• Journal of Korean Neurosurgical Society
• /
• 제40권1호
• /
• pp.47-50
• /
• 2006

This 51-year-old man suffered from paraparesis of 1-week history. On preoperative images, spinal cord compression by infiltrative vertebral mass was shown at T3 and T4 level. Several months earlier, he underwent surgical resection of left 2nd to 4th ribs, due to painful growing chest wall mass, which was proved to be hepatocellular carcinoma. All available diagnostic procedure failed to uncover origin of malignancy. Operation was followed by adjuvant irradiation and chemotherapy to the vertebral mass, however he only to die in 3 months after operation. This is an extremely rare case of ectopic hepatocellular carcinoma at thoracic vertebrae which showed very aggressive clinical course. Possible pathogenic process is presented and discussed.

• 대한방사선치료학회지
• /
• 제1권1호
• /
• pp.79-83
• /
• 1985

Carcinoma of the breast has been treated by surgery followed by irradiation of the chest wall and regional lymphatics treatment planning of the breast cancer is required that lung must be spared as much as possible. However megavoltage irradiation of the internal mammary chain results in high dose to underlying heart, esophagus and spinal cord. Electron beam can be used for the irradiation of the internal mammary chain instead of megavoltage beam. We studied dose distribution of single anterior electron field, compared with traditional treatment methods. 12 and 15MeV electron beam with bolus has good dose distribution to spare underlying lung tissue and other organs.

• Journal of Chest Surgery
• /
• 제10권1호
• /
• pp.164-172
• /
• 1977

This is a report of a case in which a left atrial myxoma was successfully removed by total cardiopulmonary bypass with total hemodilution and moderate hypothermia. The patient was a 17 old girl with mitral valvular symptoms that occured suddenly three months prior to operation. After the onset of symptoms. it was progressively aggravated to serious general condition. The preoperative diagnosis of left atrial tumor was made from echocardiography. and the tumor was confirmed as myxoma by the histopathological examination of the tumor tissue removed during operation. The myxoma was unusually originated from posterior wall of the left atrium. which was located between drainage orifices of right and left pulmonary veins, The tumor developed in the left atrial cavity and one of the polypoid processes of the myxoma was prolapsed into the the left ventricle through the mitral orifice. Following operation. there was no evidence for peripheral vascular embolism, and all valvular symptoms disappeared. The postoperative course was uneventful.

• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.987-993
• /
• 1990

An unusual but often lethal complication of mitral valve replacement is rupture of the left ventricle. From March 1977 through June 1990, 424 mitral valve replacements were performed as isolated or combined procedures. Rupture of the posterior wall of the left ventricle was observed in 3 patients. Their was one type I and two type II rupture. Once the diagnosis was made, all of the patient were connected to the heart-lung machine again and total cardiopulmonary bypass is re-established. Repair was attempted in all of them from the outside of the heart. One of them was successively repaired but two were failed due to myocardial ischemia by circumflex coronary artery injury and failure of adequate closure of the ruptured site. From this results, we concluded that prevention is the best solution. But if we encountered this condition, early diagnosis and rapid treatment may improve the patient`s chances for survival.

• Journal of Chest Surgery
• /
• 제33권1호
• /
• pp.112-115
• /
• 2000

A-13-urar-old with a history of Alport syndrome had been suffering from progressive dysphagia and postprandial vomiting for over 7 years. Exophagogram and manoemtric studies were consistent with achalasia. Barum study demonstrated marked esophageal dilatation and smooth tapered narrowing of the distal esophagus. However in spite of the medical treatment including the injection of the distal esophagus. However in spite of the medical treatment including the injection of botulinum toxin at the lesion site using an endoscope symptom did not improved and he suffered growth failure and malnutrition. Esophagectomy and esophagogastrostomy were performed to relieve the dysphagia. A firm circumferential intramural mass about 7$\times$5$\times$5 cm was found in the distal esophagus. The lumen of the esophagus was markedly dilated and esophageal wall was hypertrophied. Histologic examination of the neoplasm revealed a rather ill defined tumor tissue consisting of interlacing or whirling spindle cells without significant mitosis and esophageal leiomyo-matosis was confirmed. The patient was discharged uneventfully.

• Journal of Chest Surgery
• /
• 제28권6호
• /
• pp.619-622
• /
• 1995

We report a successful surgical correction of type II truncus arteriosus without using a extra-cardiac conduit in an 2 month-old infant. The truncal root is transected, and the confluence of branch pulmonary arteries is brought anterior to the aorta by using Lecompte`s maneuver. The aorta is then reconstructed directly with an end-to-end anastomosis. The right ventricular outflow tract is reconstructed by anastomosing the posterior wall of the confluence directly to the upper part of the vertical right ventriculotomy. A monocusp ventricular outflow patch is then placed anteriorly to complete reconstruction of the right ventricular outflow tract. The patient had an uncomplicated postoperative course and was discharged on the 9th postoperative day.

• 대한후두음성언어의학회지
• /
• 제16권1호
• /
• pp.81-84
• /
• 2005

Vagus nerve palsy caused by herpes virus infection is rare. Here, the author presents a 65-year-old woman with acute onset of right side otalgia and sore throat, followed by delayed vocal fold paralysis on the same side. Vesicles were also found on the posterior wall of ear canal but the tympanic membrane was not involved. Laryngoscopy revealed multiple ulcerative lesions on the pharyngeal and laryngeal mucosa exclusively on the right side. One month later, she noticed dyshonia which turned out right vocal fold paralysis. Skull base to upper chest CT did not reveal local lesion. Three months after finishing the acyclovir, her symptoms were almost gone and vocal fold movement has almost completely improved. Vagus nerve involvement of herpes infection should be considered as a differential diagnosis for patients with herpes zoster oticus with sore throat.

• Journal of Chest Surgery
• /
• 제23권4호
• /
• pp.622-639
• /
• 1990

The use of aortic valve homograft has been developed since 1962 when Ross and Barratt - Boyes independently replaced a diseased aortic valve with an orthotopically inserted homograft valve. And also surgical treatment of complex congenital cardiac malformations utilizing homograft extracardiac conduit has been tried with better result than any other prosthetic material. The present study was undertaken to clarify the safety tissue viability, sterility, after following our protocol of procurement of heart, dissection of aortic and pulmonic homograft, sterilization, cryopreservation, thawing and dilution, and transplantation on experimental animal, sheep. Tissue viability of valve and great artery was assessed by tissue culture. Sterility was evaluated by bacterial and fungal culture. The method used was proven no deleterious effect on the integrity of the valve. Tissue culture of valve tissue before, and after cryopreservation process resulted that active fibroblast growth was observed from homograft sterilized with antibiotics. And culture of the transplanted homograft from sacrificed animal showed active fibroblast growth. Pathologic examination of implanted valve tissue from sacrificed sheep showed mild calcification and minor change, but there were moderate and severe calcification of wall of great arteries.

• Journal of Chest Surgery
• /
• 제23권4호
• /
• pp.776-781
• /
• 1990

The association of aortopulmonary window and tetralogy of Fallot is rare. The aortopulmonary window lies usually between the left side of the ascending aorta and the right wall of the pulmonary artery just anterior to the origin of the main pulmonary artery. Recently, we experienced a case of aortopulmonary window associated with tetralogy of Fallot in a 4 years old male. Operation was done under the Impression of the tetralogy of Fallot. On operation, the anomaly was confirmed as aortopulmonary window[type 1] and tetralogy of Fallot. The aortopulmonary window was closed with Gortex patch via the main pulmonary artery and tetralogy of Fallot was repaired. Postoperative course was uneventful.

• Journal of Chest Surgery
• /
• 제28권2호
• /
• pp.188-192
• /
• 1995

A 50 year old man with acute aortic dissection DeBakey type I, involving right coronary artery and aortic valve, underwent replacement of the ascending aorta and aorto-right coronary bypass grafting. The operative findings showed a large transverse intimal tear was at about 4cm above the aortic valve. The dissection extended out into the proximal right coronary artery. And we found that the right coronary artery originated from the left sinus of Valsalva, run transversally in the aortic wall, with partial rupture. Postoperatively he had no ischemic cardiac symptoms and neurologic complications. He was discharged on postoperative 9th day with good result.