• Journal of Chest Surgery
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• 제50권3호
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• pp.171-176
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• 2017

Background: In elderly patients who have atrial fibrillation (AF), surgical ablation of the arrhythmia during cardiac surgery may be challenging. Despite the reported advantages of ablating AF with the Cox maze procedure (CMP), the addition of the CMP may complicate other cardiac operations. We evaluated the effect of the CMP in elderly patients concurrent with other cardiac operations. Methods: From October 2007 to December 2015, we enrolled 27 patients aged >70 years who had AF and who underwent the CMP concurrently with other cardiac operations. The mean preoperative additive European System for Cardiac Operative Risk Evaluation score was $8{\pm}11$ (high risk). Results: Only 1 hospital death occurred (4%). The Kaplan-Meier method showed a high 5-year cumulative survival rate (92%). At mean follow‐up of 51 months, 23 patients (89%) had sinus rhythm conversion. The postoperative left atrial dimensions did not significantly differ between the 8 patients who had reduction plasty for giant left atrium ($53.4{\pm}7.5cm$) and the 19 patients who did not have reduction plasty ($48.7{\pm}5.7cm$). Conclusion: In patients aged >70 years, concurrent CMP may be associated with a high rate of sinus rhythm conversion without increased surgical risk, despite the added complexity of the main cardiac procedure.

• Journal of Chest Surgery
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• 제43권5호
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• pp.562-564
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• 2010

임파루는 대퇴부 절개를 이용한 혈관 수술시 흔히 발생하는 합병증이다. 임파선은 해부학적으로 혈관과 매우 가깝게 위치하기 때문에 혈관 노출 과정에서 드물지 않게 손상된다. 임파액을 적절하게 배액시키지 않으면 환자가 다른 합병증으로 이환되는 원인으로 작용할 수 있으며, 흔히 창상 감염을 야기한다. 이에 대한 다양한 치료법이 보고되었음에도 임파루는 치료하기 어렵고 결국에는 재원기간을 연장 시킨다. 서혜부 절개를 이용한 혈관 수술을 받은 72세 여자환자에게서 수술후 임파루가 발생하였으며 창상에 음압 요법을 시행하였다. 조기에 적절한 배액이 되었고, 창상 치유가 원활하여 창상 봉합이 가능하였기에 재원기간을 단축할 수 있었다.

• Journal of Chest Surgery
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• 제41권2호
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• pp.273-276
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• 2008

심장 정지에 있어서 체외 심폐 보조가 1983년도에 도입된 이래로 심장 정지의 치료에 응급 경피적 심폐 보조가 사용되어 왔다. 다량의 급성 폐동맥 색전증은 사망률이 높고, 특히 수술 중 발생한 경우는 외과의와 마취의에게 힘든 문제를 제기한다. 본 증례는 수술 도중에 발생한 다량의 폐동맥 색전증으로 인한 심장 정지에 대하여 효과적인 치료수단으로써 응급 체외 순환기를 사용한 56세의 여자 환자에 대하여 기술하였다. 환자는 와파린을 복용하면서 퇴원하였고, 패동맥 색전증의 재발없이 외래추적 중이다.

• Journal of Chest Surgery
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• 제52권3호
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• pp.131-140
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• 2019

Background: The purposes of this study were to evaluate the appropriateness of the stage migration of stage IIA non-small cell lung cancer (NSCLC) in the seventh edition of the tumor, node, and metastasis classification for lung cancer to stage IIB lung cancer in the eighth edition, and to identify prognostic factors in patients with eighth-edition stage IIB disease. Methods: Patients with eighth-edition stage IIB disease were subclassified into those with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease, and their recurrence-free survival and disease-specific survival rates were compared. Risk factors for recurrence after curative resection were identified in all included patients. Results: Of 122 patients with eighth-edition stage IIB NSCLC, 101 (82.8%) had seventh-edition stage IIA disease and 21 (17.2%) had seventh-edition stage IIB disease. Nonsignificant differences were observed in the 5-year recurrence-free survival rate and the 5-year disease-specific survival rate between the patients with seventh-edition stage IIA disease and those with seventh-edition stage IIB disease. Visceral pleural invasion was a significant risk factor for recurrence in patients with eighth-edition stage IIB NSCLC. Conclusion: The stage migration from seventh-edition stage IIA NSCLC to eighth-edition stage IIB NSCLC was appropriate in terms of oncological outcomes. Visceral pleural invasion was the only prognostic factor in patients with eighth-edition stage IIB NSCLC.

• 대한물리의학회지
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• 제17권4호
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• pp.37-43
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• 2022

PURPOSE: To find out how wearing a mask due to COVID-19 affects cardiovascular function as the pace of walking changes. METHODS: Forty-nine college students (27 men, 22 women) were subjected to treadmill exercises without masks (Group I) and wearing masks (Group II). The body temperature, heart rate, oxygen saturation, and blood pressure were measured to determine the changes in cardiovascular function. These parameters were measured at rest (Control I), low-intensity (Control II), medium-intensity (Control III), and high-intensity (Control IV) before and after exercise. RESULTS: Significant differences in heart rate were observed between Control III and Control IV, and a significant difference in oxygen saturation was noted in Control IV. Significant differences in the exercise intensity change in Group II were as follows: Body temperature was Control IV compared to Control I and Control II, heart rate was Control III and Control IV compared to Control I and Control II, and Control IV compared to Control III. The heart rate was Control III and Control IV compared to Control I and Control II, Control IV for Control III, oxygen saturation was Control IV compared to Control I, blood pressure was Control II and Control III and Control IV compared to Control I, and Control IV compared to Control II. CONCLUSION: Exercising when wearing a mask affects the cardiovascular system. Therapists should consider the patient's condition when setting the exercise intensity. In particular, therapists should be more careful when setting the exercise intensity of patients with cardiovascular disease.

• Journal of Chest Surgery
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• 제55권6호
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• pp.470-477
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• 2022

Background: Upfront surgery followed by systemic treatment is recommended to treat clinical stage I-IIA small cell lung cancer (SCLC), but data on the clinical outcomes are sparse. Thus, this study evaluated the stage migration and long-term prognosis of surgically treated clinical stage I-IIA SCLC. Methods: We retrospectively reviewed 49 patients with clinical stage I-IIA SCLC who underwent upfront surgery between 2000 and 2020. Additionally, we re-evaluated the TNM (tumor-node-metastasis) staging according to the eighth edition of the American Joint Committee on Cancer staging system for lung cancer. Results: The clinical stages of SCLC were cIA in 75.5%, cIB in 18.4%, and cIIA in 6.1% of patients. A preoperative histologic diagnosis was made in 65.3% of patients. Lobectomy and systematic lymph node dissection were performed in 77.6% and 83.7% of patients, respectively. The pathological stages were pI in 67.3%, pII in 24.5%, pIII in 4.1%, and pIV in 4.1% of patients. The concordance rate between clinical and pathological stages was 44.9%, and the upstaging rate was 49.0%. The 5-year overall survival (OS) rate was 67.8%. No significant difference in OS was found between stages pI and pII. However, the OS for stages pIII/IV was significantly worse than for stages pI/II (p<0.001). Conclusion: In clinical stage I-IIA SCLC, approximately half of the patients were pathologically upstaged, and OS was favorable after upfront surgery, particularly in pI/II patients. The poor prognosis of pIII/IV patients indicates the necessity of intensive preoperative pathologic mediastinal staging.

• Journal of Chest Surgery
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• 제57권2호
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• pp.205-212
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• 2024

Background: Postoperative atrial fibrillation (A-fib) is a serious complication of cardiac surgery that is associated with increased mortality and morbidity. Traditional 24-hour Holter monitors have limitations, which have prompted the development of innovative wearable electrocardiogram (ECG) monitoring devices. This study assessed a patch-type wearable ECG device (MobiCARE-MC100) for monitoring A-fib in patients undergoing cardiac surgery and compared it with 24-hour Holter ECG monitoring. Methods: This was a single-center, prospective, investigator-initiated cohort study that included 39 patients who underwent cardiac surgery between July 2021 and June 2022. Patients underwent simultaneous monitoring with both conventional Holter and patchtype ECG devices for 24 hours. The Holter device was then removed, and patch-type monitoring continued for an additional 48 hours, to determine whether extended monitoring provided benefits in the detection of A-fib. Results: This 72-hour ECG monitoring study included 39 patients, with an average age of 62.2 years, comprising 29 men (74.4%) and 10 women (25.6%). In the initial 24 hours, both monitoring techniques identified the same number of paroxysmal A-fib in 7 out of 39 patients. After 24 hours of monitoring, during the additional 48-hour assessment using the patch-type ECG device, an increase in A-fib burden (9%→38%) was observed in 1 patient. Most patients reported no significant discomfort while using the MobiCARE device. Conclusion: In patients who underwent cardiac surgery, the mobiCARE device demonstrated diagnostic accuracy comparable to that of the conventional Holter monitoring system.

• Journal of Chest Surgery
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• 제46권2호
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• pp.162-163
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• 2013

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 1993년도 제2차 춘계 심포지움
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• pp.6-6
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• 1993

• 한국어병학회지
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• 제4권1호
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• pp.49-57
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• 1991