Intraabdominal vascular complications associated with lumbar disc surgery are rare but have potentially fatal consequences. Clinical manifestations of such injuries may be extremely variable and confused with anesthetic complications, myocardial infarction, or pulmonary embolism. So, the presence of vascular injury may not be recognized immediately. Recently, we experienced a case of extensive retroperitoneal hemorrhage during lumbar disc surgery. The patient was a 35 year-old healthy female. During operation, unexplained profound hypotension and tachycardia developed, but abnormal bleeding was not seen in the operative wound. Emergency CT of the abdomen was performed, and huge retroperitoneal hematoma was confirmed by the CT scan. Immediate abdominal exploration revealed the injury to right common iliac artery and vein. The patient underwent primary repair of lacerated artery and vein. Postoperative recovery was uneventful. We think awareness of the likelihood of vascular complications related to disc surgery is quite important for early diagnosis and management of these life-threatening complications.
Abdomen ; Adult ; Arteries ; Diskectomy* ; Early Diagnosis ; Emergencies ; Female ; Hematoma ; Hemorrhage ; Humans ; Hypotension ; Iliac Artery* ; Myocardial Infarction ; Pulmonary Embolism ; Rupture* ; Tachycardia ; Tomography, X-Ray Computed ; Vascular System Injuries ; Veins* ; Wounds and Injuries

In 1956, Prader and Willi first described a clinical syndrome that included severe neonatal hypotonia, hyperphagia, obesity, diabetes, hypogonadism, cryptorchidism, dental caries and mental deficiency. We have anesthetized a male patient who had Prader-Willi syndrome. He suffered for both pyoknee. General anesthesia was performed using N2O-O2-isoflurane. During induction and maintenance of anesthesia, we focused on the airway management, hypotonia, abnormal glucose metabolism, protection of aspiration and cardiovascular stabilization. Emergence of anesthesia was unremarkable. But he was expired from sepsis on the fourth postoperative day.
Airway Management ; Anesthesia ; Anesthesia, General ; Cryptorchidism ; Dental Caries ; Glucose ; Humans ; Hyperphagia ; Hypogonadism ; Intellectual Disability ; Male ; Metabolism ; Muscle Hypotonia ; Obesity ; Prader-Willi Syndrome* ; Sepsis

Endometriosis is defined as the presence of endometrial tissue (gland and stroma) outside the uterus. The most frequent sites of implantation are the pelvic viscera and the peritoneum. About 1% of woman with endometriosis have urinary tract lesions, of which 85% involve the bladder. We report one case of vesical endometriosis that have been treated by partial cystectomy.
Cystectomy ; Endometriosis* ; Female ; Humans ; Peritoneum ; Urinary Bladder ; Urinary Tract ; Uterus ; Viscera

No abstract available.
Humans

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Leucovorin*

BACKGROUND: Diffuse panbronchiolitis(DPB) is a chronic inflammatory disease affecting the respiratory bronchioles which was first described in Japan in 1966. DPB is prevalent in Japan and is known to be very rare in western countries. The first cases of DPB were reported in Korea in 1992 and the number of the patients has been increasing. The prognosis of DPR had been very poor because there had been no effective treatment for the disease. Hut it has been dramatically changed since the introduction of low-dose long-term erythromycin therapy. In Korea, there is rare experience of 1ong-term follow-up of DPH patients and we presents the results of mean 21.6 months of follow-up after erythromycin treatment. METHODS: We analyzed the long-term follow-up data of 25 DPH patients who were diagnosed in Seoul National University Hospital during the period from September 1989 to December 1994 and followed up more than 6 months with erythromycin therapy. We tried erythromycin 250mg b.i.d. on all the patients and analyzed the changes of subjective symptoms, physical signs, pulmonary function tests, and chest X-rays. RESULTS: 1) The mean follow-up period was 21.6 months. 2) Subjective symptoms improved in 96% of the patients within 3 months and 76% of the patients showed no symptom after 18 months of treatment. 3) Crackles and wheezing decreased in all patients within 3 months and completely disappeared in 76% of the patients after 18 months of treatment. 4) Diffuse small nodular lesions on chest X-ray decreased in 56% of the patients within 3 months and chest PA was normal in 32% of the patients after 12months of treatment. 5) FVC and FEV1 increased remarkably during the first 3 months and slowly increased thereafter, reaching normal level after 12 months of treatment. FEV1/FVC was 60.4% before treatment and in- creased slowly reaching 76.1% after 24 months of treatment. 6) Erythromycin therapy could be finished in 7 patients. The mean duration of medication was 26 months and no evidence of recurrence was found in 6 months of follow-up. 7) No patients had experienced the side effect of erythromycin, CONCLUSION: The prognosis of DPR is very goad when treated with erythromycin. And at least 2 years of erythromycin treatment seems to be needed for DPB patients.
Bronchioles ; Erythromycin* ; Follow-Up Studies* ; Humans ; Japan ; Korea ; Prognosis ; Recurrence ; Respiratory Function Tests ; Respiratory Sounds ; Seoul ; Thorax

No abstract available.
Hypertriglyceridemia*

The cylindrical cell papilloma, also known as oncocytic Schneiderian papilloma, is a rare benign sinonasal neoplasm. It accounts for 2-6% of the total sinonasal papillomas. Due to its rare incidence, this disease is not well-understood by clinicians. Recently, we experienced a case of cylindrical cell papilloma which was originated from the frontal sinus with bony destruction and had extended into the anterior ethmoid sinus in a 69-year old female patient. We adopted the frontal sinus approach via eye glass incision and removed the tumor thoroughly. The anterior wall of the frontal sinus was reconstructed with Medpore(R), and we thus report on the treatment of this case, along with a review of literature.
Ethmoid Sinus ; Eye ; Female ; Frontal Sinus ; Glass ; Humans ; Incidence ; Papilloma ; Paranasal Sinus Neoplasms ; Reconstructive Surgical Procedures

While angina pectoris is not uncommonly seen in hyperthyroidism, only rare case reports have proved that the myocardial ischemia was induced by coronary artery spasm. A 62 year-old man with a prior diagnosis of hyperthyroidism presented with repeated episodes of syncope and chest pain. The coronary angiogram showed normal coronary arteries. Severe diffuse spasm of both coronary was spontaneously induced and normalized after intracoronary nitroglycerin injection during the procedure of coronary angiography. For one year, he was on simultaneous antianginal and antithyroidal medicines with accomplishment of euthyroid state. He did not experience and anginal symptom for the last six months. The followup coronary angiogram performed 1 year later revealed a newly developed atherosclerotic lesion (about 50% stenosis in diameter) at the proximal left anterior descending artery. However provocative challenge test with intracoronary acetylcholine infusion failed to induce coronary spasm at the lesion. We report a case of coronary artery spasm associated with hyperthyroidism with a review of literatures.
Acetylcholine ; Angina Pectoris ; Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Follow-Up Studies ; Humans ; Hyperthyroidism* ; Middle Aged ; Myocardial Ischemia ; Nitroglycerin ; Spasm ; Syncope

Single coronary artery is one of coronary artery anomalies, which originates from single aortic ostium and distributes blood to whole myocardium and is reported to occur in about 0.02 percent of general population. Although this condition does not produce severe clinical complications, it is often combined with other congenital cardiac anomaly and may produce angina pectoris, arrythmia, and sudden cardiac death syndrome rarely. Bicuspid aortic valve is anomalous aortic valve which consists of two commisure and two cusps and is said to occur in about 2 percent of the population. In some cases, the valve may function normally for many decades, but in others, it may produce aortic stenosis and/or aortic regurgitation frequently. We report here a case of single coronary artery combined with bicuspid aortic valve.
Angina Pectoris ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Aortic Valve* ; Arrhythmias, Cardiac ; Bicuspid* ; Coronary Vessels* ; Death, Sudden, Cardiac ; Myocardium