• Title/Summary/Keyword: Thoracic wall

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흉벽에 발생한 거대한 유건종 1례 (A Large Dumb Bell Shaped Desmoid Tumor in Chest Wall: A Case Report)

  • 박주철;유세영
    • Journal of Chest Surgery
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    • 제11권4호
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    • pp.456-460
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    • 1978
  • Desmoid tumor is found most often in the anterior abdominal wall of parous women. Although it may originate in virtually any musculotendinous structure, those of the chest wall are rare. We experienced a case of large dumb bell shaped desmoid tumor originated in intercostal muscle and invaded anterior chest wall, pericardium, pleura and the lung. The patient was healthy in appearance except a painful swelling on the anterior chest wall. Roentgenographic studies demonstrated a huge homogenous mass in the right anterior chest cavity. He was treated with resection of the tumor including .anterior chest wall, a portion of the pericardium, middle lobe, and part of upper & lower lobes of the right lung because of tumor invasion. The tumor composed with two parts, one [$5{\times}4{\times}3$cm in size] is over the rib cage and another [$10{\times}15{\times}10$cm in size] is in the right chest cavity. Postoperative course was uneventful and there was no evidence of recurrence until last visit, 5 months after surgery.

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대동맥판막 폐쇄부전이 동반된 심실중격결손증의 외과적 치료 (Ventricular Septal Defect Associated with Aortic Insufficiency)

  • 두홍서
    • Journal of Chest Surgery
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    • 제21권6호
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    • pp.1111-1116
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    • 1988
  • Neurofibromatosis is very rare syndrome characterized by abnormal cutaneous pigmentation and numerous skin tumors was described by Smith in 1849, which is inherited as an autosomal dominant trait. Von Recklinghausen reported 2 cases of multiple skin and subcutaneous tumors in 1982. Malignant peripheral nerve tumors, although generally rare, are one of the most characteristic malignant tumors associated with Neurofibromatosis. We have experienced 3 cases of malignant Schwannoma in neurofibroma patients from 1982 to 1988 for 6 years at Thoracic and Cardiovascular surgery department, College of Medicine, Yonsei University, Seoul, Korea. l. One is 62 years old female who was taken total hysterectomy followed by irradiation treatment due to Uterine Carcinoma 21 years ago. She had a large bulging mass on left anterior chest wall and was taken enbloc resection of tumor including rib confirmed malignant Schwannoma. 2. Another is 18 years old female who had large bulging mass on right chest wall and pleural effusion in right thoracic cavity. Thoracentesis revealed a large amount of lymphocytes misdiagnosed of Tbc, pleurisy with Neurofibromatosis. We performed tissue biopsy on bulging mass and the specimen was confirmed malignant Schwannoma 2 months after first diagnosis of Tbc. pleurisy. She was not accessible to radical resection because of far advanced malignant Schwannoma at that time. 3. Third case is 28 years old male who was taken enbloc resection of tumor including rib due to Neurofibroma with Neurofibromatosis at M. hospital 6 months ago. But he had rapid growing mass at operation site again and taken tissue biopsy confirmed of malignant Schwannoma. He was not accessible to enbloc resection due to malignant Schwannoma extending to mediastinal structures.

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The Effects of Aging and Atherosclerosis on Elastin of Human Aortas; Quantitative Analysis of Elastin-Content and SEM Analysis of Elastolysis

  • Song, Seh-Hoon;Roach, Margot R.
    • The Korean Journal of Physiology and Pharmacology
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    • 제2권5호
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    • pp.591-600
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    • 1998
  • We have examined 24 human aortas aged $46{\sim}90$ years obtained from autopsies. Most exhibited gross lesions of some degree on the lumenal surface. Using hot alkaline treatment (0.1 N NaOH) at $70{\sim}75^{\circ}C$ for 5 hours, we extracted and quantitated elastin portions from the aortic wall in 3 different segments (UTA=upper thoracic aorta, LTA=lower thoracic aorta, AA=abdominal aorta). We have found UTA had $70.6%{\pm}1.39$ (SE), LTA $61.6%{\pm}1.94$ (SE), AA $49.2%{\pm}1.84$ (SE) elastin respectively based on wet weight. The differences between segments are statistically significant (p<0.05, 0.025). However, there is no significant correlation between the age of the patients and the relative amounts of elastin in each segment. We have also observed the structure of elastin in the internal elastic lamina (IEL) and tunica media (TM) with SEM (scanning electron microscopy), and discovered that the IEL shows various forms of elastolysis- broken sheets, discontinuity, various sizes of lumps, vesicles, and possible newly formed elastin in the aortic lesions (Song and Roach submitted to YMJ). From these studies we conclude that elastin in the aortic wall remains well balanced quantitatively with age in spite of evidence suggesting vigorous degeneration and regeneration in the atherosclerotic lesions.

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연속적 재발성 미성숙 기형종의 외과적 치료 (Surgical Experience of Recurrent Immature Teratoma - Report of a case -)

  • 홍민수
    • Journal of Chest Surgery
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    • 제24권8호
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    • pp.792-796
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    • 1991
  • Immature teratoma can be viewed as intermediate between mature teratoma and embryonal carcinoma. Unlike the mature teratoma, elements of the three perm cell layers are incompletely differentiated and not arranged in organoid fashion In some area, more mature forms of these tissues may also be seen, Although this tumor is clearly malignant, they may not display clear-cut cytologic features of malignancy. The clinical prognosis is poor. We have experienced one case of recurrent immature teratoma. In first operation[1987, April], tumor of anterior mediastinum was removed with wedge resection of ant. segment of RUL % med. segment of RML. In 2nd operation[1990, June], recurrent teratoma of right inner thoracic wall was resected with partial 5th rib resection and wedge resection of lat. segment of middle lobe. Two months later, the 3rd operation[1990, September] was done, which was a removal of mass on thoracic wall near sup, segment of RLL and partial rib resection of 3rd, 4th & 5th. In November 1990, last operation[4th operation] was made. It was enucleation of walnut sized tumor located between medial segment of RML, and 4th. intercostal space, well encapsulated with endothoracic fascia and invaded into lung parenchyme, Adjuvant chemotherapy was done after each operation, but radiotherapy[5000 Rad] was done only after 1st operation. There was no evidence of recurrence after last operation. The patient is well-being still now.

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Surgical Correction of Pseudo-flail Chest Using Interfragmentary Wiring, Latissimus Dorsi Flap, and External Splinting in a Dog

  • Min, Byong-Su;Jeong, Soon-Wuk;Yoon, Hun-Young
    • 한국임상수의학회지
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    • 제33권2호
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    • pp.124-128
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    • 2016
  • A 7-year-old intact female Maltese dog presented with a history of bite wounds. Physical examination revealed labored breathing, four puncture wounds with subcutaneous emphysema of the thorax, and paradoxical respiratory movement of the right thoracic wall. On radiography, a segmental fracture of the right 7th rib and a single fracture of the 8th rib were evident on the dorsal thorax. An inward displacement of the fractured segment and contusion of the right caudal lung lobe were identified with computed tomography. A diagnosis of pseudo-flail chest was made. Exploratory thoracotomy revealed a full-thickness muscular defect, a marked discoloration of the right caudal lung lobe, a segmental fracture of the right 7th rib, and a single fracture of the right 8th rib. Necrotic tissues were removed using surgical debridement. The fractured 7th and 8th ribs were corrected using a single interfragmentary wiring technique. The thoracic wall was reconstructed using the latissimus dorsi muscle flap. Additional thoracic stabilization using a thermoplastic splint was applied to correct paradoxical respiratory movement. The external splint was removed 4 weeks postoperatively. There was no evidence of respiratory abnormalities 18 months postoperatively.

급성 심근경색 후 좌심실류절제술을 받은 환자에서 재 좌심실용적감소술의 시행 (Redo-left Ventricular Volume Reduction Surgery in a Patient with Left Ventricular Aneurysm -1 case-)

  • 이삭;이창영;이교준;유경종
    • Journal of Chest Surgery
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    • 제38권1호
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    • pp.63-66
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    • 2005
  • 전벽의 급성심근경색에 의한 좌심실류가 있는 경우 수술적 전측심실내복원술(SAVER)은 좌심실의 무운동과 이상운동 구획을 분리하여 정상적인 좌심실 원형구조와 심근벽의 긴장도를 정상적인 수준으로 감소시켜 줌으로써 혈역학적 향상을 기할 수 있는 술식이다 저자들은 급성심근경색에 의한 좌심실류로 좌심실류절제술을 시행 받은 과거력이 있는 40세 남환에서 12년간에 걸친 remodelling의 결과로 진행된 말기심부전의 치료방법으로써 다시 수술적 전측심실내복원술을 시행한 후 만족할 만한 결과를 얻었기에 이를 보고하는 바이다.

인두위문합술과 유리공장이식술을 이용한 하인두 및 경부식도 재건술 (Reconstruction of Hypopharynx and Cervical Esophagus using Gastric Pull Up and Jejunal Free Graft)

  • 정동학;김영모;이원영;김대식;노병선
    • 대한기관식도과학회지
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    • 제2권1호
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    • pp.63-70
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    • 1996
  • Reconstruction for hypopharynx and cervical esophagus after wide resection of extensive hypopharynx and larynx cancers have been used various methods including myocutaneous flaps, gastric pull up, md jejunal or large bowel free graft. Recently, the authors had experienced hypopharynx and larynx cancers with extension to the posterior hypopharyngeal wall and thoracic esophagus. Of course, these reconstructive methods should be selected in accordance with the patient's age, physical status, extend of prim.:W lesion, and defect after on block resection, however, gastric pull up was performed in hypopharynx cancer which had skipped lesion in the thoracic esophagus and jejunal free grafts were performed in case 2, 3 which had a extended lesions to the posterior pharyngeal wall. Some complications were noted, which were successfully stabilized by conservative managements. The gastric pull up and jejunal free graft were considered suitable methods for reconstrunction of hypopharynx and cervical esophagus, however, further studies are necessary about it.

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흉벽에 발생한 동정맥기형 -1례 보고- (A Case Report of Arteriovenous Malformation on the Chest Wall)

  • 박성용;심성보
    • Journal of Chest Surgery
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    • 제29권7호
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    • pp.802-806
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    • 1996
  • Arteriovenous malformations are vascular anomalies containing a communication between artery and vein without an intervening capillary bed and also are the most dangerous of vascular malformations being hemodynamically active. Treatment must be careful usually limited and considered in the phase of activity of hemodynamics. The patient was 29-year-old female and had no specific signs and symptoms except buldging, pal- pable mass on the right posterolateral chest wall from several years ago and it was gradually growing from that time. The operation was done with ligation of the right 9th, 1 Oth intercostal arteries and dissection from other normal tissues and then excised the arteriovenous malformation mass and its feeding vessels. The pathologic result was arteriovenous malformation.

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

  • 배두현
    • Journal of Chest Surgery
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    • 제3권2호
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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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Teratoma with Malignant Transformation in the Anterior Mediastinum: A Case Report

  • Jung Im Jung;Seog Hee Park;Jae Gil Park;Sun Hee Lee;Kyo Young Lee;Seong Tai Hahn
    • Korean Journal of Radiology
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    • 제1권3호
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    • pp.162-164
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    • 2000
  • Malignant transformation of teratoma in the anterior mediastinum is rare; the mass usually has a long history and is seen in older patients. We report a case of teratoma with malignant transformation in the anterior mediastinum, complicated by rupture. CT revealed a lobulated, inhomogeneous cystic mass with a fat component and wall calcifications. The lateral wall was disrupted and consolidation in the adjacent left upper lobe was noted, suggesting rupture. A heterogeneously enhanced solid portion, obliterating the fat plane between the mass and the great vessels was present in the medial aspect of the mass, and pathologic examination demonstrated the presence of adenocarcinoma.

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