• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.568-573
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• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

• Journal of Chest Surgery
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• 제46권2호
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• pp.138-141
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• 2013

Pericardial cysts are reported by some authors, but epicardial cysts are extremely rare. We report one case of epicardial cyst that was detected incidentally and was removed successfully. Furthermore, unusually, pathological examinations confirmed that the cyst wall was looked like a vessel wall.

• Journal of Chest Surgery
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• 제45권4호
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• pp.269-271
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• 2012

Solitary plasmacytoma of the bone, and especially of a single rib, is a rare disease. Here we report a 73-year old male patient complaining of continuous chest wall pain around the right 5th rib shaft who underwent a wide excision of the rib tumor with surrounding connective tissue. He was diagnosed with solitary plasmacytoma and will undergo radiation therapy. We report this case with a review of the literature.

• Journal of Chest Surgery
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• 제28권1호
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• pp.65-68
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• 1995

Pectus excavatum occasionally occurs in patients who have underlying cardiac disease, especially Marfan syndrome. This report describes a patient with pectus excavatum who had ascending aortic aneurysm with aortic regurgitation and anterior leaflet prolapse of mitral valve. This patient underwent replacement of aortic valve and ascending aorta with 25 mm SJM valved conduit graft[Bentall operation with Cabrol shunt , and mitral valve replacement with SJM 31 mm, the pectus excavatum was corrected at the time of completion of the intracardiac operation with the modified sternal turnover. This procedure offered excellent operative exposure for the inracardiac operation with prevention of low cardiac output after operation due to depressed sternum and maintained chest wall stability resulting good cosmetic chest wall appearance. This patient recovered and discharged in good postoperative result with minimal temporary peroneal nerve palsy in his left leg.

• Journal of Chest Surgery
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• 제32권9호
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• pp.844-846
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• 1999

이물질(foreign body)의 만성적인 자극은 혈관에 지연성 손상을 가져올 수 있다. 척추 측후만증을 교정하고 자 약 14개월 전에 흉추에 CD 금속강과 나사못(Cotrel-Dubousset rods and screws)을 장치했던 환자에서 CD 나사못의 만성적인 자극으로 흉벽의 박동성 혈종을 합병한 가성 대동맥류가 발생하였다. 이 환자에서 가성 대동맥류가 발생한 하행대동맥 부위를 절제하고 인조혈관 대치술로 치료하였기에 보고한다.

• Journal of Chest Surgery
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• 제35권10호
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• pp.750-754
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• 2002

원발성 심장 종양은 드물며 이들 중 20~25%에서 악성 종양이다. 더욱이 심장에서의 원발성 악성 간엽세포종은 극히 드문데, 최근 저자 등은 2례의 심장 악성 간엽세포종을 경험하였다. 첫 번째 예는 승모판 폐쇄부전증을 보인 61세의 여자환자로 승모판을 막고있는 좌심방의 후측벽에서 생긴 악성 간엽세포종이었다. 2.7$\times$3.7cm크기의 종괴는 승모판의 후내측 교련과 판륜까지 자라고 있었다. 좌심방의 벽측은 남긴채 종괴는 부분 절제하였다. 환자는 항암치료를 받고 30일 후에 별문제 없이 퇴원하였으며, 19개월 동안 외래 추적관찰 중이다. 두 번째 예는 좌측 하폐정맥에서 기원한 4$\times$5cm기의 약하고 연노란색의 다엽성의 종괴였다. 다른 작은 종양결절들이 좌심방의 벽과 승모판 후엽에서 발견되었다. 수술은 종양의 부분절제와 승모판막치환술을 시행하였다.

• Journal of Chest Surgery
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• 제29권7호
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• pp.792-797
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• 1996

기관지흥막루를 동반한 농흥은 폐 수술이후 나타날 수 있는 심각한 합병증중의 하나이다. 이같은 기관지 흥막루를 동반한 농흥의 수술을 치료하는 몇가지 방법들이 있으나 그 결과는 언제나 만족스러운 것은 아니다. 최근 조직편 (대망, 흉벽근)을 이용하여 농흥환자에서 기관지흥막루를 막아 좋은 결과를 얻은 보고들이 나오고 있다. 우리는 1명의 환자에서 대망을, 3명의 환자에서 흉벽근을 이용하여 기관지흥막루를 막아주었다. 수술후 환자들은 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제41권6호
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• pp.768-771
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• 2008

관상동맥질환에서 경피적 관상동맥 중재술 시 IVUS는 혈관내강과 혈관벽의 상태 죽상경화의 위치 및 범위, 중재술 후의 혈관내강의 상태에 대한 다양한 정보를 제공한다. 근래에 스텐트 삽입 후 IVUS의 사용이 점차 증가하는 추세이지만 장기적 유용성은 아직 입증되지는 않았다. 스텐트 삽입술 후 IVUS로 확인하는 과정에서 카테터가 포획되었고 이를 제거라는 과정 중 골절이 발생한 경우를 외과적으로 치험하였기에 문헌고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
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• 제39권10호
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• pp.799-801
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• 2006

40세 여자가 앞가슴에 발생한 종양을 주소로 내원하였다. 종양은 흉벽에 생긴 결절성근막염으로 진단되었다. 결절성근막염은 섬유모세포의 증식을 특징으로 하는 드문 양성 연부조직 종양으로, 외과적 절제가 가장 효과적인 치료이다. 외과적 절제 후 저자들은 결절성근막염을 치험하였기에 문헌 고찰과 함께 이를 보고하는 바이다.

• Journal of Chest Surgery
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• 제44권5호
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• pp.364-367
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• 2011

True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.