• Title/Summary/Keyword: Closed Cavity

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Surgical Treatment of Empyema using Intrathoracic Transposition of Extrathoracic Skeletal Muscles (흉곽내로 전위시킨 골격근을 이용한 농흉의 외과적 치료)

  • Kim, Gi-Bong;Park, Jong-Ho
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.630-636
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    • 1992
  • From August 1990 through December 1991, 14 patients[all males] underwent int-rathoracic muscle transposition of extrathoracic skeletal muscles to treat empyemas, 6 patients had tuberculous empyemas, 4 had chronic empyemas of unknown etiology, 3 had pos-tpneumonectomy empyemas, and 1 had postlobectomy empyema. 9 patients had associated bronchopleural fistulas, Their ages ranged from 22 to 67 years, with mean age of 45.1$\pm$17. 6[$\pm$S.D] years. The serratus anterior was transposed in 13 patients, the latissimus dorsi in 12. In 11 patients, both the serratus anterior and the latissimus dorsi were transposed. The omental flap also transposed in 3 patients. To reduce the dead space in the thoracic cavity, thr-oacoplasty was also carried out in 10 patients. The number of the partially resected ribs was 3.0$\pm$0.8[$\pm$S.D.]. All operations were single stage procedures, and all wounds were closed primarily, with no permanent tubes or chest wall openings. There was no hospital mortality, and so no subsequent operation has been required. Follow-up of the patients ranged from 5 to 16 months with a mean of 9.2$\pm$3.1[$\pm$S.D] months, All the patints had no further signs or symptoms of the original infection after discharge. We conclude that intrathoracic transposition of extrathoracic skeletal muscle is an excellent method of treatment for persistent, life-threatening intrathoracic infections.

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Surgical Treatment of Empyema with Bronchopleural Fistula (기관지 흉막루의 외과적 치료)

  • 신형주
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.750-757
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    • 1990
  • Empyema with bronchopleural fistula is an uncommon, but serious problem. Early diagnosis and adequate drainage of the empyema cavity are well established principles for the initial management of this condition and will enable patient to recover from the toxic effects of loculated pus. 37 patients of empyema with bronchopleural fistula were treated at the department of the chonbuk National University Hospital between 1981 and 1988. The age group of fifty and sixty decades occupied 64.8%. Bacteriologic cultures of the pus were postive in 56.8%. The most common organism of the culture was staphylococci(42.9%). And the others were Pseudomonas(19%). Klebsiella(14.3%), and E. doli. No growth of pathologic organism was reported 43.2%. 24 patients of empyema with bronchopleural fistula were nonoperative causes : There were 10 pulmonary tuberculosis, 3 abscess, 9 ascending infection, one bronchiectasis and one tumor, respectively. The remaining 13 were occurred as postoperative complications ; pneumonectomy in 6, lobectomy in 4, decortication in 2, and lobectomy with segmentectomy in 1. When used as the initial mode of drainage, closed thoracostomy was performed to almost all of the patients, but 4 patients were died during this treatment. Main operations were performed except 4 died patients ; open thoracostomy in 21, open thoracostomy with myoplasty in 3, decortication in 5, decortication with resection in 3, and completion pneumonectomy in 1. Open thoracostomy was performed in 21 patients which results were favorable except one death. Permanent open thoracostomy is an old but still useful minor operation in patients with empyema with bronchopleural fistula. The overall mortality rate was 15% (6 patients) and the causes of the death were respiratory insufficiency or sepsis, or both.

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Right Bochdalek Hernia - The Third Case Report in Korea - (우측 Bochdalek Hernia - 1례 보고 -)

  • 배인근
    • Journal of Chest Surgery
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    • v.6 no.1
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    • pp.109-112
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    • 1973
  • Bochdalek hernia is the most common congenital diaphragmatic hernia and that of the foramen of Bochdalek is rare in right side of the diaphragm. Two cases of right Bochdalek hernia were reported in literatures published in Korea. The first case was associated with hypoplasia of the lung and could not be survived. The second case [four months old male infant] was operated on August 28, 1971. at Ewha University Hospital arid survived. The third case was a three months old male infant who had been born at 8th lunar month in a private clinic. During the period of three months prior to admission this premature infant was suf-fered from mild respiratory distress measured as pneumonia. On December 20. 1972, this infant was admitted at Kyung Hee University Hospital with severe respiratory distress developed abruptly. Chest X-ray examination [barium study] demonstrated right diaphragmatic hernia. Right hemithorax was filled with intestines and right lobe of the liver which were repositioned back into the peritoneal cavity through the foramen of Bochdalek. 3. 0 cm x3.5 cm in size, and the defect was closed with interrupt mattress sutures. There was hypospadia with chordee but no other associated anomalies such as hypoplasia of the lung, malrotation or malfixation of intestines, and cardiovascular anomalies. The Postoperative hospital course was not eventful and the baby was discharged on the 14th postoperative day.

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Microstructural Characteristics by Compression Holding Time in Semi-Solid Forging (반용융 단조에서 가압유지 시간에 의한 미세조직의 특성)

  • 최재찬;박형진;이병목
    • Proceedings of the Korean Society for Technology of Plasticity Conference
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    • 1997.06a
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    • pp.174-182
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    • 1997
  • The technology of Semi-Solid Forging (SSF) has been actively developed to fabricate near-net-shape products using light and hardly formable materials. Generally, the SSF process is composed of slug heating, forming, compression -holding and ejecting step. After forming step in SSF, the slug is compressed during a certain holding time in order to be completely filled in the die cavity and be accelerated in solidification rate. The compression holding time that can affect microstructural characteristics and shape of products is important to make decision, where it is necessary to find overall heat transfer coefficient properly which has large effect on heat transfer between slug and die. This paper presents the procedure to predict compression holding time of obtaining the final shaped part with information of temperature and solid fraction for a cylindrical slug at compression holding step in closed-die compression process using heat transfer analysis considering latent heat by means of finite element method. The influence of the predicted compression holding time on microstructural characteristics of products is finally investigated by experiment.

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Management of Post-lobectomy Bronchopleural-cutaneous Fistula With a Rectus Abdominis Free Flap (폐절제술 후 발생한 기관지늑막 피부루에서 유리 복직근피판을 이용한 치료)

  • Heo, Chan Yeong;Min, Kyung Hee;Eun, Seok Chan;Baek, Rong Min;Cheon, Sang Hoon
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.795-798
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    • 2009
  • Purpose: The repair of complex chest wall defects presents a challenging problem for the reconstructive surgeon. In particular, a free flap is often required when the defect is large, in which case suitable recipient vessels must be found to insure revascularization. The authors report a case of persistent bronchopleural - cutaneous fistula developed after undergoing lobectomy for lung cancer. Methods: The defect area was repaired using a free vertical rectus abdominis muscle flap revascularized by microvascular anastomosis to the 6th intercostal pedicle. The flap obliterated the right chest cavity, closed the site of empyema drainage, and aided healing of a bronchopleural - cutaneous fistula. Results: The patient has remained healed for 14 months without any postoperative complications and recurrent infection or fistula. Conclusion: We suggest that a rectus abdominis musculocutaneus free flap and intercostal pedicle as a recipient could be a useful method for repair of chest defects.

A Study of Pathogenesis and Treatment of Spontaneous Pneumothorax (자연성 기흉의 성인과 치료에 대한 고찰)

  • 홍완일;김진식
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.11-18
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    • 1968
  • Author studied the possible pathogenesis of spontaneous pneumothorax and its effective treatment in 33 cases, and the results obtained as follows:1) Of the 33 cases, 15 cases were originated from pulmonary tuberculosis, 11 cases were non-tuberculous natures and 7 cases were followed by traumatic chest injuries which were not associated with a laceration of the lung or rib fractures.2) So called "Idiopathic spontaneous pneumothorax" seemed mostly to be caused by rupture of the emphy- sematous blebs.3) Spontaneous pneumothorax, in process of the pulmonary tuberculosis, seemed to be caused by the rupture of blebs which was formed with a pathological process of chronic pulmonary tuberculosis.4) Author experienced interesting cases of giant blebs which had been fully occupied the right thoracic cavity. At first, it was misdiagnosed as extensive spontaneous pneumothorax on X-ray which was revealed extensive pleural air shadow with total atelectasis of the right lung. A pneumonectomy was performed together with the giant multiple blebs.5] Generally, closed thoracotomy with water-sealed drainage is the treatment of choice in spontaneous pneumothorax. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage or recurrent attack of spontaneous pneumothorax.aneous pneumothorax.

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Effects of the Decomposition Residue of Compound Additive on Resintering Behavior

  • Kim, H.S.;C.Y. Joung;Kim, S.H.;S.H. Na;Lee, Y.W.;D.S. Sohn
    • Nuclear Engineering and Technology
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    • v.34 no.4
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    • pp.323-330
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    • 2002
  • Various types of compounds were tested with the aspects of decomposition and formation of residue in a $CO_2$ or 7H$_2$+93$N_2$ atmosphere. The evaporation temperature range of each compound was determined from thermogravimetric curve. Decomposition of dicarbon amide, stearic acid, acrowax and zinc stearate was studied by thermogravimetry in $CO_2$ or in 7H$_2$+93$N_2$ atmosphere. All compounds were decomposed in $CO_2$ atmosphere at lower than 40$0^{\circ}C$, but the residue, ZnO remained for zinc stearate. ZnO did not decompose in $CO_2$ atmosphere up to 130$0^{\circ}C$, but reduced into Zn metal and disappeared in the temperature range of $600^{\circ}C$ to 120$0^{\circ}C$ in 7H$_2$+93$N_2$ atmosphere. The effect of residue, which trapped in closed pores of sintered pellet, on the thermal stability was studied using the resintering test at 1$700^{\circ}C$ in 7H$_2$+93$N_2$ atmosphere. In the case of oxidative sintered pellet with admixing zinc stearate, the cavity formation accompanied with a density drop after resintering is due to the pressure of the Zn gases trapped in the isolated pores.

Surgical Removal of Intrathoracic Lipoma from Herniated Omentum through the Diaphragmatic Defect in an Abyssinian Cat

  • Lee, Jiyeon;Park, Hyojin;Kim, Jieyoo;Kim, Na-Hyun;Lee, Dongbin;Lee, Hee-Chun;Hwang, Tae-Sung;Lee, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.38 no.4
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    • pp.174-178
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    • 2021
  • A nine-year-old neutered male cat was presented with chronic cough and vomiting. Thoracic radiography showed regions of fatty opacity in the right caudoventral region. On positive contrast celiography, contrast agent did not move into thoracic cavity. Computed tomography revealed 7-mm diameter of defect at the right diaphragmatic crus and a 2-mm diameter defect at the left ventral diaphragmatic crus. Through the right diaphragmatic defect omental herniation was confirmed by the presence of contrast enhanced omental vessel running across the diaphragm. On exploratory thoracotomy, the omentum protruded into the thorax through the right diaphragmatic defect, and it contained a yellowish lipomatous mass. The protruded omentum containing a mass in the thorax was removed, and the right diaphragmatic defect was closed. Histopathologic examination revealed that the protruded omentum showed normal omental structure and the adipose mass showed lipoma surrounded by fibrous tissue. In conclusion, a thorough examination is necessary to confirm the origin of the mass located near the diaphragm.

Reconstruction of a large lower lip defect using a combination of Abbe and staircase flaps: a case report

  • Moon, Bo Min;Pae, Woo Sik
    • Archives of Craniofacial Surgery
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    • v.22 no.6
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    • pp.324-328
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    • 2021
  • Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient's oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.

Analysis of Acoustical Performance of Exhaust System by Lattice Filter (격자필터에 의한 배기계의 소음특성 해석)

  • Hwang, Won-Gul
    • Journal of the Korean Society for Precision Engineering
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    • v.12 no.5
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    • pp.126-135
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    • 1995
  • An exhaust muffler is one of the simple and effective means to meet the demand for a quiet vehicle, and it deserves a close attention to effectively reduce the engine noise. The transfer function technique is one of the tools that have been used to analyze the noise characteristics of the exhaust muffler. In this paper we obtained a transfer function using the forward-going and backward-going components of sound pressure in the exhaust muffler, which is compatible wiht lattice filter algorithm. This form of transfer function is obtained for the basic elements of a muffler, such as uniform tube, open termin- ation, closed termination, anechoic termination, expansion, contraction, extended-tube resonator, hole, Helmholtz resonator, and concentric hole-cavity resonator. The results are combined to produce the transfer function of various types of mufflers. With this transfer function we calculate the transmission and insertion losses of mufflers, and examined the effects of various design parameters. Comparisons were made between the calculation and experimental results, which showed a good agreement, and we conclude that the transfer function of lattice form can be used to analyze the noise characteristics of the exhaust mufflers.

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