• Journal of Trauma and Injury
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• v.32 no.4
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• pp.248-251
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• 2019

Traumatic intrapulmonary glass foreign bodies that are missed on an initial examination can migrate and lead to severe complications. Here, we present a rare case of a traumatic intrapulmonary glass foreign body surgically removed by a direct pulmonary incision, which preserved the pulmonary parenchyma and avoided severe complications caused by migration.

• Kosin Medical Journal
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• v.33 no.2
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• pp.215-222
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• 2018

An incidentaloma is a tumor found incidentally without clinical symptoms or suspicion; the lesion may be adrenal, pituitary, or thyroidal. We report the case of an asymptomatic individual with preoperatively undiagnosed pheochromocytoma (size: 4.86 cm) that was revealed using elective nonadrenal surgical procedures. The patient demonstrated peri- and post-operative hypertensive crisis and tachycardia. Three days after the dramatic onset of symptoms, the patient expired due to pulmonary edema, multiple organ failure, and terminal sepsis, despite administration of extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation. A left medial kidney mass obtained at autopsy confirmed pheochromocytoma.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.180-187
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• 2011

Background: In mediastinal lymph node sampling in non-small cell lung cancer (NSCLC) it is important to determine the appropriate treatment as well as to predict an outcome. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a recently developed, accurate, safe technique in patients with NSCLC for sampling mediastinal lymph nodes. We sought to determine the usefulness of EBUS-TBNA in mediastinal staging with NSCLC considered to be operable. Methods: We retrospectively reviewed the records of 142 patients who underwent EBUS-TBNA for mediastinal staging in the Asan Medical Center, Korea from July 2008 to July 2010. If patients were in an operable state, they underwent subsequent surgical staging. Diagnoses based on biopsy results were compared with those based on surgical results. Results: We performed EBUS-TBNA in 184 mediastinal lymph nodes in 142 NSCLC patients. Almost all of the EBUS-TBNA samples were from the lower paratracheal (112, 60.9%) and subcarinal (57, 31.0%) lymph nodes. In 142 patients, 51 patients (35.9%) were confirmed with malignant invasion of the mediastinal lymph node by EBUS-TBNA and 91 (64.1%) patients were not confirmed. Among the 91 patients, 64 patients (70.3%) underwent surgical staging. 3 patients (4.7%) who were misdiagnosed by the EBUS-TBNA were confirmed by surgery. After Diagnostic sensitivity of EBUS-TBNA, the prediction of mediastinal metastatsis was 94.4% and specificity was 100%. The procedures were performed safely and no serious complications were observed. Conclusion: We demonstrated the high diagnostic value of EBUS-TBNA for mediastinal staging.

• Journal of Chest Surgery
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• v.31 no.7
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• pp.650-659
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• 1998

Between August 1996 and August 1997, 22 patients underwent extracardiac Fontan operations. The basic diagnoses included univentricular heart of the right ventricular type (n=12); univentricular heart of the left ventricular type (n=4); tricuspid atresia (n=4); left isomerism, transposition of great arteries, ventricular septal defect and pulmonary stenosis (n=1); and criss-cross heart with uneven ventricle (n=1). The median age of the 14 men and 8 women was 29 months (range from 21 months to 26 years). Previous procedures included bidirectional cavopulmonary shunt (n=15, interval=15.6$\pm$3.4 months), Kawashima operation (n=4, interval=37.5$\pm$20 months), and classic Glenn shunt (n=1, interval=14 years). In 2 patients, extracardiac Fontan operations were done without any previous procedures. A 16- to 22-mm flexible Gore-Tex tube graft (n=18), Hemashield graft (n=3), or, alternatively, a nonvalved aortic allograft (n=1) was cut and anastomosed end-to-end between inferior vena cava and undersurface of pulmonary artery using Gore-Tex or Prolene suture in a running fashion. In risk Fontan patients (n=12), a communication between the extracardiac conduit and the right atrium was constructed. In the most 13 recent patients, the procedures were done without cross-clamping of the aorta and with a beating heart. Operative mortality was 9.1% (n=2). Complications included persistent chest tube drainage for more than 7 days (n=5), chorea (n=2), and low cardiac output (n=1). There were no late deaths. Follow-up echocardiogram (mean: 6 months) demonstrated satisfactory hemodynamic results in the surviving 20 patients. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creationof a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function. Further investigations during a longer follow-up are needed to confirm the intermediate and long-term results, especially the reduction of late atrial arrhythmias.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.241-248
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• 2013

Esophageal cancer has one of the highest malignant potentials of any type of tumor. The 3-field lymph node dissection is the standard procedure in Japan for surgically curable esophageal cancer in the middle or upper thoracic esophagus. Minimally invasive esophagectomy is being increasingly performed in many countries, and several studies report its feasibility and curability; further, the magnifying effect of the thoracoscope is another distinct advantage. However, few studies have reported that minimally invasive esophagectomy is more beneficial than open esophagectomy. A recent meta-analysis revealed that minimally invasive esophagectomy reduces blood loss, respiratory complications, the total morbidity rate, and hospitalization duration. A randomized study reported that the pulmonary infection rate, pain score, intraoperative blood loss, hospitalization duration, and postoperative 6-week quality of life were significantly better with the minimally invasive procedure than with other procedures. In the future, sentinel lymph node mapping might play a significant role by obtaining individualized information to customize the surgical procedure for individual patients' specific needs.

• Journal of Chest Surgery
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• v.15 no.3
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• pp.274-277
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• 1982

A Clinical analysis of 59 patients of thoracic empyema was done who were received surgical intervention at dept. of thoracic surgery of the C.A.F.G.H. in the period of 2.5 years from January 1979 to June 1982. Occurrence ratio of Left and Right side pleural cavity of empyema was 1: 1.4. The predisposing factors of empyema were pulmonary Tbc. [49%], Chest pain [25%], Cough [8%], in order. B.P.F. was associated with empyema in 5 cases. The pleural cavity empyema was treated with several surgical procedures and conservative measures. Among of the 59 cases, the 30 cases [50%] were treated with decortication, 12 cases [20%] with closed thoractomy drainage, 9 cases with frequent thoracenteses, 5 cases with partial decortication and thoracoplasty and 3 cases with open thoracostomy tube drainage. Among of the 59 cases thoracic empyema, the full recovery were in 32 cases [54%], partial recovery in 20 cases [34%], not improved in 3 cases [5%] and 3 cases were died. The mortality rate was 5% and the recovery rate was 89%.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.815-820
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• 1987

Excision of the metastatic pulmonary sarcoma or carcinoma in the selected cases is now the accepted and the most effective method of treatment. From January 1978 to July 1987, 14 patients with metastatic lung cancer were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College. Ages ranged from 26 years to 68 years [mean=38.0 years]. Primary sites were uterus in 6 patients, colorectum in 2, sarcoma of extremities in 2, and 1 case of pancreas, kidney, skin and melanoma of hand. Fourteen posterolateral thoracotomies were done and resected the 36 metastatic masses in 14 patients. Surgical mortality was none. The performed procedures of resection were as follows; lobectomy with wedge resection in 2, lobectomy in 3, segmentectomy in 1 and wedge resection in 8. Eleven patients were received radiotherapy or chemotherapy, or both postoperatively. Among the 14 patients, there were 5 survivors. They are 6, 7, 21, 35, and 63 months postoperatively. Among them, 9 patients were dead. Within one year in 2, two years in 6, and three years in l.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.54-57
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• 2012

Neurilemmoma is a benign and slowly growing neurogenic tumor. Intrathoracic neurilemmoma often develops in the chest wall and posterior mediastinum, but endobronchial neurilemmoma is extremely rare. The diagnosis of endobronchial neurilemmoma with preoperative imaging findings is challenging and is usually made via postoperative pathological examination. These authors encountered a case of primary endobronchial neurilemmoma in a 52-year-old woman who had no symptoms. A $3.0{\times}2.6$ cm mass in the right lower lobe projecting into the mediobasal segmental bronchus was shown in the results of the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the chest. Benign neurilemmoma was confirmed via bronchoscopic biopsy, and surgical resection (sleeve bronchial excision and end-to-end anastomosis) was performed.

• Journal of Chest Surgery
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• v.14 no.4
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• pp.331-338
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• 1981

The inhalation of a foreign body into the tracheobronchial tree is a child is a life-threatening accident. Forgotten foreign bodies In the airways cause chronic pulmonary infections, allergic asthma, bronchiectatic changes, and lung abscess Foreign bodies that cannot be grasped by bronchoscopic forceps should be removed by thoracotomy and bronchotomy. This report describes our experience In 16 patients who were treated to remove inhaled foreign bodies from the airways after repeated bronchoscopies had been unsuccessful from 1963 to 1981 at the department thoracic surgery of Seoul National University Hospital. The surgical procedures are as follows: 12 patients bronchotomy, 2 patient pneumonectomy, 2 patients lobectomy. In these cases, the foreign bodies are 8 metallic material, 3 plastic material, 1 bean, 1 black snail, and 3 cases of no records. Bronchotomy must be performed as soon as possible in order to avoid more advanced pathologic changes In the Involved lung, such as bronchiectasis, fibrosis or abscess.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.555-559
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• 1991

Post-pneumonectomy empyema thoracis is an uncommon, but very serious problem. Early diagnosis & adequate drainage followed by thoracoplasty and or myoplasty are very important principles for the management of the empyema thoracis & will enable patient to recover from the toxic effects. During the period of January, 1985 to December, 1990, 13 patients with post-pneumonectomy empyema thoracis were treated in the department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine. There were 10 males % 3 females ranging from 31 years to 79 years of age. The occurrence ratio of left to right side was 8: 5. The underlying pathologic lesions of empyema thoracis were pulmonary tuberculosis[7], lung ca. [2] pneumothorax[2], lung abscess[1] pneumonia[1]. We treatment procedure for post-pneumonectomy empyema thoracis were open window thoracostomy in 10 cases, Clagett procedures in 2 cases, one thoracoplasty, and two cases of Clagett procedures followed by open window thoracostomy in one cases.