• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.949-952
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• 2006

Spontaneous pneumothorax is rarely occurred as an initial sign of primary lung cancer. As a lot of these cases have already advanced, even then surgical resection is performed, the prognosis is often undesirable, We happened to find a ruptured cavity on a 65-year-old male patient who had suffered from pulmonary tuberculosis in the past, while performing VATS bullectomy for simple spontaneous pneumothorax, Then, as a result of frozen biopsy, it was diagnosed as squamous cell cancer Because the tumor was infiltrated from the upper lobe into the lower lobe passing by fissure, we should remove by pneumonectomy and the pathologic stage was found stage I(T2N0M0). When we made an follow-up observation for one year and a half, there was neither relapse nor complication. When there appears spontaneous pneumothorax to the high risk group for lung cancer who were smokers over forty-year old, with chronic bronchitis or pulmonary emphysema, it needs to have a closer observation on a base lung disease such as lung cancer through chest CT, and it is also necessary to make more active approach by performing the surgical operation through a thoracoscopy when there is a continued air release.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.59-62
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• 2009

Background: Pleural drainage following video-assisted thoracic surgery has traditionally been achieved with largebore, semi-rigid chest tubes. Recent trends in thoracic surgery have been toward less invasive approaches for a variety of diseases. The purpose of this study was to evaluate the safety and efficacy of drainage by means of small, soft, and flexible 14Fr Blake drains. Material and Method: Between December 2007 and March 2008, 14Fr silastic Blake drains were used for drainage of the pleural cavity in 37 patients who underwent a variety of video-assisted thoracic surgical procedures at our institution. Result: The average postoperative length of hospital stay was 3.26 days (range, 2~12 days), Blake drains were left in the pleural space for an average of 3.15 days (range, 1~7 days), and the average amount of drainage was 43.8 ml/day. The maximal amount of blood removed daily by a Brake drain was as much as 290 mL. There were no drain-related complications. Blake drains seemed to cause less pain while in place, and particularly at the time of removal. Conclusion: The use of a Blake drain following minor thoracic surgery appeared to be safe and effective in drainage of fluid or air in the pleural space, and were associated with minimal discomfort.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.724-728
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• 2008

Background: The purpose of this study was to identify factors associated with recurrent pneumothorax after wedge resection in primary spontaneous pneumothorax in our hospital. Material and Method: Two hundred thirty-five consecutive patient (98% males; mean age, $23.9{\pm}4.5$ years) who had undergone video-assisted thoracoscopic surgery (VATS) were reviewed retrospectively. The two groups were divided as follows: group A, non-recurrent patients (225 patients [96%]); and group B, recurrent group (10 patients [4%]); the risk factors were compared between the two groups. The single and multiple factors that influenced the recurrence rate were analyzed using Cox's proportional hazard model. Result: There were no significant differences between the recurrent and non-recurrent groups in terms of gender, smoking, site of recurrence, degree of collapse, operative time, and number or weight of resected bullae. The recurrence rate was significantly more common in the following: younger ages, increased height/weight ratio, longer initial air leakage period, and shorter duration of chest drainage. Early aggressive exercise (<30 days) of patients after wedge resection increased the tendency for recurrence. Conclusion: Thoracoscopic wedge resection does not have a higher recurrence rate than open thoracotomy. However, young age, height/weight ratio, continuous air, and duration of chest tube placement were risk factors for a recurrent pneumothorax.

• Journal of the Korean Society for Marine Environment & Energy
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• v.19 no.2
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• pp.151-158
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• 2016

Tidal farm is a multi-arrayed turbine system for utilizing tidal stream energy. For horizontal-axis turbine(HAT) system, it is recommended that each unit has to be deployed far apart in order to avoid hydrodynamic interference among turbines, as proposed by the European Marine Energy Centre(EMEC). But there is no rule for the arrangement of vertical-axis turbine(VAT) yet. Moreover it has been reported that a proper arrangement of adjacent turbines can enhance the overall efficiency even greater than an arrangement without mutual interference effect. This paper suggests the layout of VATs showing the better performances, which turned out to be quite different from HATs' arrangement. Numerical calculations were performed to investigate the performance variation in terms of the rotational direction as well as the distance between turbines. It has been shown that the best combination of rotational direction and distance between turbines can increase its performance higher about 9.2% than that of two independently operated turbines. It is likely that such improvement is due to the increased velocity between adjacent turbines. For diagonally arranged turbines, the maximum normalized mean power coefficient was obtained to be higher about 5.6% than that of two independent turbines. It is expected that the present results can be utilized for conceptual design of tidal farm to harness the tidal stream energy.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.40-45
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• 1998

Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

• Korean Journal of Environment and Ecology
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• v.15 no.3
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• pp.213-223
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• 2001

This study was carried out to clarify the distribution pattern of Salicaceae species which are considered as obligatory riparian vegetation, and also the correspondence between their distribution and the environment factors. Eighty-three study sites by stratified sampling were selected from the upstream to the downstream of An-sung stream. Vegetation factors such as coverage by species, disturbance, etc., and environmental factors including microtopography, soil properties, etc., measured and analyzed. Salicaceae species were identified as total 2 genera, 11 species through all study area, and the average occurring species were 2.8 species.5. koreensis among other species showed highest occurring frequency at An-sung streams, and also it was distributed widely through study area. S. gracizistyla was mainly fecund at upstream sites, where sandy soil texture and high longitudinal slope were developed. S. purpurea vats. japonica was mostly observed in the sandy soil, the same as S. gracilistytu and however, was not dominant but rather mixed with S. gracitistyta and S. koreensis. On the other hand, distribution of S. glandulosa were closely related with littoral zone of the lake and the lower sea level with sandy loam and loamy sand Boils of high organic matter content. Under CCA, canonical correspondence analysis, distribution of Saticaceae species was positively correlated with environmental gradients such as soil properties along to topography.

• Journal of Chest Surgery
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• v.31 no.5
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• pp.525-530
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• 1998

Thoracoscopic thoracic sympathectomy for primary palmar hyperhidrosis has been known to be effective and to have cosmetic merits compared to conventional open sympathectomy. In spite of its cosmetic advantages over thoracotomy, VATS using 5 mm or 10 mm instruments still has the problem of operative wound as well as pain on trocar sites. Recently, 2 mm thoracoscopic instruments have been used. The purpose of this study was to examine the results of thoracoscopic sympathectomy for palmar hyperhidrosis with 2 mm thoracoscopic instruments. From January 1997 to April 1997, 46 patients underwent bilateral thoracoscopic sympathectomy with 2mm instruments at Seoul National University Hospital. T-2 ganglion was carefully dissected and resected out in all patients. In one patient, the lower third of T-1 ganglion was inadvertently resected together with T-2 ganglion due to poor anatomical localization. In 4 patients who also complained of excessive axillary sweating, T-3 ganglion was resected as well. The instruments were removed without leaving any chest drain after reexpansion of the lung. Trocar sites were approximated with sterile tapes. All patients were relieved of excessive sweating in their upper extremities immediately after the operation. Nine patients(19.6%) showed incomplete reexpansion of the lung, and two of them required needle aspiration. Complications related to the surgical procedures, such as Horner's syndrome, hemothorax, and brachial plexus injury, were not detected in any cases. Most patientsdid not complaine of pain. All patients were discharged from the hospital on the day of operation. Despite a narrow operative viewfield, thoracic sympathectomy with 2 mm thoracoscopic instruments can be performed without increasing any severe complications. We recommend 2 mm instruments for thoracoscopic sympathectomy because they make as the more cosmetic, less painful, and equally effective compared to thoracoscopic sympathectomy using 5 mm or greater instruments.

• The Journal of the Korean Society for Microbiology
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• v.7 no.1
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• pp.29-41
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• 1972

To grow Myocbacterium leprae in cultured mouse peritoneal macrophages, studies were made with trypsin-purified Myco. laprae on 1) the dynamics of infection of mouse peritonal macrophages in vivo with Myco. leprae by intraperitoneal inoculation, 2) growth experiment of Myco. leprae in cultured mouse peritoneal macrophages by in vivo infection and in vitro cultivation and 3) the observation of pathological changes in spleens of mice induced by intraperitoneal inoculation of Myco. leprae. Results are summarized as follows; 1. Continuing and significant decreases were observed in the numbers of both acid-fast bacilli in cultured macrophage and of macrophages harboring.acid-fast bacilli by the length of inter vats between the time of intraperitoneal inoculation of Myco. leprae and the time of initiation of macrophage culture. 2. No evidence of multiplication of Myco. leprae in the peritoneal macrophages in vivo was found up to 5 months after intraperitoneal inoculation. 3. With cultures of macrophages made 24 hours and 1 week after intraperitoneal inoculation of Myco. leprae and maintained in vitro up to 2 to 3 months, microscopic examination of the stained preparations of cultured macrophages indicated that an apparent increase in the number of acid-fast bacilli in the macrophages did occur. 4. Quantitative experiment with in vivo infected-in vitro cultured macrophages revealed certain features of increase in the number of total acid-fast bacilli in the cultured macrophages 7 and 9 weeks after initiation of the cultures. 5. Pathological changes in the spleens mice inoculated with Myco. leprae were of mainly degenerative nature in the red pulp. No multiplication of Myco. leprae was observed in the spleens of mice up to 5 months after intraperitoneal inoculation.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.394-398
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• 2010

Background: The overexpression of transforming growth factor-beta 1 receptor II (TGF-${\beta}1$RII) and transforming growth factor-beta 1 (TGF-${\beta}1$) ligand may be involved in the formation of a bulla. In this study, we tested if serum TGF-${\beta}1$ ligand levels correlated with the expression level of TGF-${\beta}1$RII and TGF-${\beta}1$ in bullous tissues from patients with spontaneous pneumothorax. Material and Method: Bullous lung tissues and blood samples were obtained from 19 patients with spontaneous pneumothorax, 18 males and 1 female, aged 17 to 35 years old. The bullous tissues were obtained by video-assisted thoracic surgery (VATS), fixed in formalin, embedded in paraffin, and cut into $5{\sim}6{\mu}m$ thick slices. Sections were immunohistochemically stained with primary antibodies against TGF-${\beta}1$ or TGF-${\beta}1$RII, and serum levels of TGF-${\beta}1$ in patients and normal controls was measured by enzyme-linked immunosorbent assay (ELISA). Result: Of the 19 patients, 16 were TGF-${\beta}1$ positive and 10 were TGF-${\beta}1$RII positive. Among the 16 TGF-${\beta}1$ positives, 9 were also TGF-${\beta}1RII$ positive. As seen previously, strong immunohistochemical staining of TGF-${\beta}1$RII and TGF-${\beta}$ was detected in the boundary region between the bullous and normal lung tissues. Average TGF-${\beta}1$ blood levels of both TGF-${\beta}1$ and TGF-${\beta}1$RII positive patients was $38.36{\pm}16.2ng/mL$, and that of five controls was $54.06{\pm}15ng/mL$. Conclusion: These results suggest that overexpression of TGF-${\beta}1$ and TGF-${\beta}1$RII expression may be involved in the formation of bullae. TGF-${\beta}1$ blood levels in patients with primary spontaneous pneumothorax is lower than normal people, suggesting that the high level of local TGF-${\beta}1$ expression in the bullous tissue region, but not in the whole blood, may contribute more in the formation of bullae.

• Journal of Chest Surgery
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• v.32 no.6
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• pp.579-583
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• 1999

Background: Thoracic sympathicotomy has been used safely and successfully to manage palmar hyperhidrosis. The preoperative and postoperative recording of Sympathetic Skin Responses(SSR) was performed for objective evaluation and follow-up of thoracic sympathicotomy in hyperhidrosis patients, and also for ascertaining the clinical usefullness of SSR. Material and Method: The recording of SSR was performed on 15 patients suffering from palmar hyperhidrosis with Medelec Sapphire Plus electromyogragh before and after thoracic sympathicotomy. Eletrical stimuli on the right median nerve was made in patients in supine position and results were recorded on right and left palms with soles at the same time by 4 channels. Skin temperatures were also monitored simultaneously. T2,3 sympathicotomy was performed with VATS in every patients. SSR was done in 2 patients one month later. Result: Clinically, all patients had symptomatic improvement with satisfaction. Postoperative complication was small amount of residual pneumothorax in 5 patients but it was absorbed sponteneously. There was no recurrence during follow-up period and ten patients(66%) complained compensatory hyperhidrosis. After operation, SSR change was shown in every 15 patients. Abolition of SSR on both palms was achieved in 12 patients(80%) and on both soles in 6 patients. In the other 3 patients, the latencies were significantly delayed and the amplitudes were significantly reduced at both palms and soles. In two patients who were examined at one month later after operation, similar results with postoperative SSRs were shown. The skin temperature on preoperative both palm and sole were lower than normal temperature, and those on postoperative both palm and sole were increased. Those had statistical significance(p<0.05), and the temperature on the palm was increased higher that than on the sole. Conclusion: After thoracic sympathicotomy was performed on palmar hyperhidrosis patients, an increment of skin temperatures and SSR changes were achieved at both palms and soles of all patients. Palmar SSRs were completely abolished in 12 patients(80%), and similar results of postoperative SSRs were achieved. The recording of SSR may be useful to easily and objectively assess the completeness of sympathicotomy and the follow-up of recurrence in hyperhidrosis patients.