Ehlers-Danlos syndrome (EDS) is a very rare genetic disorder characterized by defects in the production of connective tissue. Among them, vascular EDS is the subtype known to have the worst prognosis due to fragile blood vessels. Accordingly, we would like to report a case report of a patient with vascular EDS with a review of the literature on possible massive transfusion and anesthesiological problems. Patients with vascular EDS have very weak blood vessels and tissues that are easily broken. So there is a high possibility of unexpected massive bleeding during emergency surgery in these patients. Therefore, the anesthesiologist should be fully prepared for the possibility of massive blood loss, keeping in mind the possibility of damage to large blood vessels. The central vein must be secured using ultrasound, sufficient blood and fluids must be prepared, and equipment capable of rapid administration must be perfectly prepared before the start of operation.

OBJECTIVE: The purpose of this study was to analyze the clinical study for patients with cervical cancer who had undergone radical hysterectomy. METHOD: The subjects of this study were one hundred and sixty two patients with cervical cancer who had undergone radical hysterectomy at Eulji Medical College Hospital, Taejon, Korea, from January 1983 to December 1992. We reviewed the medical record retrospectively and analyzed the data. RESULT: The distribution of patients by age was found in the order of 50 decade and 60 decade, 40 decade. Those by the clinical stages were as follows: Stage Ia, 12 cases(7.4%); Stage Ib, 84 cases(51.9%); Stage IIa, 39 cases(24.1%); Stage IIb 27 cases(16.7%). The results of histopathologic type were distributed as follows: squamous cell carcinoma was 91.9%, adenocarcinoma was 4.9% and adenosquamous cell carcinoma was 3.1%. The histologic subtypes of squamous cell carcinoma(149 cases) were as follows: Large cell non-keratinizing type was 75.9%, large cell keratinizing type was 14.8% and small cell type was 1.2%. The frequancy of lymph node metastasis was 22.9% in stage I and 31.8% in stage II. The overall incidence of lymph node metastasis was 26.4%. The frequency of external radiation therapy done after radical hysterectomy was 63.5% in stage I and 75.8% in stage II. The 5-year survival rate was as follows: The Ia was 100%; Stage Ib, 95.2%(4cases); Stage IIa, 87.2%(5cases); Stage IIb, 77.8%(6cases). The incidence of recurrence was 7.4% and recurrent sites were vaginal stump , rectum and pelvic wall. CONCLUSION: The highest incidence of cervix cancer in age distribution was 50 decade(30.9%) and 60 decade(30.9%). The most common clinical stage was Ib(51.9%) and most frequent pathologic type was squamous cell carcinoma(91.9%). The overall incidence of lymph node metastasis was 26.4% and The most common site of recurrence was vaginal stump. The 5-year survival rate was 100% in the stage Ia, 95.2% in the stage Ib, 87.2% in the stage IIa, 77.8% in the stage IIb.
Adenocarcinoma ; Age Distribution ; Carcinoma, Squamous Cell ; Daejeon ; Humans ; Hysterectomy* ; Incidence ; Korea ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Rectum ; Recurrence ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

We report three cases of coincidental cerebral aneurysm with pituitary tumor. In our hospital the incidence of such cases was 4.4% of 68 patients with pituitary tumors from March, 1970 to October, 1990. Cases No. 1 was a 47-year-old female suffering from progressive loss of visual acuity. Preoperative brain C-T scan and angiographies revealed unruptured posterior communicating aneurysm with pituitary tumor. Case No. 2 was a 39-year-old male suffering from headache after head trauma with acromegaly. Preoperative brain C-T scan and angiographies appeared unruptured anterior communicating aneurysm and pituitary tumor. Case No. 3 was a 62-year-old female suffering progressive loss of visual acuity and headache. Left middle cerebral artery aneurysm and pituitary tumor were found by preoperative brain C-T scan and angiographies. All cases were operated by transcranial route and performed tumor removal after primary clipping of aneurysm. Postoperatively remained tumor of all cases was treated by radiosurgery successfully.
Acromegaly ; Adult ; Aneurysm ; Angiography ; Brain ; Craniocerebral Trauma ; Female ; Headache ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Middle Aged ; Pituitary Neoplasms* ; Radiosurgery ; Visual Acuity

OBJECTIVE: We investigated the long-term efficacy, safety, and tolerability of aripiprazole in a large number of patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder in Korea. METHODS: This was an open-label, multi-center, single-arm, 52-week study of patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. Korean patients (N=300) experiencing either a first episode or recurrence participated in this study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score. Secondary efficacy measures included the PANSS positive and negative subscales, and the Clinical Global Impression-Severity of Illness (CGI-S). Safety was evaluated prospectively by recording treatmentemergent adverse events; measuring extrapyramidal symptoms (EPS), vital signs, and body weight; and performing laboratory tests. RESULTS: Overall, 55 (18.33%) of the patients completed the entire 52-week study. Treatment with aripiprazole provided rapid and significant improvement in all of the efficacy measures. Comparing PANSS total scores, PANSS positive subscale scores, and CGI-S scores, first-episode patients showed significant improvement than the patients who had experienced at least one recurrence. There were no significant differences in the mean change of EPS during the study, except for akathisia at week 8 and a significant decrease in serum prolactin level in patients experiencing first and recurrent episodes. At the end of the study, the mean weight gain was 2.40 kg. CONCLUSION: Aripiprazole is effective and safe for patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder during a long-term, 52-week treatment. The result may be associated with the unique mechanism of aripiprazole. We have extended the findings of previous studies in the United States and other countries and demonstrated a similar effectiveness of aripiprazole for Korean patients.
Humans ; Piperazines ; Prolactin ; Prospective Studies ; Psychomotor Agitation ; Psychotic Disorders ; Quinolones ; Recurrence ; Schizophrenia ; United States ; Vital Signs ; Weight Gain ; Aripiprazole