• Title/Summary/Keyword: 흉부 손상

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Pictorial Essay: Understanding of Persistent Left Superior Vena Cava and Its Differential Diagnosis (임상화보: 지속성 좌측상대정맥의 이해와 감별 진단)

  • Eo Ram Jeong;Eun-Ju Kang;Joo Hee Jeun
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.846-860
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    • 2022
  • Persistent left superior vena cava (PLSVC) is a rare congenital, thoracic, and vascular anomaly. Although PLSVCs generally do not have a hemodynamic effect, several types of PLSVC and some cardiac anomalies may manifest with clinical symptoms. The presence of PLSVC can render catheterization via left subclavian access difficult when placing a pacemaker or central venous catheter. As such, recognizing a PLSVC that is typically incidentally discovered can prevent complications such as vascular injury. Differentiating vessels found in a similar location as PLSVC is necessary when performing thoracic vascular procedures. This pictorial essay explains the multi-detector CT findings of a PLSVC, and provides a summary of other blood vessels that require differentiation during thoracic vascular procedures.

Surgical Treatment of Traumatic Rib Fracture with Judet's Rib Struts (Judet씨 Struts를 이용한 외상성 늑골골절의 치료)

  • Heo, Gang-Bae;Kim, Dae-Yeon
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1010-1014
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    • 1997
  • Judet's rib struts which are designed for osteosynthesis are made of stainless steel This report describes clinical analysis of our experiences of 30 cases with the operative stabilization of multiple rib fractures with Judet's rib struts from December, 1995, to December, 1996 in Chungmoo Hospital, Chounan. Our indications for operative stabilization were as follows: 14 cases in flail chest, 8 cases in severe displacement of rib including segmental fractures, 7 cases in additional procedures during intrathoracic operation, and 1 case in other cause. Postoperative artificial ventilation is needed in only 1 case for 5 days and postoperative complications were few: 2 cases of hemopneumothorax, 2 cases of alcohol withdrawal delirium, and 1 case of postoperative hepatitis. Average duration of hospital admission who have limited thoracic injuries was 10.5 days. Though more comparative studies is necessary, we find this technique to be better than previously published m thods, since it provides better stabilization and immobilization of the ribs and shortening the duration of hospital admission.

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Carotid-jugular Arteriovenous Fistula Caused by Gunshot Injury (총상으로 인한 경동맥-경정맥 동정맥루)

  • Han Jong-Hee;Kim Yong-Ho;Yu Jung-Hwan;Kang Min-Woong;Yu Jae-Hyeon;Lim Seung-Pyung;Lee Young;Na Myung-Hoon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.407-410
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    • 2006
  • Carotid artery-internal jugular vein arteriovenous fistula is very rare, but it should be suspected in case of vascular injury by neck trauma because the diagnosis may be missed due to anatomical complexity of neck, We report a 57-year old male who had the carotid artery-jugular vein arteriovenous fistula caused by gunshot injury in the neck 44 years ago.

A Case of Primary Endobronchial Leiomyoma Diagnosed During Treatment of Pneumonia (폐렴치료 중 발견된 원발성 기관지내 평활근종 1예)

  • Kim, Jin-Woo;Lee, Sang-Haak
    • Korean Journal of Bronchoesophagology
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    • v.15 no.2
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    • pp.75-80
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    • 2009
  • A 44 year-old nonsmoker female presented to our hospital with persistent cough with sputum for three months. She had been diagnosed as pneumonia and treated with antibiotics in a local hospital but was transferred to our hospital because of no symptomatic improvement. We performed flexible bronchoscopy and found an ovoid and smooth surfaced mass obstructing the bronchus of right middle lobe. The biopsy specimen revealed a benign tumor composed of spindle cells without dysplasia consistent with leiomyoma. There was no evidence of leiomyoma in uterus. The right middle lobectomy and bronchoplasty were performed and the patient was healthy twelve months later. Primary endobronchial leiomyoma is a rare benign tumor of the lung. Herein we report a case of primary endobronchial leiomyoma diagnosed during treatment of pneumonia.

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Modified Norwood Procedure without Circulatory Arrest and Myocardial Ischemia - Report of 2 cases - (완전순환정지와 심근허혈 없이 시행한 변형 Norwood 술식 - 2 례 보고 -)

  • 백만종;김웅한;전양빈;김수철;공준혁;류재욱;오삼세;나찬영;김양민
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.547-551
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    • 2001
  • The effects of deep hypothermia and circulatory arrest during aortic arch reconstruction are associated with potential neurologic and myocardial injury. We describe a surgical technique that two patients underwent a modified Norwood procedure without circulatory arrest and myocardial ischemia. One was 13-day-old female patient, weighing 3.1kg, having a variant of hypoplastic left heart syndrome and another was 38-day-old male patient, weighing 3.4 kg, diagnosed Taussig-Bing anomaly with severe aortic arch hypoplasia, coarctation of the aorta, and subaortic stenosis. The arterial cannula was inserted in innominate artery directly. During Norwood reconstruction, regional high-flow perfusion into the inominate artery and coronary perfusion were maintained and there were no neurologic, cardiac, and renal complications in two patients. This technique may help protect the brain and myocardium from ischemic injury in patients with hypoplastic left heart syndrome or other arch anomalies including coarctation or interruption.

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Delayed Diagnosis of Cardiac Tamponade That Was Caused by Intramural Hematoma of the Ascending Aorta -A case report- (상행대동맥 벽내 혈종에 의해 발생한 심낭 압전의 지연 진단 - 1예 보고 -)

  • Hwang, Yoo-Hwa;Song, Suk-Won;Yi, Gi-Jong
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.194-198
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    • 2010
  • Intramural hematoma of the aorta (IMH) is the precursor or a variant of a classic aortic dissection where hemorrhage occurs within the aorta wall in the absence of an initial intimal tear. IMH has a high rate of mortality and morbidity. The optimal therapy for IMH is uncertain, yet the involvement of the ascending aorta is usually considered as an indication for surgery due to the associated risk of rupture or cardiac tamponade. We report here on a case of a 71-year-old man who presented with syncope. Because of misdiagnosis, he underwent computed tomography (CT) after 5 hrs from arriving to the ER. Computed tomography of the aorta revealed intramural hematoma of the ascending aorta with cardiac tamponade. He also had vascular complications such as acute renal failure and visceral ischemia. We performed emergency graft replacement of the total arch and ascending aorta. He was discharged without complication on postoperative day 14.

Non-Robotic, Endoscopic Hemi-Thyroidectomy via Retro-auricular Single-incision Approach : A Preclinical Feasibility Study in Cadavers (후이개 절개를 이용한 내시경 갑상선 절개술-전임상 사체연구)

  • Lee, So-Yoon;Sun, Dong Il;Ahn, Su Hyun;Lee, Il Hwan;Park, Young Hak
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.10-14
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    • 2014
  • 목 적 CO2 가스 삽입 없이 내시경 보조 갑상선 절제술, 특히 액와 절개를 이용하는 경우의 대부분은 기구 사용을 용이하게 하기 위하여 흉부 또는 유륜에 절개를 넣어 시행하는 것이 대부분이다. 본 연구는 후이개 절개를 통하여 추가적 절개 없이 내시경을 이용한 갑상선 절제술 및 중심 임파선 절제술이 가능한지의 여부를 사체연구를 통하여 확인해 보고자 한다. 방 법 사체 이용 해부 및 수술 후이개 내시경 보조 갑상선 절제술이 가능한지의 확인은 수술 시야 및 접근성, 수술 완성도, 그리고 주요 구조물의 보존 여부인 3가지 항목으로 평가하였다. 결 과 수술 시야는 기구를 다루고 수술을 하기에 충분하였으며, 추가 절개 없이 수술을 완성할 수 있었다. 절제된 갑상선 조직의 피막은 손상되지 않았으며, 잔존 갑상선 조직이 없음을 수술 부위를 통하여 확인하여, 수술의 완성도 여부를 평가할 수 있었다. 모든 사체에서 되돌이 후두신경 및 상 또는 하부갑상선의 보존을 확인하였으며, 주변 구조물들의 손상이 없음을 확인하였다. 결 론 로봇이 아닌 후이개 절개를 이용한 내시경 보조 갑상선 절제술은 시행 가능한 접근법 및 수술방법이라 사료된다.

The convergence effect of phenylephrine, isoprenaline and prazosin on vascular contractility (혈관 수축성에 대한 phenylephrine, isoprenaline 및 prazosin의 융합성 조절 효과)

  • Je, Hyun Dong;Min, Young Sil
    • Journal of Convergence for Information Technology
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    • v.12 no.4
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    • pp.119-125
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    • 2022
  • In the study, we endeavored to investigate the effect of phenylephrine, isoprenaline and prazosin on the tissue-specific vascular contractility and to determine the mechanism involved. There were few reports addressing the question whether thin or thick filament modulation is included in phenylephrine, isoprenaline and prazosin-induced regulation. We hypothesized that isoprenaline and prazosin play a role in tissue-dependent regulation of vascular contractility. Denuded arterial muscles of Sprague-Dawley male rats were suspended in organ baths and isometric tensions were transduced and recorded using isometric transducers and an automatic data acquisition system. Interestingly, sustained continuous contraction of thoracic and abdominal aorta. Furthermore, isoprenaline and prazosin together with phenylephrine inhibited transiently and persistently vasoconstriction of thoracic and abdominal aorta suggesting that additional mechanisms (e.g. decreased receptor density, chemical interaction, postreceptor signaling or distribution of agonists) might be included in the modulation of vascular contractility.

Effect of Aster scaber and Ixeris dentata on Contractility and Vasodilation of Cardiovascula and Endothelial Cell in Hyperlipidemic Rat (참취 및 씀바귀 첨가식이가 고지혈증 흰쥐의 심혈관 수축과 이완 및 혈관내피세포에 미치는 영향)

  • Lim, Sang-Sun;Lee, Jong-Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.26 no.2
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    • pp.300-307
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    • 1997
  • The effects of Aster scaber and Ixeris dentata on cadiovascular system in hyperlipidemic rats were examined. Five groups of thirty Sprague Dawley rats were fed with the diet contained 1% cholesterol, 0.25% sodium cholate, 10% coconut oil and 5% lard(control group) for 4 weeks. Each experimental diet group was added with 5% plant powder or extract of the 5% plant powder by dry weight. Contractile or relaxation responses in the isolated artria and thoracic aortae were measured and the morphological changes of the aortic endotherium from the rats fed the experimental diet were inspected. In response to isoproterenol, the number of right atrial spontaneous beat was significantly lower in Cham chyi powder group$(PP_{1})$ and Sumbagui powder group$(PP_{2})$ than control at $10^(-8)M$ concentration. The contraction forces by injection of phenylephrine and calcium in isolated thoracic aorta were significantly low in each experimental groups compared with the control. The relaxation rates by acetylcholine represented comparatively higher value in $PP_{1}$ than control. The morphological changes of endothelial cell surface was a little in $PP_{1}$ and $PP_{2}$ compared with control, while the damages were considerably advanced in Cham chyi and Sumgbagui extract diet group$(PE_{1},\;PE_{2})$.

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Effect of Reperfusion after 20 min Ligation of the Left Coronary Artery in Open-chest Bovine Heart: An Ultrastructural Study (재관류가 허혈 심근세포의 미세구조에 미치는 영향 : 재관류 손상에 관한 연구)

  • 이종욱;조대윤;손동섭;양기민;라봉진;김호덕
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.739-748
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    • 1998
  • Background: It has been well documented that transient occlusion of the coronary artery causes myocardial ischemia and finally cell death when ischemia is sustained for more than 20 minutes. Extensive studies have revealed that ischemic myocardium cannot recover without reperfusion by adequate restoration of blood flow, however, reperfusion can cause long-lasting cardiac dysfunction and aggravation of structural damage. The author therefore attempted to examine the effect of postischemic reperfusion on myocardial ultrastructure and to determine the rationales for recanalization therapy to salvage ischemic myocardium. Materials and methods: Young Holstein-Friesian cows(130∼140 Kg body weight; n=40) of both sexes, maintained with nutritionally balanced diet and under constant conditions, were used. The left anterior descending coronary artery(LAD) was occluded by ligation with 4-0 silk snare for 20 minutes and recanalized by release of the ligation under continuous intravenous drip anesthesia with sodium pentobarbital(0.15 mg/Kg/min). Drill biopsies of the risk area (antero-lateral wall) were performed at just on reperfusion(5 minutes), 1-, 2-, 3-, 6-, 12-hours after recanalization, and at 1-hour assist(only with mechanical respiration and fluid replacement) after 12-hour recanalization. The materials were subdivided into subepicardial and subendocardial tissues. Tissue samples were examined with a transmission electron microscope (Philips EM 300) at the accelerating voltage of 60 KeV. Results: After a 20-minute ligation of the LAD, myocytes showed slight to moderate degree of ultrastructural changes including subsarcolemmal bleb formation, loss of nuclear matrix, clumping of chromatin and margination, mitochondrial destruction, and contracture of sarcomeres. However, microvascular structures were relatively well preserved. After 1-hour reperfusion, nuclear and mitochondrial matrices reappeared and intravascular plugging by polymorphonuclear leukocytes or platelets was observed. However, nucleoli and intramitochondrial granules reappeared within 3 hours of reperfusion and a large number of myocytes were recovered progressively within 6 hours of reperfusion. Recovery was apparent in the subepicardial myocytes and there were no distinct changes in the ultrastructure except narrowed lumen of the microvessels in the later period of reperfusion. Conclusions: It is likely that the ischemic myocardium could not be salvaged without adequate restoration of coronary flow and that the microvasculature is more resistant to reversible period of ischemia than subendocardium and subepicardium. Therefore, thrombolysis and/or angioplasty may be a rational method of therapy for coronarogenic myocardial ischemia. However, it may take a relatively longer period of time to recover from ischemic insult and reperfusion injury should be considered.

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