No abstract available.
Child* ; Humans ; Lung Diseases, Interstitial*

We underwent 3 cases of laparoscopic splenectomy in pediatric patients of hereditary spherocytosis and had excellent outcome. Average operation time was 100 minutes and it was longer than average operation time of traditional open splenectomy in pediatric patients of hereditary spherocytosis (83 minute), but average hospitalization day was 3 days and it was shorter than compared group (6.2 days). Advantages of laparoscopic surgery were appeared in this study. Excellent outcome of these cases will help further performance of laparoscopic splenectomy in children.
Child* ; Hospitalization ; Humans ; Laparoscopy ; Splenectomy*

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.
Aneurysm, False* ; Angiography ; Child* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Rupture ; Splenic Artery* ; Tomography, X-Ray Computed

No abstract available.
Diagnosis* ; Female ; Humans ; Ovarian Neoplasms*

No abstract available.
Brain Stem Infarctions*

Ulnar tunnel syndrome by anomalous muscles has not been reported in Korea because it is asymptomatic in most cases. The most common anomalous muscles are the accessory abductor digiti minimi and palmaris longus. This is a case report of a patient with ulnar tunnel syndrome at the wrist by the accessory abductor digiti minimi muscle. For patients with ulnar tunnel syndrome, it is important to consider that anomalous muscles can cause ulnar tunnel syndrome.

OBJECTIVES: Several studies have delineated the relationship between hearing disturbances and the prevalence or characteristics of psychotic symptoms; however, most of those studies focused on psychiatric patients and not general inpatients. Delirium has a high incidence among general inpatients, and patients with delirium are easily affected by psychotic symptoms that lead to irritable behaviors. This study examined the relationship between hearing disturbance and psychotic symptoms among patients with delirium. METHODS: At the Asan Medical Center in Seoul, South Korea, this study examined 27 inpatients who had both delirium and hearing disturbances between January 1, 2009 and December 31, 2018, and 146 inpatients at the Asan Medical Center who had delirium but no hearing disturbances between July 1, 2018 and December 31, 2018. This study investigated whether the two groups showed differences in the prevalence and characteristics of delirium symptoms, particularly psychotic symptoms. In addition, the correlation between clinical characteristics of delirium and the recommended dosage of antipsychotics was analyzed in patients who had been diagnosed with delirium and had hearing disturbances. RESULTS: Compared to inpatients who only had delirium, those who had both delirium and hearing disturbances had a significantly higher prevalence of hallucination and delusion. CONCLUSION: The prevalence of psychotic symptoms, such as hallucination and delusion, was higher in patients who had both delirium and hearing disturbances, which is in line with the results from previous studies on psychiatric patients. Physicians should focus on improving communication with such patients by employing non-verbal communication methods.
Antipsychotic Agents ; Chungcheongnam-do ; Delirium ; Delusions ; Hallucinations ; Hearing ; Humans ; Incidence ; Inpatients ; Korea ; Prevalence ; Seoul

To examine the cytotoxic effect of chemotherapy on the ovary, 23 cases undergoing oophorectomy with radical hysterect,orny in premenopausal wemen receiving induction chemotherapy with cisplatin and 5-fluomouracil for carcinoma of the cervix between March, 1989 and December, 1992 were studied by light microscopy. Out of 23 cases, 19 (82.6%) showed vascular congestion and 12(52.1%) revealed hemorrhage around folliele and within corpus luteum. The follicular structure was desLroyed in 16 cnses (69.5%) and oocytes of ovums were lost in 17 cases. The mechanism of injury of the ovarian structures after combination chemotherapy with cisplatin and 5-fluorouracil is considered to be caused by secondary cell damage following circulatory disturbance of direct toxicity on fallicular cells of oocytes.
Cervix Uteri ; Cisplatin ; Corpus Luteum ; Drug Therapy* ; Drug Therapy, Combination ; Estrogens, Conjugated (USP) ; Female ; Fluorouracil ; Hemorrhage ; Humans ; Induction Chemotherapy ; Microscopy ; Oocytes ; Ovariectomy ; Ovary* ; Ovum

A 50-year-old man who had a gout presented with a difficulty in flexing his left small finger. Operative exploration revealed a rupture of the deep flexor tendons because of gouty tophus on flexor tendon sheath infiltration. The patient underwent single stage tendon graft using the palmaris longus tendon, resulting in satisfactory results. Gouty tophus infiltration should be considered as one of causes of flexor tendon rupture of the fingers in patients with a long history of gout.
Fingers ; Gout ; Humans ; Middle Aged ; Rupture ; Tendons ; Transplants

Most patients with tyrosine kinase inhibitor (TKI)-sensitive non-small cell lung cancer (NSCLC) eventually develop acquired resistance to TKIs. Factors that affect TKI-sensitive patient survival after progression during TKI treatment remain unknown. We attempted to identify factors that affected post-progression survival. We retrospectively reviewed 81 advanced NSCLC patients with disease progression following tumor response and durable (> or = 6 months) disease stabilization with first-line or second-line gefitinib. Post-progression survival (PPS) and characteristics were investigated and compared in patients who did (n = 16) and did not (n = 65) resume TKIs. Most patients were female never-smokers with adenocarcinoma. Median overall PPS was 10.3 months (95% confidence interval [CI], 7.458-13.142). Age, gender, smoking history, histology, Eastern Cooperative Oncology Group performance status at gefitinib initiation, initial stage, and platinum-based chemotherapy after gefitinib were not significant predictors of PPS. Pemetrexed use after gefitinib significantly improved PPS (18.5 vs 8.6 months; hazard ratio [HR], 0.45; P = 0.008). Gefitinib reuse tended to lengthen PPS but was insignificant in multivariate analysis (27.4 vs 8.8 months; HR, 0.53; P = 0.095). NSCLC patients assumed to have clinically acquired resistance to TKIs had relatively long PPS. TKIs reuse or pemetrexed use after progression with gefitinib may improve PPS.
Adenocarcinoma/drug therapy/*mortality ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Carcinoma, Non-Small-Cell Lung/drug therapy/*mortality ; Disease-Free Survival ; Drug Resistance, Neoplasm ; Female ; Glutamates/*therapeutic use ; Guanine/*analogs & derivatives/therapeutic use ; Humans ; Lung Neoplasms/drug therapy/*mortality ; Male ; Middle Aged ; Protein Kinase Inhibitors/*therapeutic use ; Quinazolines/*therapeutic use ; Retrospective Studies ; Survival ; Treatment Outcome