• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.69-73
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• 2007

The mortality rate of the invasive pulmonary aspergillosis to be able to developed during chemotherapy induced myleosuppressionin is high in hematologic malignancy patients despite antifungal treatment. Effective antifungal treatment combined with operation can decrease the mortaligy rate of the invasive pulmonary aspergillosis. Recently, we experienced the successful management of the two cases of invasive pulmonary aspergillosis in acute lymphoblastic leukemia through effective antifungal treatment and surgical resection. We report this cases with review of literature.

• Tuberculosis and Respiratory Diseases
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• v.49 no.4
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• pp.421-431
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• 2000

Background : The length of postoperative drug therapy remains controversial in pulmonary tuberculosis. We analyzed our experiences to determine the postoperative duration of chemotherapy after resection. Method : A retrospective review was performed in 66 of 95 patients that underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1998. We compared the relapse rates according to the length of postoperative chemotherapy in each group, classified by the results of sputum AFB culture before the surgery, the number of resistant drugs, the number of prior treatment and the division of anti-TB drugs used postoperatively. Results : Fifty three of 66(80.3%) were men and 13(19.7%) were women with a median age of 33.5 years(range, 16 to 63). The mean lengths of the pre- and post-operative chemotherapies were 4.9 months, and 12.9 months respectively. Five of 66 patients (7.6%) relapsed during the mean period of follow up (39.7 months). In the group less than three times of the prior treatment, there were two relapses (20%) in Ed-the highlight above-rephrase 10 patients that were medicated for 6 months or less, and one relapse in 43 patients (2.3%) that took medicine for more than 6 months (p=0.03). In the group using second-line drugs postoperatively, there was one relapse (25%) in four patients that were medicated for 12 months or less. No patient in a total of 17 that received medicine for more than 12 months relapsed (p=0.03). Conclusion : We recommend that patients with the prior treatment less than three times should be treated for more than 6 months after resection and patients using the second-line drugs postoperatively should be medicated for more than 12 months.

• Journal of Chest Surgery
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• v.24 no.2
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• pp.182-189
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• 1991

Fourteen patients underwent surgical resection of bullae between February, 1987 and June, 1990 via median sternotomy. Twelve patients had spontaneous pneumothorax with previous history of pneumothorax on the contralateral side or visible bullae on chest X-ray films. Two patients had bullous emphysema. The duration of operation and admission, frequency and amount of analgesic administered for pain control, pulmonary function test [FEV1, FVC, MVV] and the amount of bleedings were compared with six cases of staged unilateral thoracotomy. The results were as follows: 1. All patients were male. 2. Mean follow up period was 13.5 month and no recurrence of pneumothorax are noted after the operation. 3. Median sternotomy showed shortened admission days than thoracotomy. [12.4$\pm$2.7, 15.6$\pm$3.1 days] 4. Significantly shortened anesthetic time in median sternotomy than thoracotomy [121$\pm$21, 184$\pm$33 minutes] 5. Median sternotomy required less injection of analgesics than thoracotomy. [6.5$\pm$2.7, 13.5$\pm$3.1 ampules] 6. Bleeding amount and PFT showed no differences. 7. Complications were prolonged air leakage for more than 7 days [2 patients], transient elevation of SGOT and SGPT[2 patients], and wound infection[1 patient]

• Journal of Chest Surgery
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• v.35 no.7
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• pp.560-563
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• 2002

Unilateral diaphragmatic paralysis due to a phrenic nerve injury is not rare after cardiothoracic surgery and may range from an asymptomatic radiographic abnormality to severe pulmonary dysfunction and even mortality in patients with reduced lung function. The most effective treatment for symptomatic unilateral diaphragmatic paralysis has been known to be a plication of the paralyzed hemidiaphragm. A 38 year-old male patient with asthma received a phrenic nerve reconstruction with a sural nerve for right phrenic nerve injury during resection of the anterior mediastinal tumor. Ten months later, chest PA showed good result and we report this case with literature.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.934-939
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• 1993

Mediastinal lymph node involvement [N2 disease] is generally accepted as an important factor influencing the outcome of patients with lung cancer.The long-term survival rates of completely resected patients with N2 disease are frequently reported from 15% to 30%.To improve the management and the outcome of patients with resectable N2 disease, we analyzed the survival rates and the prognostic factors for resected N2 lung cancer. Between August 1989 and September 1993, we experienced 27 patients with N2 disease of 115 surgically treated lung cancer at the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University Medical School. Of these 27 N2 disease 4 had only an exploratory thoracotomy, and 23 underwent pulmonary resection by pneumonectomy[15], bilobectomy[3], lobectomy[4] and sleeve lobectomy[1].All of resected 23 patients received postoperative adjuvant chemotherapy[3], radiotherapy[2] or combined chemo-radiotherapy[18].Complete follow-up was obtained in 23 patients and median survival was 22 months and overall 1-year and 2-year survival rates by Kaplan-Meir method were 65 % and 45 %, respectively. Survival differences according to histology, tumor location, number of positive nodal station and operative method were not significant, statistically. Conclusively, we think that in resectable N2 lung cancer, complete tumor resection and mediastinal lymph node dissection, and postoperative adjuvant therapy should be done to improve the survival.

• Journal of Chest Surgery
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• v.37 no.1
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• pp.98-101
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• 2004

Complex regional pain syndrome is pain disorder which is characterized by aching pain, marked painful sensation, hypothermesthesia, vasomotor dysfunction, hyperhidrosis, impairment of motor function, trophic changes of distal part of not-operated extremity after trauma and operation. Pain produce increased sensitivity to catecholamine and diagnosed by infra red thermography and Treatment consists of pain relief and rehabilitational therapy for functional restoration of affected limb. We experienced a case of complex regional pain syndrome in a 16-year-old man after wedge resection of pulmonary apex for bullae and report this case with a review of the literature.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.88-91
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• 1999

Leiomyoma of the bronchus is a very rare, benign tumor of the lung. We herein report a case of endobronchial leiomyoma which was treated by sleeve bronchoplasty without resection of the lung and without any complications. A 35-year-old man was admitted to our hospital complaining of stridor. Bronchoscopy revealed a round, hypervascular and smooth tumor nearly obstructing the left main bronchus at 1.5 cm distal portion from the carina. Biopsy was not performed for fear of massive hemorrhage. A sleeve resection of left main bronchus including the tumor and end-to-end anastomosis were performed. The histologic diagnosis was leiomyoma. The early diagnosis and appropriate surgical treatment to preserve the pulmonary function are important points of consideration.

• Korean Journal of Bronchoesophagology
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• v.14 no.2
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• pp.10-16
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• 2008

Surgical resection and reanastomosis has been the treatment of choice in patients with tracheobronchial stenosis. Recent development of bronchoscopic intervention has been replacing the role of surgery in these patients. After summarizing the upto date data of bronchoscopic intervention, the proper management of tracheobronchial stenosis will be presented. Bronchoscopic intervention would be much effective when performed under rigid bron- choscopy, due to the stable patients' condition and endoscopic view. The usual method of intervention includes ballooning, Nd-YAG laser resection, bougienation, mechanical airway dilatation, stenting and photodynamic therapy. Silicone stents are very effective in patients with tracheobronchial stenosis to maintain airway patency. Bronchoscopic intervention provided immediate symptomatic relief and improved lung function in most of patients. After airway stabilization, stents were removed successfully in 2/3 of the patients at a 12-18 months post-insertion. Less than 5% of patients eventually needs surgical management. Acute complications, including excessive bleeding, pneumothorax, and pneumomediastinum develops in less than 5% of patients but managed without mortality. Stent-related late complications, such as, migration, granuloma formation, mucostasis, and restenosis are relatively high but usually controlled by follow-up bronchoscopy. In conclusion, bronchoscopic intervention, including silicone stenting could be a useful and safe method for treating tracheobronchial stenosis.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.298-301
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• 2014

A 35-year-old man was admitted to Korea University Anam Hospital for evaluation of intermittent chest pain. Computed tomography of the chest showed enlargement of a previously identified anterior mediastinal mass and also a well-defined, circumscribed mass in the subcarinal area, surrounded by the roof of the left atrium, right pulmonary artery, and the carina. Complete resection of the intrapericardial tumor was performed through median sternotomy without cardiopulmonary bypass. Pathologic examination identified the tumor as schwannoma, of an ancient type, diffusely positive for the S-100 antigen. Unlike other reported cases, grossly, the tumor did not seem to be involved with any nerve.

• Tuberculosis and Respiratory Diseases
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• v.71 no.4
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• pp.266-270
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• 2011

Background: Photodynamic therapy (PDT) is effective in managing small superficial early lung cancer patients who were deemed nonsurgical candidates. However, we do not have any previous report on the usefulness of PDT in early lung cancer in South Korea. Thus we report here our experience of PDT in early lung cancer patients. Methods: 10 patients who underwent PDT for managing early lung cancer between June 2006 and July 2010 were analyzed. PDT was carried out 48 hours after photosensitizer injection. Re-bronchoscopy was carried out 48 hours after PDT in order to remove a necrotic tissue from the PDT site. For evaluation of PDT response, bronchoscopy and chest computed tomography (CT) were performed after 3 months. Results: The median age of patients was 69 (49~77) and all patients were male. The smoking history of patients was 48 (20~75) pack-year and the median follow up of patients was 25 (11~52) months. Complete remission was observed in 10 patients and the recurrence of lung cancer was observed in 3 patients. Out of 10 patients, 3 patients died (one case of lung cancer progression and two cases of pneumonia). Conclusion: The PDT is a safe and effective treatment in early lung cancer patients who are not suitable for surgical resection. The PDT in clinical practice is an attractive option in the treatment of early lung cancer.