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

• Journal of Chest Surgery
• /
• v.29 no.3
• /
• pp.311-314
• /
• 1996

Eighteen patients (13 female and ave male) aged from 15 to 62 years (mean age 42.6 years) underwent excision of cardiac myxoma(17 left atrial, one right atrial) between 1985 and 1994 at Pusan National University hospital. All patients complained of exertional dyspnea and most had a few additional symtoms including palpitation, chest pain, syncope, general weakness, weight loss, fever, cough and epigastric disconyort. The diagnosis was made by echocardiography alone in left atrial myxomas but a myxoma in right atrium was diagnosed incidentally during mitral valve replacement for rheumatic valvular heart disease. The tumor attachment sites were fossa ovalis in 13, other interatrial septum in 4, mitral valve annulus in one and free wall of left atrium in two cases. The tumor was excised successfully via right atriotomy in 8 and biatriotomy in 10 cases. There was no hospital nor late death, and no recurrent case during the follow up period. Curative surgical excision of cardiac myxoma can be performed with low morbidity and very low r currence rate.

• Tuberculosis and Respiratory Diseases
• /
• v.75 no.6
• /
• pp.264-268
• /
• 2013

A 73-year-old, previously healthy man presented with nausea, vomiting, diarrhea, dry mouth and febrile sensation 3 hours after eating boiled wild mushrooms. After admission, he showed progressive severe respiratory distress, pancytopenia, azotemia, hypotension, hypoxemia and consolidation of the entire left lung on chest radiography. With a preliminary diagnosis of necrotizing pneumonia, he underwent left pneumonectomy in order to remove all necrotic lung tissue. Lung histology showed extensive hemorrhagic necrosis, massive inflammatory cell infiltration, prominent proliferation of young fibroblasts and the formation of an early-stage hyaline membrane along the alveolar wall. Despite aggressive treatment, including mechanical ventilation, continuous renal replacement therapy and administration of granulocyte colony stimulating factor and broad spectrum antibiotics, he died on hospitalization day 13. Subsequently, the mushroom was identified as Podostroma cornu-damae. This is the first case of a histological evidence of lung involvement by Podostroma cornu-damae poisoning in Korea.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.32 no.3
• /
• pp.246-250
• /
• 2010

Mediastinal emphysema, also referred to as pneumomediastinum or Hamman's syndrome, is defined as the presence of air or gas within the fascial planes of the mediastinum. Superior extension of air into the cervicofacial subcutaneous space via communications between the mediastinum and cervical fascial planes or spaces occurs occasionally. The mediastinal air may originate from the respiratory tract, the intrathoracic airway, the lung parenchyma, or the gastrointestinal tract. The presence of air in the mediastinum may be spontaneous, iatrogenic or due to penetrating trauma. Pneumothorax is defined as the presence of air or gas within the pleural cavity. A pneumothorax can occur spontaneously. It can also occur as the result of a disease or injury to the lung or due to a puncture to the chest wall. Pneumomediastinum and pneumothorax is a rare complication of head and neck surgery. Nevertheless, when it occurs, it is usually considered to result from direct dissection by the air at the time of injury or of surgery. Most of the cases of pneumomediastinum and pneumothorax that have been described in the oral and maxillofacial surgery literature result from air dissecting down the fascial planes of the neck. The authors report a case with subcutaneous emphysema, pneumomediastinum and pneumothorax after orthognathic surgery.

• Clinical and Experimental Pediatrics
• /
• v.59 no.6
• /
• pp.262-270
• /
• 2016

Purpose: Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF. Methods: The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the sildenafil (S) group (MCT 60 mg/kg+ sildenafil 30 mg/kg/day for 28 days). Masson Trichrome staining was used for heart tissues. Western blot analysis and immunohistochemical staining were performed. Results: The mean right ventricular pressure (RVP) was significantly lower in the S group at weeks 1, 2, and 4. The number of intra-acinar arteries and the medial wall thickness of the pulmonary arterioles significantly lessened in the S group at week 4. The collagen content also decreased in heart tissues in the S group at week 4. Protein expression levels of B-cell lymphoma-2 (Bcl-2)-associated X, caspase-3, Bcl-2, interleukin (IL)-6, matrix metalloproteinase (MMP)-2, endothelial nitric oxide synthase (eNOS), endothelin (ET)-1 and ET receptor A (ERA) in lung tissues greatly decreased in the S group at week 4 according to immunohistochemical staining. According to Western blotting, protein expression levels of troponin I, brain natriuretic peptide, caspase-3, Bcl-2, tumor necrosis factor-${\alpha}$, IL-6, MMP-2, eNOS, ET-1, and ERA in heart tissues greatly diminished in the S group at week 4. Conclusion: Sildenafil alleviated right ventricular hypertrophy and mean RVP. These data suggest that sildenafil improves right ventricular function.

• Parasites, Hosts and Diseases
• /
• v.32 no.4
• /
• pp.277-280
• /
• 1994

In the definitive hosts, metacercariae of Parofonimn westermani excyst in host duodenum, penetrate intestinal wall, migrate peritoneal and thoracic cavities, and develop to sexual maturity in 8 weeks. This study was undertaken to examine the age of the maturing p. westernnni when their infectivity to the other definitive hosts was retained. On 3, 7, 10, 14,21 and 28 days after feeding the metacercariae to cats through a gastric tube, the developing worms were harvested. The juveniles of different age were fed again to other experimental cats. One to 12 weeks after the oral-transfer infections, the experimental cats were examined for establishment of infections. In the cats to which 3- day and 7-day old juveniles (grown up to 1.4 mm long) were fed, 31.4% and 22.6% of the transferred worms were found infected. The worms of 10-28 days old were not infective. Early maturing stages grown up to 7 days maintained their infectivity to the other definitive hosts.

• Clinical and Experimental Pediatrics
• /
• v.61 no.9
• /
• pp.271-278
• /
• 2018

Purpose: Abnormal potassium channels expression affects vessel function, including vascular tone and proliferation rate. Diverse potassium channels, including voltage-gated potassium (Kv) channels, are involved in pathological changes of pulmonary arterial hypertension (PAH). Since the role of the Kv1.7 channel in PAH has not been previously studied, we investigated whether Kv1.7 channel expression changes in the lung tissue of a monocrotaline (MCT)-induced PAH rat model and whether this change is influenced by the endothelin (ET)-1 and reactive oxygen species (ROS) pathways. Methods: Rats were separated into 2 groups: the control (C) group and the MCT (M) group (60 mg/kg MCT). A hemodynamic study was performed by catheterization into the external jugular vein to estimate the right ventricular pressure (RVP), and pathological changes in the lung tissue were investigated. Changes in protein and mRNA levels were confirmed by western blot and polymerase chain reaction analysis, respectively. Results: MCT caused increased RVP, medial wall thickening of the pulmonary arterioles, and increased expression level of ET-1, ET receptor A, and NADPH oxidase (NOX) 4 proteins. Decreased Kv1.7 channel expression was detected in the lung tissue. Inward-rectifier channel 6.1 expression in the lung tissue also increased. We confirmed that ET-1 increased NOX4 level and decreased glutathione peroxidase-1 level in pulmonary artery smooth muscle cells (PASMCs). ET-1 increased ROS level in PASMCs. Conclusion: Decreased Kv1.7 channel expression might be caused by the ET-1 and ROS pathways and contributes to MCT-induced PAH.

• Journal of Trauma and Injury
• /
• v.22 no.1
• /
• pp.1-4
• /
• 2009

Purpose: This study was conducted to evaluate the length of the catheter used in a needle thoracostomy for emergency decompression of a tension pneumothorax by measuring the chest wall thickness (CWT) in patients with chest trauma Methods: A retrospective review of 201 patients with chest trauma who had been transported the emergency department in a tertiary university hospital in a metropolitan area between 1 January and 31 February 2007 was performed. The average CWT at the second intercostal space (ICS) in the midclavicular line (MCL) was measured by using a chest computed tomography scan. Results: As the left and the right mean CWTs were $3.4{\pm}1.0cm$ and $3.4{\pm}1.0cm$, respectively, there was no significant statistical difference between them. The mean CWT of female patients was significantly higher than that of male patients (p=0.001). The mean CWT of patients under the age of 65 years was significantly thicker than that of the patients over the age of 65 years (p<0.001). Of the studied patients, 12 (6.0%) a CWT > 5 cm. Conclusion: A 5 cm-length catheter in a needle thoracostomy may be insufficient for emergency decompression of a tension pneumothorax, so a catheter longer than 5 cm in length is needed.

• Journal of Veterinary Clinics
• /
• v.29 no.1
• /
• pp.87-92
• /
• 2012

A six months old, male Shih Tzu dog was referred to the Veterinary Medical Teaching Hospital at Kangwon National University, for lethargy, respiratory embarrassment. Survey radiography revealed enlarged cardiac silhouette due to displacement of gas-filled intestine in the pericardium. Although there were no specific clinical signs, this case was diagnosed as peritoneopericardial diaphragmatic hernia (PPDH) based on the results of positive contrast radiography and thoracic ultrasonograpic findings. In addition, the thickened gall bladder wall observed in ultrasonography, increase of alkaline phosphatase and neutrophils indicated cholecystitis. Two hepatic lobes and gall bladder were severely necrotized and adhere to the diaphragm. Direct reduction of the herniated organs might cause hepatic hemorrhage and bile juice leakage which may induce very poor prognosis. To solve the problems, the adhered organs were dissected with part of diaphragm, and lobectomy with cholecystectomy was performed for prevention of some possible complications including peritonitis. This is case report describing resection of part of diaphragm adhered to herniated organ reduce the risk of possible hepatic hemorrhage during surgical correction of PPDH followed bycholecystectomy and lobectomy.

• Journal of Chest Surgery
• /
• v.37 no.11
• /
• pp.929-932
• /
• 2004

The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.