A very rare case of mycotic aneurysm in the descending thoracic aorta due to salmonellosis was treated in our hospital. The patient was a 62 year-old male who 48 days before the operation was admitted to the department of internal medicine complaining of fever, nausia, vomiting, and loose stool. He was treated for 35 days and discharged. Three days after discharge, however, the patient was readmitted to the hospital complaining of right upper quadrant abdominal pain. Fever developed on the third hospital day, and on the eighth hospital day, the patient complained of back pain and epigastric pain. A simple chest x-ray showed evidence of hemothorax in the left plueral space, and therefore, computed tomography of the chest was done. The patient was diagnosed as a ruptured mycotic aneurysm of the descending thoracic aorta, and was transferred to our Department of Thoracic and Cardiovascular Surgery. The aneurysm and infected tissues was widely debrided, and the site was then patched with a Dacron graft. Salmonella choleraesuis was identified in the blood and aneurysm cultures, and antibiotics were administered for 6 weeks according to the sensitivity of the organism. The patient experienced no complication thereafter and for the last three months since the operation, he has been leading a healthy and normal social life.
Abdominal Pain ; Aneurysm ; Aneurysm, Infected ; Aneurysm, Ruptured* ; Anti-Bacterial Agents ; Aorta, Thoracic* ; Arteritis* ; Back Pain ; Fever ; Hemothorax ; Humans ; Internal Medicine ; Male ; Middle Aged ; Polyethylene Terephthalates ; Salmonella Infections ; Salmonella* ; Thorax ; Transplants ; Vomiting

We have experienced two cases of mycotic aneurysms of the superior mesenteric artery. The first case originated from septic embolism of infective endocarditis and the second case originated from salmonella enteritis eight months before. The aneurysms were diagnosed by abdominal ultrasonography and comfirmed by computed tomogram and angiography but the blood culture was negative in both cases at the time of the surgery. Both patient were successfully treated by resection only and the restorations of vascular continuity were not neccesary because of adequate collateral circulations to the intestine. Both patient's postoperative courses were uneventful after the follow up of one year and nine months, respectively.
Aneurysm ; Aneurysm, Infected* ; Angiography ; Collateral Circulation ; Embolism ; Endocarditis ; Enteritis ; Follow-Up Studies ; Humans ; Intestines ; Mesenteric Artery, Superior* ; Salmonella ; Ultrasonography

The prognosis of Behcet's disease characterized by recurrent orogenital ulcers and ocular and skin lesions depends upon the complications in the central nervous system, the gastrointestinal tract and the vascular system. Cardiac involvement, especially aortic regurgitation, is quite uncommon and hemodynamic instability is usually treated with open heart surgery. But serious postoperative complications had been reported in many cases, which are prosthetic valve detachment, paravalvular leakage, conduction disturbance, and false aneurysm. Many efforts to prevent the complications have been made such as application of cryopreseved homograft. We have described an experience of root replacement with homograft in a 39 year-old male patient for prosthetic valve detachment because of Behcet's aortitis with a review of the literatures regarding treatment, complication, and prognosis.
Adult ; Allografts* ; Aneurysm, False ; Aortic Valve Insufficiency ; Aortitis ; Central Nervous System ; Gastrointestinal Tract ; Hemodynamics ; Humans ; Male ; Postoperative Complications ; Prognosis ; Skin ; Thoracic Surgery ; Ulcer

Congenital long-segment tracheal stenosis with complex cardiac anomaly has generally been regarded as a fatal disease. This report described the successful concomitant repair of unexpected congenital tracheal stenosis and complex cardiac anomaly with the use of cardiopulmonary bypass. The patient was a 3-month-old girl with coarctation of aorta, VSD, and PDA. The presence of tracheal stenosis was not discovered until when difficulty with endotracheal intubation was encountered at operating room. Thus, we decided concomitant repair of both lesions and performed anterior pericardial tracheoplasty combined with one stage repair of coarctation of aorta, VSD, and PDA under the cardiopulmonary bypass. The patient is doing well without any signs of complication at present, 2 years and 1 month after the operation.
Aortic Coarctation ; Cardiopulmonary Bypass ; Female ; Heart Defects, Congenital ; Humans ; Infant ; Intubation, Intratracheal ; Operating Rooms ; Tracheal Stenosis*

Taussig-Bing anomaly is infrequently associated with interrupted aortic arch and size discrepancy of great arteries makes it difficult to undergo arch recons- truction and arterial switch operation. A 20-day old male infant was admitted with the diagnosis of Taussig-Bing anomaly with type B interrupted aortic arch. Multi-organ failure, due to the diminution of ductal flow, was stabilized after 3 weeks of prostaglandin E1 and controlled ventilatory support. The surgical correction consisted of VSD closure, arterial swtich and extended aortic arch reconstruction. The marked disparity between the hypoplastic ascending aorta and the dilated main pulmonary artery was overcome by constructing distal neoaorta using both native ascending and descending aortic tissue. The patient was extubated on postoperative 2nd day. Postoperative catheterization showed no left ventricular outflow obstruction, no intracardiac shunt, and no incompetence of neoaortic valve.
Alprostadil ; Aorta ; Aorta, Thoracic* ; Arteries ; Catheterization ; Catheters ; Diagnosis ; Double Outlet Right Ventricle* ; Humans ; Infant ; Male ; Pulmonary Artery ; Ventricular Outflow Obstruction

Sixty children were admitted to the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10- year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in 32% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45%), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severity Scale(MISS) score was measured in the multiple injured group. MISS score correlated significantly with the length of stay in the intensive care unit. One child(1.7%), involved in a traffic accident, died of sepsis.
Accidents, Traffic ; Child* ; Gyeongsangbuk-do ; Hospital Records ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Retrospective Studies ; Rib Fractures ; Sepsis ; Thoracic Injuries ; Thoracotomy ; Ventilation

Myasthenia gravis is relatively rare disease which is related autoimmune response. There are various methods of management for myasthenia gravis, but nowaday radical thymectomy is the treatment of choice in the aspect of bringing out complete remission and clinical improvement. Sixteen patient of myasthenia gravis underwent radical thymectomy during last eight years, and its result was analyed. Complete remission was achieved in five patients(31 %) and pharmacological or symptomatic improvement in seven patients(44 %), thus giving a total remission in 12 patients(75 %). Postoperative result was not correlated with age, sex, degree of preoperative symptom, surgical approach, pathologic diagnosis.
Autoimmunity ; Diagnosis ; Humans ; Myasthenia Gravis* ; Rare Diseases ; Thymectomy

Though thymoma is considered benign in a histopathologic specimen, its unusual behavior makes it important for surgeons to manage this neoplasm as cancerous lesion. Hence we clinically analysed the surgical cases of thymoma in our hospital, and we suggest the risk factors for its prognosis. From January 1987 to December 1994, we experienced 41 surgical cases of thymoma, excluding thymic carcinoma and cysts. There were 21 male and 20 female; age ranged from 16 to 64 years. Among them, myasthenia gravis was present in 22 patients (53.7%). Surgical treatment consisted of complete resection in 31 patients, partial resection in 7 patients, and biopsy only in 3 patients. According to Masaoka's classification, there were 27 patients in stage I, 4 patients in stage II, and 10 patients in stage III. Histopathology was of epithelial type in 14 patients, lymphocytic type in 11, and mixed type in 19. Eleven patients had adjuvant radiotherapy, chemotherapy, or both and there was no surgical mortality. Postoperative follow-up ranged from 1 to 88 months (mean 36 months) and three patients died and 5 patients suffered recurrences during the follow-up period. Postoperative risk factors were advanced Masaoka stage, invasiveness, and surgical method.
Biopsy ; Classification ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Mortality ; Myasthenia Gravis ; Prognosis ; Radiotherapy, Adjuvant ; Recurrence ; Risk Factors* ; Thymoma*

Between January 1986 and December 1995, 24 patients were treated surgically for thymoma. There were 17 males and 7 females, and their ages ranged from 23 to 69 years old and mean age was 49 years. Thymomas were associated with fourteen my asthenia gravis, and classified histologically as lymphocytic in 12 patients, mixed in 8, epithelial in 4, and classified clinically as stage I in 11, stage II in 4, stage III in 8 and stage VI in 1 patient. Eleven patients with non-invasive thymoma had received surgical resection, and 10 out of 13 patients with invasive thymoma were able to undergo complete resection. A partial resection or tissue biopsy followed by radiation or chemotherapy was done with the remaining three patients. Three died, four had improvement of symptom, two had relapse and fifteen had no symptom during follow up ranged from 25 days to 60 months. In fourteen cases of thymoma with myasthenia gravis, one died due to myasthenic crisis, two showed symptom aggravation, six had less medical treatment and five patients had medical treatment as same as dosage received preoperatively.
Aged ; Asthenia ; Biopsy ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Myasthenia Gravis ; Recurrence ; Thymoma*

We reviewed 40 cases of primary mediastinal tumors which were operated on at Seoul Paik Hospital from September, 1987 to December, 1995. Of these, 18 were male and 22 were female. The patient ranged in age from 4 years to 68 years with a mean age of 34.1 years. The most common symptoms included chest pain(12.5%), cough(12.5%), dyspnea(7.5%), and palpable neck mass(7.5%), and symptoms were absent at the time of diagnosis in 37.5% of cases. Chest roentgenography and computed tomography(CT) were performed in all patients, and magnetic resonance imaging(MRI) in 5 patients, and transthoracic needle aspiration (TTNA) performed in 22 patients. The sensitivity of TTNA was 72.7%(16 of 22 patients). The lesion was located 60% in the anterosuperior mediastinum, 35% in the posterior mediastinum, and 5% in the middle mediastinum. The primary tumors included thymic neoplasms(11 cases), germ cell tumors(7 cases), neurogenic tumors(10 cases) and a miscellaneous group. The malignant tumors(12.5%) were invasive thymoma(3 cases), spindle cell sarcoma(1 case), and non-Hodgkin's lymphoma(1 case). A complete excision was done in all 35 benign tumors and 3 malignant tumors. There was no operative mortality, and postoperative complications occurred in 3 cases.
Diagnosis ; Female ; Germ Cells ; Humans ; Male ; Mediastinal Neoplasms ; Mediastinum ; Mortality ; Neck ; Needles ; Postoperative Complications ; Radiography ; Seoul ; Thorax