• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.34-43
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• 2009

Purpose: Glomus tumors are rare benign vascular tumors, usually located in the skin or soft tissue of extremities. Approximately 30-50% of glomus tumors occur in subungal area, but glomus tumors have been described in every location even where glomus bodies are not or rarely present. The purpose of this study was to identify clinical, histologic and MRI characteristics of soft tissue glomus tumor. Materials and Methods: Between 1993 and 2008, eight patients underwent surgery of soft tissue Glomus tumor at our institution. Exclusion criteria were patients with Glomus tumors in digits, stomach, trachea and glomus tympanicum. We analyzed medical records, interviews, physical examinations, MR findings and histolocial types retrospectively. Results: There were four men and four women. The mean age was fourty-seven years. The mean prevalence time was eight-point-nine years. In the classic triad of symptoms, all eight patients had pain and tenderness. Two patients complained of cold sensitivity. Two showed skin color changes. After surgery, two showed symptom improvement (VAS $9^{\circ}{\rightarrow}8$, $8^{\circ}{\rightarrow}5$) and?six showed complete disappearance of symptoms. Slightly symptom improvemented (VAS $9^{\circ}{\rightarrow}8$) one had additional surgery two times after first surgery due to relapse/remaining Glomus tumor. The mean size was 13.9 mm. In histology, six were 'solid glomus tumor', one was a mixture of 'solid glomus tumor' and 'lomangioma' and one was 'malignant glomus tumor'. MR findings showed isointense signal on T1 image, high signal on T2 image and strong enhancement on the Gadolinium enhanced image. Conclusion: Glomus tumor has low recurrence rate and malignant change, rapid diagnosis and surgical excision is critical in treatment to prevent unnecessary pain of patient.

• Advances in pediatric surgery
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• v.1 no.2
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• pp.140-148
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• 1995

To study the clinical profiles and outcome of surgery in infants with esophageal atresia, we reviewed 96 esophageal atresia cases who were treated from April, 1978 to June, 1995. There were 51 male and 45 female infants, a ratio of 1.1:1. The low birth weight(<2500g) patients were 32%. Clinical findings at the time of diagnosis included drooling in 57%, choking in 50%, cyanosis in 38%, respiratory distress in 27% and swallowing difficulty in 20%. Gross classification included 6 cases of type A esophageal atresia(6%), 79 cases of type C(82%), 3 cases of type E (3%) and 8 cases of type F(8%). Associated anomalies occurred in 34 infants(35%). Among them, cardiac anomalies were most common(60%). A primary repair of the defect was carried out in 76 patients with type A or C. A staged operation comprising a repair or gastric tube interposition after gastrostomy was performed in 8 patients. In all 3 infants with H-type, a division of fistula was performed. Esophageal resection and anastomosis was done in 8 infants with esophageal stenosis. In one infant, a gastrostomy was performed and he expired before staged operation. Anastomotic complications included leakage in 16 cases(17%), stricture in 37 cases(39%) and recurrent tracheoesopohageal fistula in 3 cases(3%). The mortality rate was 14% and the leading cause of death was pneumonia. The overall survival rate was 86%, and according to Waterston criteria, the survival rates were 93%, 85% and 58% in class A, Band C, respectively. 75 patients were followed up with median follow up 6.4 years. Among them, 93% were uneventful and 7% had frequent pneumonia.

• Journal of Chest Surgery
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• v.38 no.9 s.254
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• pp.622-626
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• 2005

Background: Non-invasive interventional therapy has been performed for main bronchial obstruction by endobronchial tuberculosis because of the risk of main bronchial reconstruction regardless of the pulmonary function. But, effects of the inteeventional therapy are attacked by arguments. This study was aimed at interpreting the risk and effectiveness of bronchoplasty for benign bronchial stenosis over the last ten years in our hospital by reviewing the results based on clinical progression. Material and Method: We retrospectively reviewed the clinical records and out-patient medical records including 2f consecutive patients who underwent main bronchial reconstruction for obstruction by endobronchial tuberculosis. All of them had past medical history of anti-tuberculosis medication. They were preoperatively evaluated by bronchoscopy and chest computed tomography. Result: There were no incidences of postoperative mortality and signifcant morbidity. There were 2 cases of retained secretions but these problems were resolved by therapeutic bronchoscopy or intubation. All of the patients are still alive without obstructive airway problem. Conclusion: Bronchoplasty should be considered as one of the primary treatment modalities, if it is anatomically feasible.

• Journal of Chest Surgery
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• v.39 no.12 s.269
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• pp.949-952
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• 2006

Spontaneous pneumothorax is rarely occurred as an initial sign of primary lung cancer. As a lot of these cases have already advanced, even then surgical resection is performed, the prognosis is often undesirable, We happened to find a ruptured cavity on a 65-year-old male patient who had suffered from pulmonary tuberculosis in the past, while performing VATS bullectomy for simple spontaneous pneumothorax, Then, as a result of frozen biopsy, it was diagnosed as squamous cell cancer Because the tumor was infiltrated from the upper lobe into the lower lobe passing by fissure, we should remove by pneumonectomy and the pathologic stage was found stage I(T2N0M0). When we made an follow-up observation for one year and a half, there was neither relapse nor complication. When there appears spontaneous pneumothorax to the high risk group for lung cancer who were smokers over forty-year old, with chronic bronchitis or pulmonary emphysema, it needs to have a closer observation on a base lung disease such as lung cancer through chest CT, and it is also necessary to make more active approach by performing the surgical operation through a thoracoscopy when there is a continued air release.

• Journal of Gastric Cancer
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• v.6 no.2
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• pp.114-119
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• 2006

Purpose: The purpose of this study is to determine whether it is possible to evaluate patients with pN2 or pN3 early gastric cancer (EGC) as being in an advanced stage before and during the operation. Materials and Methods: 4,430 patients underwent a gastrectomy for cancer from 1990 to 2003. Eight of the 552 patients with EGC included pN2 or pN3. The estimated clinical and surgical stage before and during the operation were compared to the pathological results, and a follow-up of progression was done. Results: The patients were evenly distributed among all age groups with seven men and one woman. The pre-operative estimate of T1 by CT was 25% (2/8). In the main, the cT stage was over estimated. The estimate of over N2 was 50% (4/8). One patient was preoperatively staged as la sT1 during operation was 57.1% (4/7), and the estimate of over N2 was 67% (4/6). Two patients were intraoperatively evaluated as Ia. Only one patient survived over 5 years, and the mean survival of these patients was 15 months $(95%\;Cl:\;0{\sim}35.5)$. Conclusion: It was generally possible to evaluate patients with EGC of over pN2 as being in an advanced stage before and during the operation. Although very rare (2/552, 0.04%), there were EGC patients whose stages were not predictable at all. Therefore, more precise preoperative and intraoperative staging methods are warranted.

• Clinical and Experimental Reproductive Medicine
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• v.31 no.2
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• pp.119-131
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• 2004

연구 목적: 난소에서 분비되는 스테로이드 호르몬인 에스트로젠과 프로게스테론은 포유동물의 생식기관 발달과 정상적인 생식 기능, 수정과 배아의 착상에 중요한 역할을 한다. 특히 에스트로젠은 자궁내액을 내강으로 분비하여 자궁부종 기작에 중요한 역할을 한다. 자궁내액은 정자의 수정능력 획득과 착상전 배아의 발달에 매우 중요하다. Aquaporin (AQP)은 막관통 물수송 단백질로서 여러 조직에 넓게 분포되어 있으며, 세포간 또는 상피세포간 물의 이동에 중요한 역할을 한다. 본 연구에서는 생쥐 자궁에서 스테로이드 호르몬에 의해 조절되는 자궁내액의 이동에 AQP 유전자가 관여하는지를 알아보았다. 연구 재료 및 방법: 난소 절제술을 시행한 생쥐에 스테로이드 호르몬을 피하주사하고 6, 12, 24시간 간격으로 자궁조직을 적출하였다. 대조군은 sesame oil만을 주사한 후 6시간째에 수획한 자궁조직을 사용하였으며, 실험군은 시간대별과 스테로이드 처리별로 채취한 자궁조직에서 역전사중합효소반응을 수행하였다. 역전사중합효소반응을 통해 막관통 단백질인 AQP-4, -5, -8 mRNA의 발현양상을 살펴보았다. 또한 mRNA의 위치를 살펴보기 위해 laser microdissection을 이용하여 RT-PCR을 수행하였다. 마지막으로 자궁조직내에서의 단백질 발현 부위를 관찰하기 위해 면역조직화학염색을 실시하였다. 결 과: AQP-4, -5, -8 mRNA은 프로게스테론을 처리한 군보다 에스트로젠을 처리한 군에서 많이 발현되었으며, 에스트로젠을 주사한 지 6시간째 발현정도를 대조군과 비교할 때 AQP-4, -5, -8 mRNA가 각각 7.9배, 2.8배, 3.8배로 나타났다. AQP-4, -5, -8 mRNA는 간충조직보다 자궁내 상피조직에서 스테로이드 호르몬의 영향을 받아 발현양상의 차이가 나타났으며, 주로 에스트로젠의 영향을 받아 발현이 증가하였다. AQP-4 단백질은 에스트로젠을 24시간 처리한 후 프로게스테론을 처리한 군의 자궁내 상피조직에서 많이 발현되었으며, AQP-5와 -8 단백질은 에스트로젠을 처리한 군의 자궁내 상피조직에서 발현이 증가하였다. 결 론: 이상의 결과를 통해 AQP-4, -5, -8은 주로 에스트로젠에 의해 자궁내 상피세포에서 발현이 증가되는 것으로 보아 에스트로젠의 영향하에 일어나는 자궁내액의 이동으로 인한 자궁부종기작에 이동통로로서 관여하는 것으로 사료된다.

• Journal of Chest Surgery
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• v.31 no.2
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• pp.212-215
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• 1998

Pulmonary mucinous cystic tumor of borderline malignancy is very rare and distinguished from bronchogenic cyst or adenocarcinoma of bronchoalveolar type. We present the case of a 63-year-old woman with a right lower lobe mass, found by chest radiographs. The preoperative diagnosis was made as bronchoalveolar cancer by percutaneous needle aspiration of mass. Right lower lobectomy and lymph node dissections were performed. The lobectomy specimen contained variable sized multilocular cystic mucous masses, filled with mucus. Microscopically, the cystic masses are lined with tall columnar mucinous epithelium but some area contains focal cellular atypism and bronchoalveolar cancer like foci. This foci are lack of cellular atypism consistent with bronchoalveolar cancer cell. After lobectomy the patient has remained free from recurrence and distant metastasis for following 12 months period. Pulmonary mucinous cystic tumor of borderline malignancy appears to have a favorable prognosis and should be distinguished from other lung neoplasms.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.344-350
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• 2007

Laryngo-tracheal perforation caused by the use of a stylet during tracheal intubation is a rare complication. We present a case of subcutaneous emphysema and connective tissue inflammation after tracheal intubation. The patient was a 41-year-old male undergoing general anesthesia for an appendectomy. The intubation was difficult during laryngoscopy (Cormack- Lehane Grade III). An assistant provided an endotracheal tube with a stylet inside while the laryngoscope was in place. During intubation, a short, dull sound was heard with a sudden loss of resistance after the distal tip of the endotracheal tube passed the rima glottis. A sonogram and computerized tomography revealed subcutaneous emphysema from the neck to the upper mediastinum and fluid collection between the trachea and the thyroid. This lesion appeared to have been caused by the protruded, loose stylet. Anesthesiologists should be aware of the damage a loose stylet protruding beyond the tip of the endotracheal tube can cause.

• Journal of Chest Surgery
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• v.30 no.4
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• pp.396-401
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• 1997

Tailoring thoracoplasty is employed prior to, following, or concomitant with pulmonary resection when it is anticipated that insufHclent lung tissue will remain to fill the pleural space following a pulmonary resection. This study reviewed a series of eight patients treated with tailoring thoracoplasty between 1990 and 1995. Indications were to close a persistent space In four patients and to tailor the thoracic cavity to accept diminished lung volume concomitant with a pulmonary resection in the other four patients. The primary underlying disease was lung cancer in three patients and pulmonary tuberculosis In five patients, two of whom had concomitant aspcrgilloma, two, pneumothora , and one, empyema with bronchopleural fistula. In four patients with a prior pulmonary resection, the tailoring thoracoplasty was performed within eight days after the resection surgery. There was no failure to accommodate the thoracic cavity to insufficient lung tissue, even though two patients needed a second thoracoplasty. We conclude that tailoring thoracoplasty may be performed to close anticipated persistent pleural space and to accommodate diminished lung volume with acceptable cosmetic results Early, after, or concomitant with pulmonary resection in selected patients.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.40-45
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• 1998

Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.