No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

No abstract available.
Cervix Uteri* ; Female ; Health Expenditures*

No abstract available.
Extremities* ; Gestational Age*

Lung transplantation is a viable option for patients with chronic obstructive pulmonary disease (COPD), and emphysema is the most common indication to undergo lung transplantation. A total of seven lung and one heart-lung transplantations were performed between July 1996 and June 2004 at the Yongdong Severance Hospital, and herein, three emphysema patients who underwent single lung transplantations are reviewed. There were 2 males and 1 female, with a mean age of 50 years (35, 57 and 58 years). They all underwent an operation, without cardiopulmonary bypass, and there was no operative mortality. The mean survival was 12 months (4 months, 15 months and 17 months) and all succumbed to death due to activation of pulmonary tuberculosis, post-transplantation lymphoproliferative disease and cytomegalovirus (CMV) gastritis associated with asphyxia. Infection was the most common postoperative complication, resulting in longer hospital stays, higher medical expenses and shorter survival rates, necessitating aggressive prophylactic management. The accumulation of experience, modifications to operative procedures and perioperative care may lead to improved early and long- term survival in patients with emphysema undergoing single or bilateral lung transplantations.
Adult ; Aged ; Asphyxia/mortality ; Cytomegalovirus Infections ; Fatal Outcome ; Female ; Gastritis/mortality/virology ; Humans ; *Lung Transplantation ; Lymphoproliferative Disorders/mortality ; Male ; Middle Aged ; Pulmonary Emphysema/*surgery ; Survival Analysis ; Tuberculosis, Pulmonary/mortality

BACKGROUND: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. MATERIAL AND METHOD: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptoms too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite findings of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraclavicular approaches in 2 cases. RESULT: There were 15 males and one female with an average age of 23.9 years (range: 19~39). Rib anomalies were observed in four cases (25.0%), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0%), left lesions in five cases (31.3%), and bilateral lesions in three cases (18.7%). The follow-up period was 9~26 months and recurrence rate was 12.5% (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. CONCLUSION: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.
Angiography ; Brachial Plexus ; Edema ; Fat Necrosis ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Korea ; Male ; Myositis ; Paresthesia ; Recurrence ; Ribs ; Thoracic Outlet Syndrome* ; Ulnar Neuropathies ; Upper Extremity ; Wounds and Injuries

Lung transplantation has been successfully employed for variety of obstructive lung disease. Single lung transplantation has become a therapeutic option for end-stage obstructive lung disease. The patient, a 57 year old man with emphysema, suffered from severe dyspnea, which progressively aggravated him for the last three years. A single lung transplantation was performed from a young brain-dead donor on April 7th, 1999 in the department of thoracic surgery, Respiratory Center, Yongdong Severance hospital, yonsei University. The immunosuppressive regimen was based on cyclosporine A and azathioprine from beginning, adding steroid. Single lung transplantation was feasible and beneficial in patients with end-stage emphysema.
Azathioprine ; Cyclosporine ; Dyspnea ; Emphysema ; Humans ; Lung Diseases, Obstructive ; Lung Transplantation* ; Lung* ; Middle Aged ; Pulmonary Emphysema* ; Respiratory Center ; Thoracic Surgery ; Tissue Donors

Chondrosarcoma is an extremely rare cause of pelvic mass mimicking ovarian carcinoma. Imaging techniques, even CT and MRI, failed to define the exact origin of the tumor. These findings as well as the elevated CA-125 level naturally resulted in a preoperative diagnosis of ovarian carcinoma. Surgical removal is the most important treatment of choice for chondrosarcoma. We experienced a case of extraskeletal myxoid chondrosarcoma of pelvic cavity in a 45-year-old patient, who presented with abdominal distension and lower abdominal palpable mass, and reported it with a brief review of literatures.
Chondrosarcoma* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Middle Aged

BACKGROUND: Recent development of endoscopic devices and surgical techniques enabled the video-assisted thoracoscopic sympathetic surgery to be reliable, safe and minimally invasive for the treatment of hyperhidrosis. People with axillary hyperhidrosis, however, were not as satisfied as those with palmar or craniofacial hyperhidrosis due to more frequent and severe compensatory sweating and lack of effect on concomitant osmidrosis. MATERIAL AND METHOD: From March 1997 through April 1999, 45 cases of axillary hyperhidrosis underwent T3,4 sympathectomy(21 patients), T2,4 sympathicotomy(20 patients) or T4 sympathectomy(4 patients). We evaluated and analyzed the early effect of symptomatic relief, compensatory hyperhidrosis and the level of long term satisfaction. The sex ratio was 28 males: 17 females with an average age of 28 years, ranging from 13 to 46 years. Two patients had concomitant osmidrosis and one patient who underwent T3,4 sympathectomy experienced profuse compensatory sweating on face and scalp for which he underwent a reoperation of T2 sympathicotomy 93 days later. All the procedures were performed under general anesthesia in semifowler's position with 30 elevation of the upper body. A 2mm needle thoracoscope was used except in 2 cases with moderate to severe pleural adhesions where a 5mm thoracoscope was used. RESULT: Average operation time was 46.2+/-11 minutes for T3,4 sympathectomy; 32.5+/-23 minutes for T2,4 sympathicotomy; and 53.8+/-18 minutes for T4 sympathectomy. Every patient who underwent T3,4 sympathectomy and T2,4 sympathicotomy showed satisfaction 17 cases(81%) and 12 cases(60%) had absolutely no sweating after T3,4 sympathectomy and T2,4 sympathicotomy, respectively and the remaining 4 cases(19%) and 8 cases(40%) experienced 'decreased amount of sweating with slightly moist armpits'. Compensatory hyperhidrosis was present in 67% and 60% of the cases after T3,4 sympathectomy and T2,4 sympathicotomy, but only 10% and 5 %, were severe enough to be embarrassing or disabling. The level of satisfaction was high in both groups, with 86% after T3,4 sympathectomy and 89% after T2,4 sympathicotomy. CONCLUSION: Both T3,4 sympathectomy and T2,4 sympathicotomy were effective means of treating axillary hyperhidrosis. T3,4 sympathectomy had superior symptomatic relief although T2,4 sympathicotomy was favored because of shorter operation time, easier surgical technique and milder compensatory sweating. Long term satisfaction level, however, was similar in both groups.
Anesthesia, General ; Female ; Humans ; Hyperhidrosis* ; Male ; Needles ; Reoperation ; Scalp ; Sex Ratio ; Sweat ; Sweating ; Sympathectomy ; Thoracoscopes

Lung transplantation is the choice of treatment for selected patients with end-stage pulmonary disease. However, retransplantation of the lung due to primary graft failure carries a high risk of morbidity and mortality. This is a case of a 52 year old male with emphysema who continuously needed a ventilator care and a tracheostomy. He underwent a left single lung transplantation but were not able to wean from the ventilator due to primary graft failure, and therefore we decided to do a retransplantation. Bilateral sequential single lung transplantation was performed under the cardiopulmonary bypass. The patient recovered quite well and was discharged and fully active with his work. Retransplantation although it carries a high risk, is a very effective treatment in patients with primary graft failure.
Cardiopulmonary Bypass ; Emphysema ; Graft Rejection ; Humans ; Lung Diseases ; Lung Transplantation* ; Lung* ; Male ; Middle Aged ; Mortality ; Pulmonary Emphysema ; Reoperation ; Tracheostomy ; Transplants* ; Ventilators, Mechanical

BACKGROUND: Lung transplantation is a definitive therapy for a variety of end stage lung diseases. Since 1996, we have performed thirteen cases of lung transplantation including two retransplantations, and we analyzed the outcomes, complications, and survivals of these patients. MATERIAL AND METHOD: We retrospectively analyzed the medical records of thirteen cases from July, 1996 to July, 2005. RESULT: During the period, 11 patients had undergone 13 lung and heart-lung transplantations, and two patients had retransplantation due to allograft failure. Mean age of recipients were 45.2+/-10.7 years (range, 25~59). Early complications were bleeding, reperfusion injury, and infection and late complications were mainly infection and post-transplantation lymphoproliferative disease. Excluding the operative mortality, the mean survival period was 16.5 months (2~60 months). Two retransplantations had been performed 2 weeks and 13 months after single lung transplantations. CONCLUSION: In order to achieve long term survival, early detection of complications and proper treatment in addition to surgical skills are necessary, and these efforts can promote better lung transplantation programs in the near future.
Allografts ; Heart-Lung Transplantation ; Hemorrhage ; Humans ; Lung Diseases ; Lung Transplantation* ; Lung* ; Medical Records ; Mortality ; Reperfusion Injury ; Retrospective Studies