• Journal of Chest Surgery
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• v.13 no.2
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• pp.149-153
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• 1980

Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.729-734
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• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.703-708
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• 1984

Fibrothorax is the end stage of chronic pathologic processes of pleura such as hemothorax, empyema, or tuberculous effusion. The pleural space become adherent and obliterated, and the lung parenchyma is covered by a thick, fibrous, unexpandable "peel", so the lung function is diminished markedly with impaired ventilation and oxygenation. Constrictive pericarditis is often accompanied fibrothorax, also cardiac and hemodynamic function is deteriorated. Surgical relief of these fibrous peels causes remarkable improvement in pulmonary function, cardiac and hemodynamic function, and subjective symptoms. We experienced a case of bilateral fibrothorax combined with constrictive pericarditis which occured 3 years after bilateral tuberculous effusion. Decortication and percardiectomy were done at the same time through bilateral submammary thoracotomy with sternal transection. Comparing postoperative Peripheral venous pressure, Circulation time, Pulmonary function test, Arterial blood gas analysis, Subjective symptoms with preoperative conditions showed noticeable improvement.provement.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.819-828
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• 1984

Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

• Journal of Chest Surgery
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• v.7 no.2
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• pp.169-174
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• 1974

Duplication of the alimentary tract, especially of the esophagus, have been regarded as rare cong- enital anomalies. However, they are being reported with increasing frequency in the literature. In the . ,- past they have been described by a variety of names, such as "enteric cysts", "intestinal cysts", "giant diverticula", "`mediastinal cysts of foregut origin" "enterogenous cysts" and other descriptive terms. . Most authorities now agree that these anomalies are best described by the term "duplications of the alimentary tract. The duplications [of the alimentary tract] are spherical or tubular structures which poses a well developed smooth muscle layer and are lined with a mucous membrane from any part of the alimentary tract. They may occur at any place in the digestive tube from the tongue to the rectum and usually are intimately attached to some portion of the alimentary tube. We have experienced a duplication of the esophagus in 14 years old middle schoolboy. He complained dysphagia, eructation and substernal pain associated with intermittent high fever and chilliness, increasing in severity for recent three weeks. Routine chest X-ray film revealed nore markable abnormal finding but esophagogram. revealed marked narrowing of the esophagus throughout with a large blind pouch in lower half with fistulous communication at mid portion of the esophagus. On thoracotomy, a large infected blind pouch communicating with the lumen of normal esophagus proximally, Was extended from the level of 5th to 10th thoracic spine. The duplicated segment of the esophagus has a common muscular .wall and proximal communication with the adjacent esophagus. The infected, duplicated esophagus was segmentally resected, and esophagogastrostomy with pyloroplasty was done by displacing the stomach into the right thoracic cavity through midline laparotomy. His Postoperative course was uneventful and discharged without complication.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.715-722
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• 1987

A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.353-353
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• 1997

Localized fibrous tumor of the pleura is a rare condition. Most follow a benign course and they are round as an incidental finding during routine chest X-ray. A small proportion of these tumors are malignant and have characteristic clinical and histopathological features. In this paper, we report three cases of localized fibrous tumors of the pleura, one malignant associated with asymptomatic hypoglycemia, the others benign. In a malignant case, the tumor was reseated through thoracotomy and the hypoglycemia was relieved immediately. In two benign cases, tumors on small pedicles were resected using video-assisted thoracic surgical technique.

• Journal of Chest Surgery
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• v.30 no.3
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• pp.253.2-356
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• 1997

Localized fibrous tumor of the pleura is a rare condition. Most follow a benign course and they are round as an incidental finding during routine chest X-ray. A small proportion of these tumors are malignant and have characteristic clinical and histopathological features. In this paper, we report three cases of localized fibrous tumors of the pleura, one malignant associated with asymptomatic hypoglycemia, the others benign. In a malignant case, the tumor was reseated through thoracotomy and the hypoglycemia was relieved immediately. In two benign cases, tumors on small pedicles were resected using video-assisted thoracic surgical technique.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.943-945
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• 2006

An 11-month old girl with a feeding difficulty and recurrent aspiration pneumonia received surgical correction of complete vascular ring, which was formed by right aortic arch, aberrant left subclavian artery(LSCA) originating from Kommerell's diverticulum(KD) and ligamentum arteriosum. Through left posterolateral thoracotomy, the ligamentum arteriosum was divided to relieve the tracheo-esophageal bundle. KD was separated from the right descending aorta, and the left subclavian artery was severed from KD at its origin and trasfered to the side wall of left common carotid artery. Postoperative course was uneventful, and the patient has been followed up with a clinical improvement.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.307-310
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• 2015

Background: To evaluate our experience of early surgical plication for diaphragmatic eventration (DE) in infancy and childhood. Methods: This study evaluated infants and children with symptomatic DE who underwent plication through an open transthoracic approach in our childhood development department between January 2005 and December 2012. Surgical plication was performed in several rows using polypropylene U-stitches with Teflon pledgets. Results: The study included 12 infants and children (7 boys and 5 girls) with symptomatic DE (9 congenital and 3 acquired). Reported symptoms included respiratory distress (91.7%), wheezing (75%), cough (66.7%), and recurrent pneumonia (50%). Preoperative mechanical ventilatory support was required in 41.7% of the patients. The mean length of hospital stay was $6.3{\pm}2.5days$. The mean follow-up period was $24.3{\pm}14.5months$. Preoperative symptoms were immediately relieved after surgery in 83.3% of patients and persisted in 16.7% of patients one year after surgery. All patients survived to the end of the two-year follow-up and none had recurrence of DE. Conclusion: Early diagnosis and surgical plication of the diaphragm for symptomatic congenital or acquired diaphragmatic eventration offers a good clinical outcome with no recurrence.