• Title/Summary/Keyword: sternum

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Malignant Fibrous Histiocytoma in Sternum after Radiation Therapy -Total Sternectomy and Chest Wall Reconstruction, A Case Report- (방사선 치료후 흉골에 발생한 악성 섬유성 조직구종 -흉골 전절제 및 흉벽 재건술 1례 보고-)

  • 조유원;박승일
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.115-119
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    • 1996
  • Malignant fibrous histiocytoma after radiation therapy is very rare and its prognosis is poor. A 52-year-old male patient was admitted due to painful mass at the sternal area which developed 6 months ago. The patient had a history of radiation therapy for esophageal cancer 5 years ago. The incisional biopy disclosed sternal sarcoma. In spite of 5 cycles of chemotherapy, the m ss progressively enlarged, and an operation was performed. Total sternectomy with overlying skin and postal cartilage was performed and reconstruction was carried out with autologous rib bone graft, bilateral pectoralis klajor muscle flap and skin graft. The microscopic examination was consistent with malignant fibrous histiocytoma. The postoperative course was uneventful and the patient was discharged on postoperative 36 day.

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Extra-Gastrointestinal Stromal Tumor Presenting as an Anterior Chest Wall Mass

  • Lim, Junghyeon;Cho, Sung Woo;Lee, Hee Sung;Kim, Hyoung Soo;Kim, Yong Han;Park, Bong Suk
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.308-311
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    • 2017
  • A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.

A Case Report of Proventriculotomy for Impaction of Proventriculus in Ostrich (타조에서 전위절개술을 통한 매복의 치유예)

  • 김남수;이종일
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.469-473
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    • 1999
  • A 120 kg, 3-year-old, male ostrich (Struthio camelus) was submitted to the veterinary teaching hospital, Chonbuk national university, for chronic weight loss, anorexia, small hard fecal pellets, and lethargy. Illness was first noticed approximately 2 weeks before submission. Although the bird was able to stand, he was extremely weak and cachectic. Blood examination indicated that the bird was dehydration (PCV: 55%). Fluoroscopic and lateral abdominal radio-graphic view indicated impaction of distended proventriculus with bigger rocks than normal. Anesthesia was induced with ketamine (10 mg/kg, IV)-xylazine (1 mg/kg, IV) combination and maintained with ketamine (10 mg/kg, IV) at intervals of 8 to 15 minutes during the entire procedure. After induction of general anesthesia, the bird was positioned in dorsal recumbency. The skin was incised approximately 15cm caudal to the caudal margin of the sternum and extended 20 to 25 cm caudally. After the proventriculotomy was peformed, the impacted material that weighed 3kg contained rocks in 4 to 6cm diameter was removed. The incision of proventriculus was closed in 2 layers. Cephalothin sodium (30 mg/kg, IV, q12hrs) and dexamethazone (2 mg/kg, IM, q24hrs) was administered before and after 5 days of the operation. The bird was eating well and defecating normal feces after 3 weeks of the surgery

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Circumferential Resection and Reconstruction of The Mediastinal Trachea Without Prosthesis for Tracheal Stenosis: A Report of 4 Cases (기관삽입관에 의한 기관협착증 의 외과적 치료: 4례 보고)

  • 박주철
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.17-24
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    • 1977
  • The present treatment of respiratory failure, using cuffed endotracheal and tracheostomy tube has produced, apparently with increasing frequency, three lesions which have serious ceminical manifestations such as tracheal stenosis, tracheomalasia, and localized tracheal erosion. Extensive resection and reconstruction of the trachea must be necessary because conservative treatment has generally failed in the fully developed stenotic lesion. of the mediastinal trachea following extensive resection is best accomplished by direct anastomosis of the patient`s own tracheobronchial tissue. Any replacement of the mediastinal trachea must be air tight and laterally rigid, and must heal dependably. A variety of materials has been used for substitution following circumferential excision of tracheal segments within the mediastinum. These attempts have often failed because of early leak or late stenosis. We have successfully performed circumferential resection and primary end-to-end anastomosis of the trachea for 4 cases of post-intubation tracheal stenosis located a few centimeter below the tracheostomy stoma in the period of 3 years between 1974 and 1976. The lesion in one patient was found in the upper trachea which was approached anteriorly through a cervicomediastinal incision with division of the upper sternum. Other three located in the lower half of the trachea were operated through a high transthoracic incision with appropriate hilar mobilization in addition to cervical flexion for the development of the cervical trachea into the mediastinum. There were no hospital death, but suture line granulations occurred in two patients were managed by bronchoscopic removal of granulations without difficulties.

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A Clinical Evaluation of the Traumatic Sternal Fracture (외상성 흉골 골절에 대한 임상적 고찰)

  • Kim, Jae-Ryeon;Im, Jin-Su;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.601-605
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    • 1995
  • Clinical evaluations were performed on 54 cases of the traumatic sternal fracture, those were admitted and treated at the department of Thoracic and Cardiovascular Surgery in Chosun University Hospital during the past 5 years period from January 1990 to December 1994. The frequency was about 7.8% of the nonpenetrating chest trauma. The ratio of male to female was 2 : 1 in male predominance. Average age was 45.7 years old and age distribution was from 18 to 80 years old. The most common cause in the sternal fracture were high decelerating injury[ 38 cases . The most common fracture site was sternal body. Associated intrathoracic organ injuries were cardiac contusion[11cases , hemopneumothorax and pulmonary contusion. Added, thoracic cage and extrathoracic organ injuries were rib fracture, head injuries, thoracic spinal fracture and long bone fracture. Abnormal ECG findings were sinus bradycardia[4 cases , sinus tachycardia[3 cases , bundle branch block, atrial fibrillaton, left ventricular hypertrophy and myocardial ischemia. The average days of admission was 19.1 days. All patients were treated with conservative treatment. The complications after treatment were atelectasis[2 cases ,empyema[1 cases , ARDS[1 cases .

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Joint mobilization techniques of the shoulder joint dysfunction (견관절 장애와 관절 가동운동)

  • Kim, Suhn-Yeop;Doo, Jung-Hee
    • Physical Therapy Korea
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    • v.2 no.2
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    • pp.108-118
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    • 1995
  • The techniques of joint mobilization and traction are used to improve joint mobility or to decrease pain by restoring accessory movements to the shoulder joints and thus allowing full, nonrestriced, pain-free range of motion. In the glenohumeral joint, the humeral head would be the convex surface, while the glenoid fossa would be the concave surface. The medial end of the clavicle is concave anterioposteriorly and convex superioinferiorly, the articular surface of the sternum is reciprocally curved. The acromioclavicular joint is a plane synovial joint between a small convex facet on lateral end of the clavicle and a small concave facet on the acromion of the scapula. The relationship between the shape of articulating joint surface and the direction of gliding is defined by the Convex-Concave Rule. If the concave joint surface is moving on a stationary convex surface, gliding occur in the same direction as the rolling motion. If the convex surface is moving on a stationary concave surface, gliding will occur in an opposite direction to rolling. Hypomobile shoulder joints are treated be using a gliding technique.

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Recognition of Falls and Activities of Daily Living using Tri-axial Accelerometer and Bi-axial Gyroscope

  • Park, Geun-chul;Kim, Soo-Hong;Kim, Jae-hyung;Shin, Beum-joo;Jeon, Gye-rok
    • Journal of Sensor Science and Technology
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    • v.25 no.2
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    • pp.79-85
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    • 2016
  • This paper proposes a threshold-based fall recognition algorithm to discriminate between falls and activities of daily living (ADL) using a tri-axial accelerometer and a bi-axial gyroscope sensor mounted on the upper sternum. The experiment was executed ten times according to the proposed experimental protocol. The output signals of the tri-axial accelerometer and the bi-axial gyroscope were measured during eight falls and eleven ADL action sequences. The threshold values of the signal vector magnitude (SVM_Acc), angular velocity (${\omega}_{res}$), and angular variation (${\theta}_{res}$) parameter were calculated using MATLAB. From the preliminary study, three thresholds (TH1, TH2, and TH3) were set so that the falls could be distinguished from ADL. When the parameter SVM_Acc is greater than 2.5 g (TH1), ${\omega}_{res}$ is greater than 1.75 rad/s (TH2), and ${\theta}_{res}$ is greater than 0.385 rad (TH3), these action sequences are recognized as falls. If at least one or more of these conditions is not satisfied, the sequence is classified as ADL.

Primary Sternal Tuberculosis with Spontaneous Fracture Treated by Resection and Reconstruction -A Case Report- (원발성 흉골결핵의 외과적 치험 -1례 보고-)

  • 배상일;김미혜;오태윤;장운하
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.190-193
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    • 1998
  • We experienced a case of primary sternal tuberculosis with destroyed midsternum and bony defect. An 22-year-old female was admitted to our hospital two times for severe sternal pain and spontaneous fracture without history of trauma. On hospital admission, chest X-ray and chest CT showed destruction of midsternum and soft tissue swelling. Fine needle aspiration cytology revealed tuberculous osteomyelitis with cold abscess. And the patient was treated with usual anti-tubeculosis medication for preoperative preparation. At operation, we confirmed midsternal destruction with cold abscess and multiple sinus tracts. After removal of diseased sternal segment and cold abscess, we performed sternal reconstruction with autologus iliac bone graft. The pathologic report was compatible with tuberculous osteomyelitis and caseous necrosis The postoperative course was smooth and uneventful, and she remains well without sternal instability two months later.

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Surgical Treatment of a Tuberculous Abscess of the Chest Wall

  • Keum, Dong-Yoon;Kim, Jae-Bum;Park, Chang-Kwon
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.177-182
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    • 2012
  • Background: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management. Materials and Methods: Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively. Results: Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases. Conclusion: Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.

Retrograde Analysis of Clinical Characteristics of Bone Metastasis in 1,031 Cases of Preliminarily Diagnosed Nasopharyngeal Carcinoma

  • Zhao, Chang-Lin;Qian, Guo-Qiang;Chen, Xiao-Yin;Chen, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3785-3788
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    • 2014
  • Purpose: To explore the clinical characteristics of bone metastasis (BM) in a large sample of preliminarily diagnosed nasopharyngeal carcinomas (NPCs). Methods: The sample consisted of 1,031 patients diagnosed with NPC at first visitg clinics between October 1989 and June 2012. Several parameters including metastasis locus, T/N staging, diagnosis, therapy and prognosis of BM were analyzed retrospectively. Results: In 70 patients who had been preliminarily diagnosed with BM, the incidence of BM in N0, N1, N2 and N3 stage was 5.7%, 17.2%, 50.2%, and 25.7%, respectively, while the incidence in T0, T1, T2 and T3 stage was 0%, 23.8%, 47.6% and 28.6% respectively. BM occurred in most common in vertebral column, rib, sternum, ilium and femur. Positive rate of Epstein-Barr virus antibody was 77.6%. The median survival time was 12 months. Conclusion: The incidence of BM in NPC preliminarily diagnosed is about 7% and it is related to N classification but not T classification.