No abstract available.
Diagnosis ; Venous Thrombosis

No abstract available.
Hemodynamics* ; Hepatocytes* ; Ischemia* ; Liver* ; Urokinase-Type Plasminogen Activator* ; Verapamil*

We report a case of subclavian artery laceration caused by the removal of a pigtail pleural drainage catheter in a patient with a pneumothorax. The patient was successfully resuscitated through diagnostic angiography with subsequent balloon occlusion and primary repair of the injured subclavian artery. Although pigtail drainage of a pneumothorax is known to be safe and effective, proper insertion and removal techniques should be emphasized to reduce the risk of complications.
Angiography ; Balloon Occlusion ; Catheters* ; Drainage ; Hemothorax ; Humans ; Lacerations* ; Pneumothorax* ; Subclavian Artery* ; Thoracostomy

PURPOSE: We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity. MATERIALS AND METHODS: Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively. RESULTS: There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003). CONCLUSION: Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.
Disease-Free Survival ; Extremities ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Recurrence ; Survival Rate

Therapeutic irradiation can induce angiosarcoma. Radiation-induced angiosarcoma constitutes 20% of all angiosarcomas. Although its common site of origin is the skin and subcutaneous tissue, it rarely arises in small or large bowels with a presentation as multifocal abdominal angiosarcomatosis. We report a case of intra-abdominal angiosarcomatosis involving the jejunum, ileum, transverse colon, mesentery and right ovary in a 63-year-old female. It developed 10 years after therapeutic irradiation for squamous cell carcinoma of uterine cervix. She developed panperitonitis due to intestinal perforation. She died from sepsis 3 days after segmental resection of the small bowel and right oophorectomy. We reviewed the previously reported cases and describe the clinicopathologic features of this tumor.
Carcinoma, Squamous Cell ; Cervix Uteri ; Colon, Transverse ; Female ; Hemangiosarcoma ; Humans ; Ileum ; Intestinal Perforation ; Jejunum ; Mesentery ; Middle Aged ; Ovariectomy ; Ovary ; Sepsis ; Skin ; Subcutaneous Tissue

BACKGROUND: The effects of a muscle relaxant may differ in elderly compared with young adult patients for a variety of the pharmacokinetic and pharmacodynamic reasons. Atracurium is eliminated by nonorgan dependent pathway, Hofmann elimination and ester hydrolysis. So there are some arguments for age-related differences. The purpose of this study was to compare the differences of the onset and duration of atracurium in young and elderly. METHODS: Eighteen young adults (21-54 yr) and 18 elderly (>65 yr) patients anesthetized with nitrous oxide and enflurane. Atracurium (0.5 mg/kg) was given and then intubation was performed after T1 response was blocked more than 80%. Neuromuscular relaxation was measured by the first twitch of train-of-four (T1) response at the adductor pollicis after supramaximal stimulation of ulnar nerve at 2Hz every 12 sec. The onset (disappearance of T1) and duration of 5, 25, 50, 75% recovery time of T1 and recovery index (time for 25-75% recovery of T1) were recorded. RESULTS: Onset of block was not significantly different between the young and elderly. Recovery time of 5, 25, 50, 75% and recovery index were not prolonged in elderly compared with young adults. CONCLUSIONS: There were no significant differences between young and elderly adults in onest time, recovery time of 5, 25, 50, 75% and recovery index when atracurium is used in a single bolus dose. The results suggest that atracurium in elderly patients has similar onset and action duration compared with younger patients.
Adult ; Aged* ; Atracurium* ; Enflurane ; Humans ; Hydrolysis ; Intubation ; Nitrous Oxide ; Relaxation ; Ulnar Nerve ; Young Adult

No abstract available.
Nifedipine* ; Vasopressins*

Adrenal cortical carcinoma is a rare disease both in adults and in children. Most of these tumors are functional, especially in children, producing endocrine syndromes such as virilization, Cushing syndrome, hyperaldosteronism or feminization. We experienced a case of adrenal cortical carcinoma in a 7yr old boy who showed features of virilization such as rapid growth rate, penile enlargement, and pubic hair. This case was diagnosed with typical hormonal findings and abdominal MRI and confirmed by pathologic findings. He was successfully treated by total left adrenalectomy and has been followed up without problem over eight months.
Adrenalectomy ; Adrenocortical Carcinoma* ; Adult ; Child ; Cushing Syndrome ; Feminization ; Hair ; Humans ; Hyperaldosteronism ; Magnetic Resonance Imaging ; Male ; Rare Diseases ; Virilism

The brachial plexus block has its greatest usefulness in surgery on upper extremities, especially emergency surgical procedure and significant medical problems. There are several techniques at level which the plexus may be block. In 1979, Vongvises and Panijayanond were described on parascalene technique which is safe, simple to perform and reliable in anesthesia the brachial plexus. From May through september 1980, this technique was employed in 53 cases on upper extremities, shoulder joint and distal part of clavicle with immobilization of needle. This technique is a simple and good analgesia but each one case of pneumothorax, Horner's syndrome and recurrent laryngeal nerve paralysis were developed.
Analgesia ; Anesthesia ; Brachial Plexus Block* ; Brachial Plexus* ; Clavicle ; Emergencies ; Horner Syndrome ; Immobilization ; Needles ; Paralysis ; Pneumothorax ; Recurrent Laryngeal Nerve ; Shoulder Joint ; Upper Extremity

BACKGROUND/AIMS: Chronic hepatitis C virus (HCV) infection is often associated with extrahepatic autoimmune disease, and autoantibodies such as anti-nuclear antibody (ANA) or anti-smooth muscle antibody (ASA). The presence of autoantibodies may make discrimination between chronic hepatitis C with autoimmune features and type 1 autoimmune hepatitis difficult. We studied the prevalence of autoantibodies in patients with chronic HCV infection and their clinical significance. MATERIALS AND METHODS: ANA, ASA, anti-mitochondrial antibody (AMA), anti-microsomal antibody (AmA), rheumatoid factor (RF), anti-cardiolipin antibody (aCL) and lupus anti-coagulant (LA) were tested in 116 patients (80 chronic hepatitis C, 36 liver cirrhosis). Genotypes of HCV were determined in 25 patients by INNO LiPA. RESULTS: The overall prevalence of autoantibody was 65.5%. The most common autoantibody was aCL (34.5%), followed by ANA (25%), RF (18%), LA (15.5%), ASA (6.9%), anti-microsomal antibody (6%) and AMA (1%). The positive rate of either ANA or ASA was 30.2%, but both were positive in 1.7% only. There was no difference in the demographic features, biochemistry, HCV genotypes and disease status between autoantibody-positive and autoantibody-negative patients. CONCLUSIONS: Autoantibodies were commonly found in patients with chronic HCV infection. But, the presence of autoantibodies may be a non-specific finding in chronic hepatitis C infection without clinical significance.
Autoantibodies* ; Autoimmune Diseases ; Biochemistry ; Discrimination (Psychology) ; Genotype ; Hepacivirus ; Hepatitis C, Chronic* ; Hepatitis, Autoimmune ; Hepatitis, Chronic* ; Humans ; Liver ; Prevalence* ; Rheumatoid Factor