Descending necrotizing mediastinitis (DNM) is one of the most lethal form of mediastinitis originating from an oropharyngeal infection. It requires an early and aggressive sugical treatment, but the operative approach and optimal form of mediastinal drainage remains controversial. We report a case of DNM in a 45-year-old male who underwent right cervicomediastinotomy to drain the deep neck space, upper mediastinum and anterior mediastinal drainage was accomplished through a subxiphoid approach. After this procedure, he steadily improved and was dischrged on hospital day 36. We report this case with a brief review of the literature.
Drainage ; Humans ; Male ; Mediastinitis* ; Mediastinum ; Middle Aged ; Neck

No abstract available.
Hematoma*

Aortic thrombi are important because it can cause the central and peripheral embolizations. Aortic thrombi can occur anywhere in the aorta but extremely rare in ascending aorta without atherosclerosis, aneurysm, cardiosurgical or traumatic state. Systemic sclerosis (SSc) is an autoimmune disorder of connective tissue and it can involve multisystem. Enhanced coagulation pathways, decreased fibrinolysis, and endothelial dysfunction probably contribute to vascular events in SSc. We report a case of a highly mobile thrombus in the ascending aorta, presented as an acute embolic stroke in the patient with systemic sclerosis. Surgical removal was performed to prevent recurrent embolic events.
Aneurysm ; Aorta ; Atherosclerosis ; Connective Tissue ; Fibrinolysis ; Humans ; Scleroderma, Systemic ; Stroke ; Thrombosis

PURPOSE: The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). MATERIALS AND METHODS: Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented Kspace cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. RESULTS: MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. CONCLUSION: Evaluation of patency of the bypass graft was clinically feasible by 2DFASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.
Angiography ; Arteries ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Feasibility Studies* ; Humans ; Magnetic Resonance Imaging* ; Mammary Arteries ; Myocardial Ischemia ; Saphenous Vein ; Transplants ; Veins

Synovial sarcoma is a malignant soft tissue tumor that primarily occurs in the paraarticular regions, especially in the knee. They are composed of keratin-positive epithelial cells and vimentin-positive spindle cells. We report a 76 year old woman with a primary synovial sarcoma in the mediastinum that had severe adhesion to the right side of pericardium. Primary synovial sarcoma in the mediastinum is extremely rare and this is the first case reported in the Korean literature. The mass including the pericardium was resected and the defect was closed with Gore-Tex patch. The patient is well and free of disease 6 months after the operation.
Aged ; Epithelial Cells ; Female ; Humans ; Knee ; Mediastinum* ; Pericardium ; Polytetrafluoroethylene ; Sarcoma, Synovial*

There was an error in article.

No abstract available.

Radiation therapy was the treatment of choice for CML in the past, in the form of Sl or radioactive phosphorus. Its use has been replaced to a large extent by various chemotherapeutic agents. Recently Sl in CML has been used, both to relieve painful splenomegaly and to take advantage of an indirect effect of Sl on unirradiated bone marrow. We have treated 15 CML cases who had a huge spleen during chemotherapy or even after chemotherapy by 6 MV linear accelerator during the past two years at the Division of Radiation Therapy, Kang Nam St. Mar's Hospital, Catholic College. Response to Sl has been rated according to the scoring system of Roger W. Byhardt, et al. which evaluated the splenic and hematologic response as well as the response of disease-elated systems. According to this scoring system, most patients demonstrated a significant relief of splenomegaly along with improvement of hemogram. And we observed the change of Karnofsky Performance Status after Sl, and survival after a confirmative diagnosis and Sl.
Bone Marrow ; Diagnosis ; Drug Therapy ; Humans ; Karnofsky Performance Status ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Particle Accelerators ; Phosphorus ; Spleen ; Splenomegaly

A 36-year-old woman with a history of spontaneous abortion and photosensitivity was admitted to our hospital with periumbilical pain and lower extremity edema. The preoperative CT scan revealed massive inferior vena cava thrombus, which extended from the suprarenal portion of the vena cava to the hepatic vein. The laboratory data showed an elevated level of anticardiolipin antibody, which suggested the diagnosis of antiphospholipid syndrome. After medical management, she underwent an operation for removal of an vena cava thrombus by performing cavectomy and thrombectomy. After the operation, she has been taking oral anticoagulation and she is doing quite well at 9 months after her operation
Abortion, Spontaneous ; Adult ; Antibodies, Anticardiolipin ; Anticoagulants ; Antiphospholipid Syndrome ; Edema ; Female ; Hepatic Veins ; Humans ; Lower Extremity ; Pregnancy ; Thrombectomy ; Thromboembolism ; Thrombosis ; Vena Cava, Inferior

A right-sided aortic arch (RAA) is a rare congenital anomaly, and Stanford type B dissection aneurysms involving this anomaly is also uncommon. Surgical approaches to dealing with an RAA are complicated by the unusual anatomical features of the condition. Here we report the case of a 47-year-old male who had a type B dissecting aneurysm involving an RAA with Kommerell's diverticulum. Graft replacement was successfully performed with an uneventful postoperative course.
Aneurysm, Dissecting/radiography/*surgery ; Aorta, Thoracic/*abnormalities/radiography/*surgery ; Aortic Aneurysm, Thoracic/radiography/*surgery ; Blood Vessel Prosthesis Implantation/methods ; Diverticulum/radiography/*surgery ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed