• Journal of Chest Surgery
• /
• v.24 no.8
• /
• pp.802-806
• /
• 1991

Primary neoplasms of the ribs and sternum are rare. Most primary bony chest wall neoplasms are malignant, and chondrosarcoma is the most common malignancy in this location The etiology of chondrosarcoma is unknown. Definitive diagnosis of chondrosarcoma can only be made pathologically. The natural history of chest wall chondrosarcoma is one of slow growth and local recurrence. Most tumors of the sternum require wide resection and reconstruction procedures, with potentially serious postoperative problems. Advances in chest wall reconstruction primarily through refinement in muscle transposition and clarification of the functional anatomy and blood supply of trunk muscles, has resulted in a more aggressive resection of the these tumors . Recently we experienced a case with chondrosarcoma of the sternum. A 56 year-old man was admitted to our hospital due to painless, slowly enlarging mass at the left sternoclavicular junctional area. The chest radiograph strongly suggested an underlying cartilaginous neoplasm owing to the appearance of typical flocculent and curvilinear calcifications within the lesion. On CT of the chest, the tumor exhibited a scalloped or lobulated contour, hypodensity of the nonmineralized component in comparison to adjacent muscle, and characteristic stippled cartilaginous matrix mineralization, also typical for cartilaginous neoplasm. The patient underwent wide resection of the chest wall tumor include with a 2-3cm margin of normal tissue on all sides and the thoracic skeletal defect was reconstructed with polytetrafluoroethylene [Gore-Tex] soft-tissue patch. Soft tissue reconstructive procedure was done with the pectoralis major muscle transposition. The patient had an uneventful postoperative course and discharged without adjuvant treatment such as radiation and chemotherapy.

• Journal of Chest Surgery
• /
• v.29 no.10
• /
• pp.1170-1172
• /
• 1996

Chest wall hamartoma Is a very rare disease. The female infant was suffered from frequent upper respiratory infection. The chest AP revealed destruction of the ribs and widening of the intercostal space Chest CT demonstrated well-defined solid and cystic extrapleural mass. Chest M Rl revealed high signal and low signal intensities In the mass. In December, 1995, she underwent excision of the mass with partial resection of the ribs and ch st wall reconstruction with thick Cortex patch. The chest wall hamartoma was confirmed with histopathological examination. The postop course was smooth and uneventful.

• Journal of Magnetics
• /
• v.21 no.2
• /
• pp.293-297
• /
• 2016

For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

• Journal of Chest Surgery
• /
• v.29 no.2
• /
• pp.239-243
• /
• 1996

Chest wall reconstruction Is difficult because of the physiological and anatomical functions of thoracic cavity where the thoracic cavity must be stabilized in order to prevent paradoxical motion, and adequate protection must be provided to the mediastinal structures. A 37-year-old male patient with full-thickness defect on the left anterior thoracic cavity due to traffic accident was treated. Emergency operation was performed for debridement and bleeding control, and on postoperative 25 days, chest wall reconstruction was performed as a second-stage operation. Left anterior chest wall was reconstructed with latissimus dorsi myocutaneous flap which had thoracodorsal arterial pedicle, and split-thickness skin grift from the left thigh was done. After chest wall reconstruction, spontaneous self-respiration was possible without ventilatory support. The pulmonary function test performed at postoperative 3 months revealed 80% of predicted values (FVC, FEV1.0). The postoperative result of chest wall reconstruction using latissimus dorsi myocutaneous flap was excellent anatomically, physiologically and aesthetically.

• Journal of the Korean Society of Physical Medicine
• /
• v.14 no.3
• /
• pp.13-20
• /
• 2019

PURPOSE: Sitting with crossed legs may have an effect on maintaining a healthy body posture and proper functioning of the respiratory system. Thus, this study's objective was to identify whether or not sitting with crossed legs affects the vertebral angle, chest wall mobility, the pulmonary function, and the activity of the respiratory muscles. METHODS: Thirty healthy subjects were recruited for this study (16 males and 14 females). The vertebral angle, chest wall mobility, pulmonary function, and the activity of the respiratory muscle were measured while the subjects sat in the correct posture and these factors were again measured with the subjects seated with their legs crossed. Three-dimensional motion analysis was used to determine the trunk and lumbar vertebral angles. Surface electromyography was employed to measure the sternocleidomastoid, the rectus abdominis, and the external and internal oblique abdominis muscles. A tapeline was utilized to evaluate the subjects' chest wall mobility. Spirometry was assessed to determine the forced vital capacity and forced expiratory volume in one second. Paired t-tests were then performed (p<.05). RESULTS: There were significant differences in the trunk and lumbar flexion angles, the chest wall mobility, the activity of the right external oblique muscle, and the left internal oblique abdominis muscle. However, the difference in pulmonary function did not reach statistical significance. CONCLUSION: A crossed leg posture caused slight thoracic extension and lumbar flexion, which may lead to a decrease of the chest wall mobility and also to an imbalance of the abdominal muscles. Therefore, sitting with a crossed leg posture should be avoided. Yet a crossed leg posture did not have any clinical effect on the pulmonary function of healthy people. It may be necessary to study the effects of sitting with crossed legs over an extended period of time for patients suffering with impaired respiratory function.

• Journal of Chest Surgery
• /
• v.52 no.5
• /
• pp.360-367
• /
• 2019

Background: Primary chest wall sarcoma is a rare disease with limited reports of surgical resection. Methods: This retrospective review included 41 patients with primary chest wall sarcoma who underwent chest wall resection and reconstruction from 2001 to 2015. The clinical, histologic, and surgical variables were collected and analyzed by univariate and multivariate Cox regression analyses for overall survival (OS) and recurrence-free survival (RFS). Results: The OS rates at 5 and 10 years were 73% and 61%, respectively. The RFS rate at 10 years was 57.1%. Multivariate Cox regression analysis revealed old age (hazard ratio [HR], 5.16; 95% confidence interval [CI], 1.71-15.48) as a significant risk factor for death. A surgical resection margin distance of less than 1.5 cm (HR, 15.759; 95% CI, 1.78-139.46) and histologic grade III (HR, 28.36; 95% CI, 2.76-290.87) were independent risk factors for recurrence. Conclusion: Long-term OS and RFS after the surgical resection of primary chest wall sarcoma were clinically acceptable.

• Journal of Radiation Protection and Research
• /
• v.26 no.3
• /
• pp.299-303
• /
• 2001

Using ultrasound techniques, the Korea Atomic Energy Research Institute has measured chest wall thicknesses of a group of male workers at the Korea Atomic Energy Research Institute. A site-specific biometric equation has been developed for these workers. Chest wall thickness is an important modifier on lung counting efficiency. These data have been put into the perspective of the ICRP recommended dose limits for occupationally exposed workers: 100 mSv in a 5-year period with a maximum of 50 mSv in anyone year. For measured chest wall thicknesses of 1.9 cm to 4.1 cm and a 30 min counting time, the achievable MDAs for natural uranium in the KAERI lung counter vary from 5.75 mg to 11.28 mg. These values are close to, or even exceed, the predicted amounts of natural uranium that will remain in the lung (absorption type M and S) after an intake equal to the Annual Limit on Intake corresponding to a committed dose of 20 mSv. This paper shows that the KAERI lung counter probably cannot detect an intake of Type S natural uranium in a worker with a chest wall thickness equal to the average value (2.7 cm) under routine counting conditions.

• Journal of Chest Surgery
• /
• v.45 no.3
• /
• pp.177-182
• /
• 2012

Background: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods: Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results: Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion: Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

• Journal of Chest Surgery
• /
• v.13 no.4
• /
• pp.486-489
• /
• 1980

16 cases of the chest wall tumors that had been treated at the dept. of thoracic & cardiovascular surgery, Chungnam National University Hospital, for 3.5 years from Jan. 1977 to Jun. 1980 were analyzed. The results were as follows; 1. Generally the chest wall tumors were most frequent in the thirties, the youngest age was 2 years, and the oldest 65 years. The incidence rate of male to female was 1.3:1. The malignant tumors were common in the fifties & sixties, the incidence rate of male to female 5:1. 2. The common disease entities were rib tuberculosis [43.7%] and metastatic tumor [25.0%], and the another chondrosarcoma, osteosarcoma, fibrous dysplasia, chronic osteomyelitis, and granuloma accompanying with acute osteomyelitis by Klebsiella infection were 6.3%, respectively. 3. The common manifestations were local swelling [100.0%] and local chest pain [43.8%].

• Journal of Chest Surgery
• /
• v.27 no.11
• /
• pp.973-976
• /
• 1994

Angiomatosis [ or Diffuse Hemangima] is a rare condition in which large segments of the body are involved by proliferating vessels. By now, some authers say that this lesion begins during early intrauterine life when the limb buds form, grow proportionately with the fetus, and consequently affect large areas of the trunk or extremity. The majority of angiomatoses present during childhood or infancy as swelling, induration, or discoloration of the affected area. The patient was 13 year old male and had no specific signs and symptoms except palpable mass on the left lateral chest wall from childhood and a painful tender mass on the posterior chest wall for 5 days before admission. The chest PA showed no abnormalities.The operation was done with the resection of left 10th rib and 9th and 10th intercostal muscles including masses and the ligation of the both intercostal and feeding vessels of the masses. The pathologic result was angiomatosis involving intercostal muscles and rib.