• Tuberculosis and Respiratory Diseases
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• v.56 no.3
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• pp.321-323
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• 2004

A-59-year old man was admitted to the hospital with a 2-month history of the right pleuritic chest discomfort and mild dyspnea. Seven years earlier, he was operated on left pneumonectomy for squamous cell carcinoma of left upper lobe (Stage IIb, $T_2N_1M_0$). The computed tomographic scan revealed an anterior herniation of the right lung in the left hemithorax. A single thorax after receiving pneumonectomy is called a "buffalo chest" because the absence of an anatomical separation of the two hemithoraxes resembles that of the North American buffalo or bison. A possible pneumothorax should be catastrophic for the patient, so he should be closely monitored regarding any invasive procedure or trauma. He improved after symptomatic treatment.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.702-704
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• 2018

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4169-4173
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• 2014

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is highly accurate in diagnosing mediastinal lymphadenopathies of lung cancer and benign disorders. However, the utility of EBUS-TBNA in the diagnosis of mediastinal lymphomas is unclear. The aim of this study was to determine the diagnostic value of EBUS-TBNA in patients with suspected lymphoma. Materials and Methods: Sixty-eight patients with isolated mediastinal lymphadenopathy and suspected of lymphoma were included in the study. EBUS-TBNA was performed on outpatients under moderate sedation. The sensitivity, specificity, negative predictive value and diagnostic accuracy of EBUS-TBNA were calculated. Results: Sixty-four patients were diagnosed by EBUS-TBNA, but four patients with non-diagnostic EBUS-TBNA required surgical procedures. Thirty-five (51.5%) patients had sarcoidosis, six (8.8%) had reactive lymphadenopathy, nine (13.3%) had tuberculosis, one (1.5%) had squamous cell carcinoma, two (2.9%) had sarcoma and fifteen (22%) had lymphoma (follicular center cell, large B-cell primary, and Hodgkin lymphomas in three, two, and ten, respectively). Of the 15 lymphoma patients, thirteen were diagnosed by EBUS and two by thoracotomy and mediastinoscopy. The sensitivity, specificity, negative predictive value, and diagnostic accuracy of EBUS-TBNA for the diagnosis of lymphoma were calculated as 86.7%, 100%, 96.4%, and 97%, respectively. Conclusions: EBUS-TBNA can be employed in the diagnosis of mediastinal lymphoma, instead of more invasive surgical procedures.

• Journal of Chest Surgery
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• v.28 no.8
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• pp.772-777
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• 1995

Bronchoplastic procedure has been considered as an appropriate surgery for traumatic bronchial disruption and occasionaly for primary bronchial tumors or tuberculosis because it can bring preservation of pulmonary tissue for patients without compromising the chance for cure. Nowadays bronchoplastic procedure is also applicable for the selected cases of bronchogenic carcinomas with favorable long term survival, when compared to standard pneumonectomy.Eighteen bronchoplastic procedures were performed with or without pulmonary resection at Department of Thoracic and Cardiovascular Surgery, Catholic University Medical College, between 1990 and 1994. The patients were 11 men and 7 wemen with average age of 57 years [range, 19 to 71 years . Tumor comprised 56% of the lesions, including 6 squamous cell carcinoma [33% , 2 bronchial adenoma [11% , 1 leiomyoma and 1 metastatic osteogenic sarcoma. Cicatrical stenosis secondary to endobronchial tuberculosis and traumatic disruption occurred in 6 [33% and 1 patient respectively.Applied bronchoplastic procedures were as follows ; sleeve lobectomy, 8 cases [right upper : 6, left upper : 1, right middle : 1 : bronchial segmental resection without pulmonary resection, 2 cases : sleeve bi-lobectomy, 1 cases :patch dilating bronchoplasty with or without concomitant lobectomy in 7. There was no perioperative mortality. Morbidity in 4 patients included 1 transient recurrent laryngeal nerve palsy, 1 unstability of bronchial patch resulting atelectasis of afftected lung and 2 bronchial stenosis of anastomotic site.Throughout our experiences, we feel strongly that bronchoplastic procedure is a safe and effective surgical method preserving normal pulmonary tissue below affected bronchus for the wide range of various bronchial lesion including selected cases of bronchogenic carcinoma with acceptable complication and mortality.

• Journal of Chest Surgery
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• v.32 no.2
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• pp.158-163
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• 1999

Background: The author studied to define the current indications for surgical management of chest tuberculosis and to analyze the results of the operative procedures. Material and Method: The records of 87 patients among 107 patients operated on between January 1992 and May 1995 were reviewed. These patients were divided into 4 groups. Group I patients (n=45) underwent decortication with or without wedge resection of the lesion. Group II patients(n=23) underwent radical curettages of chest wall involving rib caries with or without thoracotomy. Group III patients(n=12) underwent standard pneumonectomy or pleuropneumonectomy. Group IV patients(n=7) underwent exploratory thoracotomy or wedge resection of tuberculous lung lesion. Result: Statistical analysis revealed an inverse correlation between AIs and intratumoral microvessel densities in squamous cell lung carcinoma(Spearman rank correlation coefficient r=- 0.229, p=0.047). Conclusion: The author concludes that surgery for chest tuberculosis is the definite management for therapeutic indications and surgical radication of tuberculous carriers for management of chest tuberculosis is safe and has satisfactory results.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4535-4538
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• 2014

Objective: To explore the value of porous titanium alloy plates for chest wall reconstruction after resection of chest wall tumors. Materials and Methods: A total of 8 patients with chest wall tumors admitted in our hospital from Jan. 2006 to Jan. 2009 were selected and underwent tumor resection, then chest wall repair and reconstruction with porous titanium alloy plates for massive chest wall defects. Results: All patients completed surgery successfully with tumor resection-induced chest wall defects being $6.5{\times}7cm{\sim}12{\times}15.5$ cm in size. Two weeks after chest wall reconstruction, only 1 patient had subcutaneous fluidify which healed itself after pressure bandaging following fluid drainage. Postoperative pathological reports showed 2 patients with costicartilage tumors, 1 with squamous cell carcinoma of lung, 1 with lung adeno-carcinoma, 1 with malignant lymphoma of chest wall, 2 with chest wall metastasis of breast cancers and 1 with chest wall neurofibrosarcoma. All patients had more than 2~5 years of follow-up, during which time 1 patient with breast cancer had surgical treatment due to local recurrence after 7 months and none had chest wall reconstruction associated complications. The mean survival time of patients with malignant tumors was ($37.3{\pm}5.67$) months. Conclusions: Porous titanium alloy plates are safe and effective in the chest wall reconstruction after resection of chest tumors.

• Tuberculosis and Respiratory Diseases
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• v.42 no.5
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• pp.685-694
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• 1995

Introduction: Transthoracic fine needle aspiration biopsy(TNAB) has shown to be a resonably safe, simple, and accurate procedure in diagnosis of intrathoracic lung lesions. We reviewed the results of 1,005 TNAB of chest lesions performed on 930 patients with 20 or 22-gauze needles over a period of 10 years. Methods: From November 1983 to June 1995, 1,005 cases in 930 patients with an undiagnosed lung lesion underwent TNAB at the Hanyang University Hospital: 66% were men and 34% were women. Most of the patients were 40~60 years old and the youngest patient was 3 years of age. Result: 540 patients had various malignant chest lesions and 322 patients had benign pulmonary lesions. The diagnostic accuracy of TNAB was 96.1 percent in malignant diseases with one false positive result and 90.1% in benign diseases. A definitive diagnosis was not obtained in the remaining 68 patients. The most common diagnoses among 519 malignancy chest lesions with TNAB were the following: squamous cell lung carcinoma, 31.7%; adenocarcinoma, 24.7%; small cell lung carcinoma, 16.7%; metastatic cancer, 14.2%; large cell lung carcinoma, 6.2% and so on. Complications included pneumothorax in 12.3% necessitating chest tube drainage in 0.6%. Minor hemoptysis occurred in 3.6%. There was no death directly attributable to the procedure. Conclusion: We concluded that TNAB permits a direct approach to all kinds of localized lung lesions with a high degree of accuracy and without major complications.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.171-181
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• 2001

Background : Angiogenesis is an essential process for the growth and metastatic ability of solid tumors. One of the key factors known to be capable of stimulating tumor angiogenesis is the vascular endothelial growth factor (VEGF). The serum VEGF concentration has been shown to be a useful parameter related to the clinical features and prognosis of lung cancer and has been recently applied to a the malignant pleural effusion showing a correlation with the biochemical parameters. The VEGF has been shown to play a role in the inflammatory diseases, but rarely in the tuberculosis (TB). The serum and pleural fluid VEGF levels were measured in patients with lung cancer and TB. Their relationship with the clinical and laboratory parameters and repeated measurement 3 months after various anticancer treatments were evaluated to assess the utility of the VEGF as a tumor marker. Methods : Using a sandwich enzyme-linked immunosorbent assay, the VEGF conoentration was measured in both sera and pleural effusions collected from a total of 85 patients with lung cancer, 13 patients with TB and 20 healthy individuals. Results : The serum VEGF levels in patients with lung cancer ($619.9{\pm}722.8pg/ml$) were significantly higher than those of healthy controls ($215.9{\pm}191.1pg/ml$), However, there was no significant difference between the VEGF levels in the lung cancer and TB patients. The serum VEGF levels were higher in large cell and undifferentiated carcinoma than in squamous cell carcinoma and adenocarcinoma. The serum VEGF levels of lung cancer patients revealed no significant relationship with the various clinical parameters. The VEGF concentrations in the malignant effusion ($2,228.1{\pm}2,103.0pg/ml$) were significantly higher than those in the TB effusion ($897.6{\pm}978.8pg/ml$). In the malignant pleural effusion, the VEGF levels revealed significant correlation with the number of red blood cells (r=0.75), the lactate dehydrogenase (LDH)(r=0.70), and glucose concentration (r=-0.55) in the pleural fluid. Conclusion : The serum VEGF levels were higher in the lung cancer patients. The VEGF levels were more elevated in the malignant pleural effusion than in the tuberculous effusion. In addition, the VEGF levels in the pleural fluid were several times higher than the matched serum values suggesting a local activation and possible etiologic role of VEGF in the formation of malignant effusions. The pleural VEGF levels showed a significant correlation with the numbers of red blood cells, LDH and glucose concentrations in the pleural fluid, which may represent the tumor burden.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5971-5976
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• 2015

Background: Several prognostic factors have been studied in NSCLC, although it is unknown which is most useful. In this study, we aimed to investigate whether pre-treatment serum albumin level has prognostic value in patients with Stage IIIB NSCLC. Materials and Methods: This cross-sectional study included a total of 204 patients with Stage IIIB NSCLC who met the inclusion criteria. Pre-treatment serum albumin levels and demographic, clinical, and histological characteristics, as well as laboratory variables were recorded. A cut-off value was defined for serum albumin level and the patients were stratified into four groups on thios basis. Results: The majority of the patients was males and smokers, with a history of weight loss, and squamous histological type of lung cancer. The mean serum albumin level was $3.2{\pm}1.7g/dL$ (range, 2.11-4.36 g/dL). A cut-off value 3.11 g/dL was set and among the patients with a lower level, 68% had adenocarcinoma and 82% were smokers. The patients with low serum albumin levels had a lower response rate to e first-line chemotherapy with a shorter progression-free survival and overall survival. Multivariate analysis showed that low serum albumin level was an independent poor prognostic factor for NSCLC. Conclusions: This study results suggest that low serum albumin level is an independent poor prognostic factor in patients with Stage IIIB NSCLC, associated with reduction in the response rate to first-line therapy and survival rates.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.471-477
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• 1999

Background : Smoking and high-risk occupation have been known to be the risk factors of lung cancer. The carcinogen-metabolizing enzymes in human body such as glutathione S-transferase M1, T1 and N-acetyltransferase 1 have also been regarded as risk factors in many cancers, because the activities of those enzymes play a role in metabolizing the carcinogen. A case-control study was conducted to evaluate the genetic polymorphism of GSTM1, T1 and NAT1 in lung carcinogenesis in Korean men. Methods : The histologically proven lung cancer cases were recruited from Seoul National University Hospital. The patients of more than 40-year-old with the nonmalignant urinary tract diseases were recruited as controls from the same hospitals. The informations of demographical characteristics and smoking were obtained by interview or chart review and the genetic polymorphisms of GSTM1, T1 and NAT1 were determined by PCR-based assay. The statistical analyses were performed by linear logistic regression. Results : The number of case-control was 118 and 150, respectively. The smoking history was significantly higher in the lung cancer patients than the controls. The prevalence of GSTM1 null-type was statistically higher(OR=2.25 ; 95% CI=1.12-4.51) in squamous cell carcinoma than other genotypes, but other histologic types were not The prevalence of GSTT1 null-type were not statistically higher than other genotypes in all histologic types. The fast acetylator of NAT1 was more prevalent than normal(OR=2.13 ; 95% CI=1.04-4.40) in all lung cancer patients. Conclusion : The null-type of GSTM1 and fast acetylator of NAT1 are associated with development of lung cancer in Korean men.