• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3079-3083
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• 2013

Objective: To investigate the effects of endostar, a recombined humanized endostatin, plus cisplatin on the growth, lymphangiogenesis and lymphatic metastasis of the Lewis lung carcinoma (LLC) in mice. Methods: A tumor model were established in C57BL/6 mice by intravenious transplantation of LLC cells. Then the mice were randomized to receive administration with NS, endostar, cisplatin, or endostar plus cisplatin. After the mice were sacrificed, tumor multiplicity, tumor size and lymph node metastasis were assessed. Then the expression of vascular endothelial growth factor-c (VEGF-C) and podoplanin were determined by immunohistochemical staining. Results: Endostar plus cisplatin significantly suppressed tumor growth. lymphatic metastasis and prolonged survival time of the mice without obvious toxicity. The inhibition of lymphatic metastasis was associated with decreased microlymphatic vessel density (MLVD) and expression of VEGF-C. Conclusions: Endostar combined with cisplatin was more effective to suppress tumor growth and lymphatic metastasis than either agent alone. Thus this may provide a rational alternative for lung carcinoma treatment.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.771-779
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• 1985

It has been recognized that the proper matching of ventilation and perfusion within the lung is essential for the efficient exchange of gases following open heart surgery. Physiologic shunt reflects the amount of blood going to lung units with inadequate ventilation and these are also areas of the lung with adequate ventilation but inadequate blood flow. This can be quantified by measuring physiological dead space. From January to August 1985, The physiologic dead space and shunt during postoperative course had been taken in 30 patients of open heart surgery in Soonchunhyang University Hospital. Twenty cases had congenital heart disease and acquired valvular heart disease were noticed in 10 cases. The physiological dead space and shunt during postoperative periods were calculated and we made 5 items of conclusion: 1. There is high probability of ventilation-perfusion mismatch in the acquired heart disease group compared to the congenital group. 2. Duration of the CPB can exert significant influences in the physiological dead space but less in the shunt fraction. 3. There is positive relationship between Qs/Qt and Vd/Vt in the group B [CPB>90 min.] but less reliable in correlation. 4. Perfusion impairment is more significant in the diminished pulmonic blood flow group compared to the increased pulmonic blood flow [Qp/Qs>2.0] group. 5. There is no significant ventilation-perfusion mismatch within the lung during all postoperative courses.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.325-331
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• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.157-164
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• 2016

Background: Heart-lung transplantation (HLT) has provided hope to patients with end-stage lung disease and irreversible heart dysfunction. We reviewed the clinical outcomes of 10 patients who underwent heart-lung transplantation at Asan Medical Center. Methods: Between July 2010 and August 2014, a total of 11 patients underwent HLT at Asan Medical Center. After excluding one patient who underwent concomitant liver transplantation, 10 patients were enrolled in our study. We reviewed the demographics of the donors and the recipients' baseline information, survival rate, cause of death, and postoperative complications. All patients underwent follow-up, with a mean duration of $26.1{\pm}16.7months$. Results: Early death occurred in two patients (20%) due to septic shock. Late death occurred in three patients (38%) due to bronchiolitis obliterans (n=2) and septic shock (n=1), although these patients survived for 22, 28, and 42 months, respectively. The actuarial survival rates at one year, two years, and three years after HLT were 80%, 67%, and 53%, respectively. Conclusion: HLT is a procedure that is rarely performed in Korea, even in medical centers with large heart and lung transplant programs. In order to achieve acceptable clinical outcomes, it is critical to carefully choose the donor and the recipient and to be certain that all aspects of the transplant procedure are planned in advance with the greatest care.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.96-99
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• 2010

Artificial lung support may be necessary in various conditions during the performance of bilateral lung transplantation, and cardiopulmonary bypass (CPB) has usually been used. Yet using the conventional CPB techniques may increase risk of bleeding and early allograft dysfunction due to the large dosages of heparin and the complement activation. Extracorporeal membrane oxygenation (ECMO) is able to support gas exchange and maintain the hemodynamics without administering high-dose heparin for anticoagulation. We performed sequential bilateral lung transplantation with ECMO support. ECMO is a valuable tool when performing lung transplantation and it has the potential to replace CPB.

• Journal of Chest Surgery
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• v.53 no.1
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• pp.22-27
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• 2020

Background: Previous studies have shown that lung cancer stem cells express CD133 and that certain cancer stem cells express cancer germline antigens (CGAs). The transcriptional regulation of CD133 is complicated and poorly understood. We investigated CD133 and CGA expression in a non-small cell lung cancer cell line. Methods: The expression levels of CD133 and CGAs (MAGE-6, GAGE, SSX, and TRAG-3) were measured in an NCI-H292 lung cancer cell line. The methylation status of the CD133 gene promoter region was analyzed. The expression levels and promoter methylation statuses of CD133 and CGAs were confirmed by treatment with the demethylating agent 5-aza-2'-deoxycytidine (ADC). Results: After treatment with ADC, CD133 expression was no longer detected. MAGE-6 and TRAG-3 were detected before ADC treatment, while GAGE and SSX were not detected. ADC treatment upregulated MAGE-6 and TRAG-3 expression, while GAGE expression was still undetected after treatment, and only weak SSX expression was observed. GAGE expression was not correlated with expression of CD133, while the levels of expression of MAGE-6, TRAG-3, and SSX were inversely correlated with CD133 expression. Conclusion: These results showed that CD133 expression can be regulated by methylation. Thus, the demethylation of the CD133 promoter may compromise the treatment of lung cancer by inactivating cancer stem cells and/or activating CGAs.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.705-709
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• 2005

Background: To assess the outcome of pulmonary resection in the management of hemoptysis caused by benign inflammatory lung disease. Material and Method: A longitudinal cohort study of 45 consecutive patients who were presented with hemoptysis and were treated with pulmonary resection from January 1995 to May 2004. The predictive preoperative risk factors of morbidity and recurrence of hemoptysis were analyzed. The mean age of the patients was 47.1 years. The mean follow-up was $35\pm34$ months. Result: The overall hospital mortality rate was $4.4\%(2/45)$. Postoperative complications occurred in 8 patients $(18.6\%)$. Complications were more common in patients who received blood transfusion than non-transfused patients (p=0.002). Patients with tuberculous destroyed lung disease had more amount of preoperative hemoptysis (p=0.002), more probability of transfusion (p=0.001), more probability of undergoing pneumonectomy (p=0.039) and more probability of postoperative morbidity. Patients of undergoing pneumonectomy had more probability of reoperation due to postoperative bleeding (p=0.047). Hemoptysis recurred in five patients but three had been subsided and two sustained during follow-up. A latter two patients had been prescribed with antituberculosis medication due to relapse of tuberculosis. Conclusion: A tuberculous destroyed lung disease has a higher rate of postoperative morbidity than other inflammatory lung diseases. A pneumonectomy in patients of inflammatory lung disease should be performed with great caution especially because of postoperative bleeding. Future study with longer and larger follow-up might show the reasons of recurrence of hemoptysis.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3857-3860
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• 2015

Background: Recent studies revealed a relationship between ground-glass opacity (GGO) ratio on computed tomography (CT) and serum carcinoembryonic antigen (CEA) level in lung adenocarcinoma. Since an association between lepidic histologic pattern and GGO is well accepted, we investigated the link between histologic subtype and serum CEA level in resected lung adenocarcinoma. Materials and Methods: One hundred and eighty-one consecutive patients with resected lung adenocarcinoma were studied retrospectively. The histologic subtype was subdivided into 2 groups: lepidic dominant histologic subtype, including adenocarcinoma in situ, minimally invasive adenocarcinoma and lepidic predominant invasive adenocarcinoma versus other subtypes. Results: The 5-year survival of patients with s high serum CEA level was significantly more unfavorable than that with normal levels. Similarly, there was also a relationship between the patient survival and histologic subtype, with favorable survival found in patients with the lepidic dominant histologic subtype. There was a significant relationship between serum CEA level and lepidic dominant histologic subtype overall and in p-stage I patients. Conclusions: Lung adenocarcinomas with non-lepidic dominant histologic subtype are associated with high serum CEA levels.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.640-645
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• 1990

We have performed four left lung reimplantation and right pulmonary artery ligation in dogs for six months from March 1989 to September 1989 at the Thoracic & Cardiovascular Surgery department, Yonsei University, College of Medicine, Seoul, Korea. Excised left lungs were perfused with 200cc of 4oC cold saline at a pressure of 60cmH2O through left pulmonary artery & preserved in 4 oC cold saline for about 20 mins. Left lung reimplantation were proceeded with inferior pulmonary vein, superior pulmonary vein, left pulmonary artery and left main bronchus in order. The main pulmonary artery pr. were 39/21[31], 22/12[15], 25/9[15] and 54/17[37] mmHg each after right pulmonary artery ligation on left reimplanted dogs, Right pul a. ligations were performed 9 days, 12 days, 16 days and 19 days after left lung reimplantation. Two dogs died at 10 days 21 days, after right pul. a. ligations in left reimplanted dogs. The remaining two dogs were sacrificed at 18 days, 21 days after right pul. a. ligation in left reimplanted dogs. Autopsy findings showed narrowing of left superior pul. vein anastomotic site in two narrowing of left pulmonary artery anastomotic site in one narrowing of left sup. pul vein & pneumonia of left lung in one. In the lung transplantation, it was thought to be important that the anastomosis of pulmonary artery and especially pulmonary vein be done with particular precaution for early and late stenosis.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1180-1184
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• 1992

The use of computed tomography of the chest in mediastinal staging of lung carcinoma lies the premiss that malignant lymph nodes are larger than benign ones. We have studied the size of mediastinal lymph nodes & the malignancy rate in 55 lung carcinomas from March 1990 to July 1992 at the Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Yonsei University College of medicine. The lack of relationship between the size of mediastinal lymph node and the probability of malignancy helps to clarify the limitations of the use of computed tomography in the staging of the mediastinum in lung carcinoma. There was no tendency for all malignant lymph nodes to be larger than benign nodes. To allow comparison with our data, malignancy rates for all lymph nodes larger than 10mm are 24.8% in sensitivity & benign rates for all lymph nodes less than 10mm are 96% in specificity. But all mediastinal lymph nodes larger than 30mm are metastatic lymph nodes in our cases. We are going to try to have thoracotomy for complete resection of lung carcinoma as possible as we can if there no evidence of contralateral mediastinal metastases of lymph nodes, even though there are large mediastinal lymph nodes in lung carcinoma.