• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.94-100
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• 1997

Background and Objectives : In children with tracheal stenosis, operative management remains a challenging problem due to difficulties of operative techniques and postoperative care. The purpose of this study was to determine the effectiveness of tracheal resection with end to end anastomosis as operative management for tracheal stenosis in children. Materials and Methods : 6 children with severe tracheal stenosis underwent tracheal resection with end to end anastomosis. Causes of stenosis were trauma in 1 case and prolonged intubation or tracheotomy in 5 cases. The diagnoses were made by radiologic evaluation (plain X-ray, CT, 3-Dimensional CT) and confirmed by direct laryngoscopy and ventilating bronchoscopy under general anesthesia. Thyroplasty and unilateral arytenoidectomy were performed in 1 case. Suprahyoid release was done in 1 case with severe adhesion. Decanulation was achieved following postoperative endoscopic examination and pulmonary function test. Postoperative physical and radiologic examinations were given at regular intervals. Results : Stenosis were improved from grade III grade I in 4 cases and from grade II to grade I in 2 cases. Decanulation was achieved on average postoperative 6 months in 5 cases, and 10 years in 1 case due to exertional dyspnea. There were 1 each case of immediate postoperative subcutaneous emphysema, pneumothorax and wound infection. Postoperative granulomas at anastomosis site were treated with laser vaporization under suspension laryngoscope and bronchoscope in 3 cases. There was 1 each case of delayed postoperative vocal cord palsy, aspiration pneumonia and loss of cough reflex. Conclusion In tracheal stenosis of children, tracheal resection with end to end anastomosis has good result with preservation of normal airway. Preoperative evaluation of local factors such as swallowing, vocal cord movement and cough reflex and general condition was important for successful treatment. As the cases in adults, authors considered this operation to be a curable operative management for tracheal stenosis.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.193-197
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• 2006

Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.221-223
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• 2010

Bronchogenic cysts are usually located in the pulmonary parenchyma or in the mediastinum. When bronchogenic cysts are located in the mediastinum, they are usually near the bronchus or esophagus, and rarely located in the retroperitoneal space. It is difficult to differentiate between bronchogenic cysts and benign cysts prior to surgert. We report here on a patient for who had a mass in the retroperitoneum, with the preoperative diagnosis being a benign neurogenic tumor. Via left open thoracotomy, pathologic reports revealed that the mass was a bronchogenic cyst. We report here on the case of a bronchogenic cyst that was located in the retroperitoneal space of the diaphragm.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.102-104
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• 2004

Inflammatory myofibroblastoma is a solid tumor, occurring mainly to children and young adults, and occupying 0.7% of total isolated pulmonary nodules. Since 1973, several cases about inflammatory myofibroblastoma have been reported. Firstly, this tumor was found in lungs. Then, tumors have been founded and reported in mesentery or cardioesophageal region. Histologically, this tumor can be classified as a benign tumor. However, since this tumor has two characteristics showing malignancy, that is, local invasion and recurrence, malignancy can not be completely excluded. Recently, a patient with pulmonary inflammatory myofibroblastoma underwent surgical resection without any signs or symptoms of recurrence.

• Korean Journal of Environmental Biology
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• v.19 no.1
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• pp.49-58
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• 2001

This study aims to compare and analyze the environment of natural parks and Ulleung island using the plant taxa classified by five degrees based on their distributional ranges. The scores differentially given based on the importance of each degree; taxa belonging to the fifth degree are given to 20 scores each, fourth 10, third 5, second 3.3, and first 2.5, respectively. The total assessed scores were ranked as Mt. Halla, Seorak, Jiri, Deokyu, Is. Ulleung, Mt. Sobaek, Odae, Palgong, Chink, Taebaek, Songni, Juwang, Gaya, Duryun, Gaeryong, Bukhan, Naebyeon, Worak, Naejang, Cheongryang, Naeyeon, Myeongii, Jokye, Mudeung, Wolchul, Geumo, Juheul, Biseul, Hwangmae, Jangan, Seonun, Moak, Seonam, Chilgap, and Gibaek, in order, respectively. It is suggested that the natural environments assessing more than 1,000 of total scores such as Mt. Halla and Mt. Deokyu are regarded as the most excellent ones, and those between 700 to 1,000 of total scores such as Is. Ulleung and Mt. Odae are regarded as relatively excellent ones. Natural parks scored between 500 to 700 such as Mt. Palgong and Mt. Gaya are regarded as good ones and parks scored between 300 to 500 such as Mt. Duryun and Mt. Mudeung are regarded as normal ones. The area assessed less than 300 of total scores such as Mt. Wolchul and Mt. Gibaek are regarded as the most inferior ones. The total scores of the national parks are generally higher than those of the provincial and county parks. In addition, Ulleung island has a total of 882.9 scores. Therefore, according to the IUCN the Ulleung island should be included in the criterion of the preservative model of natural ecosystem, suggested by Ministry of Environment. At the same time, Ulleung island should be included to the superior model of natural scenery resources by its uniqueness of topography, geography and natural environments. Ulleung island is assessed as having relatively excellent natural environments as compared with other national parks, suggesting that the island should be designated as a new national park.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.280-284
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• 2010

Background: The postoperative management following lung transplantation has dramatically improved in the recent decade. However, some complications still remain as troublesome problems. We retrospectively reviewed the gastrointestinal complications and their management after lung transplantation. Material and Method: We performed a retrospective review of the medical records of 25 cases in 23 patients who underwent lung and heart-lung transplantations from July 1996 to March 2009. The definition of gastrointestinal complication was the gastrointestinal tract-related disease that occurred after lung transplantation. There were eight postoperative deaths (within postoperative 30 days) that were excluded from the analysis. Result: Twenty three gastrointestinal complications occurred in 11 (64.7%) of the 17 cases. The median follow-up period was 6.9 months (range: 2 months to 111 months), and chronic gastritis (23.5%, 4 of 17 cases) was the most common complication. Severe, prolonged (more than 2 weeks) diarrhea occurred in 3 cases. Three patients had gastric ulcer with one case requiring gastric primary closure for gastric ulcer perforation. This patient had gastric bleeding due to recurrent gastric ulcer 2 months after laparotomy. Cytomegalovirus gastritis and esophagitis occurred in 2 cases and 1 case, respectively, and esophageal ulcer occurred in 2 cases. There were esophageal strictures in 2 patients who underwent esophageal stent insertion. Other complications were one case each of ileus, early gastric cancer requiring endoscopic mucosal resection, gall bladder stone accompanied with jaundice, and pseudomembranous colitis. Conclusion: The incidence of gastrointestinal complication is relatively high in patients after they undergo lung transplantation. Since gastrointestinal complications can induce malnutrition, which might be related to considerable morbidity and mortality, close follow-up is necessary for the early detection and proper management of gastrointestinal complications.

• Journal of Chest Surgery
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• v.30 no.8
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• pp.780-785
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• 1997

Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

• Radiation Oncology Journal
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• v.29 no.1
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• pp.44-52
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• 2011

Purpose: To evaluate the outcomes and prognostic factors of postoperative radiotherapy (PORT) for patients with pathological stage III non-small-cell lung cancer (NSCLC) at a single institution. Materials and Methods: From 2000 to 2007, 88 patients diagnosed as having pathologic stage III NSCLC after curative resection were treated with PORT. There were 80 patients with pathologic stage IIIA and eight patients with pathologic stage IIIB in the AJCC 6th staging system. The majority of patients (n=83) had pathologic N2 disease, and 56 patients had single station mediastinal LN metastasis. PORT was administered using conventional technique (n=76) or three-dimensional conformal technique (n=12). The median radiation dose was 54 Gy (range, 30.6 to 63 Gy). Thirty-six patients received chemotherapy. Radiation pneumonitis was graded by the Radiation Therapy Oncology Group system, and other treatment-related toxicities were assessed by CTCAE v 3.0. Results: Median survival was 54 months (range, 26 to 77 months). The 5-year overall survival (OS) and disease free survival (DFS) rates were 45% and 38%, respectively. The number of metastatic lymph nodes was associated with overall survival (hazard ratio, 1.037; p-value=0.040). The 5-year locoregional recurrence free survival (LRFS) and distant metastasis free survival (DMFS) rates were 88% and 48%, respectively. Multiple stations of mediastinal lymph node metastasis was associated with decreased DFS and DMFS rates (p-value=0.0014 and 0.0044, respectively). Fifty-one relapses occurred at the following sites: 10 loco-regional, 41 distant metastasis. Grade 2 radiation pneumonitis was seen in three patients, and symptoms were well tolerated with anti-tussive medication. Grade 2 radiation esophagitis was seen in 11 patients. There were no grade 3 or more severe complications associated with PORT. Conclusion: Our retrospective data show that PORT for pathological stage III NSCLC is a safe and feasible treatment and could improve loco-regional control. The number of metastatic lymph nodes and stations of mediastinal lymph node metastasis were analyzed as prognostic factors. Furthermore, efforts are needed to reduce distant metastasis, which is a major failure pattern of advanced stage NSCLC.

• Journal of Gastric Cancer
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• v.1 no.4
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• pp.210-214
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• 2001

Purpose: The aim of this study was to evaluate the shortterm outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to $86.0\%$ and $87.6\%$ of the recent original body weight in the jejunal interposition (JI) group and to $90.8\%,\;87.0\%$, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the JI group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the JI group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the JI group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the JI group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in $7.1\%$ of the patients in the JI group and in $3.5\%$ in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1143-1147
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• 1996

Video-assisted thoracic surgery(VATS) is emerging as a potentially less invasive means of managing a wide variety of thoracic disorders. VATS was performed in 46 cases, in the Department of Thoracic & Cardiovascular Surgery of Chonbuk national University Hospital from August 1992 to July 1995. There were 20 men and 26 women, whose age ranged from 14 to 56 years. They were diagnosed hyperhidrosis in 21 cases, mediastinal tumor in 12 cases, pneumothorax in· 10 cases, and one case each of lelomyoma of the esophagus, Raynaud's syndrome, Burger's disease. Operation time averaged 89.7 minutes, and no patient was converted to d thoracotomy. The number of troche used, period of chest tube drainage, and postoperative hospitalization were 3, 1.8 days, and 4.B days, respectively. The postoperative complication ocurred in 5 cases (remnant pneumothorax 1 case, phrenic nerve aralysis 1 case, persistant air leakage 2 cases, compensatory hyperhidrosis 1 case). One patient with persistent air leak was managed by thoracotomy on postoperative) days, and the other patient by chemical pleurodesis. One patient diagnosed pathologically as thymic carcinoma, was managed by radiation therapy. There was no postoperative death. VATS has the benefits of reduced postoperative pain and postoperative hospitalization, and good cutsmetic effect.