[Decision to avoid general anesthesia on 3 cases with anterior mediastinal masses].

We report 3 cases of anterior mediastinal masses in which we avoided providing general anesthesia for a biopsy and a central venous catheter placement. In all cases, chest X-rays on admission showed mediastinal mass ratio (MMR) greater than 44% and thoracic computed tomographic scans demonstrated cross sectional area (CSA) of the trachea 60% less than expected and the main stem bronchi narrowing. We made a decision not to provide general anesthesia, considering the risk of airway obstruction after induction of general anesthesia.

[Case of a schizophrenic patient refusing emergent operation for ovarian torsion].

We report a case of a schizophrenic patient who rejected an emergent operation for ovarian torsion. A 48-year-old woman with ovarian torsion strictly turned down emergent surgery against the recommendation of her gynecologist, who could not communicate with her. In response to his request, a psychiatrist examined and diagnosed her as schizophrenia.