• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.568-573
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• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.138-141
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• 2013

Pericardial cysts are reported by some authors, but epicardial cysts are extremely rare. We report one case of epicardial cyst that was detected incidentally and was removed successfully. Furthermore, unusually, pathological examinations confirmed that the cyst wall was looked like a vessel wall.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.269-271
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• 2012

Solitary plasmacytoma of the bone, and especially of a single rib, is a rare disease. Here we report a 73-year old male patient complaining of continuous chest wall pain around the right 5th rib shaft who underwent a wide excision of the rib tumor with surrounding connective tissue. He was diagnosed with solitary plasmacytoma and will undergo radiation therapy. We report this case with a review of the literature.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.65-68
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• 1995

Pectus excavatum occasionally occurs in patients who have underlying cardiac disease, especially Marfan syndrome. This report describes a patient with pectus excavatum who had ascending aortic aneurysm with aortic regurgitation and anterior leaflet prolapse of mitral valve. This patient underwent replacement of aortic valve and ascending aorta with 25 mm SJM valved conduit graft[Bentall operation with Cabrol shunt , and mitral valve replacement with SJM 31 mm, the pectus excavatum was corrected at the time of completion of the intracardiac operation with the modified sternal turnover. This procedure offered excellent operative exposure for the inracardiac operation with prevention of low cardiac output after operation due to depressed sternum and maintained chest wall stability resulting good cosmetic chest wall appearance. This patient recovered and discharged in good postoperative result with minimal temporary peroneal nerve palsy in his left leg.

• Journal of Chest Surgery
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• v.32 no.9
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• pp.844-846
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• 1999

Chronic irritation to arterial wall by foreign material may give rise to delayed vascular injury. A 50 years old male patient with kyphoscoliosis had undergone fixation of orthopedic Cotrel-Dubousset(CD) rods and screws. Fourteen months after that surgery, a false aneurysm of the descending thoracic aorta associated with pulsating hematoma in the muscular chest wall developed. The false aneurysm was managed by resecting the diseased aortic segment and replacing the vascular graft.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.750-754
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• 2002

Primary cardiac tumors are rare and about 20~25% of primary cardiac tumors are malignant. Moreover, primary malignant mesenchymoma of the heart is extremely rare. Recently, we have experienced two cases of cardiac malignant mesenchymoma. In the first case, malignant mesenchymoma which was originated from the posterior wall of the left atrium obstructing the mitral orifice was revealed pathologically in a 61-year-old woman with mitral regurgitation. The mass, which was 2.7$\times$3.7cm in size on the posterior wall of left atrium, was extended to the posteromedial commissure and annulus of the mitral valve. The mass was resected partially without excision of the left atrial free wall. She was discharged after 30 days without any problems and she received chemotherapy and followed up for 19months. The second case was a 4$\times$5cm in size, friable, yellow-whitish multilobulated mass in the left atrium which was originated from the left lower pulmonary vein. Multiple minor tumor nodules were found in the wall of the left atrium and the posterior leaflet of mitral valve. Partial mass excision and mitral valve replacement were performed.

• Journal of Chest Surgery
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• v.29 no.7
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• pp.792-797
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• 1996

Empyema with bronchopleural fistula is a serious complication after resectional surgery of the lung. Several methods in treating empyema with bronchopleural fistula have been developed, but the results were not always satisfactory. Recently, successful results have been reported with the surgical treatments using tissue flap (the omentum and f or the chest wall muscles) to close the bronchopleural fistula in patients with thoracic empyema. We have performed surgical procedures to treat bronchopleural fistula using omentum in 1 patient an chest wall muscles in 3 patients. Their postoperative courses were uneventful.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.768-771
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• 2008

The use of IVUS provides information about the lumen and arterial wall, the location and extent of atherosclerotic plaque and the state of the arterial wall after PCi. The use of IVUS after insertion of an intracoronary stent has currently increased, while conflicting evidence exists concerning the long-term benefits of IVUS. We report here on a case of surgical removal of an entrapped and fractured IVUS catheter during insertion of intracoronary stents, and we include a review of the relevant literature.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.799-801
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• 2006

A 40-year-old woman was admitted to the hospital due to a palpable tumor on an anterior chest wall. The tumor was diagnosed with a nodular fasciitis. It is a rare benign soft-tissue tumor which has a characteristic referred to as proliferation of fibroblast, and a surgical removal is the best effective treatment. Therefore, we report this case with documents and considerations after the surgical removal.

• Journal of Chest Surgery
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• v.44 no.5
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• pp.364-367
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• 2011

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.