• Journal of Chest Surgery
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• v.32 no.1
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• pp.43-48
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• 1999

Background: Although treatment of spontaneous pneumothorax by video-assisted thoracic surgery(VATS) has generally shown better clinical results than conventional thoracotomy, treatment of spontaneous pneumothorax by midaxillary thoracotomy(MAXT) has also shown good clinical results. The author studied to compare the clinical results of MAXT group I and VATS group II. Material and Method : Group I included 30 midaxillary thoracotomy among 83 operative cases of spontaneous pneumothorax from Jan. 1992 to Dec. 1993. Group II included 30 VATS among 101 operative cases of pneumothorax from Jan. 1994 to Aug. 1995. The author selected the 30 patients, age 18 to 25 years, with recurrent spontaneous pneumothorax in each group. The author analyzed the operative indication, gender, operating time, amounts of the used staplers, tube drainage, total amounts of analgesics used during postoperative 24hr, tube stay time, postoperative complications and mortality. Result: The follow-up periods of both procedures were from 6 to 43 months. The operating time from start of skin incision to end of skin closure was 84.79${\pm}$21.70(from 40 to 150) minutes in MAXT group I and 108.8${\pm}$42.02(from 58 to 120) minutes in VATS group II(P<0.001). The numbers of the used staples useo was 1.31${\pm}$0.6(from 0 to 3) in group I and 3.41${\pm}$2.37(from 0 to 11) in group II. The amounts of postoperative 24hour tube drainage were 220.76${\pm}$106.73(from 65 to 400) ml in group I and 260.63${\pm}$233.18(from 70 to 320) in group II(P>0.05). The amounts of postoperative 24 hourly used analgesics(Tarasyn ) was 1.38${\pm}$1.32(from 0 to 5) amples in group I and 0.72${\pm}$1.02(from 0 to 4) amples in group II (P<0.05). The postoperative tube stay is 5.45${\pm}$30.9 (from 3 to 7) days in group I and 4.75${\pm}$3.1(9 from 2 to 14) days in group II(P>0.05). The number of complications after operations was 2 cases of prolonged air leakage in group I, and in group II. (P is not significant). The number of recurrence after the operation was one in group I and also one in group II(P is not significant). In conclusion, there were no statistical differences in the postoperative 24 hour chest tube drainage, days of postoperative tube stay, postoperative complications and recurrence in the analysis between group I and group II. Conclusion: The author found that group II of VATS between 18 years and 25 years of age in recurrent spontaneous pneumothorax, statistically, requires longer operative time, more number of autosuture staples and less postoperative analgesic dosage than the midaxillary thoracotomy group I.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.839-845
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• 2003

Background: Even today when chemotherapy has been established as a treatment for tuberculosis and the prevalence of tuberculosis is gradually decreasing, multi-drug resistance tuberculosis still results in poor treatment performance and lowered survival periods. This research sought to analyze the surgery of multi-drug resistance tuberculosis, and determine the usefulness and danger of surgery in connection with this disease. Material and Method: Starting from February 1990 to February 2002, retrospective surveys were conducted targeted at 21 cases involving 20 patients who underwent surgery due to multi-drug resistance tuberculosis. The survey included 14 males cases and 6 females cases with the age averaging 42.8$\pm$12.1 years. 10.3$\pm$7.6 years on average passed after patients were initially diagnosed with tuberculosis. 13 patients (65%) tested positive in the pre-operative sputum AFB test, and all showed resistance against an average of 3.5 anti-tuberculosis agents including INH and RFP. Pre-operative radiologic examinations revealed cavitary lesions in 15 patients (75%), and three patients had lesions in the both lung fields, with the major lesions existing in the unilateral area. 13 patients (75%) failed negative conversion with medical treatment, while two patients (10%) with recurrent hemoptysis and five patients (25%) with lesions involving high recurrence-rate received the operation. Operations included nine cases (40%) of pneumonectomy, nine cases (45%) of lobectomy, and three cases of lobectomy with segmentectomy. The average follow-up period of patients stood at 23 months. Result: There was no post-operative death, and found were a total of eleven cases involving complications were found: three cases of long-term air leakage, three cases of bleeding requiring re-operation, two cases of empyemas due to broncho-pleural fistula, and one case of atelectasis, wound infection and chest wall fistula each. Eleven cases (85%) of negative conversion were completed immediately after the operation, and two cases failed negative conversion. Eleven months after the operation, the disease recurred in one case of negative conversion patients, and the patient was cured by completion pneumonectomy. Conclusion: If patients' lung function was sufficient and appropriate resection was possible, multi-drug resistance tuberculosis could achieve high-rate negative conversion and cure using combination of surgical and medical treatment, and also there were not many serious complications.

• Journal of Chest Surgery
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• v.34 no.8
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• pp.621-625
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• 2001

For many years, 10mm videothoracoscope has been widely used in bullectomy of primary spontaneous pneumothorax. However we used a 2mm videothoracoscope to minimize operative wound. Thus, we compared the clinical results of bulllectomy using 2mm videothoracoscope with bullectomy using 10mm videothoracoscope. Material and method: We analyzed 118 patients who underwent VATS for primary spontaneous pneumothorax from April, 1998 to December, 2000. 2mm videothoracoscope was used in 53 patients(Group A) and 10mm videothoracoscope was used in 65 patients(Group B). The mean age was 20.2$\pm$6.9 years old in group A and 20.1$\pm$6.1 years old in group B. The mean follow up was 10.9$\pm$3.8 months in group A and 11.4$\pm$4.3 months in group B. Result: The operation time was shorter in group A than group B(55.7$\pm$22.9 minutes, 71.2$\pm$21.4 minutes, p<0.05). The duration of postoperative hospital stay was shorter in group A than group B(7.2$\pm$3.2 days, 9.2$\pm$3.6 days, p<0.05). The duration of postoperative chest tube indwelling was shorter in group A than group B(4.7$\pm$3.1 days, 6.3$\pm$2.8 days, p<0.05). The duration of postoperative air leakage(0.6$\pm$2.1 days, 1.0$\pm$2.4 days, p>0.05), the amount of analgesics(1.38$\pm$1.0 ampules, 1.7$\pm$1.4 ampules, p>0.05), the amount of analgesics(1.38$\pm$1.0 ampules, 1.7$\pm$1.4 ampules, p>0.05), postperative complications(2 cases, 7cases, p>0.05) and recurrences(1 case, 1 case, p>0.05) were not statistically different between two groups. Operative wound was smaller in group A than B. Conclusion: There were non adverse results in group A than group B. Furthermore, bullectomy using 2mm videothoracoscope brought us minimized operative wound and good cosmetic results. Thus, we could recommend bullectomy using 2mm videothoracoscope in primary spontaneous penumothorax.

• Restorative Dentistry and Endodontics
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• v.25 no.1
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• pp.46-55
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• 2000

During bonding procedure of composite resin, the prepared cavity can be contaminated by saliva. In this study, marginal microleakage and shear bond strength of a composite resin to primed enamel and dentin treated with artificial saliva(Taliva$^{(R)}$) were evaluated. For the marginal microleakage test, Class V cavities were prepared in the buccal surfaces of fifty molars. The samples were randomly assigned into 5 groups with 10 samples in each group. Control group was applied with a bonding system (Scotchbond$^{TM}$ Multi-Purpose plus) according to manufacture's directions without saliva contamination. Experimental groups were divided into 4 groups and contaminated with artificial saliva for 30 seconds after priming: Experimental 1 group ; artificial saliva was dried with compressed air only, Experimental 2 group ; artificial saliva was rinsed and dried. Experimental 3 group ; cavities were etched with 35% phosphoric acid for 15 seconds after rinsing and drying artificial saliva. Experimental 4 group ; cavities were etched with 35% phosphoric acid for 15 seconds and primer was reapplied after rinsing and drying artificial saliva. All the cavities were applied a bonding agent and filled with a composite resin (Z-100$^{TM}$). Specimens were immersed in 0.5% basic fuschin dye for 24 hours and embedded in transparent acrylic resin and sectioned buccolingually with diamond wheel saw. Four sections were obtained from one specimen. Degree of marginal leakage was scored under stereomicroscope and their scores were averaged from four sections. The data were analyzed by Kruscal-Wallis test and Fisher's LSD. For the shear bond strength test, the buccal or occlusal surfaces of one hundred molar teeth were ground to expose enamel(n=50) or dentin(n=50) using diamond wheel saw and its surface was smoothed with Lapping and Polishing Machine(South Bay Technology Co., U.S.A.). Samples were divided into 5 groups. Treatment of saliva-contaminated enamel and dentin surfaces was same as the marginal microleakage test and composite resin was bonded via a gelatin capsule. All specimens were stored in distilled water for 48 hours. The shear bond strengths were measured by universal testing machine (AGS-1000 4D, Shimaduzu Co., Japan) with a crosshead speed of 5 mm/minute. Failure mode of fracture sites was examined under stereomicroscope. The data were analyzed by ANOVA and Tukey's studentized range test. The results of this study were as follows : 1. Enamel marginal microleakage showed no significant difference among groups. 2. Dentinal marginal microleakages of control, experimental 2 and 4 groups were lower than those of experimental 1 and 3 groups (p<0.05). 3. The shear bond strength to enamel was the highest value in control group (20.03${\pm}$4.47MPa) and the lowest value in experimental 1 group (13.28${\pm}$6.52MPa). There were significant differences between experimental 1 group and other groups (p<0.05). 4. The shear bond strength to dentin was higher in control group (17.87${\pm}$4.02MPa) and experimental 4 group (16.38${\pm}$3.23MPa) than in other groups, its value was low in experimental 1 group (3.95${\pm}$2.51 MPa) and experimental 2 group (6.72${\pm}$2.26MPa)(p<0.05). 5. Failure mode of fractured site on the enamel showed mostly adhesive failures in experimental 1 and 3 groups. 6. Failure mode of fractured site on the dentin did not show adhesive failures in control group, but showed mostly adhesive failure in experimental groups. As a summary of above results, if the primed tooth surface was contaminated with artificial saliva, primer should be reapplied after re-etching it.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.281-286
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• 1999

Background: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. Material and Method: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6${\pm}$11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. Result: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). Conclusion: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.

• Journal of Korean Society of Disaster and Security
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• v.12 no.1
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• pp.11-21
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• 2019

This study assessed the risk of disaster by using QRE(Quick Risk Estimation - UNISDR Roll Model City of Basic Evaluation Tool) tools for three natural disasters and sixteen social disasters managed by the Seoul Metropolitan Government. The criteria for selecting 19 disaster types in Seoul are limited to disasters that occur frequently in the past and cause a lot of damage to people and property if they occur. We also considered disasters that are likely to occur in the future. According to the results of the QRE tools for disaster type in Seoul, the most dangerous type of disaster among the Seoul city disasters was "suicide accident" and "deterioration of air quality". Suicide risk is high and it is not easy to take measures against the economic and psychological problems of suicide. This corresponds to the Risk ratings(Likelihood ranking score & Severity rating) "M6". In contrast, disaster types with low risk during the disaster managed by the city of Seoul were analyzed as flooding, water leakage, and water pollution accidents. In the case of floods, there is a high likelihood of disaster such as localized heavy rains and typhoons. However, the city of Seoul has established a comprehensive plan to reduce floods and water every five years. This aspect is considered to be appropriate for disaster prevention preparedness and relatively low disaster risk was analyzed. This corresponds to the disaster Risk ratings(Likelihood ranking score & Severity rating) "VL1". Finally, the QRE tool provides the city's leaders and disaster managers with a quick reference to the risk of a disaster so that decisions can be made faster. In addition, the risk assessment using the QRE tool has helped many aspects such as systematic evaluation of resilience against the city's safety risks, basic data on future investment plans, and disaster response.

• Economic and Environmental Geology
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• v.55 no.4
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• pp.407-419
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• 2022

Soil(vadose zone) gas compositions were measured for about 3 days to suggest a method for monitoring and interpreting soil gas data collected around wells from which methane(CH₄) is outflowing. The vadose zone gas samples were collected within 1 m around two test wells(TB2 and TB3) at Pohang and analyzed for CO₂, CH₄, N₂ and O₂ concentrations in situ. CO₂ flux was measured beside TB2. In addition, gas samples from well head in TB2 and atmospheric air samples were collected for comparison. Carbon isotopes of CO₂(δ¹³C_CO2) of samples collected on the last day of the study period were analyzed in the laboratory. The two test wells (TB2 and 3) were 12.7 m apart and only TB3 was cemented to the surface. According to the bio-geochemical process-based interpretation, the relationships between CO₂ and O₂, N₂, and N₂/O₂ of vadose zone gas were plotted between the lines of CH₄ oxidation and CO₂ dissolution. In addition, the CH₄ concentrations of gas samples from the wellhead of the uncemented well (TB2) were 5.2 times higher than the atmospheric CH₄ concentration. High CO₂ concentrations (average 1.148%) of vadose zone gas around TB2 seemed to be attributed to the oxidation of CH₄. On the other hand, the vadose zone CO₂ around the cemented well(TB3) showed a relatively low concentration(0.136%). This difference indicates that the vadose zone gas(including CO₂) around the CH₄ outflowing well were strongly affected by well completion(cementing). This study result can be used to establish strategies for environmental monitoring of soil around natural gas sites, and can be used to monitor leakage around injection and observation wells for CO₂ geological storage. In addition, the method of this study is useful for soil monitoring in natural gas storage and oil-contaminated sites.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.917-923
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• 2001

Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.37-44
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• 2007

Background: It is known that long-term survival rate in patients underwent bronchial sleeve lobectomy for primary lung cancer is at least equal to that in patients underwent pneumonectomy, and bronchial sleeve lobectomy is performed in patients with suitable tumor location even in patients have adequate pulmonary function. Sleeve pneumonectomy is performed when carina was invaded by tumor or tumor location was near to the carina. We performed this study to know our results of sleeve resection for primary lung cancer. Material and Method: We analyzed retrospectively the medical records of 45 patients who underwent sleeve lobectomy or sleeve pneumonectomy for primary lung cancer by one thoracic surgeon from May 1990 to July 2003 in Department of Thoracic & Cardiovascular Surgery, College of Medicine, Kyung Hee University. Follow-up loss was absent and last follow-up was performed in April 5, 2005. Kaplan-Meyer method and log-lank test were used to know long-term survival rate and p-value. Result: Mean age was 60 years old and male to female ratio 41:1. Histologic types were squamous cell carcinoma were 39, adenocarcinoma were 4, and others were 2 patients. Pathologic stages were I 14, II 14, and III 17 patients. Nodal stages were N0 23, N1 13, and N2 9 patients. Types of operation were sleeve lobectomy 40 and sleeve pneumonectomy 5 patients. Operative mortality was 3 patients and its cause was respiratory complications. Early complications were pneumonia 4, atelectasis 8, air leakage more than 7 days 6, and atrial fibrillation 4 patients. In 19 patients tumor was recurred. Local recurrence was 10 and systemic metastasis was 9 patients. Overall 5, 10-year survival rate were 54.2%, 42.5%. The 5, 10-year survival rates according to the pathologic stage were 83.9%, 67.1% in stage I, 55%, 47.1% in II, 33.3%, 25% in III, and significance difference was present between stage I and III. The 5, 10-year survival rate according to the lymph node involvement were 63.9%, 54.6% in N0, 53,8%, 46.5% in N1, 28.5%, 14.2% in N2, and significance difference was present between N0 and N2. Conclusion: Because bronchial sleeve lobectomy for primary lung cancer could be performed safely and shows acceptable long-term survival rate, it could be considered primary in case of suitable tumor location if complete resection is possible. Although sleeve pneumonectomy for primary lung cancer shows somewhat high operative mortality rate, it could be considered in view of curative treatment.