• Tuberculosis and Respiratory Diseases
• /
• 제65권2호
• /
• pp.142-146
• /
• 2008

소세포폐암은 비교적 초기 항암치료에 대한 반응이 우수하지만 빠르게 진행하는 것으로 알려져 있다. Topotecan은 topoisomerase I inhibitor로 소세포폐암에서 이차치료제로 사용된다. Topotecan의 흔한 부작용으로는 빈혈, 혈소판감소증, 호중구감소증과 같은 혈액학적 부작용이 있으나, topotecan에 의한 폐독성은 잘 알려져 있지 않다. 저자들은 일차치료에 불응하여 이차치료제로 topotecan을 투여 받던 소세포폐암 환자에서 3주기 topotecan 투약중에 발생한 급성호흡곤란증후군을 경험하여 보고한다. 환자는 호흡곤란을 호소하면서 호흡부전에 빠졌으며, 흉부전산화단층촬영에서 약제에 의한 폐손상을 시사하는 미만성 간유리음영을 보였다. 환자는 급성호흡곤란증후군으로 사망하였다.

• Journal of Chest Surgery
• /
• 제27권11호
• /
• pp.965-969
• /
• 1994

Infantile lobar emphysema is a pulmonary hyperinflation state that has the clinical features of an air block syndrome characterized by bronchial cartilaginous abnormalities or unknown origin. Left upper lobe was affected in most of the reported infantile lobar emphysema. Infantile lobar emphyema is divided into two categories. e.g., congenital and acquired. We have experienced a case of left lower lobe involved infantile lobar emphysema which had undergone left pneumonectomy. She had progressive signs of tension accompanied by mediastinal displacement, ventilatory and circulatory failure in infant period. Because of the combined left upper lobe hypoplasia, left pneumonectomy was performed. And there was no cartiliginous abnormality in pathologic finding. This is the first domestic case which was affected in the lower lobe and successful surgical repaired.

• Journal of Chest Surgery
• /
• 제20권1호
• /
• pp.139-147
• /
• 1987

in general rapid and complete resolution of pulmonary emboli, even massive, is the natural history. However, rarely, the emboli do not resolve but rather became fibrotic organization and densely adherent to the arterial wall, therefore, may lead to significant clinical disability. In patients with chronic pulmonary embolism, medical management usually has little effect and only surgical treatment can offer improvement. The case was 30-year-old man who had admission to the Hanyang University Hospital due to fall-down from 11th floor 407 days before operation and then transferred to our department for surgical management under the diagnosis of chronic pulmonary embolism, Pulmonary angiogram demonstrated multifocal thromboembolism with infarction and lung scans showed no improvement in spite of anticoagulant and thrombolytic therapy. At median sternotomy for pulmonary artery thromboembolectomy, the well organized and multiple septic emboli could be removed by gallstone forceps. But reoperation of left upper lobectomy was performed because of the repeated hemoptysis and suspicious pulmonary arterio-bronchial fistula 19 days postoperatively. Despite of ventilatory support and drug treatment, the patient died due to right heart failure associated with cor pulmonale 27 days after first operation. Discussion of the operative and perioperative problems are offered.

• Journal of Chest Surgery
• /
• 제38권9호
• /
• pp.656-659
• /
• 2005

뮤코르진균증은 비교적 드문 질환으로 면역이 저하된 환자에게 있어서 치명적인 기회감염을 일으킨다. 감염은 주로 혈액암, 만성 신부전, 당뇨 환자나 장기이식을 받은 환자에게 일어난다. 저자들은 조절되지 않은 당뇨를 동반한 신장이식을 받은 환자에서 발생한 폐뮤코르진균증을 암포테리신과 함께 수술적 절제를 통해 성공적으로 치료하였다.

• Journal of Chest Surgery
• /
• 제26권5호
• /
• pp.384-389
• /
• 1993

A clinical analysis of pleural effusion was done on 100 patients who were between 5 and 67 years old. The etiologic diagnosis of pleural effusion at the time of discharge were pulmonary tuberculosis in 38 cases[38%],pneumonia in 20 cases[20%],lung carcinoma in 16 cases[16%],liver cirrosis in 9 cases[9%],congestive heart failure in 4 cases[4%],nephrosis in 3 cases[3%],Meig,s syndrom in 3 cases[3%].liver abscess 2 cases[2%],pancreatitis in 1 cases[1%] and other metastatic malignancy in 4 cases[4%]. Their chief complaints was chest pain in 89 cases[89%],dyspnea in 74 cases[74%],coughing in 46 cases[46%], fever in 13 cases[13%],weakness in 12 cases[12%] and dizziness in 11 cases[11%].

• Journal of Chest Surgery
• /
• 제20권4호
• /
• pp.780-785
• /
• 1987

Pulmonary atresia with VSD is uncommon congenital anomaly with high mortality in neonatal period. Recently we experienced surgical correction of 2 cases of pulmonary atresia with VSD. The first case was 7-year old female patient and diagnosed as pulmonary atresia with VSD combined PDA. So, total correction was undertaken which consisted of PDA ligation, patch repair of VSD, transannular enlargement of RVOT with woven Dacron vascular graft, and closure of PFO. Postoperative systemic Rt. ventricular and radial artery pressure ratio was 0.44 and her postoperative course was uneventful. The second case was 6-year old male patient diagnosed as pulmonary atresia with VSD and large systemic-pulmonary collateral arteries. There were two large systemic-pulmonary collaterals, one was simply controlled by ligation, but the other was considered to supply Rt. upper lung. So end to side anastomosis was performed to the RVOT patch. Postoperative systolic Rt. ventricular and radial artery pressure ratio was 0.54. During the follow up period he showed clinical picture of Rt. heart failure, which is relatively well controlled with anticongestive therapy.

• Journal of Chest Surgery
• /
• 제28권5호
• /
• pp.487-490
• /
• 1995

We have experienced the 37 patients of pericardial effusion during last 8 years[1986-1993 . They were 17 male and 20 female patients, and their age range was 6months to 80 years.The causes of this pericardial effusion were 10 cases of tuberculosis, 7 cases of malignancy, 2 cases of acute pyogenic infection, 2 cases of postpericardiotomy pericardial effusion, 2 cases of trauma, 1 case of congenital heart disease, 1 case of SLE, and other 12 cases of unknown origin. All patients, except one, were managed by pericardiotomy with subxiphoid tube drainage. One case was managed by pericardiectomy. After operation, their symptoms and sign were dramaticaly improved. However, 3 patients were died postoperatively. Two of them were died of respiratory failure. One of them was died 28 months later with unrelated cause. They have already far advanced lung cancer. We conclude that the pericardiotomy with subxiphoid tube drainage was effective treatment in the patients with pericardial effusion.

• Journal of Chest Surgery
• /
• 제23권5호
• /
• pp.987-993
• /
• 1990

An unusual but often lethal complication of mitral valve replacement is rupture of the left ventricle. From March 1977 through June 1990, 424 mitral valve replacements were performed as isolated or combined procedures. Rupture of the posterior wall of the left ventricle was observed in 3 patients. Their was one type I and two type II rupture. Once the diagnosis was made, all of the patient were connected to the heart-lung machine again and total cardiopulmonary bypass is re-established. Repair was attempted in all of them from the outside of the heart. One of them was successively repaired but two were failed due to myocardial ischemia by circumflex coronary artery injury and failure of adequate closure of the ruptured site. From this results, we concluded that prevention is the best solution. But if we encountered this condition, early diagnosis and rapid treatment may improve the patient`s chances for survival.

• The Korean Journal of Pain
• /
• 제9권1호
• /
• pp.206-209
• /
• 1996

Thoracic sympathetic nerve block has a wide range of therapeutic applications which clinicians utilize neurolytics or perform operative sympathectomy. All methods have advantages and disadvantages. We performed "thoracic sympathetic ganglion cauterization" using resectoscope as it is less invasive and more effective than traditional operative methods. Successful procedures were performed involving 2 cases of idiopathic hyperhidrosis and 1 case of sympathetically maintained pain on chest and upper extremity. We experienced failure with one case of idiopathic hyperhidrosis due to severe pleural adhesion. There was also a case of complication of periganglional hemorrhage and parenchymal lung perforation which we successfully treated.

• Journal of Chest Surgery
• /
• 제22권2호
• /
• pp.297-304
• /
• 1989

A 45-year old woman with congestive heart failure due to left atrial tumor was operated on. Three tumor masses arising from posterior wall, atrial septum, anterior portion of mitral valve were resected. Pathological diagnosis was malignant fibrous histiocytoma [MFH]. Above one case and sixteen previous reports are reviewed. Eleven cases out of 17 were females. The tumors all originated primarily in the left atrium and 8 had distant metastases. The metastatic sites are lung [4 cases], brain [2 cases], liver, jejunum, cervix and pleura etc. Careful pathologic study is necessary to differentiate the uniformly fatal MFH of the heart from the more common benign atrial myxoma. The treatment modalities are surgical resection, chemotherapy, and radiation therapy & the prognosis of intracardiac MFH is poor. We underwent partial resection of left atrial MFH and obtained symptom relief and patient still alive 7 months post-operatively in state of NYHA class II.