No abstract available.
Cholecystectomy

We report a case of subcutaneous panniculitic T-cell lymphoma (SPTCL) which occurred in a 10-year-old Korean girl. Her disease presented as multiple erythematous subcutaneous nodules on the right cheek, left chest, abdomen, left flank, both calves, and left shin with systemic symptoms. She had a protracted course of multiple erythematous subcutaneous nodules for 2 months often with spiking fever. Histopathologic findings for the subcutaneous nodules revealed lobular panniculitis-like findings composed of atypical small, bland lymphocytes and histiocytes. Characteristically, atypical lymphocytes rimmed individual fat cells in a lace-like pattern and some histiocytes occasionally phagocytosed WBCs. Bone marrow findings revealed increased phagocytic histiocytes with engulfed hematopoietic cell. The immunophenotypic studies showed CD45RO (UCHLl)+, CD20-, CD4-, CD8+ and CD56+ (focal), lysozyme+, CD45 (LCA)+ and EBV-. She received three cycles of high-dose cyclophosphamide, adriamycin, vincristine, prednisolone (CHOP) and methotrexate, intrathecal methotrexate and one cycle of fludarabine, mitoxantrone and dexamethasone (FND) chemotherapy. She died of acute renal failure during multiple chemotherapy.
Abdomen ; Acute Kidney Injury ; Adipocytes ; Bone Marrow ; Cheek ; Child* ; Cyclophosphamide ; Dexamethasone ; Doxorubicin ; Drug Therapy ; Female ; Fever ; Glycogen Storage Disease Type VI ; Histiocytes ; Humans ; Lymphocytes ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Cutaneous ; Methotrexate ; Mitoxantrone ; Prednisolone ; T-Lymphocytes* ; Thorax ; Vincristine

PURPOSE: This study addressed the feasibility and effect of surgical treatment of metachronous periampullary carcinoma after resection of the primary extrahepatic bile duct cancer. The performance of this secondary curative surgery is not well-documented. METHODS: We reviewed, retrospectively, the medical records of 10 patients who underwent pancreaticoduodenectomy (PD) for secondary periampullary cancer following extrahepatic bileduct cancer resection from 1995 to 2011. RESULTS: The mean age of the 10 patients at the second operation was 61 years (range, 45-70 years). The primary cancers were 7 hilar cholangiocarcinomas, 2 middle common bile duct cancers, and one cystic duct cancer. The secondary cancers were 8 distal common bile duct cancers and 2 carcinomas of the ampulla of Vater. The second operations were 6 Whipple procedures and 4 pylorus-preserving pancreaticoduodenectomies. The mean interval between primary treatment and metachronous periampullary cancer was 20.6 months (range, 3.4-36.6 months). The distal resection margin after primary resection was positive for high grade dysplasia in one patient. Metachronous tumor was confirmed by periampullary pathology in all cases. Four of the 10 patients had delayed gastric emptying (n = 2) or pancreatic fistula (n = 2) after reoperation. There were no perioperative deaths. Median survival after PD was 44.6 months (range, 8.5-120.5 months). CONCLUSION: Based on the postoperative survival rate, PD may provide an acceptable protocol for resection in patients with metachronous periampullary cancer after resection of the extrahepatic bile duct cancer.
Ampulla of Vater ; Bile Ducts, Extrahepatic* ; Cholangiocarcinoma ; Common Bile Duct ; Cystic Duct ; Gastric Emptying ; Humans ; Medical Records ; Neoplasms, Second Primary ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Pathology ; Reoperation ; Retrospective Studies ; Survival Rate

No abstract available.
Carcinoma, Squamous Cell* ; Cisplatin* ; Drug Therapy* ; Head* ; Neck*

Transfusion-related acute lung injury (TRALI) is one of the leading causes of transfusion-related morbidity and mortality. However, it is frequently not diagnosed and under-reported, which could result in inappropriate treatment. Diagnostic definition for TRALI consists of hypoxia and bilateral pulmonary edema occurring during or within 6 hours of a transfusion in the absence of cardiac failure or intravascular volume overload. Here, we report a fatal case, which resulted from under-recognition and misdiagnosis of TRALI occurring during transfusion with packed red blood cells during a bilateral total knee replacement.
Acute Lung Injury ; Anoxia ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Diagnostic Errors ; Erythrocytes ; Heart Failure ; Knee ; Pulmonary Edema

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Crohn's disease is a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. In the early stages of Crohn's diseaae, the combiation of bowel wall edema and spasm produces intermittent obstructive manifestations, so the usual subjective symptoms were appeared long standing diarrhea, low grade fever and abdominal pain and distension. We recently experienced a case of Crohn's colitis with repeated bowel obstruction in female adult who underwent surgical resection.
Abdominal Pain ; Adult ; Colitis ; Crohn Disease* ; Diagnosis, Differential ; Diarrhea ; Edema ; Female ; Fever ; Humans ; Inflammatory Bowel Diseases ; Korea ; Spasm ; Tuberculosis

Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.

Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.

Intraoperative neurophysiologic monitoring during brain tumor surgery should acquire a baseline data as soon as possible. However, motor unit potentials (MEP) in our case showed baseline data could not be acquired in the early stage of surgery, but consecutive trials had abrupt appearance of MEP just after dura opening. This case shows the acquisition of baseline MEP during brain tumor surgery should not be given up until the dura is open especially in a state of raised intracranial pressure.