We report here on a very rare case of granulocytic sarcoma of the pectoralis muscle on the left chest wall of a patient with chronic myelogenous leukemia, and this malady presented as a very rapidly growing hematoma-like mass.
Humans ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Pectoralis Muscles ; Sarcoma ; Sarcoma, Myeloid ; Thoracic Wall

A 20 year old woman had developed stenosis at the lower part of the trachea, right main bronchus, and right upper lobe bronchus as a complication of endobronchial tuberculosis. The patient had complained of severe dyspnea. Tracheobronchial stenosis was so extensive that we did reconstruction of the trachea and right bronchus with resection of the lower trachea and right main bronchus and right upper lobectomy. She has been doing well without any respiratory symptoms or complications.
Bronchi ; Constriction, Pathologic ; Dyspnea ; Female ; Humans ; Trachea ; Tracheal Stenosis ; Tuberculosis

PURPOSE: This study was performed to evaluate the contribution of appendiceal computed tomography (CT) in the more accurate diagnosis of acute appendicitis and decrease in the rate of negative appendectomies. METHODS: Between May and August 2005, 146 patients with right lower quadrant (RLQ) abdominal pain and tenderness were diagnosed using appendiceal CT. The appendiceal CT scans were performed with contrast media in the abdominal and pelvic areas. 7 mm slice scans were taken both before and after the contrast media injection, with a time delay. The control group was comprised of 99 patients, who were also checked by abdominal CT or ultrasonography, between December 2004 and April 2005, with the data analyzed retrospectively. RESULTS: In the study group, 85 of the 146 cases were diagnosed with acute appendicitis on appendiceal CT, and had undergone an appendectomy, including 42 men (mean age 39.9 yr) and 43 women (mean age 44.6 yr). The sensitivity and specificity of appendiceal CT in acute appendicitis were 95.3 and 98.4%, respectively. There were 4 (4.7%) negative appendectomy cases; 2 in men and 2 in women. The control group conprised of 47 men and 52 women. There were 13 (13.1%) negative appendectomy cases; 4 in men and 9 in women. CONCLUSION: The routine use of appendiceal CT, in patients with RLQ abdominal pain and tenderness, resulted in a significant decrease in the negative appendectomy rate.
Abdominal Pain ; Appendectomy ; Appendicitis* ; Contrast Media ; Diagnosis ; Female ; Humans ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonography

A 51-year-old woman visited our hospital with massive hemoptysis. She had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times. The patient had a history of pulmonary tuberculosis and bronchiectasis. Chest radiography showed consolidation around the nodule in the lateral basal segment of the right lower lobe. We successfully performed a right lower lobectomy. The histological study of the resected specimen showed a vegetable foreign body and clumps of Actinomyces, indicating actinomycosis, which was suggested to be the cause of the hemoptysis. This was a very rare case of hemoptysis caused by a vegetable foreign body and actinomycosis.
Actinomyces ; Actinomycosis* ; Bronchial Arteries ; Bronchiectasis ; Female ; Foreign Bodies* ; Hemoptysis ; Humans ; Middle Aged ; Radiography ; Thorax ; Tuberculosis, Pulmonary ; Vegetables*

BACKGROUND: Numerous statistical models have been developed to accurately predict outcomes in multiple trauma patients. However, such trauma scoring systems reflect the patient's physiological condition, which can only be determined to a limited extent, and are difficult to use when performing a rapid initial assessment. We studied the predictive ability of the systemic inflammatory response syndrome (SIRS) score compared to other scoring systems. METHODS: We retrospectively reviewed 229 patients with multiple trauma combined with chest injury from January 2006 to June 2011. A SIRS score was calculated for patients based on their presentation to the emergency room. The patients were divided into two groups: those with an SIRS score of two points or above and those with an SIRS score of one or zero. Then, the outcomes between the two groups were compared. Furthermore, the ability of the SIRS score and other injury severity scoring systems to predict mortality was compared. RESULTS: Hospital death occurred in 12 patients (5.2%). There were no significant differences in the general characteristics of patients, but the trauma severity scores were significantly different between the two groups. The SIRS scores, number of complications, and mortality rate were significantly higher in those with a SIRS score of two or above (p<0.001). In the multivariant analysis, the SIRS score was the only independent factor related to mortality. CONCLUSION: The SIRS score is easily calculated on admission and may accurately predict mortality in patients with multiple traumas.
Emergency Service, Hospital ; Humans ; Inflammation* ; Models, Statistical ; Mortality* ; Multiple Trauma* ; Retrospective Studies ; Systemic Inflammatory Response Syndrome ; Thoracic Injuries

Schwannoma is a common soft tissue tumor, but it appears to be rare among the spindle cell mesencymal tumors of the gastrointestinal tract. Gastrointestinal Schwannomas (GIS) are rare and most of them originate in the stomach or the small bowel. GIS of the colon is extremely rare. The most important issue to be addressed for this type of tumor is the difficulty in making the correct preoperative diagnosis. Less than 10% of cases have been diagnosed as schwannoma preoperatively. A 58-year-old man was found to have a 3.5cm sized submucosal transverse colon tumor on the preoperative colonoscopy, abdominal CT and MRI. Wedge resection was done and the submucosal mass was diagnosed as schwannoma on the immunochemical staining. The immunochemical results were negative staining for CD 117(KIT) and CD 34 and positive staining for S-100 protein, which is all consistent with schwannoma. We report here on the first case of colonic schwannoma in Korea, along with a review of the literature.
Colon* ; Colon, Transverse ; Colonoscopy ; Diagnosis ; Gastrointestinal Tract ; Humans ; Korea ; Magnetic Resonance Imaging ; Middle Aged ; Negative Staining ; Neurilemmoma* ; S100 Proteins ; Stomach ; Tomography, X-Ray Computed

Anaphylactic reaction to protamine sulfate, which is used widely to reverse the anticoagulative effect of heparin after cardiopulmonary bypass, is very rare. But the result of anaphylactic reaction can be very fatal and the mechanism of it is still not clear. We report a case of severe anaphylactic reaction to protamine sulfate following the replacement of the mitral valve and Maze procedure using microwave in a non-diabetic 57-year-old female patient.
Anaphylaxis* ; Cardiopulmonary Bypass* ; Female ; Heparin ; Humans ; Microwaves ; Middle Aged ; Mitral Valve ; Protamines

BACKGROUND: This study was undertaken in infant patients with isolated ventricular septal defect(VSD) to determine the effect of surgical closure on ventricular systolic time interval, as a parameter for ventricular performance, by echocardiography. MATERIAL AND METHOD: Thirty patients were enrolled. Mean age of patients at operation was 6.5+/-3.2 months and all patients had non-restrictive VSD. We checked the left atrium/aorta(LA/Ao) ratio, left ventricle ejection fraction(EF), left ventricular systolic time interval(LVSTI), and right ventricular systolic time interval(RVSTI). Echocardiographic studies were done before surgical correction and postoperative periods(postop1: within 2 weeks, postop2: between 4 and 6 months, postop3: between 1 and 2 years). RESULT: LA/Ao ratio decreased significantly at immediate postoperative period compared to preoperative period and sustained during further follow-up period(from 1.74+/-0.37 to 1.36+/-0.24*, 1.32+/-0.22*, and 1.27+/-0.19*, p<0.01 ). LV EF had not changed during follow-up periods(from 65.1+/-7.0 to 62.3+/-9.5, 62.8+/-5.7, and 64.1+/-6.9). LVSTI decreased significantly at postop2 and sustained during further follow-up period (from 0.46+/-0.13 to 0.46+/-0.11, 0.37+/-0.08*, and 0.34+/-0.07*, p<0.01 ). RVSTI decreased significantly at postop3(0.33+/-0.08 to 0.32+/-0.08, 0.31+/-0.07, and 0.27+/-0.05*, p<0.01). CONCLUSION: We found that right and left ventricular systolic time intervals had decreased over the period of 1 year after surgical correction of VSD. Therefore, it is necessary to observe the change of ventricular function during that period.
Echocardiography ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Infant ; Postoperative Period ; Preoperative Period ; Systole* ; Ventricular Function

A rare case of schwannoma involving lower thoracic esophagus is presented. A 64-year-old male was seen with slowly progressing dysphagia for 2 years. Large sized submucosal tumor was found by endoscopy and chest CT. On surgery, tumor was very solid and tightly adherent to the adjacent tissue. Esophagectomy and esophagogastrostomy was done.
Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Male ; Middle Aged ; Neurilemmoma* ; Tomography, X-Ray Computed

BACKGROUND: Obtaining precise hemodynamic and morphological information in the early postoperative period after surgical correction of congenital heart disease is important in determining the need for future medical or surgical intervention. We investigated the residual shunting after surgical repair of simple ventricular septal defect in order to know the incidence of residual shunting in the postoperative period and the natural history of small residual shunts located in the peripatch area. MATERIAL AND METHOD: Forty three consecutive patients under one year of age who underwent patch repair of a simple ventricular septal defect were evaluated for incidence of residual shunts by echocardiography. RESULT: Eleven patients had echocardiographic residual shunt in the peripatch area at immediate postoperative period, however, there were no patients who needed reoperation due to deteriorated hemodynamic effect of residual shunt. The incidence of residual shunts was not significantly different with type of ventricular septal defect and material used for closure. During follow up period, two patients were lost and remaining nine patients no longer showed evidence of residual shunt. The mean time of last evidence of shunt was 4.2+/-3.6 months after operation. CONCLUSION: Residual peripatch shunt flow was frequently noted in the immediate postoperative period following surgical repair of ventricular septal defect, however, most of them were disappeared within six months.
Echocardiography ; Follow-Up Studies* ; Heart Defects, Congenital ; Heart Septal Defects ; Heart Septal Defects, Ventricular* ; Hemodynamics ; Humans ; Incidence ; Natural History ; Postoperative Period ; Reoperation