• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 2009년도 제51차 학술대회 초록집
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• pp.30-30
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• 2009

• Journal of Chest Surgery
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• 제27권5호
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• pp.374-378
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• 1994

Bronchoplastic and angioplastic operation in lung surgery is appropriate treatment for a wide range of benign endobronchial lesions and low grade malignancies. Between March 1990 to February 1994, four patients underwent bronchial sleeve resection and one patient received left upper lobe lobectomy with pulmonary artery angioplasty. Types of disease includes two cases of endobronchial tuberculosis and three cases of lung cancer. The main operation performed are one pneumonectomy, two right upper lobectomy and one each of left upper lobectomy and left lower lobectomy. All cases received sleeve resection not due to decreased respiratory reserve but due to anatomic suitability. One patient who received pneumonectomy had postoperative complication of empyema thoracis.

• 한국임상수의학회지
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• 제34권2호
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• pp.108-111
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• 2017

A 4-year-old, weighing 7.6 kg, castrated male, Pug presented with ingestion of gastric cavity foreign body. Physical examination revealed panting, retching and hyper-salivation. Blood chemistry and complete blood cell count were normal, but hypophosphatemia was observed. An abdominal radiograph revealed the foreign body (FB), round shape and 2 cm length, at the pyloric region of stomach. A thoracic radiograph revealed an incidental metal FB, 3.5 cm length, at the cranial portion of the diaphragm. An upper gastrointestinal endoscopy was performed to remove the FB in the stomach and then a peach-pit was removed. However the metal FB was not found in the esophagus therefore a lateral thoracotomy was performed. A right lateral thoracotomy through the $7^{th}$ intercostal space was accomplished to expose the right caudal lung lobe. After open the thoracic cavity, foreign body was not observed by gross evaluation and caudal lung lobe was attached to the diaphragm. The FB was identified inside the lung lobe and surrounded by granulation tissue. The metal FB (sewing needle) was removed with blunt dissection and incised lung lobe was sutured using absorbable suture material PDS 4-0 with interrupted suture. A thoracotomy tube was inserted into the thoracic cavity during surgery. Patient's respiration became stable after surgery. A chest tube was removed 3 days after surgery. No complications were noted and the dog was discharged 4 days after surgery. In small animal, foreign body ingestion is a common reason for emergency. After ingestion of the FB, perforation through the esophagus and migration to inside the lung lobe is not common in small animals. In this case, thoracic metal FB was identified incidentally and removal of a thoracic FB with thoracotomy was performed successfully.

• IMMUNE NETWORK
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• 제23권4호
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• pp.34.1-34.15
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• 2023

Lung cancer, particularly non-small cell lung cancer (NSCLC) which contributes more than 80% to totally lung cancer cases, remains the leading cause of cancer death and the 5-year survival is less than 20%. Continuous understanding on the mechanisms underlying the pathogenesis of this disease and identification of biomarkers for therapeutic application and response to treatment will help to improve patient survival. Here we found that a molecule known as DUSP10 (also known as MAPK phosphatase 5) is oncogenic in NSCLC. Overexpression of DUSP10 in NSCLC cells resulted in reduced activation of ERK and JNK, but increased activation of p38, which was associated with increased cellular growth and migration. When inoculated in immunodeficient mice, the DUSP10-overexpression NSCLC cells formed larger tumors compared to control cells. The increased growth of DUSP10-overexpression NSCLC cells was associated with increased expression of tumor-promoting cytokines including IL-6 and TGFβ. Importantly, higher DUSP10 expression was associated with poorer prognosis of NSCLC patients. Therefore, DUSP10 could severe as a biomarker for NSCLC prognosis and could be a target for development of therapeutic method for lung cancer treatment.

• Journal of Chest Surgery
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• 제47권1호
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• pp.13-19
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• 2014

Background: The aim of this study is to evaluate prognostic factors for survival in pathologic stage IIIA/N2 non-small-cell lung cancer (NSCLC), to identify the prognostic significance of the metastatic patterns of mediastinal lymph nodes (MLNs) relating to survival and to recurrence and metastasis. Methods: A total of 129 patients who underwent radical resection for pathologic stage IIIA-N2 NSCLC from July 1998 to April 2011 were retrospectively reviewed. The end points of this study were rates of loco-regional recurrence and distant metastasis, and survival. Results: The overall 5-year survival rate was 47.4%. A univariate analysis showed that age, pathologic T stage, and adjuvant chemotherapy were significant prognostic factors, while in multivariate analysis, pathologic T stage and adjuvant chemotherapy were significant prognostic factors. The metastasis rate was higher in patients with multi-station N2 involvement and with more than 3 positive MLNs. Further, non-regional MLN metastasis was associated with a higher loco-regional recurrence rate. Conclusion: Pathologic T stage and adjuvant chemotherapy were independent prognostic factors for long-term survival in pathologic stage IIIA/N2 NSCLC. The recurrence and the metastasis rate were affected by the metastatic patterns of MLNs. These results may be helpful for planning postoperative therapeutic strategies and predicting outcomes.

• Journal of Chest Surgery
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• 제33권5호
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• pp.377-384
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• 2000

Background: Numerous studies of safe, long term preservation for lung transplantation have been performed using ex vivo models or in vivo single lung transplantation models. However, a safe preservation time which is applicable for clinical use is difficult to determine. We prepared LPDG solution for lung preservation study. In this study we examined the efficacy of LPDG(low potassium dextran glucose) solution in 24-hour lung preservation by using a sequential bilateral canine lung allotransplant model. Material and Method: Seven bilateral lung transplant procedures were performed using weight-matched pairs(24 to 25kg) of adult mongrel dogs. The donor lungs were flushed with LPDG solution and maintained hyperinflated with 100% oxygen at 1$0^{\circ}C$ for a planned ischemic time of 24 hours for the lung implanted first. After sequential bilateral lung transplantation, dogs were maintained on ventilators for 3 hours: arterial resistance were determined if the recipients hourly after bilateral reperfusion and compared with pretransplant-recipient values, which were used as controls. After 2hours of reperfusion, the chest X-ray, computed tomogram and lung perfusion scan were performed for assessmint of early graft lung function. Pathological examinations for ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery were performed. Result: Five of seven experiments successfully finished the whole assessments after bilateral reperfusion for three hours. Arterial oxygen tension in the recipients was markedly decrased in immediate reperfusion period but gradually recovered after reperfusion for three hours. The pulmonary artery and pulmonary vascular resistance showed singificant elevation(p<0.05 versus control values) but also recovered after reperfusion for three hours(p<0.05 versus immediate period value). The ultrastructural findings of alveolar structure and endothelial structure of pulmonary artery showed reversible mild injury in 24 hours of lung perservation and reperfusion. Conclusion : This study suggests that LPDG solution provides excellent preservation in a canine model in which the dog is completely dependent on the function of the transplanted lung.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2775-2780
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• 2016

Background: Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI. Materials and Methods: PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas. Results: PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies. Conclusions: Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.

• Journal of Chest Surgery
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• 제30권4호
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• pp.396-401
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• 1997

변형식 흉곽 성형술은 폐절제 후 잔여 폐가총장을 채울 수 없는 경우나 농흉이 합병된 경우 폐 절제 후 이차적으로 실시하거나 폐 절제와 동시에 또는 그 이전에 시행된다. 원광대학병원 흉부외과에서는 1990년 3월부터 1995년 8월 까지 폐암종 3예와 폐결핵에 의한 이차성 병변 5예 (2예에서 기흉, 2예에서 아스페루질루스종에 의한 각혈, 떼는 기관지루를 동반한 농흉)에서 폐엽 절제술에 부가적으로 변형 흉곽성형술을 시행하고 조기 및 만기적인 임상 결과를 관찰하고 폐의 부분절제시 변형 흉곽성형술의 적절한 시행방법과 임상적 의의에 대해서 알아보았다. 술식에 있어서 1 번 늑골을 보존하는 대신 폐첨을 늑골로부터 박리하고 2, 3, 4번의 늑골을 골막외로 절제하였다. 4예에서 변형 흉곽성형술이 폐 절제와 동시에 시행되었고,다른4예에서는 폐 절제 후 1내지 8일째에 시행되 었다. 흉곽 성형술 후 재원기간은 평균 13일 (범 위, 10-26일)이었으며 2차 흉곽 성형술을 시 행한 2 예를 제외한 6예에서 술후 4 내지 10일 (평균 6일)에 흉관의 발거가 가능하였다. 흉곽성형술은 폐 절제 후 발생하는 합병증인 농흉의 치료를 위해 이차적으로 시행되는 경향\ulcorner 있으 나, 폐의 부분 절제 (전폐 절제를 제외한 폐엽 절제 및 폐염의 부분절제)후 잔여 폐의 용적이 적거나 폐 실질로부터 공기 누출이 심한 경우, 폐 절제와 동시에,또는 절제 후 조기에 변형 흉곽성형술을시행함 으로써, 빠른 늑막 유착을 유도하고 만기에는 흉곽 변형이 없이 잔여 폐의 확장을 얻을수 있을것으로 사료된다.

• Journal of Chest Surgery
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• 제37권5호
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• pp.423-431
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• 2004

배경 : 폐 말초발생의 소형 선암은 타 조직형태의 폐암들과는 달리 종양의 크기가 예후와 밀접한 관계를 보이지 않아 예후의 예측이 어려운데, 최근 예후와 관련이 있는 화상적 소견들이 보고되고 있다. 이에 저자들은 절제된 소형 폐선암에서 병리적 소견과 예후를 분석하여 화상적 소견들과의 관계를 알아보고자 하였다. 대상 및 방법: 절제술을 시행 받았던 말초 폐 발생 소형 선암증례 중 종양의 최대경이 3cm 이하인 176예를 대상으로 수술 전 HRCT상의 소견들을 분석하였으며, 이들 소견과 병리학적 그리고 임상적 예후인자들과의 관계를 분석하였다. 결과: GGA의 정도가 큰 암일수록 병리학적 그리고 임상적으로 양호한 예후인자를 보였다. 또한 종양의 육안적인 형태에 따른 분류에서도 GGA형 혹은 bubble-like형이 scar-like형 혹은 solid형에 비하여 병리학적 그리고 임상적으로 양호한 예후인자를 나타내었다. 결론: 말초 폐의 소형 선암에서 HRCT 소견은 병리학적 그리고 임상적 예후인자들과 밀접한 관계가 있음이 확인되어, 화상적인 소견에 의하여 절제술 후의 예후를 예측할 수 있을 것으로 생각된다.

• Journal of Chest Surgery
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• 제57권4호
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• pp.351-359
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• 2024

Background: Major pulmonary resection after neoadjuvant concurrent chemoradiation therapy (nCCRT) is associated with a substantial risk of postoperative complications. This study investigated postoperative complications and associated risk factors to facilitate the selection of suitable surgical candidates following nCCRT in stage IIIA-N2 non-small cell lung cancer (NSCLC). Methods: We conducted a retrospective analysis of patients diagnosed with clinical stage IIIA-N2 NSCLC who underwent surgical resection following nCCRT between 1997 and 2013. Perioperative characteristics and clinical factors associated with morbidity and mortality were analyzed using univariable and multivariable logistic regression. Results: A total of 574 patients underwent major lung resection after induction CCRT. Thirty-day and 90-day postoperative mortality occurred in 8 patients (1.4%) and 41 patients (7.1%), respectively. Acute respiratory distress syndrome (n=6, 4.5%) was the primary cause of in-hospital mortality. Morbidity occurred in 199 patients (34.7%). Multivariable analysis identified significant predictors of morbidity, including patient age exceeding 70 years (odds ratio [OR], 1.8; p=0.04), low body mass index (OR, 2.6; p=0.02), and pneumonectomy (OR, 1.8; p=0.03). Patient age over 70 years (OR, 1.8; p=0.02) and pneumonectomy (OR, 3.26; p<0.01) were independent predictors of mortality in the multivariable analysis. Conclusion: In conclusion, the surgical outcomes following nCCRT are less favorable for individuals aged over 70 years or those undergoing pneumonectomy. Special attention is warranted for these patients due to their heightened risks of respiratory complications. In high-risk patients, such as elderly patients with decreased lung function, alternative treatment options like definitive CCRT should be considered instead of surgical resection.