• Journal of Chest Surgery
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• v.42 no.2
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• pp.256-258
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• 2009

A 63-year-old man who had a permanent pacemaker placed 17 years ago presented to us with local inflammatory signs on his chest. The skin was opened to remove the permanent pacemaker. However, the pacing wire was not easily removed. So, the permanent pacemaker was removed from the chest with leaving the remnant wire inside. However, the local infection recurred because of the remnant wire. Right thoracotomy was performed and cardiopulmonary bypass was started. After total circulatory arrest, the right atrium was opened and the wire was completely removed.

• The Korean Journal of Pain
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• v.3 no.2
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• pp.119-124
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• 1990

Reiestad and Stromskag recently introduced the interpleural installation of local anesthetic solutions as a technique for the management of postoperative pain in patients undergoing cholecystectomy, renal surgery, and breast surgery. This study was done to manage postoperative pain in the patients undergoing unilateral upper-abdominal surgery and thoracotomy. Twenty patients received 0.5% bupivacaine 20 ml with epinephrine (Children, received 10 ml). Results were as follows: 1) Analgesic effects appeared in 15.56 minutes; mean analgesic duration from the initial intrapleural injection was 10.5 hours. 2) Blood pressure increased more after the operation than before the operation. Blood pressure before injection of bupivacaine was highest (p<0.01). Heart rate was increased before injection and 10 minutes after injection of 0.5% bupivacaine (p<0.05). 3) The values of $PaCO_2$, were improved from $41.7{\pm}2.02\;mmHg$ ($PaCO_2$), $85.2{\pm}2.41\;mmHg$ ($PaO_2$) to $37.8{\pm}2.41\;mmHg$ ($PaCO_2$), $107.0{\pm}7.86\;mmHg$ ($PaO_2$) respectively (p<0.01). 4) Complication such as pneumothorax, atelectasis and CNS toxicity did not appear. 5) Intrapleural administration of local anesthetics after unilateral upper-abdominal and thoracic surgery provided a satisfactory pain control.

• Journal of Korean Neurosurgical Society
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• v.55 no.6
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• pp.383-386
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• 2014

Objective : Symptomatic thoracic disc herniation often requires prompt surgical treatment to prevent neurological deterioration and permanent deficits. Anterior approaches offer direct visualization and access to the herniated disc and anterior dura but require access surgeons and are often associated with considerable postoperative pain and pulmonary complications. A disadvantage with using posterior approaches in the setting of central calcified thoracic disc herniation however, has been the limited visualization of anterior dura and difficulty to accurately assess the extent of decompression. Methods : We report our experience with intraoperative ultrasound (US) guidance during a modified posterior transpedicular approach for removal of a central calcified thoracic disc herniation with a review of pertinent literature. Results : The herniated thoracic disc was successfully removed with posterior approach with the aid of intraoperative US. The patient had significant neurological improvement at three months follow-up. Conclusion : Intraoperative ultrasound is a simple yet valuable tool for real-time imaging during transpedicular thoracic discectomy. Visualization provided by intraoperative US increases the safety profile of posterior approaches and may make thoracotomy unnecessary in a selected group of patients, especially when a patient has existing pulmonary disease or is otherwise not medically fit for the transthoracic approach.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.214-218
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• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.81-84
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• 1978

A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.102-107
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• 1978

This is a report of a chylous cyst in the mediastinum found in a 61 year old Korean female patient who suffered from mild swallowing difficulty and right chest discomfort. These symptoms had developed 5 years previously when chest P-A view showed thumb-tip sized mass shadow in right mediastinum, just right to ascending aorta. Esophagogram revealed an indentation of midesophagus. Follow up checks showed growing mass shadow which suggested aneurysm of ascending aorta. On admission chest X-ray revealed a well circumscribed infant head sized mass density along the right heart border and middle mediastinal border, and extended near to the middle clavicular line in right chest cavity. Aortogram revealed no relationship between the mass and aorta. Right thoracotomy was performed under impression of mediastinal tumor. There was a large cyst containing 700 cc of milky fluid. There was no connection to the thoracic duct nor adjacent organs. The fluid was analyzed chemically and identified the fluid as chyle. The origin of the isolated chylous cyst was uncertain postoperative course was uneventful.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.881-886
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• 1990

Thirty-three patients less than 40 years of age were diagnosed at CS Dept. of Catholic University Medical College between 1979 and 1988 as having primary lung cancer. There were 22 men and 11 women; the average age was 36.3 years. The youngest patients was 23 years old. Eighteen male patients were only habitual smokers more than 1 pack per day. In the 33 cases, the distribution by tumor type was as follows: squamous cell carcinoma 36.4%[13 cases]; adenocarcinoma 33.3%[11 cases]; small cell carcinoma 24.2%[8 cases]; and large cell carcinoma 3.0%[1 case]. At the time of diagnosis, 2 patients[6.1%] had stage I disease, 2[6.1%] had stage II disease, 5[15.6%] had stage IIIA disease, 10[30.3%] had stage lllB disease, and 14[42.4%] had stage IV disease. Thirteen patients[36.4%] underwent an exploratory thoracotomy. Of these patients, 9[27.3%] had surgical resection[six lobectomies, two pneumonectomies, and one wedge resection]. Thirty-one patients were treated with palliative radiation therapy, chemotherapy, or combinations of each. The survival rate at 1 year, 3 year, and 5 year were 48.2%, 14.5%, and 8.3% respectively. But in the resectable 9 patients, they were 78.1%, 43.6%, and 33.3% respectively.

• Journal of Chest Surgery
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• v.49 no.2
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• pp.122-125
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• 2016

Postpartum aortic intramural hematoma (IMH) is a rare but potentially lethal condition. We report a case of aortic IMH with massive hemothorax in a postpartum woman. The patient was a 31-year-old woman who had delivered twins by cesarean section. Two days after delivery, she complained of sudden-onset dyspnea. Chest computed tomography revealed a massive left hemothorax. Exploratory thoracotomy was performed, and we found a defect measuring approximately 6 mm in the adventitial layer of the thoracic aorta and an IMH. We repaired the defect primarily, and no more bleeding was observed. The patient was discharged on the 19th postoperative day without any complications.

• Journal of Chest Surgery
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• v.43 no.4
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• pp.409-412
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• 2010

We have experienced five cases of atrial septal defect closure under complete port access using the da Vinci system. We used only six 8∼12 mm ports without thoracotomy or sternotomy for operation.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.69-71
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• 2018

A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left atrium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.