• Journal of Chest Surgery
• /
• v.41 no.3
• /
• pp.399-403
• /
• 2008

Carinal resection is technically demanding and the surgical risk is relatively high. When tumor is confined around the carina, then lung parenchymal sparing surgery is technically feasible in selected cases. We performed carinal resection and reconstruction without pulmonary resection for a patient suffering with squamous cell carcinoma that involved the carina and this patient had undergone right upper lobectomy 19 months previously due to lung cancer.

• Journal of Chest Surgery
• /
• v.29 no.2
• /
• pp.248-250
• /
• 1996

Congenital esophageal stenosis due to tracheobronchial remnant is very rare disease entity and usually occurs in mid and lower esophagus. The cause is esophageal sequestration of a tracheobronchial anlage before embryologic separation. A 4 years old girl was admitted with swallowing difficulty, food regurgitation which progressively got worse in recent 2 years. She was operated under the dagnosis of achalasia. During the myoto y procedure we found the bean sized hard nodular mass, which was 4cm above the esophagogastric junction, and after the resection of mass, esophagoplasty was carried out. The histologic finding of the mass revealed traheal cartilages and respiratory glands.

• Journal of Chest Surgery
• /
• v.24 no.9
• /
• pp.918-925
• /
• 1991

The technique of sleeve lobectomy has emerged as a relatively recent mode of excisional therapy. Acceptance of the technique has been slow because initially it has believed to be more difficult technically, to be associated with more complications, and be an inadequate operation for cancer. Sleeve lobectomy for bronchogenic carcinoma is an alternative to pneumonectomy. Four patients with bronchogenic carcinoma were treated by lobectomy with sleeve resection of the bronchus from 1986 to 1990. Three patients were male and one patient was female. Ages ranged from 43 years to 68 years. Symptoms were cough, sputum, blood tinged sputum, and dyspnea. Histopathologically, 3 cases were squamous cell carcinoma, 1 case was adenocarcinoma. Preoperative stage was stage I in 3 cases and stage II in 1 case. All of them were alive after operation.

• Journal of Chest Surgery
• /
• v.33 no.12
• /
• pp.974-977
• /
• 2000

유아에서 흔치 않지만, 선천적 혹은 후천적 원인으로 혈관에 의해 기도가 눌릴 수 있다. 8개월 남자 환아가 승모판 성형술, 동맥관 개존증 결찰 후 좌측 폐의 무기폐가 발생하였다. 흉부 컴퓨터 단층 촬영상 동맥관 개존증 결찰 후 남은 비대해진 하행대동맥에 의해 좌측 폐의 무기폐가 발생하였다. 흉부 컴퓨터 단층 촬영상 동맥관 개존증 결찰 후 남은 비대해진 하행대동맥에 의해 좌측 주기관지가 눌리는 소견이 관찰되었다. 결찰 부위를 완전히 분리하고 하행대동맥을 봉합하여 크기를 줄여 기관지 압박을 해결할 수 있었다. 술 후 환자는 특별한 합병증 없이 퇴원하였으며 외래 추적 관찰 중이다.

• Journal of Chest Surgery
• /
• v.32 no.12
• /
• pp.1093-1099
• /
• 1999

배경 : 류마티스성 승모판막 폐쇄부전증과 퇴행성 승모판막 폐쇄부전증에서 승모판막 성형술의 결과와 비교하여 류마티스성 승모판막 폐쇄부전증에서도 승모팍막성형술이 적합한 치료방법이 될 수 있는지를 알아보았다. 대상 및 방법 : 95년 1월부터 98년 12월 까지 승모판막 성형술을 시행받은 184명의 환자중에서 류마티스성 승모판막 폐쇄부전증 49례(1군)의 퇴행성 승모판막 폐쇄부전증 78례(2군)를 대상으로 하였다. 평균연령은 1군이 36.3$\pm$14.6(16-74세) 2군은 52.5$\pm$13.4(14-77)세였다 총 추적 관찰기간은 1군이 72.2인년 2군이77.2인년이었다 두군에서 수술후와 수술후 6개월 1년 및 이후 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과 : 두 군간에 수술전 혈류역학적인 차이를 보이지 않았고 수술전 평균 승모판막 폐쇄 부전의 정도는 1군이 3.0$\pm$0.4, 2군이 3.9$\pm$0.3였으나 수술후 추적 관찰에서 각각 0.9$\pm$0.9와 0.8$\pm$0.7정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의 변화나 승모판막에서의 평균압력차이 등 혈류역학적인 결과에도 차이를 보이고 있지 않았다 수술조기 사망과 후기 사망은 없었으며 재수술율은 1군이 인년대비 1.4% 2군이 인년대비 2.6%였고 색전발생율은 1군이 인년대비 2.8% 2군이 1.3%였다. 심내막염발생은 1군에서만 1례있었으며 상기 결과들에서 두군간에 의미있는 차이를 보이고 있지는 않았다 결론 : 향후 장기적인 추적 관찰이 필요하나 중기 성적에서 승모판막 성형술이 류마티스성 승모판막 폐쇄 부전증에서도 효과적인 치료방법임을 알수 있었다.다 출생후 폐포막의 FN의 활성은 출생후 5일 및 7일에 최고주에 달했다. 출생직후 1-2일경에 혈관의 조직내 FN의 활성이 양성을 나타내지만 3일이후 활성이감소되었다. 폐포대식세포내 FN의 활성은 출생후 증가되었다. 폐조직내 소기관지의 FN의 활성은 출생후 완만하게 상승되었다. 큰 폐포세포는 출생 1-3일에 일정량의 FN 반응이 세포질과 미세융모내에 관찰되었다. 결론 : 이상과 같은 결과로 흰쥐의 폐포의 분화과정이 계속되는 출생후 폐에서 FN의 분비는 7일이내에 성숙흰쥐의 폐포내 반응과 비슷한 반응으르 보이며 이때 폐의 실질조직은 분화가 거의 완료되었을 것으로 사료되었고 큰 폐포세포에서도 FN이 분비되는 것으로 결론지울수 있다.X>에서 $1,332.75{\mu}g/mL$으로 최 대값을 나타내었으며, 추출시간 4.24시간 및 시료에 대한 용매비 9.71 mL/g에서 가장 높게 나타났다. 추출온도가 높고, 추출시간이 증가할수록 총 polyphenol 함량이 증가하는 경향을 나타내었다. Gallic acid 함량은 $65.84^{\circ}C$에서 $30.51{\mu}g/mL$으로 최대값을 나타내 었으며, 추출시간 1.65시간 및 시료에 대한 용매비 17.17mL/g에서 가장 높은 추출율을 보였다. Gallic acid 함량에 대한 추출조건의 영향은 추출시간과 용매비에 영향을 받는 것으로 나타났으며, 설정된 범위 내에서 온도에 대한 영향은 거의 나타나지 않는 것으로 나타났다. 실험연구가 더 필요하리라 본다. 혈액학적 변화를 유도하고 환자의 연령, 혈소판 수, 대동맥 차단 시간, 체외 순환 시간, 술후 PT 및 aPTT와 같은 다인적 상황들이 술후 출혈에 영향을 미친다는 점들을 시사하고

• Archives of Craniofacial Surgery
• /
• v.12 no.1
• /
• pp.22-27
• /
• 2011

Purpose: Packing the nose is a common procedure after the closed reduction of a nasal bone fracture to prevent postoperative complications, such as bleeding and adhesion formation as well as to stabilize the framework of the nasal bone. On the other hand, it is difficult for a patient to endure nasal packing because of breathing difficulties, headaches, chest discomfort, insomnia, general weakness and hypoxia. This study examined the availability of a bronchodilator to improve the decreased oxygen saturation and postoperative symptoms on nasal packing. Methods: From February, 2010 to July, 2010, a prospective randomized comparison of the incidence of a range of postoperative signs and symptoms was conducted on 60 patients, who did (n=30) and did not (n=30) undergo bronchodilator infusion (aminophylline 250 mg/10 mL + normal saline 100 mL IV qd) following nasal packing. The postoperative symptoms and oxygen saturation in the two groups were compared. Results: Patients who had infused the bronchodilator showed improved oxygen saturation. Nevertheless, there were no significant differences in the postoperative uncomfortable symptoms (dyspnea, headache, chest discomfort, insomnia, general weakness) between the two groups. Conclusion: A bronchodilator after nasal packing improves oxygen saturation by dilating the airway tract but it cannot reduce the uncomfortable symptoms caused by nasal obstruction. Overall, the bronchodilator is a useful medication for improving the level of oxygen saturation.

• Journal of Chest Surgery
• /
• v.30 no.9
• /
• pp.936-940
• /
• 1997

Pulmonary aspergilloma is potentially a life threatening disease resulting from the colonization of lung cavities by Aspergillus fumigatus. A case is reported: a 43-year-old man with symtomatic cavitary aspergilloma presenting with severe productive coughing, hemopt sis, occasional fever, and chilling. On preoperative plain chest radiograph and CT scan, we could find a rounded irregular opacity in a large pulmonary cavity. He received 2 separate operations for therapeutic need. At the first opertion, we performed cavernostomy and thoracoplasty because of severe pleural adhesions, tearing of cavity wall, and high risk of respiratory insufficiency. At the second operation, we performed myoplasty and omentoplasty for closure of remaining air space and complete wrapping of the BPF site. All symptoms of dyspnea and hemoptysis have since resolved. We believed that in the high risk patients who have severe respiratory symptoms, such as in aspergilloma and open cavity with a risk of respiratory insufficiency, cavernostomy followed by myoplasty or omentoplasty should be recommended.

• Journal of Chest Surgery
• /
• v.25 no.6
• /
• pp.616-620
• /
• 1992

A sleeve lobectomy is an appropriate operative procedure in patients with endobronchial neoplasms of low-grade malignancies in the proximal airways and for a small but significant number of patients with carcinoma. Here, we present eleven cases of sleeve lobectomy which were performed from 1984 to the August of 1991 in the Department of Thoracic Surgery of Seoul National University Hospital. The sex distribution was 6 males and 5 females in the age range from twenty to sixty seven, with an average of 44.9 years. The pathologic diagnoses were 7 cases of pulmonary malignancies: carcinoid in two, mucoepidermoid carcinoma in two, adenoid cystic carcinoma in one, adenocarcinoma in one, and squamous carcinoma in one. Other diagnoses were two cases of tuberculous bronchial strictures and two cases of benign tumors: one case of pesudolymphoma and one case of neurilemmoma. The procedures consisted of five right upper sleeve lobectomies [Fig. 1], four left upper sleeve lovectomies [Fig. 2], one left lower sleeve lobectomy[Fig. 3], and one right middle and lower lobetomy [Fig. 4]. All except one had a normal preoperative pulmonary function. The case which had a poor pulmonary function was a 66-year-old female adenocarcinoma patient. She seemed to be very intolerable to pneumonectomy [predicted FEV1=0.60L]. Therefore, she had a right sleeve upper lobectomy and experienced smooth postoperative course without any pulmonary problems. All cases had good postoperative results and no postoperative complications.

• Journal of Chest Surgery
• /
• v.28 no.10
• /
• pp.911-916
• /
• 1995

Thirteen patients with lung cancer have undergone bronchoplastic procedures from January 1991 to July 1994 in Kyung Hee univ. Hospital.Among them,twelve patients were male and one patient was female from 33 to 76 years of age.[ mean 56.6 11.5 years of age The pathologic diagnoses were squamous cell carcinoma in twelve patients and adenoid cystic carcinoma in one patient.The bronchoplastic procedures consisted of seven right upper sleeve lobectomies, one right middle sleeve lobectomy, one left lower sleeve lobectomy and four sleeve pneumonectomies. In these sleeve pneumonectomies, right sleeve pneumonectomy was done in three patients and the other was left sleeve pneumonectomy. Including the four sleeve pneumonectomies, carinoplasty was performed in seven patients. Postoperatively, we carried out bronchoscopic suction of intrabronchial secretions in necessary for the prevention of postoperative complication. All except one were discharged without any complication and have been in good condition. Postoperative mortality was in one patient who expired 25days after right middle sleeve lobectomy with respiratory failure.

• Journal of Chest Surgery
• /
• v.21 no.2
• /
• pp.408-413
• /
• 1988

Sleeve resection is safe, effective, and appropriate treatment for a wide range of endo-bronchial lesions including neoplasms of low grade malignant potential and selected cases of bronchogenic carcinoma. Five cases of bronchoplastic procedures were performed for primary bronchogenic carcinoma patients at Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital from Aug. 1983 to Oct. 1987. Of the 5 patients, four were male and one patient was female and ages ranged from 51 years to 66 years old. Histopathologically, 4 cases were squamous cell carcinoma and one case small cell carcinoma. Operative procedures of the 5 patients were as follows: Right upper sleeve lobectomy, 1 case; Left upper sleeve lobectomy, 1 case; left lower sleeve lobectomy, 1 case; Left lower lobe and lingular segment sleeve resection, 2 cases. The early and late postoperative complications of the above operations were pneumonia, atelectasis, bronchopleural fistula, empyema, brain metastasis, and local recurrence of primary tumor.