• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.174-176
• /
• 2022

Mediastinal paragangliomas are rare tumors that have only been reported in individual cases or limited case series. Surgical resection of these tumors can be challenging, as they are highly vascular and intimately related to the great vessels. Surgery is usually performed via median sternotomy with or without cardiopulmonary bypass. We present the case of a mediastinal paraganglioma that was resected via a left-sided posterolateral thoracotomy. Histopathology revealed a completely resected 38-mm paraganglioma with a positive station 5 lymph node, indicative of locally aggressive disease. Hereditary paragangliomas are associated with malignant transformation; therefore, genetic testing is important. These tumors do not respond well to chemoradiotherapy, and consequently lifelong surveillance for early detection of recurrence is recommended.

• Journal of Chest Surgery
• /
• v.9 no.2
• /
• pp.139-142
• /
• 1976

A 33 year old male patient was admitted with 20 years history of recurrent hemoptysis. On clinical examination, mild left chest discomfortness and foul odored sputum with occasional rusty hemoptysis were principal complaints noted. Chest X-ray film revealed moderately advanced active tuberculosis lesion on both upper lung fields, and hen-egg sized mass surrounded with linear crescent of air shadow in a cavity on his left upper lung field. On left thoracotomy, dense pleural adhesions on left apicoposterior segmental surface with multiple lymphnode enlargements were noted, and the soft encapsulated mass of $5{\times}5{\times}8cm$ was localized in the apicoposterior segment of the left upper lobe. Apicoposterior segment with anterior segment of the left upper lobe was resected. Cavity was opened to find a rusty grayish colored, fragile mass, which was confirmed as "fungus ball" of aspergillosis by histological section slide with Gomori staining. The authors report one case of pulmonary aspergilloma superinfected with previous long standing pulmonary tbc.

• Journal of Chest Surgery
• /
• v.36 no.6
• /
• pp.444-447
• /
• 2003

Sleeve pneumonectomy can be a method of treatment in a selected patient with bronchogenic carcinoma involving carina. A 64 years old male with a history of mitral valve replacement via midsternotomy 13 years ago and resection of papilloma of the vocal cord 2 years ago. The patient was admitted due to blood-tinged sputum. Bronchoscopy and computerized tomogram of the chest revealed 3.5 cm mass at lower margin of the trachea and totally obstructing the left main bronchus. A biopsy revealed squamous cell carcinoma. He underwent left sleeve pneumonectomy through sequential bilateral thoracotomy without cardiopulmonary bypass, and the pathologic stage was T4N0M0 stage IIIB. The patient is being followed through the outpatient clinic in good general condition.

• Journal of Chest Surgery
• /
• v.17 no.2
• /
• pp.205-211
• /
• 1984

Developmental anomalies of the aortic arch, commonly known as vascular rings, are relatively rare congenital vascular anomalies which can compress the trachea and esophagus. We have presented six patients with surgically treated vascular rings at Seoul National University Hospital during the period June 1970 through May 1984. Two patients had double aortic arches and four patients had right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum. Four patients had symptoms relating vascular ring and two patients were detected incidentally during diagnostic evaluation of symptomatic intracardiac defects. Associated congenital malformations were seen in four patients. The operative approach was through left thoracotomy in three patients and median sternotomy in remaining three patients associated with congenital cardiac defects. There were no postoperative deaths with excellent result in preoperative symptomatic patients. To our knowledge, successful surgical repair of vascular ring has been reported only once in the Korean literature.

• Journal of Chest Surgery
• /
• v.25 no.9
• /
• pp.900-904
• /
• 1992

Pulmonary blastoma is a very rare, primary, malignant neoplasm of the lung. The tumor typically is large, well-defined mass and arises in the periphery of the lung. Histologically, it resembles fetal lung tissue evoking the concept that these tumors are drived from the primitive pluripotential pulmonary blastema, but controversy also exit about the nature of this tumor. Clinical evaluation is inconsistant and unreliable as to the diagnostic determination of the tumor type and degree of malignancy. Therefore, diagnosis is usually based on histologic findings. The prognosis after adequate resection appears to be better than for other malignant tumors of the lungs. We experienced a case of pulmonary blastoma occurring in 56-year-old female. She was hospitalized for evaluation of an abnormal shadow in the left lower lung field which found incidentally on chest roentgenogram. We approached the lesion though left posterolateral thoracotomy and performed the left lower lobectomy. The microscopic findings of resected specimen revealed characteristic appearance of pulmonary blastoma. The postoperative course was uneventful without complication.

• Journal of Chest Surgery
• /
• v.36 no.1
• /
• pp.35-38
• /
• 2003

Glomus tumors are uncommon lesions of glomus cell origin with structural and immunohistochemical features of smooth muscles. Primary glomus tumors of the lung and bronchus are extremely rare and only several cases have been reported. A 16-year-old woman was admitted for the complaint of productive cough, fever, and dyspnea. Imaging studies revealed a protruding mass in the left main bronchus and the mass was completely resected via a left thoracotomy incision. We report this case with literature review.

• Korean Journal of Veterinary Research
• /
• v.56 no.3
• /
• pp.193-195
• /
• 2016

The purpose of this report is to introduce persistent left cranial vena cava (PLCVC) with persistent right aortic arch (PRAA) and patent ductus arteriosus (PDA). Case 1 was a Cocker Spaniel with PRAA and case 2 was a Maltese with PDA. PLCVC was enclosed at the sites of PRAA and PDA surgery; therefore, it was lifted dorsally during PDA and PRAA surgery. Surgery to repair congenital heart defects including PRAA and PDA is recommended for dogs that do not die of PLCVC at a young age.

• Journal of Chest Surgery
• /
• v.32 no.12
• /
• pp.1127-1130
• /
• 1999

Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

• Journal of Chest Surgery
• /
• v.27 no.9
• /
• pp.779-784
• /
• 1994

Vidio-assisted thoracic surgery[VATS] has recently evolved as an alternative to thoracotomy for several thoracic disorders,and the role of thoracoscopy has expanded with advances in surgical techniques and instruments. From May 1993 to May 1994, 13 patients with mediastinal mass underwent VATS for diagnosis and treatment at Gil General Hospital. There were four males and nine females, and their ages raged from 5 years to 66 years with average 38.8 years. Among 13 patients, 3 were operated for tissue diagnosis,9 for treatment,and 1 for diagnosis and treatment. Pathologic diagnoses were as follows; 5 benign neurogenic tumors, 2 thymoma, 2 sarcoidosis, 1 teratoma, 1 peripheral neuroepithelioma, 1 tbc lymphadenitis, and 1 pericardial cyst. The mean time of operation was 111.7 $\pm$ 30.7 minutes[60-160], mean duration of chest tube drainage was 2.9 $\pm$1.9days[1-9], mean hospital stay was 6.2 $\pm$2.6 days[4-13]. There was no patient needed blood transfusion or conversion to open thoracotomy. Accurate diagnosis was possible in all patients operated for diagnosis and /or treatment.[4/4,100%] Two complications occurred in two patients: 1 transient Horner,s syndrome,1 anhydrosis of left arm. Compared with those of conventional thoracotomy done for mediastinal mass during previous 2 years[May 1991 - April 1993], operative results of VATS were better in all aspects. For mediastinal mass, we concluded that VATS can be done with less morbidity,less complication,less blood loss,shorter operation time and hospital stay,and not more expensive in cost than conventional thoracotomy. Noticeably, we think that VATS is the operation of choice for the diagnosis and palliation of malignant mediastinal mass.

• Journal of Chest Surgery
• /
• v.32 no.11
• /
• pp.978-983
• /
• 1999

Background: Complement activation with transpulmonary leukocyte sequestration is considered a main mediator leading to ischemia-reperfusion lung(I-R) injury. We studied the role of leukocytes in the formation of I-R injury in ovine cardiopulmonary bypass(CPB) model with a membrane oxygenator. Material and Method: Five sheep were used. CPB circuitry consisted of a roller pump(American Optical Corp., Greenwich, CT, USA) and a membrane oxygenator(UNIVOX-IC, Bentley, Baxter Health Corp, Irvine, CA, USA). The CPB time was fixed at 120 min. Ten minutes after the start of CPB, total CPB was established. Thereafter a total CPB of 100 min was performed, followed by another 10 min of partial CPB. The CPB was discontinued and the animals were fully recovered. For measuring left and right atrial leukocyte counts, blood samples were taken before thoracotomy, 5 min and 109 in after the start of CPB, and 30 min and 120 min after weaning. C3a was measured before thoracotomy, 109 min after the start of CPB, and 30 min and 120 min after weaning. Plasma malondialdehyde(MDA) was checked before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. One to two grams of lung tissue were taken for water content measurement before thoracotomy, 109 min after the start of CPB, and 30 min after weaning. Lung biopsy specimens were examined by light and electron microscopy. Result: Of 5 animals, 4 survived the experimental procedures. Of these, 3 animals survived on a long-term basis. No significant differences in transpulmonary gradients of leukocyte were found and no significant complement activation was expressed by C3a levels. MDA level did not show significant changes related to lung reperfusion despite an increase after the start of CPB. On both light and electron microscopic examinations, mild to moderate acute lung change was observed. Interstitial edema, leakage of erythrocytes into the alveolar space and endothelial cell swelling were the main findings. Water content of the lung showed a slight increase after the start of CPB, but there was no statistical significance. Conclusion: These findings indicate that ischemia-repersusion lung injury may not be from complement activation-leukocyte sequestration but from another source of oxygen free radicals related to CPB.