Partially thrombosed intracranial aneurysm was difficult to treat because of higher recurrence rate compared to non-thrombosed saccular aneurysm. The author reports a case of partially thrombosed intracranial aneurysm causing transient ischemic symptom. A 40-year-old man presented with transient right hemiparesis. Brain magnetic resonance imaging (MRI) depicted low-signal intensity target-like mass lesion on left sylvian fissure, and magnetic resonance angiography (MRA) showed aneurysm on left middle cerebral artery bifurcation (MCBF), suggested thrombosed aneurysm. On operative finding, aneurysm wall had thick and atherosclerotic change, and it was fusiform aneurysm not saccular type. We initially planned direct clip for the aneurysm, but it was failed due to collapse of parent artery after clipping on aneurysm neck. To prevent ischemia, extracranial-intracranial bypass was performed and then thrombectomy with clip reconstruction. To remodeling the fusiform aneurysm, stent-assisted coiling was performed for remnant portion of aneurysm. With staged hybrid technique, giant thrombosed fusiform aneurysm was completely obliterated and the patient did not suffer any neurologic symptoms no longer.

A 35-year-old female complaining of a painful huge right posterior chest wall mass was admitted. Chest computed tomography showed the pleural invasion of mass and deformed ribs. Suspected diagnosis was hemangioma. Entire mass was removed carefully and pleural biopsy was performed. The operation was finished after bleeding control and chest tube insertion. The mass was diagnosed as a cavernous hemangioma histopathologically. Cavernous hemangioma of chest wall is a rare benign vascular tumor. Surgical operation of hemangioma demands meticulous bleeding control because of risk of hemorrhage.
Adult ; Biopsy ; Chest Tubes ; Diagnosis ; Female ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Ribs ; Thoracic Wall* ; Thorax*

This study determined the feasibility of the cuff technique for small-caliber vascular grafts in a rat model. A graft was implanted with the cuff technique or suture technique in a 1-cm segment of the abdominal aorta in 12 rats. The mean aortic clamp time was 29 minutes with the cuff technique and 44 minutes with the suture technique; the cuff technique was significantly shorter. Abdominal angiography at 1 week after implantation showed no significant stenosis in 9 rats, focal stenosis of the mid-portion of the graft in 1 rat with each technique, and total occlusion of the graft in 1 rat with the suture technique. We have successfully used the cuff technique for anastomosis for small-caliber vascular grafts in an animal model.
Angiography ; Animals ; Aorta, Abdominal ; Constriction, Pathologic ; Models, Animal ; Rats* ; Suture Techniques ; Transplants*

OBJECTIVE: Single-incision thoracoscopic surgery (SITS) is being applied to various thoracic diseases because it produces a smaller surgical scar, and is associated with less pain and loss of sensation compared to the traditional 3-port video-assisted thoracoscopic surgery (VATS). In our previous study, we showed that SITS can be used as a first-line surgical method to treat primary spontaneous pneumothorax. Therefore in this study, we looked into whether SITS can be safely and conveniently applied to other various thoracic diseases. METHODS: The subjects for this study those patients who underwent SITS at this hospital for thoracic diseases, who were admitted to this hospital between December 2013 and February 2015. RESULTS: In this study, SITS was attempted in 50 patients with various thoracic diseases. In 46 cases, SITS was successfully performed. However, in the remaining 4 cases were converted to 2-port or 3-port VATS (8%, 4/50). The reasons for conversion to VATS was due to difficulty in approaching the lesion (n=3) and severe pleural adhesion (n=1). CONCLUSION: We found that SITS is a relatively easy and safe procedure that can be applied to various thoracic diseases. However, the operation may be difficult to perform depending on the location of the lesions or the extent of pleural adhesions. Therefore we recommend SITS in conditions where the lesion is mainly in the upper lobe, such as spontaneous pneumothorax, and in patients with minimal level of pleural adhesions.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Cicatrix ; Humans ; Pneumothorax ; Sensation ; Thoracic Diseases* ; Thoracic Surgery, Video-Assisted ; Thoracoscopy*

PURPOSE: To compare the clinical outcomes of the ulnar shortening osteotomy alone and the ulnar shortening osteotomy with arthroscopic debridement in the idiopathic ulnar impaction syndrome with positive ulnar variance. MATERIALS AND METHODS: Twenty seven cases, who underwent the ulnar shortening osteotomy with or without arthroscopic debridement for treatment of the idiopathic ulnar impaction syndrome with positive ulnar variance, were included. The mean age was 40.3 years (range, 21 to 63 years) and the mean follow-up period was 20.6 months (range, 12 to 60 months). The ulnar shortening osteotomy alone and the ulnar shortening osteotomy with arthroscopic debridement were performed in 14 and 13 cases respectively. Pre- and postoperative functional results of the wrist were evaluated by the modified Mayo wrist score. RESULTS: The ulnar variance was corrected from 4.61 mm (range, 1.8~10 mm) to -0.06 mm (range, -3.3~3.1 mm) in the ulnar shortening osteotomy alone group and from 3.01 mm (range, 1.2~7.6 mm) to -0.74 mm (range, -1.8~0 mm) in the ulnar shortening osteotomy with arthroscopic debridement group. The final results of the ulnar shortening osteotomy alone were excellent in 4 cases, good in 5 cases, and fair in 5 cases. Those of the ulnar shortening osteotomy with arthroscopic debridement group were excellent in 6 cases, good in 2 cases, fair in 1 case, and poor in 2 cases. The modified Mayo wrist score at the last follow-up were 83.57(range, 75~100) in the ulnar shortening osteotomy alone group and 83.35(range, 40~100) in the ulnar shortening osteotomy with arthroscopic debirdement group. No statistically significant difference was demonstrated between two groups (p=0.43). CONCLUSION: The ulnar shortening osteotomy is valuable treatment for the idiopathic ulnar impaction syndrome with positive ulnar variance. The combined arthroscopic debridment does not appear to have positive influence to the final results.
Debridement ; Follow-Up Studies ; Osteotomy ; Wrist

BACKGROUND: Malignant pleural effusion is a common condition in neoplastic patients and palliative therapy is the usual treatment. Talc has been generally accepted to be the most effective sclerosant for chemical pleurodesis, but the optimal route of administration remains controversy. We compared the results of video-assisted thoracoscopic talc poudrage (VTP) with administering a bedside talc slurry through a chest tube (BTS) for the treatment of malignant pleural effusion. MATERIAL AND METHOD: From December 2004 to May 2006, 20 patients with malignant pleural effusion underwent chemical pleurodesis via VTP (group A, n=10), and BTS (group B, n=10). RESULT:The durations of chest tube placement after the procedure were 7.0+/-4.0 days (group A) and 6.7+/-3.6 days (group B). The hospital stays were 24.3+/-9.4 days (group A) and 30.7+/-21.5 days (group B), respectively. The symptoms of dyspnea were much more improved in group A (p-value=0.014) after discharge (mean f/u group A=8.5+/-2.2 months, group B 8.0+/-7.4 months). The collapsed portions of lung were better expanded in group A than in group B (p-value= 0.011). CONCLUSION: We recommend VTP for the selected patients with malignant pleural effusion because of the advantages of dissecting the fibrous peel to relieve the atelectasis and dyspnea, and excising the pleura for diagnosis with direct viewing of the lesion.
Chest Tubes ; Diagnosis ; Dyspnea ; Humans ; Length of Stay ; Lung ; Palliative Care ; Pleura ; Pleural Effusion ; Pleural Effusion, Malignant* ; Pleurodesis ; Pulmonary Atelectasis ; Talc* ; Thoracoscopy

A 40-year-old woman was admitted to the hospital due to a palpable tumor on an anterior chest wall. The tumor was diagnosed with a nodular fasciitis. It is a rare benign soft-tissue tumor which has a characteristic referred to as proliferation of fibroblast, and a surgical removal is the best effective treatment. Therefore, we report this case with documents and considerations after the surgical removal.
Adult ; Fasciitis* ; Female ; Fibroblasts ; Humans ; Thoracic Wall* ; Thorax*

Central venous stenosis or occlusion is a serious complication in end-stage renal disease patients undergoing maintenance hemodialysis. It is mostly secondary to trauma caused by temporary or permanent hemodialysis catheter placement. Venous hypertension may cause pain, edema of the ipsilateral arm and increased venous pressure prevents acceptable flow rates during dialysis. Venous bypass to the internal jugular vein, the external jugular vein, or axillary vein to saphenous vein bypass have been described as alternative options of surgical management. Our patients underwent internal jugular vein bypass. We think it is an effective and low risk surgical option.
Arm ; Axillary Vein ; Catheters ; Constriction, Pathologic ; Dialysis ; Edema ; Humans ; Hypertension ; Jugular Veins ; Kidney Failure, Chronic ; Renal Dialysis* ; Saphenous Vein ; Veins* ; Venous Pressure

A 43-year-old male was admitted to our hospital complaining of dyspnea and wheezing sound at respiration. He had received esophageal exclusion and esophagogastrostomy due to spontanous esophageal rupture 1-year ago. Chest computed tomography revealed esophageal mucocele like that of mediastinal tumor. Trachea is compressed by esophageal mucocele. The operation was performed by resection of thoracic esophagus through right open thoracotomy. Herein we report a case of a tracheal compression by esophageal mucocele after surgical exclusion of the esophagus.
Adult ; Dyspnea ; Esophagus* ; Humans ; Male ; Mucocele* ; Respiration ; Respiratory Sounds ; Rupture ; Thoracotomy ; Thorax ; Trachea

BACKGROUND: Recently 980-nm diode laser endovenous treatment was introduced and used as a method of treatment for varicose vein in lower extremities. The advantages of endovenous laser treatment are good cosmetic effects without incision and avoidance of complications associated with surgery. Therefore, we performed an endovenous laser treatment using a 980-nm diode laser and observed the effects and the efficiency of treatment. MATERIAL AND METHOD: From October, 2003 to March, 2004, 56 patients (84 limbs) underwent endovenous laser treatment with a 980-nm diode laser. The effects of treatment, complications and recurrences were reviewed. RESULT: The mean age of patients was 47.2 years old and the number of men and women were 21 and 35. In a total of 84 limbs, postoperative complications were transient ecchymosis(84 cases), local paresthesia (24 cases), local skin discolorization (6 cases), minimal burn (3 cases), and post operative phlebitis (1 cases). Adjuvant sclerotherapy was performed in 27 limbs and it was performed in varicose veins missed at operation and varicose veins remaining after endovenous laser treatment. In a total of 56 patients, 2 patients (3.57%) had recurrences after endovenous laser treatment and were treated with phlebectomy. CONCLUSION: Our findings demonstrated that 980-nm endovenous laser treatment had good cosmetic results with acceptable complications. This study was based on short-term results and long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence. We think that multimodality treatment with endovenous laser treatment including phlebectomy or transilluminated powered phlebectomy can help decreasing of recurrence especially in patients with tortuous varicose cluster.
Burns ; Extremities ; Female ; Follow-Up Studies ; Humans ; Lasers, Semiconductor* ; Lower Extremity* ; Male ; Paresthesia ; Phlebitis ; Postoperative Complications ; Recurrence ; Sclerotherapy ; Skin ; Varicose Veins*