• Title/Summary/Keyword: Chest Expansion

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Analysis of Body Surface Developments for the Pattern of Armhole line (길의 진동둘레선 설계를 위한 체표전개도 분석에 관한 연구)

  • 이정란
    • Journal of the Korean Society of Clothing and Textiles
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    • v.21 no.6
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    • pp.1031-1040
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    • 1997
  • This study was done to analyze the body surface developments of armhole area. The major conclusions of this study are: 1. The body surface developments showed the characteristics of expansion and contraction of body at armhole area. By arm movements, front armhole lines on the body surface developments of upper arm were slow going, but back armhole lines were full and round. As a whole, armhole line of the back torso was swollen outside especially at backarmpit point area, it seemed like a line of raglan sleeve. 2. Regression Analysis was carried out to adapt armhole line on the upper arm and upper body to bodice and sleeve pattern, following the axillary circumference line and chest breadth line changed to the basic pattern form. As the result, armhole lines of 90$^{\circ}$ and 135-180$^{\circ}$ movements deviated from those of standard posture. U-type, clear armhole curve of standard posture turned to V-type, slanting line by arm movements.

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Surgical management of spontaneous pneumothorax (자연기흉의 외과적 치료 -310례의 임상고찰-)

  • 김삼현
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.82-88
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    • 1984
  • Total 310 cases of spontaneous pneumothorax in 281 patients were analyzed to review the results of surgical treatment for this condition. Clinical data on the age & sex distribution, recurrence, etiologic conditions and on the other aspects of spontaneous neumothorax were summarized. The results of surgical management of spontaneous pneumothorax are followings; 205 out of 310 cases[66.1%] were cured by closed thoracostomies. 82 cases[26.5%] were cured by thoracotomy. The indications of thoracotomy were 1] persistent air leakage, 2] history of recurrences, 3] blebs or bullae on thoracoscopy, 4] associated parenchymal lesion, 5] pneumothorax caused by paragonimiasis. Other reasons of thoracotomy were bilateral pneumothorax and inadequate expansion due to chronicity. Excision of blebs or wedge resection was performed in most cases with good result. Lobectomy [9 case] or pneumonectomy [3 cases] was carried out depending on the pathological involvement of the lung. There was no operative death and only one case showed recurrent pneumothorax during follow-up after thoracotomy.

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Reoperation after Open Heart Surgery -Clinical analysis of 27 cases- (개심술후 재수술에 대한 임상적 고찰)

  • 서의수
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.50-58
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    • 1989
  • The emergence and expansion of cardiac surgery over the past decade has resulted in an increasing number of patients undergoing cardiac operations but many kinds of heart surgery was realized only palliative, resulting in increasing numbers of secondary cardiac procedures. From 1978 to 1988, 10 cases of various congenital heart diseases and 17 cases of acquired heart diseases were reoperated at Hanyang University Hospital. The leading indication of second operation was residual shunt or valvular malfunction due to technical failure in congenital heart disease and primary valve failure, endocarditis, paravalvular leakage were for acquired heart disease. The mortality of reoperation was 0% for congenital heart disease and 11.7%[2 death among the 17 patients] for acquired heart disease. The leading causes of death were myocardial failure, sepsis with endocarditis, acute renal failure and congestive heart failure.

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Histologic Change of Free Muscle Graft in the Rabbit Pleural Space (토끼에서 늑막강내 자유근육이식의 조직학적 변화: 술후 공기누출방지를 위한 자유근육이식술의 예비실험)

  • 원용순
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.10-15
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    • 1989
  • Excision of bullous emphysema or decortication of chronic empyema commonly results in a prolonged air leakage. Prolonged air leakage requires prolonged intercostal drainage, delays recovery, and can be followed complications such as pneumothorax, atelectasis, incomplete expansion of remained lung, secondary infection. To minimize these complications free muscle grafts can be used like a patch to close the opening of visceral pleura and reinforce suture lines without undue tension. From a preliminary study using the latissimus dorsi muscle as a free muscle graft in the rabbit pleural space, viable muscle fibers that seems the result of the process of regeneration can be consistently identified around the degenerating muscle fibers. Voluminous connective tissues and numerous blood vessels are also observed in the peripheral zone. Further studies in that free muscle graft will be sutured with visceral pleura and lung parenchyme will hopefully provide additional information before clinical application.

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Surgical Treatment of Postpneumonectomy Syndrome with Tissue Expanders in Children

  • Jung, Hee Suk;Suh, Jee Won;Kim, Tae Hoon;Lee, Chang Young;Chung, Kyung Young
    • Journal of Chest Surgery
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    • v.48 no.3
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    • pp.217-219
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    • 2015
  • Postpneumonectomy syndrome (PPS) is a rare late complication of pneumonectomy. It occurs more often in children than in adults, and is characterized by respiratory failure resulting from bronchial compression caused by severe mediastinal shift. Various methods have been used to treat PPS, including aortopexy and the insertion of plastic balls, silastic implants, and saline-filled breast prostheses. We describe two cases of PPS corrected with tissue expanders after right pneumonectomy in patients with esophageal atresia.

Surface Activity in Various Pulmonary Diseases (각종 폐질환에서의 Pulmonary Surfactant 에 대해서)

  • Lim, Buyng-Wha;Shin, Keun-Soo;Kim, Jin-Sik
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.1-8
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    • 1972
  • On the study of surface activity in excized lung extracts of various pulmonary diseases, following facts were concluded. 1]The minimum surface tension measured in lung extracts of tuberculous tissue surrounding cavitary lesion was 26.3dyne/cm and its stability index was 0.53. 2]Macroscopically almost normal lung tissue at a distance of tuberculous lesion in same lobe revealed 21.3 dyne/cm of minimum surface tension in extracts and its stability index showed 0.66. This low surface activity may be due to the chronic pneumonitis microscopically. 3] In the atelectatic lung which had been collapsed by chronic empyema the extracts revealed much higher minimum surface tension in 27.3 dyne/cm and its stabillry index revealed the least value of 0.47 without correlation of duration of disease. This suggests that the longstanding collapsed lung may be soon collapsed even after mechanical full expansion because of lack of surfactant.

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Bronchoscopic Ethanolamine Injection Therapy in Patients with Persistent Air Leak from Chest Tube Drainage

  • Lim, Ah-Leum;Kim, Cheol-Hong;Hwang, Yong-Il;Lee, Chang-Youl;Choi, Jeong-Hee;Shin, Tae-Rim;Park, Yong-Bum;Jang, Seung-Hun;Park, Sang-Myeon;Kim, Dong-Gyu;Lee, Myung-Goo;Hyun, In-Gyu;Jung, Ki-Suck;Shin, Ho-Seung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.441-447
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    • 2012
  • Background: Chest tube drainage (CTD) is an indication for the treatment of pneumothorax, hemothroax and is used after a thoracic surgery. But, in the case of incomplete lung expansion, and/or persistent air leak from CTD, medical or surgical thoracoscopy or, if that is unavailable, limited thoracotomy, should be considered. We evaluate the efficacy of bronchoscopic injection of ethanolamine to control the persistent air leak in patients with CTD. Methods: Patients who had persistent or prolonged air leak from CTD were included, consecutively. We directly injected 1.0 mL solution of 5% ethanolamine oleate into a subsegmental or its distal bronchus, where it is a probable air leakage site, 1 to 21 times using an injection needle through a fiberoptic bronchoscope. Results: A total of 15 patients were enrolled; 14 cases of spontaneous pneumothorax [idiopathic 9, chronic obstructive pulmonary disease (COPD) 3, post-tuberculosis 2] and one case of empyema associated with broncho-pleural fistula. Of these, five were patients with persistent air leak from CTD, just after a surgical therapy, wedge resection with plication for blebs or bullae. With an ethanolamine injection therapy, 12 were successful but three (idiopathic, COPD and post-tuberculosis) failed, and were followed by a surgery (2 cases) or pleurodesis (1 case). Some adverse reactions, such as fever, chest pain and increased radiographic opacities occurred transiently, but resolved without any further events. With success, the time from the procedure to discharge was about 3 days (median). Conclusion: Bronchoscopic ethanolamine injection therapy may be partially useful in controlling air leakage, and reducing the hospital stay in patients with persistent air leak from CTD.

Clinical Evaluation of Open Thoracotomy Cases in Spontaneous Pneumothorax (자연 기흉의 개흉례에 대한 임상적 고찰)

  • 이연재;황산원
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1225-1231
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    • 1997
  • Spontaneous pneumothorax is the sudden collapse of a lung usually caused by air leakage from a subvisceral pleural blob. Responses to closed thoracostomy,thoracentesls and simple observation are usually prompt and effective. But in some cases, these are unsucceful and open thoracotomy is indicated. A clinical evaluation was performed on 242 cases(236 patients) of open thoracotomy in spontaneous pneumoth rax who were admitted and treated at department of Thoracic and Cardiovascular Surgery. Masan Samsung General Hospital during the past 9 years from January 1988 to December 1996. The results were as follows 1. The sex ratio was male predominance(M:F=11.7:1) 2. The most common age group were 2nd, 3rd decades(2nd=29.3%, 3rd=30.2%). 3. The most common chief complaints were chest pain and dyspnea(chest pain=41.7%. dryspnea= 36.8). 4. The etiologic factors of spontaneous pneumothorax were primary spontaneous pneumothorax(86.4%), tuberculosis(9.1%), COPD(3.7%) and pleuritis(0.8%). 5. The site of spontaneous pneumothorax was 52.1% in right, 45.4% in left and 2.5% in both. 6. The common indications of open thoracotomy were recurrence(44.2%), persistent air leakage(31.8%) and inadequate expansion(15.7%). 7. The operative procedures were bullectomy or mechanical pleurodesis through posterolateral thoracotomy or median sternotomy. 8. The most frequent location of bulla or blob were apical segme t oi RUL(35.1%) and apicoposterior segment of LUL(41.3 %). 9. The number of bulla or blob were mainly 1 to 5(88%), and there were no significant differences among operation indications. 10. The size of bulla or bleb were mainly below 5cm(81%)and small bulla($\leq$1cm) were predominant in recurrence group but large bulla(>5cm)were predominant in persistent air leakage and inadequate expansion group. 11. The pleural adhesion was seen in 54.5%.(Recurrence group 64.1%,Persistent air leakage group 51.9%,Inadequate expansion group 47.4%).

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Lateral Thoracic Expansion Surgery for Jeune's Syndrome (Jeune 증후군 환아에게 시행한 외측 흉벽 확장술)

  • Kim Joon Bum;Moon Il Hong;Choi Byung Min;Lee Kee Hyoung;Choi In Cheol;Park Seung Il
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.873-877
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    • 2005
  • Jeune's asphyxiating thoracic dystrophy is a rare, complex malformation with a broad spectrum of clinical expression. The degree of chest wall deformity is the most important prognostic factor and the only part which is correctable. A 11 month-old male infant was diagnosed as having Jeune's syndrome and received right side lateral thoracic expansion surgery. But because respiratory distress symptom was sustained postoperatively, we performed left side procedure 3 months after the initial operation. Respiratory distress symptom got worse after fracturing the left titanium plate which was inserted to fix the expanded thoracic wall and reimplantation was performed. The patient was discharged 6 months after the initial operation. He was readmitted and received ventilator care for respiratory failure and died 10 months after the initial operation.

Influence of Radiologically Evident Residual Intimal Tear on Expansion of Descending Aorta Following Surgery for Acute Type I Aortic Dissection

  • Kim, Yun Seok;Kim, Jeong Heon;Kim, Joon Bum;Yang, Dong Hyun;Kang, Joon-Won;Hwang, Su Kyung;Choo, Suk Jung;Chung, Cheol Hyun
    • Journal of Chest Surgery
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    • v.47 no.1
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    • pp.6-12
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    • 2014
  • Background: Although a residual intimal tear may contribute to the dilatation of the descending aorta following surgical repair of acute type I aortic dissection (AD), its causal relationship has not been elucidated by clinical data due to the limited resolution of imaging modalities. Methods: This study enrolled 41 patients (age, $55.2{\pm}11.9$ years) who were evaluated with dual-source computed tomography (CT) imaging of the whole aorta in the setting of the surgical repair of acute type I AD. Logistic regression models were used to determine the predictors of a composite of the aortic aneurysm formation (diameter >55 mm) and rapid aortic expansion (>5 mm/yr). Results: On initial CT, a distal re-entry tear was identified in 9 patients. Two patients failed to achieve proximal tear exclusion by the surgery. Serial follow-up CT evaluations (median, 24.6 months; range, 6.0 to 67.2 months) revealed that 14 patients showed rapid expansion of the descending aorta or aortic aneurysm formation. A multivariate analysis revealed that the residual intimal tear (odds ratio [OR], 4.31; 95% confidence interval [CI], 1.02 to 19.31) and the patent false lumen in the early postoperative setting (OR, 4.64; 95% CI, 0.99 to 43.61) were predictive of the composite endpoint. Conclusion: The presence of a residual intimal tear following surgery for acute type I AD adversely influenced the expansion of the descending aorta.