• Journal of Chest Surgery
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• 제22권5호
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• pp.862-866
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• 1989

We are experienced one case of \ulcornerinchu" method operation for chronic thoracic empyema with bronchopleural fistula. A 30-years old male was admitted to our hospital because of right thoracic empyema. In spite of pleural tube drainage, the right entire lung was poorly expanded. The right upper lobectomy and decortication for visceral side of empyema peel were done but expansion of right middle and lower lobe was not enough to fill the pleural space remained Extraperiosteal detachment without performing thoracoplasty was done as the method proposed by Kinchu. The patient recovered without significant problem and the good expansion of remained lung with acceptable pulmonary function was obtained.ined.

• Radiation Oncology Journal
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• 제35권4호
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• pp.380-384
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• 2017

Massive chylous leakage is a rare postoperative complication that can prolong hospital stay and cause secondary morbidities. Conservative management strategies are the treatment of choice; however, radiation therapy (RT) can be used as an alternative for cases that are refractory to conservative treatment. Herein, we report a 69-year-old female patient who suffered from massive chylous leakage after subtotal gastrectomy. Due to persistent massive chylous leakage, she was scheduled to undergo low-dose RT. Radiation was delivered with a daily dose of 1 Gy, using an anterior-posterior and posterior-anterior beam arrangement. The clinical target volume encompassed the entire lymph node area of the D2 dissection. RT was completed at the total dose of 8 Gy because the amount of chylous leakage declined rapidly. Percutaneous drainage tube was removed after 3 days of RT. The patient did not complain of any symptoms related to massive chylous leakage 2 years after the completion of RT.

• Journal of Hospice and Palliative Care
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• 제12권4호
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• pp.194-198
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• 2009

목적: 진행성 암 환자에서 악성장폐색은 구역, 구토, 통증을 비롯한 소화기계 증상을 유발하여 삶의 질을 저하시킨다. 악성장폐색의 증상 조절을 위해 octreotide를 투여한 후의 효능에 대한 보고들이 발표되었고, 저자들은 악성장폐색이 있는 환자에게 보존적 치료에 octreotide를 추가하여 투여시의 효과와 안전성을 알아보고자 하였다. 방법: 의무기록을 통하여 일반적인 치료로 호전이 없어 octreotide를 추가한 악성장폐색의 환자 29명에서 octretide를 0.1 mg을 시작으로 증상 조절될 때까지 증량하여, 약 투여 전후의 통증의 변화, 구토 횟수의 변화, 비위관 삽입환자의 경우 배액량의 변화를 조사하였다. 결과: Octreotide 투여량의 중간 값은 0.2 mg이고 0.1~0.6 mg의 범위이며, 약제 투여시점으로부터 사망까지 2일에서 103일의 범위로 중간 값은 20일이었다. 약제 투여 전의 VAS는 평균 5.6$\pm$1.2이고, 약 투여 후 VAS의 평균은 2.7$\pm$1.0이었으며 통계적으로 유의한 감소를 보였다(P<0.05). 약제 투여 전의 구토 횟수는 평균 3.6회/일$\pm$2.5이었고 약 투여 후에는 0.4회/일$\pm$0.8로 감소되었고, 통계적으로 유의한 감소를 보였다(P<0.05). 약제 투여전에 비위관 삽입 환자는 평균 975$\pm$1,083 cc/일의 배액이 확인되었고, 약 투여 후에는 평균 115$\pm$196 cc/일로 유의하게 감소하였다(P<0.05). 결론: 일반적인 약물치료에 반응이 없는 악성장폐색환자에서 octretide의 추가 투여는 효과적이며 안전하였다. 악성장폐색 환자의 증상조절을 위해서 octreotide의 추가 투여를 적극적으로 고려해야 하겠다.

• Journal of Chest Surgery
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• 제37권12호
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• pp.987-991
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• 2004

배경: 외상성 혈흉에서 부적절한 배액은 농흉, 섬유흉 및 늑막석회화 등 합병증으로 입원 기간을 연장시킨다. 외상성 혈흉 80%에서는 단순 흉강삽관술로 치료가 되지만, 나머지 경우는 수술적 치료가 필요하다. 대상 및 방법: 2002년 3월부터 2003년 2월까지 흉강삽관술을 시행했던 123예 중 조기에 비디오 흉강경으로 저류된 응고된 혈흉을 제거하였던 10명(group I)과 국소적 혈흉 혹은 농흉으로 수술을 받았던 5명(group II)을 대상으로 하였다. 두 군에서 남자가 여자보다 많았으며, 평균 나이는 비슷하였다. 수상 원인은 교통사고가 가장 많았으며, 가장 흔히 동반된 병변은 복부였다. 결과: Group I에서 평균 수상일로부터 수술일까지 평균 기간, 수술 시간, 평균 흉관 유지 기간 및 재원기간은 group II보다 더 짧았다(p<0.05). Group I에서는 추적 관찰 기간(17.8$\pm$3.8개월) 중 재발되거나 수술과 관련된 합병증은 없었으나, group II(21.5$\pm$5.3 months)에서는 2예가 있었다. 결론: 외상성 혈흉에 남아 있는 국소적으로 응고된 혈흉을 비디오 흉강경으로 7일 이내에 제거한다면 안전하고 효과적이다.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.121-126
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• 2018

중환자실에 입원한 환자들의 구강위생은 매우 중요한 문제이다. 중환자들은 기본적으로 면역이 저하된 환자들로 각종 병원성 세균들에 의한 감염의 기회가 높기 때문이다. 구강문제는 감염의 1차 방어선인 구강이 감염의 우선적인 부위로 작용될 뿐 아니라 전신감염을 초래하기도 한다. 본 연구에서는 중증환자의 구강청소를 용이하게 하는 마우스 피스 형태의 새로운 진공 구강 세정기 설계에 관한 연구를 수행하였다. 이중 구조 방식의 세정기와 표준 치아 모델로써 3D CAD 모델링 및 유동해석 모델을 수립하고 압력 및 유동특성을 분석하였다. 세정기 내부의 압력은 거의 일정한 분포를 보였으나, 속력분포의 경우 치아 안쪽과 바깥쪽에서 큰 차이를 보였다. 치아 안쪽에서도 가운데 부분의 속도가 가장 높고 가운데에서 멀어질수록 속력이 감소하는 특성을 보였다. 세정기의 흡입관과 배출관을 바꾸어 해석한 결과 치아 바깥쪽 가운데 부분의 속도가 가장 높게 나타났다. 세정기의 효과를 높이기 위해서 흡입-배출을 교대로 바꾸는 교번식을 제안하고, 어금니 부위의 속력을 높이는 설계 보완이 요구된다.

• Tuberculosis and Respiratory Diseases
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• 제72권5호
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• pp.441-447
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• 2012

Background: Chest tube drainage (CTD) is an indication for the treatment of pneumothorax, hemothroax and is used after a thoracic surgery. But, in the case of incomplete lung expansion, and/or persistent air leak from CTD, medical or surgical thoracoscopy or, if that is unavailable, limited thoracotomy, should be considered. We evaluate the efficacy of bronchoscopic injection of ethanolamine to control the persistent air leak in patients with CTD. Methods: Patients who had persistent or prolonged air leak from CTD were included, consecutively. We directly injected 1.0 mL solution of 5% ethanolamine oleate into a subsegmental or its distal bronchus, where it is a probable air leakage site, 1 to 21 times using an injection needle through a fiberoptic bronchoscope. Results: A total of 15 patients were enrolled; 14 cases of spontaneous pneumothorax [idiopathic 9, chronic obstructive pulmonary disease (COPD) 3, post-tuberculosis 2] and one case of empyema associated with broncho-pleural fistula. Of these, five were patients with persistent air leak from CTD, just after a surgical therapy, wedge resection with plication for blebs or bullae. With an ethanolamine injection therapy, 12 were successful but three (idiopathic, COPD and post-tuberculosis) failed, and were followed by a surgery (2 cases) or pleurodesis (1 case). Some adverse reactions, such as fever, chest pain and increased radiographic opacities occurred transiently, but resolved without any further events. With success, the time from the procedure to discharge was about 3 days (median). Conclusion: Bronchoscopic ethanolamine injection therapy may be partially useful in controlling air leakage, and reducing the hospital stay in patients with persistent air leak from CTD.

• Tuberculosis and Respiratory Diseases
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• 제57권5호
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• pp.465-469
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• 2004

저자들은 패혈증이나 혈액응고장애가 이상이 없는 소방이 형성된 흉막삼출 환자에서 비교적 안전한 것으로 알려진 urokinase의 주입 후에 발생한 혈흉과 이로 인한 hypovolemic shock을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제49권2호
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• pp.85-91
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• 2016

Background: This study was conducted to determine the efficacy of staple line coverage using a polyglycolic acid patch and fibrin glue without pleural abrasion to prevent recurrent postoperative pneumothorax. Methods: A retrospective analysis was carried out of 116 operations performed between January 2011 and April 2013. During this period, staple lines were covered with a polyglycolic acid patch and fibrin glue in 58 cases (group A), while 58 cases underwent thoracoscopic bullectomy only (group B). Results: The median follow-up period was 33 months (range, 22 to 55 months). The duration of chest tube drainage was shorter in group A (group A $2.7{\pm}1.2day$ vs. group B $3.9{\pm}2.3day$, p=0.001). Prolonged postoperative air leakage occurred more frequently in group B than in group A (43% vs. 19%, p=0.005). The postoperative recurrence rate of pneumothorax was significantly lower in group A (8.6%) than in group B (24.1%) (p=0.043). The total cost of treatment during the follow-up period, including the cost for the treatment of postoperative recurrent pneumothorax, was not significantly different between the two groups (p=0.43). Conclusion: Without pleural abrasion, staple line coverage with a medium-sized polyglycolic acid patch and fibrin glue after thoracoscopic bullectomy for primary spontaneous pneumothorax is a useful technique that can reduce the duration of postoperative pleural drainage and the postoperative recurrence rate of pneumothorax.

• Journal of Chest Surgery
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• 제53권1호
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• pp.16-21
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• 2020

Background: Patients undergoing cardiac surgery require postoperative chest drainage. However, the drain is difficult to keep in place in children with congenital heart disease. Since 2015, at Kyungpook National University Hospital, the chest tube is removed on postoperative day 1 in patients who have undergone simple congenital cardiac surgery (i.e., closure of an atrial or ventricular septal defect). In this study, we evaluated the relationship between the duration of drain placement and the likelihood of pericardial effusion after congenital cardiac surgery. Methods: The medical records of patients who underwent closure of an atrial or ventricular septal defect at our hospital between January 2014 and December 2016 were reviewed. In total, 162 patients who received follow-up echocardiography and had information available on postoperative pericardial effusion after the repair procedure were enrolled. Results: Echocardiography was performed at a median of 5 days (range, 4 to 6 days) postoperatively before discharge from the hospital. Pericardial effusion occurred in 21 patients (13.0%), of whom only 3 (1.9%) had moderate or greater pericardial effusion, regardless of the drain duration. All patients improved during outpatient follow-up without invasive management. No patient had severe complications because of pericardial effusion. The duration of drain placement did not affect the incidence of postoperative pericardial effusion (p=0.069). Operative survival was 100%. Conclusion: Based on our study, we recommend removing the drain as soon as its role is complete, generally on postoperative day 1, because early removal does not increase the incidence of pericardial effusion in patients undergoing simple congenital cardiac surgery.

• Journal of Chest Surgery
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• 제56권5호
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• pp.353-358
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• 2023

Background: Malignant pleural effusion affects many patients with advanced cancer. When chemotherapy or radiotherapy fails to relieve malignant pleural effusion and related symptoms, drainage and pleurodesis can help. Although surgical talc pleurodesis is the most widely used method, Viscum album, which has been recently used in surgical or bedside procedures, has demonstrated significant results and is as effective as talc. This study aimed to determine the most effective agent and procedure. Methods: Between January 2015 and July 2022, chemical pleurodesis was performed in 137 patients with malignant pleural effusion, using a V. album surgical procedure in 48, a V. album bedside procedure in 55, and a talc surgical procedure in 34 patients. We reviewed patients' clinical responses and disease progression after chemical pleurodesis. Results: The success rate was not significantly different among the V. album surgical procedures (91.7%), V. album bedside procedures (83.6%), and talc surgical procedures (91.2%). However, the total drainage amount and tube insertion duration in both Viscum groups were more effective than those in the talc group. Furthermore, the bedside Viscum group showed significantly lower post-pleurodesis pain scores than the other 2 groups. Conclusion: According to our results, talc and V. album can be considered ideal agents for chemical pleurodesis. However, Viscum pleurodesis showed safer outcomes in terms of ensuring quality of life than talc. Additionally, the bedside Viscum group showed significantly lower pain scores than the other groups. Hence, patients for whom surgical procedures are inappropriate can undergo bedside Viscum pleurodesis without diminishing the therapeutic effect.