A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient’s vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

No abstract available.
Ear* ; Papain*

No abstract available.
Fungi* ; Plastics*

Trichloroethylene is a very common chemical used principally as a solvent and a degreasing agent in industry, We have experienced a case of toxic erythema, toxic hepatitis, and subsequent exfoliative dermatitis possibly due to trichloroethylene in a 23-year-old male. He had dealed with a cleaning process with trichloroethylene in a factory of stainless steel materials. We report our case with the review of the toxicity of trichoroethylene.
Dermatitis, Exfoliative ; Drug-Induced Liver Injury* ; Erythema* ; Humans ; Male ; Stainless Steel ; Trichloroethylene* ; Young Adult

We experienced an atypical case of sebaceous gland hyperplssis in a 28-year old male. He had asymptomatic, multiple, globoid, yellowish papules in a zosteriform distribution on the right lower abdomen (T8 dermatome) that were of 5 years duration. Histologically, there are many hyperplastic lobules of sebaceous glands, some of which are connected with a central dilated duct.
Abdomen ; Adult ; Humans ; Hyperplasia* ; Male ; Sebaceous Glands*

PURPOSE: To investigate corneal surface changes and subjective symptoms after small incision cataract surgery and to compare the changes between clear corneal incision and corneoscleral incision. METHODS: The present prospective randomized study included 18 eyes of 18 patients with corneoscleral incision (Group 1) and 25 eyes of 25 patients with clear corneal incision (Group 2). All patients were examined for tear break-up time (BUT), Schirmer test, cornea and conjunctiva fluorescein staining, and dry eye symptoms using the Ocular Surface Disease Index (OSDI). All values were compared before surgery and at one day, one week, four weeks, and seven weeks after surgery. RESULTS: BUT decreased significantly (p < 0.05) and fluorescein staining scores increased significantly (p < 0.05) at postoperative day 1. The values of BUT and fluorescein staining returned to the preoperative level at postoperative week 3 in Group 1. In Group 2, fluorescein staining scores returned at one week and BUT returned to the preoperative level at postoperative week 3. Postoperative Schirmer test results were unchanged compared to preoperative values, and there was no difference between the two groups. OSDI scores significantly improved compared to preoperative scores at postoperative one week. In Group 1, the scores improved at postoperative one week (p < 0.05) compared to those in Group 2 at postoperative three weeks (p < 0.05). CONCLUSIONS: Phacoemulsification with a small incision induced transient corneal surface changes and tear film instability, but the changes returned to the preoperative level at postoperative three weeks. Dry eye symptoms also improved at postoperative one week. The changes lasted longer with clear corneal incision than with corneoscleral incision but returned to the preoperative level at postoperative three weeks in both groups.
Cataract ; Conjunctiva ; Cornea ; Eye ; Fluorescein ; Humans ; Phacoemulsification ; Prospective Studies ; Tears

Background: Brain MRI may unexpectedly display abnormalities in splenium of the corpus callosum (SCC). However, the clinical implications of this lesion are unclear and are not always consistent with ischemic infarctions. We performed this study to clarify the clinical and radiological implications in patients with SCC lesions. Methods: We retrospectively reviewed consecutive patients with MRIreported SCC changes between 2009 and 2012. We analyzed clinical and radiological findings, etiologies, cognitive impairment, and clinical outcomes. Results: We found 30 patients (16 females; mean 50.5 years) who had SCC lesions on MRI. Confusion was the most common clinical finding in 50% of cases. Cerebral infarction was the most common etiology (50%). The most consistent SCC changes on MRI were low signal in T1WI, high signal on T2WI and FLAIR, and high signal on DWI. We classified SCC lesions into in situ SCC lesions (SCC only) and multiple (SCC plus) lesions for patients with multiple lesions. The clinical symptoms of SCC only lesions were relatively mild. Cognitive functions were evaluated by Mini Mental State Examination (MMSE) and clinical dementia rating (CDR) scale at the time of discharge and patients with SCC only lesions showed less impaired cognition compared with those with SCC plus lesions. Clinical outcomes were evaluated by the modified Rankin scale at 1 month and patients with SCC only lesions revealed good clinical outcomes compared with those with SCC plus lesions. Conclusions: MRI-reported SCC lesions may have heterogeneous etiologies and present with various symptoms. The clinical course and outcome are relatively good, particularly in small isolated and oval shaped SCC lesions.

Paget's disease of bone (osteitis deformans), a chronic osseous disease of unknown etiology, is extremely rarein Asia although well known in western countries. This disease is characterized by the simultaneous absorption ofbone and the new bone formation of abnormal character affecting middle and later age groups. The authorsexperienced a case of monostotic Paget's disease involving left pelvic bone in 56-years old female. To ourknowledge, this is the first cas report of monostotic Paget's in Korea.
Absorption ; Asia ; Female ; Humans ; Korea ; Osteitis Deformans ; Osteogenesis ; Pelvic Bones

Cubitus varus deformity is the most common angular deformity resulted by supracondylar fractures in children. Although, this deformity rarely limit elbow function, the correction is frequently requested due to cosmetic problem. The normal carrying angle can be restored by supracondylar osteotomy. Previous reports controversy over the cause of the deformity, the necessity and timing of operative correction, the operative technique itself, and the attendant risks. We performed 18 lateral closing wedge osteotomies with French technique(10 cases), and Sherman plate fixation(8 cases) by posterolateral approach from January 1978 to December 1988 at Chosun University Hospital. The results were as follows: 1. The most common cause of cubitus varus was suprcondylar fracture of the humerus(88.9%). 2. The results of supracondylar osteotomies were excellent is 8 cases(44.8%), good in 7 cases (38.9%), poor in 3 cases(16.7%). 3. The varus and rotational deformities were corrected by modified French method and Sherman plate fixation after lateral closing osteotomy. 4. In case of plate fixation, good results were obtained even older cases because of reducing time of extermal immobilization and promotion early joint exercise.
Child ; Congenital Abnormalities ; Elbow ; Humans ; Immobilization ; Joints ; Methods ; Osteotomy

PURPOSE: To evaluate the clinical effectiveness of topical diquafosol tetrasodium (DQS) after laser epithelial keratomileusis (LASEK). METHODS: This randomized prospective study included 97 eyes of 49 patients who were scheduled for LASEK. Patients in the DQS group used both 0.3% sodium hyaluronate and 3% DQS for 3 months after surgery while patients in the control group used only 0.3% sodium hyaluronate. Corneal staining score, tear film break-up time (TF-BUT), Schirmer test and ocular surface disease index (OSDI) were evaluated before surgery and 2, 4, 8, 12 and 16 weeks after surgery. RESULTS: There was no significant difference in visual acuity, spherical equivalent and corneal haziness between the 2 groups after surgery. Corneal staining score was significantly lower in the DQS group than in the control group 2 weeks after LASEK (p < 0.01) and increased in the control group after LASEK compared with the preoperative value (2 weeks after LASEK, p < 0.01), but decreased in the DQS group (12 and 16 weeks after LASEK, p < 0.05). TF-BUT was significantly higher in the DQS group than in the control group 2 to 16 weeks after LASEK (p < 0.01) and increased values were observed in the DQS group after LASEK compared with the preoperative value (4 to 16 weeks after LASEK, p < 0.05). The mean OSDI was significantly higher 4 to 16 weeks after LASEK in the control group than in the DQS group (p < 0.01). CONCLUSIONS: Subjective dry eye symptoms and objective markers were worse for 4 weeks after LASEK. The use of 3% DQS for 12 weeks after surgery improved these symptoms and markers with the effect lasting 16 weeks after LASEK.
Dry Eye Syndromes ; Humans ; Hyaluronic Acid ; Keratectomy, Subepithelial, Laser-Assisted ; Prospective Studies ; Refractive Surgical Procedures ; Tears ; Visual Acuity