• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권6호
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• pp.597-599
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• 2010

Subcutaneous emphysema and pneumomediastium is a relatively uncommon phenomenon. Most case of pneumomediastium are caused by iatrogenic injury on the cervical region and chest during tracheostomy. It is also well known that emphysema may occur secondary to dental treatment using high-speed air turbine handpiece, but there have been few cases of emphysema extended to involving the mediastinum. These complications are reported to occur mainly in patients after dental procedures, in particular during mandibular third molar extraction. Early recognition and conservative treatment of these problems is essential in preventing life-threatening complications such as airway obstruction, mediastinitis, pneumothorax and cardiac failure. As we report a case of 25-year-old woman with subcutaneous emphysema and pneumomediastium after mandibular third molar extraction using high-speed air turbine handpiece.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.139-141
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• 2019

The causes of vocal cord paralysis include iatrogenic injury during thyroid or cervical surgery, heart and chest surgery, and tumorous lesion such as laryngeal cancer and lung cancer. In addition to these common causes, rarely, cardiovascular disease can also cause vocal fold paralysis. A disease known as Cardiovocal syndrome, or Ortner's syndrome, causes left vocal fold paralysis when the left recurrent laryngeal nerve is compressed by the pulmonary artery and aorta, which is occurred by pulmonary hypertension from heart disease. We report for the first case in Korea the diagnosis of vocal fold paralysis caused by Ortner's syndrome.

• Journal of Chest Surgery
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• 제15권2호
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• pp.139-147
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• 1982

In case of segmental injury of trachea, the primary repair is very difficult, because the trachea is fixed in place without movability from the surrounding tissue. In addition to special anatomical situation of trachea, any ideal artificial prosthesis for tracheal replacement is not still appeared. Many authors proposed several procedures for the tracheal repair, but satisfactory results were few. Among the proposed procedures end to end anastomosis of trachea was noted superior when both ends of trachea could be approximated by mobilization of upper and lower injured trachea. The author's experiment was designed to determine the effect about decreased tension on trachea when the hyoid bone was released downward from the surrounding muscular structures. The experimental dogs were divided into two groups, suprahyoid releasing group (SH R) and control group of intact hyoid. SH R group was subdivided into two groups accord ing to he degree of tension. The experimental results were as follow; 1. SH R group: In view of X-ray, the distance between the angle of mandible and the displaced hyoid bone was lengthened downward. And it's range was from 1.3cm (38%) minimally to 2.7cm(108%) maximally. 2. Control group: The distance between the angle of mandible and hyoid was same in both pre and postoperation. As the result of this experiment study, the suprahyoid release technique seems to be the efficient method that enable of release the trachea maximally. And it should be expected that the SH R technique is applicable clinically.

• Journal of Chest Surgery
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• 제23권1호
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• pp.90-94
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• 1990

Between Dec. 1958 and Oct. 1989, we had been experienced 14 cases of the esophageal corrosion carcinoma among 562 cases of corrosive esophageal stricture, which incidence was revealed 5.6 % of total esophageal carcinoma cases and 2.5 9o of total benign esophageal stricture cases. The age distribution was from 15 to 64 years, and the mean age was 45.6 years. Ten of the patients were women. The caustic agents were lye in 12 patients and hydrochloric acid in 2 patients. The latent time from injury to the development of carcinoma was from 12 years to 45 years, and the mean latent time was 29 years. In majority of cases, the developing site of carcinoma was just or just above the benign stricture portion of the esophagus. Corrective surgery were made in seven cases; three cases were made esophagectomy and esophagogastrostomy, and the other four cases were made esophagectomy and colon interposition. Palliative surgery including feeding gastrostomy were made in seven cases. All cases had a longstanding history of difficult oral swallowing especially at the site of stricture. We think chronic food irritations of stricture portion of the esophagus induced the development of corrosion carcinoma. In conclusion, we had to suspect possibility of carcinoma in patient with long standing history of benign esophageal stricture. So we recommended preoperative esophagoscopic biopsy in such cases.

• Journal of Chest Surgery
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• 제9권1호
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• pp.69-72
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• 1976

This is to report a case of bronchgenic cyst. While most of the bronchogenic cysts reported in the literature so far were located either in the lung parechym or in the mediastinum near the tracheal bifurcation or main bronchi. the cyst presenting in this study was originated in the wall of the esophagus and was reported to be very rare. The cystic tumor was found accidentally by X-ray fluoroscopic examination of the esophagus and stomach in the patient with gastric hemorrhage. X-ray study revealed that the cystic tumor was oval in shape and located in the left posterolateral wall of the esophagus in the thoracic lower third. Two surgical operations, gastrectomy for gastric hemorrhage and the resection of the cystic tumor, were carried out separately. Gastrectomy including the removal of prepyloric ulcer by the Billroth II type procedure was performed in regular fashion, and the cystic tumor was resected radically without any injury of the mucous membrane of the esophagus. The cyst removed appeared to be filled with mucinous material, and histological examination identified the tumor as a bronchogenic cyst with ciliated epithelial internal lining. Postperative course of the patient was uneventful.

• Journal of Chest Surgery
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• 제40권12호
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• pp.878-881
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• 2007

흉강경적 종격동 종양 절제 후 발생하는 뇌공기증은 매우 드문 합병증으로, 척수근 주위 경막의 손상으로 인해 발생한 거미막하강-흉강 누공이 그 원인이다. 후종격동 종양으로 흉강경적 종양 절제술을 시행 받은 60세 환자가 수술 직후부터 지속적인 오심과 두통을 호소하여 시행한 뇌 전산화 단층 촬영에서 뇌공기증이 진단되었고, 보존적 치료로 호전되었기에 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제20권1호
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• pp.106-111
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• 1987

Twenty eight patients with atrial septal defect operated on from May, 1983, to July, 1986 at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, were analyzed retrospectively. Among the 28 patients of atrial septal defect, 8 were male and 20 were female. Their ages ranged from 4.6 years to 52.5 years old with the mean of 15.3 years. The main clinical symptoms on admission were exertional dyspnea [82%], frequent respiratory infection [75%], palpitation [54%] and easy fatigability [25%]. Electrocardiographic findings were as follows: Regular sinus rhythm [100%], RVH [54%], RBBB [25%] and first degree of A-V block [4%]. Hemodynamic studies were performed in all cases and mean pulmonary systolic arterial pressure was 34.1*11.8mmHg. and mean Qp/Qs was 2.6*0.9. All 28 patients were operated under direct vision using extracorporeal circulation. 23 cases were secundum type defect and a single hole was found in 22 cases. The associated cardiovascular anomalies were found in 11 patients: ventricular septal defect in 3, patent ductus arteriosus in 1, partial anomalous pulmonary venous drainage in 2, mitral regurgitation in 2, tricuspid regurgitation in 1, anomalous left atrial septation in 1 and valvular pulmonary stenosis in 1. The defect closed directly in 22 cases and with patches in 6 cases. Postoperative complications were wound infection, arrhythmia bleeding, intracardiac patch detachment, pneumothorax and urethral injury. But there was no operative mortality.

• Journal of Chest Surgery
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• 제16권1호
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• pp.97-101
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• 1983

The steadily increasing number of operations performed on the heart has given rise to occasional complications involving the nervous system, and this has been interested to cardiac surgeons and neurologists. This survey has been carried out on all Gases submitted to open heart surgery at Seoul National University Hospital during 1982 to determine which operative features were associated with the occurrence of neurological damage. 514 subjects were studied and neurological damage was noted in twenty-five patients [4.9%]. Eight of these 25 patients died in the postoperative period, but neurological damage contributed to the fatal outcome in six cases. Remaining seventeen patients were discharged without problems except one Cortical blindness and one hemiplegic patients who were survived without other problems . A number of features were found to be related to the development of neurological damage, which were age, duration of perfusion, nature of operation, cardiac rhythm and presence of the thrombi or calcification and hypothermic arrest. But many unknown etiological factors are remained out of our sight. A significant increase in the incidence of neurological damage was shown in older age group [13.3% in over 40 year of age], and also the duration of the bypass was associated with subsequent neurological injury especially more than 120 minutes [11.6%]. The presence of atrial fibrillation with intracardiac thrombi or calcification was also a contributing factor to developing neurological complication [16.7%]. These factors were regarded to influence the postoperative neurological complications and more effective method for prevention of these neurologic complication should be studied.

• Journal of Chest Surgery
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• 제17권4호
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• pp.565-573
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• 1984

The increasing use of cardioplegic solution for the reduction of ischemic tissue injury requires that all cardioplegic solution be carefully assessed for any protective or damaging properties. This study describes functional assessment of the efficiency of steroid in cardioplegic solution by using a Langendorffs perfusion model. Isolated rat heart were subject to a 2 minute period of coronary infusion with the steroid mixed cold cardioplegic solution immediately before and also at the midpoint of a 60 minutes period of hypothermic [10\ulcorner\ulcorner] ischemic arrest. The result of this study were as follows: 1.Spontaneous heart beat after ischemic arrest occurred 14 second later Langendorffs reperfusion in the steroid mixed Young & GIK group and 16 second later in the control group. [Young & GIK without steroid] A good recovery state of spontaneous heart beat was shown in both groups. 2.The percentage of recoveries of heart rate during the 30 minute after postischemic Langendorffs reperfusion was; at first 5 minute 106.3\ulcorner.7% [P<0.05] in the steroid mixed Young & GIK group. This percentage of recovery of steroid mixed Young & GIK group was significantly greater than the control group during the first 5 minute course. 3.The percentage of recovery of coronary flow during the 30 minute after postischemic Langendorffs reperfusion was; at first 5 minute 101\ulcorner.2% in the steroid mixed Young & GI K group. This percentage of recovery of the steroid mixed Young & GIK group was not significantly than the control group during the first 5 minute.

• Journal of Chest Surgery
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• 제29권1호
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• pp.63-66
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• 1996

폐 절제술후 기관지 늑막루를 갖는 농흥은 흔하지는 않지만 치료가 매우 힘든 치명적인 합병증이다. 본 이화대학교목동병원 흉부외과에서는 1993년 10월 부터 1994년 12월 까지 본원에서 기관지 늑막루를 갖는 농흥을 근성형술을 이용하여 치료하였다. 치료는 술전 농흥강내 세척을 실시하고 수술대에서 염증조직을 완전히 제거한후 신경 혈관속이 보존된 근육으로 농흥강내를 채웠다. 술후 추적관찰 기간은 4개월에서 12개월 이었다. 수술한4명중 3명은 수술이 성공한 것으로 생각되며 1명은실패로 생각된다. 실패의 원인으로 농흥강을 채운 복직근의 혈관손상으로 인한 무혈성 괴사와 농흥강내 잔존한 염증조직이 다른 근육을 감염시켜 같이 괴사 하였다고 생각된다.