A malformation of azygos and hemiazygos system were observed from the cadaver for anatomy practice in College of Medicine, Chungnam National University. The observing results were as followings ; Hemiazygos vein was connected with left superior vena cava and drained into coronary sinus, which engorged enough to fill up with blood about 20cc to 30cc. Communicating pathway from hemiazygos vein to azygos veln wasn't found the diameter of left brachiocephalic vein was very small, about 2mm to 3mm. And, the diameter of left internal jugular vein was smaller than that of right infernal jugular vein. In this case, the azygos and hemiazygos system ceased its development at early embryologic stage(around 7 week embryo) and didn't progress into next stage.
Brachiocephalic Veins ; Cadaver ; Chungcheongnam-do ; Coronary Sinus ; Jugular Veins ; Veins ; Vena Cava, Superior

Hemangioma in the esophagus is an uncommon tumor. There have only been about 30 cases reported in the world literatures. It occurs predominantly in men and although majority are asymptomatic, may cause bleeding and dysphagia. Hemangioma in the esophagus was diagnosed with a barium swallowed esophagography and endoscopy. The main treatment modes recommended are surgery and endoscopic resection. We experienced one case of cav ernous hemangioma occurring at the distal esophagus. The patient was a forty-six year old male with dysphagia and indigestion. Barium esophagogram showed a filling defect at the distal portion. Esophagoscopy showed a bluish polypoid mass. Surgical resection was per formed and the pathologic diagnosis was confirmed as cavernous hemangioma. Postoperative course was uneventful and the patient had been followed up without any problems.
Barium ; Deglutition Disorders ; Diagnosis ; Dyspepsia ; Endoscopy ; Esophageal Neoplasms ; Esophagoscopy ; Esophagus* ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Male

In a double-blind clinical study, single-dose lumbar epidural blockade was instituted in 45 healthy patients undergoing cesarean section. Patients were randomly assigned to one of three groups. Each group received treatment with a different local anesthetic solution used were 2.0% Lidocaine HCL 20 ml in group I, 0.5% Bupivacaine HCL 20 ml in group II and Lidocaine-Bupivacaine Mixture in the ratio of 1:1 20 ml in group III The injections were made at the third lumbar interspace. The local anesthetic was injected directly through 176 Tuohy needle at 1 ml/s with the bevel directed cephalad(11 ml) and caudad(9 ml), The onset times were fastest in group I and slowest in group III. The durations were shortest in group L The times reguired to reach the highest level in group I and III were shorter than group II. The Apgar scores and blood pressure changes were similar in the diifferent groups. The frequency of pain sense was highest in group II. It is concluded that Lidocaine and Lidocaine-Bupivacine Mixture are superior to Bupivacaine for lumbar epidural blockade for cesarean section.
Blood Pressure ; Bupivacaine* ; Cesarean Section* ; Female ; Humans ; Lidocaine* ; Needles ; Pregnancy

No abstract available.
Perfusion*

No abstract available.
Endocardial Cushion Defects* ; Endocardial Cushions* ; Ultrasonics*

BACKGROUND: Surgical endarterectomy had been known to be the standard treatment modality in management of carotid stenosis. However, endarterectomy had several limitations in high-risk patients, particulary with coronary artery disease. Carotid angioplasty and stenting has been suggested to be a safer and more cost-effective alternative to carotid endarterectomy in the management of symptomatic carotid artery disease. The purpose of this study is to evaluate the feasibility and safety of elective carotid artery stent implantation in patients with carotid artery stenosis. METHOD: We treated 19 patients with symptomatic and asymptomatic stenosis of >60% in 19 carotid arteries with balloon angioplasty followed by elective stent implantation. Of all carotid stenting procedures, 18 stents were implanted in obstructing atherosclerotic plaques and in one for Takayasu's arteritis. Of all patients, 10 patients were symptomatic with a history of stroke or transient ischemic attacks which were ipsilateral to the treated carotid artery. 12 patients represented a high-risk subset with myocardial infarction, previous coronary artery bypass graft and coronary artery stenosis. 6 months follow up angiogram was done in 7 patients, a patient(Takayasu's arteritis) showed restenosis. Result: Angiographic and procedural success rate were 100%, and there were no acute or subacute stent thrombosis. Immediately after initial carotid stenting, the mean(+/-SD) stenosis was reduced from 74.9+/-13.6% to 10.2+/-8.7% and the minimal luminal diameter was increased from 1.4+/-0.8mm to 5.3+/-1.0mm corresponding to an acute gain of 3.9mm. There were no major or minor stokes during follow-up. CONCLUSION: Percutaneous carotid angioplasty with stenting is a safe and feasible procedure. It is associated with high immediate success rates and relatively low complications in the management of carotid artery stenosis. Carotid stenting seems to be a reasonable alternatives to medical management for the treatment of carotid stenosis in patients deemed to be poor candidates for standard carotid endarterectomy.
Angioplasty ; Angioplasty, Balloon ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis* ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Stenosis ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies ; Humans ; Ischemic Attack, Transient ; Myocardial Infarction ; Phenobarbital ; Plaque, Atherosclerotic ; Stents* ; Stroke ; Takayasu Arteritis ; Thrombosis ; Transplants

OBJECTIVE: To evaluate the relationship between uterine weight and morbidity in women undergoing vaginal total hysterectomy. METHODS: A retrospective chart review of 549 cases of patients with vaginal totoal hysterectomy was performed. Patients included in this study underwent vaginal total hysterectomy as benign uterine tumors at Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from June 2003 through June 2004. These patients were stratified into four groups; Group I patients with uterine weight of <180 gm (n=132), Group II patients with uterine weight of between 180 gm to 280 gm (n=238), Group III 280 gm to 380 gm (n=100), Group IV patients with uterine weight of >380 gm (n=79). The groups were compared as regard age, paturity, previous pelvic operations, postoperative discharge day, postoperation hemoglobin change, operation time, postoperative complications. RESULTS: There was no significant difference between the four groups with repect to postoperative discharge day (Mean=9.08 day), concurrent surgical procedure, age (M=45.96 years old), parturity (M=1.88). The overall complication rate was not significantly different (postoperation hemoglobin change (M=1.25), Complication). But the morcellation rate increased 8.33% in group I, 34.18% in group II, 55% in group III, 83.5% in group IV, respectively. The operation time prolonged as uterus weight increased.; 73 minutes in group I, 79 minutes in group II, 85 minutes in group III, 91 minutes in group IV. CONCLUSION: The vaginal total hysterectomy can be performed successfully in case of greatly enlarged uterus. Uterus enlargement is not an absolute contraindication.
Female ; Heart ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Korea ; Leiomyoma* ; Postoperative Complications ; Retrospective Studies ; Seoul ; Uterus

OBJECTIVE: To evaluate the relationship between uterine weight and morbidity in women undergoing vaginal total hysterectomy. METHODS: A retrospective chart review of 549 cases of patients with vaginal totoal hysterectomy was performed. Patients included in this study underwent vaginal total hysterectomy as benign uterine tumors at Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea from June 2003 through June 2004. These patients were stratified into four groups; Group I patients with uterine weight of <180 gm (n=132), Group II patients with uterine weight of between 180 gm to 280 gm (n=238), Group III 280 gm to 380 gm (n=100), Group IV patients with uterine weight of >380 gm (n=79). The groups were compared as regard age, paturity, previous pelvic operations, postoperative discharge day, postoperation hemoglobin change, operation time, postoperative complications. RESULTS: There was no significant difference between the four groups with repect to postoperative discharge day (Mean=9.08 day), concurrent surgical procedure, age (M=45.96 years old), parturity (M=1.88). The overall complication rate was not significantly different (postoperation hemoglobin change (M=1.25), Complication). But the morcellation rate increased 8.33% in group I, 34.18% in group II, 55% in group III, 83.5% in group IV, respectively. The operation time prolonged as uterus weight increased.; 73 minutes in group I, 79 minutes in group II, 85 minutes in group III, 91 minutes in group IV. CONCLUSION: The vaginal total hysterectomy can be performed successfully in case of greatly enlarged uterus. Uterus enlargement is not an absolute contraindication.
Female ; Heart ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Korea ; Leiomyoma* ; Postoperative Complications ; Retrospective Studies ; Seoul ; Uterus

Proteus syndrome is a rare condition that can be loosely categorized as a hamartomatous disorder. It is a complex disorder with multisystem involvement and great clinical variability. At this time, it is unknown how many individuals have Proteus syndrome, since not all cases of Proteus syndrome are documented. We do not know whether anesthetic problems in Proteus syndrome are common or not, but as there is a high incidence of cervical spine involvement, we anticipate significant anesthetic problems. We experienced such a case under general anesthesia for liposuction to lipomatosis in the posterior neck and right upper back, in a 18-year-old boy with Proteus syndrome. We report this case of Proteus syndrome and review the literature on this rare disease.
Adolescent ; Anesthesia, General ; Humans ; Incidence ; Lipectomy ; Lipomatosis ; Male ; Neck ; Proteus Syndrome* ; Proteus* ; Rare Diseases ; Spine

Resectional surgery of sympathetic nerves has been known to be the most effective treatment for essential hyperhidrosis and the application of thoracoscopic electrocauterization has provided a minimally-invasive procedure with the least morbidity and a resultant higher satisfaction rate. This paper describes our experience on the 1,167 cases of thoracoscopic sympathetic surgery for the treatment of essential hyperhidrosis. A total of 1,167 patients (674 males (58%) and 493 females (42%), mean age of 26.4 years with palmar (930), craniofacial (190) or axillary (47) hyperhidrosis underwent thoracoscopic sympathetic surgery from July 1992 to March 1999. Since the T2-4 sympathectomy, first performed in July 1992 for a patient of palmar hyperhidrosis, the operative methods have been altered to achieve a higher satisfaction level with the least complication by adopting less invasive procedures. Our current standard procedures being performed are T3 and T2 clipping for palmar and craniofacial hyperhidrosis and T3,4 sympathicotomy for axillary hyperhidrosis, all using a 2 mm needle thoracoscope. As the surgical procedures have been transited to a less invasive method with limited resection using the newest endoscopic devices, the average operation time and complications such as Horner's syndrome and compensatory hyperhidrosis have gradually decreased and thus the long-term satisfaction rate has been raised up to 98% for palmar hyperhidrosis, 92% for craniofacial hyperhidrosis and 89% for axillary hyperhidrosis. The recurrent cases (14/1167) were treated successfully with reoperations of thoracoscopic sympathetic surgery. The optimal goal of therapy could be achieved by complete elimination of the hyperhidrotic symptom, by decreasing the incidence and degree of compensatory hyperhidrosis through a selective and limited resection, and by adopting the least invasive procedures. Sympathicotomy has provided the advantages of a limited extent of denervation and the resultant decrease of compensatory hyperhidrosis compared to sympathectomy. The reversible method of clipping may be an effective, provisionary means for cases of severe, intractable compensatory sweating. For craniofacial hyperhidrosis, T2 sympathicotomy or clipping has been proven to be superior to the T1 sympathectomy due to the decreased occurrence of Horner's syndrome and T3,4 sympathicotomy providing a satisfactory outcome with less compensatory hyperhidrosis for axillary hyperhidrosis.
Adolescence ; Adult ; Aged ; Child ; Female ; Human ; Hyperhidrosis/surgery* ; Male ; Middle Age ; Sympathectomy* ; Thoracoscopy*