Precise fluid administration is important to prevent hypo- or hypervolemia. However, the accuracy of scales marked on intravenous (IV) fluid plastic bags had remained unknown. Ten 1 L sized IV crystalloids were prepared from each of three manufacturers (H, J, and D). At each scale, the actual volume of the IV fluid was measured. Differences with the measured volumes for each scale were investigated between the three manufacturers. All initial total volume was greater than 1 L. Except for the full-filled level, H overfilled, whereas J and D filled less. For J and D, the maximal differences between the scale and the measured volume were about 200 mL. Fluid volumes of each scale were significantly different among the three manufacturers (P < 0.001). It is inaccurate to measure the amount of fluid depending on the IV bag scales. Clinicians must use electronic infusion pumps for accurate fluid administration.

Symmetrical Digital Gangrene (SDG) is characterized by the sudden onset of peripheral, symmetrical gangrene in the absence of any major vascular occlusive disease. Catecholamine inotropes are frequently used for the treatment of septic shock combined with an unstable hemodynamic state, and their usage can rarely induce SDG. There is no standard treatment for the SDG. Early recognition and prompt management of sepsis and expeditious process of weaning off of the inotropes are necessary to prevent progression of SDG. To the best of our knowledge, this is the first report in Korea regarding the treatment of SDG induced by catecholamine inotropes.

Solitary fibrous tumor is a rare spindle cell neoplasm of mesenchymal origin that occurs most commonly in the pleura. This tumor can be found in various extrathoracic sites that contain soft tissue. There are few reports of solitary fibrous tumors in the head & neck and only 5 cases of solitary fibrous tumors of the cheek have been reported. A 53-year-old man visited our department complaining of a firm mass in the left cheek. We suspected a schwannoma originating from the infraorbital nerve. The mass was removed via a gingivobuccal approach and was diagnosed as a solitary fibrous tumor.
Cheek* ; Head ; Humans ; Middle Aged ; Neck ; Neurilemmoma ; Pleura ; Solitary Fibrous Tumors*

BACKGROUND AND OBJECTIVES: Various techniques have been reported for the correction of deviated nasal septum, most of them for caudal septal cartilage. For deviated posterior septal cartilage, the typical method of the day is the resection of deviated portion. However, we developed a bone anchoring technique that conservatively corrects deviated posterior septal cartilage. The aim of the current study is to determine the efficacy of this bone anchoring technique. SUBJECTS AND METHOD: The patients who had undergone septoplasty using bone anchoring technique by a single surgeon (J.S.K) between October 2015 and June 2016 were enrolled in this study. The result of the surgery was evaluated using a visual analogue scale (VAS, ranged 0– 10) for nasal obstruction, acoustic rhinometry, and assessment of surgeon. RESULTS: A total of 44 patients were included in this study. The VAS of nasal obstruction was significantly decreased after surgery from 7.5±1.7 to 2.4±1.4. In acoustic rhinometry, minimal cross-sectional area and volume were increased after surgery from 0.35±0.18 to 0.52±1.40 cm2 and from 3.6±1.1 to 5.8±1.5 cm3, respectively. Most of the deviated septum was well corrected, and complication or recurrence did not developed. CONCLUSION: Bone anchoring technique is easy to perform. It enables the preservation of septal cartilage, which is useful in revision septoplasty or rhinoplasty. We conclude that this technique is a good method for the correction of deviated posterior septal cartilage.
Cartilage ; Humans ; Methods ; Nasal Obstruction ; Nasal Septum* ; Reconstructive Surgical Procedures ; Recurrence ; Rhinometry, Acoustic ; Rhinoplasty ; Suture Anchors*

Atypical fractures have been reported as a complication of long-standing bisphosphonate therapy and occur commonly in the subtrochanteric region or shaft of the femur showing typical radiographic features. We encountered a case of atypical fracture of the proximal one-third of the shaft of the ulna. Radiographic findings of this case differed from previously reported cases of ulnar fracture in terms of showing a transverse fracture line with cortical thickening and an oblique fracture line with anterior cortical spike. On the other hand, these findings were similar to radiographic features of atypical femoral fractures. The present case was managed surgically and union of fracture was achieved after 6 months. As there are possibilities of occurrence of atypical fractures in sites other than the femur, the physicians should cautiously examine the patients' history and radiographic findings.
Femoral Fractures ; Femur ; Forearm ; Hand ; Ulna*

PURPOSE: The purpose of this study was to evaluate the effect of steroid injection according to the stage of Finkelstein's test and the severity of tenderness on radial styloid in de Quervain's disease. METHODS: Between January 2011 and December 2012, a total of 57 patients (57 wrists) treated with steroid injection in de Quervain's disease were enrolled on this study. The severity of tenderness, the stage of Finkelstein's test and pain score using visual analogue scale (VAS) were assessed before steroid injection. And the effect of steroid injection was assessed until one year after steroid injection. The relationship between the recurrence of de Quervain's disease after steroid injection and pre-injection findings including tenderness, Finkelstein's test and VAS was assessed. RESULTS: The success rate of steroid injection was 71.9% (41/57 patients). The outcome of steroid injection was not significantly related to the severity of tenderness (p=0.648), the stage of Finkelstein's test (p=0.530) and VAS score (p=0.607). CONCLUSION: The tenderness on radial styloid and the Finkelstein's test are important physical findings for the diagnosis of de Quervain's disease. However, the severity of tenderness and the stage of Finkelstein's test were not showed as predictive factors for the outcome.
De Quervain Disease* ; Diagnosis ; Humans ; Recurrence*

Most cystic lesions of the liver are found incidentally in imaging studies because they are not symptomatic, and generally do not require treatment. Rarely, however, symptomatic hepatic cysts may develop complications and require treatment. Here, we describe a case of a 77-year-old woman who developed biliary obstruction with abdominal pain due to compression of the bile duct by a simple hepatic cyst. We confirmed the diagnosis based on symptoms and imaging studies. The patient's symptoms improved after simple cyst ablation by sclerotherapy.
Abdominal Pain ; Aged ; Bile Ducts ; Cholestasis ; Diagnosis ; Female ; Humans ; Liver* ; Sclerotherapy

BACKGROUND: Cellulite is a 'cottage cheese-like' cutaneous change caused by subcutaneous fat bulging into the dermis that usually leads to cosmetic problems. Slimming cream containing 3.5% water-soluble caffeine and xanthenes exhibits a lipolytic effect with penetration into the dermis. OBJECTIVE: To evaluate the efficacy and safety of slimming cream for the treatment of cellulite. METHODS: Fifteen subjects with cellulite applied slimming cream to the thighs and inner side of the upper arms twice daily for 6 weeks. Efficacy was assessed using a standard visual scale, changes in the circumferences of the thighs and upper arms, and patient satisfaction by a questionnaire at baseline, week 3, and week 6. Safety was assessed by inquiring about adverse events through questionnaires. RESULTS: The standard visual scale score improved significantly by 0.49 points (19.8%) at week 6. Thigh and upper-arm circumferences decreased by 0.7 cm (1.7%) and 0.8 cm (2.3%), respectively, at week 6. Slight itching and transient flushing were commonly reported, but no serious adverse event occurred. CONCLUSION: The slimming cream tested appears to be effective for the treatment of cellulitis without serious adverse effects. However, additional large clinical trials are required to confirm the efficacy and safety of slimming cream for the treatment of cellulitis.
Arm ; Caffeine* ; Cellulitis ; Dermis ; Flushing ; Patient Satisfaction ; Pruritus ; Subcutaneous Fat ; Thigh ; Xanthenes* ; Surveys and Questionnaires

The purpose of this study was to evaluate treatment patterns, outcome and prognosticators for patients with leptomeningeal metastases from solid tumor. Medical records of 80 patients from January 1, 2004 to May 31, 2011 were retrospectively reviewed. Most frequent site of origin was the lung (59%) followed by the breast (25%). Most patients were treated with intrathecal chemotherapy (90%) and/or whole brain radiotherapy (67.5%). Systemic therapy was offered to 27 patients (33.8%). Percentage of patients treated with single, dual, and triple modality were 32.5%, 43.8%, and 23.8%, respectively. Median survival was 2.7 months and 1 yr survival rate was 11.3%. Multivariate analysis showed that negative cerebrospinal fluid cytology, fewer chemotherapy regimen prior to leptomeningeal metastases, whole brain radiotherapy, systemic therapy, and combined modality treatment (median survival; single 1.4 vs. dual 2.8 vs. triple 8.3 months, P<0.001) had statistical significance on survival. Subgroup analysis of non-small cell lung cancer (NSCLC) patients showed that targeted therapy had significant independent impact on survival (median survival; 10.5 vs. 3.0 months, P=0.008). Unlike previous reports, survival of patients with NSCLC primary was comparable to breast primary. Furthermore, combined modality treatment for all patients and additionally targeted therapy for NSCLC patients should be considered in the treatment of leptomeningeal metastases from solid tumor.
Adult ; Aged ; Chemoradiotherapy/methods/*mortality/*statistics & numerical data ; Disease-Free Survival ; Female ; Humans ; Male ; Meningeal Neoplasms/mortality/*secondary/*therapy ; Middle Aged ; Neoplasm Recurrence, Local/*mortality/*prevention & control ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome

PURPOSE: The purpose of this study was to assess the clinical outcomes of hypofractionated radiotherapy (HFRT) with three-dimensional conformal technique for medically inoperable patients with early stage non-small-cell lung cancer (NSCLC) and to evaluate prognostic factors. MATERIALS AND METHODS: We performed a retrospective review of 26 patients who underwent HFRT for early stage NSCLC between September 2005 and August 2011. Only clinical stage T1-3N0 was included. The median RT dose was 70 Gy (range, 60 to 72 Gy) and the median biologically equivalent dose (BED) was 94.5 Gy (range, 78.0 to 100.8 Gy). In 84.6% of patients, 4 Gy per fraction was used. Neoadjuvant chemotherapy with paclitaxel and cisplatin was given to 2 of 26 patients. RESULTS: The median follow-up time for surviving patients was 21 months (range, 13 to 49 months). The overall response rate was 53.9%, and the initial local control rate was 100%. The median survival duration was 27.8 months. Rates of 2-year overall survival, progression-free survival (PFS), local control (LC), and locoregional-free survival (LRFS) were 54.3%, 61.1%, 74.6%, and 61.9%, respectively. Multivariate analysis showed that BED (>90 vs. < or =90 Gy) was an independent prognostic factor influencing PFS, LC, and LRFS. Severe toxicities over grade 3 were not observed. CONCLUSION: Radical HFRT can yield satisfactory disease control with acceptable rates of toxicities in medically inoperable patients with early stage NSCLC. HFRT is a viable alternative for clinics and patients ineligible for stereotactic ablative radiotherapy. BED over 90 Gy and 4 Gy per fraction might be appropriate for HFRT.
Cisplatin ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Multivariate Analysis ; Paclitaxel ; Radiotherapy, Conformal ; Retrospective Studies