• Journal of Chest Surgery
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• v.48 no.3
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• pp.202-205
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• 2015

Formation of an aneurysm in the sinus of Valsalva of the aortic root is usually due to an area of congenital weakness in its wall. This aneurysm may progressively dilate and rupture into any of the cardiac chambers or into the pericardial cavity. Though this is conventionally treated by surgery, interventional therapy using various closure devices is becoming more common. Embolization of these closure devices may occur. We report a case of embolization of such a device into the left pulmonary artery which during surgical retrieval, unmasked the hidden ventricular septal defect (VSD). Therefore one has to be cautious while making a diagnosis of rupture of the sinus of Valsalva of right coronary sinus without VSD.

• Archives of Plastic Surgery
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• v.36 no.6
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• pp.795-798
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• 2009

Purpose: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural - cutaneous fistula developed after undergoing lobectomy for lung cancer. Methods: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleural - cutaneous fistula. Results: The patient has remained healed for 14 months without any postoperative complications and recurrent infection or fistula. Conclusion: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.

• Korean Journal of Veterinary Research
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• v.15 no.2
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• pp.271-277
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• 1975

한국재내산양(韓國在來山羊) 11두(頭)의 흉벽근(胸壁筋)을 절개하여 관찰하였던 바 다음과 같은 결과(結果)를 얻었다. 1. 산양(山羊)의 흉벽(胸壁)에는 횡격막을 포함하여 11개의 筋들을 확인할 수 있었다 : 전배거근(前背鋸筋) M. serratusdorsalis cranialis, 후배거근(後背鋸筋) M. serratus dorsalis caudalis, 사각근(斜角筋) M. scalenus, 늑횡근(肋橫筋) M. transversus costarum, 늑골거근(肋骨擧筋) Mm. levatores costarum, 외늑간근(外肋間筋) Mm. intercostales externi, 내늑간근(內肋間筋) Mm. intercostales interni, 늑연골간근(肋軟骨間筋) Mm. intercartilaginei, 늑골후인근(肋骨後引筋) M. retractor costae, 흉횡근(胸橫筋) M. transversus thoracis, 횡격막(橫隔膜) Diaphragma. 2. 전배거근(前背鋸筋)의 발달이 아주 미약하여 단지 1예(例)에서만 볼 수 있었다. 3. 사각근(斜角筋)은 천부(淺部)(M. scalenus supracostalis)와 심부(深部)(M. scalenus primal costae)로 구분되었으며 이들은 각각 배(背), 복(腹)으로 나누어졌고, 천부(淺部)는 제 1늑골 및 제 3~4늑골에서 기시(起始)하고 있었다. 4. 늑연골간근(肋軟骨間筋)은 제 7늑간에서는 양쪽 늑골이 서로 밀접하게 붙어있어 나타나지 않았으며, 제 1늑간 부터 제 6늑간 사이에서는 섬유방향이 거의 수평으로 향하고 있어 내늑간근(內肋間筋)의 연장으로 보이고 제 8늑간 부터 마지막 늑간사이에서는 거의 수직으로 향하고 있어 외늑간근(外肋間筋)의 연장으로 보인다.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.701-711
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• 1991

We experienced 6 cases of primary cardiac tumor, all received operation for removal of tumor. Mean age was 43.8 years-old ranging from 17 years-old to 66 years-old. Five cases were female, one case was male. Five cases were benign, myxoma, all located within left atrium. One case was malignant, angiosarcoma within right atrium. All patient showed cardiac manifestations. One case was in NYHA functional class II, two were in III, three were in IV. Four patients showed constitutional symptoms, but no one showed evidence of embolic phenomenon. All case of myxoma showed cardiomegaly except one malignancy. Only one case was regular sinus rhythm, three were sinus tachycardia 8z two were atrial fibrillation. The most common site of tumor origin was fossa ovalis limbus[four of all]. Two of five myxomas received emergency operation, one patient died postoperatively. Lived four patients showed no evidence of recurrence[mean follow-up, 3,5 years], but one patient has Grade II /IV mitral regurgitation & in OPD follow-up now, One malignant case, 17 years-old cerebral palsy female, was angiosarcoma occupied most of right atrial chamber originated from anterior wall of right atrium, received emergency operation which was removal of mass & reconstruction of right atrium with artificial pericardial patch. This patient died on postoperative 36th day due to persistent LCOS[low cardiac output syndrome] with combined sepsis.

• Journal of Chest Surgery
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• v.24 no.7
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• pp.693-700
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• 1991

A rare case of the association of distal aortopulmonary septal defect, aortic origin of the right pulmonary artery, intact ventricular septum, patent ductus arteriosus and interrupted aortic isthmus in a 40-day-old infant is reported. The infant was suffered from two operations with an interval of nine days. At the first operation a 10mm polytetrafluoroethylene prosthesis was inserted instead of the interrupted aortic isthmus and ductus was ligated via the left posterolateral thoracotomy. But the patient could not be weaned from the respirator because of large amount of left-to-right shunt. So the total correction was subsequently performed after an interval of nine days. At the second operation, tunneling of the right pulmonary artery to the main pulmonary artery through the aortopulmonary septal defect was performed using the Dacron patch via a longitudinal transaortic approach and a separate autologous pericardial patch was applied to the longitudinally incised margins of the anterior wall of the ascending aorta. The second postoperative course was relatively uneventful except some respiratory distress and nutritional problems. Now he is at 6 months of age and thrives well without any symptom. Because the success of the surgical repair of this complex anomalies depends upon the accurate diagnosis and meticulous design of each step of procedure prior to operation these problems are also discussed.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.930-934
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• 1999

Background: The purpose of this study is to analyze the clinical results ad operative compatability by Ravitch methods with pectus excavatum. Material and Method: From 1984 to 1997, were performed Ravitch operations in 40 patients of pectus excavatum and analyzed the effects of correction and postoperative complication according to time of operation retrospectively. The group comprised 35 mem and women whose mean age was 8.9$\pm$7.9 years(between 2 to 35 years). All patients had corrected with Ravitch operation or its modified operation. Modified fixations were accomplished with K-wire in 15 patients and internal plate in 2 and the materials were removed 3 months after operation. The result of correction was estimated with the degree of changed distance between inner surface of sternal body and vertebral in 3 months after correction. Result: Postoperative complications were wound disruption in 14 patients. Estimated distances after correction ranged 0.4 cm to 4 cm. The acceptability for chest wall correction was high(6 excellent, 29 good in criteria of Humphreys). Conclusion: We concluded that the benefits of Ravitch operation were a high acceptability of patients and their family, and sufficient correction with no specific complications related operation.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.878-882
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• 2003

Tracheal bronchus is an aberrant, accessory or ectopic bronchus arising almost invariably from the right lateral wall of the trachea and may be related to inflammatory conditions affecting the lung, including recurrent pneumonia, bronchiectasis. Recently we experienced a case of tracheal bronchus associated with pulmonary actinomycosis. The 37-year-old male patient had suffered recurrent hemoptysis and had been medicated as a presumptive diagnosis of tuberculosis, but either clinical or radiologic improvement was not seen. Right upper lobectomy was performed and pulmonary actinomycosis was confirmed by the histologic examination. Postoperatively, the patient was medicated with penicillin and ampicillin for 3 months and completely recovered without any evidence of recurrence during the 6month follow-up period.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.125-128
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• 1988

A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.

• Korean Journal of Veterinary Service
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• v.35 no.2
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• pp.147-151
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• 2012

We report large tumors of the left thoracic cavity, which arose from the ribs, were diagnosed as chondrosarcoma in a 4-year-old male mixed dog. The dog was presented with swelling in the left side of the chest wall and lameness. The masses were found to be circumscribed, whitish-grey, large and firm. The cut surface revealed whitish-grey lobules of varying size with cartilaginous consistency. Those were subsequently metastasized to the lung and mandibular lymph node. Histologically, the tumors were made up of clusters of chondroid cells having pleomorphic hyperchromatic nuclei with occasional mitosis. A special and immunohistochemical staining was performed to confirm the diagnosis. Chondroid matrix in tumor showed a positive reaction for alcian blue-periodic acid-Schiff staining. Immunoreactivity to S-100 proteins was present in the cytoplasm and/or nucleus of chondrocytes in tumor. The final diagnosis was grade III chondrosarcoma in the rib, considering histological features in grading criteria.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.68-74
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• 1986

15 patients with constrictive pericarditis who underwent interphrenic pericardiectomy from January, 1981 to April, 1983 and 11 patients who underwent radical pericardiectomy from May, 1983 to September, 1984 were compared to the clinical improvement and the results of pre- and postoperative cardiac catheterization. In the group of partial pericardiectomy the pericardium was removed anteriorly from the left phrenic nerve to the right phrenic nerve and in the group of radical pericardiectomy the pericardium was removed from almost entire surface of the heart including diaphragmatic surface and posterior wall of the left ventricle. The following results were obtained. 1. Both group of the patients showed marked symptomatic improvement early after operation. 2. The central venous pressure was decreased significantly after operation in both group of the patients. 3. The right atrial mean pressure and pulmonary arterial mean pressure decreased significantly after operation in both group of the patients and there was no significant difference in the amplitude of decrease between the two groups. 4. The right ventricular end-diastolic pressure and left ventricular end-diastolic pressure were decreased postoperatively in both group of the patients and the patients of the radical pericardiectomy showed more decrease than the patients of interphrenic pericardiectomy, and in the group of radical pericardiectomy the right and left ventricular end-diastolic pressure were normalized postoperatively but in the group of partial pericardiectomy they showed abnormally high pressure persistently. 5. The ejection fraction showed normal level pre- and postoperatively in both group of the patients.