five-minute IP had the greatest protective effect against I/R injury.
Animals ; Blotting, Western ; Cell Death ; Chemokines ; Creatinine ; Cytokines ; Gene Expression ; Humans ; Ischemia ; Ischemic Preconditioning* ; Kidney ; Male ; Mice* ; Necrosis ; Reperfusion ; Reperfusion Injury* ; Toll-Like Receptor 4

Laparoscopic live donor nephrectomy (DN) has been established as a useful alternative to the traditional open methods of procuring kidneys. To maximize the advantages of the laparoendoscopic single-site (LESS) method, we applied natural orifice specimen extraction to LESS-DN. A 46-year-old woman with no previous abdominal surgery history volunteered to donate her left kidney to her husband and underwent single-port laparoscopic DN with transvaginal extraction. The procedure was completed without intraoperative complications. The kidney functioned well immediately after transplantation, and the donor and recipient were respectively discharged 2 days and 2 weeks postoperatively. Single-port laparoscopic DN and transvaginal graft extraction is feasible and safe.
Female ; Humans ; Intraoperative Complications ; Kidney ; Laparoscopy ; Living Donors ; Middle Aged ; Natural Orifice Endoscopic Surgery ; Nephrectomy* ; Spouses ; Tissue Donors* ; Transplants*