• International Journal of Stem Cells
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• v.10 no.1
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• pp.1-11
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• 2017

Human cardiomyocytes (CMs) cease to proliferate and remain terminally differentiated thereafter, when humans reach the mid-20s. Thus, any damages sustained by myocardium tissue are irreversible, and they require medical interventions to regain functionality. To date, new surgical procedures and drugs have been developed, albeit with limited success, to treat various heart diseases including myocardial infarction. Hence, there is a pressing need to develop more effective treatment methods to address the increasing mortality rate of the heart diseases. Functional CMs are not only an important in vitro cellular tool to model various types of heart diseases for drug development, but they are also a promising therapeutic agent for cell therapy. However, the limited proliferative capacity entails difficulties in acquiring functional CMs in the scale that is required for pathological studies and cell therapy development. Stem cells, human pluripotent stem cells (hPSCs) in particular, have been considered as an unlimited cellular source for providing functional CMs for various applications. Notable progress has already been made: the first clinical trials of hPSCs derived CMs (hPSC-CMs) for treating myocardial infarction was approved in 2015, and their potential use in disease modeling and drug discovery is being fully explored. This concise review gives an account of current development of differentiation, purification and maturation techniques for hPSC-CMs, and their application in cell therapy development and pharmaceutical industries will be discussed with the latest experimental evidence.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.844-848
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• 2005

Background: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. Material and Method: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptom too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite finding of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraciavicular approaches in 2 cases. Result: There were 15 males and one female with an average age of 23.9 years (range:19$\∼$39). Rib anomalies were observed in four cases (25.0$\%$), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0$\%$), left lesions in five cases (31.3$\%$), and bilateral lesions in three cases (18.7$\%$). The follow-up period was 9$\∼$26 months and recurrence rate was 12.5$\%$ (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. Conclusion: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1277-1283
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• 1998

Background : Surgical tracheostomy(ST) is usually performed by surgeons in operating room. For a patient with mechanical ventilation, however, transportation to operating room for ST could be dangerous for patients. In addition, ST is often delayed due to unavailability of operating room or surgeon. Percutaneous dilatational tracheostomy(PDT), although novel in Korea, is gaining popularity as a bedside procedure in the hospitals of western countries. We evaluated the technical ease and safety of PDT in comparison with ST. Method : Thirty-eight patients in medical intensive care unit (ICU) who were either under mechanical ventilation for more than 7 days or required airway protection, were randomly assigned to ST(18 patients) or PDT(20 patients). Between two groups, there was no significant clinical difference except that female to male ratio was higher in the ST group. ST was performed by second year residents of the department of otolaryngology while PDT was performed by third grade medical resident and pulmonologist under bronchoscopic guide using Ciaglia Percutaneous Tracheostomy Set(Cook Critical Care, Bloomington, USA) in medical ICU. The following factors were compared between two groups : number of delayed cases after the decision for tracheostomy, procedural time, complications related to tracheostomy. Results : Delayed cases were 11 in ST group and 3 in PDT group (P<0.05). Procedural time was significantly shorter in PDT group ($15.6{\pm}7.1min$) than in ST group ($29.1{\pm}11.6min$, P<0.0001). Complications related to tracheostomy occurred in 5 cases in ST group : accidental decannulation (1), subcutaneous emphysema (2) and minor bleeding (2), and in 4 cases in PDT group : minor bleeding (2), subcutaneous emphysema (1) and premature extubation (1) (P>0.05). Conclusion : Since percutaneous dilatational tracheostomy was easy to practice and its complications were not different from surgical tracheostomy, PDT can be a useful bedside procedure for mechanically ventilated patients.

• Tuberculosis and Respiratory Diseases
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• v.63 no.1
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• pp.59-66
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• 2007

Background: Surgical lung biopsy is required to establish the etiology and stage of interstitial lung disease(ILD). and this procedure can be safe and meaningful for making clinical decisions. We wanted to determine the safety of surgical lung biopsy(SLB) in patients with interstitial lung disease(ILD). Methods: We conducted a retrospective review of 40 patients with suspected ILD and they underwent surgical lung biopsy from January 2001 to June 2006 at Chungnam University Hospital. We analyzed retrospectively according to their age, gender, pulmonary function, chest tube duration, the arterial blood gases, the procedural technique, and the requirement for supplemental oxygen and mechanical ventilation(MV) at the time of SLB. Results: The mean age of the patients was 56.4${\pm}$16.13 years(range: 21 to 77 years). Overall, the 30-day and 90-day mortality rates were 15% and 20%, respectively. The predictors of perioperative mortality were either the need for mechanical ventilation(MV) at the time of SLB or the need for supplemental oxygen prior to undergoing SLB. Among the 32 patients who were 90-day survivors, the proportion of those patients using the oxygen supplement was 28.1% (n=9). All 8 patients who were 90-day non-survivors used oxygen supplement (p=0.000). The use of the MV was 12.5% (n=4) in the 90-day survivors (n=32) and 62.5% (n=5) in the 90-day non-survivors (n=8); there was a significant difference between the 90-day survivors and non-survivors (p=0.000). Conclusion: Patients who require MV and supplemental oxygen are associated with an increased risk for death following SLB.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.1
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• pp.13-15
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• 2014

Presbyphonia is defined as voice change caused by aging. Since presbyphonia is one of the natural aging processes, the treatment should be considered for the patients complaining communication difficulties. The treatment should not only target on presbylaryngis, but also on underlying systemic conditions such as lung function, neurological diseases and medications. Therefore, the treatment for the patients with presbyphonia should be multidisciplinary including underlying disease control, voice therapy and surgical treatment. Although various experiments on treatment of presbylaryngis are currently being tried, repeated injection laryngoplasty is still playing an important role because presbyphonia is destined to get worse over time.

• Journal of Chest Surgery
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• v.47 no.4
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• pp.431-433
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• 2014

Aspergillus is a common saprophytic fungi of the human airways and causes a broad spectrum of diseases, ranging from aspergilloma to invasive aspergillosis. There are few reports on mediastinal aspergilloma without any underlying pulmonary disease or immunocompromise. Herein, we report a case of mediastinal aspergilloma that we experienced and treated by thoracoscopic resection and oral antifungal medication.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.178-180
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• 2014

Pulmonary and/or bronchial aneurysm with systemic thrombophlebitis can be seen in the case of both Behcet's disease and Hughes-Stovin syndrome. These two diseases may be indistinguishable since the clinical, radiological, and histopathological findings are similar in both cases. In particular, from the perspective of pulmonary involvement, hemoptysis is the leading cause of death in both conditions and is followed by aneurysmal rupture. Here, we report a case in which surgical resection was performed for a patient presenting recurrent hemoptysis as an atypical presentation of Behcet's disease.

• Childhood Kidney Diseases
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• v.21 no.1
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• pp.26-30
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• 2017

Newborn infants with huge and highly vascular sacrococcygeal teratoma (SCT) are frequently subjected to renal hypoperfusion secondary to high-output cardiac failure. Any underlying renal dysfunction is a significant risk factor for the development of contrast-induced nephropathy (CIN). However, reports on CIN in infants are rare. I report here a case of a premature infant born at 28 weeks and 3 days of gestation with a huge SCT who survived preoperative embolization and surgical resection but presented with persistent non-oliguric renal failure that was suggestive of CIN. During radiological intervention, a contrast medium had been administered at about 10 times the manufacturer-recommended dose for pediatric patients. Despite hemodynamic stabilization and normalization of urine output immediately following surgery, the patient's serum creatinine and cystatin-C levels did not return to baseline until 4 months after birth. No signs of reflux nephropathy were observed in follow-up imaging studies. Dosing guidelines for the use of a contrast medium in radiological interventions should be provided for infants or young patients.

• Journal of Chest Surgery
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• v.10 no.2
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• pp.349-354
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• 1977

Mediastinoscopy is a surgical endoscopic technique used mainly for examination and biopsy of lesions of the superior and posterior middle mediastinum. It is particularly concerned with diseases that primarily or secondary involve the paratracheal and parabronchial lymphatics. A total of 18 cases of mediastinoscopy are presented with a detailed analysis of indications and results. Of these mediastinoscopy was positive in i0 [56%] and negative in 8 [44%]. The 10 positive mediastinoscopies were diagnostic in 4 patients with malignant lymphoma, 5 patients with carcinoma of the lung, one patient with active pulmonary tuberculosis. Of 8 negative mediastinoscopies, one was inoperable due to recurrent laryngeal nerve involvement, 7 patients were subjected to radical resection. Complications of mediastinoscopy were developed in 2 cases, one was minimal degree of subcutaneous emphysema on anterior chest wall, and the other was widening of right mediastinal border due to hematoma. Two complications were completely absorbed after 7 days.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.319-324
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• 1986

Congenital coronary arteriovenous fistula is uncommon disease, and was first described by Krause in 1865. About 20% of the cases, it associates additional congenital heart diseases. A 5-year-old female patient was diagnosed as coronary AV fistula with VSD, and was taken surgical correction under cardiopulmonary bypass. VSD was small and subarterial in type, and the fistula was dilated as adult thumb tip size at its distal portion. VSD was closed directly through the pulmonary arteriotomy and the aneurysmal dilation was opened vertically, then it was obliterated using 5-0, 6-0 prolene continuous suture fashioning into a long slender tube. Postoperative course was uneventful.