• Title/Summary/Keyword: Computed-Assisted

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Surgical Repair of a Traumatic Tracheobronchial Injury in a Pediatric Patient Assisted with Venoarterial Extracorporeal Membrane Oxygenation

  • Suh, Jee Won;Shin, Hong Ju;Lee, Chang Young;Song, Seung Hwan;Narm, Kyoung Sik;Lee, Jin Gu
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.403-406
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    • 2017
  • Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury in the pediatric population. Computed tomography (CT) is not always reliable in the management of these patients. An additional concern is that ventilation may be disrupted during surgical repair of these injuries. This report presents the case of a 4 -year-old boy with an injury to the lower trachea and carina due to blunt force trauma that was missed on the initial CT scan. During surgery, he was administered venoarterial extracorporeal membrane oxygenation (ECMO). Although ECMO is not generally used in children, this case demonstrated that the short-term use of ECMO during pediatric surgery is safe and can prevent intraoperative desaturation.

Pulmonary Nodular Lymphoid Hyperplasia in a 33-Year-Old Woman

  • Park, Ji Ye;Park, Seong Yong;Haam, Seokjin;Jung, Joonho;Koh, Young Wha
    • Journal of Chest Surgery
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    • v.51 no.2
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    • pp.133-137
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    • 2018
  • Pulmonary nodular lymphoid hyperplasia is a reactive lymphoproliferative disease. It is very rare, which means that many aspects of the disease are unknown or have not been proven. Pulmonary nodular lymphoid hyperplasia can be symptomatic or asymptomatic, progressive or not, and solitary or multiple, and a surgical approach is the current treatment of choice. We present a case of pulmonary nodular lymphoid hyperplasia that was visualized as multiple ground glass opacities on a computed tomography (C T) scan, and observed for 1 year because the patient was pregnant. Over this period, the number and extent of the opacities progressed, but no symptoms were reported. A surgical biopsy was done and some remaining lesions regressed on follow-up CT scans, while others progressed, without any appearance of symptoms.

Long-Term Survival Following Port-Site Metastasectomy in a Patient with Laparoscopic Gastrectomy for Gastric Cancer: A Case Report

  • Kim, Sang Hyun;Kim, Dong Jin;Kim, Wook
    • Journal of Gastric Cancer
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    • v.15 no.3
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    • pp.209-213
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    • 2015
  • A 78-year-old man underwent laparoscopy-assisted total gastrectomy for gastric cancer (pT3N0M0). Multiple port sites were used, including a 10 mm port for a videoscope at the umbilical point and three other working ports. During the six-month follow-up evaluation, a 2 cm enhancing mass confined to the muscle layer was found 12 mm from the right lower quadrant port site, suggesting a metastatic or desmoid tumor. Follow-up computed tomography imaging two months later showed that the mass had increased in size to 3.5 cm. We confirmed that there was no intra-abdominal metastasis by diagnostic laparoscopy and then performed a wide resection of the recurrent mass. The histologic findings revealed poorly differentiated adenocarcinoma, suggesting a metastatic mass from the stomach cancer. The postoperative course was uneventful, and the patient completed adjuvant chemotherapy with TS-1 (tegafur, gimeracil, and oteracil potassium). There was no evidence of tumor recurrence during the 50-month follow-up period.

Temporary Semi-Jailing Technique for Coil Embolization of Wide-Neck Aneurysm with Small Caliber Parent Artery Following Incomplete Clipping

  • Byun, Jun Soo;Kim, Jae Kyun;Lee, Hwa Yeon;Hwang, Sung Nam
    • Journal of Korean Neurosurgical Society
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    • v.53 no.4
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    • pp.241-244
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    • 2013
  • The authors describe the use of a self-expandable stent in a temporary deployment for treatment of a very wide-neck A1 segment of anterior cerebral artery (ACA) aneurysm following incomplete clipping. A 39-year-old hypertensive man presenting with seizure-like movement underwent computed tomography, which showed acute subarachnoid hemorrhage and an A1 segment of ACA aneurysm with superior and inferior projection. He underwent surgical clipping of the aneurysm, but superior and posterior portion of wide-neck aneurysm remained. We decided to treat the remnant aneurysm using an endovascular modality. After selection of the aneurysm, coil packing was performed assisted by the temporary semi-jailing technique. The Enterprise stent (Cordis Neurovascular, Miami, FL, USA) was deployed and recaptured repeatedly for angiography to ensure safety of the small caliber parent artery. Successful semi-deployment and recapture of the stent allowed subtotal coil occlusion of the aneurysm with good anatomic and clinical results. No complications were encountered. The stent could be recaptured up to the point where the proximal end of the stent marker was aligned with distal marker band of the microcatheter, approximately 70% of the stent length. The temporary semi-jailing technique is feasible for wide-neck aneurysm with small caliber parent artery.

Notchplasty for Treatment of Impingement of the Cranial Cruciate Ligament on Osteophyte in a Cat

  • Hong, Youngchae;Park, Jiyoung;Choi, Ho-Jung;Lee, Young-Won;Jeong, Seong Mok;Lee, Haebeom
    • Journal of Veterinary Clinics
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    • v.34 no.6
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    • pp.459-462
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    • 2017
  • A 3-year-old, 5.6 kg, castrated, male, British short hair cat presented with subtle weight-bearing lameness of the right hindlimb when walking suddenly after rest. On physical examination, the patient experienced pain when the right stifle joint was hyperextended. There was no clinical improvement of lameness or pain of the right hindlimb, despite the administration of analgesic drugs for one week. During diagnostic arthroscopy of right stifle, mild synovitis and cranial cruciate ligament (CCL) impingement on osteophyte of the intercondylar notch (ICN) was observed. Computed tomography was applied to determine an accurate surgical plan. Arthroscopy-assisted notchplasty, including removal of the osteophyte, was performed using chisel and arthroscopic burr. At 4 weeks postoperatively, the frequency of subtle weight-bearing lameness of the right hindlimb was significantly reduced. At 6 months postoperatively, the patient exhibited normal ambulation without recurrence of lameness. Impingement of CCL may cause subtle lameness and pain. Arthroscopy can be a good diagnostic tool for early-stage CCL disease. Notchplasty can be recommended for osteophyte-induced CCL disease.

Voice Change Due to Paratracheal Air Cysts

  • Rhee, Youn Ju;Han, Sung Joon;Chong, Yoo Young;Cho, Hyun Jin;Kang, Shin Kwang;Lee, Choong-Sik;Kang, Min-Woong
    • Journal of Chest Surgery
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    • v.49 no.4
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    • pp.313-316
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    • 2016
  • Paratracheal air cysts are a rare entity in which cystic formation occurs adjacent to the trachea. Most patients with paratracheal air cysts are asymptomatic, and the cysts are detected incidentally on chest radiograph or computed tomography (CT) scan. Most symptomatic patients complain of pulmonary symptoms or repeated respiratory infection. Rarely, the air cysts can lead to paralysis of the recurrent laryngeal nerve as a result of direct compression. We report a case of a 59-year-old male patient who presented with voice change, and the cause was identified as paratracheal air cysts on a chest CT scan. Surgical resection via video-assisted mediastinoscopy was performed, and the voice recovered immediately after the operation.

Traumatic Extrapleural Hematoma Mimicking a Hemothorax (혈흉으로 오인된 흉막외혈종)

  • Park, Young-Woo;Lee, Jae-Wook;Lee, Dong-Gi
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.328-331
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    • 2010
  • Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.

Pulmonary Paragonimiasis Misdiagnosed with Pulmonary Tuberculosis (객혈과 공동 폐병변으로 폐결핵으로 오인된 폐흡충증 1예)

  • Park, Su Eun;Song, Bokyung;Hwang, Jae-Yeon
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.178-182
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    • 2017
  • Paragonimiasis was one of the most common causes of cavitary lung lesions until the 1960s, but now it has become a very rare disease in Korea. A 16-year-old boy presented with hemoptysis and several days of cough. His plain chest radiograph showed nodular opacity with a cavity in the left upper lung region. Although his symptoms disappeared after taking antituberculous drugs, his plain chest radiograph and computed tomography images after completion of therapy showed a new nodule with a cavity in the left lung field. Through video-assisted thoracoscopic wedge resection, Paragonimus eggs were found in the lung tissues.

Arthroscopic Stabilization for Displaced Lateral Clavicular Fractures: Can It Restore Anatomy?

  • Khan, Prince Shanavas;Yoo, Yon-Sik;Kim, Byung-Su;Lee, Seong-Jin;Ha, Jong Mun
    • Clinics in Shoulder and Elbow
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    • v.19 no.3
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    • pp.143-148
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    • 2016
  • Background: The purpose of our study was to evaluate the accuracy of reduction based on postoperative computed tomography (CT) images after arthroscopic stabilization using tightrope system for unstable distal clavicle fracture. Methods: Twelve patients with distal clavicle fracture combined with coracoclavicular (CC) ligament injury (type II, V) who received arthroscopically assisted fixation using a flip button device were evaluated for accuracy of reduction using 3-dimensional postoperative CT scan by measuring the degree of distal clavicular angulation and clavicular shortening. Results: Immediate postoperative plain radiograph confirmed restoration of the CC distance (CCD) in 10 patients. At final follow-up, the CCD remained reduced anatomically on plain radiographs in these patients. All patients showed excessive posterior angulation and shortening compared to the opposite side. The average Constant score recovered to 94.8 at final follow-up. Conclusions: Indirect reduction and arthroscopic subacromial approach with flip button fixation of unstable distal clavicle fractures demonstrated favorable clinical results despite unavoidable posterior angulation of distal clavicle and shortening the total length of clavicle.

Massive hemothorax resulting from spontaneous pneumothorax (자연성 기흉으로 인한 대량의 혈흉)

  • Hong, Ji Yeon;Kim, Su Wan
    • Journal of Medicine and Life Science
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    • v.17 no.1
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    • pp.16-20
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    • 2020
  • Spontaneous hemopneumothorax is a rare disease, and it can cause life threatening condition. It is characterized by the accumulation of more than 400 mL of blood and air in the pleural cavity without any other apparent causes. A previously healthy 22-year-old female patient presented with acute chest pain and dyspnea. Chest X-ray and computed tomography revealed a massive hemopneumothorax in the left hemithorax. The images showed a completely collapsed left lung with right-sided tracheal deviation, several pleural adhesion bands, and fluid collection with air-fluid level. We emergently performed a closed thoracostomy, and then 560 mL of fresh bloods were initially drained. We considered an emergent video-assisted thoracoscopic surgery for pulmonary wedge resection and bleeding control because of the massive hemothorax. However, the patient's vital signs were stabilized after blood transfusion and supportive cares for re-expansion pulmonary edema. The patient discharged from the hospital on 11th in-hospital day after removal of the chest tube, and there had not been any recurrence of the pneumothorax for 10 months. We suggest that treatment strategy should be decided upon individually based on the patient's condition and clinical course of the disease.