• Tuberculosis and Respiratory Diseases
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• v.69 no.3
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• pp.191-195
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• 2010

Abnormally located liver tissue has been described in the vicinity of the liver proper, near anatomical structures such as the gallbladder, the umbilical fossa, the adrenal gland, the pancreas, and the spleen. Supradiaphragmatic ectopic liver is a rare finding, but has been reported to have been found in the intrathoracic cavity and in the pericardium. In the majority of supradiaphragmatic ectopic liver cases, there was an accompanying transdiaphragmatic pedicle of the main liver body into the abdominal cavity. In a minority of supradiaphramatic ectopic liver cases, the liver was completely separated from the abdominal cavity without a connection between the thorax and the abdomen, with accompanying diaphragmatic anomalies. We describe one case of intrathoracic ectopic liver in a patient with a previous history of lower chest wall trauma, and a brief review of the English-language medical literature on this topic.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.273-278
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• 1985

The case of a patient with abnormal position of the atrial septum resulting in a left atrium with two atrioventricular valves and a disconnected right atrium is presented with review of related articles. Anatomic details showed atrial situs solitus and a left sided cardiac apex. The right atrium received both venae cavae and a coronary sinus. No AV valve was found in the right atrium, and the floor of this chamber was placed above the posterior wall of right ventricular chamber. The atrial septum with secundum ASD was displaced to right anteriorly at its lower portion and inserted to right of tricuspid annulus. The tricuspid and mitral valve configuration was that of so-called partial ECD, i.e. mitral cleft with large anterior mitral leaflets. The ventricular septum was intact and both ventricular chambers were equally well developed with normal relationships. Surgical repair of this anomaly was performed by resecting the abnormally positioned lower part of the atrial septum, repairing the cleft of the anterior mitral leaflet, and septating the atrium for diverting the systemic and pulmonary venous blood to RV and LV, respectively.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.143-152
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• 1991

From 1983, until June, 1990, 10 patients with various type of truncus arteriosus underwent total surgical correction including Rastelli procedure at Seoul National University Hospital. The age at operation ranged from 1 month to 9 years [mean 2.1 years]. Six patients had truncus type I, 3 patients had truncus type II, and one patients had truncus type IIIc. Right ventricular pulmonary artery continuity was established with a porcine valved conduit in 6 patients, mechanical valved conduit in 1 patient, and bovine pericardial conduit in 3 patients. The postoperative right ventricular /left ventricular pressure ratio ranged from 0.4 to 0.71 [mean 0.51${\pm}$0.14]. The lung histology revealed grade II pulmonary obstructive disease even at 4 month of age. Five patients were dead in hospital [50%], and they were less than 2 year of age. One patient, who had severs congestive heart failure preoperatively, died of low output syndrome and the other died of low output syndrome with postoperative bleeding. There were three death, because of a pulmonary hypertensive crisis that might have been prevented. Two of the five survivors had conduit failure over a mean follow up of 42 months [range 1 to 78 months]. Obstructed conduit was removed and a new conduit constructed using the conduit bed as the posterior wall and the patch of bovine pericardium and Dacron as patch the roof of the conduit. One patient died of acute cardiac failure during the operation. Although results in infants less than 2 years old have not been good, current improvement of intra-and postoperative care suggested that prompt repair is indicated for infants with truncus arteriosus.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.593-597
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• 2018

Sternal malunion, or loss, developed after a median sternotomy cannot only be difficult to manage and treat, but also may diminish one's quality-of-life drastically. The technique presented here represents a multispecialty approach in one stage for the reconstruction of an unstable thoracic cage. The procedure utilized a donated sternum and ribs. The sternum with ribs harvested from a single donor included adipose derived stromal vascular fraction (ADSVF) cells with marrow also from the same donor. Autologous muscle flaps, stabilized with acellular dermal matrix were utilized to provide a robust blood supply to the ADSVF cells and bone grafts. Acellular dermal matrix was used to construct the ribs and stabilize the plugs of stem cells and bone. These procedures, in the hands of multispecialty physicians, have led to several successful reconstructions involving complex chest wall deformities. This surgical intervention was performed in a one stage operation. This represents the first successful complete sternal transplant in a patient with return to normal activities and increased quality-of-life.

• The Journal of Internal Korean Medicine
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• v.22 no.4
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• pp.755-759
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• 2001

Acute Myocardica Infarction has high mortality and bad prognosis. We treated a 68 year-old female patient of acute myocardiac infacrtion to follow cerebral infarction. The chief complainment is right hemiplegia, dyspnea, chest discomfort, palpitation, anxiety, insomnia. The prognosis cannot be good, Because she has anterior wall infarction, cardiomegaly, conduction block, hypertention and she is 68 years old. We treated her with chiefly Nogyongdaebo-tang and Gongjin-dan, and gradually increased momentum. also we used self west medicine. The chief complainment was improved. She became to do cane walking by herself.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.773-775
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• 2006

Purpose: The sternalis muscle is an accessory muscle of the anterior chest wall. This is a rare anatomic variant reported in approximately 8 percent of the population, with variation among races. While several anatomic studies of the sternalis muscle exist, nothing in the literature addresses the implications of this muscle on staged breast reconstruction with implant. Methods: We encountered two consecutive patients with a left sternalis muscle who underwent immediate staged breast reconstruction with a tissue expander. We offer a strategy for dealing with this rare, but known, anatomic variant during staged implant reconstruction. Firstly, recognizing the presence of a sternalis muscle mandates the elevation of the pectoralis major muscle and the sternalis muscle in continuity. Secondly, slight modifications must be made during the submuscular dissection to create a properly placed pocket for the tissue expander. Results: While our encounters with this anatomic variant are few, our experiences with two consecutive patients illustrate that the reconstructive surgeon must be familiar with the sternalis muscle and be prepared to adapt his or her technique for tissue expander placement when faced with this accessory muscle. Conclusion: To date, no reports exist in the literature describing the operative implications of this anatomic variant. We offer our technique for dealing with this accessory muscle during staged implant reconstruction of the breast.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.943-945
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• 2006

An 11-month old girl with a feeding difficulty and recurrent aspiration pneumonia received surgical correction of complete vascular ring, which was formed by right aortic arch, aberrant left subclavian artery(LSCA) originating from Kommerell's diverticulum(KD) and ligamentum arteriosum. Through left posterolateral thoracotomy, the ligamentum arteriosum was divided to relieve the tracheo-esophageal bundle. KD was separated from the right descending aorta, and the left subclavian artery was severed from KD at its origin and trasfered to the side wall of left common carotid artery. Postoperative course was uneventful, and the patient has been followed up with a clinical improvement.

• Journal of Korean Neurosurgical Society
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• v.59 no.3
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• pp.310-313
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• 2016

Intracranial tuberculous subdural empyema (ITSE) is extremely rare. To our knowledge, only four cases of microbiologically confirmed ITSE have been reported in the English literature to date. Most cases have arisen in patients with pulmonary tuberculosis regardless of trauma. A 46-year-old man presented to the emergency department after a fall. On arrival, he complained of pain in his head, face, chest and left arm. He was alert and oriented. An initial neurological examination was normal. Radiologic evaluation revealed multiple fractures of his skull, ribs, left scapula and radius. Though he had suffered extensive skull fractures of his cranium, maxilla, zygoma and orbital wall, the sustained cerebral contusion and hemorrhage were mild. Eighteen days later, he suddenly experienced a general tonic-clonic seizure. Radiologic evaluation revealed a subdural empyema in the left occipital area that was not present on admission. We performed a craniotomy, and the empyema was completely removed. Microbiological examination identified Mycobacterium tuberculosis (M.tuberculosis). After eighteen months of anti-tuberculous treatment, the empyema disappeared completely. This case demonstrates that tuberculosis can induce empyema in patients with skull fractures. Thus, we recommend that M. tuberculosis should be considered as the probable pathogen in cases with posttraumatic empyema.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.81-84
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• 1978

A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

• Advances in pediatric surgery
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• v.15 no.1
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• pp.68-72
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• 2009

Neuroblastoma is the most common extracranial solid tumor in children, and accompanies various clinical symptoms including hypertension. Hypertension is associated with catecholamines secreted from the tumor, and is usually not severe. We report one case of malignant hypertension with cardiac failure in a patient with adrenal neuroblastoma, successfully treated with adrenalectomy. A 3 year-old boy complained of protrusion of the chest wall. Physical examination revealed severe hypertension with cardiac failure. The levels of metabolites of catecholamine were increased in blood (norepinephrine >2000 pg/mL) and urine (norepinephrine 1350.5 ug/day). Abdominal CT showed a 7 cm-sized solid mass arising from the right adrenal gland. After stabilizing the hemodynamics with oral phenoxybenzamine, right adrenalectomy was performed. Pathological diagnosis was a ganglioneuroblastoma. The hypertension and cardiac failure were resolved after tumor removal.