• Title/Summary/Keyword: Upper thoracic

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Surgical Management for Incidental Finding of an Intrapulmonary Foreign Body - A case report (우연히 발견된 폐내 이물의 수술적 치료 -1예 보고-)

  • Ko, Moo-Sung;Lee, Sub;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.248-250
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    • 2006
  • A 48-years-old woman was visited to our hospital because of incidental finding of intrapulmonary foreign body. Chest X-ray showed a 4cm sized foreign body in left upper lung field without adjacent fibrosis. Chest CT showed a sewing needle shaped foreign body of metallic density, located in the 113ft upper lobe. The foreign bodies including the needle were removed surgically using a wedge resection. The extracted needle was divided into three 4 cm pieces. Patient was discharged without other respiratory symptoms after surgery. We report a case of wedge resection in a patient with intrapulmonary needle in the left upper lobe, with review of literatures.

Ultrasound Guided Thoracic Paravertebral Space Block for Chronic Intractable Upper Back Pain (만성 난치성 상부 등 통증에서 초음파 유도 하 흉추 주위 공간 차단술)

  • Kim, Myungsang;Paek, Min Chul;Cho, Han Eol;Park, Jung Hyun
    • Clinical Pain
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    • v.20 no.2
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    • pp.141-144
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    • 2021
  • There are some cases of myofascial pain syndrome (MPS) with chronic upper back pain that does not respond to dry needling or trigger point injection, well-known treatments for MPS. A 67-year-old female developed a stabbing upper back pain with trigger point at left T7~8 levels 10 years ago. She complained of the pain with Numeral Rating Scale (NRS) 8 points. Myofascial release technique and trigger point injection had no effect. Under ultrasound guidance 20 ml of 1% lidocaine was injected into thoracic paravertebral space. Immediately, the pain was reduced to NRS 4 points. One week later, the second block was performed in the same way as the first, and the pain was reduced to NRS 2 points. The stabbing pain disappeared, and oral opioids were discontinued. Ultrasound guided thoracic paravertebral space block is an effective and safe treatment for refractory MPS with chronic upper back pain.

A Case of Thoracic Vertebral Chondroblastoma, Treated with 3-D Image Guided Resection and Reconstruction

  • Lee, Yoon-Ho;Shin, Dong-Ah;Kim, Keung-Nyun;Yoon, Do-Heum
    • Journal of Korean Neurosurgical Society
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    • v.37 no.2
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    • pp.154-156
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    • 2005
  • We present a case of chondroblastoma in the thoracic vertebra. A 40-year-old patient with upper back pain and lower extremity weakness was admitted to our clinic. On neurological examination, the patient exhibited lower extremity spastic paraparesis. Magnetic resonance imaging revealed a mass infiltrating the 7th thoracic vertebra and its adjacent structures with concomitant compression of the epidural space. After right upper lung tuberculoma was resected through the transthoracic approach, T7 total corpectomy was done with anterior stabilization using a MESH cage and T7 rib bone graft. Two weeks after the first operation, remained part of vertebra was removed and posterior stabilization was performed using a pedicle screw fixation and cross linkage bar with the assistance of the navigation system. The final pathologic diagnosis of the vertebral lesion was benign chondroblastoma.

Endoscopic Cauterization of Upper Thoracic Sympathetic Ganglions (내시경을 이용한 상흉부교감신경 소작술)

  • Lee, Kyu-Jong;Kim, Jong-Il;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.206-209
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    • 1996
  • Thoracic sympathetic nerve block has a wide range of therapeutic applications which clinicians utilize neurolytics or perform operative sympathectomy. All methods have advantages and disadvantages. We performed "thoracic sympathetic ganglion cauterization" using resectoscope as it is less invasive and more effective than traditional operative methods. Successful procedures were performed involving 2 cases of idiopathic hyperhidrosis and 1 case of sympathetically maintained pain on chest and upper extremity. We experienced failure with one case of idiopathic hyperhidrosis due to severe pleural adhesion. There was also a case of complication of periganglional hemorrhage and parenchymal lung perforation which we successfully treated.

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Migratory Azygos Lobe: A Case Report

  • Min Suk Choi;Eung-Joong Kim
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.140-142
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    • 2023
  • The azygos vein sometimes merges abnormally across the right upper lobe of the lung and it hangs at the lower edge of a membranous septum, called the meso-azygos. The septum invaginates the lobe and makes a fissure. The smaller medial part of the right upper lobe is called an azygos lobe. A 16-year-old male patient was diagnosed with right-sided pneumothorax, and a closed thoracostomy was done in the emergency room. During elective wedge resection including the bulla, the meso-azygos, abnormal azygos vein, and azygos lobe were detected. We reviewed the computed tomography images and found that the azygos lobe had re-expanded laterally, not medially, to the meso-azygos after the closed thoracostomy in the emergency room. The patient had been diagnosed with left-sided pneumothorax a year ago, and no one noticed the azygos lobe at that time. We report the intraoperative findings and comparative images of a migratory azygos lobe.

The Effects of Thoracic Spine Self-mobilization Exercise Using a Tool on Pain, Range of Motion, and Dysfunction of Chronic Neck Pain Patients (소도구를 이용한 등뼈 자가 관절 가동성 운동이 만성 목통증 환자의 통증, 관절가동범위, 기능장애에 미치는 영향)

  • Kim, Su-jin;Kim, Suhn-yeop;Lee, Min-ji
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.1-10
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    • 2020
  • Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (-51.16%); NPQ (-53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (-7.14%); CVA (9.82%); and FSA (-4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic self-mobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

Recurrent True Brachial Artery Aneurysm

  • Ko, Seong-Min;Han, Il-Yong;Cho, Kwang-Hyun;Lee, Yang-Haeng;Park, Kyung-Taek;Kang, Mee-Sun
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.364-367
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    • 2011
  • True aneurysm of the brachial artery is a rare disease entity. The mechanism of aneurysm formation is considered to be compression of the arterial wall, producing contusion of the media and subsequent weakness of the wall and fusiform dilatation. It can be caused by arteriosclerotic, congenital, and metabolic disorders, and can be associated with diseases such as Kawasaki's disease. Doppler ultrasonography, computed tomography, arteriography, and selective upper extremity angiography may be performed for establishing the diagnosis of aneurysm. The best therapeutic option is operative repair, and it should be performed without any delay, in order to prevent upper extremity ischemic or thrombotic sequelae. Here, we report a case of recurrent brachial artery aneurysm with review of the literature.

Treatment of Tumor Involving Thoracic Inlet by Using Transmanubrial Osteomuscular Sparing Approach - One case report- (흉강입구를 침범한 종양의 근골보존 경흉골병 접근술을 이용한 치유 -1예 보고-)

  • Choi Chan Young;Kim Wook Sung;Ryoo Ji Yoon;Chang Woo Ik;Kim Min-Kyung;Cho Seong Joon;Kim Yeon Soo
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.175-179
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    • 2005
  • The operative case of transmanubrial osteomuscular sparing approach for the tumor involving thoracic inlet is reported. A 69-year-old man visited the hospital due to right upper extremity weakness. Chest roentgenogram showed bronchiectasis, chronic pulmonary tuberculosis, and fungal ball in right upper lobe. On computed tomogram, tumor was located in epidural space of the 6th, the 7th cervical, and the 1st thoracic spine and extended to the apex of the right thorax. A neurosurgeon performed laminectomy and removed the tumor located in the spinal canal. A thoracic surgeon performed a transmanubrial osteomuscular sparing approach and removed the tumor involving thoracic inlet. The tumor was diagnosed as hemangiopericytoma. The patient recovered without complication.

Lobectomy with Video-Assisted Thoracoscopy - 4Cases Report - (비디오 흉강경을 이용한 폐엽절제술;4례 보고)

  • 윤용한
    • Journal of Chest Surgery
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    • v.26 no.3
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    • pp.236-240
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    • 1993
  • Video thoracoscopic surgery is a new modality that gains acceptance rapidly from thoracic surgeons. We have experienced two left lower lobectomies, one left upper lobectomy & one right upper lobectomy with using video thoracoscopy for the four patients with lung parenchymal disease from July 1992 to February 1993. The post-operative courses were uneventful. The final pathologic diagnosis were sclerosing hemangioma, adenocarcinoma, bronchiectasis, leiomyoma & the post-operative courses were short. These patients needed less analgesics because postoperative pain was reduced markedly, and hospitalization was shortened due to rapid recovery. We would like to prefer video thoracoscopic lobectomy to the lobectomy through standard thoracotomy in uncomplicated patients with simple pulmonary parenchymal diseases.

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Herpes Zoster Infection Involved in Cervical and Thoracic Spinal Segment Bilaterally (경부 및 흉부신경근에 동시에 발생한 대상포진 -증례 보고-)

  • Han, Kyung-Ream;Kwak, No-Kil;Kim, Soo-Mi;Min, Kyung-Shin;Kim, Chan;Kim, Seong-Mo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.144-147
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    • 1999
  • A 72-year-old female patient was presented complaining of unbearable abdominal pain in the upper left quadrant at our hospital. Two weeks earlier she had developed a vesicular eruption on the right C3 dermatome and 1 week earlier she had experienced a vesicular eruption on the left T11 dermatome. Her medical history was unremarkable. She had suffered from severe abdominal pain in the upper left quadrant for 10 days and the mild pain in the right shoulder region for 20 days. The pain in the upper left quadrant had increased and was unresponsive to drugs prescribed by the local clinic. And we performed T11 root block with 0.5% lidocaine 5 ml and dexametasone 5 mg, and thoracic epidural blockade on 1st hospital day under diagnosis of herpes zoster infection. Her VAS were improved from 10 to 2 on 2nd hospital day. We performed thoracic epidural blockade with 0.5% lidocaine 6 ml. Her VAS were changed from 2 to 7 and so then we performed the thoracic epidural blockade with 0.5% lidocaine 5 ml and triamcinolone 40 mg on 3rd hospital day. On 4th hospital day, her VAS were from 7 to 1. After 4 month of our managements she was tolerable without any medications.

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