No abstract available.
Arthroplasty, Replacement, Hip*

Endovascular treatment of isolated bilateral common iliac artery aneurysm (CIAA) requires salvage of at least one internal iliac artery to prevent complications such as ischemic buttock claudication. We treated a case of bilateral CIAAs using an internal iliac branched stent graft. We report a case of a 58-year-old man who presented with bilateral CIAAs. The left internal iliac artery was occluded with coil embolization. The right internal iliac artery was saved by using a branched stent graft. The aneurysms were excluded with conventional endovascular aneurysm repair. Completion angiography showed technical success. Follow up computed tomography angiogram at three months showed complete exclusion of bilateral CIAAs, no endoleaks, and patent right internal iliac artery. There was no pelvic ischemic complication. We treated successfully a case of isolated bilateral CIAAs using an iliac branched stent graft.
Aneurysm* ; Angiography ; Blood Vessel Prosthesis* ; Buttocks ; Embolization, Therapeutic ; Endoleak ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Iliac Artery* ; Middle Aged

A case of esophagopleural fistula after pleuropneumonectomy is reported. A 59 years old male underwent right pleuropneumonectomy due to tuberculous empyema. The postoperative small esophagopleural fistula was confirmed by esophagogram and was initially managed by a conservative treatment. There was a persistent fistula on follow up esophagogram, therefore we planned the next treatment modality for obstruction of the fistula. For poor general conditions and arrhythmia, an esophageal stent was applied as a non-surgical method. At first, a covered-form stent was inserted, but it migrated to the stomach after 3 months. By using an uncovered-form stent, a complete obstruction of the esophagopleural fistula was achieved.
Arrhythmias, Cardiac ; Empyema, Tuberculous ; Esophageal Fistula ; Fistula* ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pneumonectomy ; Stents* ; Stomach

Partial anomalous pulmonary venous connection is frequently found in any ASD(atrial septal defect) patients. These patients are usually symptomatic, therefore, easily diagnosed as just simple ASD. We experienced a case of a 37-year-old female patient with ASD in which the left upper pulmonary vein was connected to SVC by the left inominate vein. The patient was diagnosed as simple ASD previously. During cardiac catheterization, we found a meaningful oxygen saturation step up between the SVC and its upper portion. Angiogram confirmed PAPVC. The surgical correction of anastomosis of PAPVC with left atrial appendage and direct closure of ASD were done. The patient was discharged 15 days later.
Adult ; Atrial Appendage ; Cardiac Catheterization ; Cardiac Catheters ; Female ; Heart Septal Defects, Atrial* ; Humans ; Oxygen ; Pulmonary Veins ; Veins

The purpose of this study is to obtain information of simple and effective methods for the pos-tlaminectomy pain control, and to reduce the consumption of supplemental analgesic drugs and side effects. In a double blind study, 75 patients scheduled for lumbar laminectomy were randomly divided into five groups according to the epidurally instilled drugs, such as, morphine 2mg,Group M2; morphine 3mg,Group M3; methylprednisolone 80 mg, Group D; morphine 2mg plus methylprednisolone 80mg, Group M2D; normal saline as a control Group C. All of the drugs were prepared in 2ml normal saline solution. The following items were recorded in the postoperative period: Pain score using visual analogue scale(VAS) at 6, 12, 24, 48 hours after the operation; the episode of supplemental systemic analgesic; the need for postoperative urethral catheterization; any evidence of respiratory depression; pruritus; nausea and vomiting. The results were as follows. I) VAS score were not significantly different between control group and group M2(p>0.05), but usually less in the group M2 and supplemental analgesic consumption was significantly less in the group M2 than in the control group. 2) VAS score were less in the group M3 than in the group M2 and significantly less than in the control group at 6 hour after operation and also supplemental analgesic consumption was significantly less in the group M3. 3) Group D revealed similar VAS score with group M2 at 6 and 12 hour but significantly lower VAS score at 24 and 48 hour after operation than group M2. 4) VAS score were the most significantly less in the group M2D at 6,12,24,48 hour after operation than in the control group and supplemental analgesic consumption was significantly less in the group M2D. 5) Side effects were not significantly different among all groups. These findings suggest that epidurally instilled morphine 3mg, or methylprednisolone 80mg or both before the closure of the laminectomy wound is effective, simple and safe method for the post-laminectomy pain control and reducing supplemental intramuscular analgesics without specific complication.
Analgesics ; Double-Blind Method ; Humans ; Laminectomy* ; Methylprednisolone* ; Morphine* ; Nausea ; Pain, Postoperative* ; Postoperative Period ; Pruritus ; Respiratory Insufficiency ; Sodium Chloride ; Urinary Catheterization ; Urinary Catheters ; Vomiting ; Wounds and Injuries

To evaluate the efficacy and safety of topical NSAIDs and topical anesthetics on post-PRK pain control, we performed a prospective, randomized, paralle group, placebe-controlled study of 105 consecutive eyes having excimer laser PRK, that were divided into 7 pain management groups. The groups were arranged in order, Group 1: Suprofen(Profenal), Group 2: Diclofenac I(Naclof), Group 3: Diclofenac II (Decrol), Group 4: diluted proparacaine, Group 5: Diclofenac I(Naclof)+diluted proparacaine, Group 6: Fluorometholone, Group 7(conrol): Tears Naturale. Results were evaluated by several types of questionnaires and pain score was recorded using visual analogue scale. Corneal epithelial defect area was measured on post-operative day 1, 2, 3, 4 and 1 week. Diclofenac-treated groups showed the best analgesic effect and the least discomfort at instillation. Diclofenac, used with diluted proparacaine, had some additive effect on pain control, but not statistically significant. Full epithelial closure occurred in all eyes within 4 days without any clinically significant complications. Topical diclofenac and combinatin with diluted proparacaine can be used in post-PRK pain management effectively and safely.
Anesthetics ; Anti-Inflammatory Agents, Non-Steroidal* ; Diclofenac ; Fluorometholone ; Lasers, Excimer ; Pain Management ; Prospective Studies ; Surveys and Questionnaires

PURPOSE: Bilateral internuclear ophthalmoplegia (INO) has been reported mostly in bilateral medial longitudinal fasciculus (MLF) lesion. To report a case who presented with typical bilateral internuclear ophthalmoplegia (INO) with no brainstem lesion on brain MRI. METHODS: Case presentation. RESULTS: Seventy two year-old woman presented with bilateral marked adduction limitation and diplopia. Bilateral marked adduction limitation did not cross midline. Nystagmus occured in abducting eye. Elevation and depression were normal in duction. Transcranial doppler revealed moderated stenosis of right internal carotid artery and severe stenosis of left intracranial internal carotid artery. Brain MRI revealed focal old infarction of right corona radiata and circumscribed acute infarction at more upper level of corona radiata, however, no pathologic finding was identified in brainstem. Initial severe exotropia was improved to 30 PD exotropia in primary position. Adduction limitation was markedly improved 2 months later but bilateral horizontal nystagmus in abducting eye persisted
Brain Stem* ; Brain* ; Carotid Artery, Internal ; Constriction, Pathologic ; Depression ; Diplopia ; Exotropia ; Female ; Humans ; Infarction ; Magnetic Resonance Imaging ; Nystagmus, Pathologic ; Ocular Motility Disorders*

A cosmetic incision for minimal invasive cardiac surgery is described. Through a small submammary skin incision combined with partial low sternotomy some kinds of cardiac operations are possible without extra-difficulty but with excellent cosmetic effect, No special instruments nor techniques are required. By this method routine cannulations for cardiopulmonary bypass as well as aortic cross clamping bicaval snaring and venting of cardiac chambers are possible, We performed 5 cases of open heart surgeries using this approach which includes two cases of atrial septal defect closure one case of ventricular septal defect closure one case of pulmonic valvotomy and one case of mitral valve replacement.
Cardiopulmonary Bypass ; Catheterization ; Constriction ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Mitral Valve ; Skin ; SNARE Proteins ; Sternotomy ; Thoracic Surgery*

Pulmonary mucinous cystic tumor of borderline malignancy is very rare and distinguished from bronchogenic cyst or adenocarcinoma of bronchoalveolar type. We present the case of a 63-year-old woman with a right lower lobe mass, found by chest radiographs. The preoperative diagnosis was made as bronchoalveolar cancer by percutaneous needle aspiration of mass. Right lower lobectomy and lymph node dissections were performed. The lobectomy specimen contained variable sized multilocular cystic mucous masses, filled with mucus. Microscopically, the cystic masses are lined with tall columnar mucinous epithelium but some area contains focal cellular atypism and bronchoalveolar cancer like foci. This foci are lack of cellular atypism consistent with bronchoalveolar cancer cell. After lobectomy the patient has remained free from recurrence and distant metastasis for following 12 months period. Pulmonary mucinous cystic tumor of borderline malignancy appears to have a favorable prognosis and should be distinguished from other lung neoplasms.
Adenocarcinoma ; Bronchogenic Cyst ; Diagnosis ; Epithelium ; Female ; Humans ; Lung ; Lung Neoplasms ; Lymph Node Excision ; Middle Aged ; Mucins* ; Mucus ; Needles ; Neoplasm Metastasis ; Prognosis ; Radiography, Thoracic ; Recurrence

The incidence of Congenital diaphragmatic hernia is 1 in 2000-5000 live births and hiatal hernia is even rarer especially in neonates. We experienced a case of congenital hiatal hernia (mixed type) in a week old female. Upon confirmation of the diagnosis, the surgery was done. Through the right thoracotomy, Belsey-Mark IV fundoplication was performed after the reduction of herniated viscera. The patient was fed 3 days after operation. there has been no complaint for 6 months after discharge. Therefore, we present this case with overall review of the literature.
Diagnosis ; Female ; Fundoplication ; Hernia, Diaphragmatic ; Hernia, Hiatal* ; Humans ; Incidence ; Infant, Newborn* ; Live Birth ; Thoracotomy ; Viscera