• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2613-2617
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• 2015

Radiation induced lung injury has long been considered a treatment limiting factor for patients requiring thoracic radiation. This radiation induced lung injury happens early as well as late. Radiation induced lung injury can occur in two phases viz. early (< 6 months) when it is called radiation pneumonitis and late (>6 months) when it is called radiation induced lung fibrosis. There are multiple factors that can be patient, disease or treatment related that predict the incidence and severity of radiation pneumonitis. Radiation induced damage to the type I pneumocytes is the triggering factor to initiate such reactions. Over the years, radiation therapy has witnessed a paradigm shift in radiation planning and delivery and successfully reduced the incidence of lung injury. Radiation pneumonitis is usually a diagnosis of exclusion. Steroids, ACE inhibitors and pentoxyphylline constitute the cornerstone of therapy. Radiation induced lung fibrosis is another challenging aspect. The pathophysiology of radiation fibrosis includes continuing inflammation and microvascular changes due to pro-angiogenic and profibrogenic stimuli resembling those in adult bronchiectasis. General supportive management, mobilization of airway secretions, anti-inflammatory therapy and management of acute exacerbations remains the treatment option. Radiation induced lung injury is an inevitable accompaniment of thoracic radiation.

• Tuberculosis and Respiratory Diseases
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• 제49권1호
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• pp.111-116
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• 2000

저자들은 전신 쇠약감 및 우하부 흉통을 주소로 내원한 33세 남자 환자에서 동반된 기저질환이나 폐렴의 소견이 없이 발생한 Pasteurella multocida 농흉 1예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제23권4호
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• pp.750-757
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• 1990

Empyema with bronchopleural fistula is an uncommon, but serious problem. Early diagnosis and adequate drainage of the empyema cavity are well established principles for the initial management of this condition and will enable patient to recover from the toxic effects of loculated pus. 37 patients of empyema with bronchopleural fistula were treated at the department of the chonbuk National University Hospital between 1981 and 1988. The age group of fifty and sixty decades occupied 64.8%. Bacteriologic cultures of the pus were postive in 56.8%. The most common organism of the culture was staphylococci(42.9%). And the others were Pseudomonas(19%). Klebsiella(14.3%), and E. doli. No growth of pathologic organism was reported 43.2%. 24 patients of empyema with bronchopleural fistula were nonoperative causes : There were 10 pulmonary tuberculosis, 3 abscess, 9 ascending infection, one bronchiectasis and one tumor, respectively. The remaining 13 were occurred as postoperative complications ; pneumonectomy in 6, lobectomy in 4, decortication in 2, and lobectomy with segmentectomy in 1. When used as the initial mode of drainage, closed thoracostomy was performed to almost all of the patients, but 4 patients were died during this treatment. Main operations were performed except 4 died patients ; open thoracostomy in 21, open thoracostomy with myoplasty in 3, decortication in 5, decortication with resection in 3, and completion pneumonectomy in 1. Open thoracostomy was performed in 21 patients which results were favorable except one death. Permanent open thoracostomy is an old but still useful minor operation in patients with empyema with bronchopleural fistula. The overall mortality rate was 15% (6 patients) and the causes of the death were respiratory insufficiency or sepsis, or both.

• Journal of Chest Surgery
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• 제33권3호
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• pp.245-251
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• 2000

Backround: Pulmonary aspergilloma is a potential life-threatening disease resulting from massive hemoptysis. Pulmonary aspergilloma has been treated surgically for many years, however, it has also had higher risk of mortality and complication rate. The purpose of this study is to analyze the operative methods and the types of complications. Material and Method: Sixty patients who underwent surgical resection for pulmonary their medical reconrds. Result: The mean age was 46.3$\pm$13.4 years(range 20 to 76 years). The most common clinical presentation was hemoptysis which occurred in 48 patients(80%). Pulmonary tuberculosis was the most common pre-existing disease, occurri9ng in 28 patients(46.7%). The other associated lung diseases were bronchiectasis(n=11), silicosis(n=2), and chronic pnumonia(n=1). Operative proceudres wer lobectomy in 35 patients, pneumonectomy in 6, segmentectomy in 5, lobectomy and thoracoplasty in 3, segmentectomy and thoracopasty in 1, and cavernostomy in 10. The operative mortality was 6%(n=3) in lung resection patients but 0% in cavernostomy patients. The most common complications were prolonged air leakage, wound infection and postoperative bleeding. Conclusion: In most cases of pulmonary aspergilloma surgical resectin remains the only effective therapy. However, cavernostomy may be more effective for pulmonary aspergilloma patients with decreased pulmonary functions and for patients with high risk for lung resection.

• Journal of Chest Surgery
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• 제36권1호
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• pp.39-42
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• 2003

기관지내 지방종은 폐에서 발생하는 양성종양중 매우 드문 것으로 알려져 있다. 대개 서서히 진행되는 기관지 폐색과 함께 증상을 나타나는데, 대부분의 경우 기관지 폐쇄가 일어난 다음에 진단되므로 비가역적 기관지 확장이나 폐실질의 비가역적 손상을 가져온다. 진단은 흠부 기관지경검사나 흉부컴퓨터 단층촬영, 자기공명영상 촬영등으로 할 수 있으나, 흉부컴퓨터 단층촬영이 특히 민감도와 특이도가 높은 것으로 알려져 있으며, 치료는 내시경하 종괴의 제거 또는 개흉술을 통한 종괴의 제거 또는 폐엽절제술을 시행하는 것으로 알려져 있다 본 저자들은 우중엽을 완전히 막고 있으면서, 폐색후 폐실질의 손상을 동반한 기관지내 지방종을 1례 경험하여 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1139-1143
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• 1995

We experienced 29 cases of patients with a chief complaint of hemoptysis who were performed pulmonary resection at the Department of Thoracic and Cardiovascular Surgery, Pusan Medical Center Hospital for 3 years from May 1990 to April 1993. The mean age of hemoptysis patients was 34.7 year old, and hemoptysis was most prevalent in third and fourth decades. The underlying lung diseases of hemoptysis patients were tuberculosis in 12[41.4% , bronchiectasis in 9[31.0% , lung cancer in 4[13.8% , aspergyllosis in 3[10.3% and pneumonia in 1[3.5% . Modes of hemoptysis were blood tinged in 7[24.1% , massive in 22[75.9% . Operation times were elective in 7[24.1% of all blood tinged hemoptysis, delayed in 20[69.0% , emergency in 2[6.9% out of massive hemoptysis. The cases of the definite bleeding focus found by bronchoscopy were 19 cases[65.5% . The operative procedures of hemoptysis were single lobectomy in 14[48.3% , pneumonectomy in 6[20.7% , lobectomy with segmentectomy in 5[17.2% , bilobectomy in 3[10.3% and segmentectomy in 1[3.5% . The postoperative results of hemoptysis were complete recovery in 27[93.0% , rehemoptysis in 1[3.5% which was treated by anti-Tbc medication completely, and hospital death in 1[3.5% which was brain metastasis of lung cancer. It was concluded that definitive diagnosis, preoperative control of hemoptysis and operation were important in the management of hemoptysis patients.

• Journal of Chest Surgery
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• 제34권8호
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• pp.640-643
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• 2001

26세 여자 환자로 좌측 주기관지 협착과 좌하엽 무기폐를 동반한 기관지결핵 1례를 보고한다. 환자는 9개월간 항결핵제치료를 받았으나 흉통과 기침을 호소하고 있었고, 기관지조영술상 좌상엽 기관지는 개방성을 보이며 좌하엽 기관지는 협착이 있으면서 기관지확장증 소견을 보여 좌하엽 절제술 및 기관지성형술을 시행받았다. 수술 후 폐기능의 의미있는 증가를 보였다. 기관지결핵의 수술적 치료는 논란이 있지만 기관지성형술은 폐기능을 보존해서 환자의 증상을 경감시킬 수 있으므로 결핵성 기관지협착의 효과적인 치료가 될 수 있다.

• Journal of Chest Surgery
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• 제28권1호
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• pp.42-46
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• 1995

Vertical axillary muscle sparing thoracotomy is newly appeared and excellent alternative method of standard posterolateral thoracotomy.It has many advantages compared to standard posterolateral thoracotomy , less postoperative pain, well preserved thoracic muscle strength, full range of motion of the shoulder girdle and attractive cosmetic results. We performed vertical axillary muscle sparing thoracotomy in 36 patients from November 1993 to July 1994. The ages of the patients ranged from 6 months to 71 years[mean 45.1 years , and the patients consisted of 20 males and 16 females.The preoperative diagnosis were as follows : lung cancer in 17 patients, tbc destroyed lung in 7, bronchiectasis in 3, bullous emphysema in 3 and the others are mediastinal tumor, bronchogenic cyst, lung abscess, empyema, esophageal diverticulum, and CCAM [congenital cystic adenomatoid malformation . The operative procedures were as follows : lobectomy and bilobectomy in 16 patients, segmentectomy in 4, wedge resection in 3, penumonectomy in 7, and the others were open biopsy, lobectomy with diaphragm excision, sleeve right upper lobectomy, decortication, mediastinal mass excision, and esophageal diverticulectomy. We had 6 complications : postoperative bleeding in 2 cases, operative wound infection, arrrhythmia[atrial fibrillation , Horner`s syndrome, hoarseness. The subcutaneous seroma occurred in 4 cases but did not require drainage and relieved within 4 weeks spontaneously. We concluded that vertical axillary muscle sparing thoracotomy could be done in most of all thoracic surgery with safety. Comparing to standard posterolateral thoracotomy vertical axillary muscle sparing thoracotomy has many advantages such as less postoperative pain, well preserved muscle strengths and good cosmetic results.

• Journal of Chest Surgery
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• 제36권11호
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• pp.878-882
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• 2003

기관기관지는 기관우측벽에서 기시하는 이상 혹은 부기관지를 말하며 재발성 폐렴, 비폐쇄성 기관지 확장증 등의 염증성 질환과 관련 있다. 최근에 우리는 폐 방사균증과 관련된 기관기관지 1예를 경험하였다. 37세의 남자 환자는 재발성의 객혈을 호소하였고 당초 폐결핵으로 추정하여 항결핵제를 투여 받았으나 임상적으로나 방사선학적으로 호전을 보이지 않았다. 우상엽 폐절제술이 시행되었으며 조직학적 검사에서 폐 방사균증으로 화진되었다. 술 후 환자는 3개월간 penicillin과 ampicillin이 투여됐으며 6개월간의 추적기간 동안 재발을 나타내지 않고 완전히 회복되었다.

• Tuberculosis and Respiratory Diseases
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• 제43권5호
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• pp.812-817
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• 1996

There were so many causes of chronic coughing including postnasal drip, pneumonia, nasal polyp, asthma, interstinal lung disease etc. Congenital bronchoesophageal fistula was not usually thought as cause of chronic coughing. A 46-year-old female patient suffered from chronic coughing without usual causes. Her chest X-ray viewed normally. She coughed especially after swallowing foods. So we recommended her esophagogram and it revealed broncho-esphageal fistula. She underwent surgical resection of broncho-esophageal fistula. She was well without cough after the surgery. We reported a case of congenital broncho-esphageal fistula that had caused chronic coughing without any evidence of pneumonia, malignancy, tuberculosis, bronchiectasis, inflammation, asthma, nasal polyp, etc. So we should suspect the bronchoesophageal fistula when patients cough chronically with eating, and recommend the esophagogram.