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Rosai-Dorfman Disease of 4-Year-Old Girl.

Jun Seak GANG ; Young Chang KIM ; Young Man LEE ; Junhun CHO ; Won Suk SUH ; Kyeong Bae PARK

Soonchunhyang Medical Science.2017;23(1):81-84.

Rosai-Dorfman disease also known as sinus histiocytosis with massive lymphadenopathy is a benign, rare systemic disease characterized by a histiocyte proliferation which presents with lymphadenopathy. We report a case of a 4-year-old girl who presented with recurrent cervical lymphadenopathy with tenderness, without any other symptoms. After 1 month of medical treatment, her lymphadenopathy still remained, so we performed complete excision and biopsy. She was diagnosed on cytology as a case of Rosai-Dorfman disease. She responded well to become asymptomatic without recurrence by 1 month.
Biopsy ; Child ; Child, Preschool* ; Female* ; Histiocytes ; Histiocytosis ; Histiocytosis, Sinus* ; Humans ; Lymphatic Diseases ; Recurrence

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Pneumomediastinum and Pneumoretroperitoneum Induced by Foreign Body in Bronchus.

Hyunho BANG ; Seung Soo KIM

Soonchunhyang Medical Science.2017;23(1):77-80.

A 5-year-old boy was on medication after diagnosed with infantile spasm, and had regular diet with bedridden state. The patient had intermittent fever and cough lasting 1 week before admission. Symptom was worsened from the night before the first day of admission, and chest swelled up on the day of admission. Chest computed tomography (CT) was performed and showed extensive subcutaneous emphysema in neck, thorax, and abdomen. Pneumomediastinum, pneumoretroperitoneum, and right lung atelectasis was accompanied. An emergency bronchoscopy was performed because of the suspicion of complete obstruction of left main bronchus. The distal part of left main bronchus was completely obstructed by multiple polypoid masses. The mass was removed with a laser incision, and a foreign body surrounded by mucus was found. It was removed with a forceps. At 2 days after the removal, the subcutaneous emphysema was improved, and the chest CT taken 14 days later showed stenosis but no obstruction.
Abdomen ; Bronchi* ; Bronchoscopy ; Child, Preschool ; Constriction, Pathologic ; Cough ; Diet ; Emergencies ; Fever ; Foreign Bodies* ; Humans ; Infant ; Infant, Newborn ; Lung ; Male ; Mediastinal Emphysema* ; Mucus ; Neck ; Pulmonary Atelectasis ; Retropneumoperitoneum* ; Spasms, Infantile ; Subcutaneous Emphysema ; Surgical Instruments ; Thorax ; Tomography, X-Ray Computed

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Delayed Recovery of Motor Block Following Radiofrequency Ablation of Varicose Veins with Femoral Nerve Block and Tumescent Anesthesia.

Mi Roung JUN ; Young Eun KIM ; Sang Chul YOON ; Mun Gyu KIM

Soonchunhyang Medical Science.2017;23(1):74-76.

Femoral nerve block with tumescent anesthesia is used to perform the radiofrequency ablation of varicose veins. The surgery can be done as day-case. But if recovery from motor block is delayed, it can make hospital discharge difficult. Prolonged femoral nerve blocks with motor blockade of the quadriceps have been noted after the use of bupivacaine. The motor blockade lasted up to 30–40 hours when 15–30 mL of 0.5% bupivacaine was used. However, it was rarely reported in ropivacaine. We report that femoral nerve block with 15 mL of 0.375% ropivacaine induced prolonged motor blockade up to 30 hours.
Anesthesia* ; Bupivacaine ; Catheter Ablation* ; Femoral Nerve* ; Sodium Bicarbonate ; Varicose Veins*

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Radial Artery Occlusion after Transradial Artery Cannulation.

Hyung Youn GONG ; Sang Hyun PARK ; Yong Han SEO ; Jin Hun CHUNG

Soonchunhyang Medical Science.2017;23(1):71-73.

Percutaneous arterial catheterization is a widely used technique for continuous hemodynamic monitoring and arterial blood gas analysis. There are various complications such as hemorrhage, hematoma, infection, and thrombosis. We performed a catheterization procedure to confirm that the lateral circulation of the radial artery was sufficient. The arterial blood pressure waveform was damped after catheterization. Immediately after removal of the catheter, ultrasonography and Doppler were used to confirm the formation of total thrombus in the radial artery. A thrombus was found in the radial artery and disappeared at 3 days postoperatively.
Arterial Pressure ; Arteries* ; Blood Gas Analysis ; Catheterization* ; Catheters ; Hematoma ; Hemodynamics ; Hemorrhage ; Radial Artery* ; Thrombosis ; Ultrasonography

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Broken Metallic Intubation Stylet after Tracheal Intubation in Pediatric Patient.

Ho Soon JUNG ; Jin Ku KANG

Soonchunhyang Medical Science.2017;23(1):68-70.

A 6-year-old male patient underwent general anesthesia for laparoscopic appendectomy. During induction of intubation, metallic intubation stylet was broken. Broken piece was confirmed by bronchoscopy and chest radiography and was rapidly removed using a surgical forceps. The patient was discharged on the fifth postoperative day without any adverse effects.
Anesthesia, General ; Appendectomy ; Bronchoscopy ; Child ; Foreign Bodies ; Humans ; Intubation* ; Male ; Radiography ; Respiratory Aspiration ; Surgical Instruments ; Thorax

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Acute Sheehan's Syndrome Associated with Postpartum Hemorrhage.

Deokkyeong KIM ; Jiwon MIN ; Yun Sook KIM ; Aeli RYU

Soonchunhyang Medical Science.2017;23(1):65-67.

Sheehan's syndrome is postpartum hypopituitarism due to the necrosis of the pituitary gland. Usually, it is the result of severe hypotension caused by massive hemorrhage during or after delivery. A 40-year-old woman who had been performed cesarean section delivery was complicated by hemorrhage due to uterine atony. After transfusion and hysterectomy, she is gradually recovering her general condition. On 16th day after operation, she visited emergency room in critical condition with nausea, vomiting, and general weakness and laboratory finding was hyponatremia. So, we medicated her with hydrocortisone and thyroxine. Sheehan's syndrome should be considered in the differential diagnosis of hyponatremia in the early postpartum period.
Adult ; Cesarean Section ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Hydrocortisone ; Hypoglycemia ; Hyponatremia ; Hypopituitarism* ; Hypotension ; Hysterectomy ; Nausea ; Necrosis ; Pituitary Gland ; Postpartum Hemorrhage* ; Postpartum Period* ; Pregnancy ; Thyroxine ; Uterine Inertia ; Vomiting

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Ruptured Tubal Pregnancy with Massive Retroperitoneal Hemorrhage.

Seong Taek MUN ; Aeli RYU

Soonchunhyang Medical Science.2017;23(1):61-64.

Ectopic pregnancy is an implantation of the fertilized ovum on a place except the endometrium. Most of the ectopic pregnancies are located at the fallopian tube. Few cases of retroperitoneal hematoma associated with ectopic pregnancy have been reported on previously; in each the retroperitoneal space had been the site of implantation. In contrast, we treated a patient with an ectopic pregnancy that implanted in the tube and then perforated through into the retroperitoneal space. To our knowledge this is very rare case of retroperitoneal hematoma caused by a ruptured tubal pregnancy.
Endometrium ; Fallopian Tubes ; Female ; Hematoma ; Hemorrhage* ; Humans ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Retroperitoneal Space ; Zygote

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Ovarian Squamous Cell Carcinoma Associated with Endometriosis: Poor Response to Chemotherapy.

Seob JEON

Soonchunhyang Medical Science.2017;23(1):56-60.

The occurrence of ovarian squamous cell carcinoma associated with ovarian endometriosis is extremely rare. Several studies revealed poor prognosis for ovarian squamous cell carcinoma especially when associated with endometriosis. We report a case of ovarian squamous cell carcinoma that invades the parametrium that is also associated with ovarian endometriosis. A 41-year-old woman with stage IIB ovarian squamous cell carcinoma was treated with debulking surgery followed by six courses combination chemotherapy composed of paclitaxel and carboplatin. Twenty months after the last course of chemotherapy (3 months after normal positron emission tomography–computed tomography [CT] scanning), upper abdominal pain developed and abdomen CT scan revealed multiple metastasis in liver and paraaortic lymph node. Although two cycles of paclitaxel and cisplatin was administrated, she died of disease three months after the recurrence.
Abdomen ; Abdominal Pain ; Adult ; Carboplatin ; Carcinoma, Squamous Cell* ; Cisplatin ; Drug Therapy* ; Drug Therapy, Combination ; Electrons ; Endometriosis* ; Epithelial Cells* ; Female ; Humans ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Paclitaxel ; Prognosis ; Recurrence ; Tomography, X-Ray Computed

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Hemoperitoneum Caused by a Spontaneously Ruptured Gastrointestinal Stromal Tumor with Cystic Degeneration.

Jin Hyung LEE

Soonchunhyang Medical Science.2017;23(1):52-55.

A 39-year-old man visited Soonchunhyang University Gumi Hospital with abdominal pain. Abdominal computed tomography showed a large heterogeneously enhancing mass abutting the stomach body and a large amount of fluid collected in the peritoneal cavity. An emergency laparotomy revealed a ruptured large tumor arising from the anterior wall of the middle section of the stomach with bloody fluid in the peritoneal cavity. The patient underwent wedge resection of the tumor. The tumor was 6.5×5.5×4.0 cm in size and 49 g in weight. Immunohistochemical staining demonstrated positivity to C-kit protein, CD34, and S-100 protein. The final diagnosis was gastric gastrointestinal stromal tumor (GIST). Hemoperitoneum caused by a spontaneously ruptured GIST with cystic degeneration is extremely rare.
Abdominal Pain ; Adult ; Diagnosis ; Emergencies ; Gastrointestinal Stromal Tumors* ; Gyeongsangbuk-do ; Hemoperitoneum* ; Humans ; Laparotomy ; Peritoneal Cavity ; Proto-Oncogene Proteins c-kit ; Rupture ; S100 Proteins ; Stomach

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Adrenal Tuberculosis Mimicking a Malignant Tumor with Primary Adrenal Insufficiency.

Woo Seok KIM ; Jin Hyung LEE

Soonchunhyang Medical Science.2017;23(1):49-51.

Adrenal tuberculosis is a relatively infrequent cause of primary adrenocortical insufficiency in developed countries. Isolated adrenal tuberculosis, especially with enlargement of adrenal glands, can cause diagnostic problems and requires differentiation from primary or secondary neoplasms. A 40-year-old woman presented to Soonchunhyang University Gumi Hospital with altered consciousness. She showed biochemical evidence of adrenal insufficiency without signs of tuberculosis. Abdominal computed tomography (CT) scan showed a calcified mass 3.3×2.3 cm in size and peripheral enhancement of the left adrenal gland. A laparoscopic adrenalectomy was performed for a diagnosis of left adrenal malignant tumor. The diagnosis of adrenal tuberculosis was confirmed by a final histological examination.
Addison Disease* ; Adrenal Glands ; Adrenal Insufficiency ; Adrenalectomy ; Adult ; Consciousness ; Developed Countries ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Laparoscopy ; Tuberculosis*

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