• Title/Summary/Keyword: Lobe

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Interfissural Fixation of the Right Middle Lobe after Video-Assisted Thoracic Surgery Right Upper Lobectomy: Bronchial Anatomical Changes and Efficacy in Preventing Torsion

  • Dong Jae Han;You Jung Ok;Se Jin Oh;Jae-Sung Choi;Yong Won Seong;Hyeon Jong Moon
    • Journal of Chest Surgery
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    • v.57 no.5
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    • pp.477-483
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    • 2024
  • Background: Torsion of the right middle lobe following right upper lobectomy is a rare but potentially fatal complication. To prevent this, fixation of the right middle lobe has been suggested. This study was performed to examine the impact of right middle lobe fixation on postoperative outcomes and bronchial changes. Methods: We enrolled patients who underwent curative-intent video-assisted thoracic surgery (VATS) right upper lobectomy for lung cancer from 2019 to 2022. Participants were grouped based on whether they did or did not receive right middle lobe fixation. Bronchial angles were measured using preoperative and postoperative chest computed tomography images, and postoperative outcomes and bronchial changes were compared between the 2 groups. Results: The study included a total of 50 patients, with 17 (34%) undergoing right middle lobe fixation. All procedures were performed using VATS. No significant differences between groups were observed in preoperative characteristics or postoperative outcomes. After surgery, both groups exhibited a significant increase in the right bronchus intermedius angle and a significant decrease in the branch angle. The postoperative right bronchus intermedius angle was significantly larger in the group without right middle lobe fixation compared to the group with fixation (47.38°±10.98° vs. 39.41°±9.21°, p=0.014). Three cases of atelectasis occurred in the group that did not undergo fixation while no cases were observed in the fixation group; however, this difference was not statistically significant. Conclusion: Fixation of the right middle lobe reduced postoperative angulation of the right bronchus intermedius, which may help prevent postoperative atelectasis.

Lobe Curve Characteristic Analysis of Resistance Spot Welding for Sheet Combination of 780MPa Steel Sheet Using Simulation (시뮬레이션을 이용한 780MPa급 강재의 판재 조합에 따른 저항 점 용접의 로브곡선 특성 분석)

  • Son, Chang-Seok;Park, Young Whan
    • Journal of Welding and Joining
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    • v.30 no.6
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    • pp.68-73
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    • 2012
  • Nowadays, car manufacturers tried to improve automotive fuel efficiency, and applied many high strength steels such as AHSS or UHSS to car bodies. Therefore, the number of steel combinations for the resistance spot welding are dramatically increased and the need for weldability evaluation of these combinations are also required. In this study, we suggest the lobe curve using FEM simulations for DP780 steel with 1.0t, 1.4t. The lobe curves which could expressed weldablity and optimal welding condition were obtained according to 6 steel combinations. There were two combinations for same steel sheet which were DP780 1.0t, DP780 1.4t. Dissimilar steel sheet combination with different thickness was 1.0t and 1.4t of DP780. Different steel combinations were DP780 1.0t and SPRC440 1.0t, and DP780 1.0t and DP590 1.0t. Finally dissimilar combinations was and DP780 1.0t and DP590 1.4t. The trend of low boundary and high boundary variation of lobe curve were analyzed with a viewpoint of the contact resistance and the heat input.

Analysis of the Ultrasonic Beam Profile Due to Variation of the Inter-Element Spacing for the Phased Array Transducer (페이즈드 어레이 트랜스듀서에 있어서 구성 압전소자의 간격 변화에 따른 초음파 빔 전파 특성 해석)

  • Choe, Sang-U;Lee, Jun-Hyeon
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.24 no.4 s.175
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    • pp.972-981
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    • 2000
  • The phased array transducer has two distinct advantages. One is rapid scanning comparing with the conventional mechanical or manual scanning system. Therefore, output image is represented in real-time. The other is the dynamic focusing and the dynamic steering of ultrasonic beam. Only the delay times that are controlled electrically are used to focus and to steer beam without any lenses or wedges. In this study, the profile of the ultrasonic beam for the phased array transducer has been simulated in the Huygens principle with varying the inter-element spacing of the linear phased array transducer. From the result of this study, it was found that the ultrasonic beam spread wider as the inter-element spacing was decreased. However, the focusing effect was improved, even when the number of the element was not big. In addition, there was grating lobes that are constructed when the inter-element spacing is more than half wavelength. However, this grating lobe has lower amplitude than the main lobe.

Intramedullary Spinal Cord Metastasis of Choriocarcinoma

  • Ko, Jun-Kyeung;Cha, Seung-Heon;Lee, Jung-Hwan;Choi, Chang-Hwa
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.141-143
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    • 2012
  • The authors describe a case of choriocarcinoma that metastasized to the cerebral cortex, vertebral body, and intramedullary spinal cord. A 21-year-old woman presented with sudden headache, vomiting and a visual field defect. Brain computed tomography and magnetic resonance examinations revealed an intracranial hemorrhage in the left temporo-parietal lobe and two enhancing nodules in the left temporal and right frontal lobe. After several days, the size of the hemorrhage increased, and a new hemorrhage was identified in the right frontal lobe. The hematoma and enhancing mass in the left temporo-parietal lobe were surgically removed. Choriocarcinoma was diagnosed after histological examination. At 6 days after the operation, her consciousness had worsened and she was in a state of stupor. The size of the hematoma in the right frontal lobe was enlarged. We performed an emergency operation to remove the hematoma and enhancing mass. Her mental status recovered slowly. Two months thereafter, she complained of paraplegia with sensory loss below the nipples. Whole spine magnetic resonance imaging revealed a well-enhancing mass in the thoracic intramedullary spinal cord and L2 vertebral body. Despite chemotherapy and radiotherapy, the patient died 13 months after the diagnosis.

Right Lower Sleeve Bilobectomy for Lung Cancer with Posteparterial Tracheal Bronchus

  • Kim, Hongsun;Kim, Jinsik;Cho, Jong Ho;Shin, Su Min;Kim, Hong Kwan;Kim, Jhingook
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.300-304
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    • 2017
  • A 42-year-old man was diagnosed with cancer of the right lower lung lobe with a posteparterial type of tracheal bronchus, in which the posterior segmental bronchus of the right upper lobe arose from the distal bronchus intermedius. A mass involved the distal bronchus intermedius, requiring a right lower bilobectomy with an additional posterior segmental resection of the right upper lung lobe. Thus, we performed a right lower bilobectomy and sleeve anastomosis of the posterior segmental bronchus of the right upper lobe to the proximal bronchus intermedius, sparing the pulmonary parenchyma of the same lobe.

Multiple Sclerosing Hemangiomas of the Lung - A Case Report - (폐에 발생한 다발성 경화성 혈관종 수술 치험 1 례)

  • 전순호;정태열;전양빈;정원상;김영학;강정호;지행옥;홍은경;전석철
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.408-412
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    • 1999
  • Since sclerosing hemangioma of the lung was first described by Liebow and Hubbell in 1956, there have been several reports on cases occurring as a solitary nodule; however, sclerosing hemangiomas occurring as multiple nodules are extremely rare. The histogenesis of this tumor remains controversial and there are several hypotheses of the etiology. Three separate nodules were found in a 57-year-old housewife, one found in the right middle lobe, one in the apicoposterior segment of the left upper lobe, and one in the superior segment of the left lower lobe. The only symptom or sign presented was a dry cough. Apicoposterior segmentectomy of the left upper lobe and wedge resection of the superior segment of the left lower lobe were performed. The postoperative course was uneventful and the patient was discharged on the postoperative 15th day.

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Middle Lobe Syndrome Caused by Occult Foreign Body in the Bronchus Intermedius -A case report- (중간기관지 내 잠복이물에 의할 중엽증후군 -1예 보고-)

  • Lee Seung-Jin;Oh Jae-Yoon;Lee Cheol-Sae;Lee Kihl-Rho;Lee Seock-Yeol
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.498-501
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    • 2006
  • Occult bronchial foreign body is that long-standing foreign body lodge in bronchial tree. A 63-year-old male was admitted our hospital complaining of a cough. Chest computerized tomography and bronchoscopy showed collapse of right middle lobe and foreign body in the bronchus intermedius. After open thoracotomy and bronchotomy, foreign body was removed and collapsed middle lobe was ventilated. Herein we report a case of middle lobe syndrome caused by occult foreign body in the bronchus intermedius.

Surgical Management of Tracheal and Bronchial Stenosis (기관및 기관지 협착증 환자의 외과적 치료)

  • 유정훈
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1299-1304
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    • 1992
  • We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

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Development of Resistance Spot Weldability Estimation Using Lobe Diagram for Steel Plate of Automobiles (로브곡선을 이용한 자동차용 신강재의 저항 점 용접성 평가 기술 개발)

  • Kim, Tae-Hyung;Lee, Dong-Ock;Rhee, Se-Hun
    • Journal of Welding and Joining
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    • v.23 no.4
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    • pp.59-65
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    • 2005
  • The resistance spot welding is one of the most commonly used welding process for joining the sheet metal in automotive manufacturing process due to higher deposition rates and higher economy achieved. Control variables in the resistance spot welding for achieving high quality are welding current, welding force and welding time. Generally at the manufacturing scene, welding current Vs welding time lobe diagram is used to estimate weldability because controlling welding force is not practical due to economical reasons. However new automotive steel plates have been developed to make lightweight automobiles and to improve resistance against rusting. Also the weldability of these steel plates are worst than the existing steel plates because of changing bare metal and surface plating effect. In consequence of above mentioned reasons, it is necessary to use welding force to present the lobe diagram. In this study, we obtained the welding force Vs welding current lobe diagram for commonly used GA steel plate and found that the second order repression model of tensile shear strength was useful in reducing the number of experiments, and the indentation, and thickness change during welding were used as a response to estimate quantitatively expulsion.

Effects of an Exercise Program on Frontal Lobe Cognitive Function in Elders (운동 프로그램이 노인의 전두엽 인지기능에 미치는 효과)

  • Shin, Mee-Kyung
    • Journal of Korean Academy of Nursing
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    • v.39 no.1
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    • pp.107-115
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    • 2009
  • Purpose: The purpose of this study was to identify the effects of an exercise program on frontal lobe cognitive function in seniors. Methods: The participants were 42 seniors using a health center in Seoul (experimental group) and 28 seniors using a facility for elders in Seoul (control group). The exercise program was carried out for 16 weeks from April to August 2007. The frontal lobe cognitive function, which includes short term memory, attention, immediate memory, delayed memory, verbal fluency and motor function, was measured by the Digit Span Forward test, Trail Making test, Immediate recall words test, Delayed recall words, Controlled oral word association test and Finger tapping test. The collected data were analyzed by Fisher's exact test, Chi-square, t-test, and ANCOVA using the SAS program. Results: The major findings of this study were as follows: Attention (p=.009), immediate memory (p=.005), delayed memory (p=.009), and verbal fluency (p=.004) improved after the exercise program. Conclusion: In this study, the exercise program was effective in improving frontal lobe cognitive function in elders. So it provides basic information for further nursing education on exercise programs which will be effective for prevention of early cognitive function decline in normally aging elders.