• Title/Summary/Keyword: Chest Wall

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Primary Osteosarcoma of the Sphenoid Bone - Case Report - (접형골에 발생한 원발성 골육종 1예 - 증례보고 -)

  • Yang, Geun Jin;Kim, Mun Chul;Chung, Hoon;Lee, Sang Pyung;Choi, Gi Hwan;Yeo, Hyung Tae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.680-683
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    • 2000
  • Osteosarcoma is the most frequently encountered primary malignant tumor of the bone. But primary osteosarcoma of the skull(POS) is rare. The author presents a case of skull neoplasm identified as osteogenic sarcoma. A twentyseven-years-old male patient was admitted because of painful swelling at left temporal and zygomatic area with impairment of extraocular movement. Chest film and long bone series showed no evidence of abnormality. Skull films revealed round irregular bony destructive area at the left pterional area. CT and MRI revealed expansile destruction of the left sphenoid bone, lateral orbital wall and temporal bone within the hemorrhagic mass lesions which showed wall enhancement. Histologic examination confirmed a rare variant of osteosarcoma of the telangiectatic type.

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Surgical Experience of Recurrent Immature Teratoma - Report of a case - (연속적 재발성 미성숙 기형종의 외과적 치료)

  • 홍민수
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.792-796
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    • 1991
  • Immature teratoma can be viewed as intermediate between mature teratoma and embryonal carcinoma. Unlike the mature teratoma, elements of the three perm cell layers are incompletely differentiated and not arranged in organoid fashion In some area, more mature forms of these tissues may also be seen, Although this tumor is clearly malignant, they may not display clear-cut cytologic features of malignancy. The clinical prognosis is poor. We have experienced one case of recurrent immature teratoma. In first operation[1987, April], tumor of anterior mediastinum was removed with wedge resection of ant. segment of RUL % med. segment of RML. In 2nd operation[1990, June], recurrent teratoma of right inner thoracic wall was resected with partial 5th rib resection and wedge resection of lat. segment of middle lobe. Two months later, the 3rd operation[1990, September] was done, which was a removal of mass on thoracic wall near sup, segment of RLL and partial rib resection of 3rd, 4th & 5th. In November 1990, last operation[4th operation] was made. It was enucleation of walnut sized tumor located between medial segment of RML, and 4th. intercostal space, well encapsulated with endothoracic fascia and invaded into lung parenchyme, Adjuvant chemotherapy was done after each operation, but radiotherapy[5000 Rad] was done only after 1st operation. There was no evidence of recurrence after last operation. The patient is well-being still now.

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Surgical Removal of a IVUS Catheter that was Fractured During PCI (경피적 관상동맥 중재술 시 골절된 혈관 내 IVUS 카테터의 외과적 제거)

  • Kim, Young-Hak;Kim, Hyuck;Song, Young-Joo;Chung, Won-Sang;Kang, Jeong-Ho
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.768-771
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    • 2008
  • The use of IVUS provides information about the lumen and arterial wall, the location and extent of atherosclerotic plaque and the state of the arterial wall after PCi. The use of IVUS after insertion of an intracoronary stent has currently increased, while conflicting evidence exists concerning the long-term benefits of IVUS. We report here on a case of surgical removal of an entrapped and fractured IVUS catheter during insertion of intracoronary stents, and we include a review of the relevant literature.

Successful Correction of Coarctation of the Aorta, the Patent Ductus Arteriosus, and Persistent Left Superior Vena Cava (대동맥축착 동맥관개존 좌공정맥을 합병한 다발성혈관기형의 수술치험예)

  • 김근호
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.93-100
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    • 1974
  • This is a case report of successful surgical correction of coarctation of the aorta associated with the patent ductus arteriosus and the persistent left superior vena cava. The patient was a 15 year old girl and congenital heart anomaly was suspected at the sixth month after birth. Afterward there has been no embarrassing symptoms until the day of operation except slight dyspnea on exertion, The diagnosis of coarctation of the aorta and the patent ductus arteriesus detected by physical signs and X-ray studies including aortography. In the first place, coarctation of the aorta was corrected with following procedure: partial resections of the aortic wall just above and below the coarctating line of the aorta and removal of diaphragmatic structure of coarctation performed by. cross clamping aorta above and below coarctation, and then the defect of the aortic wall was closed by lateral aortorrhapic suture with atraumatic needle 3-0 silk continuously [Fig. 6]. In the second place, the patent ductus arteriosus was closed with double ligation method. The persistent left superior vena cava left as it has been, because there has been no evidence of hemodynamic abnormal shunt. After operation, excellent result was obtained; blood pressure in the upper and lower extremities was normalized and subjective complains of hypertension in the upper extremity was disappeared.

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Aorticopulmonary Window: one case report (대동맥중격결손증[수술치험 1예])

  • 최영호
    • Journal of Chest Surgery
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    • v.14 no.3
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    • pp.302-306
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    • 1981
  • Aorticopulmonary window is a rare anomaly among congenital heart disease. Various terms have been suggested including A-P window, A-P fenestration, fistula, aorticseptal defect etc. The defect lies usually between the left side of the ascending aorta and right wall of the pulmonary artery just anterior to the origin of the right main pulmonary artery. We have experienced one case of aorticopulmonary septal defect which was diagnosed as V5D with pulmonary hypertension in 1 4/12 year old, 7.2 Kg, male patient. Operation was done under the hypothermic cardiopulmonary bypass using 5t. Thomas cardioplegic solution. Vertical right ventriculotomy over the anterior wall of RVOT revealed no defect in the ventricular septum, and incision was extended up to the main pulmonary artery to find the source of massive regurgitation of blood through MPA. Finger tip compression of the aorticopulmanary window was replaced with Foley bag catheter balloon, and the $7{\times}10$ mm aorticoseptal defect located 15mm above the pulmonic valve was sutured continuously wih 3-0 nylon suture during azygos flow of cardiopulmonary cannula which was located distal to the window resulted massive air pumping systemically, and temporary reversal of pumping was tried to minimize cerebral air embolism. Remained procedure was done as usual, and pump off was smooth and uneventful. Postoperatively, patient was attacked frequent opistotonic seizure with no recovery sign mentally and p.hysically. Vital signs were gradually worsen with peripheral cyanosis and oliguria, and cardiac activity was arrested 1485 minutes after operation. Autopsy was performed to find the sutured window and massive edema of the brain.

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Left ventricular aneurysm (Two cases report) (좌심실에 발생한 진성심실류 (2례 보고))

  • 이철세
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.175-183
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    • 1983
  • Ventricular aneurysm which was first described by John Hunter on 18th century, has been experienced by many surgeons after successful using of cardiopulmonary bypass by Cooley on 1958. According to Gorlin, the definition of ventricular aneyrysm is portion of the ventricle which is not motile at systole (akinesis) or which has paradoxical dilatation at systole(dyskinesis). The ventricular aneurysm is classified to anatomical and functional. The anatomical ventricular aneurysm is devided into true or false again. Average age incidence is ranged from 49 to 60 and male predominance is reported. The cause is ischemic coronary artery disease in almost cases but hypertropoc cardiomyopathy, congenital abscence of myocardium, complication after mitral valvular replacement and trauma may also cause the ventricular aneurysm. Angina pectoris and congestive heart failure are most common clinical manifestations Ventricular tachycardia and systemic embolization are also complained. Using cardiopulmonary bypass, aneurysmectomy alone or combination with coronary artery revasculization are currently done for surgical treatment with steady improvenment of mortality. The first patient was 33 years old man who had true type of ventricular aneurysm on inferior wall the left ventricle near apex with protruded huge organized thrombus. The thromboembolic phenomenon was noted on both lower extremities. Under cardiopulmonary bypass, aneurysmectomy and thrombectomy were done. The aneurysmal orifice was repaired with Teflon buttless suture. The second patient was 30 years old female who had large true type of ventricular aneurysm on inferior wall of the left ventricle. Under cardiopulmonary bypass, aneurysmectomy with repair of aneurysmmal orifice defect by means of double layered Dacron patch was done with reinforce by outer silastic sheet covering. She was discharged from hospoital at post op. 15th day uneventfully.

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Radiotherapy Treatment Planning using Computed Tomography in Breast Cancer (유방암에서 CT planning를 이용한 치료계획)

  • 김성규;신세원;김명세
    • Progress in Medical Physics
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    • v.3 no.2
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    • pp.59-65
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    • 1992
  • Carcimoma of the breast are first frequency malignancy in women in the world. third frequency in Korea. Radiation therapy in breast cancer were treated through opposed tangential fields with photon beam or electron beam. Density within the field and thickness to tumor are very importent factors determining dose distribution in radiation therapy of electron beam. Radiotherapy traetment planning using computed tomography in Breast cancer are able to ideal dose distribution. Authors concluded as following. 6MeV energy of electron beam propered below 1.5cm in chest wall's thickness or internal mammary lymphnode's depth. 9MeV energy of electron beam from 1.5cm to 2.0cm. 12 MeV energy of electron beam from 2.0cm to 2.5cm.

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Echocardiographic Findings after Mitral Valve Replacement (승모판막치환수술 전후 심장초음파 소견의 변화에 관한 연구)

  • 이상진
    • Journal of Chest Surgery
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    • v.27 no.8
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    • pp.656-663
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    • 1994
  • Evaluation of heart function is of importance in assessing the results of valvular heart surgery. Information on volume and functional change of heart chamber can be obtained by cardiac catheterization and echocardiography. We studied 41 patients with mitral stenosis[MS] and 23 patients with mitral regurgitation[MR] using M-mode echocardiography before and after mitral valve replacement[MVR] at Pusan Paik Hospital. Preoperative cardiac catheterization was available in 56 cases, and the results were obtained as follows. 1. In patients with MS, preoperative average LV end-diastolic dimension[EDD] and end-systolic dimension[ESD] were remained within normal range, but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative and postoperative LV ejection fraction[EF] were remained within the normal range and no significant change[P>0.05]. The preoperative left atrial dimension[LAD] was enlarged considerably above normal[P<0.01], but was significantly decreased after surgery[P<0.001]. The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05]. 2. In patients with MR, preoperative average end-diastolic dimension[EDD] and end-systolic dimension[ESD] were significantly greater than normal[P<005], but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative LV ejection fraction[EF] and fractional shortening[FS] were within normal range, and no significant change after surgery[P>0.05].The preoperative left atrial dimension[LAD] was enlarged considerably above normal [P<0.01], but was significantly decreased after surgery[P<0.001].The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05].

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Recurrent True Brachial Artery Aneurysm

  • Ko, Seong-Min;Han, Il-Yong;Cho, Kwang-Hyun;Lee, Yang-Haeng;Park, Kyung-Taek;Kang, Mee-Sun
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.364-367
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    • 2011
  • True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.

Clinical Observation of Cough-induced Rib Fracture Mimicking Chuna Therapy-induced Rib Fracture (추나로 발생된 통증으로 오인된 만성 기침에 의해 유발된 늑골골절 1례)

  • Choi, Young-Doo;Jo, Su-Jeong;Jung, Chan-Yung;Kim, Kyung-Ho;Kim, Kap-Sung;Lee, Seung-Deok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.10 no.2
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    • pp.27-35
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    • 2015
  • Objectives: The purpose of this study is to discriminate the cough-induced rib fracture with chest pain occurred after chuna therapy. Methods: A 68-year-old female patient who is suffering from left chest wall pain with chronic cough was treated by Korean medical treatment and chuna therapy from November 11th 2014 to November 15th 2014. The improvement of the patient's pain was measured by 100 mm Visual Analog Scale (VAS). For diagnosis the rib fracture, we conducted the radiography, computed tomography (CT), and bone scan. Results: After treatment, pain intensity was decreased and the rib fracture was negative in radiography and CT. But, in bone scan, the 5th-8th rib fractures in left side were detected. Conclusions: When the patient with chest pain visit the hospital after chuna therapy, a doctor keep in mind the possibility of coughinduced rib fracture.