• Title/Summary/Keyword: Thoracic duct

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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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Left Ventricular Inflow Obstruction Caused by a Persistent Left Superior Vena Cava and a Dilated Coronary Sinus - A case report - (관상정맥동 확장에 의한 좌심실 유입로 폐쇄 - 1예 보고 -)

  • Sim, Hyung-Tae;Jhang, Won-Kyoung;Jang, Wan-Sook;Ko, Jea-Kon;Yun, Tae-Jin
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.499-502
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    • 2007
  • Left ventricular inflow obstruction can be caused by a persistent left superior vena cava (SVC) and a dilated coronary sinus. A 31-day-old male infant with secondum atrial septal defect (ASD) and bilateral SVC underwent an operation for treating his uncontrollable congestive heart failure. The preoperative 2-dimensional echocardiography showed a normally sized mitral valve shrouded by a dilated coronary sinus. The operation consisted of pericardial patch closure of the ASD, coronary sinus unroofing and left SVC transfer to the right atrial auricle. The postoperative course was complicated by persistent chylothorax, which was controlled by thoracic duct ligation, He was discharged to home at the postoperative day 39. He has been followed up for 9 months and has displayed normal development.

Surgical treatment of recurrent pseudochylothorax occurring after therapy of tuberculous pleurisy (결핵성 흉막염 치료 후 반복되는 가성유미흉의 수술적 치료)

  • Yi, Jae Ryung;Kim, Woo Sik;Jeong, Eun Jung;Jung, Yu Na;Lee, Hee Sook;Jo, Gi Ho;Lee, Ji Yeon
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.65-68
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    • 2014
  • Pseudochylothorax is an uncommon pleural effusion disease characterized by the presence of cholesterol crystals or high lipid content not resulting from a disrupted thoracic duct. Most of the cases reported so far had been found in patients with long-standing pleural effusion due to a chronic inflammatory disease such as old tuberculous pleurisy or chronic rheumatoid pleurisy. Authors encountered a case of pseudochylothorax in a 45-year-old man who had been treated for tuberculous pleurisy 6 years before his visit to authors' hospital. After that, he had visited the emergency department many times for removal of pleural effusion. The patient's chest X-ray revealed dyspnea and large left-sided pleural effusion. Although a large amount of pleural fluid was removed with a drainage catheter, massive pleural effusion was likely to recur, and the underlying lung was able to fully re-expand. Accordingly, decortication was done, and the patient's symptom was improved without postoperative complications.

Factors Affecting Blood Loss During Thoracoscopic Esophagectomy for Esophageal Carcinoma

  • Urabe, Masayuki;Ohkura, Yu;Haruta, Shusuke;Ueno, Masaki;Udagawa, Harushi
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.466-472
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    • 2021
  • Background: Major intraoperative hemorrhage reportedly predicts unfavorable survival outcomes following surgical resection for esophageal carcinoma (EC). However, the factors predicting the amount of blood lost during thoracoscopic esophagectomy have yet to be sufficiently studied. We sought to identify risk factors for excessive blood loss during video-assisted thoracoscopic surgery (VATS) for EC. Methods: Using simple and multiple linear regression models, we performed retrospective analyses of the associations between clinicopathological/surgical factors and estimated hemorrhagic volume in 168 consecutive patients who underwent VATS-type esophagectomy for EC. Results: The median blood loss amount was 225 mL (interquartile range, 126-380 mL). Abdominal laparotomy (p<0.001), thoracic duct resection (p=0.014), and division of the azygos arch (p<0.001) were significantly related to high volumes of blood loss. Body mass index and operative duration, as continuous variables, were also correlated positively with blood loss volume in simple linear regression. The multiple linear regression analysis identified prolonged operative duration (p<0.001), open laparotomy approach (p=0.003), azygos arch division (p=0.005), and high body mass index (p=0.014) as independent predictors of higher hemorrhage amounts during VATS esophagectomy. Conclusion: As well as body mass index, operation-related factors such as operative duration, open laparotomy, and division of the azygos arch were independently predictive of estimated blood loss during VATS esophagectomy for EC. Laparoscopic abdominal procedures and azygos arch preservation might be minimally invasive options that would potentially reduce intraoperative hemorrhage, although oncological radicality remains an important consideration.

Lymphatic Delivery of Oral Anticancer Tegafur by Emulsion Formulations

  • Lee, Yong-Bok;Koh, Ik-Bae
    • Journal of Pharmaceutical Investigation
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    • v.23 no.3
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    • pp.19-30
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    • 1993
  • The influence of emulsion type of tegafur, an oral anticancer agent, on lymphatic transport was studied in rats. The water-in-oil-type of emulsion and the oil-in-water-type emulsion of tegafur each in 50 mg, calculated in terms of tegafur, were prepared by adding tegafur aqueous solution to sesame oil containing hydrogenated castor oil following ultrasonic treatment, and then the prepared emulsions and aqueous solution as a comparative formulation were administered orally to rats (50 mg/5 ml/kg). The concentration levels of tegafur in plasma of femoral artery and lymph from thoracic duct cannula were measured simultaneously along a time course after administration and the pharmacokinetic parameters were investigated. At the same time, we examined the above described factors of 5-FU which is known as an active metabolite of tegafur. 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. Ratios between area under the lymph and plasma concentration time curves were always less than 1 reflecting the passive lymphatic delivery after oral administration of the prepared tegafur emulsions, but those to the 5-FU in the case of w/o-emulsion were more than 1. These results suggested that lymphatic delivery of tegafur by w/o-emulsion was more effective than that by o/w-emulsion due to its differences of formation ability of chylomicrons.

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Simultaneous chylothorax and chylous ascites (암죽가슴증 및 암죽복수의 동시발생)

  • Jang, Tae Soo;Jeong, In Beom;Cho, Do Yeun;Kang, Sung Ju;Kwon, Oh Jung
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.265-269
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    • 2017
  • Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.