No abstract available.
Mediastinum*

A 70-year old male with dilated cardiomyopathy was admitted to our hospital because of a renal stone, and a supra-renal abdominal aortic aneurysm was detected during work-up. We performed a hybrid surgery using an endovascular stent because of his co-morbidities. The operation consisted of removal of the renal stone, de-branching of the visceral artery and both renal arteries from the abdominal aorta, reperfusion of the de-branched arteries with retrograde bypass surgery using two Y-graft from the left external iliac artery, and deployment of stent graft in the abdominal aorta. Therefore, we report a case of hybrid surgery for supra-renal abdominal aortic aneurysm.
Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal ; Arteries ; Cardiomyopathy, Dilated ; Chimera ; Humans ; Iliac Artery ; Male ; Renal Artery ; Reperfusion ; Stents ; Transplants

A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those of a pseudoaneurysm.
Adult ; Aneurysm ; Aneurysm, False ; Angiography ; Humans ; Leg Injuries ; Lower Extremity ; Male ; Popliteal Artery ; Saphenous Vein ; Soccer ; Transplants

A 38-year-old male was admitted to our hospital due to painful swelling of his right popliteal fossa. He had been kicked in his right popliteal fossa during a soccer game about three weeks earlier. Computerized tomographic angiography of the lower extremity demonstrated a 4-cm-wide, 3-cm-long aneurysmal change of the popliteal artery. He underwent aneurysmectomy and graft interposition using a great saphenous vein graft. Pathologic findings of the resected specimen were consistent with those of a pseudoaneurysm.
Adult ; Aneurysm ; Aneurysm, False ; Angiography ; Humans ; Leg Injuries ; Lower Extremity ; Male ; Popliteal Artery ; Saphenous Vein ; Soccer ; Transplants

BACKGROUNG: Continuous air leakage through chest tube after lung surgery may increase pt's hospital stay and lead to many complications including empyema etc. Chemical pleurodesis has frequently been used for prevention of air leakage. Therefore, we performed chemical pleurodesis using diluted fibrin glue in patients with continuous air leakage and observed the effects and efficiency of treatment. MATERIAL AND METHOD: From September, 2001 to August, 2005, 16 patients whose continuous air leakage lasted more than 7 days underwent chemical pleurodesis with diluted fibrin glue. The effects of treatment, complications and recurrences were reviewed. Dissolved fibrinogen 1.0 g and aprotinin 500,000 KIU were mixed in a 50 cc syringe (Mixed solution A). And dissolved thrombin 5,000 IU and Calcium chloride 600 mg were mixed in a 50 cc syringe (Mixed solution B). Cefazolin 1.0 g was mixed in a 50 cc syringe (Mixed solution C). Rubber tube was inserted between the chest tube and the collecting bottle. An inserted rubber tube was positioned 60cm above the patient and forming a loop appearance was done. Mixed solutions A, B and C were injected into the highest rubber tube. RESULTS Continuous air leakages disappeared in all 16 patients at next day. Chest tubes were removed after 3 days in all patients. Complications were chest pain in 12 patients (75%), leukocytosis in 14 patients (88%), fever and chill in 14 patients (88%). All complicaitons were transient and disappeared without specific treatment. CONCLUSION: Our findings demonstrated that diluted fibrin glue chemical pleurodesis was effective in patients with continuous air leakage lasting more than 7 days. Diluted fibrin glue chemical pleurodesis had good results with acceptable complications. Long term follow-up is necessary to evaluate the accurate effects of treatment and recurrence in a large number of patients.
Aprotinin ; Calcium Chloride ; Cefazolin ; Chest Pain ; Chest Tubes ; Empyema ; Fever ; Fibrin Tissue Adhesive* ; Fibrin* ; Fibrinogen ; Humans ; Length of Stay ; Leukocytosis ; Lung* ; Pleurodesis ; Recurrence ; Rubber ; Syringes ; Thrombin ; Tissue Adhesives

A 51-year-old male was admitted three month previously with a cardiac stab injury and he underwent direct cardiac repair. He had no problem after this event. He complained of dyspnea that started 2 months after the original injury. Echocardiography showed severe tricuspid regurgitation and so, chordac replacement and ring annuloplasty was performed. Herein we report on a case of tricuspid valve repair for treating tricuspid insufficiency following a cardiac stab injury.
Dyspnea ; Echocardiography ; Humans ; Male ; Middle Aged ; Tricuspid Valve Insufficiency* ; Tricuspid Valve* ; Wounds, Stab

Xiphodynia is a term used to describe a painful xiphoid process, and this is a rare musculoskeletal disorder that can radiate to the anterior chest, epigastrium, neck, shoulders and back. Clinical awareness of xiphodynia is important for making its correct diagnosis. We report here on two cases of xiphodynia. The diagnosis was suggested by the reproduction of the anterior chest pain or/and the epigastrium pain with light pressure on the xiphoid process. The patient of case 1 had suffered from xiphodynia throughout the years, and this patient underwent surgical excision of the xiphoid process. The patient of case 2 received an injection of local anesthetic agent to the xiphoid process.
Chest Pain ; Humans ; Light ; Neck ; Reproduction ; Shoulder ; Thoracic Wall ; Thorax ; Xiphoid Bone

BACKGROUND: The surgical treatment of pectus carinatum is usually a modified Ravitch operation that consists of complete costal cartilage resection and sternal wedge osteotomy. We tried a simple and easy technique that is resection of only deformed, protruded costal cartilage and pre-sternal compression with using a stainless steel bar and this is done without sternal osteotomy. Therefore, we performed partial cartilage resection and pre-sternal compression with a stainless steel bar and we observed the effects and the efficiency of treatment. MATERIAL AND METHOD: From July, 2006 to June, 2008, 10 patients with pectus carinatum underwent our modified technique of pectus carinatum surgery. The effects of surgery and the complications were reviewed. RESULT: 5 patients with only pectus carinatum underwent our modified technique of pectus carinatum surgery. 5 patients with pectus carinatum and pectus excavatum underwent our modified technique of pectus carinatum surgery and Nuss surgery. The mean patient age was 13.4+3.3 years old. The mean operation time was 137.6+22.9 minutes for the pectus carinatum patients and 234.0+36.5 minutes for the pectus carinatum and pectus excavatum patients. The mean length of hospitalization was 11.8+1.0 days. The Haller pectus index of pectus carinatum was 2.10+/-0.21 preoperatively and this was increased to 2.53+/-0.07 postoperatively. The only complication was simple partial wound disruption in 1 patient. CONCLUSION: We performed partial cartilage resection and pre-sternal compression with a stainless steel bar in 10 patients with pectus carinatum and its effects were good. Our modified technique of pectus carinatum is easy and simple as compared with the Ravitch operation. But removal of the stainless steel bar has not yet been performed for these patients and long-term follow up is needed to accurately evaluate the effects of this surgery in many surgical cases.
Cartilage ; Follow-Up Studies ; Funnel Chest ; Hospitalization ; Humans ; Osteotomy ; Stainless Steel ; Thoracic Wall

Popliteal artery entrapment syndrome is a rare disorder and lead to claudication and disturbance of blood flow from the results of an abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in a young male population. The specific diagnosis is difficult. In most cases, surgical treatment provides a definitive diagnosis of the lesion and is necessary for the patient's recovery. A 34-years-old male was admitted complaining of claudication and pain on left leg. Ankle-brachial index, vascular sonography, CT-angiogram and MRI revealed an occlusion of proximal popliteal artery of left leg. The patient was confirmed as a popliteal artery entrapment syndrome (type IV) that the popliteal artery was entrapped by a fibrous band around the popliteus muscle in the operative field. Completely occluded fibrotic popliteal artery was removed, and interposition with ipsilateral greater saphenous vein graft was done. After surgery, symptoms of the patient have improved.
Ankle Brachial Index ; Arteries ; Diagnosis ; Humans ; Leg ; Magnetic Resonance Imaging ; Male ; Muscle, Skeletal ; Peripheral Vascular Diseases ; Popliteal Artery* ; Saphenous Vein ; Transplants

A 48-year-old female complained of edema and pain in her left neck. She underwent acupuncture therapy for 1 month in a local oriental medicine clinic because of her arm pain. Computer tomography showed left internal jugular vein thrombosis. The patient's condition improved after antibiotic medication and anticoagulation. The patient is currently in outpatient department follow-up and doing well. To the best of our knowledge, this is the first report of an internal jugular vein thrombosis secondary to acupuncture.
Acupuncture ; Acupuncture Therapy ; Anticoagulants ; Arm ; Edema ; Female ; Follow-Up Studies ; Humans ; Jugular Veins ; Medicine, East Asian Traditional ; Middle Aged ; Neck ; Outpatients ; Thrombosis ; Vascular Diseases ; Veins