• Journal of Chest Surgery
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• v.9 no.2
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• pp.251-264
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• 1976

Forty three patients with disease of the aorta were admitted in this department during the period from beginning of 1956 to the end of 1976. They consisted of eighteen cases of aortic aneurysms, eight cases of Takayasu's arteritis, eight Leriche syndromes, six dissecting aneurysms, two aortic coarctations and one case of vascular ring. Of eighteen aortic aneurysms, twelve were operated resulting in eight survivors. Three of four mortalities were in shock preoperatively because of aneurysmal rupture. Among six dissecting aortic aneurysms, four were type III and two were type I according to DeBakey's classification. For the purpose of relief of acute arterial insufficiency in the lower extremities, a re-entry operation grafting a Y-shaped dacron vessel between abdominal aorta and common iliac arteries was performed. The patient regained consciousness soon after the operation and was well until postoperative second day, when severe convulsion developed abruptly and died. And in a chronic case of type III dissecting aneurysm, a dacron graft bypass shunt between ascending aorta and lower descending thoracic aorta with resection of the aneurysm was performed, but acute severe aortic insufficiency developed soon after the operation and fell into intractable heart failure resulting in death. The cause of the aortic insufficiency seems to be retrograde dissection from the proximal anastomosis site in the ascending aorta. Three cases were treated medically with Wheat's regimen. Two of them survived with relief of symptoms. Eight patients of Takayasu's arteritis were all females and aged between twenty and forty-four averaging twenty nine. Bypass graft operation between aortic arch and carotid arteries using Y-shaped nylon prostheses were performed in three patients resulting in death in two cases postoperatively due to severe cerebral arterial insufficiency during the procedure. All the patients with Leriche syndrome were males and over forty. In two cases, bypass graft with Y-shaped dacron vessel between terminal aorta and common iliac or femoral arteries were performed with good result. Thromboembolectomy or thromboendarterectomy was employed in three patients, of whom one was aggravated in sexual problem postoperatively. One out of two aortic coarctations and a vascular ring were treated surgically with excellent results.

• Journal of Chest Surgery
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• v.8 no.2
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• pp.159-168
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• 1975

We have experienced 61 cases of Clinically diagnosed tuberculous peripleural abscess which was surgically treated at St. Mary's Hospital of Catholic Medical College from Mar. 1963 to Feb. 1974. Out of them, 52 cases of pathologically confirmed tuberculous peripleural abscess were reviewed and its pathogenesis, treatment and so called "rib caries" were discussed. In the past, they have been described as a variety of the names, such as rib caries, cold abscess of the chest wall, pericostal abscess, lymphadenitis tuberculosa of the chest wall, chronic draining sinuses of the chest wall and other descriptive terms. Although it has been said that the tuberculous abscess on the chest wall developed as a secondary disease from so called "rib caries" but now it has been clear that this abscess occurred not from tuberculosis of the rib but from tuberculous lesion developed between end-othoracic fascia and parietal pleura usually following pulmonary tuberculosis and/or tuberculous pleurisy and the involvement of rib or ribs are secondary one from peripleural abscess, as we confirmed. Therefore we advocate that the nomination, rib caries, should not be used unless there is a primary tuberculous lesion on ribs. The results were as follows: 1. The highest age group of tuberculous peripleural abscess was ranged from the first to third decade (78%) 2. The location of tuberculous peripleural abscess on the chest wall were as follows, 31 cases on the anterior, 19 cases on lateral and 2 cases on the posterior. 3. On x-ray examination, abnormal findings including parenchymal tuberculous lesion and pleural changes were seen is 38 cases. 4. There was no destructive change of periosteum and rib in 23 cases of tuberculous peripleural abseess during operation. However the periosteal denudation and/or rib destruction were found in 29 cases. 5. The all cases of tuberculous peri pleural abscess developed from between endothoraclc fascia and parietal pleura, as we confirmed. With antituberculous therapy, operation should be radical by wide incision on the lesion including thorough curettage with proper drainage of Iiquified caseating materials and appropriate rib resection, if necessary.tion, if necessary.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.686-689
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• 1999

Descending necrotizing mediastinitis(DNM) is a rare complication of the oropharyngeal and cervical infection. Descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. A 39-year-old man complained of odynophagia, neck swelling, and disturbance of swallowing with dyspnea. CT scans of the neck suggested a peritonsillar abscess and retropharyngeal and peripharyngeal abscess. He underwent cervical drainage. He remained febrile and complained of severe both pain in both shoulders. On postoperative day 5, a follow-up CT scan confirmed a mediastinal abscess. Reexploration of the neck and right thoracotomy for debridement and drainage of the mediastinal abscess were performed.. A large amount of pus was drained from the anterior and posterior mediastinum and its necrotic tissue was debrided. The patient's condition and radiologic findings gradually improved. Cultures of the drain fluid revealed Klebsiella pneumoniae. He was discharged on the 85th hospital day. In our experience, both transcervical drainage and aggressive mediastinal exploration via thoracotomy can lead to an improvement in the survival of the patient with descending necrotizing mediastinitis. CT scanning is useful for early diagnosis of mediastinitis and for follow up.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.979-984
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• 2003

Primary pulmonary artery sarcoma is very rare disease. The diagnosis of pulmonary artery sarcoma is frequently confused with pulmonary embolism because its clinical symptom and radiologic findings are similar with pulmonary embolism. It was often diagnosed at autopsy as it progresses rapidly. So Pulmonary artery sarcoma must be suspected if the origin of thrombus is not known and anticoagulation therapy is not effective. In this case, a 57 years old man who has been diagnosed pulmonary embolism was transferred to our department because of ineffective anticoagulant therapy and its worsening lesion despite of 5 month-therapy. In operative findings, it was pulmonary artery sarcoma that invaded to pericardium. There was angiosarcoma in right pulmonary artery, which metastasized to lung parenchyme. Under cardiopulmonary bypass, we resected main pulmonary artery and right lung. The Gore-tex graft was interposed between main pulmonary artery and left pulmonary artery. He was discharged after chemotherapy.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.796-799
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• 2004

A 52 day-old male infant who had Taussig-Bing anomaly with coarctation of the aorta underwent initial palliative Damus-Kaye-Stansel (DKS) procedure including arch reconstruction because of suspected intramural coronary artery, size discrepancy of great arteries, potential subaortic stenosis, refractory pneumonia, and severe congestive heart failure. Total repair was done 44 months later, which was composed of VSD patch closure, DKS take-down, and arterial switch procedure, We report a successful case of DKS take-down and arterial switch operation for the reuse of native aortic and pulmonary valves rather than Rastelli-type procedure in a patient with Taussig-Bing anomaly having palliative DKS procedure.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.112-119
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• 2015

Background: Pectus excavatum (PE) is the most common chest wall deformity. The Nuss Questionnaire modified for Adults (NQmA) is a disease-specific health-related quality of life assessment tool for patients with pectus deformities. The aim of this study is to adapt the NQmA into Turkish. Methods: Two hundred and sixty-five patients with PE were participated, with an age range of 14 to 29 years. All patients underwent a physical examination and had not undergone corrective surgery. The Turkish version of the NQmA was completed by patients and their parents. Results: The content validity index based on expert opinions was 91% for the patient questionnaire and 96% for the parent questionnaire. The Cronbach's alpha value for the NQmA was found to be 0.805 for the patient questionnaire and 0.800 for the parent questionnaire. Exploratory factor analysis was used to assess construct validity. Two factors explained 51.1% of the total variance in the patient questionnaire (psychosocial: 31.145%, Cronbach's alpha=0.818; physical: 19.955%, Cronbach's alpha=0.862). In the parent questionnaire, two factors explained 51.422% of the total variance (psychosocial: 26.097%, Cronbach's alpha=0.743; physical: 25.325%, Cronbach's alpha=0.827). Construct validity was confirmed by confirmatory factor analysis. Conclusion: The Turkish version of the NQmA was found to be valid and reliable for the assessment of quality of life in patients with PE.

• Biomedical Science Letters
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• v.9 no.4
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• pp.215-222
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• 2003

As the obesity has been known to be related with the hyperlipidemia, cardiovascular disease, cerebral apoplexy, fatty liver, and other chronic diseases, recent researches have focused on the functional food materials and their anti-obesity activities. This study was performed to study the effects of vanilloid family capsaicin, major pungent ingredient of hot chillies and peppers, on anti-obesity activities. ICR male mice were fed one of the pellet diet, basal diet, and high fat diet with capsaicin (45 $\mu\textrm{g}$/day) solution for 5 days. Mice in the corresponding control groups were given water for 5 days. In results, capsaicin reduced body weights in any diet groups. Percent weight and cell size of the abdominal white adipose tissue in mice on the high fat diet with capcaicin were significantly lower compared with those in mice on the high fat diet with water. However, percent brown adipose tissue weight per body weight in mice on the high fat diet was not affected by capsaicin. Capsaicin reduced the levels of s-triglyceride and s-total cholesterol in the pellet diet or high fat diet groups. There was no difference in the s-protein levels between the capsaicin group and the control water group. These data indicate that 1) orally administered capsaicin has a reducing effect on the blood triglyceride and total cholesterol levels, and 2) capsaicin has lowering effects on the body weight, percent weight and cell size of the abdominal white adipose tissue.

• Journal of Chest Surgery
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• v.33 no.11
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• pp.881-885
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• 2000

배경: 승모판막 질환에 동반된 심방세동의 경우 그 기간이 길면 승모판막 질환을 수술하여도 동성 율동으로 전환될 가능성이 매우 적다. 본 연구는 승모판막 질환에 동반된 심방세동에 대한 변형 Maze 수술후 장기 결과와 심방세도의 재발에 미치는 요인을 조사 하고자 하였다. 대상 및 방법: 1990년부터 1996년까지 승모판막 질환과 동반된 심방세동으로 외과적 요법을 시행받은 35명의 환자를 대상으로 하였다. 심방세동의 평균 유병기간은 평균 7.7$\pm$4.5년이었고 수술은 승모판막 대치술 34례(재수술 3례)와 승모판막 성형술 1례를 시행하였고 승모판 질환 수술 외에 동반 수술로는 삼첨판륜 성형술 4례, 삼첨판막 대치술 3례 였다. 심 방세동에 대한 수술은 좌측 폐정맥 부위는 격리하지 않는 변형 Maze 수술을 시행하였다. 수술 후 동성 율동으로 회복여부, 심방세동의 재발에 미치는 요인과 장기 결과를 분석하였다. 결과: 수술 직후 2례를 제외한 33례(93.9%)에서 동성율동으로 돌아왔으나 수술 후 퇴원 전에 12례에서 심방세동이 재발되었다. 수술환자중 1례에서 수술 후 3일에 동성 정지에 따른 심정지가 발생하여 소생되었으나 뇌손상으로 수술 후 15일에 사망하였다. 심방세동이 재발된 경우 수술 후 약 2개월에서 6개월 사이에 항부정맥 약물(mquinidine)과 전기적 제세동으로 치료하여 12례중 10례에서 동성 율동으로 돌아온 환자는 항부정맥 약물을 모두 중단하 였으며, 수술 후 3년에서 9년(평균 71.1$\pm$17.5개월) 추적 관찰 중 9례에서 심방세동이 재발되어 장기간 동성 율동이 유지된 환자는 34명중 25명으로 73.5%이었다. 승모판 질환이 있던 환자에서 수술 후 심방세동의 재발에 미치는 요인들을 조사한 결과 수술전 심방세동의 기간(동성율동 유지군 : 재발군=6.3년 : 10.3년, P=0.008)과 수술 전 단순 흉부 X선상 심흉비율(0.58 : 0.72, p=0.009)은 통계학적으로 유의하게 나타났으나 심초음파 검사상 좌심방의 직경(57.2mm : 77.4mm, p=0.106)은 통계학적 유의성이 없었다. 결론: 심방세동이 있는 환자에서 동반 질환 수술시 병행하여 수술한다면 정상 동성 율동으로 회복될 기회를 증가시킬 수 있는 유용한 수술법으로 생각된다. 그러나 수술후 재발률을 감소시키기 위하여 적절한 술기의 변형에 대한 연구와 약물요법의 병행을 고려하여야 할 것으로 사료된다.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.963-966
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• 1995

Ischemia reperfusion injury occurs in various diseases. The role of oxygen free radicals in IR injury of the lung has been spotlighted and many studies have been performed. In this study, we tried to prepare a stable rat lung model for IR injury, focusing on surrounding conditions as hilar stripped left lung, clamped left pulmonary artery and bronchus,and declamped after determined period was passed, and right main pulmonary aretery was clamped. Arterial blood gas analyes were performed at 1, 10, 20, 30, minutes after reperfusion. Before clamping, PaO2 was 95 to 120 mmHg in all animals. There were six groups; Group I : temperature 15o C, and 120 minutes clamping, Group II: 20 oC, and 120 minutes clamping, Group III : 25 oC, and 120 minutes clamping, Group IV : 15oC, 90 minutes clamping, Group V : 20 oC, 90 minutes clamping,Group VI: 20 oC, 75 minutes clamping. Each groups contained 10 Sprague Dayley rats. The humidity was maintained 100 % as circulation imerged isotonic Hartmann`s solution of the pleural cavity. In group IV, V, and VI, PaO2 decreased significantly in all animals immediately after reperfusion, but 43 % survived till 10 minutes after reperfusion, it was 74.0$\pm$5.7, 73.3$\pm$10.8,and 88.2$\pm$17.7 mmHg. Pulmonary edema was observed histologically in 2/10 animals in group IV, 6/10 in group V , 3/10 in group VI, 9/10 in group I, and the other lungs showed all edema. We established a stable model by setting ischemic time,and temperature, between 75 to 90 minutes,15 to 20o C, and isotemperature Hartmann`s solution immersion of the pleural cavity.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.905-909
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• 1996

From 1991 to 1994, We performed 75 cases of pulmonary resection. These were divided into two groups according to the method of bronchial stump closure : 51 cases automatic staplers were a plied in 49 patients (Group 1), 24 patients were closed with manual interrupted suture (Group II). Disease entities of the patients were malignant tumor in 33 patients(Group I: Group II, 22· II, bronchiectasis in 23(18:5), benign tumor in 5(3:2), aspergilloma in 5(2:3), tuberculosis(2:1) in 3, bronchogenic cyst in 2 (0 : 2) and so on. Surgical Procedure% for these Patients were 21 Pneumonectomies(18:3), 13 bilobectomies(11:2), 26 lobectomles (14:12), 11 segmentectomies (6:5) and 4 lobectomy with segmentectomies (4:0). In conclusion, the Amount of tube drainage was smaller and the removal of chest tube after surgery was shorter than manual bronchial closure group by means of statistical significance (p=0.047, p=0.005). Although there were no statistical significance, the duration of air leakage was reduced and incidence of bronchopleural rstula was reduced in the stapler used group compared with manual bronchial closure.