Two patients with gustatory hyperhidrosis complaining of discomfort during usual activities were relieved of sweating by using anticholinergic benztropine. Herein, we report two cases of gustatory hyperhidrosis treated with benztropine.
Benztropine* ; Humans ; Hyperhidrosis ; Sweat ; Sweating ; Sweating, Gustatory*

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

Elastofibroma dorsi, a rare, noncapsulated benign entity is characterized by the proliferation of fibrous tissue with elastin and occurs most often in the infrascapular area of elderly women. It is a relatively slowly growing lesion and no reports of malignant transformation exist. Which is overlooked easily because it rarely causes symptoms such as tenderness, pain, or restriction of movement. The diagnosis of elastofibroma is established by typical histopathologic findings. Radiographic evaluation may lead to a presumptive diagnosis. We experienced a case of elastofibroma dorsi in a 48-year-old woman and report this case with a review of the literature.
Aged ; Diagnosis ; Elastin ; Female ; Fibroma ; Humans ; Middle Aged

Primary malignant melanoma occurring in the lung is very rare and only few cases have been reported in the literatures. We have experienced one case of primary malignant melanoma of the right middle lobe. The patient was a 65-year-old male who had cough with blood tinged sputum for one month. Chest computed tomography showed about 4.5x3 cm sized mass at the right middle lobe encasing the bronchus. Percutaneous needle biopsy was performed and confirmed to malignant melanoma. Physical examination and additional clinical history showed that the mass had not metastasized to other possible primary sites. The patient underwent thoracotomy with right middle lobe lobectomy. Histologically, the tumor showed sheets of tumor cells that have nuclear atypia and melanin pigment Postoperative course was uneventful and the patient has been followed up for 24 months with no recurrence.
Aged ; Biopsy, Needle ; Bronchi ; Cough ; Humans ; Lung Neoplasms ; Lung* ; Male ; Melanins ; Melanoma* ; Physical Examination ; Recurrence ; Sputum ; Thoracotomy ; Thorax ; Tolnaftate

Cytomegalovirus (CMV) pneumonitis leading to inflammation and obstruction of the tracheobronchial tree may cause the cystic changes in the lung. We performed segmentectomy of lung under the diagnosis of congenital cystic lung disease in an infant of 2 weeks presenting severe respiratory failure. Histology and serology confirmed congenital CMV bronchiolopneumonitis.
Bronchiolitis ; Cytomegalovirus ; Diagnosis ; Humans ; Infant ; Inflammation ; Lung Diseases ; Lung* ; Mastectomy, Segmental ; Pneumonia ; Respiratory Insufficiency

Creation of an axillary arteriovenous fistula (AVF) was performed in two patients with high risks of Fontan operation after a cavopulmonary shunt. The patients complained of progressive cyanosis and decrease in exercise tolerance, and they showed pulmonary arteriovenous fistula on the pulmonary angiography. They were uneventfully transferred to the general ward on the first postoperative day and discharged 3 and 4 days after the operation respectively. There was no evidence of fistula-related volume loading and the other postoperative complications. An 8-month follow-up revealed improved symptoms such as, cyanosis and exercise intolerance, but not sufficient regression of pulmonary arteriovenous fistula on a lung perfusion scan and contrast echocardiography, which should be carefully checked hereafter.
Angiography ; Arteriovenous Fistula* ; Axilla ; Cyanosis ; Echocardiography ; Exercise Tolerance ; Follow-Up Studies ; Fontan Procedure* ; Heart Bypass, Right ; Humans ; Lung ; Patients' Rooms ; Perfusion ; Postoperative Complications

A 15 year-old boy was referred to us because of mild dyspnea on exertion and incidentally found heart murmur. On echocardiography, a mass involving mainly interventricular septum and causing left ventricular outflow tract obstruction was detected. Cardiac catheterization demonstrated a transaortic pressure gradient of 20 mmHg. Partial excision of the septal mass was performed via aortotomy under cardiopulmonary bypass. The pathologic diagnosis revealed myocardial hamartoma. The lesion was mainly composed of mature, severely hypertrophic myocytes and intervening fibrosis. During the 5 year of follow-up after the surgery, no evidence of arrhythmia or tumor recurrence was documented.
Adolescent ; Arrhythmias, Cardiac ; Cardiac Catheterization ; Cardiac Catheters ; Cardiopulmonary Bypass ; Diagnosis ; Dyspnea ; Echocardiography ; Fibrosis ; Follow-Up Studies ; Hamartoma* ; Heart Murmurs ; Heart Septum ; Humans ; Male ; Muscle Cells ; Recurrence

We report a surgical case of 39-year-old male with a pseudoaneurysm of the left ventricle. Four years ago, the patient underwent aortic and mitral valve replacements with mechanical valves and abscess removal for infective endocarditis with annular abscess. Recent echocardiography demonstrated a communication between left ventricle and abscess pocket, and the size of pocket increased further at the follow-up echocardiography. The patient underwent patch closure of the defect between left ventricle and pseudoaneurysm located at the aortomitral fibrous continuity, under the cardiopulmonary bypass and cardioplegia. The postoperative course was uneventful and the patient was discharged on the 9th postoperative day.
Abscess* ; Adult ; Aneurysm, False* ; Cardiopulmonary Bypass ; Echocardiography ; Endocarditis* ; Follow-Up Studies ; Heart Arrest, Induced ; Heart Ventricles ; Humans ; Male ; Mitral Valve

BACKGROUND: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. MATERIAL AND METHOD: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. RESULT: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer. Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was 3.6+/-1.0 cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. CONCLUSION: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.
Academic Medical Centers ; Anastomosis, Surgical ; Bronchoscopy ; Chungcheongnam-do ; Constriction, Pathologic ; Dilatation ; Dyspnea ; Granulation Tissue ; Humans ; Mortality ; Postoperative Complications ; Retrospective Studies ; Rupture ; Thyroid Cartilage ; Thyroid Neoplasms ; Trachea ; Tracheal Stenosis ; Tuberculosis ; Ulsan ; Wound Infection

BACKGROUND: Surgery of abdominal aortic aneurysm revealed high operative mortality. We reviewed our 11-years' experiences of abdominal aortic aneurysm operation and wish to obtain information on the treatment. MATERIAL AND METHOD: From Jan. 1990 to Dec. 2000, 48 patients were operated due to abdominal aortic aneurysm in Yonsei Cardiovascular Center. Mean age was 62.8+/-12.7 and there were 40 males and 8 females. Among 48 patients, nine patients had ruptured abdominal aortic aneurysm, and mean aneurysm diameter of non-ruptured cases was 8.8+/-2.4 cm. RESULT: There were 6 early deaths, and early mortality was 12.5%. Among 9 patients of preoperative aneurysm rupture, three patients died (33.3%), and among 39 patients of non-ruptured cases, 3 patients died (7.7%). Among preoperative variables, age (p<0.05), preoperative BUN level (p<0.05), and DM (p<0.05) were risk factors of early mortality. Among discharged 42 patients, 40 patients were followed up (f/u rate=95.2%) and mean follow up was 3.6+/-0.2 years. During follow up periods, five patients died (late mortality=11.9%), and Kaplan-Meier survival analysis revealed 81.7+/-7.6% survival rate at five and ten year. Linealized incidence of graft related event was 3.53% per patient-year. CONCLUSION: Surgical mortality of ruptured abdominal aortic aneurysm was higher than non-ruptured cases; therefore, early resection of the aneurysm can decrease the surgical mortality.
Aneurysm ; Aortic Aneurysm, Abdominal* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mortality ; Risk Factors ; Rupture ; Survival Rate ; Transplants