• 한국임상수의학회지
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• 제25권1호
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• pp.31-36
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• 2008

1년령 수컷 비글견이 심한 호흡곤란, 청색증, 식욕감소로 내원하였다. 외상의 병력은 없었으며, 내원 5일전에 Pseudomonas aeruginosa와 E. coli로 인한 세균성 폐렴의 진단을 받았다. 제한적인 호흡 양상을 보여 즉각적으로 산소를 투여하고 방사선검사를 실시하였다. 배복 촬영상에서 우측 흉강에 공기가 차 있었고, 우측 폐엽의 허탈, 종격, 심장과 대혈관의 좌방 변위가 관찰되었다. 외측상에서는 심첨이 흉골로부터 떨어져 있는 것이 관찰되었다. 이상의 결과로 세균성 폐렴으로 인한 속발성 자발 기흉으로 진단하고, 우측 흉강에 흉강 튜브를 삽관하였다. 삽관 3일후에 방사선 배복 촬영상에서, 우측 흉강의 공기는 제거되었으나 좌측 흉강에 기흉이 발생하여 심장이 우방변위된 것이 확인되었다. 따라서, 흉강튜브를 좌측 흉강에도 삽관하였다. 기흉이 완전히 회복되기까지, 우측 흉강 튜브는 5일간, 좌측 흉강튜브는 45일간 유지하였다. 추가로 세균성 폐렴의 치료와 튜브로 인한 역행성 감염을 방지하기 위해 항생제와 비타민 E를 처치하였다. 결과적으로, 환자는 완전히 회복되었고, 2년동안의 관찰기간 동안 재발증상 없이 정상 생활을 유지하였다.

• Journal of Chest Surgery
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• 제36권8호
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• pp.627-629
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• 2003

흉부둔상에 의한 심막기종은 매우 드물다. 교통사고에 의해 응급실로 내원한 환자로 초기 흉부단순 촬영에서는 발견되지 않았으나, 흉부단층촬영상 좌측 기흉과 함께 심막기종이 발견되어 좌측 흉막에 관을 삽입한 후 해결된 경우가 있어 보고한다.

• Journal of Chest Surgery
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• 제8권1호
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• pp.9-12
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• 1975

Four patients with postpneumonectomy empyema were treated successfully by modification of Clagett`procedure. Their primary diseases were chronic bronchiectasis, empyema with bronchopleural fisula, pulmonary tuberculosis, and pyohemothorax. The time interval between 1st and 2nd operation was 26.5 months in average. The pleural space was irrigated with various kinds of antiseptic solutions for 23.3 days in average and debrided, filled with antibiotic saline solution. After the procedure, patients had no recurrences of empyema and discharged from hospital after brief days. (averages: 15.5 days)

• Journal of Chest Surgery
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• 제23권3호
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• pp.546-549
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• 1990

Spontaneous esophageal perforation occurred rarely but often lead to a high mortality and morbidity. We had experienced one case of spontaneous rupture of esophagus. A 52 - year old male patient was admitted to our hospital because of the chest pain and massive hematemesis after emetic strain. Esophagogram that taken at private clinic revealed leakage of dye into the right pleural space. Under the diagnosis of the thoracic esophageal perforation, two stage operation was planned because the size of perforation was large and pyothorax was developed on the right side. At first, exclusion and diversion of the esophagus were carried out. After six months, the esophageal reconstruction with left colon was performed.

• Tuberculosis and Respiratory Diseases
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• 제51권3호
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• pp.265-269
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• 2001

저자들은 악성 늑막삼출 환자에서 talc로 늑막유착술을 시행하여 급성 호흡곤란증후군을 보인 환자를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제29권12호
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• pp.1381-1384
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• 1996

42세 남자는 약 10년간 석면에 노출되는 직업에 종사하다가 그만둔지 5년 후, 진행하는 호흡곤란을 주소로 검사를 받던중 우측 늑막에 다양한 크기의 종괴를 보이는 암종으로 입원하였다. 환자는 부분 마취하에 늑막 조직 생검을 받고 침윤성 흉선종의 의심하에 우 전늑막 및 우전폐 절제술을 받았다. 수술중 흉선의 상태는 정상이었으며 폐 첨부로부터 횡격막부위까지의 늑막과 폐엽간, 부분적인 폐 침습을 보이고 심낭의 침윤을 보이는 Masaoka 분류 Stage 로 보이는 침윤성 흉선종으로 진단되 었다. 환자는 술후 600의 방사선 조사를받고 술후 8개월인 현재까지 재발의 징후 없이 경과관찰중이다.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.35-37
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• 2015

Pleuropulmonary diseases caused by Clostridial species infections are rare, but have a mortality rate of up to 30%. Furthermore, older people are at greater risk of developing invasive clostridium infections, and the majority of reported cases of clostridium empyema have been attributed to iatrogenic trauma or aspiration. The authors report a case of spontaneous empyema caused by Clostridium perfringens. A 72-year-old woman was admitted to Kangwon National University Hospital for empyema. The patient had no history of trauma, a dental procedure, or aspiration, and was treated using empirical antibiotics and by drainage of pleural fluid. Bacteria species that cause empyema are usually not detected, but on the 4th day of admission, C. perfringens was isolated from the pleural space. The patient was continuously treated with antibiotics for C. perfringens and drainage, and was discharged 25 days after admission with almost a fully recovered status. Increased awareness of Clostrium species infection in the elderly is needed to ensure appropriate treatment.

• Journal of Chest Surgery
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• 제33권8호
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• pp.688-692
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• 2000

Descending Necrotizing Mediastinitis(DNM) is a complication of oropharyngeal infections that can spread to the mediastinum. It is difficult to diagnose early because clinical and radiologic findings appear in the late stage of the infection. late diagnosis is the principal reason for the high mortality in DNM. An 18-year-old female admitted with Ludwig's angina from dental caries. Despite of combined antibiotics, dental extraction and drainge of submental abscess, infection spread to the cervical area. Chest computed tomogram revealed extension of the abscess to the pretracheal and periaortic space and development of bilateral pleural empyema. We performed bilateral cervical mediastinotomy and thoracotomy for drainage and debridement. Tracheostomy to secure the airway and postoperative pleural irrigation were performed. Postoperative course was uneventful and patient was discharged on the 40th postoperative day. It is important to perform chest CT scanning for early diagnosis of DNM when oropharyngeal infection spreads to the cervical area. Improved survival of patients with DNM implies early and radical surgical drainage and debridement via a cervical mediastinomy and thoracotomy.

• Journal of Chest Surgery
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• 제26권5호
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• pp.390-394
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• 1993

This study elvaluated clinically the surgical results of the thirty-eight patients who had exploratory thoracotomy for spontaneous pneumothorax between Jan. 1989 and Nov. 1992. Thirty three, or 86.8%, of the patients were male. The most frequent age of the spontaneous pneumothorax requiring thoracotomy was between fifteen years and twenty years. Sudden onset dyspnea and chest pain, which developed in thirty-five patients[89.5%], were the major chief complaints. Bleb and Bulla located in the both upper lobes were the most frequent causes of spontaneous pneumothorax for exploratory thoracotomy. There was no operative death. Postoperative morbidity included three cases of residual air space in the apical pleural space, tow cases of atrial fibrillation, and one each case of reoperation for bleeding, mediasitinitis, and sternal osteomyelitis. All postoperative complications were treated without any serious problems. This study suggests that early exploratory thoracotmy is desirable for patients with prolonged air-leak, massive air-leak, or multiple blebs and giant bullae on the computed tomography of the chest.

• Journal of Chest Surgery
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• 제15권1호
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• pp.129-135
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• 1982

Congenital pericardial defect is a rare anomaly, which was first described by M. Columbus in 1559. Four hundred years later the first clinical diagnosis was reported by Ellis et al. The congenital pericardial defect Is usually asymptomatic and Is found Incidentally at thoracotomy and autopsy, but it appears that partial absence of pericardium Is not Innocuous because of sudden death due to herniation of a portion of heart. We experienced congenital left pericardial defect in 20 year old female who was diagnosed as left ventricular aneurysm before operation. This patient complained of dyspnea on exertion and anterior chest discomfortness. Physical examination revealed Grade II pansystolic murmur on the 3rd and 4th intercostal space left sternal border. There were specific abnormal findings on the chest plain film, EKG, ultrasonography, and left ventriculography. On 9th July 1981, an operation was performed and found the left partial pericardial defect through which a large portion of left ventricle was herniated Into left pleural space. The method of operation was removal of adhesion and widening of the pericardial defect to avoid Incarceration. After operation, we observed marked Improvement of symptoms and disappearance of cardiac murmur.