• 제목/요약/키워드: Thoracic wall

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Jeune 증후군 환아에게 시행한 외측 흉벽 확장술 (Lateral Thoracic Expansion Surgery for Jeune's Syndrome)

  • 김준범;문일홍;최병민;이기형;최인철;박승일
    • Journal of Chest Surgery
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    • 제38권12호
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    • pp.873-877
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    • 2005
  • Jeune 증후군은 체염색체 열성으로 유전되는 질환으로 다발성 연골 형성장애에 의한 흉벽, 골반, 사지 등의 골격계 발달 이상을 보이며 신장, 간, 췌장, 망막 등에도 병변을 동반할 수 있는 드문 질환이다. 예후에 가장 중요한 인자는 흉곽 기형의 정도인데 특징적으로 경직된 종 모양의 제한적 흉곽을 보이며, 이로 인해 호흡부전과 폐렴의 증상을 보이게 된다. 어린 나이에 증상이 발현될수록 예후가 좋지 않은 것으로 보고되고 있으며 흉곽 기형을 교정하기 위한 여러 수술 방법들이 소개되어 왔으나 1세 이전에 증상이 발현된 경우에 있어서는 수술 교정을 했다고 하더라도 대부분 사망하는 것으로 보고되고 있다. 생후 11개월 된 남자 환아가 출생 후부터 지속된 호흡부전과 폐렴 증상을 주소로 내원하여, Jeune증후군으로 진단받고 측흉벽 확창술을 우측에 시행하였다. 수술 후 호흡 부전이 해결 되지 않아 첫 수술 3개월째 좌측에 대해서도 같은 시술을 시행하였고, 수술 후 좌측 티타늄 판 골절이 발생하여 티타늄 판 재이식술을 시행하였다. 이후 호흡 양상의 호전과 악화를 반복하다가 첫 수술 6개월째 퇴원하였다. 환자는 퇴원 2개월 후 폐렴의 증상으로 재입원하였으며, 재입원 치료 5개월째에 결국 호흡부전으로 사망하였다. Jeune증후군에 대한 측흉벽 확창술을 시행하였기에 그 결과를 문헌 고찰과 함께 보고하는 바이다.

기관지흉막루를 동반한 전폐절제술후 농흉의 수술치료: 유경 대망판과 흉벽근육을 사용한 치험 2례 (Surgical Treatment of Postpneumonectomy Empyema with Bronchopleural Fistula - 2 Cases using Pedicled Omental Flap & Muscle Transposition -)

  • 김기봉
    • Journal of Chest Surgery
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    • 제24권9호
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    • pp.945-949
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    • 1991
  • The treatment of acute and chronic empyema with bronchopleural fistula is remained as serious postoperative complication in thoracic surgery. Although several operative procedures for the treatment of postpneumonectomy empyema have been reported, the method of treating empyema, and in particular empyema associated with fistula, remains controversial. Recently some successful results have been reported by use of the omentum in the patients with thoracic empyema resulting from bronchial fistula. We have performed one-stage operations using the omentum and chest wall muscles in 2 patients, one was acute, and the other was chronic case. Their postoperative courses were uneventful

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Pleuritis and pericarditis associated with Klebsiella pneumoniae in a Eurasian beaver (Castor fiber)

  • You, Mi Hyeon;Kim, Ji Hyung;Kim, Dae Yong;Gomez, Dennis Kaw;Jung, Tae Sung;Park, Se Chang
    • 대한수의학회지
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    • 제48권4호
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    • pp.501-503
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    • 2008
  • An adult one-year-old male Eurasian beaver (Castor fiber) died of a traumatic injury to its right leg from a fall. At necropsy, fibrinopurulent exudates were observed in the thoracic cavity. Histopathologic examination showed that the pericardium, thoracic wall, pulmonary pleura and the lungs were markedly thickened due to mixtures of necrotic cellular debris, neutrophils, fibrin, red blood cells, and bacterial aggregates. Pure culture of Klebsiella (K.) pneumoniae was isolated from the thoracic exudates, pleura and heart tissues. Based on these findings, this is the first report describing pleuritis and pericarditis associated to K. pneumoniae in a beaver.

식도(食道) 평활근종(平滑筋腫)의 수술치험(手術治驗) 1례(例) (Leiomyoma in the Esophagus (Report of A Case))

  • 오철수;김근호
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.311-314
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    • 1976
  • This is a report of leiomyoma in the esophagus. patient had suffered from mild intermittent dysphagia on eating without any other complaints. This complaint had been going for 45 days, but was not progressed. The esophagogram revealed an ovoid walnut-sized smooth filling defect in the midportion of the esophagus. The mucosal folds of the esophagus were not destroyed. A benign intramural tumor of the esophagus, such as leiomyoma, was suspected with X-ray finding and clinical features. On Aug. 13, 1976 a thoracotomy was performed at right 4th intercostal space. A firm, irregular shaped mass in the wall of the esophagus was enucleated by blunt dissection without any injury of the mucosa of the esophagus. The diagnosis of leiomyoma was confirmed with histopathological finding. Postoperative course was uneventful.

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후두개절제환자에서 시술한 인두위문합술 -1예 보고- (Pharyngogastrostomy in an Epiglottectomized Patient -A Case Report-)

  • 송요준;김종환
    • Journal of Chest Surgery
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    • 제7권2호
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    • pp.175-178
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    • 1974
  • The patient was 21-year old male who had gastrostomy and tracheostomy after swallowing lye-stuff in July 1971. He could restore his normal voice and breathing after removal of his destructed epiglottis obstructing his upper airway two years later. Pharyngogastrostomy was performed in Nov 1973. The esophagus which was totally obliterated in its full length was removed and the stomach was brought high up to the level of pharynx where it was anastomosed to the posterior wall of pharynx. His postoperative course was temporarily complicated by aspiration of small food into trachea which could be completely relieved with training, and he is doing his normal life quite well on the follow-up.

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종격동내에 발생한 Cystic Hygroma: 1 치험례 (Mediastinal Cystic Hygroma: Report of 2 Cases)

  • 조건현;이홍균
    • Journal of Chest Surgery
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    • 제10권1호
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    • pp.65-70
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    • 1977
  • Cystic hygroma is a benign tumor of lymphatic origin encountering most frequently in young children, and composed of softly fluctuated mono or multilocular cystic masses which developed from embryonic outpouching of the venous system. The majority of these tumors are found at the anterolateral neck region particularly posterior .triangle, and occasionaly axilla, mesentery and spleen etc. In the mediastinum, the incidence of hygroma is very rare and also of mediastinal neoplasms. Recently, we have experienced 2 cases of mediastinal cystic hygroma connected up lateral neck and to anterior chest wall respectively, which were surgically removed successfully and confirmed histopathologically. Authors present the cases and discussion with a brief review of the relevant literatures.

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심한 척추기형을 동반한 기도협착의 수술적 교정 1례 (Surgical Therapy of Airway Compression with Severe Kyphoscoliosis)

  • 조현민;이누가;이두연
    • Journal of Chest Surgery
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    • 제35권11호
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    • pp.839-841
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    • 2002
  • 일반적으로 척추기형에 의한 기계적인 기도협착 환자의 경우 척추기형을 교정함으로써 증상을 완화시킬 수 있다. 그러나 흉곽기형의 원인이 되는 척추기형이 너무 심하여 교정이 어려울 경우에는 심한 기도협착으로 인해 호흡부전을 유발하고 치명적인 결과를 초래할 수 있다. 본 교실에서는 교정이 불가능할 정도의 심한 척추기형으로 인한 기도협착 환자에서 흉벽거상술을 통해 비교적 좋은 성적을 얻었기에 이에 문헌고찰과 함께 보고하고자 한다.

폐쇄성 흉부손상후 발생한 유미흉 1례 보고 (One Case of Surgical Treatment for Chylothorax following Closed Thoracic Injury)

  • 정황규
    • Journal of Chest Surgery
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    • 제21권2호
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    • pp.379-382
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    • 1988
  • We have experienced a case of right side chylothorax following closed chest injury. A 35-year-old man in his car was accidentally collided against obstacles on September 19, 1986 resulting in a contusion on right anterior chest wall. The only complaint noted on admission was right chest pain. Chest X-ray showed near total radiopaque density of right thorax. Conservative treatment of closed tube thoracostomy at right pleural cavity through midaxillary 7th intercostal space had been continued for 25 days without improvement. Chyle outflow through the chest tube was averaging 1,700cc per day. Oversewing of the thoracic duct and pleura by silk and pledgetted prolene sutures were done. There was no complication and recurrence till postoperative 20 days. Chylothorax following closed chest injury was never reported in this country, and will be a interesting clinical case report.

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Boerhaave`s Syndrome: 치험1례 (Boerhaave`s Syndrome - One case report -)

  • 방정현;김호경;이두연
    • Journal of Chest Surgery
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    • 제24권4호
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    • pp.371-375
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    • 1991
  • Postemetic rupture of the esophagus is an intrathoracic catastrophe which is universally fatal if untreated immediately. We have experienced one case of Boerhaave`s syndrome at the Thoracic & Cardiovascular Surgery Yonsei University College of Medicine. He was 56 years old male who complained severe chest-pain, dyspnea with sudden vomiting after alcohol. Esophagogram showed barium leakage through rupture site on lower esophagus into left thoracic cavity. He had taken repair of the rupture site of lower esophagus and wrapping it with the body of the stomach wall because of relatively clean rupture margin even though 48 hours following the rupture. He has been uneventful in post-operative courses & he discharged with good conditions.

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Radiological assessment of pectus excavatum in a Pekingese dog

  • Cho, Sung-Jin;Hong, Sun-Hwa;Chung, Yung-Ho;Kim, Ok-Jin
    • 한국동물위생학회지
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    • 제35권3호
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    • pp.251-254
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    • 2012
  • Pectus excavatum (PE) is a ventral chest wall deformity, also known as funnel chest, sunken chest, chondrosternal depression or koilosternia. The 4 months old, 1.3 kg intact-female Pekingese dog was evaluated for acute semicoma and convulsion. The client reported that this patient have had chronic loss of appetite, intermittent dyspnea and palpable sunken breast. The other littermates did not show any abnormalities. On physical examination, cachexia (BCS 1/5), concave sternum, flatten thoracic cavity and cardiac murmur were observed. On radiographic study, the caudal sternum cave to vertebrae and narrowing thoracic cavity. The severities of thoracic deformity were evaluated by deformation indices such as-Frontosagittal index (FSI) and vertebral index (VI). Moderate to severe PE was founded by the radiological measurements.