• Journal of Chest Surgery
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• v.10 no.1
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• pp.59-64
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• 1977

Mediastinal tumor are frequently encountered in clinical practice. Hanten, in 1955, reported-2 adult patients with spontaneous rupture of mediastinal dermoid cysts into the pleural cavity and also, Thompson, in 1963, reported 2 child patients with spontaneous rupture of mediastinal teratoma into the pleural cavity. Mediastinal teratomas have also been reported rupture into other contiguous structures, such as the bronchus, aorta, pericardium, SVC and esophagus. This report presents an instance of spontaneous rupture of an anterior mediastinal teratoma into the right pleural cavity of a 43 year old female. Despite variable diagnostic procedures, the true nature of the lesion was not determined until a thoracotomy and window formation was performed for adequate drainage of empyema thoracis. Removal of the teratoma and mediastinal window formation resulted in complete cure.

• Neurospine
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• v.15 no.4
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• pp.394-399
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• 2018

Subarachnoid pleural fistula (SPF) is an aberrant communication between the pleural cavity and subarachnoid space, resulting in uncontrolled cerebrospinal fluid drainage. The negative pressure of the pleural cavity creates a continuous suctioning effect, thereby impeding the spontaneous closure of these fistulas. Dural tears or punctures in cardiothoracic procedures, spinal operations, and trauma are known to cause such abnormal communications. Failure to recognize this entity may result in sudden neurological or respiratory complications. Hence, a high index of suspicion is required for early diagnosis and prompt management. Noninvasive positive pressure ventilation has been described to be effective in managing such fistulas, thus mitigating the high morbidity associated with exploratory surgery for primary repair. Herein, we describe the typical presentation of SPF and the clinical course, treatment, and follow-up of a patient who sustained SPF following anterior thoracic spinal surgery.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.323-325
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• 2011

Purpose: Breast implant ruptures and displacement are problematic complications after augmentation mammoplasty. The authors report a patient whose cohesive silicone gel implant ruptured and migrated into the pleural cavity after augmentation mammoplasty. Methods: A 23-year-old female had received augmentation mammoplasty at a local clinic a week before visiting our hospital. When the patient's doctor performed a breast massage on the sixth postoperative day, the left breast became flattened. The doctor suspected a breast implant rupture and performed revision surgery. The implant, however, was not found in the submuscular pocket and no definite chest wall defect was found in the operative field. The doctor suspected implant migration into the pleural cavity, and after inserting a new breast implant, the doctor referred the patient to our hospital for further evaluation. The patient's vital signs were stable and she showed no specific symptoms except mild, intermittent pain in the left chest. A CT scan revealed the ruptured implant in the left pleural cavity and passive atelectasis. Results: The intrapleurally migrated ruptured implant was removed by video-assisted thoracic surgery (VATS). There were no adhesions but there was mild inflammation of the pleura. No definite laceration of the pleura was found. The patient was discharged on the first day after the operation without any complications. Conclusion: Surgeons should be aware that breast implants can rupture anytime and the injury to the chest wall, which may displace the breast implant into the pleural cavity, can happen during submuscular pocket dissection and implant insertion.

• International Journal of Vascular Biomedical Engineering
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• v.4 no.1
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• pp.27-30
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• 2006

Background; Pleural micro-metastasis of lung cancer is detected by touch print cytology or pleural lavage cytology, but its prognostic impact has not elucidated yet. We hypothesize that recurrence may depend on the amount of tumor cells disseminated in pleural cavity, if the invasiveness of all cancer is the same. To predict the amount of tumor cells disseminated in pleural cavity, we need pleural surface area, distributed pattern of cells and concentration of cells per unit area. Human pleural surface area has not reported yet. In this report, we calculate the normal human pleural surface area using CT image data processing. Methods; Twenty persons were checked CT scan, and we obtained the data from each image. In order to calculate the pleural surface, the outline of lung was firstly extruded from CT image data using home-made Digitizer program. And the distance between CT images was calculated from the extruded outline. Finally a normal human pleural surface was calculated from function between the distance of consecutive CT images and the calculated length. Results; Their mean age is $65{\pm}12$ years old (range $26{\sim}77$), body weight is $62{\pm}9\;kg\;(48{\sim}80)$, and height is $167{\pm}6\;cm\;(156{\sim}176)$. The number of images used is $36{\pm}7\;(24{\sim}51)$. Pleural surface area is $211,888{\pm}35,756\;mm^2\;(143,880{\sim}279,576)$. Right-side pleural surface area is $107,932\;mm^2$ and Lt is $103,955\;mm^2$. Costal, mediastinal and diaphragmatic surfaces of right-side pleura are $77,483\;mm^2,\;39,057\;mm^2,\;and\;8,608\;mm^2$ respectively, and left-side are $72,497\;mm^2,\;35,578\;mm^2,\;and\;4,120\;mm^2$ respectively. Conclusion; Normal human pleural surface area is calculated using CT image data at first and the result is about $0.212\;m^2$.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.205-213
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• 1977

In order to evaluate the therapeutic effect of thoracostomy on the patients with pathological changes in pleural cavity which were caused by various etiological factors, a clinical study was carried out during a period of 5 and half years from May 1972 to September 1977 in the department of thoracic surgery, Hanyang University Hospital, and the following results were obtained. Of a total of 264 patients, 205 cases were male, and 59 female, exhibiting the ratio of male to female being 3.5 to 1. The pathological changes in pleural cavity could occur at any age from 4 months after birth to 76 years old, the peak incidence being in the third decade in either male or female. The incidence decreased in the second, fifth and fourth decade in order. The type of pathological changes observed and their frequencies of occurrences were 93 cases [35.2%] in pneumothorax, 62 cases [23.5%] in hemothorax, 48 cases [18.2%] in pyothorax, 46 cases [17. 4%] in hemopneumothorax, 13 cases [4.9%] in hydropneumothorax, and one case each in hydrothorax and chylothorax. The incidence of the primary diseases which predisposed the pathological changes in pleural cavity were, 119 cases [45-1%] in trauma, 64 cases [24.2%]in lung tuberculosis, 38 cases [14.4%] in pneumonia or empyema, 14 cases [5.3%] in lung emphysema and blebs, 13 cases [4.9%] in process after thoracotomy, 3 cases [1.1%] each in lung malignant tumor and lung paragonimiasis, one case in mechanical ventilator and 9 cases [3.4%] in unknown origin. The pathological changes in pleural cavity were located in the right side of the cavity in 124 cases, in the left side in 133 cases and in both sides in 7 cases, indicating that the difference between the incidence of the left and rightside occurences was insignificant. Of 93 cases of pneumothorax studied, 63 cases were found to have been tension pneumothorax and 30 cases non-tension pneumothorax, showing greater prevalence of tension type over non-tension type. Of 119 cases of trauma observed, 82 cases were accompanied with rib fractures and 37 cases were without any fracture [non-bone fracture]. Patients with the rib fractures were characterized by multiple rib fractures and multiple double fractures of ribs, accompanying with or without fracture of bones other than ribs, and patients with non-bone fracture were characterized by penetrating stab wound and blunt trauma. Of 264 cases who received thoracostomy, 207 cases [78.4%] demonstrated that their pathological changes in pleural cavity were removed and subsided by a simple measure of thoracostomy. In 43 cases [16.3%], various surgical measures including radical operation and thoracotomy were required for complete healing, since their pathological changes were not abolished by thoracostomy alone. The rest 14 cases [5.3%] were expired following thoracostomy.

• Tuberculosis and Respiratory Diseases
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• v.76 no.5
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• pp.199-210
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• 2014

Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references.

• The Journal of Internal Korean Medicine
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• v.21 no.4
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• pp.671-676
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• 2000

Pleural effusion is a state, retention of a mount of liquid in pleural cavity. Main causes of pleural effusion is Congestive Heart Failure that is caused by left ventricular heart failure. And that of Congestive heart failure is caused by increase of pleural capillary pressure or remain of effusion in pleural cavity. Bilateral venous pressure of pleura make worse pleural effusion and one way of venous pressure of that bring out pleural effusion. The purpose of this study is to examine the efficacy of oriental treatment for pleural effusion is caused by heart failure. One woman of 86 years old complained the symptom of general weakness, dyspnea, flank pain, anorexia, insomnia, coughing, secretion mixed blood. The symptom is caused by effusion that is brought out acute pneumonia, heart failure. At the time of Admission, in the diagnosis of Admission, in the diagnosis of Hyuneum(懸飮) she had taken Kungha-tang hap pleurisy-bang,(芎夏湯合助膜炎方), so improved dyspnea, flank pain, insomnia, coughing. In views of examination, decrease of heart failure' s symptom and pleural effusion. After 13days of admission, she had taken palmul-tang.(八物湯). As a conseguence of that, the symptom of general weakness. anorexia is improved and she was discharged.

• Childhood Kidney Diseases
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• v.27 no.1
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• pp.46-53
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• 2023

Pleuroperitoneal communication (PPC) is a rare mechanical complication of peritoneal dialysis (PD), which causes dialysate to move from the peritoneal cavity to the pleural cavity, resulting in pleural effusion. Typically, PPC is discovered through pleural effusion in PD patients who are not in volume overload status. A unique characteristic of the pleural effusion caused by PPC is that it is not resolved by increasing ultrafiltration by dialysis. In this report, we present a 7-year-old girl with PD after birth with the history of various infectious PD-related complications, presenting with fever ongoing for 6 months. PPC-associated pleuritis was suspected as the cause of fever, which eventually developed after long-term PD and induced complicated pleural effusion, lung inflammation, and prolonged fever for 6 months.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.260-262
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• 2012

Postpneumonectomy empyema is a life-threatening complication, which is often related with a bronchopleural fistula. After surgical repair of fistula, sterilization of infected pleural cavity is important and usually carried out by long-term cyclic irrigation. We report a case in which vacuum-assisted closure device was successfully applied to sterilize the pleural cavity and obliterate bronchopleural fistula.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.633-637
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• 2001

The authors report a case of syringo-pleural shunt for recurrent distal obstruction of syringosubarachnoid shunt in a 23-year-old woman. She complained of tingling sensation and dysesthesia on the left upper extremity. Neuroradiologic imaging studies revealed syringomyelia in the left lateral side of the cord from medulla to 7th thoracic cord level. We identified intraoperatively high internal pressure of the syrinx cavity due to distal shunt tube obstruction. Syringo-pleural shunt was performed and cavity size was markedly decreased at later follow up MRI. In conclusion, the posttraumatic syrinx, especially in cases with previous syringosubarachnoid shunt or diffuse subarachnoid scarring, can be successfully managed with syringo-pleural shunt.