We report a case of a 48-year-old woman with end-stage renal failure who had a Polytetrafluoroethylene graft for hemodialysis and who had developed complications of venous outflow stenosis and venous backflow. Although venous backflow is an harbinger of graft failure, it is not enough reason to abandon the graft immediately. The patient was able to utilize her graft for 6 further months.
Arteriovenous Shunt, Surgical ; Constriction, Pathologic ; Female ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Polytetrafluoroethylene* ; Renal Dialysis ; Transplants*

Thoracoscopic sympathicotomy is effective in treating not only palmar hyperhidrosis, but, also in treating axillary hyperhidrosis. In previous studies in Korea, sympathicotomy was focused on combinations including the 2nd to 4th sympathetic chains (R2,3,4). Using a minimally invasive technique, the results of sympathicotomy of the 4th and 5th chains (R4,5) of five patients, from February to August, 2002, for axillary hyperhidrosis without osmidrosis, were reviewed. All patients had a successful operation, their profuse sweating ceased. Three patients suffered from some degree of compensatory sweating. Among the three patients, only one patient suffered from moderate compensatory sweating over his back and thighs. Thoracoscopic R4,5 sympathicotomy offers a very appealing method in the treatment for axillary hyperhidrosis in patients who have profuse axillary sweating.
Humans ; Hyperhidrosis* ; Korea ; Sweat ; Sweating ; Thigh

No abstract available.
Adult* ; Humans ; Neural Conduction*

Chloracne is a refractory acneiform eruption due to halogenated polyaromatic compound(eg. dioxin, dibenzofurans, polychlorinated biphenyls, etc.). 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin, a kind of dioxin isomer, contained in the Agent Orange which was used for defoliating agent during Vietnam war. It is characterized by recalcitrant comedones and cyst predominantly in the malar and postauricular area. Lesions of the penis and scrotum are also relatively frequent. The key pathological feature is the non-inflammatory keratinization of pilosebaceous unit. The meibomian glands are typically affected. Xerosis, conjunctivitis, pigmentation, follicular hyperkeratosis, actinic elastosis are occasionally associated with chloracne. We report a case of typical chloracne due to exposure to defoliating agent during Vietnam war in a 54-year-old-man who shows typical clinical and histopathological features.
Acneiform Eruptions ; Actins ; Chloracne* ; Citrus sinensis ; Conjunctivitis ; Male ; Meibomian Glands ; Penis ; Pigmentation ; Polychlorinated Biphenyls ; Scrotum ; Vietnam*

No abstract available.
Humans ; Lung ; Renal Insufficiency, Chronic ; Rhabdomyolysis

We report a case of a 46-year-old man with end-stage renal failure who developed a giant aneurysm after a brachiocephalic arteriovenous shunt. The patient had complaints of pulsating pain and swelling of his left upper extremity. The patient had abandoned use of the arteriovenous shunt and had a second arteriovenous shunt procedure over his right extremity. The giant venous aneurysm was removed just distal to his anastomosis. The patient's postoperative course was uneventful.
Aneurysm* ; Extremities ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Upper Extremity

Herniation of the kidney through a traumatic diaphragmatic rupture in itself is rare. However, complete avulsion of the renal pedicle implies not only a more rare event, but also a surgical emergency. We report a case of a patient with complete avulsion of renal vessels and ureter of an intrathoracic kidney herniated through a diaphragmatic rupture caused by blunt trauma. Prompt diagnosis with a computer tomographic scan and immediate surgery saved the patient's life.
Diagnosis ; Diaphragm ; Emergencies ; Humans ; Kidney ; Pleural Cavity* ; Rupture ; Ureter

Nonossifying fibromas are not uncommon, but those described in the rib are unique. We report the case of a 15-year-old patient with symptoms of chest wall pain for 5 days who underwent a video-assisted thoracoscopic rib resection for a 2.5-cm rib mass. Unexpectedly, pathological results revealed a nonossifying fibroma of the rib. The results showed excellent cosmesis and new bone formation because of the preservation of the overlying periosteum.
Adolescent ; Fibroma* ; Humans ; Osteogenesis ; Periosteum* ; Ribs* ; Thoracic Surgery, Video-Assisted* ; Thoracic Wall

BACKGROUND: The synthetic narcotic sufentanil has been used in clinical practice for anesthetic induction and maintenance. But there is little information concerning its direct effects on heart. The purpose of this study is to evaluate the direct effects of sufentanil on contracture of ventricular myocardium. METHODS: Isometric contraction of isolated right ventricular papillary muscle of rabbit was measured under 0.2 Hz electrical stimulation in Krebs solution. Peak developed force(F), maximum rate of rise of developed force(+dF/dt(max)), maximum rate of fall of developed force(-dF/dt(max)) were analyzed. RESULTS: There were no statistically significant differences in frequency of isometric contraction from the 100% baseline value in time-matched control group. Sufentanil, in concentration of 0.01-0.1 mM, increased F, and -dF/dt(max) was decreased especially in concentration of 0.1 mM but not +dF/dt(max) Fo +dF/dt(max) and -dF/dt(max) were statistically different from time-matched control group in concentration of 0.1 mM. CONCLUSIONS: We conclude that sufentanil has mild contracture effect on ventricular muscle of rabbit directly.
Analgesics ; Contracture ; Electric Stimulation ; Heart ; Isometric Contraction ; Myocardium ; Papillary Muscles ; Rabbits* ; Sufentanil*

Delayed esophageal rupture due to blunt injury is not new. However, rupture due to suspected barotrauma is very rare. We describe a case of esophageal rupture in a male 24-year-old patient after diving in shallow waters. The patient was quadriplegic and could not experience the typical chest pain related to rupture and resulting mediastinitis. The rupture was discovered 4 days after emergency decompressive laminectomy and fusion for his cervical spine. The rupture was evidently caused by barotrauma and was discovered four days after admission. He underwent primary closure and pericardial flap as a life-saving procedure.