• Journal of Chest Surgery
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• v.15 no.3
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• pp.267-273
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• 1982

We have observed 360 cases of spontaneous pneumothorax from Jan. 1971 to Dec. 1981 at the department of Thoracic and Card iovascular Surgery, Yonsei University College of Medicine. The patients age ranged from 2 days to 95 year-old. The associated pulmonary lesions were shown pulmonary tuberculosis in 158 cases[43.9%], bullae in 35, pulmonary emphysema In 32, pneumothorax in 10, paragonimiasis In 7 and unknown underlying pathology in 109 patients. 70 [51.1 %] out of 1 37 cases who received conservative medical treatment Including thoracentesis were cured completely, but the 67 cases [48.9 %] of remaining uncured patients were treated by surgical procedures. The 290 patients who received surgical management were recovered without recurrent pneumothorax. The surgical procedures were closed thoracotomy drainage or explothoracotomy. The choice of treatment should be based on the extent of pneumothorax or the presence of underlying pulmonary disease. Tube thoracotomywas the most effective procedure in achieving the expansion of collapsed lung. On the other hand, open thoracotomy could be a good approach to recurrent pneumothorax, persistent air leakage, incomplete expansion of the lung and bilateral pneumothorax. The minithoracotomy Is the best procedure to recurrent pneumothorax.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.445-449
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• 2013

Retrobulbar hemorrhage, especially when associated with visual loss, is a rare but significant complication after facial bone reconstruction. In this article, two cases of retrobulbar hematoma after surgical repair of blow-out fracture are reported. In one patient, permanent loss of vision was involved, but with the other patient, we were able to prevent this by performing immediate decompression after definite diagnosis. We present our clinical experience with regard to the treatment process and method for prevention of retrobulbar hematoma using a scalp vein set tube and a negative pressure drainage system.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.166-169
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• 1995

Pneumothorax, a frequently encountered disease in the clinic, has been interesting to surgeons for it`s high recurrence rate. 52 patients with a second attack of pneumothorax at our hospital in a 24 month period were evaluated especially for the risk factors of recurrence. The results were as follows:1. Patients after operative treatment[21 cases There were no postoperative complications and recurrence.2. Patients with tube drainage or conservative treatment [31 cases [i Overall recurrence rate was 45.2 %. [ii Suggestive risk factors for the recurrence were: age above 30 years, short period of thoracostomy less than six days. And other factors such as male, right lung, higher level of lung collapse were thought to be followed further more.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.951-953
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• 1995

A male 17-year-old boy was tranferred from a private hospital for persistent bilateral pleural effusion.The effusion was confirmed　as bilateral chylothorax by chest CT and lymphangiography. Persistent accumulation of the chylothorax was uncontrollable more 1000cc daily ever after pleuroperitoneal shunt operation and thoracoscopic thoracic duct ligation at Rt. side. Chemical pleurodesis with OK 432 into pleural cavity through thoracostomy tube was attempted as 1.5 KE-3 KE diluted in 50ml of normal saline for 3 consecutive days resulted dramatic reduction of the drainage amount. Chemical pleurodesis with OK 432 appeared to be very helpful for management idiopathic bilateral chylothorax.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.800-805
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• 1992

Acquired, nonmalignant tracheoesophageal fistula is an uncommom and difficult problem to manage. The most commom cause is a complication of endotracheal or tracheostomy tubes. Most are diagnosed while patients still require mechanical ventilation. The principle of treatment is two stage operation. First, new tracheostomy tube is placed so that the baloon is below the fistula, and gastrostomy and feeding jejunostomy are made for the drainage and feeding. Finally after weaning from the mechanical ventilation, tracheal resection and reconstruction are made, and the esophageal defect is closed in two layers and a viable strap muscle interposed into the two suture site to prevent recurrence. Recently, we experienced a case of acquired nonmalignant tracheoesophageal fistula which was developed during mechanical ventilation. She was successfully treated with the above two stage operation.

• Journal of Chest Surgery
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• v.22 no.6
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• pp.1044-1048
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• 1989

In this study, 26 cases of bilateral spontaneous pneumothorax experienced at the department of thoracic and cardiovascular surgery, Chungnam National University Hospital during from 1985 to August 1989 were analyzed retrospectively. The results were as follows; 1. The incidence of bilateral spontaneous pneumothorax was 13.5 % and sex ratio was 7.7:1 with male preponderance. 2. Among the nonsimultaneously occurring cases of bilateral pneumothorax, 12 patients [75 %] were developed at contralateral side within a year. 3. The most patients [65.4%] belonged to the age group between 15 and 25 year-old, and among 57 male patients suffered spontaneous pneumothorax in the same age group, 16 cases[28%] developed bilaterally. 4. The etiologic factors were as follows; blebs or bullae; 65.4 %, tuberculosis; 15.4 %, unknown; 19.2 %. 5. In the method of treatment, 15 patients were treated by closed tube thoracotomy and underwater-seal drainage only, 10 patients were treated by open thoracotomy. One patient died of respiratory failure due to severe destructed lung.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.969-971
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• 1993

The sternal turnover has a limited use in an asymmetrical funnel chest. However we tried `One-half sternal turnover` as a new operative approach for an asymmetrical funnel chest. Through the bilateral submammary skin incision, median sternotomy was made from xiphoid process to midsternum and extended horizontally. The segment of ribs were cut at the angle of depression. The en-bloc resected chest wall segment contained one-half sternum as well as a part of ribs and left half of rectus muscle. After turning over the en-bloc segment, reapproximation with wiring was done. Sternotomy wound was closed in layer after placing of substernal drainage tube. Postoperatively, the chest wall was stable and the recovery course was uneventful except left-sided minimal pneumothorax which was cured spontaneaously. The patient was discharged on postoperative 14th day.

• Journal of Chest Surgery
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• v.36 no.11
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• pp.883-885
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• 2003

Traditional surgical management of chylothorax refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy. A new surgical procedure of ligation of the thoracic duct via extrapleural approach is presented. Its advantages are less invasive, no need of a new drainage tube, and easier to expose the thoracic duct than the conventional transthoracic approach. We experienced a new surgical method in the treatment of the chylothorax and report it with literatures.

• Journal of Chest Surgery
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• v.46 no.5
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• pp.383-387
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• 2013

Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.

• Journal of Chest Surgery
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• v.22 no.5
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• pp.731-738
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• 1989

The development of chylothorax and chylopericardium are serious and often life-threatening clinical entity. The ideal treatment of these problems is not well established to date. We reviewed our experiences with chylothorax or chylopericardium in 16 patients [17 cases] from July 1979 to May 1989. Ages ranged from 20 days to 41 years. The etiologies were traumatic in 10, congenital or idiopathic in 5, and tuberculous lymphadenopathy in one. In 8 patients, the chylothorax or chylopericardium occurred as a complication of cardiothoracic surgery. Eleven patients were treated nonoperatively with either repeated thoracenteses or chest tube drainage. Five patients underwent operative treatment: transthoracic thoracic duct ligation [three patients], thoracic duct ligation combined with decortication [one], and oversewn the defect of mediastinal pleura[one]. Duration of preoperative therapy ranged from 18 to 38 days. One of eleven [9.1 %] patients treated nonoperatively died. Of the surgically treated group, there were no deaths. All patients except one dead cured or improved either treated nonoperatively or operatively. Our experience suggests that surgical management of the chylothorax or chylopericardium is not always required, and each patient must be judged individually according to disease process.