• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.155-158
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• 2015

Lymphangioma is a congenital abnormality of the lymphatic system detected primarily in early childhood. There are rare reports of mediastinal lymphangioma in older adults. We hereby report on a 66-year-old female patient who underwent kidney transplantation 20 years previously and who developed pathologically confirmed solitary mediastinal lymphangioma 1 year ago. Chest radiography showed a mediastinal nodule, which was not observed 2 year previously, therefore she was referred to the pulmonary division. She had no symptoms, and chest computed tomography demonstrated a 25-mm, well-defined, low-density nodule located at the anterior mediastinum. The size of the nodule had increased from 25 mm to 34 mm 1 year later, and it was completely resected via video-assisted thoracic surgery. The histological diagnosis was cystic lymphangioma. Therefore, we recommend that clinicians consider cystic lymphangioma as a possible diagnosis even in older patients with a mediastinal cystic mass that shows progressive enlargement.

• Journal of Chest Surgery
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• 제37권5호
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• pp.460-463
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• 2004

종격동에 발생한 혈관종은 전체 종격동 종양의 0.5% 미만을 차지할 정도로 드문 질환이다. 후종격동에 발생한 혈관종의 경우는 전종격동에 비해 더 드문 것으로 알려져 있다. 환자는 21세 여자로 단순흉부 방사선촬영상 후종격동에 비정상적인 음영을 보여 본원으로 전원되어 시행한 흉부 전산화 단층촬영과 흉추 자기공명 영상촬영에서 척수 경막까지 도달되어 있는 아령모양의 후종격동 종양 소견을 보였다. 이에 수술적 절제를 시행하였고 병리 조직학적 검사결과 3${\times}$4${\times}$2 cm의 모세혈관상 혈관종의 소견이 관찰되었다.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.351-355
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• 2009

Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

• Tuberculosis and Respiratory Diseases
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• 제38권2호
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• pp.128-134
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• 1991

This report is an analysis of 60 cases of primary mediastinal tumors and cysts which were experienced in chonbuk National University Hospital, Wonkwang University Hospital and Chonju Presbyterian Medical Center from january 1985 to October 1990. The result was summarized like this; 1) Age distribution was various from ages of 5 to 75 years. There were 26 males and 34 females, sex ratio of patients was 1: 1.3 (M:F). 2) The most common chief compliant was dyspnea (21 cases, 35%) and followed by chest pain, coughing and chest discomfort. 17 patients (28%) were asymptomatic. 3) The most common primary mediastinal tumor was thymoma, which comprise 28% (17 cases) of all our cases and followed by neruogenic tumor (14 cases, 23%) and germ cell tumor (11 cases, 18%). 4) The incidence of malignancy of all case was 22%; 2 cases were asymptomatic and the most common malignancy was malignant lympoma (5 cases, 38.5%). 5) The anterior mediastinum was the most common tumor location and followed by posterior and middle mediastinum. Anterior mediastinal tumors mainly consisted of thymomas and germ cell tumors and posterioc mediastinal tumors mainly did neurogenic tumors. 6) Of 60 cases, 21 cases were confirmed histopathologically by percutaneous transthoracic needle lung biopsy. 7) Of 60 cases, 40 cases were received radical tumor resection.

• Journal of Chest Surgery
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• 제31권10호
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• pp.1017-1021
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• 1998

중피낭종은 심막체벽낭종, 스프링워터낭종, 장막낭종 등 여러 가지 이름으로 명명되고 있다. 대부분의 중피낭종은 심낭의 기형으로 부터 발생 된다고 하나, 본 증례는 늑막기형에서 발생된 아주 희귀한 중피낭종이므로 조직학적으로 특수 염색을 통하여 확진하게 되었다. 본 증례는 64세 여자 환자로서 입원 당시 우측 목 부위에 통증 없는 낭성 종괴가 만져져 외래를 통하여 내원케 되었다. 컴퓨터 단층촬영상 종격동 림프관종이라는 진단하에 수술을 시행하여 낭성종괴를 완전 절 제 하였다. 수술후 절제된 조직소견 결과 종격동 중피낭종이 확진 되었으며 수술후 환자는 큰 후유증 없이 완치되어 퇴원 하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권1호
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• pp.31-34
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• 2015

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.

• Tuberculosis and Respiratory Diseases
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• 제56권1호
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• pp.103-108
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• 2004

저자들은 44세 여환에서 흉부 단순 촬영상 심장비대로 오인되어 순환기내과로 전원된 환자에서 흉선지방종으로 진단 후 수술적제거로 치료한 환자 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제8권2호
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• pp.119-124
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• 1975

This is a case report of the rupture of the trachea and the esophagus following external blunt trauma without any associated injury. A 7 year old male patient was brought to the emergency room. Hanyang University Hospital, on 23 Jul, 1974 while he played under the pile of pingpong table A table was fall down over the patient accidentally. The patient was injured by the table and found lying in unconsciousness on the ground.There was subcutaneous emphysema on his anterior chest and neck. A contusion on the upper part of the sternum was noted. The breathing sound were diminished over the left side of the chest. Ronchi were heard over the right lung field. This patient was suffered from vomiting, dypsnea, and irritable mental state after this accident. On the chest roentgenogram in A-P view, hyperlucency at the mediastinum and parapericardiac area suggested the pneumomediastinum. On the next day, a diagnosis of the tracheal and esophageal rupture was confirmed by the esophagogram with Lipiodol swallowing. A right thoracotomy was performed and ruptured orifice of the trachea and the esophagus were closed with interrupted sutures. Postoperative course was uneventful and primary closure of the rupture of the trachea and the esophagus were succeeded.

• Journal of Chest Surgery
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• 제35권8호
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• pp.634-637
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• 2002

흉선 유암종 또는 흉선의 신경내분비 종양은 매우 드문 질환이며 재발이나 전이가 많아 예후가 좋지 못하다. 43세 남자 환자로 우측 흉부의 통증과 불편감으로 내원하였다. 단순 흉부 촬영상 우측 전종격동에 $7{\times}8$cm 크기의 종양을 발견하였으며 추가검사 후 수술적 절제를 시행하였다. 절제된 종괴는 조직학적, 면역조직화학적, 전자현미경적 소견상 흉선 낭종을 동반한 흉선의 비정형 유암종으로 진단 되었다. 수술 후 재발이나 전이 소견 없이 3개월째 외래 관찰중이다. 저자들은 흉선 낭종을 동반한 비정형 흉선유암종 1례를 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제32권4호
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• pp.421-427
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• 2005

Although the incidence of mediastinal wound infection in patient undergoing median sternotomy for cardiovascular surgery is relatively low(less than 1%), it is not only a devastating and potentially life-threatening complication but also associated morbidity, mortality and cost are unacceptably high. During the past few decades various methods had been applied for the treatment of postoperative mediastinitis. Currently, chest wall reconstruction by using muscle flaps-especially pectoralis major muscle and rectus abdominis muscle are commonly selected for the reconstruction after wide debridement has become widely accepted. We performed bilateral pectoralis major-rectus abdominis muscles in-continuity bipedicle flap to overcome the limit of each flap for reconstruction of sternal defects in 17 patients. We analyzed the results of the surgery. Recurrent infection developed in 17.6% of cases and abdominal herniation was observed in one patient. There was no postoperative hematoma or death. We conclude that this flap is very valuable in reconstruction of the anterior chest wall defect caused by post-sternotomy infection because it provides sufficient volume to fill the entire mediastinum, and the complication rate compares favorably to that of other methods.