• 대한기관식도과학회지
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• 제2권1호
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• pp.57-62
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• 1996

Tracheal stenosis can be classified into intrinsic stenosis secondary to tracheal inflammatory lesion or mass effect and extrinsic stenosis secondary tumors of thyroid, esophagus and mediastinum. Extrinsic stenosis which is frequently encountered in clinical setting could be often overlooked due to mild symptom. Recently, even with the increasing interest in extrinsic tracheal stenosis there are limitation in it's diagnosis and treatment. The purpose of this study is to provide guidance in the diagnosis and treaonent of extrinsic tracheal stenosis. Here, we report the etiology, symptoms, radiologic findings, pulmonary fuction finding, treatment and its results in 26 cases of extrinsic tracheal stenosis. Causes of extrinsic tracheal stenosis included compression of aiway by thyroid benign tumor in 13 cases to be the most common, next by thyroid malignancy in 9 cases, metastatic mediastinal turner in 2 cases, 1 case each for esophageal cancer and parathyroid cancer. In 3 cases simple tracheal resection and end to end anastomosis were done, 1 cases underwent total laryngectomy, and 8 cases were treated by conservative management, where all cases failed in treatment. The remaining 14 cases were successfully treated by removing the causes and maintaining tracheal tube insertion for amount of time. Extrinsic tracheal stenosis due to benign conditions were treated satisfactorily by removing mass, however with the malignant causes there was considerable amount of difficulty in treatment.

• Tuberculosis and Respiratory Diseases
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• 제72권2호
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• pp.124-131
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• 2012

Background: DNA damage-inducible 1 (Ddi1), one of the ubiquitin-like and ubiquitin-associated family of proteins, may function in the regulation of the ubiquitin-proteasome pathway, which has been validated as a target for antineoplastic therapy. We investigated Ddi1 expression in human lung cancer tissues and evaluated the relationship of this expression pattern with clinicopathological factors in patients with non-small-cell lung cancer (NSCLC). Methods: Ddi1 expression was examined by immunohistochemistry in tumor tissues from 97 patients with stage I NSCLC, who had undergone curative surgical resection at two tertiary referral hospitals from 1993~2004. None of the patients received preoperative chemotherapy and/or radiation therapy. Results: Thirty-nine (40.2%) of the 97 cases were positive for Ddi1. Ddi1 expression was dominantly seen in cytoplasm rather than in the nuclei of cancer cells in all histological types, whereas adjacent nontumoral lung tissue showed negative Ddi1 staining in most cases. Ddi1 expression tended to increase in well-differentiated tumors but without statistical significance. Positive Ddi1 expression was associated with a tendency for better disease-free survival and disease-specific survival, although the difference was not significant. Conclusion: Ddi1 expression is a property of NSCLC. Because Ddi1 could be a potential target for cancer therapy, more research is needed to evaluate its role in NSCLC.

• Journal of Chest Surgery
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• 제8권2호
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• pp.159-168
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• 1975

We have experienced 61 cases of Clinically diagnosed tuberculous peripleural abscess which was surgically treated at St. Mary's Hospital of Catholic Medical College from Mar. 1963 to Feb. 1974. Out of them, 52 cases of pathologically confirmed tuberculous peripleural abscess were reviewed and its pathogenesis, treatment and so called "rib caries" were discussed. In the past, they have been described as a variety of the names, such as rib caries, cold abscess of the chest wall, pericostal abscess, lymphadenitis tuberculosa of the chest wall, chronic draining sinuses of the chest wall and other descriptive terms. Although it has been said that the tuberculous abscess on the chest wall developed as a secondary disease from so called "rib caries" but now it has been clear that this abscess occurred not from tuberculosis of the rib but from tuberculous lesion developed between end-othoracic fascia and parietal pleura usually following pulmonary tuberculosis and/or tuberculous pleurisy and the involvement of rib or ribs are secondary one from peripleural abscess, as we confirmed. Therefore we advocate that the nomination, rib caries, should not be used unless there is a primary tuberculous lesion on ribs. The results were as follows: 1. The highest age group of tuberculous peripleural abscess was ranged from the first to third decade (78%) 2. The location of tuberculous peripleural abscess on the chest wall were as follows, 31 cases on the anterior, 19 cases on lateral and 2 cases on the posterior. 3. On x-ray examination, abnormal findings including parenchymal tuberculous lesion and pleural changes were seen is 38 cases. 4. There was no destructive change of periosteum and rib in 23 cases of tuberculous peripleural abseess during operation. However the periosteal denudation and/or rib destruction were found in 29 cases. 5. The all cases of tuberculous peri pleural abscess developed from between endothoraclc fascia and parietal pleura, as we confirmed. With antituberculous therapy, operation should be radical by wide incision on the lesion including thorough curettage with proper drainage of Iiquified caseating materials and appropriate rib resection, if necessary.tion, if necessary.

• 대한골관절종양학회지
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• 제12권1호
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• pp.71-77
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• 2006

연골 육종은 가장 흔한 원발성 골육종 중 하나로, 간엽성 연골육종을 제외하면 대체로 저 악성도 병변이며, 다발성 발현이나 원격 전이가 드문 것으로 알려져 있다. 다발성 내연골종(Ollier's disease)과 Maffucci's 증후군에서 다발성 연골육종이 발생한 례가 드물게 보고되었으며, 아직까지 한 관절을 사이에 두고 그 근위부와 원위부에서 연골육종이 동시에 발생한 례는 보고된 적이 없었다. 저자들은 30세 남자 환자에서 폐나 내장의 전이를 동반하지 않고, 한쪽 견관절을 사이에 두고 견갑골의 견봉과 상완골에서 동시에 발생한 다발성 연골육종을 경험하였으며, 이를 "동시성 다발성 관절 근접 연골육종"이라 명하였다. 견봉에 위치한 병변은 소파술과 함께 동종 골이식과 시멘트 충전술을 시행하였으며, 근위 상완골 병변은 설상 절제술과 시멘트 충전술을 시행하였다. 수술 후 18개월까지 재발의 증거가 관찰되지 않았으며, 통증 없이 전 범위 운동이 가능하였다.

• Journal of Chest Surgery
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• 제40권11호
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• pp.793-797
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• 2007

Communicating bronchopulmonary foregut malformation (CBPFM)은 매우 드문 선천성 기형으로 격리된 호흡계 조직과 식도 또는 위장 사이의 누관이 특징적이다. 원시위장관에서 기원한 부속의 폐조직이 모든 종류의 bronchopulmonary furegut malformation 발생의 중요한 요인이 된다. 반복되는 폐렴이 있는 환자의 chest X-ray에서 낭성 병변이 보인다면 CBPFM을 생각해봐야 하며, 진단적 방법으로 식도조영술, 기관조영술, 컴퓨터 단층촬영, 자기공명영상 그리고 혈관조영술 등이 도움이 된다. 치료는 수술적 제거가 권장되며 예후도 좋다. 좌측 완전 심낭결손증과 동반되었으며, 이중식도에 연결된 외엽성 폐격리증과 기관지성 낭종을 보인 CBPFM 1예를 보고한다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2875-2878
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• 2014

Background: Lung cancer is one of the commonest and most lethal cancers throughout the world. The majority of the patients present at advance stage and are not suitable for curative intent treatment. Even among patients with localized disease, there has been underutilization of curative treatment modalities. The aim of this study was to analyze the radical treatment utilization rates in patients with non small cell lung cancer (NSCLC) treated at our centre. Materials and Methods: We analyzed case records of 104 patients with a pathologically confirmed diagnosis of NSCLC having stage 1-3B disease who were treated at our centre over last 3 years, to assess the utilization of curative treatment modalities i.e. surgery or radical radiotherapy. Results: The median age of this cohort was 58 years. Out of 104 patients only 33 (31.7%) received curative intent treatment, 14 undergoing curative resection and 19 receiving radical doses of radiotherapy. The baseline characteristics of both the groups (with or without radical treatment) were not different. Major factors associated with underutilization with curative treatment were progressive disease or loss of follow up after chemotherapy and inappropriate use of TKI and/or palliative radiotherapy in patients with stage 1-3B disease. Patients who did not receive radical treatment had inferior PFS and OS than those who received radical treatment. Conclusions: In our practice we observed gross underutilization of curative intent treatment modalities in patients with NSCLCs which is associated with inferior survival.

• Journal of Chest Surgery
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• 제48권6호
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• pp.435-438
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• 2015

Gestational trophoblastic disease (GTD) is a condition of uncertain etiology, choriocarcioma, or placental-site hydatidiform moles, invasive moles, choriocarcinoma, and placental-site trophoblastic tumors. It arises from the abnormal proliferation of trophoblastic tissue and spreads beyond the uterus hematogenously. The early diagnosis of GTD is important to ensure timely and successful management and the preservation of fertility. We report the unusual case of a metastatic choriocarcinoma that formed bullae on the lung surface and presented as recurrent pneumothorax in a 38-year-old woman with elevated beta-human chorionic gonadotropin (hCG) levels. She underwent thoracoscopic wedge resection of the involved lung and four subsequent cycles of consolidation chemotherapy. No other evidence of metastatic disease or recurrent pneumothorax was noted during 22 months of follow-up. GTD should be considered in the differential diagnosis of spontaneous pneumothorax in reproductive-age women with an antecedent pregnancy and abnormal beta-hCG levels.

• Journal of Chest Surgery
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• 제41권6호
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• pp.795-798
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• 2008

50세 남자 환자가 좌상복부 동통 및 발열 증상을 주소로 내원하였다. 환자는 과거력상 28년전에 폐결핵 및 늑막염으로 약물치료를 받았으며 8년전 재생불량성 빈혈로 비장 절제술을 받았다. 내원 후 시행한 CT 검사상에서 만성 좌측 농흉과 연결을 보이는 복강내 농양이 진단되었다. 만성 농흉과 더불어 전흉벽에 농흉에 의한 흉벽 침습이 의심되는 병병도 아울러 관찰되었다. 환자는 복강내 농양 배액술 이후 좌측 늑막전폐절제술 및 흉벽 절제술을 시행 받았고 병리 조직 검사상 육종이 진단되었다.

• Journal of Chest Surgery
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• 제47권5호
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• pp.483-486
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• 2014

A 76-year-old male underwent a left upper lobectomy with wedge resection of the superior segment of the left lower lobe using video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer of the left upper lobe. He presented with shortness of breath, fever, and leukocytosis. Chest radiography showed atelectasis at the remaining left lower lobe. Bronchoscopy revealed narrowing of the left lower bronchus with purulent secretion, and computed tomography showed downward kinking of the left lower lobar bronchus. He underwent exploratory VATS, and intraoperative findings showed an inferiorly kinked left lower lobar bronchus with upward displacement of the left lower lobe. After adhesiolysis, the kinked bronchus was straightened, and bronchopexy was performed to the pericardium to prevent the recurrence of bronchial kinking. Also, the inferior pulmonary ligament was reattached to prevent upward displacement. Postoperative follow-up bronchoscopy revealed no evidence of residual bronchial obstruction, and chest radiography showed no atelectasis thereafter.

• Journal of Gastric Cancer
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• 제18권2호
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• pp.109-117
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• 2018

Purpose: This study aimed to investigate the outcomes of laparoscopic gastrectomy in very elderly patients with gastric cancer, who have outlived the average lifespan of the Korean population (men: ${\geq}77years$, women: ${\geq}84years$). Materials and Methods: Between 2004 and 2015, 836 patients with gastric cancer underwent a laparoscopic gastrectomy. They were divided into the elderly group (EldG) and non-elderly group (nEldG). Propensity score matching for covariates of sex, tumor depth, node status, and extent of resection was performed. Clinicopathologic characteristics, and surgical and survival outcomes were compared between the 2 groups. Results: The EldG had a higher American Society of Anesthesiologists (ASA) score and a higher number of comorbidities. There was no significant difference in the post-operative complications, except for pulmonary complications, which were more frequent in the EldG (5/56, 8.9%) than in the nEldG (0/56, 0%). The EldG had a shorter overall survival (OS), but cancer-specific survival was similar for both groups. Among deceased patients, 2 (25%) and 8 patients (50%) died within a year of surgery in the nEldG and EldG, respectively. Univariate and multivariate risk factor analyses for OS showed that age, ASA score, tumor, node, metastasis (TNM) stage, and occurrence of complications were significantly related to deterioration in OS. Conclusions: Laparoscopic gastrectomy can be safely performed in very elderly patients with gastric cancer who have outlived the average lifespan of the Korean population. However, impact of laparoscopic gastrectomy on improving survival is not clear, and careful patient selection is recommended.