ABSTRACT
Descending necrotizing mediastinitis(DNM) is a rare complication of the oropharyngeal and cervical infection. Descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. A 39-year-old man complained of odynophagia, neck swelling, and disturbance of swallowing with dyspnea. CT scans of the neck suggested a peritonsillar abscess and retropharyngeal and peripharyngeal abscess. He underwent cervical drainage. He remained febrile and complained of severe both pain in both shoulders. On postoperative day 5, a follow-up CT scan confirmed a mediastinal abscess. Reexploration of the neck and right thoracotomy for debridement and drainage of the mediastinal abscess were performed. A large amount of pus was drained from the anterior and posterior mediastinum and its necrotic tissue was debrided. The patient's condition and radiologic findings gradually improved. Cultures of the drain fluid revealed Klebsiella pneumoniae. He was discharged on the 85th hospital day. In our experience, both transcervical drainage and aggressive mediastinal exploration via thoracotomy can lead to an improvement in the survival of the patient with descending necrotizing mediastinitis. CT scanning is useful for early diagnosis of mediastinitis and for follow up.
Subject(s)
Adult , Humans , Abscess , Debridement , Deglutition , Drainage , Dyspnea , Early Diagnosis , Follow-Up Studies , Klebsiella pneumoniae , Mediastinitis , Mediastinum , Mortality , Neck , Peritonsillar Abscess , Shoulder , Suppuration , Thoracotomy , Tomography, X-Ray ComputedABSTRACT
The experiment was designed to investigate type-selectivity of the involved muscle fibers and changes in the component ratios of the fiber types following the progression of disuse atrophy in the skeletal muscle. After inducing disuse atrophy of the skeletal muscle by applying cast on the hind limb, we used histological and histochemical stains in the sections of the rat Tibialia anterior muscles. The results were as follows. 1. Even 8 weeks after immobilization of the hind limb, differentiation of muscle fiber types by histolo gical and histochemical staining methods in the Tibialis anterior muscle could be possible. 2. Atrophy of muscle fibers was more pronounced in type IIB and type I fibers than in type IIA fibers. 3. Central migration of sarcolemmal nuclei and ring fiber appeared after 6th and 8th weeks of immobilization respectively, in the H&E and trichrome preparations. Ac-pase or Alk-pase positive fibem were not noted throughout the experimental periods.
Subject(s)
Animals , Rats , Atrophy , Coloring Agents , Extremities , Immobilization , Muscle, Skeletal , Muscles , Muscular Disorders, AtrophicABSTRACT
Defect of the radius should be managed with either fusion of radius and ulna forming “one-bone forearm”, or restoration of its continuity by bone graft. Reported hereia are two cases in which the radius developed defect following sequestrectomy and treatment of open infected fructure respectively. Reconstruction of the radius was tried with bone graft; utilizing the ulnar end resected from the same side in one case and fibula in other. Both Sowed sound bony union of the graft about four months postoperatively.
Subject(s)
Fibula , Radius , Transplants , UlnaABSTRACT
Two cases of congenital multiple joint laxity are reported here. One was a 18-year-old boy, in whom the hypermobility of the joints was striking that 4 criterias (Carter & Wilkinson, 1964) could be observed. The other was a 18-year-old male who showed positive findings in three of the five diagnostic criterias. In both no familiar occurrence was noted.