BACKGROUND: To evaluate the efficacy of Fibrin glue to decrease recurrence in video-assisted thoracoscopic surgery(VATS) for a treatment of spontaneous penumothorax. MATERIAL AND METHOD: All medical records of 17 patients who underwent a thoracoscopic wedge resections of bullae with stapling device with Fibrin glue in our institute between May 1998 and December 1999 were reviewed. variables analyzed include affected sites primary indication of VATS. duration from admission to discharge duration of postoperative stay duration of chest tube drainage recurrence and complication. There were 16 men and 1 woman. RESULT: There was no evidence of hemodynamic instability or arterial blood gas abnormalities encountered during the procedure. Mean age at the time of the VATS was 26.9 years (range 15 to 61 years) The mean duration from admission to discharge was 7.8 days and mean postoperative stay was 5.1days mean chest tube indwelling period was 4..0 days. There was no recurrence of pneumothorx. CONCLUSION: Thoracoscopic wedge resections with introduction of fibrin glue are safe and effective and requires only a short hospital stay. We believe that this thoracoscopic technique will further simplify the surgical treatment of pneumothorax.
Chest Tubes ; Drainage ; Female ; Fibrin Tissue Adhesive* ; Fibrin* ; Hemodynamics ; Humans ; Length of Stay ; Male ; Medical Records ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted

No abstract available.
Mediastinum*

No abstract available.
Hematoma*

BACKGROUND: To determine the efficacy and safety of endoscopic resection and ablation of superficial varicosities using a powered vein resector, irrigated illuminator. MATERIAL AND METHOD: 83 consecutive patients were involved in the study. 103 limbs in 83 patients were treated using a minimal invasive, powered, vein resecting device with cutaneous transillumination and tumescent anesthesia technique. There were 51 women and 32 men. All patients were operated under general anesthesia or regional anesthesia. Operative time and patient satisfaction scores were recorded along with the number of incisions made. RESULT: 83 patients(51/61.4% female, 32/38.6% male, aged 25-78 years) had varicose vein. Average age at the time of operation was 45 years(range, 25 to 78 years). There were 63 unilateral procedures and 20 bilateral operations. Operative time ranged from 24 to 46 minutes (average 35.3 minutes) in the unilateral procedure. The number of incisions per limb averaged 2.7(range, 2 to 5). Postoperative complications occurred in 7(8.4%) patients. Patients were asked to describe their pain on an analog scale ranging from 1 to 10 with 1 representing no pain and 10 worst imaginable pain. Immediately postoperative pain score was 2.4. Postoperative pain score at 72 hours had a mean score of 2.0. Postoperative pain score at 1 months were 1. CONCLUSION: Varicose vein removal using Transilluminated Powered Phlebectomy(TIPP) is a safe and efficient procedure. The procedure saves time, is easy to perform, and gives direct visualization and a distinct endpoint of the removal of veins. It is also less tedious to perform and gives good cosmetic results with significant pain relief.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, General ; Extremities ; Female ; Humans ; Male ; Operative Time ; Pain, Postoperative ; Patient Satisfaction ; Postoperative Complications ; Surgical Procedures, Minimally Invasive ; Transillumination ; Varicose Veins* ; Veins

No abstract available.
Lipoma*

BACKGREOUND: The ideal drug for treatment of pulmonary hypertension would be a vasodilator which acts preferentially on the pulmonary vascular bed. The aim of this study was to compare the effects of prostaglandin I2 (PGI2) on central hemodynamics and right ventricular function with the more widely used vasodilators, prostaglandin E1 (PGE1) and nitroglycerin (NTG) and to investigate whether PGI2 is more selective to the pulmonary vascular bed compared with PGE1 and NTG in dogs. METHODS: We have used a method for producing sustained pulmonary hypertension in vivo by continuous infusion of U46619 adjusting the infusion rate until a mean pulmonary artery pressure (PAP) exceeded 25 mmHg. And the pulmonary and systemic effects of the three pulmonary vasodilators were compared at doses producing equivalent, lowered approximately 20% of mean arterial pressures (MAP) or mean PAP returned to baseline. RESULTS: After infusion of the three vasodilators, heart rate, cardiac output, and mean PAP/MAP ratio were significantly increased, but there was no statistical significant differences among the three vasodilators. PGI2 and PGE1 significantly increased (worsened) the PVR/SVR ratio, but NTG decreased. However there was no significant difference among the three vasodilators. After infusion of the three vasodilators, the arterial oxygen tension (PaO2), mixed venous oxygen tension (PO2), O2 deliver, and O2 uptake were increased, and shunt ratio (s/t(%)) were significantly decreased, but there were no significant differences among three vasodilators. CONCLUSIONS: PGI2, PGE1, and NTG all decreased both PVR and SVR. None of these vasodilatorswere more selective to the pulmonary vascular bed, myocardial performance, and improved gas exchange.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Alprostadil* ; Animals ; Arterial Pressure ; Cardiac Output ; Dogs* ; Epoprostenol* ; Heart Rate ; Hemodynamics* ; Hypertension, Pulmonary* ; Nitroglycerin* ; Oxygen ; Pulmonary Artery ; Vasodilator Agents ; Ventricular Function, Right

BACKGROUND: Prostacyclin administered intravenously has demonstrated intermediate pulmonary specificity and its aerosol form has an even greater pulmonary selectivity. There have been few systematic analyses of the difference in response according to the route of administration and the dose of administration of prostacyclin. So we have compared prostacyclin infusion versus inhalation in various concentrations in an animal model. METHODS: Pulmonary hypertension was induced by continuous intravenous infusion of the vasoconstrictor U46619 and prostacyclin solutions of 10, 50, 100, 200 mcg/ml were inhaled using a jet nebulizer. Prostacyclin infusion was done at a rate of 100, 200, 400 ng/kg/min. RESULTS: With inhalation of 10, 50, 100, 200 mcg/ml prostacyclin, PVR fell to values of 85%, 76%, 64%, 55% of the preinhalation value and SVR fell to values of 94%, 80%, 76%, 64% of the preinhalation value, respectively (p<0.05). PVR/SVR ratios decreased significantly in all inhalation doses (p<0.05). With infusion of prostacyclin at a rate of 100, 200, 400 ng/kg/min, PVR fell to values of 73%, 60%, 50% of the preinfusion value and SVR fell to values of 68%, 54%, 38% of the preinfusion value, respectively (p<0.05). PVR/SVR ratios increased at an infusion rate of 400 ng/kg/min. CONCLUSION: Prostacyclin inhalation did not result in selective pulmonary vasodilation without causing any efects on the systemic vascular bed (absolute pulmonary selectivity). But it did cause more predominant vasodilation on the pulmonary vascular bed (relative pulmonary selectivity). By contrast, prostacyclin infusion caused more predominant vasodilation on the systemic vascular bed, creating the risk of severe systemic hypotension.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid ; Epoprostenol* ; Hypertension, Pulmonary* ; Hypotension ; Infusions, Intravenous ; Inhalation ; Models, Animal ; Nebulizers and Vaporizers ; Sensitivity and Specificity ; Vasodilation

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

BACKGROUND: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. MATERIAL AND METHOD: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was 57.6+/-2 years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. RESULT: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. CONCLUSION: It is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.
Angiography ; Angioplasty ; Diagnosis* ; Edema ; Humans ; Iliac Vein ; Korea ; Lower Extremity ; May-Thurner Syndrome* ; Phlebography ; Stents ; Thrombectomy ; Varicose Veins ; Veins ; Venous Thrombosis

BACKGROUND: There are limited number of reports on May-Thurner syndrome (Iliac vein compression syndrome) in Korea, We analysed the clinical features, diagnostic modalities and endovascular treatment of May-Thurner syndrome. MATERIAL AND METHOD: We reviewed 12 cases of May-Thurner syndrome between March 2001 and June 2003. Mean age was 57.6+/-2 years. We were used in venography, color doppler and computed tomographic angiography as diagnostic modalities and in thrombolysis, thrombectomy, angioplasty and stent insertion as endovascular treatment. RESULT: Clinical features showed edema of lower extremities in 4 patients, pain of lower extremities in 1 patient, edema with pain in 5 patients, and all in 1 patient. In one patient, he did not have any pain and any edema of lower extremities but was diagnosed as May-Thurner syndrome using venography due to varicose veins on lower extremities. Diagnostic modalities included venography, computed tomographic angiography in all patients with clinical presentation except in one patient and color doppler was only performed only in 4 patients. Four kinds of endovascular treatment were performed for May-Thurner syndrome, angioplasty in 11 patients, stent insertion in 10 patients, thrombectomy in 9 patients and thrombolysis for 7 patients. Nine patients were followed up and we can show good blood flow in Left iliac vein for 7 of 9 patients. CONCLUSION: It is necessary to recognize the possibility of May-Thurner syndrome in Deep vein thrombosis patients and we should use a variety of modalities to diagnose May-Thurner syndrome. Finally, endovascular treatment is a safe and effective therapy for May-Thurner syndrome.
Angiography ; Angioplasty ; Diagnosis* ; Edema ; Humans ; Iliac Vein ; Korea ; Lower Extremity ; May-Thurner Syndrome* ; Phlebography ; Stents ; Thrombectomy ; Varicose Veins ; Veins ; Venous Thrombosis