• Title/Summary/Keyword: Thoracic wall

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A Clinical Evaluation of 120 Chest Injuries (흉부외상 120례에 대한 임상적 고찰)

  • 이호완
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.13-22
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    • 1974
  • A clinical evaluation was done on 120 cases of chest injury patients treated in the department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital for the period of 6 years and 3 months from January, 1968 to March, 1974. 1] Of 120 cases, 52 cases[43. 3%] were non-penetrating injuries and 65 cases[56.7%] penetrating injuries. Of them, 107 cases [89.2%] were males and 13 cases[10.8%] were females. 2] The most common etiology was stab wound[64 cases] and traffic accident[23 cases] was the next. 3] In 70% of all cases, treatment was initiated within 6 hours after receiving trauma. 4] The types of lesions in order of frequency were hemothorax[35 cases], chest wall injuries alone. 27 cases], hemopneumothorax [22 cases], pneumothorax[17 cases]. Of them, right sided lesions were 52 cases[43. 3%] and left sided lesions were 65 cases[54.2%] and 3 cases were bilateral lesions. 5] Repeated thoracentesis and closed thoracostomy were the treatment of choice in most cases in order to reestablish early and rapid reexpansion of the lungs. Open thoracotomy was, however, mandatory on 39 cases[32.5%]. 6] The overall mortality was 5.8% [7 cases]; 5 cases of nonpenetrating injuries and 2 cases of penetrating ones.

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Bronchogenic Cyst (Two Case Report) (기관지성 낭종(2례수술보고))

  • 김형묵;김영철;최인환
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.9-12
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    • 1974
  • Bronchogenic cysts, though known as a relatively common malformation of the mediastinum, were rarely discussed in Korean literatures. Since the surgical removal of asymptomatic lesions was adopted as the reasonable therapeutic principle, the incidence of bronchogenic cysts were found to be higher than previously expected. Two cases of bronchogenic cysts operated on in The Dept. of Thoracic Surgery, Korea University Woo Sok Hospital were reported and related literatures were reviewed. Case 1. 5 year old boy with chief complaints of bulging cystic mass on left supraclavicular region during straining or coughing since his age of 2 was admitted, and cystogram with Lipiodol revealed hen-egg sized mass in the left antero-superior mediastinum without any communication with bronchus or esophagus. Cyst was successfully removed under general anesthesia thru left supraclavicular incision, and pathological examination of the cyst revealed thin cystic wall lined with stratified columnar epithelium and it`s content was milky white mucoid fluid devoid of any bacterial growth. Case 2. 15 year old school girl has been noted slowly growing walnut-sized mass on anterolateral side of the neck for 4 months without any subjective symptom except cosmetic problem... Mass was aspirated to find milky white mucoid fluid in some loculation and yellowish turbid fluid in other part due to chronic infection. Cystic tumor was removed under local anesthesia, which was loculated in between the trachea and esophagus without any communication, and pathological diagnosis of the cyst was bronchogenic cyst with columnar epithelial cell lining with moderate chronic inflammatory cell infiltrations. Postoperative conditions of the two cases were all excellent with normal life.

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A Case for Chest Wall Panetrating Injury by Nail Gun (못총에 의한 흉부관통상에 대한 치험 1예)

  • Kim, Jae Jin;Paik, Jin Hui;Kim, Ji Hye;Han, Seung Baik;Yun, Sung Hyun;Kim, Jun Sig;Jung, Hyun Min
    • Journal of Trauma and Injury
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    • v.26 no.1
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    • pp.26-29
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    • 2013
  • We describe the case of a 56-year-old man who had been shot by a pneumatic nail gun in the chest during work. He had removed the nail by himself immediately at the accident field. He visited to the emergency department of a local hospital and, after a simple dressing and simple history had been taken, he was referred to our emergency department for penetrating thoracic injury. Immediately, Transthoracic echocardiography were done and showed moderate hemopericardium. Patient had been hydrated and transported to the operating room. After cardiac wound repaired by midsternotomy, the patient was discharged on the 13th postoperative day without complications except mild mitral valve regurgitation.

A Case of Aberrant Right Subclavian Artery in a Dog (개에서 우쇄골하동맥잔존 증례)

  • Park Jin-hee;Ha Dong-soo;Lee Sang-gwan;Eom Ki-dong
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.281-283
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    • 2005
  • A 3-month-old male, Cocker Spaniel with persistent regurgitation immediately after weaning and stunted growth was referred. Radiographic findings on the lateral view include ventral deviation of the thoracic trachea caused by draping of the dilated esophagus and a distinct interface of the dorsal wall of the esophagus silhouetting with the cranial thoracic hypaxial muscles. On the ventrodorsal view, the cranial mediastinum was widened with soft tissue opacity. The trachea was deviated to the right. In an esophagogram, the segmental dilation of the esophagus with constriction of the lumen just cranial to the heart base was identified. In a fluoroscopic examination, the contrast medium was massively accumulated in the cranial portion of the constricted esophagus. At surgery, it was confirmed that the esophageal tract was constricted at the cranial to the base of the heart by aberrant right subclavian artery. It was ligated and divided surgically. Current state of the referred is maintained normal condition from the surgical repair.

Pulmonary Sequestration: report of 2 cases (Pulmonary Sequestration [2례 보고])

  • 남충희
    • Journal of Chest Surgery
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    • v.14 no.4
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    • pp.350-353
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    • 1981
  • The pulmonary sequestration is an uncommon congenital anomaly characterized by the presence of a part of lung tissue which is supplied by an aberrant artery from the aorta or its branch and usually has no communication with the normal bronchial tree. It was first presented by Hubber in 1777 and presented in details by Pryce in 1946. We present a case of extralobar pulmonary sequestration experienced recently with a case of intralobar type experienced in 1962. The patient was 11 year old male with the complaint of chronic productive cough. Serial chest films showed a large cyst with or without the air-fluid level on the posterobasal segment area of the left lower lobe. Bronchography showed no definite communication between the cyst and bronchial tree. On operation, the cystic lesion was supplied by an aberrant artery from the descending thoracic aorta 5 cm above the aortic hiatus and was sited at the posterobasal segment area of the left lower lobe. We performed the sequestrectomy and the sequestration was surrounded by its own pleura, 6.8x3.9x3.2 cm in size, contained the pale brown mucoid secretion in a large cyst and showed the primitive alveolar structure of the wall. The aberrant artery was 1 -5 cm long, 0.3 mm in internal diameter and arterio-sclerotic. We also compared 6 cases of collection, 5 intralobar and 1 extralobar type, presented in Korea.

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Transient Myocardial Thickening in a 4-year-old Korean Domestic Shorthair Cat

  • Yunhee Joung;Hyerin Ahn;Jeongbae Choi;YoungMin Yun;Woo-Jin Song
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.106-111
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    • 2024
  • A 4-year-old neutered female domestic shorthair cat weighing 5.1 kg was referred to Jeju National University Hospital with acute onset respiratory distress, weakness, and anorexia. The patient had a history of stressful antecedent events that involved bullying by a newly introduced cat. Thoracic radiography and echocardiography revealed a stage C hypertrophic cardiomyopathy phenotype based on the American College of Veterinary Internal Medicine classification system with pulmonary edema, pleural effusion, and pericardial effusion at the same time. The patient was treated with furosemide, pimobendan, and rivaroxaban. Pericardiocentesis was performed because pericardial effusion was identified. Reevaluation after 30 days revealed a normal respiratory rate on physical examination, normal cardiac shape on thoracic radiographs, and normal cardiac measurements on echocardiography. The patient was tentatively diagnosed with transient myocardial thickening (TMT) and all medications were discontinued. Six months after the initial hospitalization, the cat continued to do well without any clinical signs or left ventricular wall thickening. This case is the first report describing feline TMT in Korea. Moreover, it involves a rare case in which pulmonary edema, pleural effusion, and pericardial effusion, which induce cardiac tamponade, occurred simultaneously due to TMT-related congestive heart failure.

Early rehabilitation treatment helpful in a case of pectus excavatum of a dog (개에서 발생한 누두흉의 초기 재활치료의 효과)

  • Chang, Dongwoo;Ahn, Miyoung;Seong, Jekyung
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.447-451
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    • 2001
  • A 6-week-old female cocker spaniel, with a history of abasia astasia, was referred to the Department of Laboratory Animal Medicine, Medical Research Center, Yonsei University College of Medicine on February 23, 2000. The ribs inclined downwards with a sharp slope on both lateral sides of the thorax. The animal was diagnosed as pectus excavatum. She showed no signs of dyspnea, dyschezia, or dysuria. There was no heart murmur or sign of neural disease. For rehabilitation treatment, she was given physical exercise therapy 2 to 3 times a day by bending and stretching each articulation of the hind limbs and pressing the costochondral junction in and upward with both hands placed on each lateral side. After a month of therapy, she was able to stand up and walk. The therapy continued and resulted in the slight reformation of a round thoracic wall. The flattened rib cartilages grew more round by palpation and the thoracic cavity distended. Rehabilitation therapy yielded good results, enabling the subject to walk and run normally, as the thoracic cavity was distended by the rounded rib junction.

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Non-infected and Infected Bronchogenic Cyst: The Correlation of Image Findings with Cyst Content

  • Jeon, Hong Gil;Park, Ju Hwan;Park, Hye Min;Kwon, Woon Jung;Cha, Hee Jeong;Lee, Young Jik;Park, Chang Ryul;Jegal, Yangjin;Ahn, Jong-Joon;Ra, Seung Won
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.2
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    • pp.88-92
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    • 2014
  • We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.

Development of a Screw-Crane System for Pre-Lifting the Sternal Depression in Pectus Excavatum Repair: A Test of Mechanical Properties for the Feasibility of a New Concept

  • Park, Hyung Joo;Rim, Gongmin
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.186-190
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    • 2021
  • Background: Pre-lifting of the sternum marked a major turning point in pectus excavatum repair. The author developed the crane technique in 2002 and successfully applied it to more than 2,000 cases using sternal wire stitching. However, blind sternal suturing limited the use of the wire-stitch crane. We propose a novel screw for sternal lifting as a new tool for the crane technique. Methods: We developed a screw system strong enough to withstand the pressure needed for sternum lifting. The screw was designed to have a broader thread to hold the bony tissue securely. The screw's sustaining power was tested using the torsion, driving torque, and axial pull-out tests in a polyurethane block and ex-vivo porcine sternum. Results: The screws were easily driven into the sternum, and the head of the screw was connectable to the table-mounted retractor. In the torsion test, the 2° offset torsional yield was 4.53 N·m (reference value, 1 N·m). In the polyurethane block driving torque test, the maximum torque was 0.98 N·m (reference value, 0.70 N·m). The axial pull-out test was 446 N (reference value, 100 N). The maximum pull-out resistance in the ex-vivo porcine sternum model was 1,516 N. Conclusion: The screw crane was strong enough to sustain the chest wall weight to be lifted. Thus, the screws could effectively replace the sternal wire stitching in crane pre-lifting of the sternum. We expect that application of the screw-crane will be easy and that it will improve the safety and success rate of pectus repair surgery.

Quantitative Analysis of Epicardial fat (심외막 지방의 정량분석)

  • O, Jung-Hwan;Gang, Cheong-Hui;Lee, Jong-Guk
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.233-236
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    • 1995
  • Subepicardial space is one of the regions in which fat in moderate amount is normally deposited. When excess deposits of epicardial fat occur, penetration or infiltration of fat into the connective tissues between muscle bundles is observed. In some cases with very extensive involvement of epicardial fat,myocardial insufficiency and conduction system defect such as heart block have been implicated. More fat is deposited over the right ventricle than over left and the anterior surface contains more fat than dose the posterior surface. We studied 40 patients who underwent open heart surgery under the cardiopulmonary bypass. This study was designed to evaluate the percentage of the area of epicardial fat of the right ventricular anterior surface, which is more accessible area during the operative procedure. Other variables included thickness of subcutanous tissue of anterior chest wall, the ratio of waist to hip circumference, body weight and age. In conclusion, the amount of the epicardial fat correlates with thickness of the subcutaneous fat of the anterior chest wall and simple linear regression analysis indicates good correlation with body weight. Increased age results in large amount of epicardial fat.

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