• Journal of Chest Surgery
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• v.30 no.11
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• pp.1149-1153
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• 1997

Unilateral reexpansion pulmonary edema(RPE) is generally considered a rare complication occurring when a chronically atelectatic lung is rapidly reexpanded by tube thoracostomy or thoracentesis. It can also take place when the lung collapse is of short duration or when the lung is reexpanded without intrapleural sucti n. We experienced a case of RPE following surgical resection in mediastinal thymic cyst A 26 year old female patient suffered from long-standing atelectasis of the right lung due to a huge mediastinal cyst that was misrecognized as tuberculous pleural effusion. Empyema developed after iatrogenic rupture of mediastinal cyst by pig-tailed tube thoracostomy. We successfally managed the ruptured mediastinal thymic cyst, empyema and postoperatively developed RPE following reexpansion of the collapsed lung. The patient was treated with drugs and mechanical ventilation with positive end-expiratory pressure for RPE. The remainder of her hospital course was uneventful.

• Tuberculosis and Respiratory Diseases
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• v.52 no.2
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• pp.166-173
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• 2002

Transient peripheral eosinophilia occurs in several disorders, such as allergic diseases, cancer, and parasitic infections. However, in most cases, their presence is not accompanied by tissue destruction or organ dysfunction. In certain disease states, eosinophils can accumulate in any organ in the body and cause tissue destruction as a result of the eosinophil infiltration or the toxic effects of the degranulated proinflammatory products. Idiopathic hypereosinophilic syndrome is a rare disorder characterized by persistent eosinophilia of an unknown origin, usually associated with a dysfunction of organs such as the heart, lung, skin, and nervous system. Idiopathic hypereosinophilic syndrome usually has an indolent course over a period of several months. However, in some cases, they have grave symptoms if vital organs such as heart and lung are infiltrated. Here we report a case of idiopathic hypereosinophilic syndrome presenting acute pulmonary edema involving the heart, bone marrow, and lung with a review of the relevant literatures.

• Journal of Chest Surgery
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• v.15 no.3
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• pp.331-337
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• 1982

Complete TGA is a common congenital cardiovacular anomaly, and without palliative or corrective surgery, the infant born with TGA rarely survives the first year of life. Hemodynamically, recirculated blood flow in the systemic and pulmonary circuit has a key role in systemic arterial oxygen saturation and the status of the pulmonary vascular bed. Recently a d-TGA with VSD and PS, in a 12 year old male patient had been tried for inversion of the ventricular flow with Rastelli operation. An intracardiac tunnel was constructed between the VSD and the aortic orifice to connect the ventricle to the aorta. The right ventricle was connected with the pulmonary circulation by anastomosis of an valved conduit between the right ventricle and the distal end of the pulmonary artery. During the postop, period, the irreversible renal failure, accompanied by metabolic acidosis and pulmonary edema, occured under relative stabilized cardiac performance state. The autopsy was done, which revealed diffuse infarcted area in both kidney and preserved intra & extracardiac graft constructed.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.113-117
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• 1977

The tetralogy of Fallot is one of the most frequent and serious congenital cardiac malformation accompanied cyanosis. For relief of cyanosis, the Waterston operation is a successful, palliative procedure in infant & young child under age of five with obstructive lesions of the right: side of the heart who require a systemic-pulmonary arterial shunt for survival. A patient, aged 3 and weighing 13 kg., who had been cyanotic since one month after birth,. was admitted to the University of Severance Hospital under a diagnosis of tetralogy of Fallot, The side to side anastomosis between the right pulmonary artery & the ascending aorta was performed in March 1976. The anastomotic channel was made only 4 ram. in diameter, thereafter massive unilateral pulmonary congestion on the side of the anastomosis developed shortly after operation. And the. patient died of congestive heart failure within a hour. And so the purpose of this report is describe the immediate & late effect of systemic-pulmonary shunt for T.O.F. with review of literatures.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.28-37
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• 1977

Authors had performed experimental study for ventilatory functions & pulmonary hemodynamics following reimplantation of lung. Preoperative & postoperative hemodynamic studies were obtained. A significant reduction in arterial $PO_2$ and $PCO_2$ was observed with the first few days. But these changes returned to near control levels from 1 week after operation in long-term survivors. Also abnormal pulmonary hemodynamic values returned toward control levels within 1 to 3 weeks, with the exception of a residual increase in pulmonary vascular resistance. Microscopically minimal focal pulmonary edema and limited alveolar infiltration developed in the reimplanted lung. But these changes never increased after the their postoperative day and were completely resolved by 1 to 3 weeks after autotransplantation.

• Journal of Chest Surgery
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• v.25 no.6
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• pp.611-615
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• 1992

Between July 1988 and August 1991, 8 cases of pulmonary resection for pulmonary asp-ergilloma had been performed in the department of thoracic surgery, Korea Cancer Center Hospital. The patients were consisted of 4 males and 4 females and were evenly distributed from fourth decade to sixth decade. Hemoptysis was the most common chief compla int. In chest roentgenogram, patch infiltration was noted in 4 cases[50%] and intracavi-tary fungus ball was noted in only 2 cases[25%]. A. fumigatus was identified pre-operatively in 2 cases by bronchoscopic washing and in 1 case by culture of pleural effusion, Eight pulmonary resections were done by 5 lobectomies, 1 segmentectomy, 1 wedge resection and 1 pneumonectomy, Postoperative pathologic findings showed that 6 cases [75%] were combined with bronchiectasis, 1 case with tuberculosis and 1 case with pneumonia. We experinced 1 case of postoperative pulmonary edema but there was no mortality case.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.274-279
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• 1996

Pulmonary veno-occlusive disease is a rare cause of pulmonary hypertension in which the primary abnormality is obliterative obstruction of pulmonary veins, especially venules. Clinicaly, we should suspect this disease in the case of congestive cardiac failure with pulmonary hypertension, chronic interstitial pulmonary edema, and normal or elevated wedge pressure on cardiac catheterization. We experience a case of pulmonary hypertension due to pulmonary veno-occlusive disease. A 55-years -old woman developed progressive dry cough and dyspnea for 3 months. Physical examination showed normal heart sounds, diffuse crackles in the whole lung fields. The liver was not palpable and pitting edema was absent. The diagnosis was made by chest HRCT, 2-D echocardiography, normal pulmonary capillary wedge pressure on cardiac catheterization, and confirmed by thoracoscopic lung biopsy. This patient was treated with vasodilator(calcium antagonist) and with mild symptomatic improvement. We reported a case of pulmonary veno-occlusive disease with review of literatures.

• Tuberculosis and Respiratory Diseases
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• v.41 no.2
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• pp.158-164
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• 1994

Pulmonary alveolar proteinosis is a disease of unknown etiology characterized by the accumulation of PAS positive lipoproteinaceous material in the alveolar spaces sparing septum. The therapy which has enjoyed the greatest success is whole lung lavage. The authors reported here, a case of 44 year old male patient with pulmonary alveolar proteinosis, and this is the 7th case in Korea. The patient underwent whole lung lavage but expired due to brain edema complicated by the procedure. He complained exertional dyspnea and cyanotic lips, and presented fine inspiratory crackle at both lower lung fields, decreased arterial oxygen pressure, and diffuse infiltration at whole lung field. Light microscopic finding of lung tissue obtained by transbronchial lung biopsy revealed PAS positive amorphous, granular material filled in the alveolar spaces, and electron microscopy of bronchoalveolar lavage fluid concentrate showed many electron-dense multi-lamellated structures. To treat the disease, the authors tried whole lung lavage of left lung with $37^{\circ}C$ isotonic saline under general anesthesia. However, he expired due to brain edema probably due to dilutional hyponatremia complicated by the procedure, 11 days after the procedure. Whole lung lavage is known relatively safe, but fatal complication may occur like this case.

• Journal of Chest Surgery
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• v.25 no.4
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• pp.356-363
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• 1992

We have performed left lung transplantations in 15 dogs for one year and six months from June, 1990 to December, 1991 at the Repartment of Thoracic and Cardiovascular Surgery Yonsei University College of medicine, Seoul, Korea. These dogs were sacrificed at from operative day to post-operative 15 days when their general conditions were deteriorated. The gross findings of the transplanted lungs were thrombi in left atrium in three cases, partial occlusion of pulmonary artery or pulmonary veins in three cases, hemorrhage at pulmonary arterial anastomotic site in one case and bronchial anastomotic stenosis in two cases, bronchial anastomotic rupture in one case % no abnormal gross findings in four cases. The microscopic findings of the transplanted lungs were hemorrhagic infarction in one case, perivascular hemorrhage or pulmonary edema in two cases, peribronchial inflammatory cell infiltration & pneumonia in three cases, and alveolar type rejection with infiltration of type II pneumocytes and septal thickening in 3 cases. And also there were no abnormal findings including rejection or inflammatory evidences in six cases. The one among these six dogs survived to 15 days without evidence of rejection or inflammatory reaction & died due to postoperative care accident.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.15-20
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• 1982

During the past ten years from 1972 to 1981, a total of 100 cases of bronchiectasis were treated by pulmonary resection at C.A.F.G.H. Pulmonary tuberculosis and frequent U.R.I. were the most frequent associated disease and encountered in 54% in this series. Various types of pulmonary resection were performed on 100 patients; left lower lobectomy in 40 cases, left lower lobectomy and lingular segmentectomy In 29 cases, right lower lobectomy in 12 cases, right middle and lower lobectomy in 12 cases, lingular segmentectomy in 3 cases, left pneumonectomy in 3 cases and both lower lobectomy in 1 case. Complications developed in 9 cases and 1 case among them died of sepsis following secondary opera-tion. Among complications of 9 cases, postoperative atelectasis showed in 4 cases, hemorrhage in 2 cases, bronchopleural fistula in 2 cases, pulmonary edema in 1 case. Complications were treated by conservative and secondary operative management with satisfactory result except one death. Remainders without complication showed good result without symptom in postoperative and follow-up periods.