• 제목/요약/키워드: Thoracic wall

검색결과 615건 처리시간 0.025초

Alport syndrome과 동반된 식도 평활근종증 (Esophageal Leiomyomatosis in a patient with Alport Syndrome)

  • 최인석;박주철;이주희
    • Journal of Chest Surgery
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    • 제33권1호
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    • pp.112-115
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    • 2000
  • A-13-urar-old with a history of Alport syndrome had been suffering from progressive dysphagia and postprandial vomiting for over 7 years. Exophagogram and manoemtric studies were consistent with achalasia. Barum study demonstrated marked esophageal dilatation and smooth tapered narrowing of the distal esophagus. However in spite of the medical treatment including the injection of the distal esophagus. However in spite of the medical treatment including the injection of botulinum toxin at the lesion site using an endoscope symptom did not improved and he suffered growth failure and malnutrition. Esophagectomy and esophagogastrostomy were performed to relieve the dysphagia. A firm circumferential intramural mass about 7$\times$5$\times$5 cm was found in the distal esophagus. The lumen of the esophagus was markedly dilated and esophageal wall was hypertrophied. Histologic examination of the neoplasm revealed a rather ill defined tumor tissue consisting of interlacing or whirling spindle cells without significant mitosis and esophageal leiomyo-matosis was confirmed. The patient was discharged uneventfully.

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제2형 동맥간의 심장외 도관을 사용하지 않는 완전교정술 -1례 보고- (Surgical Repair of Type II Truncus Arteriosus Without a Extra-cardiac Conduct -A Case Report-)

  • 조은희
    • Journal of Chest Surgery
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    • 제28권6호
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    • pp.619-622
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    • 1995
  • We report a successful surgical correction of type II truncus arteriosus without using a extra-cardiac conduit in an 2 month-old infant. The truncal root is transected, and the confluence of branch pulmonary arteries is brought anterior to the aorta by using Lecompte`s maneuver. The aorta is then reconstructed directly with an end-to-end anastomosis. The right ventricular outflow tract is reconstructed by anastomosing the posterior wall of the confluence directly to the upper part of the vertical right ventriculotomy. A monocusp ventricular outflow patch is then placed anteriorly to complete reconstruction of the right ventricular outflow tract. The patient had an uncomplicated postoperative course and was discharged on the 9th postoperative day.

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초저온 냉동보관법을 이용한 동종판막 이식술에 대한 연구 (Aortic and Pulmograft Transplantation Utilizing Cryopreservation)

  • 송명근;이동순
    • Journal of Chest Surgery
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    • 제23권4호
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    • pp.622-639
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    • 1990
  • The use of aortic valve homograft has been developed since 1962 when Ross and Barratt - Boyes independently replaced a diseased aortic valve with an orthotopically inserted homograft valve. And also surgical treatment of complex congenital cardiac malformations utilizing homograft extracardiac conduit has been tried with better result than any other prosthetic material. The present study was undertaken to clarify the safety tissue viability, sterility, after following our protocol of procurement of heart, dissection of aortic and pulmonic homograft, sterilization, cryopreservation, thawing and dilution, and transplantation on experimental animal, sheep. Tissue viability of valve and great artery was assessed by tissue culture. Sterility was evaluated by bacterial and fungal culture. The method used was proven no deleterious effect on the integrity of the valve. Tissue culture of valve tissue before, and after cryopreservation process resulted that active fibroblast growth was observed from homograft sterilized with antibiotics. And culture of the transplanted homograft from sacrificed animal showed active fibroblast growth. Pathologic examination of implanted valve tissue from sacrificed sheep showed mild calcification and minor change, but there were moderate and severe calcification of wall of great arteries.

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활로 사징증과 동반된 대동맥 폐동맥 중격 결손증 - 1례 보고 - (Aortopulmonary Window Associated with Tetralogy of Fallot - Report of a case -)

  • 김한용
    • Journal of Chest Surgery
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    • 제23권4호
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    • pp.776-781
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    • 1990
  • The association of aortopulmonary window and tetralogy of Fallot is rare. The aortopulmonary window lies usually between the left side of the ascending aorta and the right wall of the pulmonary artery just anterior to the origin of the main pulmonary artery. Recently, we experienced a case of aortopulmonary window associated with tetralogy of Fallot in a 4 years old male. Operation was done under the Impression of the tetralogy of Fallot. On operation, the anomaly was confirmed as aortopulmonary window[type 1] and tetralogy of Fallot. The aortopulmonary window was closed with Gortex patch via the main pulmonary artery and tetralogy of Fallot was repaired. Postoperative course was uneventful.

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Myeloma로 인한 흉골절제와 Tantalum 의 흉골재건술 (1례 보고) (Total Sternal Resection and Reconstruction Using Tantalum Plate)

  • 김근호
    • Journal of Chest Surgery
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    • 제7권1호
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    • pp.67-72
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    • 1974
  • This is a case report of total sternal resection and successful reconstruction of the sternum applying Tantalum plate in multiple myeloma. The patient was a 57 year old male with a tumor located on the middle sternum invading the manubrium and the body of the sternum developing symptoms after a contusion of the anterior sternum. The sternum resected with left and right. from first to sixth costochondral cartilages, and then Tantalum plate was fixed to the all fragments of the ribs with wire sutures. After reconstruction of the sternum applying Tantalum plate, the patient has had good breathing movements of the chest wall and also maintenance of respiratory function was satisfactory. Histopathologically, the tumor was consisted of a tissue of plasma cells, which was identical to multiple myeloma. Postoperative chemotherapy with Endoxan for multiple myeloma was administered. No recurrent symptoms of multiple myeloma could be observed during one year follow up period.

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우관상동맥 침범한 급성 대동맥 박리증 치험 1례 (Acute Type 1 Aortic Dissection Involving Right Coronary Artery)

  • 민경석;이재원;송명근
    • Journal of Chest Surgery
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    • 제28권2호
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    • pp.188-192
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    • 1995
  • A 50 year old man with acute aortic dissection DeBakey type I, involving right coronary artery and aortic valve, underwent replacement of the ascending aorta and aorto-right coronary bypass grafting. The operative findings showed a large transverse intimal tear was at about 4cm above the aortic valve. The dissection extended out into the proximal right coronary artery. And we found that the right coronary artery originated from the left sinus of Valsalva, run transversally in the aortic wall, with partial rupture. Postoperatively he had no ischemic cardiac symptoms and neurologic complications. He was discharged on postoperative 9th day with good result.

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둔상에 의한 우측 주기관지 완전 절단 치험 1례 (Complete Transsection of Right Main Bronchus by Blunt Trauma -A Case Report-)

  • 조원민
    • Journal of Chest Surgery
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    • 제28권10호
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    • pp.924-927
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    • 1995
  • Main bronchial injury after blunt trauma is very rare in all bronchial injuries and the pathogenesis is variable and not well known in everycases. We report a case of complete transsection of right main bronchus by blunt trauma. This 24-year old patient was transferred from a local hospital with a chest tube. Because of the severe subcutaneous emphysema and tension pneumothorax, we inserted one more chest tube resulting no obvious interval change. With the impression of bronchial injury, we performed an exploratory thoracotomy. We couldn't proceed bronchoscopy in the operation room because of his unstable vital sign. After opening of the chest wall, we could identify completely transsected right main bronchus. We anastomosed the bronchus with 4~0 Vicryl interruptedly. After operation, the patient was recovered without any complication.

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승모판 치환술에 관련된 좌심실 파열[2례] (Left Ventricular Rupture Related to MVR - 2 Case Report -)

  • 최순호
    • Journal of Chest Surgery
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    • 제25권6호
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    • pp.605-610
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    • 1992
  • Improving intraoperative and postoperative myocardial protection and better construction and design of valvular prosthesis has reduced the mortality of MVR. But, ventricular rupture after MVR occurred occasionally and represented a potentially lethal complication. Transverse midventricular disruption presented as refractory myocardial failure immediately on termination of bypass or later often on initial period of good hemadynamics. From Jan., 1985 through Dec., 1991 131 MVRs were performed as isolated or combined procedures. Rupture of the posterior wall of left ventricle was observed in 2 patients. There were 2 type III ruptures Prevention is of utmost importance, and by taking certain precautions, the chance of ventricular rupture can be reduced. Repair should always be done by patch technique in the aid of the use of cardiopulmonary bypass with cardioplegic arrest. When the laceration is in the middle of the posterior left ventricle, external repair with the pericardial patch can be attempted first.

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하인두 및 위의 손상을 동반한 급성 부식성 식도손상의 외과적 치료 (Surgical Treatment for Acute Caustic Injury of the Hypopharynx, Esophagus, and Stomach -Two Cases-)

  • 김형곤;이삼윤;최종범
    • Journal of Chest Surgery
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    • 제28권10호
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    • pp.935-938
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    • 1995
  • Two cases of severe caustic injury of the hypopharynx, esophagus, and stomach are presented. Restoration of digestive continuity was accomplished by retrosternal isoperistaltic interposition of the transverse and left colon on the post-injury 73rd and 66th day respectively. The upper oro-colon continuity was made by a cervical approach, a vertical incision at the posterior hypopharyngeal wall, and interrupted one-layer sutures using 3-0 Dacron suture materials. The distal continuity was made by colojejunostomy between the transposed colon and proximal jejunum. There was no event after the operation in both cases. The posterior vertical hypopharyngotomy and hypopharyngocolostomy at the early post-injury period may be the preferred procedure to obtain normal deglutition in patients with esophageal stricture associated with hypopharyngeal injury.

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Anomalous right coronary artery from pulmonary artery discovered incidentally in an asymptomatic young infant

  • Kim, Kyu Seon;Jo, Eun Young;Yu, Jae Hyeon;Kil, Hong Rang
    • Clinical and Experimental Pediatrics
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    • 제59권sup1호
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    • pp.80-83
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    • 2016
  • Isolated anomalous right coronary artery originating from the pulmonary artery (ARCAPA) is a rare congenital coronary anomaly that is asymptomatic and discovered incidentally in most cases. ARCAPA is generally not considered a fatal defect in infancy or childhood, although cases of sudden death have been reported. Here, we report a 2-month-old female infant who presented with a prolonged fever that was determined to be caused by rhinovirus infection. Myocardial ischemia of the left ventricular posterior wall was already seen on echocardiography, and ARCAPA was discovered incidentally. The patient underwent successful surgical reimplantation of the right coronary artery to the aortic root to re-establish dual ostial circulation.