ABSTRACT
A glomus tumor is an uncommon soft tissue tumor that is most commonly found in the subungual area and a glomus originating in the trachea is extremely rare. Histologically and ultrastructurally, these tumors have been divided into three subtypes: classic glomus tumors, glomangiomas, and glomangiomyomas. Glomangiomyomas account for less than 10% of all glomus tumors and are the least common type. We report a case of a 54-year-old man with glomangiomyoma of the trachea who presented with stridor. We treated the tumor by segmental resection and primary repair via a transcervical approach.
Subject(s)
Humans , Middle Aged , Glomus Tumor , Respiratory Sounds , Trachea , Tracheal NeoplasmsABSTRACT
BACKGROUND: The clinical history and physical findings of the patients with spontaneous pneumothorax depend largely on the extent of the collapse of the lung and the presence of pre-existing pulmonary disease. Large primary spontaneous pneumothorax is a possible serious condition and so more active treatment will be necessary for these patients. The therapeutic guideline for large pneumothorax remains controversial. Therefore, by assessing the clinical results of surgical treatment for large primary pneumothorax, we aim to determine the indicators of treatment. MATERIAL AND METHOD: Among 348 patients with primary spontaneous pneumothorax and who underwent surgical treatment from August 2004 through December 2007, 58 patients who responded to treatment for a large primary pneumothorax were included in the current study. We then retrospectively evaluated the operative findings and the surgical results. The patients with a pneumothorax of 80% or more, including those patients with tension pneumothorax, were considered to have a "large pneumothorax". Most of these patients should be treated with a 12F chest tube. Thoracoscopic wedge resection was considered for treating recurrent pneumothorax, continuous air leakage, controlateral pneumothorax and first episode pneumothorax with visible blebs (> 1 cm) seen on the computed tomography. RESULT: There were 50 men and 8 women with a mean age of 28.2 years (range: 14~54 years). The mean length of hospitalization was 5.3 days (range: 2~10 days). Nine patients underwent chest tube drainage only. Forty-nine patients underwent thoracoscopic wedge resection. The mean follow up time was 27.8 months (range: 10~58 months). The actual site of air leakage could be located in 35 patients (71.4%) and this was correlated with pleural adhesion (p=0.005). The initial air leakage tended to be more correlated with intraoperative air leakage, although this was not statistically significant (p=0.066). The recurrence rate was 11.1% for the patients with chest tube drainage and 2.0% for the patients with thoracoscopic wedge resection. CONCLUSION: Large primary pneumothorax requires an early diagnosis and early treatment. Thoracoscopic wedge resection may help to prevent recurrence of large primary pneumothorax.
Subject(s)
Female , Humans , Male , Blister , Chest Tubes , Drainage , Early Diagnosis , Follow-Up Studies , Hospitalization , Lung , Lung Diseases , Pneumothorax , Recurrence , Retrospective StudiesABSTRACT
Exogenous lipoid pneumonia (ELP) is a chronic inflammatory reaction of the lungs resulting from the aspiration of vegetable, animal or mineral oils. Squalene, is a derivative of shark liver oil that is taken as a traditional remedy in some Asian countries, and is used widely also in cosmetics. Similar to the symptoms in most cases of oil aspiration, the symptoms of squalene-induced lipoid pneumonia are either absent or nonspecific. Hence, the disease is generally detected incidentally. Although many cases with predisposing factors have been reported, ELP with achalasia is quite rare. We report a 47-year old woman with achalasia who developed ELP after ingesting squalene. The patient was treated successfully by supportive care and surgical treatment of the achalasia.
Subject(s)
Animals , Female , Humans , Asian People , Cosmetics , Eating , Esophageal Achalasia , Liver , Lung , Mineral Oil , Pneumonia , Sharks , Squalene , VegetablesABSTRACT
The thymoma with extrathoracic metastasis is an exceedingly rare malady. We report here on the surgical resection and the pathologic findings of liver metastasis from an invasive thymoma in a 57-year-old female. In 1998, a benign thymoma in the anterosuperior mediastinum was removed from the patient and then postoperative radiation therapy was given. After 6 years, the patient complained of dyspnea, dry cough and abdominal pain. Abdominal CT and MRI showed an encapsulated and septated 19 x 14 cm sized cystic mass in the right liver. Right hepatectomy was done and it was shown to be a metastatic thymoma. An extensive literature review has revealed only a few cases of surgical resection of liver metastasis in a patient with invasive thymoma.
Subject(s)
Female , Humans , Middle Aged , Abdominal Pain , Cough , Dyspnea , Hepatectomy , Liver , Magnetic Resonance Imaging , Mediastinum , Neoplasm Metastasis , Thymoma , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: Video-assisted thoracic sympathicotomy plays an important role as an effective method for the treatment of axillary hyperhidrosis. People with axillary hyperhidrosis were not satisfied by the occurrence of the high rate of disabling compensatory hyperhidrosis and axillary resweating. Therefore, by comparing and assessing the clincal results according to the level and extent of sympathicotomy in axillary hyperhidrosis, we aim to determine which method will result in maximal benefits. MATERIAL AND METHOD: Among 70 patients suffering from axillary hyperhidrosis having undergone thoracoscopic sympathicotomy from January 2001 through December 2003, 57 patients who responded to either telephone interview or questionnaire were included in the current study. The patients were divided into two groups, Group I (n=25): patients having undergone R3, 4, 5 sympathicotomy which consist of blocking the interganglionic neural fiber on the third, fourth, and fifth rib, Group II (n=32): patients having undergone R3,4 sympathicotomy which consist of blocking the interganglionic neural fiber on the third and fourth rib. The study parameters were satisfaction rate and degree of compensatory sweating. RESULT: There was no difference on age and sex, family history, combined hyperhidrosis, and mean follow up month between the two groups. Patients expressing satisfaction were 88.0% in group and 56.3% in groups II with statistically significant difference (p=0.02). Moderate to severe compensatory sweating were 52.0% (embrassing 6 patients, disabling 7 patients) in group I and 62.5% (embrassing 5 patients, disabling 15 patients) in groups II with no significance in the statistical analysis. CONCLUSION: R3, 4, 5 sympathicotomy was an effective means of treating axillary hyperhidrosis because of higher long term satisfaction rate.
Subject(s)
Humans , Follow-Up Studies , Hyperhidrosis , Interviews as Topic , Quality of Life , Surveys and Questionnaires , Ribs , Sweat , SweatingABSTRACT
Cryptococcus neoformans is a ubiquitous fungus found worldwide, particularly in soil contaminated by pigeon droppings. Pulmonary cryptococcosis occurs rarely in immunocompetent individuals. The risk of cryptococcal infection increases with the degree of immunal compromise, in human immunodeficiency virus infection especially. Pulmonary cryptococcosis is most frequently encountered as asymptomatic single or multiple pulmonary nodules found by routine chest x-ray examination. The diagnosis is most often made in these situations by the histology of the resected lesion. Acute progressive pneumonia may occur, with symptoms of cough, sputum production, fever, and weakness. The clinical picture is not pathognomonic. The yeasts are stained well by any of the special stains for fungi. Treatment is now indicated for all cases given a diagnosis of cryptococcosis, even if the diagnosis has been made by resecton of a solitary, asymptomatic pulmonary nodule.
Subject(s)
Coloring Agents , Columbidae , Cough , Cryptococcosis , Cryptococcus neoformans , Diagnosis , Fever , Fungi , HIV , Multiple Pulmonary Nodules , Pneumonia , Soil , Sputum , Thorax , YeastsABSTRACT
A 39 years old woman was admitted to the hospital because of recurrent hemoptysis. On a bronchoscopic inspection, nodular shaped mass-like lesions were found on the orifice of right middle and lower lobar bronchus and a biopsy was performed. This was immediately followed by massive bleeding into the airways. The bleeding could not be controlled by nonsurgical treatment. Immediately she underwent a right middle and lower bilobectomy in order to control of bleeding. Biopsy revealed the bleeding to have been caused by a biopsy injury of an abnormal artery that had run superficially in the bronchial mucosa.
Subject(s)
Adult , Female , Humans , Arteries , Biopsy , Bronchi , Bronchial Arteries , Bronchoscopy , Hemoptysis , Hemorrhage , Mucous MembraneABSTRACT
A 39 years old woman was admitted to the hospital because of recurrent hemoptysis. On a bronchoscopic inspection, nodular shaped mass-like lesions were found on the orifice of right middle and lower lobar bronchus and a biopsy was performed. This was immediately followed by massive bleeding into the airways. The bleeding could not be controlled by nonsurgical treatment. Immediately she underwent a right middle and lower bilobectomy in order to control of bleeding. Biopsy revealed the bleeding to have been caused by a biopsy injury of an abnormal artery that had run superficially in the bronchial mucosa.
Subject(s)
Adult , Female , Humans , Arteries , Biopsy , Bronchi , Bronchial Arteries , Bronchoscopy , Hemoptysis , Hemorrhage , Mucous MembraneABSTRACT
Pulmonary aspergilloma usually arises in preexisting lung cavities characterized by recurrent hemoptysis. Although surgical resection of the aspergilloma is the best treatment, most patients are poor candidates for surgery because of far-advanced underlying pulmonary disease. On the other hand, pulmonary actinomycosis is a chronic, indolent bacterial infection and follows aspiration of oropharyngeal material. Bronchiectasis and obstructive lung disease are often associated underlying conditions. We report a case of pulmonary aspergilloma in bronchogenic cyst associated with an actinomycosis in 21-year-old woman treated by thoracoscopic surgery with a review of literature.
Subject(s)
Female , Humans , Young Adult , Actinomycosis , Bacterial Infections , Bronchiectasis , Bronchogenic Cyst , Hand , Hemoptysis , Lung , Lung Diseases , Lung Diseases, Obstructive , ThoracoscopyABSTRACT
Elastofibroma dorsi, a rare, noncapsulated benign entity is characterized by the proliferation of fibrous tissue with elastin and occurs most often in the infrascapular area of elderly women. It is a relatively slowly growing lesion and no reports of malignant transformation exist. Which is overlooked easily because it rarely causes symptoms such as tenderness, pain, or restriction of movement. The diagnosis of elastofibroma is established by typical histopathologic findings. Radiographic evaluation may lead to a presumptive diagnosis. We experienced a case of elastofibroma dorsi in a 48-year-old woman and report this case with a review of the literature.
Subject(s)
Aged , Female , Humans , Middle Aged , Diagnosis , Elastin , FibromaABSTRACT
A primary pulmonary malignant lymphoma is a rare disease. It is thought to be a category of non-Hodgkin's lymphoma arising from the bronchous-associated lymphoid tissue (BALT). The majority of primary pulmonary lymphomas are low-grade, small B-cell lymphomas, which are associated with Sjogren's syndrome and similar autoimmune disorders. A case of primary pulmonary low-grade B-cell lymphoma arising from the BALT was encountered in a patient with systemic lupus erythematosus. A 54-year-old man was admitted to the hospital for the evaluation of left pleuritic chest pain and multiple joint pain in both hands. Serologic tests for collagen vascular disease were performed. The results of ANA and anti-ds-DNA were all positive. The computed tomography of the chest showed patchy concolidations in the left lower lobe with a pleural effusion and a video-assisted thoracoscopic biopsy was performed. Here we report a case of low-grade B-cell lymphoma of BALT in a patient with systemic lupus erythematosus with a review of the relevant leteratures.
Subject(s)
Humans , Middle Aged , Arthralgia , Biopsy , Chest Pain , Collagen , Hand , Lupus Erythematosus, Systemic , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell , Lymphoma, Non-Hodgkin , Pleural Effusion , Rare Diseases , Serologic Tests , Sjogren's Syndrome , Thorax , Vascular DiseasesABSTRACT
BACKGROUND: With the advances of video technology, thoracoscopic surgery has been applied to various areas of the thoracic surgical fields including major surgeries. Now a days, thoracoscopic surgery is performed as a procedure of choice for primary spontaneous pneumothorax. But the operative indication for the primary spontaneous pneumothorax has not been changed since the last few decades, although the procedure of choice was changed from open thoracotomy to thoracoscopy. Therefore, we thought new treatment strategy will be necessary for the management of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between January 1998 and December 1999, 149 primary spontaneous pneumothorax patients were admitted to the Kyungpook National University Hospital. Result; Of these patients, 177 were first attack pneumothoraces and the number of total attacks were 250. CONCLUSION: Analyzing the amount of pneumothorax, methods of treatment, number of recurrences, recurrence rate and hospital stay, we propose a critical pathway for establishing new treatment strategy for the management of primary spontaneous pneumothorax.
Subject(s)
Humans , Critical Pathways , Length of Stay , Pneumothorax , Recurrence , Thoracoscopy , ThoracotomyABSTRACT
BACKGROUND: To evaluate the efficacy of cellulose mesh with fibrin glue to decrease recurrence rate after bullectomy for a treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: 222 patients underwent a bullectomy for primary spontaneous pneumothorax in our institute between April. 1996, and June, 2000. Patients were divided into four groups by period and operation method. Group 1(n=25) underwent video-assited thorasic surgery(VATS) and mechanical pleurodesis between 1996 and 1997. Group 2(n=53) underwent axillary thoracotomy and mechanical pleurodesis between the same period. Group 3(n=110) undewent VATS and mechanical pleurodesis between 1998 and April, 2000. Group 4(n=34) underwent VATS and reinforcement with absorbable cellulose mesh and fibrin glue between 1998 and June, 2000. The data of recurrence rate, duration of air leakage, and duration of chest tube drainage evaluated by each group were compared and analysed using general linear model procedure. RESULT: There were 203 men and 19 women. Mean age was 23.2+9.6 years. Recurrent rate in group 1 was 25%, 3.8% in group 2 and 4.5% in group 3. Threre was no recurrence of pneumothorax in group 4. All recurrent cases after bullectomy were developed at the period of surgeon' s experience of bullectomy if it was less than 2 years. Chest tube indwelling period in group 4 was shorter compared to that of group 1,group 2(p<0.0006) and group 3(p<0.0001). There was no postoperative air- leakage in group 4. Recurrence rate was higher in minimal and moderate size pneumothorax than that in massive pneumothorax. In the 12 recurred cases, nine cases had blebs near the suture line. CONCLUSION: The covering of the suture area with an bsorbable cellulose mesh and the application of the fibrin glue on the mesh in wedge resection of blebs are effective and shorter tube indwelling period was resulted. There were no postoperative air leakage through chest tube after this additional procedure and no recurrence in short term follow-up period. Recurrence rate was higher in small size pneumothorax than that in large sizepneumothorax. Recurrence rate was also influenced by the experience of surgeon.
Subject(s)
Female , Humans , Male , Blister , Cellulose , Cellulose, Oxidized , Chest Tubes , Drainage , Fibrin Tissue Adhesive , Fibrin , Follow-Up Studies , Linear Models , Pleurodesis , Pneumothorax , Recurrence , Sutures , Thoracic Surgery, Video-Assisted , ThoracotomyABSTRACT
Necrotizing fasciitis, an uncommon, often fulminant bacterial infection, rarely originates in the chest wall. Although it can occur in any region of the body, the abdominal wall, perineum, and extremities are the most common sites of infection. It is characterized by wide spread fascial necrosis with relative sparing of skin and underlying muscle. Diagnosis is often extremely difficult and relies on a high index of suspicion. Prompt surgical intervention is essential. We experienced a patient with idiopathic necrotizing fasciitis in the chest wall and reported with brief review of literature.
Subject(s)
Humans , Abdominal Wall , Bacterial Infections , Diagnosis , Extremities , Fasciitis, Necrotizing , Necrosis , Perineum , Skin , Thoracic Wall , ThoraxABSTRACT
BACKGROUND: Ischemic preconditioning enhances the tolerance of myocardium against ischemia/reperfusion injury, with the enhancement of the recovery of post-ischemic myocardial function. This study was disigned to assess whether the protective effect of ischemic preconditioning could provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rate heart. MATERIAL AND METHOD: Fourty four Spargue-Dawley rats, weighing 300-450gm, were divided into four groups. Group 1(n=7) and group 3 (n=12) were subjected to 30 minutes of aerobic Langendorff perfusion without ischemic preconditioning and then preserved in saline solution at 2-4 degree C for 4 hours and 5 respectively. Group 2 (n=7) and group 4 (n=18) were perfused in the same way for 20 minutes, followed by 3 minutes of global mormothermic ischemia and 10 minutes of perfusion and then preserved in the same cold saline solution for 4 hours and 5 hours respectively. Heart rate, left ventricular developed pressure (LVDP), and coronary flow were measured at 15 minutes during perfusion as baseline. Spontaneous defibrillation time was measured after reperfusion. Heart rate, LVDP, and coronary flow were also recorded at 15 minutes, 30 minutes, and 45 minutes during reperfusion. Samples of the apical left ventricular wall were studied using a transmission electron microscope. Time of spontaneous defibrillation (TSD) was significantly longer in group 4 than in group 1 (p<0.001), and TSD in group 1 was significantly longer in comparision to that of group 2 (p<0.05). Heart rate at 45 minutes was significantly higher in group 1 than in group 4 (p<0.05). Heart rate at 15 min was significantly higher in group 2 than in group 1(p<0.001) and in group 4 than in group 3 (p<0.05). Left ventricular developed pressure (LVDP) at 30 minutes and 45 minutes was higher in group 1 than in group 4 (p<0.01), LVDP at 45 minutes was higher in group 4 than in group 3 (p<0.05). Rate-pressure product (RPP) at 30 minutes and 45 minutes was higher in group 1 than in group 4 (p<0.05). RPP at 15 minutes was higher in group 2 than in group 1 (p<0.01). RPP at 30 minutes and 45 minutes was higher in group 4 than in group 3 (p<0.05). Group 2 showed relatively less sarcoplasmic edema and less nuclear chromatin clearance than group 1. Group 4 showed less myocardial cell damage than group 3, group 4 showed less myocardial cell damage than group 3, group 4 showed more myocardial cell edema than group 1. CONCLUSION: Ischemic preconditioning enhanced the recovery of postischemic myocardial function after 4 hours and 5 hours preservation. However, it was not demonstrated that ischemic preconditioning could definitely provide one additional hour of myocardial preservation in four hour myocardial ischemia in a rat heart.
Subject(s)
Animals , Rats , Chromatin , Edema , Heart Rate , Heart , Ischemia , Ischemic Preconditioning , Myocardial Ischemia , Myocardium , Perfusion , Reperfusion , Sodium ChlorideABSTRACT
BACKGROUND: Bullectomy through a transaxillary minithoracotomy have been widely used in the treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: From September 1997 to September 1998, 22 consecutive cases of those who underwent transaxillary mini thoracotomy with Finochieto rib spreader(group F) and 24 consecutive cases with Naruke thoraco-opener(group N) at Taegu Fatima Hospital were reviewed retrospectively to compare the clinical results of transaxillary minithoracotomy with different rib spreaders in the opera tive treatments of primary spontaneous pneumothorax. RESULT: There were no significant differences in operative time, hospital stay, postoperative hospital stay, the duration of the indwelling chest tube, and the number of postoperative recurrences and complications in the two group. CONCLUSION This technique may be useful in the operative treatments of primary spontaneous pneumothorax.
Subject(s)
Chest Tubes , Length of Stay , Operative Time , Pneumothorax , Recurrence , Retrospective Studies , Ribs , ThoracotomyABSTRACT
A 45 year old man was admitted for further examination of an abnormal shadow of the right posterior mediastinum. The patient suffered from dysesthesia in the right thoracic wall of dermatome T7. CT scan and MRI revealed that two separate tumors had developed in the right paravertebral area linked to the vertebral canal via an intervertebral foramina. One-stage removal of the tumors were performed safely through the right posterolateral thoracotomy following the resection of the rib head and vertebral pedicle. The tumors were confirmed as histologically neurilemomas. The postoperative course was uneventful.
Subject(s)
Humans , Middle Aged , Head , Magnetic Resonance Imaging , Mediastinal Neoplasms , Mediastinum , Neurilemmoma , Paresthesia , Ribs , Thoracic Wall , Thoracotomy , Tomography, X-Ray ComputedABSTRACT
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.