• Tuberculosis and Respiratory Diseases
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• v.47 no.6
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• pp.727-734
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• 1999

본원의 비데오 흉강경술 경험과 문헌에서 볼 때, 흉막강 질환에서 흉강경술의 역활은 수기가 국소 또는 경막하 마취 혹은 전신 마취에서 가능하고 작은 구경의 흉강경으로 전 흉막강을 관찰할 수 있으므로 진단 및 치료 효과가 우수하였다. 흉막강 질환에서의 주요 적응증은 흉수, 농흉, 기흉, 흉막 종양, 흉막의 외상, 흉막강내 이물의 진단 및 치료되고 있다. 흉막강내 각종 수기에 사용하는 기구의 개발과 수기의 발전으로 흉막강내 질환에 대한 치료 성적은 전통적인 개흉수술에 비교하여 우수한 결과를 나타내고 있다.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.328-331
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• 2010

Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.

• Journal of Chest Surgery
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• v.31 no.11
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• pp.1085-1088
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• 1998

Background: In trauma patients, bony thorax are exposured to the trauma in many cases. With simple x-ray, we can not detect all definitive bony abnormalities, especially in less severe cases. Bone scan is very sensitive diagnostic method in such cases. Materials and methods: We experienced 680 cases and results were as follows. Results: 1. Diagnostic sensitivity was 97.4% and false negative rate was 2.6%. 2. In sensitivity study, the time factor(when we perform bone scan) was the most important thing according to trauma pattern. In rib fracture, sensitive test time was after 1 week. In sternal fracture, sensitive test time was after 1 week, too. In costochondral junction fracture and combined cases, it was after 3 days. Conclusions: We recommend timely using of bone scan as definitive diagnostic method in bony thorax trauma patients.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1222-1226
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• 2020

Lymphoma is a common cause of nontraumatic chylothorax. Clinical success rates of thoracic duct embolization are lower in patients with nontraumatic chylothorax compared to patients with traumatic chylothorax. Herein, we report a case of nontraumatic chylothorax and lymphoma in a 77-year-old man managed with thoracic duct embolization. The chest tube drainage decreased but not was sufficient to enable removal of the chest tube. Therefore, a second embolization was performed through a direct puncture of the lymphatic mass in the lung, following which the chyle leakage ceased, and the chest tube was removed. The treatment strategy discussed in this report may be an effective therapeutic option for select patients with nontraumatic chylothorax.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.627-629
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• 2003

The pneumopericardium following blunt chest trauma is exceedingly unusual. A patient was admitted to the emergency room after a motorcycle accident. Pneumopericardium and left pneumothorax were not detected on initial chest AP, but they were detected on chest computed tomograpy and resolved completely after chest tube insertion into the left pleural space.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.160-165
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• 2004

Successful treatment of multi-loculated pleural effusion or thoracic empyema requires effective drainage and definitive diagnosis of causative organism. The purpose of this study was to assess the efficacy of the video-assisted thoracoscopic surgery in the management of thoracic empyema or multi-loculated pleural effusion after chest tube drainage treatment had failed. Material and Method: Between April 2000 and July 2002, 20 patients with thoracic empyema or multi-loculated pleural effusion that failed to chest tube drainage or other procedures who underwent an operation. All patients were assessed by chest-computed tomogram and underwent video assisted thoracoscopic drainage, debridement, biopsy and irrigation of pleural cavity. Result: In 18 cases (90%), underwent successful video-assisted thoracoscopic surgery. In 2 cases, decortications by mini-thoracotomy were necessary. The ratio of sex was 4 : 1 (16 male: 4 female), mean age was 48.9 years old (range, 17∼72 years), mean duration of postoperative chest tube placement was 8.2 days (range, 4∼22 days), mean postoperative hospital stay was 15.2 days (range, 7∼33 days). Causative disease was tuberculosis, pneumonia, trauma and metastatic breast cancer, There were no major postoperative complications. Symptoms improved in all patients and were discharged with OPD follow up. Conclusion: In an early organizing phase of empyema or multi loculated pleural effusion, video-assisted thoracoscopic drainage and debridement are safe and suitable treatment.

• Tuberculosis and Respiratory Diseases
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• v.49 no.6
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• pp.724-732
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• 2000

Background : In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known that inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous bood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. Methods : Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical out∞me, chest radiography and pulmonary function tests. Results : The mean duration of air leak was 18.4${\pm}$6.16 days before ABP (autologous blood and dextrose pleurodesis) and $5.2{\pm}1.68$ days after ABP. The mean severity of pain was $2.3{\pm}0.70$ for DP(doxycycline pleurodesis) and $1.7{\pm}0.59$ for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of $0.6{\pm}0.63$. The mean dyspnea scale was $1.7{\pm}0.46$ before pneumothrax and $2.0{\pm}0.59$ after ABDP (p>0.05). The mean $FEV_1$ was $1.47{\pm}1.01$ before pneumothorax and $1.44{\pm}1.00$ after ABDP (p>0.05). Except in 1 patient, 14 patients had no recurrent pneumothorax. Conclusion : Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.74-78
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• 2007

Systemic artery to pulmonary vessel fistula (SAPVF) is an abnormal communication between the systemic arterial circulation and the pulmonary circulation. Most SAPVF are congenital, but some SAPVF may also develop as a consequence of trauma, neoplasm, and inflammation of pleura or lung parenchyma. A 38-year-old man was referred to our department for hemoptysis. He underwent an operation for traumatic diaphragm rupture 16 years ago. Chest CT scan and angiography revealed SAPVF between several intercostal arteries and pulmonary vessels. He had an angiographic transcatheter embolization and the SAPVF disappeared at follow-up chest CT. To the best of our knowledge, this is the first case report of traumatic SAPVF in Korea.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.729-732
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• 2006

Mediastinal teratoma is one of the most common lesions found in the anterior mediastinum, accounting for $8\sim13%$ of all mediastinal tumors. This tumor is incidentally detected by routine chest roentgengography, but pericardial perforation or pleural effusion occurs rarely. In our patient cardiac tamponade was developed due to anterior chest wall contusion, we confirmed the anterior mediastinal tumor. Vital signs were stabilized after the pericardiocentesis, and the patient underwent the tumor resection in the anterior mediastinum for a definite treatment. On histologic examination, the tumor revealed cystic structures composed of mature squamous epithelium, pilosebaceous glands, mature fat tissue, gastrointestinal mucosa, respiratory epithelium, and pancreatic tissues.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.131-136
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• 2008

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.