• Journal of Chest Surgery
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• v.36 no.2
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• pp.101-104
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• 2003

Although lung transplantation has been accepted as the most effective treatment for end-stage pulmonary emphysema, it is not only very hard to find a donor but also to obtain a relatively healthy lung. Furthermore, it is more difficult to match the size of the allograft, considering the height, the weight, and the size of the thoracic cage. The single lung transplatations for the end-stage emphysema have been more commonly performed than bilateral lung transplantation due to the shortage of the donors and the long-term survival rate of the single lung transplantations has shown no reasonable difference compared with that of the bilateral lung transplantationh. Recently, the functional criteria based on a comparison of predicted TLCs(Total Lung Capacities) of the donor and recipient according to height, sex and age, have been accepted at a more suitable.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.903-906
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• 1998

A 17-year-old-boy with a bilateral incomplete cervical rib, upon abduction of his left arm at 45 degrees, had immediately begun to show symptoms of severe tingling, claudication, pallor, and weakness of his left upper extremity. These symptoms were aggravated at 90 degrees, leaving him debilitated from his work in the printing office. Transfemoral positional subclavian arteriography revealed total occlusion of the subclavian artery immediately distal to a cervical rib during 90 degrees abduction. Resection of the anterior scalene and medial aspect of the middle scalene muscles, cervical and first ribs, and arteriolysis were performed via a combined supraclavicular and infraclavi cular approach. He has returned to work as a printer with marked relief of symptoms and has remained asymptomatic over follow-up periods of 10 months.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.873-877
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• 2005

Jeune's asphyxiating thoracic dystrophy is a rare, complex malformation with a broad spectrum of clinical expression. The degree of chest wall deformity is the most important prognostic factor and the only part which is correctable. A 11 month-old male infant was diagnosed as having Jeune's syndrome and received right side lateral thoracic expansion surgery. But because respiratory distress symptom was sustained postoperatively, we performed left side procedure 3 months after the initial operation. Respiratory distress symptom got worse after fracturing the left titanium plate which was inserted to fix the expanded thoracic wall and reimplantation was performed. The patient was discharged 6 months after the initial operation. He was readmitted and received ventilator care for respiratory failure and died 10 months after the initial operation.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.93-99
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• 1998

We measured the glenohumeral and scapulothoracic movements during abduction of the arm in the coronal plane with radiologic analysis in the 30 shoulders of normal male adults who were without pain, limitation of motion, and history of trauma. In the resting position, the glenoid cavity of the scapula faced somewhat superiorly in over 80 percents of the individuals, the mean superior tilting was 5.7 degrees. The mean total scapulothoracic movement was 65.8 degrees and the mean total glenohumeral movement was 106.8 degrees during abduction of arm in the coronal plane. The mean ratio of the glenohumeral movement to the scapulothoracic movement was 1.6 and this GH/ST ratio was decreased toward the extreme abduction. When the arm was abducted, external rotation of the humeral head occurred and this external rotation was increased smoothly during 0 degree through 90 degrees, but steeply above 90 degrees. The acromiohumeral interval was 10.9 mm at the resting positon, and this interval decreased during the arm abduction. The superior migration of the humeral head was 3.1 mm while abducting the arm. Our measurement of the relationships of glenohumeral and scapulothoracic movements at the coronal plane would be useful in the understandings of the biomechanics of shoulder, but further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.

• Tuberculosis and Respiratory Diseases
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• v.65 no.3
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• pp.216-221
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• 2008

A chronic expanding hematoma (CEH) in the thorax is a rare and specific condition of chronic empyema. CEHs in the thorax are often associated with tuberculosis and/or previous surgical procedures. While the incidental detection of a pleural mass and dyspnea are common clinical manifestations, a few cases present with hemoptysis. We encountered a case of CEH in the thorax. This case is unique in that it developed without a prior history of tuberculosis or surgery and presented with massive hemoptysis accompanied by bronchopleural fistula. We report the third case of CEH in the thorax in Korea with a summary of the clinical characteristics of previous cases.

• Journal of Korean Society for Atmospheric Environment
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• v.4 no.1
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• pp.58-70
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• 1988

대기오염이 건강에 미치는 영향의 유무를 알아보고 그 영향의 정도를 반영해 줄 수 있는 지표의 개발을 목적으로 우리나라 전역을 서울, 대도시, 중소도시, 농어촌 등 4개 지역으로 구분하고 의료보험대상자 3,922,027명에 대한 호흡기질환 외래수진률을 지역별로 비교해 보았다. 조사대상 질환군으로서는 다음 7가지의 호흡기질환을 채택하기로 하였다. 1) 결핵성 질환 2) 호흡기 및 흉곽내장기의 악성신생물 3) 급성호흡기 감염 4) 폐염 및 인플루엔자 5) 만성폐색성 폐질환 및 유사증 6) 진폐증 및 외인성의 기타 폐질환 7) 상기도의 기타질환 상기 질환으로 인한 외래수진에 관한 정보는 1983년 1월 1일 부터 12월 31일 사이에 제출된 보험의료비 청구서에 나타난 자료를 이용하여 수집하였으며, 그 분석을 통해 다음과 같은 결론을 얻었다. 1) 지역별 연간종합외래수진률을 비교해 본 결과 농촌지역에서 가장 낮은 수준을 나타내고 있는 질환은 조사대상 7개 호흡기질환군중 다음 4개 질환군이 해당되고 있다. (1) 결핵질환 (2) 호흡기 및 흉곽내장기의 악성 신생물 (3) 상기도의 기타질환 (4) 진폐증 및 외인성의 기타 폐질환 한편 이 종합외래수진률이 가장 높은 지역은 대도시 지역으로서 5가지 호흡기질환군의 수진률이 다른 지역에 비해 훨씬 높게 나타나 있다. 이와같은 결과는 의료보험환자들의 "외래수진률"을 이용하여 대기오염과 건강과의 관련도를 측정할 수 있는 "대기오염 - 건강" 지표의 개발이 가능할 것임을 뒷받침해 주고 있다. 그러나 가장 오염도가 높다고 예상되는 서울지역에서의 외래수진율이 대도시 지역보다 높지 않다는 것은 오염도와 외래수진률과의 관계에서 일관성있는 결과를 보여주지 못하고 있음을 뜻하는데 과거의 자료로서는 외래수진률만 가지고 대기오염과 건강과의 관계를 표시해주는 지표로 삼기에는 미흡함을 알 수 있다. 2) 월별 외래수진률의 경향을 보면 거의 모든 호흡기질환군에서 계절적인 특이성을 나타내지 못하고 있다. 단 이 경우도 농촌지역이 연중 계속 최하위를 유지하고 있는 질환군이 7개 대상질환군 중에 4개군에 달하고 있다. 3) 보험환자들의 "외래수진률"은 아직은 미흡한 점이 있으나 앞으로 "대기오염 - 건강" 지표로서 개발 활용할 가치는 있다고 볼 수 있으며 서울, 대도시, 중소도시, 농어촌 등 4개 지역에 대한 월별 외래 수진률을 다음 4가지 질환군에 대하여 계속 관측하여 그 경향을 분석할 것을 권장한다. (1) 호흡기 및 흉곽내장기의 악성 신생물 (ICD. 160-165) (2) 급성호흡기 감영 (ICD. 460-466) (3) 폐염 및 인플루엔자 (ICD. 480-487) (4) 만성폐색성 폐질환 및 유사증 (ICD. 490-496) 4) 외래수진률은 진료방식 즉, 투약기간의 장단등으로 인한 통원 (通院) 빈도 차이의 영향을 받게 되므로 지역별 병 $\cdot$ 의원의 보험환자 진료방식에 대한 비교검토가 요구된다.

• Journal of Radiation Protection and Research
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• v.27 no.3
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• pp.155-164
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• 2002

Methodology to evaluate the effective doses to adults undergoing various diagnostic x-ray examinations were established by Monte Carlo simulation of the x-ray examinations. Anthropomorphic mathematical phantoms, the MIRD5 male phantom and the ORNL female phantom, were used as the target body and x-ray spectra were produced by the x-ray spectrum generation code SPEC78. The computational procedure was validated by comparing the resulting doses to the results of NRPB studies for the same diagnostic procedures. The effective doses as well as the organ doses due to chest, abdomen, head and spine examinations were calculated for x-rays incident from AP, PA, LLAT and RLAT directions. For instance, the effective doses from the most common procedures, chest PA and abdomen AP, were 0.029 mSv and 0.44 mSv, respectively. The fact that the effective dose from PA chest x-ray is far lower than the traditional value of 0.3 mSv(or 30 mrem), which results partly from the advances of technology in diagnostic radiology and partly from the differences in the dose concept employed, emphasizes necessities of intensive assessment of the patient doses in wide ranges of medical exposures. The methodology and tools established in this study can easily be applied to dose assessments for other radiology procedures; dose from CT examinations, dose to the fetus due to examinations of pregnant women, dose from pediatric radiology.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.719-724
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• 2009

Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1116-1118
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• 1998

Intrathoracic teratoma is mainly found on the anterior mediastinum. For teratoma of the pleura, one case was described. We have presented what we believe to be the first report of a teraroma of the pleura, which was mainly composed of neuroglial cells and was accompanied with lymph node metastasis.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.184-188
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• 2001

선천성 횡경막탈장은 2000∼5000명의 신생아 당 한명 꼴의 발생율을 가진 드문 질환이다. 그 중 신생아에서 열공탈장은 더욱 희귀한 질환이다. 저자는 생후 1주일된 신생아의 선천성 복합열공탈장을 경험하였다. 진단은 빠른 시간내 이루어졌으며 수술은 우측 흉곽절제술을 통해 탈장된 장기를 복원하고 Belsey-mark IV 술식을 시행하였다. 환아는 술후 3일째 음식을 먹었고 퇴원 6개월후 지금까지 별 문제없이 잘 지내고 있다.