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*

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*

No abstract available.
Diagnosis* ; Hemangioma* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Pectus excavatum is the most common deformity of anterior chest wall. Since the first surgical correction performed by Meyer et al. in 1911, various operative techniques have been developed. These methods, however, needed a large skin incision on the anterior chest wall and wide excision of costal cartilages. Nuss et al. has introduced a less invasive method of inserting a molded stainless steel bar through the small incisions on the lateral chest wall in young patients. MATERIAL AND METHOD: This retrospective analysis was performed on 14 cases of pectus excavatum corrected between Nov. 1999 and July 2000. The correction under 15 of age was done using one bar. Above 16 of age, we used two bars. RESULT: There were 11 male and 3 female patients with ranging 2 years to 52 years. The pectus index was 5.3+/-1.84 and asymmetric index was 1.06+/-0.03. They were transferred to general ward at the next day of operation. Mean hospital stays were 4.2 days. The postoperative complications were pneumonthorax in one, hemothorax in one and delayed pleural effusion in one and all complications were among adults. CONCLUSION: We have corrected the pectus excavatum successfully using Nuss' method. In adults, the deformed walls were corrected with two bars but complications were higher than younger patients because of fully developed muscles and bones.
Adult ; Cartilage ; Congenital Abnormalities ; Female ; Fungi ; Funnel Chest* ; Hemothorax ; Humans ; Length of Stay ; Male ; Muscles ; Patients' Rooms ; Pleural Effusion ; Postoperative Complications ; Retrospective Studies ; Skin ; Stainless Steel ; Thoracic Wall

BACKGROUND: Atherosclerosis obliterans affecting lower extremities may involve the abdominal aorta and its major branches to the lower extremities, especially the common iliac arteries. It may affect focal segment or multiple segments. MATERIAL AND METHOD: A retrosp ective study was performed on 23 cases of aortoiliac arterial atherosclerotic pa tients who were treated with bypass graft surgery at Eulji University Hospital f rom January, 1995 through December, 1999. RESULT: All the patients were male and the mean age was 60.15+/-8.7. All had history of smoking and the associa ted diseases were diabetes mellitus in 8, hypertension in 7, ischemic heart dise ase in 6, and valvular heart disease in 1. Operative methods of aortoiliac athro sclerotic disease were aortobifemoral bypass graft only(7), aortobifemoral bypas s graft and concomitant femoropopliteal bypass graft(8), aortofemoral bypass gra ft(2), axillofemoral and femorofemoral bypass graft(3), and femorofemoral bypass graft(3). Postoperative complications were retroperitoneal hematoma or bleeding (3), paralytic ileus(3), pneumonia(3), cerebrovascular accident(1), acute renal failure(2), wound infection(2). Three perioperative mortality occurred among ana tomical bypass patients. CONCLUSION: We concluded that anatomical bypass treament has been a standard procedure for treatment of aortoi liac occlusive disease, but extraanatomical bypass surgery colud be a good alter natives for compromised patients with lower morbidity and mortality.
Aorta, Abdominal ; Arterial Occlusive Diseases ; Arteries* ; Atherosclerosis* ; Diabetes Mellitus ; Heart ; Heart Valve Diseases ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Iliac Artery ; Lower Extremity ; Male ; Mortality ; Population Groups ; Postoperative Complications ; Smoke ; Smoking ; Transplants ; Wounds and Injuries

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: 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