A 10-year-old female child was underwent the tonsillectomy and adenoidectomy. She was relieved from the upper respiratory tract infection about 1 week before the operation. Her heart rate was recorded 100 to 110 per minute at the preanesthetic period, and then increased to about 140 per minute during the operation. We speculated that tacchycardia resulted from the inhalation anesthesia of sevoflurane as other common cases, so we didn't consider it as a serious problem. But the taccycardia was not relieved after the termination of anesthesia, and after the extubation, it was severely and rapidly aggravated to the ventricular tacchycardia with the circulatory collapse during the emergence period. After the rapid defibrillation and the chest compression, her resuscitation was successfully finished. We suspected her event was derived from the childhood cardiomyopathy, especially the viral myocarditis. So we reviewed viral myocarditis and focused a new aspect of childhood cardiac disease and screening.
Adenoidectomy ; Anesthesia ; Anesthesia, General ; Anesthesia, Inhalation ; Cardiomyopathies ; Cardiopulmonary Resuscitation ; Child ; Female ; Heart Diseases ; Heart Rate ; Humans ; Mass Screening ; Methyl Ethers ; Myocarditis ; Pediatrics ; Respiratory Tract Infections ; Resuscitation ; Shock ; Tachycardia, Ventricular ; Thorax ; Tonsillectomy

Malignant mesothelioma (MM) is a rare tumor that associated with asbestos exposure. For the reliable diagnosis, the adequate representative tissue samples are essential for the histology and immunohistochemical staining. We report a case of desmoplastic malignant mesothelioma (DMM), accounting for only 5 to 10% of all MM and having poor prognosis. A 76-year-old male visited emergency room presenting with chest pain. Chest computed tomography showed focal lobulated pleural enhancing mass in posterior aspect of left upper lobe. After video-assisted thoracoscopic surgery and several immunohistochemical stains, we could diagnose as DMM. The patient refused chemotherapy, but received analgesics and palliative radiation for the painful back area. Subsequently, he was transferred to hospice clinic after 17 months from appearance of the initial symptom.
Accounting ; Aged ; Analgesics ; Asbestos ; Chest Pain ; Coloring Agents ; Emergencies ; Hospices ; Humans ; Immunohistochemistry ; Male ; Mesothelioma ; Prognosis ; Thoracic Surgery, Video-Assisted ; Thorax

The transport proteins such as thyroxine-binding-globulin (TBG), albumin and transthyretin carry over 99% of circulating thyroid hormones. TBG is a major thyroid hormone transport protein in serum. Although TBG deficiency does not have metabolic consequences, it has diagnostic implications as it can lead to an incorrect interpretation of thyroid function tests. We experienced a case that a man who had an abnormal thyroid function showed unexpectedly low concentrations of serum total thyroxine. We detected the low TBG in his serum and he was diagnosed the TBG deficiency. We report this case along with a review of the related literature.
Carrier Proteins ; Prealbumin ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyroxine

Immediate implant placement is one of the treatment options in postextraction sites in anterior region. This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior maxilla using a flapless approach and modifying a provisional restoration. The case reported illustrates the practical procedure involved in developing natural esthetics with modifying a provisional restoration. The technique provides an accurate impression of the soft tissue through the intraoral use of provisional restoration. The final restoration uses a custom-made titanium abutment and porcelain fused gold crown. The technique is relatively simple and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores and white esthetic scores after 1 year.
Crowns ; Dental Implants, Single-Tooth ; Dental Porcelain ; Esthetics ; Humans ; Maxilla ; Titanium

Stiff man syndrome is a rare neurological condition characterized by progressive muscle stiffness and rigidity, painful spasm of axial and limb muscles with impairment of walking. Because its etiology is still unclear, diagnosis is based on typical clinical manifestations. Benzodiazepines are known as effective drug for the treatment of symptoms. We report a case of 39-year-old female patient who has suffered from rigidity of trunk, back pain, gait disturbance and depressive mood for 18 months. She was diagnosed as stiff man syndrome and successfully treated with medications such as diazepam, clonidine, baclofen.
Adult ; Back Pain ; Baclofen ; Benzodiazepines ; Clonidine ; Diazepam ; Extremities ; Female ; Gait ; Humans ; Muscles ; Spasm ; Stiff-Person Syndrome ; Walking

We report one case of implant plate exposure after Ahmed valve implantation, treated with preserved fascia lata transplantation. Exposure of implant occurred in 47-year-old patient with Ahmed glaucoma valve implantation. She was treated with preserved fascia lata graft and amniotic membrane transplantation. No recurrent implant plate exposure has been found since then. Intraocular pressure has been maintained well for 3 months of follow-up. In cases of implant plate exposure, additional preserved fascia lata graft and amniotic membrane transplantation can improve surgical success.
Amnion ; Fascia ; Fascia Lata ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Middle Aged ; Transplants

Streptococcus pneumoniae (pneumococcus) has been known to cause pneumonia, sinusitus, otitis media, meningitis, endocardiditis, myelitis and arthritis. Spinal epidural abscess by S. pneumoniae has been diagnosed rarely among the patients with spinal trauma, intravenous drug abuse, alcoholism, diabetes mellitus, long term steroid use, chronic renal failure, and acquired immune deficiency syndrome. We experienced a case of pneumococcal spinal epidural abscess occurred in 75-year-old female with L1 compression fracture since 4 years ago. Her spine magnetic resonance imaging revealed epidural abscess at the level from L3 to S1. S. pneumonia was identified on blood which was susceptible to penicillin. She was immediately treated with antibiotics and surgical exploration. The pneumococcal spinal epidural abscess is very unusual. Therefore, we report here this case with a brief review of the literature.
Acquired Immunodeficiency Syndrome ; Aged ; Alcoholism ; Anti-Bacterial Agents ; Arthritis ; Bacteremia ; Diabetes Mellitus ; Epidural Abscess ; Female ; Fractures, Compression ; Humans ; Kidney Failure, Chronic ; Magnetic Resonance Imaging ; Meningitis ; Myelitis ; Otitis Media ; Penicillins ; Pneumonia ; Spine ; Streptococcus pneumoniae ; Substance Abuse, Intravenous

Primary leiomyosarcomas of the stomach are very rare tumors originating from mesenchymal tissues and account for only 1% of all malignant gastric neoplasm. We present here a case of primary gastric leiomyosarcoma in a 79-year-old man who presented with a 10 day history of epigastric pain and gastric subepithelial tumor. Endoscopic examination showed a 5 cm in diameter, subepithelial tumor located in the body of the stomach. Radiological investigations showed nonspecific findings except for the primary gastric lesion. Complete histological evaluation including immnuohistochemical staining after complete surgical resection revealed a true leiomyosarcoma of the stomach. One year later, the patient presented with dyspepsia. Endoscopic and radiological evaluation showed a recurrent leiomyosarcoma with multiple liver metastases. Our experience suggests that a careful clinical follow-up after surgical resection should be recommended in patients with gastric leiomyosarcomas because of their aggressive clinical behavior.
Aged ; Benzeneacetamides ; Dyspepsia ; Follow-Up Studies ; Humans ; Leiomyosarcoma ; Liver ; Neoplasm Metastasis ; Piperidones ; Stomach ; Stomach Neoplasms

We report two cases of progressive localized retinal nerve fiber layer (RNFL) defect following cotton wool spots and a dot hemorrhage, 63-year-old woman with RNFL defect in inferior temporal retina of the right eye and 43-year-old man with RNFL defect in superior temporal retina of the right eye. Case 1 showed a dot hemorrhage adjacent to RNFL defect in the right eye and a new slit-like localized RNFL defect in the left eye 5 months later. The visual field in the left eye demonstrated corresponding field defect 9 months later. Case 2 showed a slit-like RNFL defect starting from cotton wool spots in the right eye and corresponding visual field defect. Cotton wool spots and dot hemorrhages represented ischemic damages at the nerve fiber layer. Two noticeable cases showed the progression of RNFL defect caused by repetitive localized microvascular ischemic events, resulting in visual field loss.
Adult ; Eye ; Female ; Hemorrhage ; Humans ; Middle Aged ; Nerve Fibers ; Retina ; Retinaldehyde ; Visual Fields ; Wool

Patellar clunk syndrome after total knee arthroplasty is a complication that causes pain and poping or catching of patella. We experienced a case after mobile bearing total knee arthroplasty that medial synovial tissue was impinged between patella and femoral component and intra-articular fibrotic nodule of superior pole of patella was observed. Also, wear of Polyethylene were observed at anterio side. We resolved the patient symptom after excision of fibrotic nodule, synovectomy of medial synovial hypertrophy, and change of polyethylene. We report this case with literature review.
Arthroplasty ; Humans ; Hypertrophy ; Knee ; Patella ; Polyethylene ; Ursidae