Poikiloderma is a combination of telangiectasia, irregular mottled hyperpigmentation/depigmentation and superficial atrophy in a reticular pattern. Poikiloderma of Civatte is a rather common, acquired poikiloderma of the face and neck, most often affecting the middle-aged or the elderly. Poikiloderma of Civatte runs a chronic, benign, but irreversible course. The ideal treatment is elimination of both the vascular and pigmented components simultaneously. Most methods to treat this condition are ineffective, inefficient, or inconvenient and may cause significant side effects such as depigmentation and scarring. Recently, intense pulsed light sources have been used in poikiloderma of Civatte with their ability to target vascular and pigment components simultaneously. We experienced two cases of poikiloderma of Civatte treated by intense pulsed light with different parameters than those used in former reports, so we report this case with a review of previously published cases.
Aged ; Atrophy ; Cicatrix ; Humans ; Light ; Neck ; Telangiectasis ; Thorax

No abstract available.
Female ; Humans ; Myiasis

PURPOSE: The purpose of this study is to evaluate the radiologic and clinical outcomes after tension band wire fixation of Neer type II distal clavicle fractures. MATERIALS AND METHODS: Twenty-six patients with Neer type II distal clavicle fractures who underwent tension band wire fixation from March 2002 to May 2011 were included in the study. Fifteen cases were classified as Neer type IIa and 11 cases as type IIb. The postoperative mean follow-up period was 14.3 months. Clinical and radiologic evaluation was performed at two weeks, six weeks, three months, six months, and 12 months postoperatively. RESULTS: Bony union on X-rays was observed at an average of 11.7 weeks (range 8-20 weeks) postoperatively. The overall visual analogue scale score for pain was 1.23+/-2.75 postoperatively. The overall postoperative University of California at Los Angeles score increased to 33.5+/-2.15 from the preoperative score of 21.6+/-1.91 (p<0.05). CONCLUSION: Among various methods of treatment for Neer type II distal clavicle fracture, K-wire and tension band fixation was used and relatively satisfactory radiological and clinical results were obtained. This surgical method yields excellent clinical results, owing to its relatively easy technique, fewer complications, and allowance of early rehabilitation.
California ; Clavicle* ; Follow-Up Studies ; Humans ; Rehabilitation

A giant thrombosed extracranial internal carotid artery aneurysm (ECCA) is extremely rare and its treatment is challenging. Despite the advance of endovascular technique, open surgery is still considered a first-line treatment in giant thrombosed ECCA. We describe a case of giant thrombosed ECCA which was successfully treated by aneurysmectomy and graft interposition with the technical details.

PURPOSE: To evaluate the results of five-pin external fixation, with the fifth pin stabilizing the distal radius articular fragment, for unstable distal radial fractures. MATERIALS AND METHODS: Twenty cases of unstable distal radial fractures were treated with five-pin external fixation (5-pin group). The fifth pin was inserted into the distal articular fragment and attached to the external fixation frame. Metacarpal pins were removed at sixth week in 12 cases and at third in 8 cases, and radial pins were removed at eighth or ninth week. The radiographic results of 5-pin group were compared with those of 20 cases of traditional four-pin external fixation (4-pin group). RESULTS: The postoperative radial inclination was 23.1 degrees in 5-pin group and 22.2 degrees in 4-pin group; while at last follow-up 21.8o and 15.1 degrees respectively. Postoperative volar tilt was 8.5 degrees and 7.3o; while at last follow-up 6.3 degrees and 0.1 degrees respectively. Postoperative radial shortening was 0.3 mm, 0.4 mm; while at last follow-up 1.1 mm and 2.1 mm respectively. In 5-pin group, there were no significant differences in results whether the metacarpal pins were removed at sixth or third week. CONCLUSION: Five-pin external fixation, with the fifth pin stabilizing the distal articular fragment, enhanced early motion of the wrist maintaining fracture stability in unstable fractures of the distal radius.
Follow-Up Studies ; Radius* ; Wrist

An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs. It is thought to be a neoplastic or reactive inflammatory condition, controversially. The treatment of choice for myofibroblastic tumor is surgery, and recurrence is known to be rare. The optimal treatment method is not well-known for patients ineligible for surgery. We report a 47-year-old patient with aggressive recurrent IMT of the lungs. The patient had been admitted for an evaluation of back-pain two years after a complete resection of pulmonary IMT. Radiation therapy was performed for multiple bone recurrences, and the symptoms were improved. However the patient presented again with aggravated back-pain six months later. High-dose steroid and non-steroidal anti-inflammatory drugs were administered, but the disease progressed aggressively, resulting in spinal cord compression and metastasis to intra-abdominal organs. This is a very rare case of aggressively recurrent pulmonary IMT with multi-organ metastasis.
Humans ; Lung ; Lung Neoplasms ; Middle Aged ; Myofibroblasts* ; Neoplasm Metastasis* ; Rare Diseases ; Recurrence ; Spinal Cord Compression

A 23-year-old woman with MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes) underwent a laparoscopy-assisted appendectomy. MELAS syndrome is a multisystemic disease caused by mitochondrial dysfunction. General anesthesia has several potential hazards to patients with MELAS syndrome, such as malignant hyperthermia, hypothermia, and metabolic acidosis. In this case, anesthesia was performed with propofol, remifentanil TCI, and atracurium without any surgical or anesthetic complications. We discuss the anesthetic effects of MELAS syndrome.
Acidosis ; Acidosis, Lactic ; Anesthesia ; Anesthesia, General ; Anesthesia, Intravenous ; Anesthetics ; Appendectomy ; Atracurium ; Female ; Humans ; Hypothermia ; Malignant Hyperthermia ; MELAS Syndrome ; Muscular Diseases ; Piperidines ; Propofol ; Young Adult

BACKGROUND: Emergence agitation frequently occurs after desflurane anesthesia in children. We designed this study to find the optimal dose of fentanyl for the prevention of emergence agitation after desflurane anesthesia in children for tonsillectomy. METHODS: Eighty-one patients (3-10 yr) receiving desflurane anesthesia for tonsillectomy was randomly allocated to one of 3 groups. Fentanyl 1 microg/kg (group 1, n = 26), 2 microg/kg (group 2, n = 27), 3 microg/kg (group 3, n = 28) was administered intravenously just before inducing anesthesia. Anesthesia was maintained with desflurane. The recovery characteristics, such as the time to first movement, extubation and discharge from the recovery room were assessed. And patients reported their frequency of emergence agitation and severity of postoperative pain at recovery room. RESULTS: There were no significant differences between the three groups regarding the time to extubation and discharge from the recovery room. The incidence of emergence agitation was 42% in group 1, 25% in group 2, 10% in group 3 and that was significantly lower in group 3 than in group 1 (P < 0.05). The incidence of severe pain was lower in group 3 than in group 1 and group 2 (P < 0.05). CONCLUSIONS: In children undergoing tonsillectomy with desflurane anesthesia, 2 microg/kg and 3 microg/kg of fentanyl given just before induction had a reduced incidence of emergence agitation without a delay in recovery.
Anesthesia ; Child ; Dihydroergotamine ; Fentanyl ; Humans ; Incidence ; Isoflurane ; Pain, Postoperative ; Recovery Room ; Tonsillectomy

BACKGROUND: The aim of this study was to compare the streamlined liner of the pharynx airway (SLIPA), a new supraglottic airway device (SGA), with the laryngeal mask airway ProSeal(TM) (PLMA) during general anesthesia. METHODS: Sixty patients were randomly allocated to two groups; a PLMA group (n = 30) or a SLIPA group (n = 30). Ease of use, first insertion success rate, hemodynamic responses to insertion, ventilatory efficiency and positioning confirmed by fiberoptic bronchoscopy were assessed. Lung mechanics data were collected with side stream spirometry at 10 minutes after insertion. We also compared the incidence of blood stain, incidence and severity of postoperative sore throat and other complications. RESULTS: First attempt success rates were 93.3% and 73.3%, and mean insertion time was 7.3 sec and 10.5 sec in PLMA and SLIPA. There was a significant rise in all of hemodynamic response from the pre-insertion value at one minute following insertion of SLIPA. But, insertion of PLMA was no significant rise in hemodynamic response. There was no statistically significant difference in the mean maximum sealing pressure, gas leakage, lung mechanics data, gastric distension, postoperative sore throat and other complication between the two groups. Blood stain were noted on the surface of the device in 40% (n = 12) in the SLIPA vs. 6.7% (n = 2) in the PLMA. CONCLUSIONS: The SLIPA is a useful alternative to the PLMA and have comparable efficacy and complication rates. If we acquire the skill to use, SLIPA may be considered as primary SGA devices during surgery under general anesthesia.
Anesthesia ; Anesthesia, General ; Blood Stains ; Bronchoscopy ; Hemodynamics ; Humans ; Incidence ; Laryngeal Masks ; Lung ; Mechanics ; Pharyngitis ; Pharynx ; Rivers ; Spirometry

PURPOSE: Hollow fiber assays offer an early in vivo method of anticancer drug screening. The assays have been optimized for human cancers originating from the lung, breast, colon, ovary, and brain, but not from the stomach and liver. The current study focused on optimization of hollow fiber assays for gastric and hepatocellular carcinoma cell lines. MATERIALS AND METHODS: Gastric (SNU-16, SNU-484, SNU-668) and hepatocellular (HepG2, SK-Hep-1, Hep3B) carcinoma cell lines in hollow fibers were transplanted subcutaneously and intraperitoneally into mice, which were subsequently treated with a standard anticancer agent, paclitaxel. The hollow fiber activity of paclitaxel in each cell line was compared with the xenograft activity. RESULTS: Using optimized inoculation densities and schedules, treatment with paclitaxel was effective in gastric carcinoma cell lines, SNU-16 and SNU-484, but not in SNU-668. In the hollow fiber assays, paclitaxel was effective in hepatocellular carcinoma cell lines, HepG2 and SK-Hep-1, but not in Hep3B. Consistent with the results of the hollow fiber assay, SNU-16 and SNU-484, but not SNU-668, showed tumor regression, and HepG2 and SK-Hep-1, but not Hep3B, showed effective tumor responses following treatment with paclitaxel in xenograft models. When EW7197, a novel compound, and flavopiridol were tested in SNU-16 cells under optimized conditions, the hollow fiber activity showed good correlation with the xenograft activity of each compound. CONCLUSION: Our protocols may be useful for screening candidate small molecules that may exhibit activity against stomach and liver cancers, both of which are common in Korea.
Animals ; Appointments and Schedules ; Brain ; Breast ; Carcinoma, Hepatocellular ; Cell Line ; Colon ; Drug Evaluation, Preclinical ; Female ; Heterografts ; Humans ; Korea ; Liver ; Liver Neoplasms* ; Lung ; Mass Screening ; Mice ; Ovary ; Paclitaxel ; Stomach Neoplasms ; Stomach*