• Journal of Chest Surgery
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• v.25 no.8
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• pp.806-811
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• 1992

The primary neuroendocrine carcinomas[NEC] of the lung are relatively rare. There are classified histologically into the following groups. 1] bronchial carcinoid, 2] well differentiated neuroendocrine carcinoma[WDNC], 3] intermediate cell neuroendocrine carci-noma[ICNC], 4] small cell neuroendocrie carcinoma[SCNC]. The NE cells can be found throughout the mucosa of the bronchial tree by the electron microscopy. By the immunocytochemistry, Neuron-specific enolase[NSE], serotonin, born-csin, and calcitonin are found in normal solitary NE cells and neuroepithelial bodies. The immunohistochemistry has the advantage that it can be applied on routine pathology specimens. The NSE was localized in all of the NE granule bearing tumors but also present in 57 per cent of the non NE carcinomas. Together the combination of chromogranin A, bombesin and NSE should provide an exellent signature for tumor cells expressing NE features, such as carcinoids and other NE carcinomas. We have experienced two cases of primary pulmonary NEC in 59 and 29 years old men. The former was admitted due to exertional dyspnea and left chest pain, the latter, newly developed mass on chest X-ray. They were treated by Lt pneumonectomy with LN dissection and RLL resection with LN dissection The postoperative diagnoses were could be confirmed by NSE study as NEC which were SCNEC and INEC in subgroups. The postoperative courses were uneventful.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1482-1486
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• 1992

Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Eight patients underwent operative treatment at Chonnam University Hospital from June, 1986 to May, 1992. Six of the patients were male and two female. Age ranged from eight to fifty six years. Associated cardiac lesions were common including AR and VSD in four patients respectively. Diagnosis was made by 2D-Echo and cine-angiogram. In six patients aneurysms of the sinus of valsalva ruptured from the right coronary sinus to the right ventricle and in two from right coronary sinus to the right atrium Direct closure of aneurysmal rupture and patch closure of VSD in four cases, resection of the aneurysm and direct closure in one case, direct closure of the fistula and AVR in two cases, direct closure in one case were performed. One patient combined with VSD, pulmonary hypertention and bacterial endocarditis underwent operation, but he died of sudden cardiac arrest the day after the operation. Operative results were relatively good in the other patients.

• Journal of Chest Surgery
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• v.25 no.1
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• pp.96-104
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• 1992

The 242 patients were operated due to chronic empyema in Hanyang University Hospital From Jan, 1983 to Aug, 1991, we operated 17 patients by modified.Schede`s thoracoplasty with myoplasty and we concluded to next scentences. 1. The age of patients were varied from 28 to 65[Average 39.1] and male preponderance was seen[more than 3 times]. 2. The preoperative cause of disease were tuberculosis in 14 patients[3 patients were associated with aspergillosis, and 1 patient was associated vrith actinomycosis], lung abscess in 2 patients, and haemophilia in 1 patient. 3. The Preoperative duration of empyema were varied from 1 month to 30 years[Average 49.8 month], and the duration from pulmonary resection to thoracoplasty were 1 month to 13.5 years[Average 55 month] except 3 patients, who were operated pneunectomy with thoracoplasty at the same time. 4. The total number of thoracoplasty were 19, because in 2 patients, we operated 2 steps, and we failed in 6 cases, so the success rate was 68.5%. 5. In failure analysis of 6 cases, the cause were obliteration failure in 3 cases, inadequete drainage in 1 case, and in the other 1 case was mixed type. 6. From 1990 to 1991, there were no death associated with operation and there were 1 failure, so the success rate was greatly improved. 7. The bronchopleural fistula or spontaneous rupture of trachea were seen in 12 cases, and the success rate was high in absent cases.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.385-390
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• 1986

Empyema is a severe infection encountered in the pediatrics. With advance of the antibiotics and chemotherapeutics, there was a marked decrease in number of empyema. Empyema complicated by staphylococcal pneumonia in infant and children has been distressing problem, and the management of this complication has been discussed repeatedly in the past. In Korea, tuberculous empyema is also troublesome. If empyema is localized within thick capsule, tube thoracostomy and closed drainage alone is unacceptable, and early open thoracotomy to eliminate the empyema has proved good result. A clinical analysis of 39 patients with thoracic empyema was done. They were managed surgical intervention at Dept. of Thoracic & Cardiovascular Surgery at Kyung-Hee University Hospital from Jan. 1974 to December, 1984. 1. Age and sex distribution, infancy 9, early childhood 11. late childhood 9, puberty 10. The male to female ratio was 21:18. 2. The highest seasonal incidence was winter [21 cases]. 3. Cardinal symptoms were cough [76%], fever and chill [66%], and dyspnea [40%]. 4. The location of the empyema was right in 27 cases [69%] and 12 cases in left side. 5. The most frequent lesion to predisposing factor was pneumonia [67%]. 6. The commonest organism was Staphylococcus aureus in 15 [38%] cases, and Mycobacterium tuberculosis in 10 cases [26%]. 7. The surgical treatment was performed in all patients. The surgical procedure was closed tube thoracostomy in 25 cases [64%], decortication in 7 cases [18%], pulmonary resection in 4 cases [10%], and decortication with curettage in 2 cases. 8. One patient died from sepsis complicated by lymphoma and in one patient bronchopleural fistula was developed postoperatively.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.543-548
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• 1999

Bronchopleural fistula(BPF) occurs as a postoperative complication in 2 to 5 percent of pulmonary resection. The detection of BPF is generally difficult and various diagnostic methods have been utilized to identify the site of the fistula in order to treat it adequately. Closure of these BPF can be surgical intervention or bronchoscopic application of various sealing agents. We report an experience with use of bronchoscopic instillation of n-butyl-2-cyanoacrylate($Histoacryl^{(R)}$) for closure of a postpneumonectomy BPF.

• Journal of Chest Surgery
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• v.19 no.1
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• pp.140-147
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• 1986

A clinical study was made on 72 cases of primary lung cancer operated in the department of thoracic & cardiovascular surgery, Kyungpook national university hospital from January 1975 to May 1985. The ratio of male to female was 13.4: I and mean age was 53. Histologically, squamous cell carcinoma comprised 72.2% of 72 operated cases. Before admission to our hospital, the erroneous diagnoses were made at local clinics on the 43 cases[59.7%] and a large percentage of them was diagnosed as pulmonary tuberculosis. And then, total of 56 cases received inadequate treatment or delayed the operation. For the location of the tumor, right to left ratio is 1.2:1 and the right upper lobe was most often involved [23.6%]. Operation was performed on the 72 cases and resection on the 59 cases[8.2%]. Postsurgical staging showed that stage III was found most frequently [59.4%] and T,N,M, was 28% of total cases. Two common surgical complications were bleeding in 7 and acute respiratory failure in 6 cases, and these 6 cases of acute respiratory failure were all died. On the basis of these experiences, we conclude that aggressive effort is needed for the early accurate diagnosis and adequate treatment of lung cancer.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.695-699
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• 1994

Pectus excavatum. the most common congenital chest wall deformity, is manifested by deformity of the costal cartilages resulting in a depressed and often rotated sternum. Surgical correction of this disease is frequently indicated for aesthetic improvement. The most popular current repair involves resection of abnormal costal cartilages, sternal osteotomy and mobilization, followed by fixation of the sternum in the corrected position.12 patients have been operated upon for pectus excavatum by the Adkins` method for 8 years in our hospital and the results were as follows: 1. All the patients were male. Age distribution was 2-26 years[average 10.8 years] and 69.2% were below 7 years. 2. The deformity was found at neonate or infant in the most of the patients [92.3 %] 3. The subjective symptoms were frequent URI[35.7%], dyspena on exertion[21.4%], chest dis comfort[7.1%], asthma [7.1%] and most of the patients didn`t like their appearance. 4. Combined diseases were urticaria in 2 cases, bilateral cryptomhism and pulmonary tuberculosis in 1 case each other. 5. Welch index ranged from 1.7 to 5.0 with the average of 3.47. 6. Postoperative complications were pneumothorax [45.5%], wound infection [36.4%] and skin necrosis [18.2%]. Although the period of follow-up was short in some cases there was no relapse.

• Journal of Chest Surgery
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• v.32 no.12
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• pp.1100-1105
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• 1999

배경 :폐절제술은 절제가능한 폐암 또는 염증성 폐질환 선천성 폐질환의 치교적 술식이 된다. 술후 경과에 영향을 줄수 있는 예측기능 요소를 인지하는 것은 중요하나 합병증에 이환된 경향이 높은 환자에 대하여 각별한 주의를 기울임으로서 술후 합병증 및 사망률은 감소시킬수 있을 것이다 방법 및 대상: 술후 결과에 영향을 미치는 요소를 예측하기 위해 1994년부터 1998 년까지 본 병원에서 종양성 및 염증성 폐질환으로 폐절저술을 시행받은 153명의 환자를 대상으로 입원챠트를 열람하여 연구하였다 평균 연령은 54.3$\pm$10.6세였다. 96명 (62%) 의 환자는 폐암화자였으며 47명 (30%)의 환자의 염증성 폐질환자였고 10명 (7%)의 환자는 선천성 폐질환자이거나 기타 폐질환자였다. 결과: 전체 153명중 폐엽절제술이 118례 전폐절제술이 29례 폐분엽절제술이 6례 시행되었다. 7명 (4.5%)의 환자가 술후 사망하였다 술후 원내 사망률의 가장 유의한 예측요소는 동반된 내과적 질환의 유무(p<0.001)과 70세 이상의 고령이다(p<0.003) 총 57명의 환자에게 67가지의 합병증이 발병되었다 그중 수술자체와 관련된 합병증이 50례 (32%) 호흡기계 합병증이 14례(9.1%) 심혈관계가 1례(0.6%) 기타 합병증이 2례(1.3%)였다 술후 합병증 이환율에 영향을 미치는 요소는 70세 이상의 고령이었다(p<0.004) 결론 : 동반된 내과적 질환과 70세 이상의 고령은 술후 사망률에 영향을 미치는 유의한 예측요소가 되며 또한 70세이상의 고령은 술 후 합병증 이환율에도 영향을 미치는 요소이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.315-320
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• 2021

Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.763-773
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• 1996

Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.