Choledochal cyst is a condition involving an abnormal dilation of the bile ducts, which can lead to various symptoms and comorbidities, including cancer. The treatment of choice for choledochal cyst is surgical correction including choledochal cyst excision and Roux-en-y hepaticoenterostomy. Minimal invasive methods like laparoscopic methods or robotic methods are used for surgical correction of choledochal cysts; however, it is still controversial which method is superior. A Korean company, LIVESMED, developed Artisential® , a laparoscopic surgical instrument that can overcome the drawbacks of laparoscopic methods. This article presents a case of the first Artisential® -performed surgical excision of a choledochal cyst and hepaticojejunostomy.

We experienced an unusual case of accelerated junctional rhythm with severe hypotension after infiltration oflidocaine containing epinephrine during dental surgery under general anesthesia. The patient’s electrocardiogramexhibited retrograde P-waves following the QRS complex, which could be misinterpreted as ST-segment depression.As a temporary measure, administration of ephedrine restored the patient’s blood pressure to normal levels.The importance of this case lies in its demonstration of an unexpected and serious side effect of commonlyused epinephrine infiltration. This case also highlights the need for accurate interpretation of the electrocardiogramand comprehensive understanding of best practices for patient management.

Vegetative electrode infection after implantation of permanent pacemaker or defibrillator is an uncommon but a serious complication. Diagnosis of the lead infection is particularly important since surgical manipulation is usually required for its treatment. We present 3 cases of electrodes related infective endocarditis among the 154 patients who implanted pacemaker or defibrillator between 2001 and 2004 in Korea university hospital. These complications were difficult to diagnose because of ambiguous clinical manifestations and indeterminate transthoracic echocardiographic (TTE) findings and were finally confirmed by transesophageal echocardiography (TEE).
Defibrillators ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal* ; Electrodes* ; Endocarditis* ; Humans ; Korea ; Pacemaker, Artificial