The anesthetic management of patient with pheochromocytoma is often difficult even when a clear-cut preoperative diagnosis has been made. We experienced a patient with a gastric polyp and an unsuspected pheochromocytoma which presented with transient hypertension during general anesthesia for an elective subtotal gastrectomy. The patient developed severe hypertension and arrhythmia leading to cardiac arrest just after the skin incision. This case illustrate the value of preoperative evaluation in a patient with transient hypertension.
Anesthesia ; Anesthesia, General ; Arrhythmias, Cardiac ; Diagnosis ; Gastrectomy ; Heart Arrest* ; Humans ; Hypertension ; Pheochromocytoma* ; Polyps* ; Skin

A case of systemic cytomegalovirus infection in a newborn baby is reported. This female baby was born after 36 weeks gestation to a 30 year-old mother who had no prenatal problem except for breech presentation and placenta previa for which Caesarian section was given. The mother has two healthy children. The clinical course of this baby was characterized by repeat spells of apnea, cyanosis and edema, that progressed to deepening jaundice and generalized petechiae. She died 58 hours after birth. A characteristic linear calcification along the ventricular wall of the brain enabled us to suggest congenital nature of cytomegalic inclusion disease in the patient. Postmortem exmaination showed numeorous cystomegalic inclusions in kidneys, pancreas, liver and thyroid. There was subependymal and periaqueductal calcification together with hydrocepalus and cerebellar hypoplasia.
Adult ; Apnea ; Autopsy* ; Brain ; Breech Presentation ; Child ; Cyanosis ; Cytomegalovirus Infections* ; Edema ; Female ; Humans ; Infant, Newborn ; Jaundice ; Kidney ; Liver ; Mothers ; Pancreas ; Parturition ; Placenta Previa ; Pregnancy ; Purpura ; Thyroid Gland

The surgical methods for the obstruction of nasolacrimal duct include conventional dacryocystorhinostomy and nasal endoscopic dacryocystorhinostomy.The authors followed 52 eyes of 54 patients who had undergone conventional or endoscopic dacryocystorhinostomy to compare the surgical success rate, between the group whose nasolacrimal duct was washed with normal saline and the control group without irrigation. Nasal cavity of all patients were examined for the abnormalities such asnasal septal deviation, hypertropy of middle concha, ethmoid sinusitis and nasal polyp.The patients with those abnormalities were excluded. There was significant difference between the two groups, showing better outcome in the group with nasal irrigation. These results suggest that washing NLD after the dacryocystorhinostomy may be effective as an additional therapy to enhance the success rate of operation.
Dacryocystorhinostomy* ; Ethmoid Sinus ; Ethmoid Sinusitis ; Humans ; Nasal Cavity ; Nasal Lavage ; Nasolacrimal Duct*

No abstract available.
Hodgkin Disease*

This study inquired the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and left ventricular (LV) dysfunction and extracellular water in continuous ambulatory peritoneal dialysis (CAPD) patients. We conducted a cross-sectional study of 30 CAPD patients. Each patient was admitted to the department of internal medicine, Chosun University Hospital between February and October, 2006. Echocardiography was performed using HDI 5000, allowing M-mode, two-dimensional measurement. A multifrequency bioimpedance analyzer was used; extracellular water was calculated as a percentage of total body water and was understood as the index of volume load of CAPD patients. The mean age was 47+/-12 years. Underlying causes of renal failure were 14 with diabetes mellitus, 7 with hypertension, and 9 with chronic glomerulonephritis. The mean serum NT-proBNP level was 14236.56 (83-35,000) pg/mL. LV mass index and LV ejection fraction were 151.67+/-42.5 g/m2 and 57.48+/-12.9%, respectively. The mean extracellular water was 35.97+/-1.04%. Serum NT-proBNP levels correlated positively with LV mass index (r=0.768, p=0.01) and extracellular water (r=0.866, p=0.01) and negatively with LV ejection fraction (r= -0.808, p=0.01). Serum NT-proBNP levels significantly correlated with LV mass index, LV ejection fraction, and extracellular water. Therefore, serum NT-proBNP levels can be a clinical predictive marker for LV hypertrophy, LV dysfunction, and volume status in CAPD patients.
Body Water ; Cross-Sectional Studies ; Diabetes Mellitus ; Echocardiography ; Extracellular Fluid ; Glomerulonephritis ; Humans ; Hypertension ; Hypertrophy ; Internal Medicine ; Natriuretic Peptide, Brain ; Peptide Fragments ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Insufficiency ; Ventricular Dysfunction, Left

PURPOSE: This study was to investigate the effect on early visual outcome of corneal cap attachment with brushing after LASIK. METHOD: We studied 40 eyes of 20 patients who received LASIK from April, 1998 to March, 1999. Early visual acuity was measured in the first, second and third day after LASIK between the group that received brushing procedure and the group that didn't. RESULT: The consecutive group that received brushing procedure showed considerable increase in recovery rate of visual acuity compared to the control group that did not receive brushing procedure on the first day (P<0.001), second day (P<0.004) and third day (P<0.005) after LASIK. However, there was no difference of visual acuity between the two groups in one month, three months and six months (P>0.05) after LASIK. CONCLUSION: We think that corneal cap attatchment with brushing helps early visual recovery and further investigation in this study is needed.
Humans ; Keratomileusis, Laser In Situ* ; Visual Acuity

Background: Epidermoid cysts are benign tumors derived from the infundibular portion of hair follicles and thus have a flattened surface epithelium and keratohyaline granules. They can occur at any age but are most frequently reported in adults, and more often occur in men than women. Most epidermoid cyst operations are performed for cosmetic purposes, or to relieve inflammation. The definitive treatment is complete excision or destruction of the cyst. The aim of this study was to improve understanding of epidermoid cysts. Methods: We analyzed 432 cases of epidermoid cyst in 398 patients that underwent complete excision and biopsy between April 2001 and March 2020, according to patient age, patient gender, and lesion location. Results: From all epidermoid cyst excisions performed, 17.6% were for patients in their 40s and 50s, 16.8% for those in their 20s, 16.1% for those in their 30s, 14.6% for those aged 60 or older, 5.0% for teenagers, and 0.5% for those under 10 years. Cases of epidermoid cysts occurred at a men-to-women ratio of about 3:2, with 59.5% of cases in men and 40.5% in women. By lesion location, 65.0% of cases were on the face, 10.9% on the trunk, 7.9% on the scalp, 7.9% on the neck, 4.3% on lower extremities, 3.9% on upper extremities, and 0.2% on genitalia. On the face, 20.8% of cases were on the cheek, 12.7% on the periauricular area, 10.9% on the periorbital area, 6.0% on the frontal area, 5.6% on the mental area, 3.7% on the perioral area, 2.8% on the nasal area, and 2.5% on the temporal area. Conclusion The proportion of women with epidermoid cysts was higher in our study than in previous studies. Moreover, the results showed that surgery has been on the rise in recent years, with facial surgery being the most common.

A uterus-like mass (ULM) is a central cavity lined by endometrial glands and stroma and surrounded by thick-walled smooth muscles. To date, 31 cases of ULM have been reported in the English literature. ULM typically presents as a single mass and is located in the pelvic cavity. We report here a very rare case of multiple extrapelvic ULMs involving the cecum, descending colon, and mesocolon. After extensive literature research, our case appears to be the first case of multiple ULMs found in extrapelvic sites and the first case of ULM in the colon. The present case suggests that ULM should be included in the differential diagnosis of colonic submucosal tumors in female patients with chronic abdominal pain or menstruation-associated symptoms.
Abdominal Pain ; Adenomyoma ; Cecum ; Colon ; Colon, Descending ; Diagnosis, Differential ; Female ; Humans ; Mesocolon ; Muscle, Smooth

Multiple myeloma is a monoclonal plasma cell proliferation disorder with various symptoms and signs caused by paraproteinemias. Among these signs, a bleeding tendency is one of the major fatal causes. However, significant severe bleeding is rare in most cases. In this study, we report a case of multiple myeloma in a patient who had a severe recurrent bleeding tendency due to platelet dysfunction caused by paraproteins. After being treated with therapeutic plasma exchange and chemotherapy, the patient's monoclonal protein level decreased and the bleeding stopped.
Blood Platelets ; Hemorrhage ; Hemostatic Disorders ; Humans ; Multiple Myeloma ; Paraproteinemias ; Paraproteins ; Plasma Cells ; Plasma Exchange ; Plasmapheresis ; Platelet Function Tests

Nerve conduction studies and sural nerve biopsies were performed on 13 patients with alcoholic peripheral neuropathy. Most patients had sensory loss and tingling sensation below knees. Wernicke's encephalopathy and pellagra dermatitis were commonly associated. There was no evidence of demyelinating newcpathy in nerve conductoion studies. Myelinated fiber oounts showed loss of small and largetbers in all patients, retaining a bimodal distribution. Segmental denyelination was not found in all teased fibers. Electron microscopy confirmed axonal degeneration of myelinated andunmyelinated fibers with seconday myelin change.
Alcoholics* ; Axons ; Biopsy ; Dermatitis ; Humans ; Knee ; Microscopy, Electron ; Myelin Sheath ; Neural Conduction ; Pellagra ; Peripheral Nervous System Diseases* ; Sensation ; Sural Nerve ; Wernicke Encephalopathy