Postpneumonectomy syndrome is a disease entity which arises after right pneumonectomy in left aortic arch and left pneumoncectomy in right aortic arch. This syndrome have a feature of severe mediastinal deviation and rotation, and induces severe respiratoy insufficiency. This syndrome is rare, but should be considered when pneumonectomized patient complaints who have severe dyspnea. In Samsung medical center, We report a sucessfully treated patient with postpneumonectomy syndrome, who had experienced right pneumonectomy at 1 years ago.
Aorta, Thoracic ; Dyspnea ; Humans ; Pneumonectomy ; Postoperative Complications

A clinical analysis was performed on 61 cases of patent ductus arteriosus experienced at Yeungnam University Hospital during 3 years period from April, 1984 to December, 1986. Of the 61 patient of PDA, 13 patients were male and 48 patient were female and age ranged 2 months to 26 years old with the average age of 9.4 years. The chief complaints on admission were frequent URI and dyspnea on exertion. diagnostic procedure were Doppler echocardiogram (in 53 among 61). Three postoperative complication were developed, but there was no operative mortality.
Ductus Arteriosus, Patent* ; Dyspnea ; Female ; Humans ; Male ; Mortality ; Postoperative Complications

Aged, 80 and over ; Dyspnea ; etiology ; Glottis ; pathology ; Hematoma ; complications ; Hemophilia A ; complications ; Humans ; Laryngeal Diseases ; complications ; Male

Aneurysm, Dissecting/complications* ; Coronary Artery Disease/complications* ; Dyspnea/complications* ; Humans ; Syncope/etiology*

We present a case of 50 year old male patient with coexistence of Pneumothorax and Chilaiditi sign. Chilaiditi sign is an incidental radiographic finding of a usually asymptomatic condition in which a part of intestine is located between the liver and diaphragm; however, the term "Chilaiditi syndrome" is used for symptomatic hepatodiaphragmatic interposition. The patient had no symptoms of abdominal pain, constipation, diarrhea, or emesis. Incidentally, Chilaiditi sign was diagnosed on chest radiography. Pneumothorax is defined as air in the pleural space. Pneumothoraces are classified as spontaneous or traumatic. Spontaneous pneumothorax is labelled as primary when no underlying lung disease is present, or secondary, when it is associated with pre-existing lung disease. Our case is the rare in the literature indicating the coexistence of Chilaiditi sign and pneumothorax.
Chest Pain ; Chilaiditi Syndrome ; complications ; diagnosis ; Dyspnea ; Humans ; Male ; Middle Aged ; Pneumothorax ; complications ; diagnosis

BACKGROUND: The larynx is longitudinally stretched and anteriorly displaced by inducing the general anesthesia and muscle paralysis, thus the laryngoscopic visualization might become difficult during direct laryngoscopy. The study was designed to assess the efficacy of the "laryngeal lift" maneuver in improving the laryngoscopic visualization to facilitate tracheal intubation. METHODS: Following the induction of general anesthesia and muscle paralysis, the laryngoscopic views of 287 patients were evaluated while the laryngeal lift by which the cricoid cartilage was displaced 0.5 cm posteriorly and 1.0~1.5 cm cephaladly were performed. One hundred and three patients with grade 2-4 laryngoscopic veiw were analysed. The laryngoscopic view which was described by Cormack and Lehane was classified from grade 1 to grade 4. The postoperative complications such as dysphasia and/or dyspnea were also observed. RESULTS: Seventy four patients of 81 patients with the laryngoscopic view of grade 2 were improved by one grade. Twenty one patients of 22 patients with the laryngoscopic view of grade 3 were improved by more than one grade. However, the laryngoscopic views of eight patients out of 103 patients were not improved. The tracheal intubation was successful in all patients. The overall, grade 2 and grade 3 improvement rate of laryngoscopic view was 92.2%, 91.4% and 95.5% respectively. The improvement rate by one grade and two grade was 89.3% and 2.9% respectively. CONCLUSIONS: The laryngeal lift had the high improvement rates of laryngoscopic view without any complications. Thus it is concluded that the laryngeal lift is a useful maneuver for improving laryngoscopic view during direct laryngoscopy with curved blade of laryngoscope.
Anesthesia, General ; Aphasia ; Cricoid Cartilage ; Dyspnea ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis ; Postoperative Complications

OBJECTIVES: Dyspnea and palpitation are common features of pregnancy. While several theories have been put forward to explain the etiology of gestational dyspnea and palpitation, there have been few systemic studies of its incidence, severity and time-course in a group of normal women. METHODS: We interviewed postpartum women, within 3 days after delivery, about dyspnea and palpitation. Separately from this interview, we performed 24-hour ECG monitoring for obstetric patients with palpitation before delivery. RESULTS: The subjects interviewed were 261 women, of whom 37.5 percent and 11.5 percent experienced dyspnea and palpitation, respectively. These symptoms had a tendency to increase to term. The presence of arrhythmias could be documented in only 22% of patients having 24-hour Holter monitoring. CONCLUSION: Dyspnea and palpitation were common among normal pregnant women and had a tendency to increase to term.
Adult ; Arrhythmia/*physiopathology ; Dyspnea/*physiopathology ; Electrocardiography, Ambulatory ; Female ; Human ; Pregnancy ; Pregnancy Complications/*physiopathology ; Time Factors

OBJECTIVES: The MVV reflects subjective dyspnea, exercise capacity, postoperative complication. But, the MVV embodies certain disadvantages and is dependent on coordination, endurance and motivation. A timed vital capacity for calculation of an indirect maximal voluntary ventilation is used. We evaluated differences in prediction formulas for the MUV according to the status of ventilatory function. METHODS: Forty-seven normal subjects, 68 patients with obstructive ventilatory impairment, and 23 patients with restrictive ventilatory impairment were studied. The relationships between the MVV and Flow or time parameters in forced expiratory volume and flow volume curves were compared among normal subjects and patients with obstructive or restrictive ventilatory impairment. RESULTS: 1) High correlation coefficients(R>or=0.87) were found between the FEV0.5, 0.75, 1 and the MVV in 47 normal subjects and 91 patients with ventilatory impairment. 2) The MVV can be conveniently estimated from the FEV1 values. The following regression formulas for the prediction of the MVV were obtained. Normal: MVV=44.01 X FEV1-21.09(r(2)=0.771, SEE=11.085) Obstructive ventilatory impairment: MVV=38.34 X FEV1-4.58(r(2)0.812, SEE=4.816) Restrictive ventilatory impairment: MVV=45.20 X FEV1-3.80(r(2)=0.899, SEE=6.929). 3) There were significant differences in prediction formulas for the MVV obtained by FEV1 between each group (P<0.05). CONCLUSION: These results suggest that different prediction formulas for the MVV, by multiplying the FEV1 by a constant, are respectively required in normal subjects and patients with obstructive or restrictive ventilatory impairment.
Dyspnea ; Forced Expiratory Volume ; Humans ; Maximal Voluntary Ventilation ; Motivation ; Postoperative Complications

BACKGROUNDMedically unexplained dyspnea refers to a condition characterized by a sensation of dyspnea and is typically applied to patients presenting with anxiety and hyperventilation without underlying cardiopulmonary pathology. We were interested to know how anxiety triggers hyperventilation and elicits subjective symptoms in those patients. Using an imagery paradigm, we investigated the role of fearful imagery in provoking hyperventilation and in eliciting symptoms, specifically dyspnea.

METHODSForty patients with medically unexplained dyspnea and 40 normal subjects matched for age and gender were exposed to scripts and asked to imagine both fearful and restful scenarios, while end-tidal PCO(2) (PetCO(2)) and breathing frequency were recorded and subjective symptoms evaluated. The subject who had PetCO(2) falling more than 5 mmHg from baseline and persisting at this low level for more than 15 seconds in the imagination was regarded as a hyperventilation responder.

RESULTSIn patients with medically unexplained dyspnea, imagination of fearful scenarios, being blocked in an elevator in particular, induced anxious feelings, and provoked a significant fall in PetCO(2) (P < 0.05). Breathing frequency tended to increase. Eighteen out of 40 patients were identified as hyperventilation responders compared to 5 out of 40 normal subjects (P < 0.01). The patients reported symptoms of dyspnea, palpitation or fast heart beat in the same fearful script imagery. Additionally, PetCO(2) fall was significantly correlated with the intensity of dyspnea and palpitation experienced during the mental imagery on one hand, and with anxiety symptoms on the other.

CONCLUSIONSFearful imagery provokes hyperventilation and induces subjective symptoms of dyspnea and palpitation in patients with medically unexplained dyspnea.

Adult ; Anxiety ; complications ; Carbon Dioxide ; analysis ; Dyspnea ; etiology ; Fear ; Female ; Humans ; Hyperventilation ; etiology ; Imagination ; Male

Aged ; Amyloidosis ; complications ; diagnosis ; Diagnostic Errors ; Dyspnea ; etiology ; Edema ; etiology ; Female ; Humans ; Immunoglobulin Light-chain Amyloidosis