No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

A clinical observation was made on 75 cases of TURP from March 1984 to August 1987 had been studied in the Department of Urology, Eul Ji General Hospital. The results were summarized as follows. 1. TURP was performed in 65 cases of benign prostatic hyperplasia and 10 cases of the pro static cancer. Of the 75 cases, blood loss was calculated in 32 cases and change of serum electrolyte was in 42 cases. 2. Weight of resected tissue was 7.1+/-5.8 grams(Mean+/-S.D.). 3. Blood loss during TURP was 317+/-199.2ml. There was a correlation between the total loss and the weight of resected tissue, but the blood loss per gram of resected tissue decreased with the larger glands. 4. Serum sodium concentration was decreased in 24 of the 42 cases and increased in 10 cases and no change in 8 cases. And these change in serum sodium concentration showed no significant correlation with the weight of resected tissue, the amount of irrigating fluid and operation time. 5. Of the 75 patients who had performed TURP, 27(36%) experienced some types of non-fatal complication, the remaining 48(64%) recovered without event. 6. Hypotension during TURP was the most common complication(13.3%). It seemed to be temporary phenomenon due to sympatholytic effect in spinal anesthesia. 7. There was no fatal case in this series.
Anesthesia, Spinal ; Hospitals, General ; Humans ; Hypotension ; Prostate* ; Prostatic Hyperplasia ; Sodium ; Sympatholytics ; Transurethral Resection of Prostate ; Urology

Arthroscopic repair of an isolated teres minor tendon tear without associated shoulder joint pathology has not been reported in the literature. We report on a case of isolated teres minor tendon tear after trauma. The patient complained of severe shoulder pain and progressive limited range of motion 4 months after the injury. Magnetic resonance imaging showed a full-thickness tear of the teres minor tendon at its musculotendinous junction and arthroscopic repair was performed. At 2 years follow-up, satisfactory clinical and radiological outcomes were observed with return to pre-injury level. Here, the authors report this case and provide a review of literature.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pathology ; Range of Motion, Articular ; Shoulder Joint ; Shoulder Pain ; Tears* ; Tendons*

Diffuse alveolar hemorrhage is life-threatening situation which is rarely caused by paraganglioma or pheochromocytoma. Here, we describe anesthetic management of 64-year-old man underwent laparoscopic pararenal mass excision and later on this mass diagnosed as paraganglioma. We induced anesthesia with propofol 120 mg, sufentanil 12.5 μg, and rocuronium 50 mg. Anesthesia was maintained with sevoflurane administration. Patient position was changed to right lateral decubitus position for laparoscopic approach. Vital signs were stable until direct stimulation of mass. When surgeon started to manipulate pararenal mass, blood pressure suddenly increased to 274/169 mmHg and heart rate also increased to 140 beat/minute. SpO2 dropped to 69% and bilateral lung sounds decreased. We used intravenous esmolol to control blood pressure and heart rate. In doubt for bronchial spasm, we used intravenous hydrocortisol and chlorpheniramine maleate. Discharge of bloody fluid was obtained from endotracheal tube. Immediate postoperative chest x-ray showed diffuse air space consolidation in right lung field. We assessed as unilateral alveolar hemorrhage and patient was transferred to intensive care unit (ICU) without endotracheal extubation. The patient was followed up with ventilator care and antibiotic treatment in ICU, and daily chest x-ray was taken. He was extubated after showing favorable prognosis on postoperative day (POD) 4, and discharged on POD 7. Anesthesiologist should be aware that incidental manipulation of undiagnosed catecholamine producing tumor can lead to fatal consequences, and should know the management of hypertensive crisis and bronchial spasm.

E. coli L-asparaginase treatment during induction therapy in acute lymphoblastic leukemia is known to be rarely complicated by thromboembolic events. It causes deficiencies of antithrombin III, plasminogen, fibrinogen, factor IX, XI, protein C and protein S. We recently experienced a case of infarction during induction therapy in a 9-year-old child diagnosed with ALL. After the four dose of L-asparaginase, she had a generalized tonic- clonic seizure and MRI of the head showed both occipital infarction. She had gross recovery of the neurological impairment in 4 days. We report this case with brief review of literature.
Antithrombin III ; Asparaginase* ; Cerebral Infarction* ; Child* ; Drug Therapy* ; Escherichia coli* ; Factor IX ; Fibrinogen ; Head ; Humans ; Infarction ; Magnetic Resonance Imaging ; Plasminogen ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Protein C ; Protein S ; Seizures

To estimate postmortem interval, it is essential to obtain information regarding fly growth. Analyzing the relationship between growth period and body length using a sigmoid function is widely accepted in animal science. However, in forensic entomology, it is difficult to find studies related to growth period and body length. Therefore, we compared growth curve models for forensically important flies using sigmoid functions. we used the data from flour fly species (Calliphora lata, Calliphora vicina, Chrysomya pinguis, and Lucilia illustris) and fited these against five sigmoid functions: quadratic-plateau model, logistic model, Gompertz model, von Bertalanffy model, and Brody model. Model evaluation criteria were, R2 mean squared error (MSE), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The von Bertalanffy model yielded the highest R2 value and the lowest MSE, AIC, and BIC values for C. lata, whereas the logistic model was the best fit for the data from the other three species C. vicina, Ch. pinguis, and L. illustris.

Conjoined twins occur when there is imcomplete fission of the inner cell mass later at approximately 13 to 15 days after fertilization. The earlist case in the literat.ure appears to be that of the Biddenden Maids who were born in England in 1100. since then over two hundred cases of successful separation were reported on literature. And also successful separation cases were reported by Seung et al.(1991) in Korea. Conjoined twins occur between one in 50,000 to 100,000 births but real incidence is one in 200,000 because two thirds are stillbirth or died immediately after birth. The conjoined twins are not associated with maternal age, race or family history and 70 % of them are females. We experienced a case of conjoined twins with omphalopagus and performed surgical separation. A brief review of related literatures was done.
Animals ; Continental Population Groups ; England ; Female ; Fertilization ; Humans ; Incidence ; Korea ; Maternal Age ; Murine Acquired Immunodeficiency Syndrome ; Parturition ; Stillbirth ; Twins, Conjoined*

BACKGROUND: Spinal cord ischemia initiates a deleterious cascade of biochemical events that ultimately result in an increased intracellular calcium concentration. Many papers have been published on this topic but without a clear consensus on the best way of minimizing the problem. For the further study of preventing neurological injury after spinal ischemia, the proper animal model is necessary. In this study we compared spinal ischemia time on neurologic and histopathologic outcome, and inflammatory gene expression in transient spinal ischemia. METHODS: Rats were anesthetized with halothane, and divided into 4 groups:12.5 minutes of spinal ischemia (Group 1), 15 minutes of spinal ischemia (Group 2), 17.5 minutes of spinal ischemia (Group 3), and 20 minutes of spinal ischemia (Group 4). Spinal ischemia was produced by both induced hypotension and thoracic aortic cross clamping. After spinal ischemia neurologic scores were assessed after 1, 3, 6, and 24 hours. After 24 hours, rats were euthanized and spinal cords were removed for histopathologic assessment and an assay of TNF-alpha and IL-1 mRNA. RESULTS: The neurologic scores worsened according to the ischemia time. The histopathologic scores correlated well with the neurologic scores. The TNF-alpha and IL-1 mRNA expression results of group 2 were larger than those of group 1. There were no significant differences between group 2, group 3, and group 4. CONCLUSIONS: Inflammatory gene expressions are increased during transient spinal ischemia. After 15 minutes of ischemia, no further increase of mRNA expression was shown. The 15 minutes of spinal ischemia was sufficient for the spinal ischemic study in rats.
Animals ; Calcium ; Consensus ; Constriction ; Gene Expression ; Halothane ; Hypotension ; Interleukin-1 ; Ischemia* ; Models, Animal ; Rats* ; RNA, Messenger* ; Spinal Cord ; Spinal Cord Ischemia ; Tumor Necrosis Factor-alpha