The amniotic band syndrome is a collection of fetal malformations caused by fibrous bands that appear to entangle or entrap various parts of fetus in utero, leading to deformation, malformation, or disruption involving the limbs, craniofacial region and trunk. The incidence of this syndrome is relatively rare. This syndrome often shows irreversible serious outcome. So, early diagnosis of amniotic band syndrome is important. Ultrasonography enables us to detect the amniotic band syndrome prenatally. In the second and third trimester of the pregnancy, it is relatively easy to detect major anomalies of amniotic band syndrome by its characteristic features, including amputation and/or constriction of the extremities, facial clefts, asymmetric encephaloceles and gastroschisis. Five cases of amniotic band syndrome which have been diagnosed prenatally by ultrasonography are discussed. The diagnosis was based on sonographic visualization of amniotic band and associated fetal deformation, malformations or disruption known to characterize the amniotic band syndrome.
Amniotic Band Syndrome* ; Amputation ; Constriction ; Diagnosis* ; Early Diagnosis ; Encephalocele ; Extremities ; Female ; Fetus ; Gastroschisis ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography*

Generally, absolute alcohol embolization has been commonly used for treatment of arteriovenous malformation (AVM) because complete surgical extirpation of AVM can be an extremely hazardous and difficult. Even if absolute alcohol is safe embolic agent, it can result in pain, pulmonary hypertension, pulmonary embolism and post-embolization syndrome such as nausea, vomiting, hemolysis and myoglobinuria. So, general anesthesia is needed for alcohol embolization. In this case, anesthesia was induced with intravenous (IV) propofol 110 mg and succinylcholine 60 mg and maintained with propofol and vecuronium. The pulmonary artery pressure was monitored with a Swan-Ganz catheter. After alcohol injectons, systolic pulmonary artery pressure was increased, ranging 35-40 mmHg. And cola-colored urine was noticed. For treatment of pulmonary hypertension, nitroglycerine was given IV. The IV fluid rate was increased and furocemide was given IV to increase the urine output. After general anesthesia, the patient was awake but appeared to be alcohol-intoxicated. Blood alcohol level was 42 mg/dl. Urinalysis showed large amounts of myoglobin, hemoglobin and albumin. So, anesthesiologists have to keep in mind of such complications when absolute alcohol embolization is done.
Anesthesia ; Anesthesia, General ; Arteriovenous Malformations* ; Catheters ; Ethanol* ; Hemolysis ; Humans ; Hypertension, Pulmonary ; Myoglobin ; Myoglobinuria ; Nausea ; Nitroglycerin ; Propofol ; Pulmonary Artery ; Pulmonary Embolism ; Succinylcholine ; Urinalysis ; Vecuronium Bromide ; Vomiting

PURPOSE: Catheter directed thrombolytic dissolution (CDT) of deep vein thrombus (DVT) is in widespread use, yet the complications especially pulmonary embolism (PE), associated with the procedure remains ill defined. To assess the incidence of PE we reviewed the clinical course of acute DVT patients treated by CDT. METHOD: From January 2000 to September 2003, 25 patients were treated by CDT. To define the new development of PE, patients had a technetium 99m lung scan before and just after CDT-, and clinical symptoms were recorded. All patients underwent ascending venogram and CT scan initially to define DVT extension. CDT with urokinase was done by a the same intervention radiologist. RESULT: Proximal thrombus extension level was the femoral vein in 8 patients, iliac vein in 12-, and inferior vena cava (IVC) in 5. Complete thrombolysis was achieved in 16 patients, partial lysis in 2 and no lysis in 7. PE was detected in 7 patients with initial lung scan whose thrombus proximal level was IVC 2, iliac vein 4, femoral vein 1 in each, and no changes in lung scan after CDT. In 17 patients with normal findings at intial lung scan, there were also no changes after CDT. One patient with normal lung scan showed high probable scan defects in lung scan after CDT. Because he also complained of sudden onset dyspnea with cough, we diagnosed him as newly developed, PE-related CDT. CONCLUSION: Only one (4%) case of PE was developed in our study. No prediction factor of PE such as CDT results, or thrombus proximal extent could be defined. These findings suggest that routine usage of temporary IVC filter is unnecessary during CDT.
Catheters* ; Cough ; Dyspnea ; Femoral Vein ; Humans ; Iliac Vein ; Incidence ; Lung ; Pulmonary Embolism* ; Technetium ; Thrombosis ; Tomography, X-Ray Computed ; Urokinase-Type Plasminogen Activator ; Veins ; Vena Cava, Inferior ; Venous Thrombosis*

Kaposi sarcoma is a rare tumor originated from skin in patients with immune suppressive illness like as acquired immunodeficiency syndrome (AIDS) or organ transplantation. It may be widely disseminated internally such as digestive or respiratory organ. In Korean patients with AIDS, Kaposi sarcoma is rarely seen rather than western countries. The reason is unknown. Although few cases of Kaposi sarcoma in patients with AIDS had been described in the Korean literatures, multi-organ involved cases were extremely rare. We describe a case of old AIDS patient in whom Kaposi sarcoma had affected multi-organs including esophagus, stomach, duodenum, colon, bronchi and skin.
Acquired Immunodeficiency Syndrome ; Bronchi* ; Colon ; Duodenum ; Esophagus ; Gastrointestinal Tract* ; Humans ; Organ Transplantation ; Sarcoma, Kaposi* ; Skin ; Stomach ; Transplants