The authors report a case of 42-year-old woman with an intraventricular tumor in the trigone of the left lateral ventricle. The first operation achieved a microscopically complete resection. The tumor was histologically atypical meningioma. After 26 months, there were recurrences of intraventricular meningioma. Complete resection of the tumor and adjuvant radiation therapy were performed, and the histological diagnosis was malignant meningioma. Sixteen months after the second operation, spinal metastasis in cervicolumbar lesion was diagnosed and a subtotal removal of cervical intradural extramedullary mass was performed. We describe an unusual case of intraventricular malignant meningioma with cerebrospinal fluid-disseminated spinal metastases with review of the clinical courses of previous reports.
Adult ; Cerebral Ventricle Neoplasms ; Female ; Humans ; Lateral Ventricles ; Meningioma ; Neoplasm Metastasis ; Recurrence

BACKGROUND AND OBJECTIVES: Pulmonary thromboembolism (PTE) after surgery is one of the rare but fatal complications causing sudden respiratory failure. This study was performed to evaluate PTE after head and neck surgery and to report our recent experience with review of the literature. SUBJECTS AND METHOD: We retrospectively analyzed 1096 patients who underwent head and neck surgery from January 2011 to June 2013 in a tertiary hospital. We evaluated the incidence and characteristics of PTE and risk factors of PTE such as smoking, body mass index, comorbidities, coronary artery disease, coagulation disorder and Caprini risk assessment model. RESULTS: PTE occurred in five of 1096 patients (0.46%; two were male and three were female, with a mean age of 56.2 year). All patients with PTE were categorized into high risk group of PTE by Caprini model. The mean Caprini risk score were 6.6 and 4.6 in the PTE patients and non-PTE patients, respectively. The significant risk factors were long operative time, cancer patients and high Caprini score in this study. One PTE patient underwent cardiopulmonary resuscitation due to respiratory arrest, afterwards received thromboembolectomy by thoracotomy. Four patients received anticoagulation therapy only. CONCLUSION: Risk stratification for PTE is necessary in patients who receive long operation for head and neck cancer or have high Caprini score.
Body Mass Index ; Cardiopulmonary Resuscitation ; Comorbidity ; Coronary Artery Disease ; Female ; Head and Neck Neoplasms ; Head* ; Humans ; Incidence ; Male ; Neck* ; Operative Time ; Pulmonary Embolism* ; Respiratory Insufficiency ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Smoke ; Smoking ; Tertiary Care Centers ; Thoracotomy ; Venous Thrombosis

Background: Abdominal compartment syndrome (ACS) occurs due to increased abdominal cavity pressure, causes multiple organ damage, and leads to fatal consequences. Increased intraperitoneal pressure due to different reasons generally does not result in serious damage, due to the compliance of the abdominal wall. However, when the pressure exceeds the limit, ACS develops, thereby causing fatal damage to the organs. Case: A patient presented with rapid stomach swelling due to excessive food intake and was known to have bulimia nervosa, which had now resulted in ACS. Mental changes, abdominal distension, color change in the legs, acute kidney injury, and acidosis were seen. The patient expired due to ischemia-reperfusion injury and disseminated intravascular coagulation, which occurred after surgical decompression. Conclusions Under suspected ACS conditions, we should be aware of various symptoms that can occur. Early attempts for decompression are helpful, and it is important to be prepared for reperfusion injury prior to surgical decompression attempts.

PURPOSE: To discribe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. MATERIALS AND METHODS: Four portogramsin five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a cntrol subject with liver cirrhosis. RESULTS: Portographic findings of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. CONCLUSION: A portogram of idiopathic portal hypertension may be useful in differentiating this andliver cirrhosis.
Fibrosis ; Humans ; Hypertension, Portal* ; Liver Cirrhosis ; Portography

Lung toxicity associated with cyclophosphamide use is a rare but serious side effect, that may result in a fatal course. However no such cases have been reported in Korea, so clinicians would not be alert to this adverse effect. We recently experienced a woman with Wegener's granulomatosis and idiopathic pulmonary fibrosis. This patient had been administered 12 grams of cyclophosphamide for 4 months. At that time of admission, She felt aggravating dyspnea on exertion for 2 weeks. Her chest x-ray and high resolution CT revealed aggravated reticular opacities and ground glass appearances. Dyspnea was improved and ground glass appearances on HRCT was disappeared after discontinuation of cyclophosphamide. We diagnosed this case as cyclophosphamide-induced pneumonitis and report it with a brief review of the literature.
Cyclophosphamide* ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Female ; Glass ; Humans ; Idiopathic Pulmonary Fibrosis ; Korea ; Lung* ; Pneumonia ; Thorax ; Wegener Granulomatosis*

PURPOSE: Certain strains of lactobacilli are known to accelerate recovery from acute diarrhea. Lactobacillus reuteri is isolated from human breast milk and a commonly occurring Lactobacillus species with therapeutic potential in acute diarrhea. The purpose of the present study was to investigate the therapeutic effect of L. reuteri in acute diarrhea in young children. METHODS: Fifty patients between 6 and 36 months of age hospitalized with acute diarrhea (rotavirus in 40 percent) were randomized into two groups to receive either 10 (8) colony-forming units of L. reuteri or a matching placebo, twice a day for their length of hospitalization, or for up to 5 days. Antidiarrheal drugs were not prescribed to either group. The clinical outcome of diarrhea was evaluated. RESULTS: The mean duration of watery diarrhea after initiation of treatment was 2.3 days for the L. leuteri group (n=25) vs. 2.9 days for the placebo group (n=25) (P=0.072). By the second day of treatment, watery diarrhea persisted in 64 percent of patients receiving L. reuteri, compared to 84 percent of those receiving placebo (P=0.006). On the second day, the mean frequency of watery diarrhea was 1.9 in the L. leuteri group and 3.4 in the placebo (P=0.046). Also, vomiting continued to the second day in 16 percent of patients receiving L. reuteri and 40 percent of those recieving placebo (P= 0.031). CONCLUSION: L. reuteri is effective as a therapeutic agent in acute diarrhea in children.
Antidiarrheals ; Child ; Diarrhea* ; Hospitalization ; Humans ; Infant* ; Lactobacillus reuteri* ; Lactobacillus* ; Milk, Human ; Stem Cells ; Vomiting

OBJECTIVE: To document our experience of the vascular anomalies or variants in paraaortic region and intend to increase vigilance among the gynecological surgeons for presence of variable vascular anomalies or variants. METHODS: We conducted a retrospective chart review of 280 patients with various gynecologic malignancies who had undergone systemic laparotomic or laparoscopic paraaortic lymphadenectomy between November 2003 and July 2011. RESULTS: We discovered total nine patients of vascular anomalies during the surgery. Seven patients had an accessory polar renal artery. One patient had a duplicated inferior vena cava and the other had a right paravertebral vein. There were no vascular complications such as tearing, ligation or transection. CONCLUSION: It is not uncommon to encounter vascular anomalies in paraaortic region during the lymphadenectomy. Hence, the gynecological surgeons must be cognizant of various vascular anomalies occurring within this area to reduce the vascular accidents.
Humans ; Ligation ; Lymph Node Excision ; Renal Artery ; Retrospective Studies ; Veins ; Vena Cava, Inferior

BACKGROUND/AIMS: Eosinophilic gastroenteritis (EG) is an uncommon disease with various gastrointestinal symptoms characterized by eosinophilic infiltration. Its incidence increases recently. We investigated the clinicopathologic features of the patients with EG. METHODS: Between January 1970 and July 2003, a total of 28 cases of EG have been reported. By adding 3 cases diagnosed in the Eulji Hospital, we evaluated the 31 cases of EG for the symptoms, laboratory findings, histologic findings, method of treatment, and allergic history. RESULTS: The incidence increased during 1990s. The predominant site of the eosinophilic infiltration was mucosa in 10 cases, muscularis in 5 cases, and subserosa in 5 cases. The remaining 11 patients had the EG in two sites. The most frequently affected organ was small intestine (12 patients), but there were 12 cases which more than two organs involved. Melena and hematochezia were dominant findings in the patients whose infiltration occurred in mucosa. On the other hand, ascites was a dominant finding in the cases that infiltration occurred in subserosa or involving over 2 layers. There was no difference in eosinophilia, clinical symptoms, and duration between two groups according to the symptom duration for less or more than 30 days. Additionally, seven patients had allergc histories. Peripheral eosinophilia was found in 24 cases. There was no recurrence of EG after the treatment. CONCLUSIONS: Our retrospective studies about EG reported in Korea could not clarify whether EG is related to allergy. Recently, the occurrence of EG is increasing and it is frequently involved in young men. The most apparent finding include peripheral eosinophilia. There is no significant clinical feature which is consistent with Klein's classification, though blood loss was more common in mucosal type and ascites was more common in serosal type and in case above two layers.
Adolescent ; Adult ; Aged ; English Abstract ; Eosinophilia/complications/*diagnosis ; Female ; Gastroenteritis/complications/*diagnosis ; Humans ; Male ; Middle Aged

BACKGROUND: This study aims to compare the surgical outcomes of open reduction and internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) using a screw compression method in simple humeral shaft fractures. METHODS: This retrospective study was performed with 50 patients who had surgical interventions for the treatment of simple humeral shaft fractures and had follow-ups of at least 12 months in Ulsan University Hospital between August 2008 and June 2015. Group 1 included 23 patients treated with ORIF and group 2 included 27 patients treated with the MIPO technique using a locking screw plate. The time to clinical/radiographic union, the joint range of motion (ROM), and function were evaluated. RESULTS: The average time to clinical/radiographic bone union was shorter in group 2 (12.0 ± 3.7 weeks/14.8 ± 2.0 weeks in group 1 and 9.4 ± 1.3 weeks/12.0 ± 3.3 weeks in group 2; p = 0.022/p = 0.034). Shoulder and elbow joint function evaluated by joint ROM and visual analogue scale (VAS), Korean Shoulder Elbow Society (KSS), American Shoulder and Elbow Surgeons (ASES), and the University of California at Los Angeles (UCLA) scores was excellent in both groups. On the average shoulder ROM at 12 months after the operation, group 1 had forward elevation of 160°, external rotation of 30° in adduction and lumbar vertebra 10 level in internal rotation and group 2 had forward elevation of 170°, external rotation of 35° in adduction and lumbar vertebra 9 level in internal rotation. The mean VAS, KSS, ASES, and UCLA scores were 2.8, 87.0 ± 0.9, 89.4 ± 0.9, and 31.0 ± 1.4, respectively, in group 1 and 1.7, 89.1 ± 2.7, 91.0 ± 1.6, and 32.4 ± 3.2, respectively, in group 2. There were statistically significant intergroup differences in VAS score (p = 0.011). There were significantly less postoperative infections in group 2 (three cases, 10.7% in group 1 and 0 case in group 2; p = 0.041) although all of them were superficial infections and well-treated by an average 4-week course of antibiotics (range, 2 to 6 weeks). CONCLUSIONS: MIPO using a screw compression method in simple humeral shaft fractures demonstrated superior efficacy to ORIF in terms of the time to clinical/radiographic union, pain score, and postoperative infection rate.
Anti-Bacterial Agents ; California ; Elbow ; Elbow Joint ; Follow-Up Studies ; Fracture Fixation ; Humans ; Humeral Fractures ; Joints ; Methods* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Spine ; Surgeons ; Ulsan

BACKGROUND: There are several different opinions regarding the improvements seen on the transverse plane after soft tissue surgery alone in independently ambulant patients with cerebral palsy. We performed a meta-analysis using data from previous studies to identify the effects of soft tissue surgery alone on pelvic and hip rotation in children with spastic diplegia. METHODS: We conducted a pilot study to evaluate the improvement in pelvic and hip rotation after muscle-tendon lengthening surgery in children with spastic diplegia. We also searched EMBASE and PubMed and selected 2 previous studies using the same test conditions with kinematic data on the pelvis and hip joints. A meta-analysis of the results of these 3 studies, including this pilot study, was then performed. RESULTS: The meta-analysis results showed an external rotation decrease (p = 0.005) in the mean difference of pelvic rotation of -3.61 (95% confidence interval [CI], -6.13 to -1.09) and a mean difference in hip rotation of 6.60 (95% CI, 3.34 to 9.86), indicating a significant increase in the hip external rotation after surgery (p < 0.001). CONCLUSIONS: In independently community-ambulant pediatric patients with spastic diplegia, pelvic retraction and hip internal rotation could be improved after soft tissue surgery.
Cerebral Palsy* ; Child ; Hip Joint ; Hip* ; Humans ; Muscle Spasticity* ; Pelvis ; Pilot Projects