• Title/Summary/Keyword: Chronic empyema

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Surgical Treatement of Lung Actinomycosis (폐방선균증의 외과적 치료 -2례 보고-)

  • Park, Kyung-Sin;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.419-422
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    • 1995
  • Pulmonary actinomycosis is a chronic pulmonary infection characterized by suppuration, abscess formation, and dense scarring. The causative agent, Actinomyces israelii, is a gram-positive, microaerophilic bacterium that resemble fungi. We recently treated two cases of pulmonary actinomycosis. A patient was underwent right lower lobectomy under the impression of bronchiectasis. Pulmonary actinomycosis was diagnosed of postoperatively. He was medicated with high-dose penicillin parenterally. The other patient was also undergone right lower lobectomy under the impression of broncholithiasis and received parenteral penicillin and oral roxythromycin. There was no recurrence or development of empyema. The purpose of this paper is to review of our experience and to enhance consideration of pulmonary actinomycosis.

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Modified Eloesser's Operation and Its Result In Chronic Empuema with Poor General Condition or Chachecic State (만성 농흉에 대한 Modified Eloesser's Operation 과 그 의의)

  • 최종범
    • Journal of Chest Surgery
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    • v.12 no.2
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    • pp.82-88
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    • 1979
  • During the past 3 years, 15 patients who could not be anesthetized generally because of poor general condition or cachecic state, of 111 patients with empyema, have been treated with modified Eloesser`s operation under the local anesthesia with 2% procaine. There were 13 males and 2 females ranging from 21 years to 61 years of age. The etiology was tuberculosis [6 cases], pyogenic pneumonia [5 cases], lung abscess [1 case], post-trauma [2 cases] and malignancy[1 case]. " The over-all mortality rate was 6.7%[1 case] and cause of its death was poor oral feeding because of post-traumatic psychosis. Modified Eloesser`s operation was performed after closed tube thoracostomy and irrigation with 1% zephanon solution for over 2 weeks. And then the other operation was not performed and all patients except 1 case appeared good progression (Complete healing; 4 cases, Progressive healing 10 cases, death: 1 case).

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Histologic Change of Free Muscle Graft in the Rabbit Pleural Space (토끼에서 늑막강내 자유근육이식의 조직학적 변화: 술후 공기누출방지를 위한 자유근육이식술의 예비실험)

  • 원용순
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.10-15
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    • 1989
  • Excision of bullous emphysema or decortication of chronic empyema commonly results in a prolonged air leakage. Prolonged air leakage requires prolonged intercostal drainage, delays recovery, and can be followed complications such as pneumothorax, atelectasis, incomplete expansion of remained lung, secondary infection. To minimize these complications free muscle grafts can be used like a patch to close the opening of visceral pleura and reinforce suture lines without undue tension. From a preliminary study using the latissimus dorsi muscle as a free muscle graft in the rabbit pleural space, viable muscle fibers that seems the result of the process of regeneration can be consistently identified around the degenerating muscle fibers. Voluminous connective tissues and numerous blood vessels are also observed in the peripheral zone. Further studies in that free muscle graft will be sutured with visceral pleura and lung parenchyme will hopefully provide additional information before clinical application.

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Phrenoplasty [Diaphragmatic Thoracoplasty]: Report of 5 Cases (횡격막 성형술: 5례 보고)

  • 배두현
    • Journal of Chest Surgery
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    • v.3 no.2
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    • pp.113-120
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    • 1970
  • Since the turn of the century there has been a constant search for a satisfactory method of controlling a large intrathoracic space following lobectomy. Primarily these methods consist of thoracoplasty, plombage, and phrenic nerve paralysis which are not completely satisfactory for they may result in loss of chest wall motility or diaphragmatic function. Incising the diaphragm at its periphery and resuturing to the chest wall at a level several rib spaces higher is an effective method of reducing intrathoracic space with minimal interference with pulmonary function. It is of particular value when the anticipated space problem is in the lower part of the thoracic cavity. Five cases are presented in which the diaphragm was peripherally detached and advanced to higher levels. Two cases were following lower lobectomy and three cases were following decortication for chronic empyema in which expansion was not good enough to adequately fill the space. Results in these cases were satisfactory.

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Video-Assisted Thoracic Surgery Under Epidural Anesthesia -in High-Risk Group (경막외마취하에 비디오 흉강경수술 - 고위험군에서)

  • Lee, Song-Am;Kim, Kwang-Taik;Kim, Il-Hyeon;Park, Sung-Min;Baek, Man-Jong;Sun, Kyung;Kim, Hyoung-Mook;Lee, In-Sung
    • Journal of Chest Surgery
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    • v.32 no.8
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    • pp.732-738
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    • 1999
  • Background: Video-assisted thoracoscopic surgery has become a standard therapy for several diseases such as pneumothorax, hyperhidrosis, mediastinal mass, and so on. These methods usually required single-lung ventilation with double-lumen endobronchial tube to collapse the lung under general anesthesia. However, risks of general anesthesia itself and single-lung ventilation must be considered in high-risk patients. Material and method: Between December 1997 and July 1998, eight high-risk patients (6: empyema, 1: intractable pleural effusion, 1: idiopathic pulmonary fibrosis) with underlying pulmonary disease and poor general condition were treated by video-assisted thoracoscopic surgerys under epidural anesthesia and spontaneous breathing. Result: Video-assisted thoracoscopic surgerys were successfully per formed in 7 patients. Conversion to general anesthesia was required in 1 patient because of decrease in spontaneous breathing. But, conversion to open decortication was not required. In two patients with chronic empyema, one patient required thoracoplasty as a second procedure and one patient required re-video-assisted thoracoscopic procedure due to a recurrence. The mean operative time was 31.8$\pm$15.2 minutes. No significant postoperative respiratory com plication was encountered. Conclusion: Video-assisted thoracoscopic surgerys can be per formed safely under epidural anesthesia for the treatment of empyema and diagnosis of pulmonary abnormalities in high-risk patients.

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A Case of Chronic Expanding Hematoma with Initial Presentation as Massive Hemotpysis through Bronchopleural Fistula in the Thorax (기관지 흉막루를 통해 대량 객혈을 한 만성 팽창성 혈종 1예)

  • Jeon, Eun Kyoung;Chung, Mun Kyung;Kim, Gun Min;Kang, Ji Young;Park, Hyun Jin;Kim, Seung Joon;Lee, Sook Young;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak;Kim, Young Kyoon
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.1
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    • pp.48-51
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    • 2008
  • Chronic expanding hematoma of the thorax is a specific subtype of the chronic empyema. It presents as a slowly expanding intrathoracic mass which result in dyspnea or recurrent hemoptysis. The symptoms develop months or years after tuberculous pleurisy, trauma or surgery. Usually, it shows three common findings: a giant mass lesion in the thorax, some surrounding calcifications, the absence of signs or symptoms of infection. We report a case of chronic expanding hematoma of the thorax, initially presenting as massive hemoptysis through bronchopleural fistula which resulted in radiologic findings of new air-fluid level within the previous pleural lesion filled with unknown materials.

Determination of Chemical Composition of Gallbladder Stones and their Association with Induction of Cholangiocarcinoma

  • Hussain, Saad Muhmood;Al-Jashamy, Karim Alwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6257-6260
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    • 2013
  • Gallstone disease is a major surgical problem in many populations; it is probably related to diet, especially excessive consumption of meat. The objective of this study was to determine the chemical composition of gallstones and their association with neoplastic changes including cholangiocarcinomas in cholecystectomised patients. The chemical composition of gallstones from 40 patients (8 males and 32 females) was analyzed. This is a prospective study performed in Baquba teaching hospital in the period from 1/10/2012 to 1/1/2013 in which we collected the gallstones for the patients who underwent cholecystectomy, whether open or laparoscopic. The stones were classified according to their chemical composition as a mixed stones (MS), and examined using a stone analysis set (chemical qualitative method) for calcium, magnesium, phosphate, uric acid and oxalate which was used reagent for qualitative determination of main individual components of stones. The results of this study showed the highest incidence of gallstones in the age group 40-49 was 13 cases followed by 11, 8 and 4 cases for age groups 30-39, 50-59, 20-29 and 60 and above, respectively. The chemical analysis showed the majority of gallstones were mixed, 38 containing calcium followed by 37 cases with uric acid, 28 with magnesium, and 25 and 22 stones with oxalate and phosphate, respectively. Microscopically, we confirmed neoplastic changes (17.5%) as cholangiocarcinomas (CCCs) (7.55%) and dysplastic cells of carcinoma in situ in 4 (10%), 31 (77.5%) cases were chronic cholecystitis and 2 (5%) cases were acute cholecystitis with empyema out of bile duct disorders patients. In conclusion, majority of cases had mixed gallstones that involved five and four of inorganic chemicals of calcium, magnesium and phosphate, the highest incidence of gallstones in age group 40-49 years old was 13 cases, and neoplastic changes were confirmed (17.5%) including CCCs, (7.5%) and dysplastic cells of carcinoma in situ (10%), while 31 (77.5%) cases were chronic cholecystitis.

Bilateral fibrothorax with constrictive pericarditis (위축성 심낭염 [Constrictive Pericarditis]을 동반한 양측성 섬유흉 [Fibrothorax] 치험 1)

  • Sun, Kyung;Kim, Yo-Han;Baek, Kwang-Je;Lee, Chol-Sae;Kim, Hark-Jei;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.703-708
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    • 1984
  • Fibrothorax is the end stage of chronic pathologic processes of pleura such as hemothorax, empyema, or tuberculous effusion. The pleural space become adherent and obliterated, and the lung parenchyma is covered by a thick, fibrous, unexpandable "peel", so the lung function is diminished markedly with impaired ventilation and oxygenation. Constrictive pericarditis is often accompanied fibrothorax, also cardiac and hemodynamic function is deteriorated. Surgical relief of these fibrous peels causes remarkable improvement in pulmonary function, cardiac and hemodynamic function, and subjective symptoms. We experienced a case of bilateral fibrothorax combined with constrictive pericarditis which occured 3 years after bilateral tuberculous effusion. Decortication and percardiectomy were done at the same time through bilateral submammary thoracotomy with sternal transection. Comparing postoperative Peripheral venous pressure, Circulation time, Pulmonary function test, Arterial blood gas analysis, Subjective symptoms with preoperative conditions showed noticeable improvement.provement.

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Surgical Correction of TO in Adults - 42 Cases Report - (성인 활로씨 사징증의 외과적 교정)

  • 안욱수
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.1-7
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    • 1991
  • This report describes our 10-year experience with intracardiac repair in 42 patients older than 16 year with tetralogy of Fallot. The mean age was 22.0$\pm$5.18 years[range 16~41]. The preoperative clinical manifestations were cyanosis & clubbing[93%], frequent URI [55%], anoxic spell[40%], pulmonary tuberculosis[21%], tuberculous empyema[7%], chronic renal failure[7%], congestive heart failure[7%] and subacute bacterial endocarditis [2%], etc. The previous shunt procedure for palliation had been performed in 7 patients. The type of VSD were typical perimembranous type[67%], total canal defect[28%] and combined type[5%]. The right ventricular outflow tract obstruction were combined type[69%], infundibular type[21%] and valvular type[10%]. Transannular patch was used in 50% of patients. Associated cardiovascular anomalies were ASD[33%], PFO[31%], Rt. aortic arch[10%], Lt. SVC[10%], single Rt. pulmonary artery, single Lt. coronary artery, ASI, proximal stenosis of Rt. pulmonary artery and anomalous systemic venous return, etc. Hospital mortality was 7.1%[3 cases]in overall. The causes of hospital deaths were revealed low cardiac output & acute renal failure[2 cases], postoperative bleeding[1 case]. There were 2 late deaths 3 & 68 months after surgery. Residual intracardiac shunt was detected in 2 patients. one patient was successfully reoperated and another patient had Qp /Qs ratio less than 1.5.

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The Literatural study of Bangpungtongsungsan (방풍통성산(防風通聖散)에 대한 문헌적(文獻的) 고찰(考察))

  • Lee, Woo-Yeol;Yoon, Il-Ji;Oh, Min-Suck
    • Journal of Haehwa Medicine
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    • v.14 no.1
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    • pp.155-165
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    • 2005
  • I have come to conclusion as follows about Bangpungtongsungsan after literatural study. 1. Bangpungtongsungsan is the medical treatment of heat, wind and dryness. 2. Bangpungtongsungsan is used in head-wind, dizziness, both eye disease, tinnitus, both ear deafness, nasal polyp, uriticaria, sajuabi, beard and hair falling, apoplexy, paralysis of hands and feet, dull mentality, tetanus, epidemic disease characterized by swelling and redness of face, carbuncle, daepungchang, pustule, syphilis, tinea capitis and so on. 3. Bangpungtongsungsan is used in the disease of cerebral hemorrhage, hypertension, arteriosclerosis, constipation, rosacea, hemorrhoids, cutaneous disease, empyema, eye disease, diabetes, asthma, obesity, beriberi, erysipelas, baldhead, fatty heart, chronic nephritis and so on. 4. Bangpungtongsungsan fits in Taeumin who has much wetness-heat and those who have much heat or have much heat but don't give off well. And it doesn't fit in the disease of intolerance to cold and fever in the form of weakness headache, asthenia of the spleen and stomach, cold by internal disorder and so on.

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