• Journal of Chest Surgery
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• 제6권1호
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• pp.51-56
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• 1973

This is one case report of successful resection of the aneurysm of the thoracic aorta, which det-ected by thoractomy unexpectedly, in the Department of Thoracic Surgery, Hanyang University Hospital. The patient was a 34 years old woman and subjective complaints was not related with the aneurysm. Chest film showed a small round hazy shadow in the left margin of the upper posterior mediastinum. A saccular aneurysm located on the descending thoracic aorta, 7cm distal to the left subclavian artery and arouse from the antero-lateral wall of the aorta. Excision of the saccular aneurysm was performed by cross clamping the descending aorta above and below the aneurysm, and then the defect of the aortic wall was closed by aortorrhaphy with continuous suture. Crossclamping time was required 15 minute. Histopathologically, the wall of the aneurysm consisted of all layers of the arterial wall, that is, intima, media and adventitia. Postoperative course was uneventful and aortogram showed good continuity of the blood flow of the entire aorta.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1240-1244
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• 1992

Human sparganosis caused by Sparganum mansoni, the larval plerocercoid worm of the genus Spirometra, is not uncommon in Korea and is mostly found in subcutaneous or adipose tissue of the abdominal, thoracic wall and inguinal region, but is rarely found in the orbital cavity, brain and breast. It, at present, is a surgical disease because its diagnosis depends almost on the demonstration of the larva[e] from lesion or finding the worm section in surgical pathology specimens. We experienced a case of human sparganosis from a 48 years old woman who had a history of eating a raw frog. We report the case and review the related literatures.

• Journal of Chest Surgery
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• 제26권7호
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• pp.571-574
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• 1993

We present a rare case of malignant lymphoma developing from the wall of chronic empyema thoracis. A 54-year old man with a 35 year history of tuberculosis empyema was admitted due to right chest pain and general weakness for 2 months. Under the impression of chronic empyema thoracis with destroyed right lung and tumor on posterior costophrenic sulcus, pleuropneumonectomy including tumor was performed as a single procedure through a right thoracotomy. The tumor arose from the thickened pleura, and it was histologically and immunologically diffuse large cell[non-cleaved] B-cell non-Hodgkin`s lymphoma [NHL]

• 한국응급구조학회지
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• 제25권1호
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• pp.235-241
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• 2021

Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

• Radiation Oncology Journal
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• 제1권1호
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• pp.41-45
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• 1983

To obtain 7 MeV electron beam which is suitable for treatment of the chest wall after radical of modified radical mastectomy, the authors reduced the energy of electron beam by means by Lucite plate inserted in the beam. To determine the proper thickness of the Lucite plate necessary to reduce the energy of 9 MeV electron beam to 6 MeV, dosimetry was made by using a parallel plate ionization chamber in polystyrene phantom. Separation between two adjacent fields, 7 MeV for chest wall and 12 MeV for internal mammary region, was studied by means of film dosimetry in both polytyrene phantom and Humanoid phantom. The results were as follows. 1. The average energy of 9 MeV electron beam transmitted through the Lucite plate was reduced. Reduction was proportional to the thickness of the Lucite plate in the rate of 1.7 MeV/cm. 2. The proper thickness of the Lucite plate necessary to obtain 6 MeV electron beam from 9 MeV was 1.2 cm. 3. 7 MeV electron beam, 80% dose at 2cm depth, is adequate for treatment of the chest wall. 4. Proper separation between two adjacent electron fields, 7 MeV and 12 MeV, was 5mm on both flat surface and sloping surface to produce uniform dose distribution.

• Tuberculosis and Respiratory Diseases
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• 제44권5호
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• pp.1158-1165
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• 1997

Ewing's sarcoma는 청소년기에 대퇴골, 척추주변부, 골반골 등의 뼈에서 흔히 발생하며 드불게 골외에서도 발생하는 종양으로서 특히 흉벽에서의 Ewing's sarcoma의 발생은 흉부 종격동 종양의 감별진단으로 고려해야 할 것으로 사료되며 광범위한 국소적인 절제와 더불어 화학요법 및 방사선 요법으로 좋은 치료 성적을 보이고 있어 골외 Ewing's sarcoma에 대한 정확한 발생부위, 예후 및 치료 방침에 대한 계속적인 연구가 필요할 것이다.

• Journal of Chest Surgery
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• 제9권2호
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• pp.265-270
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• 1976

Implantation of a permanent pacemaker is a widely accepted procedure for the patient with complete heart block.As a result of these device, the prognosis for patients with Adams-Stokes syndrome caused by complete A-V block and other cardiac arrhythmia have become much more optimistic. Permanent pacemaker implantation by means of a transvenous approach has made the operative risk much less and the procedure simpler. However, a number of complications have been reported in the literature regarding transvenous endocardial pacemaker implantation during the last a decade. The patient presented in this paper is a 26-year old girl who was implanted with a permanent pacemaker at 14 years of age because of a congenital A-V block. Following first exchange of pulse generator, the electrode (lead) was fractured, so that by the pulse generator, a change to the transvenous technique of implantation was made, After this, there were episodes of recurrent wound infection on three occasions, even though the site of pulse generator implantation was exchanged to the contralateral side of chest wall, massive doses of antibiotics were administered and sensitivity tests for coagulase positive staphylococcal infection were performed. Though there was no definite evidence of blood stream infection by blood culture, we decided not to use the transvenous technique and not to implant the pulse generator in the chest wall because the venous system and the entire anterior chest wall appeared to be diseased or contaminated by virulent pyogenic organisms. Finally this intractable systemic and local wound infection was successfully controlled by myocardial lead implantation via a subxiphoid approach and implantation of the pulse generator far down in the abdominal wall. The causes and routes of recurrent wound infection and possible blood born infection in this particular patient are still obscure. We strongly believe that myocardial pacemaker implantation is much safer than transvenous endocardial pacemaker implantation & myocardial pacemaker implantation is a definite method for controlling such an intractable wound infection. following transvenous pacemaker implantation.

• Archives of Reconstructive Microsurgery
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• 제7권2호
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• pp.114-121
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• 1998

The purpose of this study is to investigate the appropriate management of severe radionecrotic wounds of the anterior chest wall associated with infection of the soft tissues and ribs and exposure of vital structures(heart and lung), and present our strategies for reconstruction of these complicated patients. 9 patients have undergone radical debridement and immediate microsurgical reconstruction for severe radionecrotic wounds of the anterior chest wall over last 7 years. All patients had extensive osteomyelitis of the ribs or sternum, and chronic infection or cutaneous fistulae. 2 patients had pericardial effusions due to longstanding inflammation, and 6 patients had pleural effusions. 2 patients had ipsilateral lung collapse. 10 free flaps were performed for coverage of the huge defects. One patient required 2 free flaps to control the inflammation. 8 free TRAM flaps were used for coverage of the defects and in addition, the rectus abdominis muscle was packed into any deep cavity. 1 patients underwent latissimus dorsi muscle free flap because of previous abdominal surgery. After extensive debridement of the infected, radionecrotic wounds, all 10 free flaps were successful. All the extensive radionecrotic defects of the anterior chest wall were completely healed. Free flaps successfully covered the exposed vital structures of the heart and lungs. Patients with severe radionecrotic defects of the anterior chest wall after ablative breast cancer surgery and radiotherapy were successfully treated by radical debridement and immediate free flap surgery. The TRAM flap together with the rectus muscle is the treatment of choice for these huge defects. The latissimus dorsi muscle flap was the second choice in patients with previous abdominal surgery. The recipient vessel should be carefully selected because of possible radiation damage and inflammation.

• Journal of Chest Surgery
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• 제28권2호
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• pp.218-220
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• 1995

This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

• Journal of Chest Surgery
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• 제20권3호
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• pp.578-581
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• 1987

A very rare form of intrapulmonary cyst is an enterogenous cyst two examples of which were described by Ward and Krahl [1942]. Microscopically, the cyst wall is lined by gastric or intestinal type of mucous membrane which may include islets of pancreatic tissue; their walls contain muscle but no cartilage. We recently experienced a case of intrapulmonary enterogenous cyst. The patient was 30-year-old-male who showed chest pain and tightness after chest trauma. Chest X-ray revealed pneumothorax in both lung field with giant bullae in left upper lung field, right 6th and 7th rib fracture. Left lower lobectomy including cyst was done and the postoperative course was uneventful.