• Title/Summary/Keyword: Pulmonary pleura

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Fontan Operation for 3 Cases of Tricuspid Atresia (삼첨판 폐쇄증 Fontan 수술 3례 보고)

  • Lee, Sang-Ho;Hong, Jang-Su;Lee, Yung-Kyoon
    • Journal of Chest Surgery
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    • v.14 no.1
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    • pp.26-32
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    • 1981
  • Three cases of tricuspid atresia were treated by Fontan varieties of operation in this department in 1980. The first case was 19 year old girl who underwent Glenn operation at the age of 6 years. Her second operation was done with ASD closure and 16mm Ionescu-Shiley valved conduit insertion between right atrium and main pulmonary artery. The second case was a 5 year old boy who underwent Kreutzer operation successfully utilizing 14mm Ionescu-Shiley va]ved conduit. The above mentioned 2 cases were Type Ib after Keith`s classification, whose immediate postoperative courses were complicated by pleura] effusion [in 2nd case chylothorax] hepatomegaly, and ascites. Those complications were relieved completely by medical treatment and closed thoractomy; Postoperative follow-up up to 11 months and 1 year periods were satisfactory with disappearance of cyanosis and dyspnea. The third case was a 8 year old boy who had complete TGA with TA [Keith`s Type IIb] who underwent Kreutze`s operation utilizing 14mm Ionescu-Shiley valved conduit, he died of low cardiac output Immediately after open heart surgery.

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Von Recklinghausen's disease involving the chest -Two cases report- (흉부질환을 병발한 Von Recklinghausen's disease -2예 보고-)

  • Kim, Chi-Kyung;Park, Jae-gil;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.149-153
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    • 1980
  • Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.

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Pulmonary Aspergilloma Treated by one Stage Cavernostomy and Myoplasty (공동절개술과 근육충진술을 이용한 폐국균증의 수술)

  • 안현성;김응중;신윤철;지현근;최광민
    • Journal of Chest Surgery
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    • v.34 no.9
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    • pp.729-732
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    • 2001
  • A 49-year-old male patient was admitted with chief complaint of hemoptysis. Preoperative chest PA and CT scan revealed air-filled large cavitary lesion at the right upper lobe with typical meniscus sign. Serum anti-fungus antibody for Aspergillus was positive and he was diagnosed as aspergilloma. We planned RULobectomy but it was impossible due to severe pleural adhesion in apex and mediastinal pleura. Therefore, we performed a cavernostomy and serratus anterior muscle flap transposition in one stage. The patient recovered without complication and was followed up for 8 months without recurrence of hemoptysis.

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Pleuropulmonary Blastoma in an Adult -Surgical Experience of One Case- (성인에 발생한 흉막폐아세포종 -수술치험 1예-)

  • 김종인;조성호;변정훈;이해영;장희경;조성래
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.959-962
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    • 2004
  • Pleuropulmonary blastoma is a rare malignant neoplasm which originates from either the lungs or pleura. Pleuropulmonary blastoma usually develops in the first decade of life, mostly younger than 5 years old and shows aggressive biological behavior. Pleuropulmonary blastoma is discriminated from classic pulmonary blastoma of adulthood by its morphological features like primitive mesenchymal and sarcomatous component without carcinomatous portions. To our knowledge, report of pleuropulmonary blastoma in adulthood is very rare. Our case support the possibility that primitive neoplasm recognized as pediatric tumors can develop in adulthood. We report a case of surgical experience of pleuropulmonary blastoma which developed in 21 years old man with literature review.

Effect of Omentum, Pleura, Diaphragm on Tracheal Autograft Survival (자가이식기관의 생존에 필요한 장막, 흉막, 횡격막의 역할 분석)

  • Keum, Dong-Yoon
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.461-467
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    • 2005
  • Pleura, diaphragm, pericardial fat pad, intercostal muscles and omentum can be used to protect and revascularize the bronchial suture line of tracheal transplantation, lung transplantation and pulmonary resection. The purpose of the present study is to compare the influence of the pleura, diaphragm and omentum in survival of isolated tracheal segments in the experimental animals. Material and Method: Sprague-Dawley rats weighing 250- 350g were used. The animals were divided in three groups; the pleura, omentum and diaphragm. Following intraperitoneal anesthesia, endotracheal intubation was performed. Then the trachea was exposed. A three-ring sec- tion of cervical trachea was excised. The resected trachea was implanted at each sites. After 2 weeks, rats were sacrificed. Histopathological examination of the tracheal segments was performed. For comparison of each groups, histopathological viability of resected tracheal segment was scored by three tissue layers; epithelium, submucosa, and cartilage. The results were presented as average score. Result: In histopathological examination, submucosa and cartilage using tracheal segment necrosis scoring system. The pleural group showed well preserved tissue. There was minimal necrosis and inflammation compared with other groups. In the pleural group, tracheal necrosis scores were $2.17\pm0.983$at epithelium, $1.67\pm0.516$ at submucosa and $2.17\pm0.753$ at cartilage. At the omental group, scores were $1.00\pm0.00,\;1.60\pm0.548\;and\;1.80\m0.447$. In the diaphragmatic group, scores were $1.40:\pm0.894,\;2.40\pm0.547\;and\;2.20\pm0.447$. Total necrosis score were $6.00\pm1.789$ in the pleural group, $4.40\pm0.894$ in the omental group and $6.00\pm1.414$ in the diaphragmatic group. Conclusion: There were no significant viability differences in terms of total necrosis score for the viability of resected tracheal segment. But the best result was achieved in the omental group. Therefore, omental wrapping on tracheal graft site will be beneficial for the prevention of graft necrosis.

Mode of regional and mediastinal lymph node metastasis of bronchogenic carcinoma in accordance with the location, size and histology of primary tumor of the lung (폐암의 조직학적 분류, 위치 및 크기와 주위 림프절 전이의 양상에 관한 연구)

  • 김길동
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.81-89
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    • 1990
  • A total of 178 patients with primary lung cancer who had undergone complete resection of the tumor in combination with complete mediastinal lymphadenectomy were reviewed at the Department of Thoracic and Cardiovascular Surgery of Yonsei Medical Center from January 1980 through July 1989. Materials; 1. There were 45 men and 33 women ranging of age from 25 to 78 years with a mean age of 55.4 years. 2. Histological types were squamous carcinoma in 115 cases [64.6%] adenocarcinoma in 42 cases [23.6 %], bronchioloalveolar carcinoma in 9 cases [5.1%], large cell carcinoma in 8 cases [4.5 %] and small cell carcinoma in 4 cases [2.2%] Results were summarized as follows: 1. The size of primary tumor was not directly proportional to the frequency of mediastinal lymph node metastasis. [P =0.0567] 2. The histologic types of the primary tumor did not related to the incidence of mediastinal lymph node metastasis. [P >0.19] 3. The chance of mediastinal lymph node metastasis in the case with lung cancer located in right middle lobe[31.8%, N=22] and left lower lobe [31.4%, N=32] were the highest and the lowest was the one located in right lower lobe, while over all incidence of mediastinal lymph node metastasis in this series was 25.4 % [N=55]. 4. The rate of mediastinal lymph node metastasis without evidence of regional and hilar lymph node metastasis was 13%. [N=23] The chance of mediastinal lymph node involvement without N1 lymph node metastasis was 16.3 % [N=17] in both upper lobes and 8.2 % [N=6] in both lower lobes. It was statistically significant that the tumors in the upper lobes had greater chance of the mediastinal lymph node metastasis without N1 than the tumors in the lower lobes. 5. In this series majority of the patients with lung cancer the mediastinal lymph node metastasis from the tumor in each pulmonary lobes usually occurs via ipsilateral tracheobronchial and paratracheal lymphatic pathway. Especially the lung cancer located in lower lobes can metastasize to subcarinal, paraesophageal and inferior pulmonary ligamental lymph node through the lymphatic pathway of inferior pulmonary ligament. It can be speculated that in some cases of this series otherwise mediastinal lymph node metastasis can also occur with direct invasion to the parietal pleura and to the mediastinal lymph node via direct subpleural lymphatic pathway .

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The Combination therapy of Chinese traditional and Western medicine about Tuberculous exudative pleural effusion (결핵성삼출성뇌막염(結核性渗出性腦膜炎)의 중서의결합치료(中西醫結合治療) (중의잡지 중심)(中醫雜誌 中心))

  • Choi, Hae-Yun;Kim, Jong-Dae
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.438-450
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    • 1998
  • Pleural effusion means the inflammation of pleura which has a majority of respiratory disease. The main clinical manifestation is pleural effusional pain, dyspnea, cough, fever, etc. and at present the Tuberculous pleural effusion has the most frequency in which exists exudate in our country. And during studying oriental medical treatment about Tuberculous exudative pleural effusional patient, we found the clinical case about The Combination therapy of Chinese traditional and Western medicine at journal of traditional Chinese Medicine and considered it would be help in oriental medical treatment, so we adjust and report now. This study was performed by analyzing the six papers reported centering around the clinical case of The Combination therapy of Chinese traditional and Western medicine in journal of traditional Chinese Medicine published between 1990-1996. As these papers have no mistakes on diagnosis because it obtained pleurocentesis, tuberculin test positive reaction on choicing clinical case, definite results on X-ray, ultrasound as well as clinical basis, so it considers an apt conclusion. The results were as follows: 1. Western medical treatment uses chemical remedy same with pulmonary tuberculosis, and in case of tubercular pleuritis, it needs thoracic duct pyorrhea, and according to simple exudation also operates therapheutic pleural paracentesis. 2. In case of hydrothorax absorption about tuberculous pleural effusion, prescription of purge the heat accumulated in the lung and eliminate the retention of fluid with powerful purgatives shows considerable effects. 3. The latter period treatment of tuberculous pleural effusion needs Supplement qi and active the collaterals, Nourishing yin and clearing heat in addition to Supporting healthy energy to eliminate evils. 4. In case of curing tuberculous pleural effusion, The Combination therapy of Chinese traditional and Western medicine shows more considerable effect than single western medical treatment in absorption of hydrothorax. 5. In case of curing tuberculous pleural effusion, The Combination therapy of Chinese traditional and Western medicine shows more considerable effect than single western medical treatment in prevention of disease reappearance. 6. In case of curing tuberculous pleural effusion, The Combination therapy of Chinese traditional and Western medicine shows more considerable effect than single western medical treatment in vitality recovery at the latter period of disease.

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Clinical Study of Pulmonary Paragonimiasis (폐흡충증 환자의 임상적 고찰)

  • Choi, Jin-Won;Park, Ik-Soo;Shin, Dong-Ho;Park, Sung-Soo;Lee, Jung-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.274-282
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    • 1993
  • Background: Pulmonary paragonimiasis is caused by consumption of raw or improperly cooked crabs infected by a laval stage (metacercaris) of the parasite. In our country it had been a highly prevalent endemic disease until th late 1960s, and after then it's prevalence has been markedly decreased. But because some people have continued to ingest undercooked crabs, this disease have yet occured sporadically. Methods: We reviewed the clinical and radiological findings retrospectively in seventy-four patients of pulmonary paragonimiasis including familial infestation in 7 familes (20 cases) who were confirmed by food history, clinical and radiological findings, and labaratory data. Results: The male: female ratio was 2.2:1 and most prevalent age was 40-49 years old. Twen6ty nine patients (39%) had ova-positive infection. The detection sites were sputum (48%), pleural fluid (17%), fine needle aspiration biopsy of nodular or cystic lesion (17%), pleural biopsy (7%), skin nodule biopsy (7%), and stool (3%). The patients had pulmonary symptoms in 63 cases (85%) but 9 cases did not have any symptoms. The 53 cases (72%) had abnormal radiological findings in lung parenchyme (75%) and pleura (63%). However 21 cases (28%) showed no specific findings in their chest X-ray. Serum titers (ELISA) of specific IgG for paragonimiasis in 13 cases were followed for average 9.8 months after treatment, which showed slow decreasement. In the evaluation of family member (7 family, 20 cases), all members having the common dietary history together with a proven patients were confirmed this disease by serological test, regardless of the presence or the abscence of clinical or radilogical symptoms. Conclusion: We evaluated the clinical and radiological findings in 74 cases of pulmonary paragonimiasis including 7 family members who had a history of ingestion of improperly cooked crabs together with patients. The paients of pulmonary paragonimiasis have various findings in clinical and radiological findings. Common diet exposure history and laboratory findings including specific IgG were important in earlier diagnosing and treating in family members of patients.

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Pleural Incarceration of the Transverse Colon after Transthoracic Esophagectomy - A case report - (개흉적 식도절제술 후 횡행결장의 흉강 내 탈장 - 1예 보고 -)

  • Jang, Hee-Jin;Lee, Hyun-Sung;Zo, Jae Ill
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.115-118
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    • 2009
  • A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

A Case of Pleural Endometriosis Presented as Right Sided Hemothorax in a Patient Who Underwent Kidney Transplantation (신장이식 후 우측 혈흉으로 발현한 흉막자궁내막증 1예)

  • Shin, Eun-Hye;Shin, Bo-Mi;Ha, Yeon-Jung;Jang, Il-Young;Jung, Ji-Won;Cho, Hyung-Jin;Park, Su-Kil
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.145-148
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    • 2013
  • Thoracic endometriosis is an uncommon disease that has four main forms: catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. Since the growth of endometrial tissue depends on the presence of estrogen, thoracic endometriosis usually occurs in menstruating women between 25 and 35 years of age. Menstrual disturbances are common in women with chronic kidney disease (CKD). However, they could be reversed after kidney transplantation. Therefore, previously asymptomatic endometriosis may become symptomatic after kidney transplantation. A 49-year-old woman with CKD underwent kidney transplantation. A month later, she experienced dyspnea, and hemothorax in her right hemithorax. However, there was no evidence of infectious diseases and malignancy in thoracentesis, pleural biopsy, and computed chest tomography (CT). The serum and pleural fluid levels of his carbohydrate antigen 125 were elevated. Hemothorax secondary to pleural endometriosis was suspected. We tried hormonal therapy, and the hemothorax disappeared. At the sixth-month follow-up, there was no recurrence of hemothorax.