• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.137-142
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• 2009

Ovarian hyperstimulation syndrome (OHSS) is one of the most common iatrogenic complications induced by assisted reproductive technology. Hydrothorax develops in about 10 percent of patients with severe OHSS and it is usually associated with marked ascites. On the other hand, severe hydrothorax without marked ascites is uncommon, and its pathogenesis remains unclear. We recently experienced a case of severe unilateral hydrothorax with minimal ascites induced by quintuplet pregnancy following intrauterine insemination with controlled ovarian hyperstimulation. Severe hydrothorax was resolved after only conservative and symptomatic management without invasive procedure such as thoracentesis or paracentesis. We report this case with brief review of literature.

• Journal of Chest Surgery
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• v.34 no.9
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• pp.711-715
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• 2001

Background: Deep venous thrombosis(DVT) is a curable disease when it is appropriately treated in the early stages of onset. The long term follow up of chronic DVT shows poor prognosis with serious complications such as venous valvular insufficiency, venous claudication, venous ulcer and leg swelling. Thrombolytic therapy is a very active treatment that delivers thrombolytic agents via catheter to the target thrombi. The aim of this study is to evaluate the effect of catheter directed thrombolysis using urokinase to acute DVT. Material and Method: We studied 5 patients, who were diagnosed as acute DVT and had no contraindication for selective hemolysis using urokinase. Result: All the patients were successfully recanalized. Total infusion time of urokinase was 2.0$\pm$0.6 days, and the amount was 5.9$\pm$2.45 million IU. In 4 patients, who were diagnosed as May-Therner syndrome, we performed the balloon angioplasty and inserted the stent at the stenotic portion. There were minor complications such as hematuria, hematoma at puncture site, and all of them are self limited. Conclusion: Catheter induced thrombolysis is an effective treatment in acute DVT.

• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.314-317
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• 2008

We report the patient presented with a left-sided pleural effusion. Pleural fluid analysis revealed lymphocyte-dominant exudates with lower level of adenosine deaminase and negative cytologic malignancy. Thoracoscopic examination and histologic examination revealed metastatic nodules on pleurae, proven to be from the papillary thyroid cancer. There were no other sites of distant metastases. Though papillary thyroid cancer is characterized with slow progression and relatively good prognosis, metastatic pleural effusion as an initial manifestation of undiagnosed papillary thyroid cancer can be considered.

• Journal of the Korean Arthroscopy Society
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• v.7 no.1
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• pp.92-95
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• 2003

A 34-year-old man with ACL total rupture due to slip down injury, had received ACL reconstruction using autogenous hamstrings tendon with cross-pin femoral fixation. Postoperative course was as usual. But postoperative 3 months later, he complained posterolateral knee pain, recurrent effusion and mild instability. He was managed repeatitive aspiration and nonsteroid antiinflammatory drugs but was failed to relieve symptoms & signs. In CT scans, perforation of posteromedial femoral cortex of lateral femoral condyle was found. In second look arthroscopy, two pieces of broken femoral cross pin were found in between tibiofemoral Joint which was badly injured cartilage. We considered malposition of pins was the main cause of failure. We propose that femoral tunnel must be made more acute angle and femoral cross-pin guide must be positioned more external rotation 10-20 degree than transepicondylar axis made confirm the cross-pin tunnel position in order to avoid posterior cortex perforation and early failure.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.1-4
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• 2009

Purpose: This study was conducted to evaluate the length of the catheter used in a needle thoracostomy for emergency decompression of a tension pneumothorax by measuring the chest wall thickness (CWT) in patients with chest trauma Methods: A retrospective review of 201 patients with chest trauma who had been transported the emergency department in a tertiary university hospital in a metropolitan area between 1 January and 31 February 2007 was performed. The average CWT at the second intercostal space (ICS) in the midclavicular line (MCL) was measured by using a chest computed tomography scan. Results: As the left and the right mean CWTs were $3.4{\pm}1.0cm$ and $3.4{\pm}1.0cm$, respectively, there was no significant statistical difference between them. The mean CWT of female patients was significantly higher than that of male patients (p=0.001). The mean CWT of patients under the age of 65 years was significantly thicker than that of the patients over the age of 65 years (p<0.001). Of the studied patients, 12 (6.0%) a CWT > 5 cm. Conclusion: A 5 cm-length catheter in a needle thoracostomy may be insufficient for emergency decompression of a tension pneumothorax, so a catheter longer than 5 cm in length is needed.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1149-1153
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• 1997

Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

• The Korean Journal of Cytopathology
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• v.2 no.2
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• pp.90-97
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• 1991

Liver is generally known as an organ which is most commonly involved by the metastic tumors. According to the tendency of using fine needle aspiration in the diagnosis of hepatic tumors, the differentital diagnosis between hepatocellular carcinoma and metastatic carcinoma frequently has been a main issue in the poorly differentitated cases, especially to the pathologists of Korea, an endemic area of hepatocellular carcinoma. Until now the problem has been usually solved by the comparison of cytologic characteristics of their tumor cells but not by background cytologic features which rarely have been studied. We observed the background cytologic features helpful for the differential diagnosis through the analysis of 20 cases who had confirmed primary cancer and were diagnosed as metastatic carcinomas in the liver by fine needle aspiration cytology. Twenty cases included 9 adenocarcinomas, 7 spuamous cell carcinomas, 1 small cell carcinoma, 1 carcinoid, 1 adenoid cystic carcinoma, and 1 renal cell cacinoma. Analysis of background cytologic features revealed that 77% of adenocacinoma cases showed benign mesenchymal components and hepatocytes and spuamous cell carcinoma cases disclosed benign mesenchymal tissue (71%) and necrosis (57%), Remaining cases showed variable combinations of benign mesenchymal component, necrosis, hepatocytes, and bile duct epithelial cells. No case revealed atypical hepatocytic naked nuclei, a useful cytologic finding of hepatocellular carcinoma. In summary, the background cytologic features more commonly observed in metastatic carcinomas than in the hepatocellular carcinoma were benign mesenchymal components, hepatocytes, necrosis, and bile duct epithelium. The endothelial cells and hepatocytic naked nuclei, two relatively specific findings of hepatocellular carcinoma were not observed except for renal ceil carcinoma. Above background cytologic features are thought to be helpful for the differential diagnosis between the hepatocellular carcinoma and various metastatic carcinomas in the poorly differentiated cases.

• The Korean Journal of Cytopathology
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• v.2 no.2
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• pp.153-159
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• 1991

Langerhans' cell histiocytosis (LCH), known for histiocytosis X, is a clinicopathologic entity characterized by proliferation of Langerhans' cells (LCs) throughout the body including the reticuloendothelial system, bone, and skin. LCs is currently considered as a distinct type of histlocytic cells, not primarily phagocytic in nature. Recently, we could make the diagnosis on cytologic specimen in a 3 month-old-boy and a 3 year-old-boy. The cases were diagnosed on scraping smear from the skin and fine needle aspiration cytology from the lymph node, respectively. The characteristic cytologic features of Langerhans' cells were noted in the nuclei, namely eccentric, indented, elongated, and grooved nuclei. The cells also had abundant and acidophilic cytoplasm. The cytologic diagnoses were confirmed on the biopsies from the skin and lymph node, respectively.

• Tuberculosis and Respiratory Diseases
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• v.51 no.5
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• pp.482-487
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• 2001

A pancreatic pseudocyst with a mediastinal extension is a rare clinical entity. Intrathoracic symptoms such as dysphagia or dyspnea due to compression or associated pleural effusions are quite common. The pseudocysts transverse the diaphragm via the esophageal hiatus or aortic hiatus or by eroding directly through the diaphragm. Here, we report a case of a pancreatic pseudocyst with a mediastinal extension presenting as dysphagia and dyspnea. The diagnosis was confirmed by computerized axial tomography of the chest and abdomen. Usually, the proper management of a large pseudocyst includes percutaneous or surgical internal drainage, but in this case the mediastinal components disappeared with conservative medical treatment.

• The Korean Journal of Pain
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• v.2 no.1
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• pp.89-93
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• 1989

We performed the autologous epidural blood patch (AEBP) for the relief of headache and other related symptoms following dural punctures of the lumbar region during 8 years from 1981 to 1988. The total of 37 patients with the patching consisted of 9 cases in 3007 of spinal anesthesia, 12 accidental dural punctures in 4283 cases of lumbar epidural anesthesia, 12 cases in 4747 of epidural analgesia for back pain control, 3 cases of myelography and a case of diagnostic lumbar puncture. The headaches were relieved completely in 35 cases following the first AEBP and the remaining two were also relieved following the second AEBP. We think that the AEBP for postdural-puncture headache is the treatment of choice.