We have experienced an anesthetic management of 56-year-old male patient with carotid stenosis. Carotid endarterectomy was performed with processed electroencephalography (compressed spectral array, CSA) monitoring. Carotid endarterectomy has significant risk of perioperative stroke and myocardial infarction. For brain protection during carotid cross clamp, body temperature of patient was maintained at 33.5oC and thiopental was infused continuously to induce burst suppression. To maintain blood pressure during cross clamp, dopamine was infused continuously and phenylephrine was injected intermittently. CSA was performed to monitor thiopental-induced burst suppression and ischemic brain insult. After releasing carotid cross clamp, body temperature was raised to 35oC.
Blood Pressure ; Body Temperature ; Brain ; Carotid Stenosis ; Dopamine ; Electroencephalography ; Endarterectomy, Carotid* ; Humans ; Hypothermia ; Male ; Middle Aged ; Myocardial Infarction ; Phenylephrine ; Stroke ; Thiopental

No abstract available.

Annular pustular psoriasis is a rare variant of the generalized pustular psoriasis characterized by annular lesions with rapidly evolving pustules, associated mild toxicity, and rapid response to therapy. We present a case of annular pustular psoriasis in a 17-year-old male, in whom no previous history of psoriasis was found. The skin lesions were characterized clinically by annular to gyrate erythematous lesions with pinpoint pustules near the periphery on both shoulders, upper arms, and back areas. The histology showed large intraepidermal spongiform pustules. Most of the skin lesions disappeared within 1 week with topical corticosteroid cream.

No abstract available.
Esophagus*

We report a case of pseudosarcomatous variant of transitional cell carcinoma of the renal pelvis which showed grossly and microscopically the distinct biphasic growth patterns. Grossly, most part of the tumor showed solid growth protruding into the renal pelvic cavity as well as infiltrating into the parenchyma of lower pole. The overlying pelvic mucosa was replaced by a diffuse, papillary transitional cell carcinoma, and the solid mass was composed of pleomorphic spindle cell sarcomatoid component with frequent myxoid change and a few foci of osteoid deposit. Ultrastructural study of the spindle cells revealed epithelial differentiation featured with rich cytoplasmic organelles, basal lamina and basement membrane-like structures, although immunohistochemistry failed to detect epithelial differentiation.

Inflammatory polyposis of the colon is rare portion of the colon polyp entity. We experienced three patieats who suffered from colitis of unknown'etiology and discovered membranous retkular with/ without filiform polyp in the distal sigmoid colon of the them. Case 1, 56-year-old female, combined with basaloid cercinoma of the rectal canal that confirmed by pathology after abdominoperineal resection. So we obtained specimen of inflammtory polyp end tried to evaluate the mechanism of it. We found healed ulcer under the mucosal bridge. Case 2. 55-year-old male, had been suffered from irritable bowel syndrome. Prior to visit outpatient clinic, he complained tenesmus with diarrhea for a week. Inflammatory polyp was discovered by colonoacopy but his symptoms relieved by tranqulizers only. Case 3. 57-year-old male, has been a good health. He undertook colonoscopy for routine check thst revealed membranous reticular with filiform inflammatory polyp from distal sigmoid colon to hepatic flexure. Such shape of inflammatory polyp was not documented in Korea, so we reported three cases of it with review of the literature.
Ambulatory Care Facilities ; Colitis ; Colon* ; Colon, Sigmoid ; Colonoscopy ; Diarrhea ; Female ; Humans ; Irritable Bowel Syndrome ; Korea ; Male ; Middle Aged ; Pathology ; Polyps* ; Ulcer

Colonna capsular arthroplasty is a two-stage procedure for congenital dislocation of the hip, but is not suitable for congenital subluxation. The bone architecture of the femoral head should approach the nearly normal and the child preferably should be more than three years old and less than eight if the best functional result is to be obtained. These brief case reports of five patients who could be followed for from one year and one month to more than seventeen years document the fact that the procedure may produce a hip with an excellent roentgenographic appearance and enduring satisfactory function.
Arthroplasty ; Child ; Dislocations ; Head ; Hip ; Humans

Although extrahepatic metastasis of hepatocellular carcinoma are frequent as about 64%, implants involving the peritoneum are rare. We presented a cases, whieh is hepatocellular carcinoma with metastasis to visceral peritoneum revealing multiple, hard, variable-sized and nodular mass including large mass over 10 cm in size. The presence of tumor was diagnosed by serum alpha fetoprotein, abdaminal CT, celiac and SMA angiography and biopsy with laparoscopy.
alpha-Fetoproteins ; Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Laparoscopy ; Neoplasm Metastasis* ; Peritoneum

PURPOSE: Obesity is a frequent nutritional disorder in children and adolescent and its prevalence is increasing. Bioelectrical impedance analysis is a simple, rapid, non-invasive and reproducible technique. The aim of this study was to measure percent of body fat using bioelectrical impedance in healthy children. METHODS: We measured height, weight and bioelectrical impedance in 1035 children aged 7-18 years(496 males and 539 females). RESULTS: Percent of body fat was decreased in male children, but it was increased during the pubertal period in female. 95th percentiles of percent of body fat by bioelectrical impedance was 32.9% in 7 year olds, 31.6% in 8, 34.7% in 9, 35.1% in 10, 35.8% in 11, 33.1% in 12, 36.1% in 13, 38.2% in 14, 33.3% in 15, 28.3% in 16, 32.8% in 17 and 32.2% in 18 year olds for males. 95th percentiles of percent of body fat by bioelectrical impedance was 25.1% in 7 year olds, 29.6% in 8, 30.5% in 9, 35.6% in 10, 34.5% in 11, 36.5% in 12, 39.1% in 13, 34.1% in 14, 33.7% in 15, 32.8% in 16, 34.5% in 17 and 35.1% in 18 year olds for females. Intraobserver reliability coefficient of bioelectrical impedance analysis was 0.995 and intraobserver reliability of BI(Bioelectrical impedance) analysis was significantly high. CONCLUSION: To measure body fat percentage using bioelectrical impedance analysis in healthy children provides objective data in diagnosing obesity.
Adipose Tissue* ; Adolescent ; Child* ; Electric Impedance* ; Female ; Humans ; Male ; Nutrition Disorders ; Obesity ; Pediatric Obesity ; Prevalence

Sebaceous hyperplasia is not a rare disorder and commonly develops on the face over the age of forty. The typical clinical manifestations are 2 ~ 3mm sized, single or multiple, soft protuberant yellowish nodules with central umbilication and histology shows a group of mature sebaceous lobules and central sebaceous ducts. We report an exceptionally "giant" size of sebaceous gland hyperplasia which lead us to such clinical impressions as an acrochordon, intradermal nevus, and verruca vulgaris. Histologically, the lesion showed a greatly enlarged sebaceous gland composed of numerous lobules grouped around a wide sebaceous duct. Besides the extraordinarily large size of the nodule, the benign proliferating pattern led us to a diagnosis of giant sebaceous hyperplasia.
Diagnosis ; Hyperplasia* ; Nevus, Intradermal ; Sebaceous Glands* ; Warts