A 51-year-old male with chronic renal failure had marked swelling and tenderness of the right arm. Venography revealed central vein occlusion involving stenosis of right proximal subclavian vein, right internal jugular vein, and left distal innominate vein, and obstruction of right brachiocephalic vein. Multiple obstruction of these veins was thought to have resulted from repeated subclavian catheterization. Right subclavian-superior vena cava was bypassed with 10 mm Gore-tex vascular graft and then left subclavian vein with 8 mm Gore-tex vascular graft was bypassed to the 10 mm Gore-tex vascular graft. The results were excellent.
Arm ; Blood Vessel Prosthesis ; Brachiocephalic Veins ; Catheterization* ; Catheters* ; Constriction, Pathologic ; Humans ; Jugular Veins ; Kidney Failure, Chronic* ; Male ; Middle Aged ; Phlebography ; Polytetrafluoroethylene ; Renal Dialysis* ; Subclavian Vein ; Transplants ; Veins*

Hypothermia during lung preservation decreases metabolic processes. After the rabbit lung was flushed with modified Euro-Collins solution, heart-lung block was harvested and the left lung was assessed after ligation of the right pulmonary artery and right main-stem bronchus. Heart-lung block was immersed in the same solution for 6 hours. The modified Euro-Collins solution and storage temperature of group 1( 10 cases ) was 4 degrees C, group 2( 10 cases ) was 10 degrees C. On completion of the storage period, the left lung was ventilated and reperfused with blood which used a cross-circulating paracorporeal rabbit as a " biologic deoxygenator " for 60 minutes. Pulmonary artery pressure, airway pressure, difference in oxygen tension between inflow and outflow perfusate and degree of pulmonary edema were assessed at 10-minute intervals while the left lung was ventilated at 0.8 of the inspired oxygen fraction. The mean pulmonary venous oxygen tensions at 10 and 60 minutes after reperfusion were 209.52 +/- 42.46 and 103.48 +/- 15.96 mmHg in group I versus 247.78 +/- 36.19 and 147.91 +/- 11.07 mmHg in group II( p = 0.049, <0.0001 ). The mean alveolar-arterial oxygen differences at 20 and 60 minutes after reperfusion were 357.95 +/- 12.84 and 437.31 +/- 14.26 mmHg in group I versus 310.88 +/- 33.47 and 390.93 +/- 15.86 mmHg in group II( p = 0.0092, <0.0001 ). The mean pulmonary arterial pressures at 10 and 60 minutes after reperfusion were 40.56 +/- 18.66 and 87.22 +/- 17.22 mmHg in group I versus 31.22 +/- 6.84 and 65.78 +/- 11.02 mmHg in group II( p = 0.048, 0.0062 ). The mean pulmonary vascular resistances at 10 and 60 minutes after reperfusion were 2.69 +/- 0.85 and 4.36 +/- 0.86 mmHg/ml/min in group I versus 1.99 +/- 0.39 and 3.29 +/- 0.55 mmHg/ml/min in group II( p = 0.0323, 0.0062 ). There were no difference between groups in peak airway pressure, lung compliance and degree of pulmonary edema. In conclusion that preservation of lung at 10 degrees C was superior to preservation at 4 degrees C.
Arterial Pressure ; Bronchi ; Hypothermia ; Ligation ; Lung Compliance ; Lung Transplantation ; Lung* ; Metabolism ; Organ Preservation ; Oxygen ; Pulmonary Artery ; Pulmonary Edema ; Reperfusion

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

A 38-year-old man, with recurrent oral ulcers for 10 years, was admitted because of recent aggravation of odynophagia and sore throat. About 4 years earlier, he had been performed abdominal surgery for intestinal perforation. Gastrofiberscopic examination showed small round ulcers at hypiopharynx and 6cm sized longitudinal linear ulcer at mid esophagus. Biopsy specimens at mid-esophagus showed chronic inflammation. Besides oral ulcer, he had perianal ulcers and skin rashes. He was managed with steroid, colchicine and sulfasalazine under the diagnosis of esophageal involvement in Behcet's disease. After 3 months from discharge, esophagogram and gastrofiberscopic examination showed some improved appearance, but symptoms recurred for steroid tapering. He has been followed in much improved status for 8 months after discharge.
Adult ; Biopsy ; Colchicine ; Diagnosis ; Esophagus ; Exanthema ; Humans ; Inflammation ; Intestinal Perforation ; Oral Ulcer ; Pharyngitis ; Sulfasalazine ; Ulcer*

BACKGROUND: Compensatory hyperhidrosis is the most common complication after thoracoscopic sympathetic operation in hyperhidrosis. It is not only decrease patient's satisfaction but also gives another burdens to the patients. Unfortunately remarkable treatment for compensatory hyperhidrosis does not exist yet. The purpose of this study was to evaluate the effect of decreased sweating production using 20% aluminum chloride hexahydrate on compensatory hyperhidrosis. MATERIAL AND METHOD: From May to July, 2000, 8 patients were evaluated. All of them complained of severe discomfort due to compensatory hyperhidrosis. Degree of compensatory sweating was subjectively assessed thorough questionnaire as follows: 1=absent, 2=mild, 3=moderate 4=severe, 5=disabling, Also degree of life satisfaction was subjectively assessed thorough questionnaire as follows: 1=Absolutely no satisfaction, 2= Aluminum* ; Follow-Up Studies ; Humans ; Hyperhidrosis* ; Postoperative Complications ; Surveys and Questionnaires ; Sweat ; Sweating

A 50-year-old male visited the emergency room due to the cervical edema caused by a traffic accident. At the cervial CT, diagnosis was confirmed as extensive cervical subcutaneous emphysema secondary to tracheal laceration as a thyroid cartilage fracture. The patient showed loss of symptom after conservative treatment. Thyroid cartilage fracture is rare and tracheal laceration as a result of thyroid cartilage fracture has never been reported in the literatures. Thus we herein report this one case.
Accidents, Traffic ; Diagnosis ; Edema ; Emergency Service, Hospital ; Emphysema ; Humans ; Lacerations* ; Male ; Middle Aged ; Subcutaneous Emphysema ; Thyroid Cartilage* ; Thyroid Gland*

At OPD follow-up in December 1998, chest x-ray of a 42-year-old female showed a solit ary pulmonary nodule at a superior basal segment in the right lower lobe. After percut aneous transthoracic needle aspiration failure, wedge resection of the superior basal segment of lower lobe in right lung was performed for diagnosis and therapy. Three years ago, she had received surgery to remove a mass in the left buttock. The mass was pathologically diagnosed as malignant fibrous histiocytoma. She subsequently received 4500 rad radiotherapy for 35 days. Pathology confirmed metastatic malignant fibrous histiocytoma of the lung.
Adult ; Buttocks ; Diagnosis ; Female ; Follow-Up Studies ; Histiocytoma, Malignant Fibrous* ; Humans ; Lung Neoplasms ; Lung* ; Needles ; Pathology ; Radiotherapy ; Thorax

An epidemiologic investigation was carried out to identify the source of infection of typhoid fever outbreak, which was occurred in Nam-Gu, Pusan city from April 20 to June 28, 1996. The distribution of 83 reported cases (55 confirmed cases and 28 suspected cases) by sex and age group showed that this epidemic would be occurred by the exposure to a common source with low toxic pathogen because 55.4% of cases were under 20 years old and most of the adults cases were female. The epidemic curve showed a unimodel curve with a peak on about 15 May and tailed down to 23 June, suggesting that the exposure was constant. These results supposed that the contamination of a public water supply would be the source of infection. The analysis of reported cases and population survey conducted to household members and community contacts living in the epidemic area, led the conclusion that the source of infection was tap water supplied through the Dae Youn pumping station, based on the following findings: (1) There were singificant differences of incidence rate among regions (Tong) even though in the same Dong and the spot map of incident cases distributed in accord with the water supply by Dae-Youn pumping station. (2) Among reported cases, 21 cases, including 17 confirmed cases, stated they had used only tap water. (3) The analysis of tap water from the house which had seven typhoid cases, revealed the contamination of E coli and the dilution of residual chlorinated concentration. (4) The outbreak of typhoid fever was stopped after the replacement of The worn-out pipe line of tap water supply to the new one.
Adult ; Busan* ; Escherichia coli ; Family Characteristics ; Female ; Humans ; Incidence ; Typhoid Fever* ; Water ; Water Supply ; Young Adult

A case of lacunar skull associated with meningomyelocele, spina bifida, kyphcsis on thoracolumbar area, hydrocephalus, bilateral club foot and paralysis of lower extremities at birth was reported. Diagnosis was made by X-ray of skull, whole spine, upper and lower extremities. On skull X-ray film, multiple small area of round rarefaction surrounded by arborizing pattern of bony ridge was visualized on both parietal area. On autopsy, outer table of the parietal bone was smooth and inner table of the parietal area was irregular and rough due to bony defect which was surrounded by bony ridges. A brief review of the literautre on lacunar skull is given.
Autopsy ; Diagnosis ; Foot ; Humans ; Hydrocephalus ; Infant, Newborn ; Lower Extremity ; Meningomyelocele ; Paralysis ; Parietal Bone ; Parturition ; Rabeprazole ; Skull* ; Spinal Dysraphism ; Spine ; X-Ray Film

OBJECTIVE: To find out the effect of depressive symptoms at acute stage on the course of disease progression in whiplash patients. METHOD: Thirty-eight patients with neck pain after acute whiplash injury were enrolled. The patients were prospectively surveyed within 7 days after whiplash injury and followed up after discharge by telephone interview. Depressive symptoms, self-perceived disability from neck pain, and pain intensity were measured by Center for Epidemiological Studies-Depression Scale (CES-D), neck disability index (NDI), and visual analog scale (VAS), respectively. Depressive group was defined as CES-D scores more than 21. The correlation between duration of total treatment and CES-D score and other variables was investigated by calculating independent t-test, Pearson's correlation coefficient and linear regression analysis. RESULTS: The mean overall score of CES-D was 20.8+/-11.7 and 20 (52.6%) patients were classified as depressive group. Depressive group showed longer duration of total treatment (55.1+/-35.1 vs 38.9+/-16.4, p>0.05) and higher pain intensity after total treatment (37.0+/-21.3 vs 29.4+/-20.1, p>0.05) than non-depressive group, but statistical significance was not sufficient. Duration of total treatment was correlated with NDI score (gamma=0.454, p<0.01) and initial pain intensity (gamma=0.349, p<0.05), but not related with socio-demographic factors - age, gender, marital status - and CES-D score. CONCLUSION: Duration of total treatment was correlated with physical disability and initial pain intensity. Depressive symptoms at acute stage of whiplash injury was correlated with both of them. Depressive symptoms could affect the outcome of whiplash injury indirectly through pain intensity and physical disability.
Depression ; Disease Progression ; Humans ; Interviews as Topic ; Linear Models ; Marital Status ; Neck ; Neck Pain ; Prognosis ; Prospective Studies ; Whiplash Injuries