BACKGROUND: Methyl alcohol poisoning has been mainly reported in community. Two cases of methyl alcohol poisoning occurred in a small-sized subcontracted factory which manufactured smartphone parts in Korea. CASE PRESENTATION: One young female patient presented with dyspnea and visual disturbance. Another young male patient presented with visual disturbance and myalgia. They treated with sodium bicarbonate infusion and hemodialysis for metabolic acidosis. In addition, he received ethyl alcohol per oral treatment. Her and his urinary methyl alcohol concentration was detected as 7.632 mg/L, 46.8 mg/L, respectively, although they were treated hemodialysis. Results of the working environment measurement showed that the concentration of methyl alcohol (1030.1–2220.5 ppm) in the air exceeded the time weighted average (200 ppm). They were diagnosed with optic neuropathy due to methyl alcohol poisoning and still have visual impairment. CONCLUSIONS: Workers who hired as dispatched employees in a small-sized subcontracted factory were exposed to high concentrations of methyl alcohol. The workplace had poor ventilation system. In addition, workers did not wear proper personal protect equipment. Working environment measurement and annual chekups for workers were not performed. They were in a blind spot to occupational safety and health. More attention is needed to protect vulnerable workers’ health.
Acidosis ; Aluminum* ; Dyspnea ; Ethanol ; Female ; Humans ; Inhalation* ; Korea ; Male ; Methanol* ; Myalgia ; Occupational Health ; Optic Disk ; Optic Nerve Diseases ; Poisoning ; Renal Dialysis ; Smartphone ; Sodium Bicarbonate ; Ventilation ; Vision Disorders

Neurilemmomas is benign tumor originating from all kinds of cranial nerve except optic nerve and olfactory nerve, spinal nerve root and peripheral nerve. It superficially resembles neoplasm of fibroblastic origin, but has distinctive histological pattern and arise from the neuroectodermal sheath of schwann. Approximately 25% to 40% of all neurilemmomas are found in the neural structure of the head and neck. The tumor mostly develops in the acoustic nerve and there are several reports of neurilemmonas originating form tongue, pharynx, lip, larynx and palate etc. However, reports of Neurilemmoma originating from cervical vagus nerve have been extremely rare. We experienced two cases neurilemmoma of cervical vagus nerve that were treated with different surgical methods. In the first case, the tumor was extirpated by sacrificing the nerve trunk and in second case, it was enucleated by preserving the neural pathway using the microsurgical technique.
Cochlear Nerve ; Cranial Nerves ; Fibroblasts ; Head ; Larynx ; Lip ; Neck ; Neural Pathways ; Neural Plate ; Neurilemmoma* ; Olfactory Nerve ; Optic Nerve ; Palate ; Peripheral Nerves ; Pharynx ; Spinal Nerve Roots ; Tongue ; Vagus Nerve*

Laryngeal chondrosarcoma is an uncommon cartilaginous tumor very rarely encountered in the head and neck but most commonly in the sarcoma of the larynx. They occur most often in middle aged and older men. The prognosis of this tumor is potentially poor and surgical resection is generally recommended for the treatment. No benefit of chemotherapy or radiotherapy in chondrosarcoma has been documented in the literature. A 57 year-old male visited our clinic with history of dyspnea and hoarseness. Direct laryngoscopy showed a submucoid, intraluminal mass in subglottic space arising from posterolateral part of the cricoid cartilage. Neck computed tomography revealed a large calcified mass in the larynx. The perioperative frozen section showed it to be grade I chondrosarcoma of the cricoid cartilage. Conservative surgery with complete excision of tumor was performed through laryngofissure approach after tracheostomy. Follow up assesment was performed under close check up at 12 months after the surgery, but we found neither recurrence nor metastasis.
Chondrosarcoma* ; Cricoid Cartilage* ; Drug Therapy ; Dyspnea ; Equidae ; Follow-Up Studies ; Frozen Sections ; Head ; Hoarseness ; Humans ; Laryngoscopy ; Larynx ; Male ; Middle Aged ; Neck ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Recurrence ; Sarcoma ; Tracheostomy

Despite advances in imaging and antibiotic treatment, brain abscess is still encountered occasionally and is one of the most significant life-threatening complications of otologic disease. Nowadays, mortality rates of up to 10 percent have been reported. Brain abscesses are developed up to 0.5 percent of cases of acute otitis media and 3 percent of cases of chronic suppurative otitis media. In this case, underlying middle ear pathology showed chronic otitis media with cholesteatoma. Successful management of otogenic brain abscess still includes medical and surgical treatment. Initial surgical treatment of abscess is very controversial today. Some authors prefer the surgical excision of brain abscess prior to the management of temporal bone, yet other authors prefer the surgery of temporal bone prior to the management of brain abscess. Although an enterococcus is a significant cause of human infections outside of the central nervous system but, enterococcal infections involving the central nervous system are uncommon clinical entities. Because of the relatively small number of individuals who develop brain abscess or meningitis due to an enterococcus, an appropriate therapy has not been well defined. We report a case of enterococcal otogenic brain abscess which was treated successfully using antibiotics, immediate radical mastoidectomy and later stereotactic abscess drainage with a review of literatures.
Abscess ; Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Central Nervous System ; Cholesteatoma ; Drainage ; Ear Diseases ; Ear, Middle ; Enterococcus ; Humans ; Meningitis ; Mortality ; Otitis Media ; Otitis Media, Suppurative ; Pathology ; Temporal Bone

BACKGROUND/AIMS: The incidence of duodenal tumors has increased by health surveillance. However, preoperative diagnosis of subepithelial duodenal tumors remains difficult because of the wide variety of pathologies and the location of the tumors. We analyzed endoscopic, radiological, and pathological features of subepithelial benign duodenal tumors (BDTs), which were treated by surgical resection. METHODS: Five patients with subepithelial BDTs treated by surgical resection were analyzed retrospectively. We compared the preoperative and postoperative diagnosis and evaluated the clinical presentations, endoscopic and radiological findings, surgical treatments, pathological results, and outcomes of these patients. RESULTS: All the patients underwent successful surgical resection. There were two cases of gastrointestinal stromal tumors (GISTs) treated with segmental duodenectomy, one case of carcinoid tumor treated with antrectomy, one case of gangliocytic paraganglioma treated with ampullectomy, and a lipoma removed by mass excision. The two GISTs were in the duodenal third and fourth segment close to the pancreas, and it was difficult to exclude pancreatic tumors by imaging studies. All the patients remained healthy for more than three years. CONCLUSIONS: Subepithelial BDTs are rare and difficult to diagnosis. Awareness and preoperative diagnosis of subepithelial BDTs can lead to minimally invasive treatment, including endoscopic or local surgical resection.
Carcinoid Tumor ; Diagnosis ; Duodenum ; Gastrointestinal Stromal Tumors ; Humans ; Incidence ; Lipoma ; Pancreas ; Paraganglioma ; Pathology ; Retrospective Studies

Spontaneous disappearance of breast calcification has rarely been reported. The majority of cases of spontaneously resolving calcifications have been concerned with benign processes. We report here on breast papillary carcinoma that showed spontaneously resolving microcalcifications without newly developed parenchymal changes on the follow-up mammogram.
Breast Neoplasms ; Breast* ; Carcinoma, Papillary* ; Follow-Up Studies

Epithelial ovarian carcinoma rarely metastasizes to the parenchyma of the stomach. A 55-years-old woman presented with epigastric pain and a feeling of fullness for one month. A subsequent contrast-enhanced CT scan demonstrated a 4.5 x 4 cm submucosal mass with focal ulceration in the gastric antrum, and this finding was suggestive of GIST. After gastric antrectomy, the final pathology showed metastatic gastric tumor from a primary ovarian serous carcinoma. Because epithelial ovarian carcinoma is usually spread along the peritoneal surface, stomach involvement is rare. Furthermore, transmural gastric metastasis is very rare in a patient with primary ovarian carcinoma. Until now, there has been no reported case of stomach involvement at presentation in a patient with primary ovarian carcinoma. We present here a case of ovarian carcinoma with gastric metastasis that mimicked GIST.
Female ; Gastrointestinal Stromal Tumors ; Humans ; Hydrazines ; Neoplasm Metastasis ; Pyloric Antrum ; Stomach ; Ulcer

PURPOSE: The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment. METHODS: The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed. RESULTS: The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis. CONCLUSION: Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'critical pathway' to improve the outcomes of patients with blunt abdominal vascular injury.
Amputation ; Aneurysm, False ; Compartment Syndromes ; Critical Pathways ; Emergencies ; Emergency Treatment ; Extremities ; Glycosaminoglycans ; Humans ; Laparotomy ; Medical Records ; Muscles ; Prognosis ; Retrospective Studies ; Tendon Injuries ; Transplants ; Upper Extremity ; Vascular System Injuries

PURPOSE: Bile duct dilatation after cholecystectomy continues to be a matter of controversy. We aimed determine the magnitude of common bile duct (CBD) dilatation after cholecystectomy followed up to 1 year. METHODS: Sixty-four cases (age, 47.3 +/- 11.7 years; men, 28; women, 36) enrolled in this study. They received laparoscopic cholecystectomy in Chungbuk National University Hospital for symptomatic cholelithiasis or gallbladder polyps with normal bile duct, less than 7 mm. The CBD diameter was measured by one radiologist using ultrasonography at the maximum point after full length evaluation of extrahepatic bile duct. Forty-five and thirty-one cases were followed at 6 months and 1 year, respectively. RESULTS: The CBD was dilated slightly from 4.1 mm at baseline to 5.1 mm at 6 months and 6.1 mm at 12 months after cholecystectomy. The number of cases of CBD dilatation of more than 7 mm at 6 months and at 12 months after cholecystectomy were 11 (24.4%) and 9 (29.0%), respectively. Seven cases at 6 months and 5 cases at 12 months showed bile duct dilation of more than 3 mm compared to baseline. There were no cases having bile duct dilation of more than 10 mm. CONCLUSION: Postcholecystectomy dilatation of the bile duct occured slightly in most cases. But some cases showed more than 3 mm dilatation over baseline. Asymptomatic bile duct dilatation of up to 10 mm can be considered as normal range in patients after cholecystectomy.
Bile Ducts ; Bile Ducts, Extrahepatic ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholelithiasis ; Common Bile Duct ; Dilatation ; Female ; Gallbladder ; Humans ; Male ; Polyps ; Prospective Studies ; Reference Values

Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.
Angioplasty ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Dimaprit ; Drug-Eluting Stents ; Emergencies ; Humans ; Stents ; Thoracic Surgery