• Journal of Chest Surgery
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• 제9권1호
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• pp.98-101
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• 1976

Clinical observations were made on a total 104 cases of spontaneous pneumothorax during the period of 5 years from MAR. 1971 to MAR. 1976 at the Dept. of Chest Surgery, Korea University Medical College. The ratio of male to female cases was 7.4 : 1 in male predominance, and age distribution was 73% of the total cases within the 15-40 age range. There were 56 patients (53.8%) of right sided pneumothorax and 44 patients (42.3%) of left sided pneumothorax, 8 patients presented bilateral spontaneous pneumothorax. The etiologic factors were tuberculous origin in 42.3%, rupture of bullae or blebs in 15.4%, acute pulmonary infection in 3.8%, pulmonary paragonimiasis in 2.9%, cysticercosis 1%, Marfan's syndrome in 1.9%, unknown causes in 32.7%. In all 104 cases, closed chest tube thoracostomy were performed for reexpansion of collapsed lung. In 50 cases of 104 cases, intrapleural instillation of Quinacrine HCl (Atabrine, Winthrop Laboratories, New York, N.Y.) thru the chest tube was used to control of recurrent pneumothorax, and compared observation with 54 cases control group of closed chest tube thoracostomy only. In both groups, 1) cure rates were 63% in control group and 88% in Atabrine group. 2) average duration of inserted chest tube were 5.6 days in control group and 5.7 days in Atabrine group.

• Journal of Chest Surgery
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• 제43권6호
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• pp.663-668
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• 2010

배경: 자연성 종격동 기종은 드문 질환으로 세계적으로 보고된 환자도 적다. 주로 젊은 남자에서 발병하며 양성의 자연 치유 경과의 질환으로 어떤 특별한 이유 없이 일어난다. 폐기포 파열을 일으키는 흉강내 압력 변화 이후 나타나게 된다. 두 병원의 임상 경험을 분석하여 적정한 치료에 도움이 되고자 한다. 대상 및 방법: 후향적으로 2003년 3월부터 2010년 8월까지 자연성 종격동 기종 환자들을 연구하였다. 결과: 24명의 환자가 자연성 종격동 기종으로 진단되었다. 이들 24명의 환자는 18명의 남자와 6명의 여자로 구성되었고, 평균 나이는 18.9세였다(범위 10~33살). 초기 주요 증상은 흉부 통증(79.2%), 이후 통증(62.5%), 피하 기종(4 1.7%)이었고 유발 인자로 운동(16.7%), 기침(12.5%), 구토(12.5%) 등이었고 유발 인자가 없는 경우가 54.2%였다. 모든 환자에서 흉부 단순 촬영과 단층 촬영이 이루어졌으며, 25% 환자에서 진단을 위해 단층 촬영이 필요하였다. 백혈구 수치와 C반응 단백(CRP)가 측정되었는데 초기 평균 수치는 각각 $9,790{\pm}3,240/{\mu}L$와 $1.31{\pm}1.71mg/dL$, 최종 평균 수치는 $5,440{\pm}1,665/{\mu}L$와 $0.72{\pm}0.73mg/dL$이었다. 23명의 환자가 입원하였으며(평균 $5.0{\pm}1.8$일) 증상은 자연 치유되었으며 합병증은 없었다. 결론: 자연성 종격동 기종은 약한 염증성 증세를 보이는 양성 질환이며 종종 흉부 또는 인후 통증을 나타낸다. 바람직하지 못한 결과를 방지하기 위하여 비침습적인 검사로 이차성 원인이 배제되어야 한다. 합병증과 재발이 거의 없는 관계로 증상에 따라 외래 진료나 단기적인 입원이 합당하다고 하겠다.

• Journal of Chest Surgery
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• 제31권11호
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• pp.1076-1080
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• 1998

연구배경 : 자연성 기흉은 흉부외과 영역에서 흔히 접하게 되는 질환 중의 하나로서 주로 젊은 연령층의 키 크고 마른 남자의 경우 호발하며 뚜렷한 유발 인자 없이 기포의 파열로 인해 발생하나, 흉강 내 혈액이 같이 축적되는 자연성 혈기흉은 드문 질환 으로 알려져 있다. 재료 및 방법 : 인제대학교 부산백병원 흉부외과학 교실에서는 1990년부터 1997년까지 최근 8년간 자연성 혈기흉 15례를 경험하여 다음과 같은 결과를 얻었다. 결과 : 남녀 비는 14:1로 남자가 대부분이었으며 30대 이하가 14례로 전체의 93.3%를 차지하였다. 발생부위는 우측이 10례 좌측이 5례였으며 내원시 흉통 및 흉부 불쾌감, 호흡곤란 등을 호소하는 경우가 대부분 이였고 과다 출혈로 인한 쇼크 현상을 나타낸 경우가 1례 있었다. 원인으로는 유착 파열이 14례였으며 내인성 폐질환인 결핵이 1례였다. 전례에서 폐쇄식 흉강삽관술을 시행하여 대부분 특별한 문제없이 치유되었으나 전원되었던 1례에서 지속적인 출혈로 발병 3일 후 개흉술을 시행하였다. 그 외 폐쇄식 흉강삽관술로 치료한 30일 및 50일 후에 발생한 섬유흉과 동측의 기흉으로 늑막박피술과 폐쇄기절제술을 시행한 경우가 각 1례씩 있었다. 결론 : 자연성 혈기흉의 치료에는 흉강천자, 폐쇄식 흉강삽관술, 비디오 흉강경 수술, 개흉술 등이 있으며 발병 후 환자의 내원이 빠른 시간 내에 이루어지고 지속적 출혈이 없다면 단순한 폐쇄식 흉강삽관술 만으로도 대부분 특별한 합병증 없이 치료가 가능할 것으로 사료된다.

• Archives of Plastic Surgery
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• 제45권2호
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• pp.177-179
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• 2018

We present a case report of a patient who experienced a late, spontaneous breast hematoma 26 years after primary breast augmentation. Late hematomas are a rare complication of breast augmentation with uncertain etiology. In this case, there was no trauma, calcifications, or implant rupture. We believe the patient's hematoma was secondary to erosion of a capsular vessel due to capsular contracture.

• Journal of Chest Surgery
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• 제19권2호
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• pp.335-340
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• 1986

Pulmonary arteriovenous fistula is unusually congenital malformation consisting of an abnormal connection between a pulmonary artery and vein. It may appear as an isolated anomaly or with hereditary hemorrhagic telangiectasis. In the classic form, symptoms and signs are caused by the abnormal right to left shunt. since severe clinical symptoms such as paradoxical embolism, infection, and spontaneous rupture with massive bleeding may occur, surgical treatment is often indicated. Recently we have experienced a surgical treatment of pulmonary arteriovenous fistula in 54 years old housewife. She was admitted in May 1986 with recurrent hemoptysis for 1 month. On admission, the PaO2 was 65.2 mmHg without specific findings. Pulmonary arteriovenous fistula was confirmed by preoperative pulmonary arteriography. A well circumscribed cystic mass was noted in visceral subpleural and inferior lingular segment of left upper lobe. Left upper lobectomy was performed with good results. Histologically angiomatous dilatation of abnormal vessels embedded in lung parenchyma was noted. Postoperative PaO2 was 90 mmHg. Postoperative results were good.

• Journal of Chest Surgery
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• 제6권2호
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• pp.165-170
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• 1973

The selection and treatment with resection and drainage for patients with emphysematous bullae is discussed with reference to two patients recently. One case with bilateral multiple bullous emphysema resulting tension pneumothorax due to rupture of the bullae on right, 47 year old man with pulmonary tuberculosis history for 16 years, was treated with resection of the bullae on right including upper lobectomy and c!osed rhoracostomy drainage on left for another spontaneous pneumothorax, and result was excellent for 6 month after discharge. Another 53 year old man with giant tension air cysts occupying right whole lung field and shifting mediastinum to the left was treated with right under water sealed closed thoracostomy drainage for 7 days in vain, and resection was not performed for his poor respiratory function and general condition. The most useful preoperarive information was obtained from a study of the plain chest radiogram and the surgical procedure of choice was obliteration of the bullae at thoracotomy.

• Advances in pediatric surgery
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• 제3권2호
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• pp.168-171
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• 1997

Appendiceal perforation is uncommon in the neonate. Diess reported the first case in 1908. Approximately 111 additional cases have been reported since that time. However, with exclusion of neonatal appendicitis associated with inguinal or umbilical hernias, necrotizing enterocolitis, meconium plug, and Hirschsprung's disease, there are only 36 cases of primary neonatal appendicitis. We treated a 12 days old boy with perforation of the appendix. The infant was 3000 g at birth and had a normal spontaneous vaginal delivary at 35 weeks of gestation. The mother was 31-year-old and had premature rupture of membrane. After normal feeding for the first 5 days of life, the infant had emesis of undigested milk, decreased activity and jaundice. The baby was admitted to the Pediatrics. Progressive abdominal distension, fever, decreased activity, and vomitting developed over the next six days. Erect abdominal radiography showed pneumoperitoneum. At exploratory laparotomy, a $0.8{\times}0.6$ cm sized perforation was noted at antime-senteric border of midportion of the appendix. Trasmural inflammation and the presence of ganglion cells were noticed on histology.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.50-53
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• 2013

Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH. The present case of spinal SAH due to rupture of dissecting aneurysm of the Adamkiewicz artery underwent subsequent spontaneous resolution, indicating that the wait-and-see strategy may provide adequate treatment option.

• Archives of Reconstructive Microsurgery
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• 제24권1호
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• pp.37-39
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• 2015

Epidermal inclusion cyst is a common mass in life. It is covered with a stratified squamous epithelium, thus, there is a granular cell layer adjacent to the keratin-containing cyst lumen. It can be caused by mechanical force, trauma, or a spontaneous event. It can rupture spontaneously or be ruptured by external mechanical forces. Epidermal inclusion cysts that exhibit inflammation or recur should be removed by simple excision. In this case, the patient showed an epidermal inclusion cyst under an anterolateral thigh free flap, which can cause the palpable mass to go unnoticed. First we thought he had neuroma formation after a surgical procedure on his foot. However it was an epidermal inclusion cyst, which was diagnosed by a special pathologist. It is a curious and rare case.

• 대한기관식도과학회지
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• 제9권2호
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• pp.44-48
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• 2003

Rupture of the esophagus is an uncommon condition that can be a formidable challenge to treat. Unless early treatment is applied, life-threatening complications, such as mediastinitis, sepsis, occurs and continue to be associated with a mortality rate of more than 20%. Definitive repair of esophageal perforation is considered the preferred treatment in the past. In the present study, conservative treatment acquired a good results by help of the development of antibiotics and nutritional supportive methods. Iatrogenic causes constituted most of the injuries, followed by external trauma, spontaneous, ingested foreign bodies, and malignancy. The incidence of perforation following ingestion of foreign bodies is very rare, so recommendations regarding treatment remain controversial. We analyzed the course of 31 patients with esophageal perforation by foreign bodies, concentrating on the diagnostic & treatment delay and methods of treatment, complications.