• Title/Summary/Keyword: Thoracic duct

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A Case of Idiopathic Bilateral Chylothorax Treated by Chemical Pleurodesis with OK 432 (양측 특발성유미흉에 대한 OK 432주입 흉막유착술)

  • 김맹호
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.951-953
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    • 1995
  • A male 17-year-old boy was tranferred from a private hospital for persistent bilateral pleural effusion.The effusion was confirmed as bilateral chylothorax by chest CT and lymphangiography. Persistent accumulation of the chylothorax was uncontrollable more 1000cc daily ever after pleuroperitoneal shunt operation and thoracoscopic thoracic duct ligation at Rt. side. Chemical pleurodesis with OK 432 into pleural cavity through thoracostomy tube was attempted as 1.5 KE-3 KE diluted in 50ml of normal saline for 3 consecutive days resulted dramatic reduction of the drainage amount. Chemical pleurodesis with OK 432 appeared to be very helpful for management idiopathic bilateral chylothorax.

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A Case of Idiopathic Chylothorax and Chyluria (원인 미상으로 Chylothorax와 Chyluria가 병발한 1예)

  • Choi, Jung Min;Oh, Hyoung-Chul;Yi, Myung Zoon;Yun, Jae Pil;Kim, Jae Il;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.4
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    • pp.377-380
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    • 2004
  • We report a rare case of idiopathic chylothorax and chyluria. A 31 year-old woman was referred to our hospital with a right-sided pleural effusion. Cream-colored pleural fluid and urine were confirmed as chylothorax and chyluria, respectively, by a lipoprotein electrophoresis. Even though she had previously underwent surgery for pelvic fibrosarcoma and experienced its recurrence, there has been no change of mass size and no evidence of thoracic duct or urinary tract obstruction as of the moment. Hence, idiopathic chylothorax and chyluira was diagnosed. Because she responded poorly to conservative treatment, thoracic duct ligation and pleurodesis were performend ; wherease chyluria was resolved spontaneously.

Direct Percutaneous Needle Puncture and Intrapulmonary Lymphatic Embolization for Treatment of Chylothorax in a Patient with Lymphoma (림프종 환자의 비외상성 유미흉에서 폐림프종의 피부경유 직접천자를 통한 색전술)

  • Lee Hwangbo;Hoon Kwon;Chang Ho Jeon;Chang Won Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1222-1226
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    • 2020
  • Lymphoma is a common cause of nontraumatic chylothorax. Clinical success rates of thoracic duct embolization are lower in patients with nontraumatic chylothorax compared to patients with traumatic chylothorax. Herein, we report a case of nontraumatic chylothorax and lymphoma in a 77-year-old man managed with thoracic duct embolization. The chest tube drainage decreased but not was sufficient to enable removal of the chest tube. Therefore, a second embolization was performed through a direct puncture of the lymphatic mass in the lung, following which the chyle leakage ceased, and the chest tube was removed. The treatment strategy discussed in this report may be an effective therapeutic option for select patients with nontraumatic chylothorax.

Mesenteric Lymphatic Delivery of Oral Anticancer Tegafur by Emulsion Formulations (유제화에 의한 경구용 항암제인 테가푸르의 장관 임파수송)

  • Lee, Yong-Bok;Nam, Kweon-Ho;Chang, Woo-Ik;Oh, In-Joon;Koh, Ik-Bae
    • Journal of Pharmaceutical Investigation
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    • v.25 no.1
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    • pp.55-62
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    • 1995
  • W/O and O/W emulsions of tegafur (50 mg/5 ml/kg) were orally administered to rats to compare with their mesenteric lymphatic delivery effects. And also in order to demonstrate the lymph targeting associated to the oral route, it was deemed necessary to investigate the fate of solution after oral administration as a control. Lymph and plasma samples were periodically taken from each subject of mesenteric lymphatic duct cannulated rats. Then, lymph and plasma levels of tegafur and its active metabolite, 5-FU, were simultaneously observed. Also pharmacokinetic parameters were compared with each others. On the other hand, most previous studies of lymphatic transport have not addressed the question of whether an increase in mesenteric or thoracic lymph transport by the manipulation of a suspected variable was due to a selective delivery to the intestinal lymphatics or an overall increase availability. Therefore, based on a physiologically based pharmacokinetic model which represents the characteristics of lymphatic systems, we are also going to determine the contributions of mesenteric lymph transport versus thoracic lymph transport of tegafur reported in reference(13). In comparison with tegafur solution, AUC and mean residence time of plasma tegafur were significantly increased in W/O emulsion but significantly decreased in O/W emulsion. Lymph flow rates were similar in both solution and W/O emulsion but half in O/W emulsion. AUC of tegafur in mesenteric lymph and in plasma for W/O emulsion were 3.7 times and 2.9 times more than those for O/W emulsion, respectively. And AUC of 5-FU in thoracic lymph for W/O emulsion was 3.7 times more than that for O/W emulsion. These results suggested that lymphatic delivery or tegafur by W/O emulsion was more effective than that by on emulsion due to its differences or formation ability of chylomicrons.

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Surgical Management of Chylothorax Complicating Transhiatal Esophagectomy in Benign Esophageal Stricture (식도 열공을 통한 식도 제거술 시행후 발생한 유미흉의 외과적 치료)

  • 홍종면;노윤우
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.672-674
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    • 1996
  • Chylothorax is a rare, but well-recognized complication of cardiothoracic surgery and operations in the region of the esophageal or aortic diaphragmatic hiatus. Especially, in nutritionally depleted patients requiring esophagectomy for benign or malignant diseases, it is a potentially life-threatening disorder that has profound respiratory, nutritional and immunologic co sequences . We have experienced a case of chylothorax after transhiatal esophagectomy in benign esophageal stricture. The diagnosis of chylothorax was confirmed after feeding through the jejunostomy tube by the change of the character of pleural effusion and high triglyceride level on the 5th postoperative day. On the thirteenth postoperative day, supradiaphragmatic thoracic duct ligation was performed through right thoracotomy. We could remove the chest tube on the 22th postoperative day, and the patient is being followed-up at out patient clinic without complications.

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Late Results of Operation for Patent Ductus Arteriosus with Preoperative Pulmonary Hypertension (폐동맥고혈압을 동반한 동맥관개존증의 장기관찰 성적)

  • O, Bong-Seok;Jo, Wan-Jae;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.775-780
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    • 1989
  • This study concerns the late results observed at follow-up[average: 32.5 months] of 23 patients, in whom Patent Ductus Arteriosus with pulmonary hypertension among 55 patients. They were operated from May 1984 to July 1987 in Chonnam University Medical School. There was predominance of woman [2.5:1]. No operative death occurred. All of patients subside preoperative symptoms, but 1 patient diagnosed recannalization of duct at follow-up. Systolic murmur was found over the pulmonary area in 5 patients [22 %], but it may be not related to systolic pulmonary arterial pressure[SPAP]. Also, SPAP were normalized in 74 % of patients and had mild hypertension in 26 % of patients. Although the patients had Patent Ductus Arteriosus with pulmonary hypertension, successful surgical correction was carried out safely in all instance but one, by ligation and facilitated by hypotensive anesthesia.

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Chyle leak after head and neck surgeries: a comprehensive review of diagnosis and management strategies

  • Aparna Ganesan;Nehal C. Singh;Naren P. Khatri;Charanjeet Singh Madaan;Savreek Kaur;Amanjot Kaur
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.3-12
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    • 2024
  • Chyle leaks are uncommon complications after head and neck surgeries. Although uncommon, such a complication is noteworthy mention due to its perplexing diagnosis and management strategies. This scoping review aims to highlight and emphasize the diagnosis and management options proposed in the literature. A comprehensive search was performed in PubMed, Google Scholar, Cochrane Library, and Scopus databases and identified 617 articles that were reduced to 40 studies and reports after applying the eligibility criteria. Although numerous treatment options ranging from simple, conservative measures to invasive surgical procedures have been mentioned for low-output, high-output, and massive leaks, there is no concrete evidence on the best method. Thus, a combination of management options must be customized by case for optimum results.

Structure of the Male Reproductive System in the Freshwater Prawn Macrobrachium nipponense (징거미새우, Macrobrachium nipponense 수컷 생식기의 구조)

  • 김대현;한창희
    • Journal of Life Science
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    • v.8 no.5
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    • pp.582-588
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    • 1998
  • The male reproductive system of Macrobrachium nipponense consists of a pair of lobulate testes enveloped within a mesenteric sheath extending the length of the carapace. The paired vasa deferentia originated from the mid-lateral region of each testis and extended to the genital pores at the base of the fifth walking legs. The vas deferens has four morphologically distinct regions, i.e., a short and slender proximal region, a long convoluted region, an elongate distal region and an ejaculatory duct that terminates at the genital pore. The sperm mass produced in the testes is surrounded by a basophilic matrix adjacent to the high columnar epithelium and an eosinophilic matrix adjacent to the simple columnar epithelium. The sperm cord is stored in the ejaculatory duct until it is ejaculated. Androgenic gland is found near the subterminal region of the ejaculatory duct between the muscles of the coxopodite of the last thoracic leg. The cell of the androgenic gland is about 6~8 $\mu$m in length, characterized by with extended chromatin in the large nucleus that stained weakly with hematoxylin and there is a large quantity of cytoplasm. The sperm of M. nipponense are typical of the palaemonid type, having a convex, cup shaped head and an elongated spike extending from the centre of the convex head. The spermatophore consisted of an eosinophilic matrix, a basophilic matrix and paired sperm masses which was surrounded by the basophilic matrix. It generally shows a bilaterally symmetrical structure.

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The legal status of the breast in assessing physical disability (신체장애 평가에서 유방의 법적 지위 - 장기 해당 여부, 수유장애, 노동력상실에 대하여 -)

  • Kim, Bong Kyum
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.265-295
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    • 2017
  • Breast tissue is composed of skin, mammary gland(including lactiferous duct), subcutaneous fat layer. The anatomical position is on the anterior chest wall(the outside of the chest cavity) but not on the inside of the thorax. Therefore, when the internal organs in the thoracic cavity are defined and expressed as 'organs' and the internal organs of each are labeled for a long time, for the breast located outside the thoracic cavity, it is thought that there is considerable difficulty in defining and recognizing the breast tissue as organs. For this reason, it is necessary to discourage the controversy over whether or not the breast is contained in the chest(or intra-thoracic cavity). In order to completely exclude it, it is assumed that the "chest-abdomen" can be called the "intra-thoraxic or intra-abdominal." But it is difficult to change the terms in various laws and regulations, I think that it would be necessary to insert only the clue clause "Breasts are excluded" in the detailed criteria for grading. In order to include it, it is necessary to change the terms of the ordinance or to say that the breast is exceptionally included.

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