Angiosarcomas are rare tumors that are derived from vascular endothelial cells. They may occur in various sites, including the skin, breast, visceral organs and deep soft tissues. The pleura usually a metastatic site from angiosarcomas. However, thirty one cases of primary pleural angiosarcomas have been reported worldwide. Here, we report a 61-year-old man with a primary angiosarcoma of the pleura with a brief review of the literature.
Breast ; Endothelial Cells ; Hemangiosarcoma* ; Humans ; Middle Aged ; Pleura* ; Skin

No abstract available.
Aneurysm, Infected* ; Endocarditis* ; Mesenteric Artery, Superior*

Hypersensitivity myocarditis is an inflammatory disease of the myocardium usually related to drug allergy. The clinical manifestation may be nonspecific, and the diagnosis is seldom suspected or established during the life. So in most of the reported patients, the diagnosis was made at autopsy. Although, retrospectively, more than 90% of the patients described have had clinically recognizable cardiac involvement before death, tole clinical suspicion of hypersensitivity myocarditis is rare. The presence of nonspecific cardiac finding in a patient receiving any drug associated with hypersensitivity should alert the clinician to the possibility of drug related myocarditis. We experienced a case of hypersensitivity myocarditis accompanying allergic skin lesion in a 58 years old man with a history of taking cefadroxil. Fortunately, the outcome was favorable, therefore we do not have histologic confirmation of the diagnosis.
Autopsy ; Cefadroxil ; Diagnosis ; Drug Hypersensitivity ; Humans ; Hypersensitivity* ; Middle Aged ; Myocarditis ; Myocardium ; Retrospective Studies ; Skin

No abstract available.
Electrolytes* ; Lung*

No abstract available.

BACKGROUND: Bronchial asthma is classically defined as a reversible obstruction and hypsrresponsiveness of the airway attributed to an inflammatory process. However, some individuals with asthma show an irreversible component of airflow obstruction. It may be associated with structural changes in the airway resulting from severe or long standing air- way inflammation and remodelling. OBJECTIVE: The study was undertaken to compare the clinical characteristics of patient and airway remodelling as shown in bronchial wall thickness in HRCT according to the duration of asthma. MATERIALS AND METHODS: A retrospective clinical study was done on 119 patients with bronchial asthma, who had been admitted to Ewha Womans University Mokdong Hospital. Patients were divided to three groups according to disease duration and, clinical characteristics, pulmonary function test and HRCT were done. RESULTS: Basal FEV, and FVC was significantly lower in patient with longer duration. (p<0. 05) However pulmonary function was improved regardless of disease duration after 2 weeks steroid and bronchodilator therapy, and there was no significant difference in level changes according to the disease duration. The inner diameter of the bronchi and thickness of the bronchial wall at segmental and subsegmental bronchi increased significantly in patient with longer duration of asthma(p<0.05). Conclusion: These findings showed that airway remodelling was more extensive in patients with longer duration of disease resulting in decreased pulmonary function. These facts suggested that early anti-inflammatory therapy would be helpful for prevention of airway remodelling.
Airway Remodeling* ; Asthma* ; Bronchi ; Female ; Humans ; Inflammation ; Respiratory Function Tests ; Retrospective Studies

PURPOSE: The purpose of our study is to evaluate the plain radiographic features of pulmonary tuberculosis in adult diabetic patients compared with those in patients without any underlying diseases. MATERIALS AND METHODS: We analyzed the chest PA and lateral views of 100 patients having active pulmonary tuberculosis;40 patients had diabetes mellitus and 60 patients had no other underlying diseases. images were assesed for anatomical distributions, extents of lesions, size and number of cavity and patterns radiographic findings. RESULTS: Diabetic tuberculosis had higher prevalence and wider involvement of unusual segments for the tuberculosis such as anterior segment, lingular segment of upper lobe and basal segment of the lower lobe, and they showed the tendency of having more cavities than those who had no other underlying diseases, but there were no meaningful differences in the cavity size between the two groups. CONCLUSION: Pulmonary tuberculosis in diabetic patients tends to have wider extent with unusual segmental involvement and multiple cavities than in the patients who had no other underlying diseases.
Adult* ; Diabetes Mellitus ; Equidae ; Humans ; Prevalence ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

Polyuria is occasionally observed after general anesthesia with sevoflurane. Usually the onset of polyuria is abrupt and remission is spontaneous, so it's not so easy to do detailed investigation. The authors came across with two cases of polyuria during general anesthesia with sevoflurane which occurred so early around one hour after induction of anesthesia. Both cases revealed no special problem like central diabetes insipidus.
Anesthesia ; Anesthesia, General ; Diabetes Insipidus, Neurogenic ; Polyuria*

BACKGROUND: Continuous interscalene block has been known to improve postoperative analgesia after arthroscopic shoulder surgery. This was a prospective study investigating the ultrasound-guided posterior approach for placement of an interscalene catheter, clinical efficacy and complications after placement of the catheter. METHODS: Forty-two patients undergoing elective arthroscopic shoulder surgery were included in this study and an interscalene catheter was inserted under the guidance of ultrasound with posterior approach. With the inplane approach, the 17 G Tuohy needle was advanced until the tip was placed between the C5 and C6 nerve roots. After a bolus injection of 20 ml of 0.2% ropivacaine, a catheter was threaded and secured. A continuous infusion of ropivacaine 0.2% 4 ml/hr with patient-controlled 5 ml boluses every hour was used over 2 days. Difficulties in placement of the catheter, clinical efficacy of analgesia and complications were recorded. All patients were monitored for 48 hours and examined by the surgeon for complications within 2 weeks of hospital discharge. RESULTS: Easy placement of the catheter was achieved in 100% of the patients and the success rate of catheter placement during the 48 hr period was 92.9%. Postoperative analgesia was effective in 88.1% of the patients in the post anesthetic care unit. The major complications included nausea (7.1%), vomiting (4.8%), dyspnea (4.8%) and unintended vascular punctures (2.4%). Other complications such as neurologic deficits and local infection around the puncture site did not occur. CONCLUSIONS: The ultrasound-guided interscalene block with a posterior approach is associated with a success high rate in placement of the interscalene catheter and a low rate of complications. However, the small sample size limits us to draw definite conclusions. Therefore, a well-designed randomized controlled trial is required to confirm our preliminary study.
Amides ; Analgesia ; Catheters ; Dyspnea ; Humans ; Nausea ; Needles ; Neurologic Manifestations ; Prospective Studies ; Punctures ; Sample Size ; Shoulder ; Vomiting

BACKGROUND: Fresh gas flow (FGF) influences the speeds of induction and emergence. In general, emergence protocol involves a stepwise decrease in the vaporizer setting at fixed FGF, which causes anesthetic overuse and contaminates operating rooms. This study was designed to compare the decreasing patterns of sevoflurane concentration among groups with a similar course but with different FGFs. METHODS: One hundred patients scheduled for elective operation were randomly allocated to 3 groups (FGF 1 L/min, FGF 2 L/min, FGF 4 L/min). After induction with thiopental sodium 5 mg/kg and rocuronium 0.9 mg/kg or vecuronium 0.1 mg/kg for tracheal intubation, anesthesia was maintained at 1.5% of end-tidal sevoflurane concentration at an inflow of 4 L/min (N2O 2 L/min and O2 2 L/min). Ten minutes prior to the estimated operation end point, we changed FGF and vaporizer settings to the following 3 different emergence protocols: changing inflow in the FGF 1 L/min group (N2O 0.5 L/min and O2 0.5 L/min) with turning vaporizer off, changing inflow in the FGF 2 L/min group (N2O 1 L/min and O2 1 L/min) with a two-step decrease in the vaporizer setting (1.0 vol% for first 5 minutes then with the vaporizer off), and maintaining the inflow in the FGF 4 L/min group with a three-step decrease in the vaporizer setting (1.0 vol% for first 5 minutes and 0.6 vol% for next 5 minutes then with the vaporizer off). In each group, inspiratory and end-tidal sevoflurane concentrations were recorded every minute for 16 minutes, while end-tidal CO2, mean arterial pressure, heart rate, and inspired oxygen fraction were recorded every two minutes for 16 minutes. RESULTS: End-tidal concentrations of sevoflurane were similar in the 3 groups at the 6th, and 7th minutes and continuously increasing differences in sevoflurane concentrations from the 11th to 16th minute were observed in the FGF 1 L/min and FGF 2 L/min groups versus the FGF 4 L/min group. The concentration curves for the FGF 1 L/min group showed a smoother decreasing pattern than those of the other groups. CONCLUSIONS: The use of low FGF without vaporizer during emergence reduces sevoflurane washout within anesthetic machines and the exhausting of anesthetics into operating rooms, and also offers an easier means of controlling anesthetic depth.
Anesthesia* ; Anesthetics ; Arterial Pressure ; Fibroblast Growth Factor 2 ; Heart Rate ; Humans ; Intubation ; Nebulizers and Vaporizers ; Operating Rooms ; Oxygen ; Thiopental ; Vecuronium Bromide