No abstract available.

Acute bilateral renal cortical necrosis (BRCN) is a rare cause of renal failure. It has been reported that contrast-enhanced computed tomography provides characteristic findings of BRCN which correlates well with the histopathology making it an important non-invasive diagnostic modality during early phase of BRCN, improving survival rate and prognosis with early diagnosis and treatment. This report presents a case of 73-year old woman with BRCN due to hemolytic uremic syndrome. The patient recovered from anuria and showed complete recovery to normal renal function of her age and serum creatinine level after early initiation of hemodialysis. Furthermore, a normal radiologic finding of kidney was obtained after 52 days from onset of the disease by contrast-enhanced computed tomography. At present, she is preserved within the normal range renal function without renal replacement therapy.
Anuria ; Creatinine ; Early Diagnosis ; Female ; Hemolytic-Uremic Syndrome ; Humans ; Kidney ; Kidney Cortex Necrosis ; Prognosis ; Reference Values ; Renal Dialysis ; Renal Insufficiency ; Survival Rate

The authors had studied the microsurgical anatomy of the choroidal fissure and the operative approaches directed through the fissure. In this study, eight formalin-fixed cadaveric hemisheres were examined. In four hemispheres, the intracranial vessels were perfused with colored silicone latex. The choroidal fissure is divided into three portion : (a) body portion, (b) atrial portion, and (c) temporal portion. Dissection through the body portion of the choroidal fissure exposes the velum interpositum, internal cerebral vein, and third ventricle. The quadrigeminal cistern, pineal region, and posterior part of the ambient cistern can be exposed through the atrial portion of the choroidal fissure. Opening through the temporal portion of the choroidal fissure exposes the structures in the ambient cistern, which include the basal vein, posterior cerebral artery, anterior and lateral posterior choroidal arteries, and hippocampal formation. This study provides valuable knowledges of microsurgical approaches to the third ventricle and basal cistern by demonstrating the neural nd vascular relaionship around the choroidal fissure.
Arteries ; Cadaver ; Cerebral Veins ; Choroid* ; Hippocampus ; Latex ; Posterior Cerebral Artery ; Silicones ; Third Ventricle

Various vascularized flaps have been used for oral reconstruction after ablative cancer surgery. Among these, the radial forearm flap, rectus abdominis flap and anterolateral thigh perforator flap are the most popular options. In cases of tongue and mouth floor reconstruction, radial forearm fasciocutaneous flap has been the empirical choice for many years. However, it often carries cosmetic and functional problems on the donor site and limitations in flap size and volume. Considering these drawbacks, the anterolateral thigh perforator flap could be a good alternative. Generally, anterolateral thigh perforator flap has been used for tongue reconstruction due to the favorable flap thickness compared to the radial forearm flap. Furthermore, if a thin flap should be required solely for lining purpose, the flap thickness can be controlled through thinning procedures without circulatory compromise. For large composite tissue defects after cancer ablation surgery, the flap can be designed in a 3-dimensional plane and used for volumetric reconstruction as well as for adequate lining. Between September 2002 and September 2003, the authors used 15 anterolateral thigh perforator flaps for reconstruction of oropharyngeal defects after cancer ablation surgery in 15 patieints and analyzed the clinical data acquired retrospectively. Based on the results, we propose the indications and drawbacks of the anterolateral thigh flap in oropharyngeal reconstruction.
Forearm ; Humans ; Mouth Floor ; Mouth* ; Perforator Flap* ; Rectus Abdominis ; Retrospective Studies ; Thigh* ; Tissue Donors ; Tongue

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Lacrimal Apparatus*

Synovial sarcomas are rarely occurring, highly malignant tumors of mesenchymal origin. Most cases are confined to the extremities. Fewer than 100 cases of synovial sarcoma have been reported in the head and neck area. We experienced a 24-year-old male patient who first complained of globus sensation. Initial suspension laryngoscopic biopsy specimen of the primary lesion was consistent with hypopharyngeal synovial sarcoma. Surgical excision through lateral pharyngotomy approach and postoperative radiotherapy were performed. We report this rare case with a literature review.
Biopsy ; Extremities ; Head ; Humans ; Hypopharynx* ; Male ; Neck ; Radiotherapy ; Sarcoma, Synovial* ; Sensation ; Young Adult

Purpose: To investigate the prevalence of copper, zinc, and vitamin D deficiencies in surgical intensive care unit (SICU) patients and the associations between those deficiencies and clinical outcomes. Methods: We conducted a retrospective study of 210 patients admitted to the SICU of Asan Medical Center between June 2020 and June 2022. Micronutrient levels were measured within 7 days of SICU admission. Primary outcomes were the mortality rate, length of SICU stay, hospital stay duration, and mechanical ventilation duration. Results: Copper deficiency was found in 35% (68/193), zinc deficiency in 52% (100/193), and severe vitamin D deficiency in 46% (82/179) of patients. Copper-deficient patients showed a significantly higher mortality rate (25.0% vs. 12.8%, P=0.044), longer hospital stays (57.8±47.0 vs. 45.2±36.6 days, P=0.041), and extended mechanical ventilation duration (26.9±23.3 vs. 18.8±15.7 days, P=0.012). Zinc deficiency was associated with higher C-reactive protein levels (16.2±9.5 vs. 11.5±8.8 mg/dL, P=0.001) and lower prealbumin levels (6.5±2.8 vs. 9.9±5.6 mg/dL, P<0.001). Severe vitamin D deficiency (<10 ng/mL) was not significantly associated with mortality or other clinical outcomes (mortality:<10 ng/mL vs. ≥10 ng/mL, 13% vs. 18%, P=0.583). Conclusion Micronutrient deficiencies are prevalent in SICU patients. Copper deficiency significantly correlated with poor clinical outcomes, and zinc deficiency showed a strong association with inflammatory markers. Early assessment and supplementation of micronutrients could be beneficial for critically ill surgical patients.

Purpose: To investigate the prevalence of copper, zinc, and vitamin D deficiencies in surgical intensive care unit (SICU) patients and the associations between those deficiencies and clinical outcomes. Methods: We conducted a retrospective study of 210 patients admitted to the SICU of Asan Medical Center between June 2020 and June 2022. Micronutrient levels were measured within 7 days of SICU admission. Primary outcomes were the mortality rate, length of SICU stay, hospital stay duration, and mechanical ventilation duration. Results: Copper deficiency was found in 35% (68/193), zinc deficiency in 52% (100/193), and severe vitamin D deficiency in 46% (82/179) of patients. Copper-deficient patients showed a significantly higher mortality rate (25.0% vs. 12.8%, P=0.044), longer hospital stays (57.8±47.0 vs. 45.2±36.6 days, P=0.041), and extended mechanical ventilation duration (26.9±23.3 vs. 18.8±15.7 days, P=0.012). Zinc deficiency was associated with higher C-reactive protein levels (16.2±9.5 vs. 11.5±8.8 mg/dL, P=0.001) and lower prealbumin levels (6.5±2.8 vs. 9.9±5.6 mg/dL, P<0.001). Severe vitamin D deficiency (<10 ng/mL) was not significantly associated with mortality or other clinical outcomes (mortality:<10 ng/mL vs. ≥10 ng/mL, 13% vs. 18%, P=0.583). Conclusion Micronutrient deficiencies are prevalent in SICU patients. Copper deficiency significantly correlated with poor clinical outcomes, and zinc deficiency showed a strong association with inflammatory markers. Early assessment and supplementation of micronutrients could be beneficial for critically ill surgical patients.

Purpose: To investigate the prevalence of copper, zinc, and vitamin D deficiencies in surgical intensive care unit (SICU) patients and the associations between those deficiencies and clinical outcomes. Methods: We conducted a retrospective study of 210 patients admitted to the SICU of Asan Medical Center between June 2020 and June 2022. Micronutrient levels were measured within 7 days of SICU admission. Primary outcomes were the mortality rate, length of SICU stay, hospital stay duration, and mechanical ventilation duration. Results: Copper deficiency was found in 35% (68/193), zinc deficiency in 52% (100/193), and severe vitamin D deficiency in 46% (82/179) of patients. Copper-deficient patients showed a significantly higher mortality rate (25.0% vs. 12.8%, P=0.044), longer hospital stays (57.8±47.0 vs. 45.2±36.6 days, P=0.041), and extended mechanical ventilation duration (26.9±23.3 vs. 18.8±15.7 days, P=0.012). Zinc deficiency was associated with higher C-reactive protein levels (16.2±9.5 vs. 11.5±8.8 mg/dL, P=0.001) and lower prealbumin levels (6.5±2.8 vs. 9.9±5.6 mg/dL, P<0.001). Severe vitamin D deficiency (<10 ng/mL) was not significantly associated with mortality or other clinical outcomes (mortality:<10 ng/mL vs. ≥10 ng/mL, 13% vs. 18%, P=0.583). Conclusion Micronutrient deficiencies are prevalent in SICU patients. Copper deficiency significantly correlated with poor clinical outcomes, and zinc deficiency showed a strong association with inflammatory markers. Early assessment and supplementation of micronutrients could be beneficial for critically ill surgical patients.

Purpose: To investigate the prevalence of copper, zinc, and vitamin D deficiencies in surgical intensive care unit (SICU) patients and the associations between those deficiencies and clinical outcomes. Methods: We conducted a retrospective study of 210 patients admitted to the SICU of Asan Medical Center between June 2020 and June 2022. Micronutrient levels were measured within 7 days of SICU admission. Primary outcomes were the mortality rate, length of SICU stay, hospital stay duration, and mechanical ventilation duration. Results: Copper deficiency was found in 35% (68/193), zinc deficiency in 52% (100/193), and severe vitamin D deficiency in 46% (82/179) of patients. Copper-deficient patients showed a significantly higher mortality rate (25.0% vs. 12.8%, P=0.044), longer hospital stays (57.8±47.0 vs. 45.2±36.6 days, P=0.041), and extended mechanical ventilation duration (26.9±23.3 vs. 18.8±15.7 days, P=0.012). Zinc deficiency was associated with higher C-reactive protein levels (16.2±9.5 vs. 11.5±8.8 mg/dL, P=0.001) and lower prealbumin levels (6.5±2.8 vs. 9.9±5.6 mg/dL, P<0.001). Severe vitamin D deficiency (<10 ng/mL) was not significantly associated with mortality or other clinical outcomes (mortality:<10 ng/mL vs. ≥10 ng/mL, 13% vs. 18%, P=0.583). Conclusion Micronutrient deficiencies are prevalent in SICU patients. Copper deficiency significantly correlated with poor clinical outcomes, and zinc deficiency showed a strong association with inflammatory markers. Early assessment and supplementation of micronutrients could be beneficial for critically ill surgical patients.