• Title/Summary/Keyword: Thoracic Expansion

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clinical evaluation of spontaneous pneumothorax -A review of 186 cases- (자연기흉의 임상적 고찰)

  • Kim, Jong-Jin;Jang, Jeong-Su
    • Journal of Chest Surgery
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    • v.20 no.2
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    • pp.251-255
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    • 1987
  • In this study, 186 cases of spontaneous pneumothorax experienced at the Dept. of thoracic and Cardiovascular surgery, chosun University Hospital during from Jan. 1978 to Mar. 1987 were analysed retrospectically. The results were as follows: 1. The sex ratio of the stadied patient was 2.5:! in male prominence and the incidence and the incidence was highest in the adolescence between 20-29 year of age. 2. The clinical symptoms were frequently Dyspnea (52.2%) and Chest pain (38.7%). The etiologic factors were as follows, Tuberculous origin in 55.9%, Unknown origin in 17.2%, Bullae in 11.8%. 3. In the method of treatment, closed thoracotomy was the most effective procedure in achieving the expansion of collapsed lung in 87.1%. Other methods were bed rest with high oxygen inhalation, thoracentesis and open thoracotomy. 4. The incidences of complication were developed in 12.4% and recurrent rates were seen in 9.7%.

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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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Reexpansion Pulmonary Edema (재팽창성 폐부종 3례 보고-)

  • Oh, Duck-Jin;Lee, Young;Lim, Seung-Pyeung;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.581-584
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    • 1996
  • Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothordx, pleural effusion, or atelectasis but occasionally life threatening. Generally, reexpansion pulmonary edema is believed to o cur only when a chronically collapsed lung is rapidly reexpanded by evacuation or large amounts of air or fluid. This complication is heralded by tachypnea, unilateral rales, and profuse expectoration of frothy secretion within several hours of reexpansion. Increased dur- ation of pneumothorax and the use o( suction are important factors in the generation of reexpansion pulmonary edema. We had experienced 3 cases of reexpansion pulmonary edema. In the two cases the pneumothorax had been present for several days, and, after insertion of a chest tube, pulmonary edema developed unilaterally but improved with supplemental oxygen. In the third case, massive pleural effusion was present. and, after insertion of a chest tube, pulmonary edema developed unilaterally, followed by cardiac arrest. He died of pulmonary edema inspire of resuscitation.

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Expandability of Cephalic Veins after Brachial Plexus Block in Arteriovenous Fistula Formation for Hemodialysis

  • Chun, Sangwook;Ryu, Jae-Wook;Ryu, Kyoung Min;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.31-35
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    • 2021
  • Background: Arteriovenous fistula (AVF) for hemodialysis is essential for patients with end-stage renal disease. However, it is difficult to maintain AVF reliably. It is vitally important to select proper blood vessels for AVF formation. In a previous study, a minimum diameter of 3 mm for the autologous vein was proposed. However, patients who did not meet the minimum vascular diameter before anesthesia, but fulfilled other criteria, showed satisfactory venous dilatation after brachial plexus block (BPB). This study investigated the extent of vein expansion by BPB and the surgical outcomes of dilated veins after BPB. Methods: Sixty-one patients who underwent AVF formation using an autologous vein between August 2018 and December 2019 were included in the study. The clinical characteristics of the patient groups, hemodynamic parameters including the diameter of blood vessels before and after BPB, and complications were investigated. Based on the venous diameter measured by sonography before anesthesia, patients were divided into group A (26 patients) and group B (35 patients), with venous diameters <3 mm and ≥3 mm, respectively. Results: The venous diameter expanded after anesthesia by 41% overall, by 62% in group A, and by 25% in group B. This difference between groups A and B was statistically significant (p=0.001). No other variables showed statistically significant differences. Conclusion: Sufficient venous dilatation was observed after BPB. Therefore, if the vein is sufficiently dilated after BPB, even in patients with a pre-anesthesia venous diameter <3 mm, surgery may still be performed with an expected desirable outcome.

Tracheal Compression by Xhronic Dissecting Aeurysm(TYpe B) -A Case Report- (기관지 압박을 초래한 만성 해리성 대동맥류(Type B) -임상적 치험 1례-)

  • 송정근
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.328-331
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    • 1995
  • A 42-year-old Marfan female had a chronic dissection of the descending aorta[Type B and the aneurysmal expansion of the descending aorta caused compression of the trachea resulting in respiratory distress which mimicked bronchial asthma. The patient has been successfully managed by resection and replacement of the aneurysm in the descending aorta. The operation could be done without the aid of the partial cardiopumonary bypass. As the patient had been prepared by unilateral axillo-bifemoral by-pass using prosthetic graft 8mm in diameter 10days prior to the main operation.

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Allocation of Donor Lungs in Korea

  • Yeo, Hye Ju
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.274-276
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    • 2022
  • The expansion of indications for lung transplantation, the growth of the waiting list, and donor shortages are increasing the waiting list mortality rate in Korea. The current lung allocation system in Korea is based mainly on urgency, but outcomes should also be considered to avoid futile transplantation. This review describes the current status of, and issues with, the lung allocation system in Korea including donors, the waiting list, and transplant outcomes in the context of an aging society, in which the frequency of end-stage pulmonary disease is increasing.

Re-Expansion Pulmonary Edema Associated with Resection of Ruptured Hlediastinal Thymic Cyst -A Case Report (파열된 종격동 흉선낭종의 절제술후 동반된 재팽창성 폐부종 -1례 보고-)

  • Jo, Deok-Geun;Lee, Jong-Ho;Gwak, Mun-Seop
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1149-1153
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    • 1997
  • Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

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Clinical Evaluation of Spontaneous Pneumothorax - A review of 360 cases - (자연기흉의 임상적 고찰: 360례 보고)

  • O, Chang-Geun;Im, Jin-Su
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.757-764
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    • 1991
  • We have observed 360 cases of spontaneous pneumothorax from January 1980 to May 1991 at the department of Thoracic and Cardiovascular Surgery, Chosun University Hospital. Males occupied 266 cases[73.9%] and females 94 cases[26.1%], and its ratio was 2.8: l. The age of patients ranged from neonate[5 days] to 84 years old. The site of pneumothorax was right in 50.3%, left in 43.3% and bilateral in 6.4%a. The clinical symptoms were frequently dyspnea, chest pain and coughing. The associated pulmonary lesions were shown pulmonary tuberculosis in 199 cases[55.3%], bullae in 54, pulmonary emphysema in 31, COPD in 17, pneumonia in 6, lung cancer in 5, paragonimiasis in 5, catamenial pneumothorax in 3 and unknown underlying pathology in 39 cases. The results of surgical management of spontaneous pneumothorax are followings: 288 out of 360 cases[80.0%] were cured by closed thoracotomy, 53 cases[14.8%] were cured by open thoracotomy. Open thoracotomy was the most effective procedure in persistent air leakage, recurrent pneumothorax, visible bleb or bullae on the chest X-ray, associated lesion, bilateral simultaneous pneumothorax, parenchymal incomplete lung expansion and bleeding after closed thoracotomy. The incidence of complication was developed in 10. ado and recurrent rate was seen in 10.6%. There was no operative death.

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Clinical Evaluation of Chest Trauma - Analysis for 97 cases - (흉부외상의 임상적 고찰)

  • 정원상
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.307-315
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    • 1988
  • A clinical analysis was performed on 97 cases of chest injuries experienced at Department of Thoracic and cardiovascular Surgery, Armed Forces Capital Hospital during 2 years period from 1986 to 1988. Of 97 patients of chest trauma, 39 cases were result from penetrating injuries whereas 58 cases were from non-penetrating injuries, and there were 77 cases of hemothorax and / or pneumothorax, 47 of rib fracture, 8 of foreign body, 6 scapular and clavicle fracture, 5 of diaphragmatic injuries, 4 of paraplegia. The majority of chest injuries were encounted in the age group between 21 and 30 years-old, mean age was 25.9 years-old and all cases were male except one. Gun-shot wound was the most common cause in the penetrating injuries and the majority of non-penetrating chest injury patients were traffic accident and fist or kick accounted for next. The principles of therapy for chest trauma were rapid expansion of the lung by closed thoracostomy[45 cases] and thoracentesis only[3 cases] but thoracotomy done at 27 cases because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic injury and bronchial rupture. The over-all mortality was 2.07 percent[2 cases among all], a case was from penetrating injuries and another was from non-penetrating injuries.

New Measurement Technique of Expiratory Air Flow Rate Using Miniatured Air Chamber (소형 공기챔버를 센서소자로 사용하는 새로운 호식기류 계측기술)

  • Kim, Kyung-Ah;Lee, Jae-Hun;Kim, Goon-Jin;Lee, Tae-Soo;Cha, Eun-Jong
    • Journal of Sensor Science and Technology
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    • v.13 no.2
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    • pp.79-84
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    • 2004
  • Asthma is one of the important respiratory diseases requiring home self care usually performed by commercialized peak expiratory flow meter (PEFM). However, this simple device can measure only single parameter, PEF, due to its purely mechanical principle, significantly limiting desease management quality. The present study introduced a new expiratory flow measurement technique by miniatured air expansion chamber easily installed within PEFM. Continuous pressure signal obtained from the chamber demonstrated an accurate quadratic relationship with flow. The volume measurement error was $<{\pm}1%$ well within the American Thoracic Society (ATS) criteria of 3%. Important spirometric parameters of FVC, PEF, and FEF25-75% were all accurately estimated with correlation coefficients > 0.95. The present technique obtains continuous expiratory air flow signal, making possible and convenient to perform spirometric test at home. Electronic interface capability would be also useful for remote asthma management.