Achondroplasia is associated with craniofacial abnormality, musculoskeletal deformations, and respiratory, cardiovascular abnormalities. So, anesthetic management is one of clinical challenges. Herein, we report and discuss a case of achondroplastic patient underwent osteosynthesis for femur fracture, which was chosen on the base of patient’s anatomical and physiological characteristics. The patient had thoracolumbar kyphosis (21.8°), previous spine surgery, short neck, obstructive sleep apnea, and mild cervical limitation. Intubation was conducted with smaller cuffed endotracheal tube under videolaryngoscope guidance. Mechanical ventilation was applied with volume control mode, using a tidal volume of 8-10 ml/kg without positive end-expiratory pressure. The patient was supine after placing support under shoulders and head during intubation and surgery. Intraoperative body temperature was maintained using air-forced waring blanket. Complete and careful preoperative evaluation is absolutely important to select the appropriate anesthetic method. Ideal anesthetic management in each case should be based on an individualized decision-making.

한국시설안전공단은 국민과 국가 주요 시설물의 안전확보를 위하여 정밀안전진단 등 시설안전 및 건설공사 안전관리 등 건설안전 임무를 수행하고 있다. 특히 점검 및 진단의 부실 예방 및 보고서의 내실화를 위하여 ‘02년도부터 시특법에 평가제도가 도입된 후 현재까지 시행되고 있다. 평가대상은 시특법 제11조의2에 따라 제출된 1·2종 점검 및 진단 실시결과를 동법 시행령 제14조에 따라 선정하고 있다. 본 고는 교량 시설물의 보고서 평가사례를 제시하여 점검·진단 시 간과하기 쉬운 사항들을 실시자가 파악함으로써 부실 예방 및 보고서 작성의 내실을 기하는데 그 목적이 있다.

A primary infection with Toxoplasma gondii is usually asymptomatic, but some patients may have cervical lymphadenopathy and ocular disease. Toxoplasmosis is a common cause of lymphadenopathy. However, histopathologic examination to diagnose it usually does not reveal toxoplasmic cysts. Diagnosis of toxoplasmosis can be established by serological techniques or by direct detection of the parasite. Therefore, it is necessary to recognize the characteristic histopathological findings of toxoplasmic lymphadenitis and to confirm by serological or PCR results for toxoplasmosis. We describe histopathologic features of a case of toxoplasmic lymphadenitis with review of the literature, confirmed by serological evidence in a 50-year-old man.

Since climate change increases the risk of extreme rainfall events, concerns on flood management have also increased. In order to rapidly recover from flood damages and prevent secondary damages, fast collection and treatment of flood debris are necessary. Therefore, a quick and precise estimation of flood debris generation is a crucial procedure in disaster management. Despite the importance of debris estimation, methodologies have not been well established. Given the intrinsic heterogeneity of flood debris from local conditions, a regional-scale model can increase the accuracy of the estimation. The objectives of this study are 1) to identify significant damage variables to predict the flood debris generation, 2) to ascertain the difference in the coefficients, and 3) to evaluate the accuracy of the debris estimation model. The scope of this work is flood events in Ulsan city region during 2008-2016. According to the correlation test and multicollinearity test, the number of damaged buildings, area of damaged cropland, and length of damaged roads were derived as significant parameters. Key parameters seems to be strongly dependent on regional conditions and not only selected parameters but also coefficients in this study were different from those in previous studies. The debris estimation in this study has better accuracy than previous models in nationwide scale. It can be said that the development of a regional-scale flood debris estimation model will enhance the accuracy of the prediction.

Many countries are faced with the threats coming from aging of infrastructures and tries to find preparations. In that sense, comprehensive reports have published through performance evaluation on main infrastructures in the USA, Australia, and Japan etc. The government of South Korea shifted the policy from safety-oriented system toward performance-based system. The concept is included in the revised act, “Special Act on the Safety Control and Maintenance of Public Structures”. According to the Special Act, an annual comprehensive report will be issued in Korea. In this paper ‘Infrastructure Evaluation Report’ is analyzed as a reference.

Although trisomy 16 is commonly detected in spontaneous abortions and accounts for over 30% of cases of autosomal trisomy detected after spontaneous abortion, trisomy 16 mosaicism is rarely detected by amniocentesis in the second trimester. Here, we report a case of level III trisomy 16 mosaicism (47,XX,+16[8]/46,XX[31]) diagnosed by cytogenetic analysis of independently cultured amniotic fluid cells. The female baby was delivered at full term with low birth weight and intrauterine growth retardation, and interestingly, her karyotype was normal (46,XX). Given the difficulty in predicting the outcomes of fetuses with this mosaicism, it is recommended to inform the possibility of mosaicisms including this trisomy 16 mosaicism during prenatal genetic diagnosis and genetic counseling for parents.

A 40-year-old G1 P0 L0 A1 woman was referred to our clinic with 6-year history of infertility. Before visiting the clinic, she had 3 cycles of In-Vitro Fertilization (IVF) procedures (2 cycles of Controlled Ovarian Stimulation-IVF and 1 cycle of frozen-thawed Embryo Transfer (ET)) at other clinic. She had medical history of abortion at early gestation following FET (frozen-thawed-ET). The patient had complete type of septate uterus, double cervix and longitudinal vaginal septum. Vaginal septotomy was done first and 1 month later, hysteroscopic septoplasty was followed using ballooning filled with dye. After septoplasty, we inserted ballooning and left for several days to compress septal endometrium on the septectomy area. All procedures were done in the ambulatory operating room without laparoscopy or admission. 3 months later, she had in vitro fertilization-embryo transfer (IVF-ET) and FET procedures in our clinic. She had successful pregnancy and now is at 22 weeks of gestation. New ambulatory septoplasty using dye-filled ballooning is easy, safe and minimally invasive surgery for treatment of complete septate uterus.

Atrial fibrillation (AF) is a common, benign, and transient type of supraventricular arrhythmia encountered during the early postoperative period after a pulmonary resection. However, it sometimes might result in hemodynamic deterioration. We report on a case of new-onset atrial fibrillation in a 74-year-old male patient after right lower lobectomy, which was not controlled with intermittent bolus injection of esmolol and diltiazem. Successful pharmacological cardioversion was achieved with intravenous (6 mg/hr for 2 hours) followed by oral (90 mg q day) diltiazem 20 hours after this treatment. The literature on the risk factors and management of atrial fibrillation after pulmonary resection is reviewed.

JAK2 V617F mutation is a common event in chronic myeloproliferative disorders. However, de novo acute myeloid leukemia with JAK2 V617F is rarely encountered. The authors report the case of a 74-year-old male with de novo acute myeloblastic leukemia without maturation (AML M1) and a JAk2 V617F heterozygotic mutation. Despite treatment with standard AML regimens, the patient died 2 months after a diagnosis of acute leukemia. This case of an AML patient with a JAK2 V617F mutation with a poor prognosis suggests that despite its rarity, a JAK2 V617F mutational study be considered for prognostic purposes in AML.

Malignant salivary gland neoplasms constitute approximately 1% to 3% of all head and neck malignancies and only 0.3% of all malignant neoplasms. Malignant mixed tumors represent 2.2% of all salivary gland tumors. We experienced a huge malignant mixed tumor in the parotid gland, and obtained good results after surgical excision of the parotid gland and reconstructive operation. Therefore, we report on our experience and review the articles related to that tumor.