• Journal of Chest Surgery
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• 제37권12호
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• pp.1019-1021
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• 2004

신경종은 후종격동 종양의 흔한 형태이며 주로 증상 없이 단순흉부촬영상 우연히 발견되거나 흉통이나 요통 등의 신경압박증상이나 기관지를 압박하여 나타나는 증상 등에 의해 발현되기 쉽다. 하지만 본 증례와 같이 자발성 혈흉을 일으키는 경우는 극히 드물다. 환자는 45세 남자로 갑자기 생긴 흉통 및 호흡곤란을 증상으로 타 병원 응급실 내원하여 시행한 단순흉부촬영상 우측 늑막삼출이 의심되어 폐쇄성 흉관삽입술 후 혈흉으로 진단되었고 흉부 전산화단층촬영상 후종격동 종양 소견 보여 본원으로 전원되었다. 전원 후 시행한 흉추 자기공명영상촬영상 아령모양의 신경종 의심되어 수술적 절제를 시행하였고 병리조직검사상 신경섬유초종으로 판명되었다.

• Journal of Chest Surgery
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• 제47권4호
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• pp.406-408
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• 2014

A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

• Journal of Chest Surgery
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• 제24권11호
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• pp.1115-1124
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• 1991

Recently the thoracic injuries have been markedly increasing due to the vast increase of traffic accident, industrial disaster, and incidental accident as well as the frequent use of the murderous weapons including gun or rifle. Because the thoracic injuries could involve the heart, lung, and great vessels, and would influence the lives, prompt diagnosis and adequate treatment are essential. Most of thoracic injuries can be managed with the conservative treatment and simple surgical procedure such as closed thoracostomy, but certain cases require open thoracotomy to preserve lives and to return to their normal environment. The authors have analysed the result of 53 cases of open thoracotomy after thoracic injuries mainly according to the patient`s chart review. The mean age was 33.4 years old and male to female ratio was about 5: l. Injury mechanisms that elicited thoracic trauma indicated for open thoracotomy were penetrating[47%] and non-penetrating[53%] injuries. The Most common type of the thoracic lesion was hemothorax with or without pneumothorax and diaphragm rupture was the second. 58\ulcornero of thoracic injuries were accompanied by abdominal injuries and 47% by bone fractures. 34 patients were operated within 24 hours after injury and their average elapsed time was 13.6 hour. The remained patients were operated after 24 hours and their average elapsed time was 7.8 days. 71 cases of operative procedures containing some overlappings were performed: diaphragm repair[28], bleeding control[12], pulmonary and cardiac repair[4 cases] Postoperative complication rate was 32.1% and operative mortality rate was 9.4%[5/53].

• Journal of Chest Surgery
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• 제10권2호
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• pp.214-218
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• 1977

There appears to be significant problems remained in the treatment of thoracic empyema inspire of the more potent broad spectrum antimicrobial agents available and improved surgical managements. Clinical analysis of 60 patients of thoracic empyema was done who received major and/or minor surgical intervention at the Dept. of Thoracic and Cardiovascular Surgery, Korea University Hospital in the period of 3 years from May 1973 to July 1976. Following was the results: 1. Male was predominent to female with the ratio of 2.16 to 1, and adult to infant was 2.75: 1. 2. Most frequent predisposing factors of thoracic empyema in infancy and childhood was pneumonia [38.3%], and in adult was pulmonary tuberculosis [36.7%]. 3. Cardinal symptoms were dyspnea, fever, chest pain and productive cough etc. 4. Positive result of bacteriological culture study was reported in 26. 7%, and among them, Staph. aureus [10%], Diplo. pneumonia [3.3%], Streptococcal group [1.7%], Pseu. aeruginosa [1.7%], Paracolon bacilli [1.7%] and others [8.3%] in respectively. No growth of pathologic organism was reported in 60.0%, and not requested in 13.3%. Among the negative group, tuberculosis was confirmed on pathological tissue slide in half and other half was not determined bacteriologically and pathologically. 5. Surgical treatment was performed to the almost all of the patients with closed thoracostomy [48.3%], empyemectomy [28.3%], empyemectomy with pulmonary resection [11.7%] and others [I1.6%] in respectively with favorable results. 6. Mortality rate was 8.3% [5 cases], each one with lung cancer, diabetes mellitus, respiratory insufficiency, sepsis and another, two months old infant with asphyxia.

• Journal of Chest Surgery
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• 제23권1호
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• pp.115-121
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• 1990

We have experienced twenty-eight patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Seoul National University Hospital during the period from Jan. 1957 to Jun. 1989. The ratio between male and female patients was 17:11, and their age ranged from 2 years to 61 years old. [average: 30.4 years old] The cause of esophageal perforation were instrumental trauma in 9 cases, caustic perforation in 6 cases, spontaneous perforation in 6 cases, surgical trauma in 2 cases, and others in 5 cases. The most frequent location of perforation was in the lower third portion of the esophagus [13 case, 46 %]. Patients complained of chest pain [86 %], dyspnea [57 %], fever [57 %], subcutaneous emphysema [43 %], and others. The frequent complications of esophageal perforation were empyema [13 cases, 46 %] and mediastinitis [11 cases, 39 %]. The first treatment was supportive care in 3 cases, primary closure and reinforced procedures in 13 cases with 3 deaths, open drainage in 5 cases with 2 deaths, diversion in 4 cases with 2 deaths and closed thoracostomy drainage in 3 cases. After the first treatment, 6 patients received multi-staged operations for several months. Overall mortality was 25 %, and the most frequent cause of death was sepsis[57 %]. We thought that factors affecting the outcome of esophageal perforation are;[1] early diagnosis and adequacy in the first treatment, [2] intensive perioperative management including multi-stage surgical approach, [3] patient`s condition at the diagnosis

• Journal of Trauma and Injury
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• 제24권1호
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• pp.7-11
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• 2011

Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

• Journal of Chest Surgery
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• 제17권4호
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• pp.729-734
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• 1984

Bochdalek hernia is a type of congenital diaphragmatic defect in the posterolateral portion of the diaphragm. The defect is usually Lt. sided due to protective effect of liver on right. Sex distribution is male preponderance [2:1] and it is diagnosed during neonate, mostly first 24 hours, due to severe respiratory distress. We experienced a rare case of old aged female patient with congenital Bochdalek hernia on Rt. side which was found incidentally during treatment of spontaneous pneumothorax of Rt. side. 17 year old female patient was admitted to CS department for chest discomfort on right and mild dyspnea with duration of 20 days. Under the diagnosis of spontaneous pneumothorax, Rt. closed thoracostomy and underwater sealed drainage with continuous suction was applied. On follow-up chest x-ray, poorly defined hazy increased density with multiple air-fluid levels in Rt. lower lung field and Lt. subphrenic free air were noted. So, Barium enema was done under the impression of Rt. diaphragmatic hernia, and nearly entire colon proximal to sigmoid was demonstrated in the Rt. hemithorax. Operation was done-for surgical repair of defected diaphragm through Rt. posterolateral thoracotomy. Operative findings were as follows; 1.Hypoplastic Rt. lung, esp. RML & RLL. 2.Nearly entirely intestines were herniated. 3.Diaphragmatic defect was located on posterolateral portion of the diaphragm, about 10x3cm in size with blunt smooth margin. 4.A large bleb on apex of RUL of lung. Herniated intestines were repaired into abdominal cavity manually and defect of diaphragm was repaired with No. I black silk interrupted sutures directly, and bleb was resected. Postoperative courses were uneventful and the patient was discharged with good condition on POD 14th.

• Journal of Chest Surgery
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• 제20권4호
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• pp.715-722
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• 1987

A clinical analysis was performed on 823 cases of the chest trauma experienced at department of thoracic & cardiovascular surgery, Kyung Hee University Hospital during the past 8 years from Jan, 1978 to Aug. 1986. 1. the ratio of male to female patient of the chest trauma was 3:1 in male predominance. 2. The common age groups were 3rd, 4th and 5th decades. 3. The most common causes of the chest trauma was traffic accidents [79.8%] were injured due to non-penetrating injuries and the remainders [166/823, 20.2%] were injured due to penetrating injuries 4. The frequently injured site of the chest trauma was left side of the chest [46%], and the right side was 42% 5. The most common injury from non-penetrating trauma was rib fracture [77.5%], and the incidence rate of flail chest was 59% of all cases of rib fractures. 6. The incidence rate of hemopneumothorax was 42.9% in non-penetrating traumas, and 84.3% in penetrating traumas. 7. The most common method of surgical treatment was closed tube thoracostomy [37.3%], and open thoracotomy was performed in 71 cases [8.6%]. 8. the overall mortality was 2.2%, and common causes of death were cerebral damage, respiratory insufficiency, and hypovolemic shock.

• Journal of Chest Surgery
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• 제21권3호
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• pp.447-453
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• 1988

Intrapleural instillation of tetracycline as a preventive measure against recurrence in spontaneous pneumothorax was performed at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for 3 years from Jul. 1984 to Aug. 1987. In this period, 124[70.0%] out of 177 patients of spontaneous pneumothorax who received closed thoracostomy were followed up. Tetracycline pleurodesis was applied to 32 cases. The recurrence rate of the tetracycline instillation group was lower than that of noninstillation group. In patients with first attack, the recurrence rate was 12.5% in the instillation group and 35.3% in the noninstillation group. In the second episodes, 25.6% and 83.3%[p< 0.01], in the third episodes 25.0%, 100.0%[p< 0.05]. In total cases, 18.8% and 39.8%[p< 0.05] of recurrence rates were observed. Systemic or local reactions such as fever, chest pain, and pleural effusion were observed in 23 patients[71.9%] after instillation, but all were transient and benign without sequelae. In cases of systemic or local reactions the recurrence rate was lower than that with no reactions but with no statistical significance. In the four patients primarily treated with tetracycline pleurodesis who then underwent thoracotomy, mild alterations were shown in the pleurae except dense adhesions at the previous thoracotomy sites. There was no significant difference between the two groups in terms of durations of hospitalization and post-treatment recurrences.

• Tuberculosis and Respiratory Diseases
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• 제57권3호
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• pp.289-291
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• 2004

Malignant melanoma develops from melanocytes and frequently metastases to other organs. Common metastatic sites are other skin, lymph nodes, lung, liver, brain and bone in decreasing order of frequency. Malignant pleural effusion is less frequent manifestation of thoracic metastasis. We experienced a 57-year-old man with pleural effusion who received radical resection with local flap on left foot due to acral lentiginous melanoma 3 years ago. He had progressive chest pain and left massive pleural effusion. The pleural cytology and biopsy showed malignant melanoma. After closed thoracostomy and talc pleurodesis, he refused further immunotherapy and chemotherapy and discharged.