No abstract available.

Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.
Child ; Male ; Female ; Humans ; Biopsy

It is thought to be reliable roentgenologic sign of pulmonary plethora that the diameter of anterior segmental artery(d-ASA) is larger than that of anterior segmental bronchus(d-ASB). To evaluate the reliability of this sign, we compared d-ASA with d-ASB on chest rentgenograms of 100 normal adults. Of the total 105 cases. d-ASA was larger than d-ASB in 40 cases (38.1%), smaller than d-ASB in 34 cases(32.4%) and equal to (d-ASA and) d-ASB in 31 cases(29.5%). The ratio(ABR) and difference between d-ASA and d-ASB ranged from 0.70 to 1.58(mean, 1.05±0.30) and from -1.85mm to +2.45mm(mean of absolute value, 0.75mm±0.57). These results showed that the relationships between d-ASA and d-ASB were variable. Conclusively, d-ASA may be larger than d-ASB in even normal adults and mild degree of pulmonary plethora cannot exectly evaluated with this findings only.
Adult ; Arteries* ; Bronchi* ; Humans ; Thorax

We have experienced 20 cases of anesthesia for Total Hip Replacement(Charnleys Lov Frictinn Arthroplasty), which had been done under the Filtered Air Flow System for the prevention of wound contamination due to long term exposure. Preoperative diagnosis was, 7 cases of Hip Joint Tuberculosis, 6 cases of Femur Neck Fracture, 5 cases, of Osteoarthritis of Hip Joint, and 2 cases, of Avascular Necrosis. Average blood loss has 1500 ml for one side operation, and 2400 ml for bilateral one. In 12 cases, hypotensive response was occurred during the application of Acrylic bone cement to the medullary canal of femur, however in 4 cases, hypotensive responses was more prominentafter the application of Acrylic bone cement to the Acetabulum fossa and the rest of cases were no changes in blood pressure and pulse rate whatsoever. In two cases, hypotensive range was over 30%(in compare with preoperative one), but recovery was soon after administration of Effortil corticosteroids, volume expanders etc. There was no mortality.
Acetabulum ; Adrenal Cortex Hormones ; Anesthesia* ; Blood Pressure ; Clinical Study* ; Diagnosis ; Etilefrine ; Femoral Neck Fractures ; Femur ; Heart Rate ; Hip ; Hip Joint ; Joints ; Mortality ; Necrosis ; Osteoarthritis, Hip ; Polymethyl Methacrylate ; Tuberculosis ; Wounds and Injuries

Anesthetic experience with unilateral adrenalectomy for two patients (ll-year-old and 19- year-old female) with Cushings syndrome due to adrenocortical carcinoma has been reported. Anesthesia was induced with intravenous thiopental followed by nitrous oxide-oxygen-halothane and Pancuronium (Mioblock) for muscular relaxation. An endotracheal semi-closed circle absorption techniqne with controlled respiration was employed. The Patient tolerated well the anesthesia and surgery with appropriate cardiovascular control using hydrocortisone, whole blood and fluid replacement under continuous monitoring of B.P., E.C.G., C.V.P., and urine output. Importance of optimal preparation of the patient with Cushings syndrome, sufficient sedation, smooth induction, complete analgesia, good mucular relaxation, adequate alveolar ventilation and of proper cardiovascular control has been stressed and discussed together with the hazards of postoperative adrenal insufficiency.
Absorption ; Adrenal Insufficiency ; Adrenalectomy ; Adrenocortical Carcinoma* ; Analgesia ; Anesthesia ; Cushing Syndrome* ; Humans ; Hydrocortisone ; Pancuronium ; Relaxation ; Respiration ; Thiopental ; Ventilation

PURPOSE: We report a case of neuromyelitis optica (Devic's syndrome) with hepatocellular carcinoma. CASE SUMMARY: A 70-year-old male with hepatocellular carcinoma presented with bilateral visual loss. A relative afferent pupillary defect was not observed in either eye due to bilateral mydriasis. On brain MRI, there was no specific finding, however, on spine MRI, multiple and severe myelopathies were observed. After high-dose methylprednisolone pulse therapy, the visual acuity was 0.03 in the right eye and counting fingers at 30 cm in the left eye. CONCLUSIONS: We encountered a case of neuromyelitis optica involving bilateral optic neuropathy in hepatocelluar carcinoma. Therefore, in patients with an optic neuropathy of uncertain etiology, clinicians should consider performing a systemic evaluation.
Aged ; Brain ; Carcinoma, Hepatocellular* ; Eye ; Fingers ; Humans ; Male ; Methylprednisolone ; Mydriasis ; Neuromyelitis Optica* ; Optic Nerve Diseases ; Optic Neuritis ; Paraneoplastic Syndromes* ; Pupil Disorders ; Spinal Cord Diseases ; Spine ; Visual Acuity

Arthroplasty ; Facial Asymmetry ; Humans ; Hyperplasia ; Mandible ; Mandibular Osteotomy ; Osteotomy

Two-hundred cases of brachial plexus block by parascalene technique for the surgery of upper extremity, shoulder and/or neck were evaluated for the period from November, 1989 to October, 1990 at the Department of Anesthesiology, Hallym University, Kangdong Sacred Heart Hosipital in Seoul, Korea. Local anesthetics we used in this technique were mixture of equal amount of 2% lidocaine and 0.5% bupivacaine with 1: 200,000 epinephrine. Total amount of local anesthetics injected were varies from 20 to 40 ml for each block. The results were as follows: 1) Of the 200 Patietns, 153(76,5%) were male and 47(23.5%) were female. Their ages ranged from 5 to 83 years. One hundred twenty-one or 60.5% of this total group's ages fell between 20 to 39 years. 2) The most common site of operation was the hand; ll6 cases of the 200 blocks(55.3%). 3) Paresthesia was most often elicited at the superior nerve trunk; 80 cases of the 200 blocks (40%). 4) The average depth of needle from the skin to eliciting the parethesia is 1.954 cm. 5) The onset of anesthesia was within 5 minutes in 166.cases(84,4%). 6) The duration of anesthesia ranged from 180 to 1,800 minutes, and average was 657+/-113 minutes. 7) The extent of anesthesia by sensory dermatomes were average from cervical 2.3+/-1.0 to thoracic 2.90+/-5. 8) Shoulder surgery(e.g. clavicle fracture) and neck biopsy were performed successfully by this technique. 9) Parascalene approach to the brachial plexus has proven both safe and reliable. It provide satisfactory anesthesia of the upper extremity, shoulder and neck in 98.5%(l97 cases) of the 200 patients. 10) Complications of parascalene brachial plexus block were 2 cases of Horners syndrom, 1 cases of recurrent laryngeal nerve paralysis and 2 cases of subclavian artery puncture. We presumed that the complications other than Horners syndrome were due to technical error.
Anesthesia ; Anesthesiology ; Anesthetics, Local ; Biopsy ; Brachial Plexus* ; Bupivacaine ; Clavicle ; Epinephrine ; Female ; Hand ; Heart ; Horner Syndrome ; Humans ; Korea ; Lidocaine ; Male ; Neck ; Needles ; Paralysis ; Paresthesia ; Punctures ; Recurrent Laryngeal Nerve ; Seoul ; Shoulder ; Skin ; Subclavian Artery ; Upper Extremity

Two-hundred cases of brachial plexus block by parascalene technique for the surgery of upper extremity, shoulder and/or neck were evaluated for the period from November, 1989 to October, 1990 at the Department of Anesthesiology, Hallym University, Kangdong Sacred Heart Hosipital in Seoul, Korea. Local anesthetics we used in this technique were mixture of equal amount of 2% lidocaine and 0.5% bupivacaine with 1: 200,000 epinephrine. Total amount of local anesthetics injected were varies from 20 to 40 ml for each block. The results were as follows: 1) Of the 200 Patietns, 153(76,5%) were male and 47(23.5%) were female. Their ages ranged from 5 to 83 years. One hundred twenty-one or 60.5% of this total group's ages fell between 20 to 39 years. 2) The most common site of operation was the hand; ll6 cases of the 200 blocks(55.3%). 3) Paresthesia was most often elicited at the superior nerve trunk; 80 cases of the 200 blocks (40%). 4) The average depth of needle from the skin to eliciting the parethesia is 1.954 cm. 5) The onset of anesthesia was within 5 minutes in 166.cases(84,4%). 6) The duration of anesthesia ranged from 180 to 1,800 minutes, and average was 657+/-113 minutes. 7) The extent of anesthesia by sensory dermatomes were average from cervical 2.3+/-1.0 to thoracic 2.90+/-5. 8) Shoulder surgery(e.g. clavicle fracture) and neck biopsy were performed successfully by this technique. 9) Parascalene approach to the brachial plexus has proven both safe and reliable. It provide satisfactory anesthesia of the upper extremity, shoulder and neck in 98.5%(l97 cases) of the 200 patients. 10) Complications of parascalene brachial plexus block were 2 cases of Horners syndrom, 1 cases of recurrent laryngeal nerve paralysis and 2 cases of subclavian artery puncture. We presumed that the complications other than Horners syndrome were due to technical error.
Anesthesia ; Anesthesiology ; Anesthetics, Local ; Biopsy ; Brachial Plexus* ; Bupivacaine ; Clavicle ; Epinephrine ; Female ; Hand ; Heart ; Horner Syndrome ; Humans ; Korea ; Lidocaine ; Male ; Neck ; Needles ; Paralysis ; Paresthesia ; Punctures ; Recurrent Laryngeal Nerve ; Seoul ; Shoulder ; Skin ; Subclavian Artery ; Upper Extremity

No abstract available.
Cholesterol* ; Triglycerides*