• Journal of Chest Surgery
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• 제13권3호
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• pp.312-318
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• 1980

The first case was a 20 year old female who has been suffered from epigastric pain, and anorexia for 2 years. A thumb tip sized pulsion diverticulum 4cm above the esophagocardial junction was elicited by esophagogram and on exploration. A diverticulectomy with long esophagocardiomyotomy was performed. The second case was a 30 year old house wife who has had postprandial epigastric pain for 2 months accompained with frequent vomiting. Fiberscopy and esophagogram showed epiphrenic diverticulum of the esophagus. Same operative procedures were carried out and obtained a good result as first case. The third case was a 55 year old house wife who was admitted to this Chest Surgery Department because of regurgitation and intermittent vomiting for approximately 3 months. Esophagogram showed a large epiphrenic diverticulum of the esophagus. On exploration, a tennis ball sized pulsion diverticulum was found on the anterolateral wall of the esophagus. A partial esophagectomy including the diverticulum and esophagoesophagostomy was performed. The specimenshowed some erosive changes of the mucosal surface of the diverticulum and also the esophagus suggestive of diverticulitis and esophagitis. She has been satisfactory result until 4 months postoperatively, when she developed regurgitation and epigastric pain. Esophagogram showed stenosis of the operative site. Readmission and esophageal dilatations were done and improved without any problem. Epiphrenic or supradiaphragmatic diverticulum of the esophagus is a rare condition. Pathophysiologically, the conditions accompanied the spasm of the esophagus, many authors prefered the procedures of a diverticulectomy plus long esophagocardiomyotomy rather than simple diverticulectomy or esophagectomy and esophagoesophagostomy. Here we report the cases and reviewed the literatures.

• Journal of Chest Surgery
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• 제37권3호
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• pp.272-274
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• 2004

드문 예인 좌심방이-농양을 수술, 항생제 및 종격동 세척술로 치료한 성공적인 치험 예를 보고하고자한다. 요로감염의 과거력을 가진 9세 여아가 지속적 발열을 주소로 내원하였다. 심초음파와 자기공명 영상에서 다량의 심낭삼출과 좌상심연의 종괴가 관찰되었다. 심낭천자액 균배양에서 포도상구균이 검출되었다. 환아는 체외순환하에 종괴 절제술을 받았는데 종괴는 좌심방이에 위치하였으며 내부는 섬유화농성 농양이 형성되어 있었다. 수술 후 종격동 세척술을 시행하였다. 병리검사소견은 기질화된 혈전을 동반한 섬유화성 벽심내막염이었다. 환아는 특별한 합병증 없이 술 후 21일에 퇴원하였다.

• Journal of Chest Surgery
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• 제15권2호
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• pp.222-229
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• 1982

The aneurysmal dilatation of ascending aorta with the aortic regurgitation presents typical surgical problems. Over the years, various surgical procedures had been used for the management of the dilated segment of sending aorta and the aortic regurgitation. The surgical technique Is still in the state of evolution. The one method is the super coronary replacement of the ascending aorta with vascular graft and replacement of the aortic valve with preservation of the coronary ostia as advocated by Miller and his colleague at Stanford University, so called conventional technique". The other is the replacement of aortic valve and the dilated segment of the ascending aorta using a composite graft and transplantation of the coronary ostia as described by Bentall and DeBono in 1968. The controversy appears to evolve around 3 technical problems. One is bleeding from the grafted area. Two is later development of the aneurysmal dilatation of the subcoronary aortic wall when non-composite graft is employed. Three is a management of the coronary arteries. The purpose of this article is to present our experience with 7 cases of annuloaortic ectasia in whom both of these surgical techniques at that employed and to review some of the problems that encountered during the management of these patients .

• Journal of Chest Surgery
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• 제35권8호
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• pp.616-620
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• 2002

기관기관지는 기관우측벽에서 기시하는 이상 혹은 부기관지를 말하며 재발성 폐렴, 비폐쇄성 기관지 확장증등 염증성 질환과 관련있다. 최근에 우리는 폐 방사균증과 관련된 기관기관지 1례를 경험하였다. 37세의 남자 환자는 재발성의 객혈을 호소하였고 당초 폐결핵으로 추정하여 항결핵제를 투여받았으나 임상적으로나 방사선학적으로 호전을 보이지 않았다. 우상엽 폐절제술이 시행되었으며 조직학적 검사에서 폐 방사균증으로 확진되었다. 술 후 환자는 3개월간 penicillin과 ampicillin이 투여됐으며 6개월간의 추적기간동안 재발을 나타내지 않고 완전히 회복되었다.

• Tuberculosis and Respiratory Diseases
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• 제69권3호
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• pp.191-195
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• 2010

Abnormally located liver tissue has been described in the vicinity of the liver proper, near anatomical structures such as the gallbladder, the umbilical fossa, the adrenal gland, the pancreas, and the spleen. Supradiaphragmatic ectopic liver is a rare finding, but has been reported to have been found in the intrathoracic cavity and in the pericardium. In the majority of supradiaphragmatic ectopic liver cases, there was an accompanying transdiaphragmatic pedicle of the main liver body into the abdominal cavity. In a minority of supradiaphramatic ectopic liver cases, the liver was completely separated from the abdominal cavity without a connection between the thorax and the abdomen, with accompanying diaphragmatic anomalies. We describe one case of intrathoracic ectopic liver in a patient with a previous history of lower chest wall trauma, and a brief review of the English-language medical literature on this topic.

• Journal of Chest Surgery
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• 제18권2호
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• pp.273-278
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• 1985

The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

• Journal of Chest Surgery
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• 제18권3호
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• pp.474-481
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• 1985

Pulmonary cavity is the result of necrosis of lung parenchyma with evacuation of the necrotic material via the tracheobronchial tree. A communication with the tracheobronchial tree permits air to enter the area of necrosis, so the radiologic result show the a lucent defect. The radiologic characteristics of the wall of a cavity are determined by the reaction of the lung parenchyma to the pathologic process. Therefore, the shadows of the chest films in cavitary lesion were variable in its nature. The author, in 42 cases which have a cavitary lesion in X-ray findings among 172 cases resected lung obtained in P.N.U.H. from 1979 to June, 1985, studied similarities and differences between the pathogenesis of these lesions and the radiologic findings. The author reviewed the 42 cavitary lesions and the following results were obtained. 1. The cavitary lesions were seen in 42 [24.4%] out of 172 cases of resected lung disease. 2. Histopathologically, pulmonary tuberculosis was 47.6% and primary lung cancer was 9.5%. 3. The most common site of the lesion was right upper lobe. 4. The most common size of the cavity was from 3 to 6 cm in diameter. 5. Lobectomy was the most common operated method.

• Journal of Chest Surgery
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• 제24권2호
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• pp.143-152
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• 1991

From 1983, until June, 1990, 10 patients with various type of truncus arteriosus underwent total surgical correction including Rastelli procedure at Seoul National University Hospital. The age at operation ranged from 1 month to 9 years [mean 2.1 years]. Six patients had truncus type I, 3 patients had truncus type II, and one patients had truncus type IIIc. Right ventricular pulmonary artery continuity was established with a porcine valved conduit in 6 patients, mechanical valved conduit in 1 patient, and bovine pericardial conduit in 3 patients. The postoperative right ventricular /left ventricular pressure ratio ranged from 0.4 to 0.71 [mean 0.51${\pm}$0.14]. The lung histology revealed grade II pulmonary obstructive disease even at 4 month of age. Five patients were dead in hospital [50%], and they were less than 2 year of age. One patient, who had severs congestive heart failure preoperatively, died of low output syndrome and the other died of low output syndrome with postoperative bleeding. There were three death, because of a pulmonary hypertensive crisis that might have been prevented. Two of the five survivors had conduit failure over a mean follow up of 42 months [range 1 to 78 months]. Obstructed conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and the patch of bovine pericardium and Dacron as patch the roof of the conduit. One patient died of acute cardiac failure during the operation. Although results in infants less than 2 years old have not been good, current improvement of intra-and postoperative care suggested that prompt repair is indicated for infants with truncus arteriosus.

• Journal of Chest Surgery
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• 제27권11호
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• pp.942-947
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• 1994

Post-thoracotomy pain is so severe that lead to postoperative pulmonary complications due to the patient`s inability to cough, deep breathing and chest wall motion. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1990, we reported the result that the cryoanalgesia reduce the immediate postoperative pain significantly. We try to compare the effect of cyroanalgesia with the effect of Bupivacain intercostal nerve block for the post-thoracotomy pain control. Ninety patients, who undergoing thoracotomy in Korea University Medical Center Guro Hospital between the January 1993 and September 1993, were evaluated. The patients were divided into three groups : Group A, control, the patients without pain control procedure [N=30], Group B, the patients with Bupivacain intercostal nerve block [N=30], Group C, the patients with cryoanalgesia [N=30]. Postoperative analgesic effects were evaluated by the scoring system which made arbiturary by author. The results were that the Bupivacain intercostal nerve block markedly reduced the immediate postoperative pain compare with two other groups, the cryoanalgesia reduced the immediate postoperative pain significantly compare with control group, the pain reduction effect of the two groups- cryoanalgesia and Bupivacain intercostal nerve block- were not different at postoperative seventh day, probably due to the action time of Bupivacain and the result that there were no significant complications of the procedures.

• Journal of Chest Surgery
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• 제11권3호
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• pp.246-252
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• 1978

A three year and seven month old girl with moderate depression deformity of the sternum associated with a huge well defined homogenous hazy mass density of the upper half of the right hemithorax on plain chest x-ray had developed, exertionaI dyspnea (Figs1, 2 and 3). Correction of the funnel chest was carried out with modified Ravitch procedure and resection of the intrathoracic cystic mass was performed through an anterolateral thoracotomy incision in one stage operation satisfactorily (Figs. 7 and 8). On exploration, the mass, $15{\times}12{\times}10$cm in size, was connected to the bronchus at 1cm a bove the carina by a stalk (Fig. 4). The outer surface showed abundant vasculature. The specimen was filled with mucoid material; the inner surface was much trabeculated. glistening and smooth (Fig. 5 and 6). yficroscopically, the cyst was lined with simple or pseudostratified ciliated columnar epithelium. The cystic wall was composed of loose fibrous connective tissue, muscle layers, cartilages with some lymphocytic infiltration (Fig. 9). Isolated cases of funnel chest deformity and congenital bronchogenic cystic disease are not uncommon; however, the assocbtion of the two conditions is yery rare. Therefore. report and review of the literature was done.