ABSTRACT
True neurogenic thoracic outlet syndrome (TOS) is an uncommon disease and is difficult to diagnose at the early stage and then completely cure. We experienced a case of true neurogenic TOS with typical clinical symptoms and electrophysiologic findings as a result of repetitive habitual sleep posture. A 31-year-old woman who had complained of progressive tingling sensation on the 4th and 5th fingers with shoulder pain was diagnosed of brachial plexopathy at the lower trunk level by electrodiagnostic studies. There was no other cause of brachial plexopathy except her habit of hyperabduction of shoulder during sleep. This case demonstrated that the habitual abnormal posture can be the only major cause of neurogenic TOS. It is of importance to consider TOS with the habitual cause because simple correction of the posture could stabilize or even reverse disease progress.
Subject(s)
Adult , Female , Humans , Brachial Plexus Neuropathies , Fingers , Posture , Sensation , Shoulder , Shoulder Pain , Thoracic Outlet SyndromeABSTRACT
Among the causes of SVC syndrome,intraluminal tumor,especially the leiomyosarcoma is very rare.We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission.On physical examination,facial edema and venous engorgement on upper extermities and upper chast wall were showed.The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC.Surgery was performed through median sternotomy.For complete resection of the tumor and thrombus,we used partial and total CPB.The follow up SVC cavogram revealed no abnormality 14 months after the operation.
Subject(s)
Adult , Female , Humans , Edema , Follow-Up Studies , Headache , Hyperemia , Leiomyosarcoma , Tomography, X-Ray ComputedABSTRACT
With the introduction of new cardiac prosthesis, it behooves surgeons and cardiologists to monitor its performance carefully. ATS (Advancing The Standard) prosthetic valve has been used first in Guro hospital in Korea, since August 1994. Between August 1994 and July 1995, 21 patients received 28 ATS prosthesis( 9 aortic, 19 mitral ). 19mitral valves were implanted through the "Extended Transseptal Approach". 10 were male and 11 were female, ranging from 20 to 54 years of age( Mean age = 37 years). The follow up period 126 patient-months(mean 6.1 months),varied from 1 month to 12 months. NYHA functional class was improved significantly, from 2.9+/-0.7 preoperatively to 1.4+/-0.5 postoperatively. Ejection fraction was also improved from 55.5+/-6.1% preoperatively to 59.8+/-7.4% postoperatively. Lactic dehydrogenase(LDH) was used as an indicator of hemolysis.The value of LDH changed from 483.3+/-162 IU/L preoperatively to 527+/-274 IU/L postoperatively with no clinical significance. Valve related complications, such as thromboembolism, valve thrombosis, anticoagulant related hemorrhage and prosthetic valve endocarditis did not develop except one anticoagulant related intracranial hemorrhage. There were no mortalities. This experience encourages us to continue using the ATS prosthetic valve, and this study will help those patients who need to have their heart valves replaced.
Subject(s)
Female , Humans , Male , Endocarditis , Follow-Up Studies , Heart Valve Prosthesis , Heart Valves , Hemorrhage , Intracranial Hemorrhages , Korea , Mortality , Prostheses and Implants , Thromboembolism , ThrombosisABSTRACT
Subacute osteomylitis is far less common than acute osteomyelitis, characterized by insidious onset of the symptoms of mild local pain or discomfort without any acute systemic illness. Radiographic findings are not infrequently confused with benign or malignant bone tumors. From Jan, 1983 to Dec. 1991, we experienced twelve patients with subacute osteomylitis of long bones. Our clinical observations were as follows. 1. There were 11 boys and one girl with an average age of 9.7 years(range, 30months-16years). 2. The involved sites were proximal in 1, distal radius in 3, midshaft of femur in 3, distal femur in 2, proximal tibia in 1, and distal tibia in 2 cases. 3. All patients had insidious onset of mild to moderate pain. ESR was increased in 9 cases(75%) with a mean value of 44 mm/hr, but leukocytosis was not found. 4. According to the Green and Edwards' classification, there were type 1 in 1, type 2 in 3, type 3 in 3, and type 6 in 5 cases. 5. Eleven patients had operative treatment. The remaining one patient was treated by antibiotic treatment. 6. Primary treatment was successful in 11 patients who were followed for and average 9.5 months. One patients was lost to follow-up.