• Tuberculosis and Respiratory Diseases
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• v.61 no.6
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• pp.585-590
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• 2006

Pulmonary arteriovenous malformations (PAVMs) are abnormal direct communications between the pulmonary arteries and veins. PAVMs may occur as either an isolated abnormality or in association with hereditary hemorrhagic telangiectasia, also called Osler-Weber-Rendu disease. The topic of PAVM has recently been extensively reviewed, but little is known about the clinical characteristics and course of patients having a diffuse pattern of the disease. Herein, is reported a case of unilateral diffuse PAVM in an 18 year old female patient, who underwent a right pneumonectomy, under a video-assisted thoracic surgery (VATS) approach, as the diffuse small pulmonary arteriovenous malformation involved the whole right lung.

• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.78-82
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• 2007

Schwannoma represents approximately 40% of neurogenic tumors arising in the mediastinum, and develops along the sympathetic or parasympathetic chain, intercostals nerve, and spinal ganglia. It is usually asymptomatic, and is confronted accidentally but can produce chest pain, cough and dyspnea. However, dyspnea with pleural effusion is rare in patients with benign schwannoma. We encountered two cases of benign schwannoma with pleural effusion. Both cases had similar initial symptoms and the characteristics of a mass but the characteristics of pleural effusion analysis were different. The benign schwannoma was confirmed in two cases using VATS (video-assisted tharawswpic surgery).

• Journal of Chest Surgery
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• v.28 no.7
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• pp.684-688
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• 1995

Hyperhidrosis, one of the abnormalities in autonomic nervous system, has been treated with dermatologic principles or thoracic sympathectomy via conventional axillary thoracotomy or dorsal spinal approach. But these techniques were rather ineffective or invasive. Recently, VATS is widely applied in thoracic surgical area, and hyperhidrosis is not the exception of these cases.From May 1993 to August 1994, 30 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic [T2, T3 sympathectomy with thoracoscopic surgery at Seoul National University Hospital. There were 20 men and 10 women and the mean age was 23.0 years.Mean operating time was 115 min and there was no thoracotomy conversion. Operative complications were anesthetic overdose in 1, Horner`s syndrome in 1, and small amount of residual pneumothorax in 6. Mean postoperative hospital stay was 2.3 days [range from 1 to 4 days and postoperative analgesics were required in 17 cases with a single dose.Sweating amount was measured in 12 patients, showing significantly decreased amount from 284.5 mg preoperatively to 18.9 mg postoperatively in 5 minutes [p=0.004 . There was no recurrence during mean 6 months follow up. Twenty two patients [73.3 % complained moderate compensatory hyperhidrosis on the trunk.In conclusion, all patients were greatly satisfied with those results including no more palmar sweating, less pain, better cosmetics, short hospital stay. In addition, recent use of sweating amount measurement and intraoperative temperature monitoring could make this technique more accurate, so we easily applied thoracoscopic sympathectomy with minimal risk.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.916-922
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• 1996

In patients with pleural adhesion, video-assisted thoracic surgery (VATS) has been regarded as a contra- indication. When such adhesions were found during a thoracoscopic trial, the thoracotomy proceeded with for fear of parenchymal Injury and bleeding. We had a question whether or not thoracoscopic surgery should be done in such pleural adhesions. Of the 226 consecutive thoracoscopic surgeries from Jul. 1992 through Sep. 1995, pleural adhesions were detected intraoperatively in 50 cases (22.1%): a detailed breakdown is as follows: pneumothorax (16 cases), pleural disease (15), benign pulmonary nodule(7), mediastinal mass(5), hyperhidrosis (2), diffuse parenchymal or interstitial lung disease (2), bronchiectasis(2), and primary lung cancer(1). We classified pleural adhesions according to their extent and severity. Extent is categorized as the involved area of the lung: degree 1, II, or III; severity is given one of four grades: mild, moderate, severe, or ve y severe. In cases of very severe severity requiring decortication, the possibility of VATS was excluded. Of the 50 cases, mild adhesions were detected in 15 cases(30.0%), moderate in 29 (58.0%), and severe in 6 (12.0%). As for the extent of the adhesions, 8 cases (16.0%) were categorized as degree 1, 32 cases (64. 0%) as degree II, and 10 cases (20.0%) as degree III. For patients with pleural adhesions, the operation time, the chest tube indwelling time, and the postoperative hospital stay were all longer than for patients in the non-adhesion group. Postoperative complications, namely prolonged air-leakage and pleural drain- age, were more common (18.0% and 6.0%, respectively) than in the non-adhesion group (5.1% and 1.7%, respectively). Only two bronchiectatic patients (4%) were converted to an open thoracotomy because of in- ability to control bleeding. Although complications were encountered more frequently in the group with adhesions, patients were still able to enjoy the benefi s of thoracoscopic surgery. It is advisable to proceed with thoracoscopic surgery even in cases of unpredicted pleural adhesions.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.59-62
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• 1996

Chemical pleurodesis with doxycycline has been used during video-assisted thoracoscopic surgery (VATS) as an auxiliary method to enhance therapeutic goal in patients with pneumothorax. However, the therapeutic effect of doxycycline pleurodesis (DP) has not been clearly defined yet. To evaluate the effect of DP, we compared two groups of patients who were given VATS bullectomy from October 1993 to June 1995. Group I composed of 21 patients who received DP and group II composed of 20 patients who did not received DP Doxycycline 500mg with saline 200ml were instilled into the pleural cavity upon a completion of bullec omy, and retained there for 0.5-1 hour and then drained out. The age of group I was 30.9 $\pm$ 20.0 and that of group II was 24.3 $\pm$ 9.49 years. Male to female ratio was 20: I in group I and 20 : 0 in group II. The postoperative indwelling time of chest tube was 5.86 $\pm$ 4.69 days in group I and 3.80 $\pm$ 2.28 days in group II. Seven patients had more than 100m1/day of chest tube drainage on the postoperative third day in group I compared to one patient in group II. Five patients had postoperative indwelling time of chest tube greater than 7 days in group I compared to two in group II. The number of patients who had postoperative fever were 3 in both group, analgesic requirements were 2.19 $\pm$ 2.77 amples in group I and 2.30 $\pm$ 1.95 ambles in group II. Follow-up was done from 2 months to 16 months after surgery. During the follow up periods, four patients had recurrence 2 (9.5%) in group I and 2 (10%) in group II. We conclude that concomitant doxycycline pleurodesis with video-assisted thor coscopic bullectomy In patients with pneumothorax is not necessary.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.404-408
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• 2010

Background: Pleural symphysis is regarded as an important treatment option in reducing recurrence rates after surgical treatment of spontaneous pneumothorax. However, there is much debate over the best method for achieving pleural symphysis. We retrospectively compared apical pleurectomy (AP) with mechanical pleural abrasion (MPA). Material and Method: Between January 2000 and December 2007, 83 patients underwent video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax. In addition to wedge resection of bullae, MPA was performed in 21 patients (group A) and AP in 62 patients (group B). Result: There were no significant differences in age, gender and site of pneumothorax between the two groups. Operative time was $97{\pm}44$ minutes in group A and $77{\pm}18$ minutes in group B (p>0.05). The mean amount of pleural drainage through the chest tube on the first postoperative day was $156{\pm}87 cc$ in group A and $147{\pm}87 cc$ in group B (p>0.05). There was no mortality or significant morbidity in all patients with the exception of reoperation for bleeding in two patients in group B. In the postoperative course, there were no statistical differences between the two groups in the rate of residual air space, air leak and indwelling time of chest tube, and hospital stay. Mean follow up time was $31.7{\pm}25.3$ months, and the recurrence rate of pneumothorax was 9.5% (2/21) in group A and 6.5% (4/62) in group B, without statistical significance. Conclusion: AP was no more advantageous than MPA in terms of operative time, postoperative course and prevention of recurrent pneumothorax. Therefore, complete resection of bullae and existence of residual bullae are more important factors in reducing the incidence of recurrent pneumothorax than pleural symphysis.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.556-560
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• 1999

Background: The cause of spontaneous pneumothorax is not yet but it is certain that intrathoracic air comes from ruptured bulla. Video-assisted thoracoscopic surgery(VATS) or open thoracotomy is recommended for thoracic incision in recurrent pneumothorax. However, recurrent rate after bullectomy with the VATS is very high compared to mini-thoracotomy, 3% to 20% and below 2%, respectively. Material and Method: This retrospective analysis was performed on 16 re-operated cases among 446 surgically treated pneumothorax of the 737 cases of spontaneous pneumothorax diagnosed at Yongdong Severance Hospital from Nov. 1992 to June 1997. Result: Among the 446 surgically-treated patients in 737 case of spontaneous pneumothorax, 16 patients underwent re-operation, showing a 3.5% re-operation rate. Male-to-female ratio was 15 to 1 and mean age at initial attack was 20.2 years(ranging from 15 to 50). Mean hospital stay was 6.34 days(ranging from 2 to 20 days) and mean chest tube indwelling period was 4.2 days(ranging from 1-10 days). Median follow-up was 46 months(range 10-66 months). Three different surgical methods were applied : video-assisted thoracoscopic surgery(VAST) in 281 cases, of whom 2 underwent local anesthesia; subaxillary mini-thoracotomy in 159 cases and limited lateral thoracotomy in the remaining 6 cases. Three different re-operative surgical methods were applied ; video-assisted thoracoscopic surgery (VAST) in 6 cases, subaxillary mini-thoracotomy in 9 cases, and limited lateral thoracotomy in the remaining 1 case. The underlying etiological factors of the recurrent pneumothorax after bullectomy were o erlooking type(9) and new growing type(7). Mean recurrent period from previous operation was 1 month for overlooking type and 18 months for new growing type. Conclusion: The underlying etiological factors of recurrent pneumothorax lead to re-operation were new-growing and over-looking type. We need additional treatments besides resecting blebs of prevent the recurrence rate and more gentle handling with forceps due to less damage to the pleura.

• Nutritional Sciences
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• v.6 no.3
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• pp.135-140
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• 2003

The purpose of this study was to investigate the effects of glucuyonic acid (isolated from xylan) on the antioxidative defense systems of red gastrocnemius in rats after aerobic exercise. The glucuronic acid was isolated from xylan. Male Sprague-Dawley vats weighing 150$\pm$10 g were randomly assigned to one normal group and three exercise training groups. The exercise training groups were classified as T (glucuronic acid-free diet), TU (250mg glucuronic acid/kg bw) and 2TU (500mg glucuronic acid /kg bw) according to the level of glucuvonic acid supplementation. The rats in the normal group were confined to a cage for 4 weeks. The rats in the exercise training groups ran on a treadmill for 30 min/day, 5 days/week at a speed of 28 m/min (7% incline) for 4 weeks. Glutamate oxaloacetate transaminase (GOT) activity in the exercise training groups increased significantly compared with that of the normal group. That of the TU and 2TU groups decreased significantly compared with that of the T group. Xanthine oxidase (XOD) activity in the T group increased significantly to 74% compared with that of the normal group. That of the 2TU group decreased to 42% compared with that of the T group, thus recovering to a normal level. Superoxide dismutase (SOD) activity in the T group decreased to 32% compared with that of the normal group. That of the TU and 2TU groups increased to 28% and 34%, respectively, compared with that of the T group. Glutathione peroxidase (GSHpx) activity in the T group decreased to 16% compared with that of the normal group, but that of the TU group increased to 17% compared with that of the T group. Glutathiones transferase (GST) activity in the T group decreased to 11% compared with that of the normal group, but that of the TU and 2TU groups Increased to 28% and 31%, respectively, compared with that of the T group. The contents of thiobarbituric acid reactive substances (TBARS) in the T group increased to 81% compared with that of the normal group, but the glucuronic supplementation group recovered to the normal level. In conclusio, the effects of glucuronic acid on red gastrocnemius in rats engaged in exercise training would appear to be to reduced lipid peroxidation of tissue as an antioxidative defense mechanism.

• Korean journal of applied entomology
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• v.40 no.1
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• pp.31-40
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• 2001

Host plants or Ectinohoplia rufipes (Motschulsky) (En) were investigated in golf courses and laboratory. E. rufipes adults fed on 61 plant species of 27 families out of 101 plant species of 41 families supplied in laboratory. In addition, twenty-seven plant species in 8 families were observed to be fed on from golf courses. Thus, total number of host plants of E. rufipes were 84 species in 29 families. E. rufipes adults preferred Japanese green alder (Alnus firma) , cherry apple (Malus sieholdii), cherry (Prunus serrulata var. spontanea) and sweet oliver (Osmantus asiaticus) in golf courses . The preference of E. rufipes adults with A. firma , P. serrulata vu. spontanea and O. asiaticus was bioassayed in laboratory. E. rufies adults preferred A. firma consuming 58.1% to O. asiaticus and p. serrulata vats. spontanea. The most number of E. rufipes adults was attracted to damaged leaf of A. firma by E. rufipes representing 45.3clo and followed by artificial damaged leaf representing 26.5% , untried feeding leaf representing 12.9% and undamaged leaf representing 4.0%. More E. rufipes adults were attracted to damaged leaf of A. firma by 67.5% than artificially damaged leaf by 30.5% or undamaged leaf treated with feces of E. rufipes by 2%.

• Journal of Chest Surgery
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• v.32 no.5
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• pp.456-460
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• 1999

Background: Thoracic sympathectomy for hyperhidrosis has been recognized as an effective treatment using thoracoscopic devices and operative techniques, but the satisfaction has decreased due to a compensatory hyperhidrosis. Therefore, the postoperative results and compensatory hyperhidrosis were analyzed. We also measured the temperature differences in the hand and foot during the preoperative and postoperative periods and measured the blood flow of upper and lower extremities. Material and Method: From December 1995 to July 1998, total of 47 patients with hyperhidrosis underwent sympathectomy via VATS at the Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital. The patients were evaluated for preoperative and postoperative temperature changes on the finger and toe, and preoperative and postoperative blood flows were measured by the Doppler examination on the digital artery, radial artery and dorsalis pedis artery. Result: There were no operative deaths but some complications existed: 7 pneumothorax, 3 recurrence and 1 Honor syndrome. Ninety-five percent of the patients also had compensatory sweating especially in the trunk. There were 5 patients who regretted recurring the operation because of the compensatory sweating. Sweating decreased in 46% of the sole hyperhidrosis patients. The temperature difference between preoperation and postoperation was 1$^{\circ}C$ on the right hand side and 1.9$^{\circ}C$ on the left hand side(P<0.05). There was no significant temperature difference on the sole. Blood flow increased significantly in the palm, but no difference in the sole. Conclusion: In conclusion, thoracic sympathectomy for hyperhidrosis is a safe and effective treatment but satisfaction has been decreased by the compensatory sweating; therefore, it is important to thoroughly explain the compensatory sweating prior to surgery. Improvement of the plantar hyperhidrosis is not due to a physiological change, but to a psychological stability.