• Title/Summary/Keyword: 흉부 손상

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The Effects of Nitric Oxide and Sphingosine 1-phosphate on the Pulmonary Microstructure in a Rat Model of Acute Lung Injury: An Intravital Videomicroscopic Approach (Nitric Oxide 및 Sphingosine 1-phosphate가 말초 호흡 단위에 미치는 영향의 생체 내 분석: 백서의 급성 폐 손상 모델에서 생체 접촉 현미경을 이용한 연구)

  • Lee, Jae-Ik;Jheon, Sang-Hoon;Sung, Sook-Whan;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.177-188
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    • 2008
  • Background: To evaluate the effects of inhaled nitric oxide (NO) and sphingosine 1-phosphate (S1P) as potential therapeutic agents of acute lung injury, we analyzed the morphology in vivo of the pulmonary microstructure using intravital videomicroscopy in a rat model of acute lung injury. Material and Method: Sprague Dawley rats were divided into five groups: a control group that underwent normal saline aspiration, an acute lung injury (ALI) group that underwent hydrochloric acid aspiration, and three treatment groups that underwent hydrochloric acid aspiration and were administered therapeutic agents- the S1P group, the NO group, and the S1P+NO group (n=7 per group). To quantify alveolar compliance and interstitial edema, the diameters of all measurable alveoli and interalveolar septa were averaged at one and two hours after aspiration. Alveolar compliance was determined according to diameter changes during the respiratory cycle and the change in tidal volume. Result: At two hours after aspiration, the mean alveolar compliance (% change) in the All group decreased significantly versus the control group of rats (respiratory cycle: 1.9% for the ALI group vs 6.5% for the control group, p=0.03; tidal volume: 3.2% for the ALI group vs 9.1% for the control group, p=0.003) and versus the NO group (tidal volume: 3.2% for the ALI group vs 16.9% for the NO group, p=0.001). At two hours after aspiration, the mean interalveolar septal thickness in the NO group tended to be smaller as compared to that in the All group ($15.2{\mu}m$ for the ALI group vs $12.3{\mu}m$ for the NO group, p=0.06). S1P did not exert a significant effect on the pulmonary microstructure of the injured rat lung. Conclusion: Improved alveolar compliance and reduced interstitial edema, observed by intravital videomicroscopy, suggest that inhaled NO ameliorates lung injury.

Invasive Pulmonary Aspergillosis Invaded to Thoracic Vertebra in a Immunocompetent Host - A case report- (정상 면역력을 가진 환자에서 발생한 흉추를 침범한 침습형 폐국균증)

  • 김혁;정기천;박지권;김영학;강정호;정원상
    • Journal of Chest Surgery
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    • v.37 no.12
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    • pp.1022-1024
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    • 2004
  • Pulmonary aspergillosis is the most common disease of fungal infection and has lower infectivity. Pulmonary asergillosis is classified by aspergilloma, bronchopulmonary aspergillosis, necrotic and invasive aspergillosis. Invasive aspergillosis is found in immune compromised host, immunosuppressive treatment after organ transplantation, anticancerous chemotherapy, blood abnormality, AIDS patients etc. We reported a case of invasive aspergillosis in an immunocompetent host, with review of literatures.

clinical analysis of vascular trauma (혈관손상의 임상적 고찰)

  • 성숙환
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.288-294
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    • 1986
  • During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

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Protective Effect of Chlorpromazine for the Isolated Rat Heart from Reperfusion Injury (Chlorpromazine 이 과분극 정지심장의 재관류 손상에 미치는 보호효과)

  • 류한영
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.9-15
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    • 1990
  • This study was designed to investigate the protective effect of chlorpromazine against the reperfusion injury of myocardium after high potassium cardioplegic arrest. Langendorff`s preparations of rat heart were infused with high potassium cardioplegic solution[St. Thomas Hospital Solution] at 25oC. Chlorpromazine [10-7M] increased the recovery of myocardial contractility[dp/dt], left ventricular pressure[LVP], and coronary flow rate of the reperfused heart. Both in control and experimental groups, the restoration of myocardial activity could not reach to the level of preplegic control. These results suggest that the etiologic factors of the reperfusion injury include the influence of high potassium cardioplegic solution and/or reperfusion itself, and that chlorpromazine protects myocardium from the reperfusion injury.

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Traumatic Diaphragmatic Injuries (외상성 횡격막 손상)

  • 오창근
    • Journal of Chest Surgery
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    • v.24 no.6
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    • pp.579-584
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    • 1991
  • The records of 25 patients with traumatic diaphragmatic injuries seen at Chosun University Hospital from February 1977 to May 1991 were reviewed. We treated 20 male and 5 female patients ranging in age from 6 to 72 years. The diaphragmatic injuries were due to blunt trauma in 19 cases[traffic accident 13, fall down 4, compression injury 2] and penetrating trauma in 6 cases[stab wound 5, gun shot 1]. Most common symptoms were dyspnea[72%], chest pain[56%] and abdominal pain [40%], Chest X-ray were normal in 7 cases[28%] and 22 cases[88%] were diagnosed or suspected as diaphragmatic injuries preoperatively. The repair of 25 cases were performed with thoracic approach in 16 cases, thoracoabdominal approach in 6 cases and abdominal approach in 3 cases. Postoperative complications included atelectasis, wound infection and empyema. there was no postoperative death.

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Stab Wound of the Heart: A report of three cases (심장손상 3례에 대한 치험)

  • Lee, Young;Kwack, Moon Sub
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.63-68
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    • 1976
  • Cardiac injury is a relatively uncommon entity, which calls for emergency surgical treatment. During the period from 1974 up to 1975, three cases of stab wound of the heart were treated in Department of Thoracic Surgery. Capital Armed Forces General Hospital among 70 chest injury cases. All of the cases had stab wounds on the heart by knife. Injured sites were found in two cases on the right ventricle, and one case on the right atrium and intrapericardial inferior vena cava. All patients were treated by thoracotomized and sutured with 000 silk for myocardial stab wounds. One of these died of cerebral hypoxia, who was resuscitated from cardiac arrest during operation. Pericardial tamponade signs were not definite except one case.

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Traumatic Hemobilia Following Blunt Chest Trauma -Report of 2 Cases- (흉벽 손상후 발생한 외상성 Hemobilia -2례 보고-)

  • Hahn, Young Sook;Lee, Hong Kyun
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.117-124
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    • 1976
  • Hemorrhage into the biliary system as a consequence of injury to the liver has been called "traumatic hemobilia," a term introduced by Sandblom in 1948. The source of gastrointestinal hemorrhage has been frequently misinterpreted, resulting in inadequate or inappropriate treatment, often with catastrophic results and needless fatalities. It is now being diagnosed with increasing frequency, due to more widespread knowledge of the syndrome and improved diagnostic means. we experienced 2 cases of hemobilia following blunt chest trauma, One patient had! multiple rib fractures on right chest by car traffic accident and 13 days later, suddenly massive melena was developed with nausea, vomiting, jaundice and severe pain on right upper quadrant. And so, he had operated on the ligation of Rt. hepatic artery and partial right hepatectomy for a traumatic hemobilia. The other one also revealed similar symptoms 20 days later following blunt chest injury by falling down accident. However, uneventful recovery was seen without any of surgical intervention in this case.

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Surgical Treatment of Vascular Injuries (혈관손상에 관한 임상적 고찰)

  • 홍종완
    • Journal of Chest Surgery
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    • v.21 no.6
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    • pp.984-989
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    • 1988
  • 2-D echocardiographic examination of the aortic root diameter was known to be useful in the selection of the size of the prosthetic valve. Valve-patient mismatch was occasionally a serious problem after valve replacement, especially in aortic valve disease. Preoperative knowledge of the patient`s valve annulus size is therefore of great importance in the surgical management of these patients. So the relationship between preoperative 2-D echocardiographic diameter of the annulus size and replaced prosthetic valve were evaluated. 13 patients were analyzed in this study. 2-D echocardiographic measurements of aortic annulus diameter, as determined from the parasternal long axis view and apical four chamber view, demonstrated a high correlation with actual prosthetic valve size implanted at surgery[r=0.86, p< 0.001, SEE=1.08].

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Traumatic Injury of Diaphragm (외상성 횡격막 손상)

  • 신호승
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.308-312
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    • 1995
  • A 5-year retrospective study of 14 patients with diaphragmatic injuries revealed 9 blunt and 5 penetrating injuries. In the blunt trauma group, 7 were left and 2 were right side. The penetrating diaphragmatic wound consist of 3 left and 2 right sided. Sex ratio was 11: 3, with male predominanace. Preoperative diagnosis was possible in 9 cases and delayed diagnosis [greater than 24 hours occured in 5 cases.Simple chest X-ray was diagnostic or highly suggestive in 7 cases. 7 cases were diagnosed diaphragmatic injuries by computed tomography, fiuroscopy or by explorative operation. All of the cases had association injury. 11 cases of diaphragmatic ruptures were corrected through thoracotomy and 3 cases needed exploratory laparotomy. One death occured after operation due to associated injuries and respiratory failure. Blunt and penetrating diaphragmatic injuries remain a diagnostic challenge and associated injuries, delayed diagnosis determine the outcome.

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A Tunnel Technique to Protect the Skeletonized Left Internal Thoracic Artery (골격화된 좌내흉동맥편을 보호하기 위한 이식편의 경로 만들기)

  • 최종범;한재오
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.690-692
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    • 1999
  • internal thoracic artery is used in myocardial revascularization because of many advantages. However, it may not be appropriate in the usual extrapleural or intrapleural route, because it can be easily displaced and injured due to the slender and weak characteristics. We introduce here, a simple technique of repositioning the skeletonized left internal thoracic artery in a stable and straight course by creating a tunnel between the left lateral pericardium and thymic tissue.

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