Castleman's disease(Giant lymph node hyperplasia) is a pathologic entity of unknown etilogy, as attested to bythe number of names it has received, lymphoid hamartoma, angiomatous hamartoma, and giant lymph node, etc.Although the mediastinum is its most common location, it also occures in other areas of the body, usually wherelymph nodes are normally found. Authors have been experienced 2 cases of histologically porven Castleman's diseaseduring recent 3 years in Kyung Hee University Hospital, and present its radiological and pathological findings asmediastinal mass.
Hamartoma ; Lymph Nodes ; Mediastinum

Ultrasonography is a predominantly accurate, relatively simple unique diagnsotic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyperreflective echo or mass in and/or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is based on the easy detectability of extra-and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and the small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than any other causes of obstruction. 2. The site of obstruction was detected in85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46).
Bile Ducts ; Bile Ducts, Intrahepatic ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice, Obstructive ; Methods ; Pliability ; Ultrasonography

Authors analyzed 72 cases of abdominal CT of Korean adults who didn't have any medical reasons to believe thespleen was abnormal. The following criteria were measured with mulitiple transverse scanning of the entire lengthof spleen (height, breadth, thickness) & relationship with fixed midline structure, the spine( the shortestdistance from midline to medial edge of spleen, the longest distance from anterior margin of vertebral body toanterior tip of spleen). The reults were as follows; 1. The average size in adult was 8.0±1.5cm in height,8.6±1.2cm in breadth and 3.4±0.6cm in thickness; in adult female, 7.8±1.1cm, 8.4±1.0cm and 3.4±0.6cm,respectively; total average, 7.9±1.3cm, 8.5±1.1cm and 3.4±0.6cm, respectively. No remarkable difference wasnoted between both sexes and age groups. 2. The shortest distance from midline to medial edge of spleen was4.1±1.1.cm in male, 3.6±1.0cm in female and total average of 3.9±1.1cm. There was remarkable difference betweenboth sexes(p<0.005) but not between age groups. 3. The longest distance from anterior margin of vertebral body toanterior edge of spleen was 2.3±1.7cm in male, 2.0±1.4cm in female and total average of 2.2±1.6cm. Noremarkable difference was seen between both sexes and age groups.
Adult ; Female ; Humans ; Male ; Spleen ; Tomography, X-Ray Computed

Two cases of spontaneous kidney rupture with literatural review was presented at first in Korea. 1) 56 years male patient and 25 years male patient admitted to our department of Urology through Emergency Room after onset of 2 and 1 day. after treatment at local clinic. 2) Chief complaints were one side flank pain which was followed by total gross hematuria. 3) Preoperative diagnoses were kidney rupture due to necrotic pelvic tumor in 56 years male and hypernephroma in 25 years male patient. 4) Operation was procedured at 8 days and 4 days after admission respectively. 5) The operative procedure were nephrectomy in both cases. 6) The pathological diagnoses were pelvis rupture due to renal stone and parenchymal rupture due to renal infarction in each case.
Carcinoma, Renal Cell ; Diagnosis ; Emergency Service, Hospital ; Flank Pain ; Hematuria ; Humans ; Infarction ; Kidney* ; Korea ; Male ; Nephrectomy ; Pelvis ; Rupture ; Rupture, Spontaneous* ; Surgical Procedures, Operative ; Urology

The purpose of this study was to determine the frequency and severity of arterial oxygen desaturation during and after endotracheal suctioning in a group of ventilator-dependent patients and to evaluate the efficacy of several maneuvers designed to minimize desaturation. All patients were ventilated with volume-typed ventilator and a synchronized intermittent mandatory ventilation(SIMV) mode was utilized. In a given patint, each study consisted of four seperate passes of the suction catheter. The oxygen status of the patient was monitored with a digital pulse oxymeter. The mean baseline SaO2 for the group with each suctioning technique was very similar and did not differ significantly. When patints were suctioned off the ventilator without extra breaths, a significant drop occurred in the mean SaO2 And when the patients were suctioned with prebreaths and postbreaths off the ventilator or were maintained on the ventilator and suctioned through the swivel adaptor, there was a significant desaturation with all three methods. However, the mean desaturation of 0.8 percent with the swivel adaptor was significantly less(p<0.05) than the mean desaturation with any of the other three methods.
Catheters ; Humans ; Oxygen* ; Suction* ; Ventilators, Mechanical

Dyke-Davidoff syndorme is a rare congenital disorder which developed hemiatropy of brain, enlargement of ventricles and prominent pneumatization of petrous pyramid of the temporal bone. It mainfests unilateral invountary movement such as seizure, athetosis, chorea and mental retardation. This disorder have strong evidence of significance to differential diagnosis of cerebral palsy because of different therapeutic approach and outcome. Recently we examined 10 years old girl who developed seizure at 2 years old and gradually progressed with hemiparesis, hypoplaisa of right side of the body. The brain CT scan showed marked dilatation of lateral ventricle, prominent sylvian fissure and cortical sulci with somewhat thickened skull vault and pneumatization of petrous pyramid of the temporal bone on left side. EEG showed high voltage slow wave and spikes. So we report a case of Dyke-Davidoff syndrome with review of literature.
Athetosis ; Brain ; Cerebral Palsy ; Child ; Child, Preschool ; Chorea ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Diagnosis, Differential ; Dilatation ; Electroencephalography ; Female ; Humans ; Intellectual Disability ; Lateral Ventricles ; Paresis ; Petrous Bone ; Seizures ; Skull ; Temporal Bone ; Tomography, X-Ray Computed

A 39 years old, ASA PS I. healthy female patient was scheduled for surgical resection of a paraganglioma surrounding right carotid artery bifurcation area. Anesthesia was induced with thiopental and sucinylcholine and maintained with 0.75-1.25 Vo1% halothane in 50% nitrous oxide in oxygen. Reconstructive carotid artery surgery with intraluminal shunt was performed due to laceration of carotid artery bifurcation area during wide dissection of tumor mass. Duration of the carotid artery clamp and release was 35 minutes and any significant changes in vital signs and EEG were not found. Soon after the patient was recovered from anesthesia. She was delivered to recovery room and then she was transferred to intensive care unit. She was discharged from hospital without any neurologic sequelae on the 13th postoperative day.
Adult ; Anesthesia ; Carotid Arteries ; Electroencephalography* ; Female ; Halothane ; Humans ; Intensive Care Units ; Lacerations ; Nitrous Oxide ; Oxygen ; Paraganglioma ; Recovery Room ; Thiopental ; Vital Signs

To compare the rate of success and incidence of complications associated with currently popular routes of percutaneous central venous cannulation, we studied 131 patients in whom central venous catheterization was attempted. Right or left external jugular veins were used in 67 cases, and success rate was 9796. Right internal jugular veins were used in 27 cases, and success rate was 100%. Right or left basilic veins were used in 21 cases, and success rate was 76%. Right or left subclavian veins were used in 16 cases, and 75% of success rate. Non-J-wire type catheters were utilized in 60 cases, and success rate was 88%. J-wire type catheters were used in 71 eases, and success rate was 94%. We found 2 cases of catheter curling in Non-J-wire type catheters.
Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Humans ; Incidence ; Jugular Veins ; Ocimum basilicum ; Subclavian Vein ; Veins

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation

The selection of either conventional mechanical ventilation or HFJV depends on the physical status of the patient,potential physioloic advantages and disadvantages, the requirements of the clinical situation and the capability of providing adequate oxygenation and ventilation. We have experienced that HFJV markedly improved the ventilatory status of a 52-year old male patient with severe respiratory failure due to flail chest and ruptured giant bulla refractory to conventional mechanical ventilatory support.
Anoxia* ; Flail Chest ; High-Frequency Jet Ventilation ; Humans ; Male ; Middle Aged ; Oxygen ; Respiration, Artificial* ; Respiratory Insufficiency ; Ventilation