• Journal of Chest Surgery
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• v.37 no.5
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• pp.432-437
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• 2004

Background : Solitary fibrous tumors of the pleura (SFTP) is one of rare neoplasms that originated from submesothelial mesenchyme. Clinical course or extent of surgical resection is not well known. Material and Method: We retrospectively reviewed all the clinical records of the patients who had undergone surgical resection of benign and malignant SFTP, Result: Twenty two (male female 14 : 8) patients were enrolled and mean age was 50.2(range 25∼83). Number of symptomatic patients at the time of diagnosis was 13 (59%) and the most common symptom was dyspnea. Operative approach was carried out through thoracotomy (n=14) or video-assisted thoracic surgery (n=8). Mass excision was performed in 12 cases and en bloc resection including adjacent structure in 10 cases. In all cases complete resection was performed. There was no operative mortality. Malignant SFTP were 11 cases and benign SFTP 11 cases. Local recurrences (n=2) or distant metastasis (n=6) occurred only in malignant SFTP. Conclusion: Number of symptomatic patients, on bloc resection, and recurrence was more in malignant SFTP. Although complete surgical resection is known as treatment of choice for SFTP, further study should be performed about systemic therapeutic modalities pre- or postoperatively to control recurrence and metastasis.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.535-538
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• 2003

Spontaneous pneumothorax accompanying primary lung cancer is rare and its occurrence as an initial sign of primary lung cancer is much rarer. A few articles on spontaneous pneumothorax accompanying lung cancer have been published in Korea so far. Lung cancers, diagnosed after spontaneous pneumothorax, are usually in advanced stage, so that conservative treatment modalities such as closed tube thoracostomy, chemotherapy, or radiotherapy are the mainstream of the treatment. We experienced a case of local recurrence of primary lung cancer in six months after radical resection and radiotherapy of neoplasm performed immediately after the diagnosis by excisional biopsy of bulla, for which resection and pleurodesis had been done under the impression of spontaneous pneumothorax. In this paper, we report the case and follow-up observation of the patient.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1019-1021
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• 2004

Neurogenic tumors are common in posterior mediastinal tumors. In most cases, tumors were accidentally showed on simple chest X-ray. In some cases, they were presented by symptoms which were induced by nerve compression or airway compression. But as in our case, neurogenic tumor with spontaneous hemothorax is very rare. A 45-year-old man admitted to emergency room of other hospital because of acute right chest pain and dyspnea. A chest X-ray showed a right pleural effusion. Hemothorax was diagnosed after closed thoracostomy. Following chest CT showed posterior mediastinal mass. The patient was transferred to our hospital. T spine MRI showed dumbbell shaped mass. Diagostic impression was neurogenic tumor. The pathologic result was neurilemmoma after surgical resection.

• The Korean Journal of Cytopathology
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• v.14 no.1
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• pp.36-41
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• 2003

Epithelioid hemangioendothelioma is a rare vascular tumor of borderline malignancy which is characterized by the presence of "epithelioid" or "histiocytoid" endothelial cells. Superficial and deep tumors have been recognized in the extremities, head, neck, chest, and mediastinum of adult patients. It may also occur as a primary tumor of liver, bone, and other visceral organs. Few effusion cytologic findings of epithelioid hemangioendothelioma have been reported. We report a case of composite epithelioid hemangioendothelioma with focal epithelioid angiosarcomatous areas of the iliac bone and adjacent soft tissue in a 38-year-old female, which, during its metastatic course, was presented as a pleural effusion. The effusion was cellular with epithelioid cells presenting both singly and in clusters. The tumor cells were round to ovoid shewing cytoplasmic vacuolization, variability in cell size, and prominent nucleoli. The effusion smears and cell block sections revealed strong positive staining for CD31 and vimentin, weak positive for CD34 and Factor VIII-related antigen, and negative for cytokeratin, CEA, and calretinin. The cytologic findings in this case were similar to that of metastatic adenocarcinoma or malignant mesothelioma. Therefore, immunocytochemical staining in smear and cell block is a helpful tool to differentiate malignant 'epithelioid' cells in effusion.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.544-547
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• 1997

We have experienced a case of pleural aspergillosis. A 50 year old female complained of malaise, anorexia, coughing with sputum, and right sided pleuritic chest pain of two weeks' duration. About ten years ago, she had been treated for pulmonary tuberculosis with medication. Chest radiography showed right pyopneumothorax with cavitation in the rig t upper lung and Chest computed topography revealed right loculated pyopneumothorax with cavity formation suggesting bronchopleural fistula. Decortication and wedge resection with pleurectomy were performed. The postoperative course was satisfactory and has been in good condition up to now. Pleural aspergillosis is a very rare and potentially life-threatening disease, but we have had good results without significant complications by treatment with systemic antifungal drugs and surgical operation.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.124-126
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• 1992

Interleukin-2 (IL-2)는 많은 immunoenhancing lymphokine의 한 종류로서 lymphokine activiated killer (LAK) cell의 생성을 자극시켜 흑종의 종양세포를 죽인다고 알려져 있다. 최근 간종양에서 비장동맥 또는 간동맥으로 투여한 IL-2가 비장의 임파계를 자극하여 LAK cell을 생성하여 어느정도효과가 있음이 밝혀지면서, 여러가지의 투여 방법이 시도되고 있다. 그러나 각종의 투여 방법에서 실제로 투여한 IL-2의 인체내 분포에 관한 연구는 없다. 저자들은 비정맥과 간문맥에 이상이 없는 증례의 비동맥에 IL-2와 $^{99m}Tc-phytate$ 혼합물을 투여하고, IL-2의 생체에서의 비장과 간에 어떻게 분포하는지 알아보기 위하여 $^{99m}Tc$의 radioactivity를 계측하여 보았다. 6예의 간세포암과 3예의 위암으로부터의 전이성간암에서 동맥조영술적방법을 이용하여 초선택적 비장동맥에 투여한 IL-2와 $^{99m}Tc-phytate$ 혼합물이 비장 27%, 간73%의 분포를 보여 비장을 거쳐온 $^{99m}Tc$의 방사능이 간에 많이 침착함을 확인하였고 간과 비장이외의 부위 즉 골수, 복수 또는 폐장이나 늑막에는 전혀 방사능 분포가 없음을 알 수 있었다. 따라서 비정맥이나 간문백에 이상이 없는 증례에서 IL-2의 비장동맥 투여는 목적하는 바 IL-2의 생체내 분포를 이룩할 수 있을 것으로 사료된다.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.447-453
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• 1988

Intrapleural instillation of tetracycline as a preventive measure against recurrence in spontaneous pneumothorax was performed at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for 3 years from Jul. 1984 to Aug. 1987. In this period, 124[70.0%] out of 177 patients of spontaneous pneumothorax who received closed thoracostomy were followed up. Tetracycline pleurodesis was applied to 32 cases. The recurrence rate of the tetracycline instillation group was lower than that of noninstillation group. In patients with first attack, the recurrence rate was 12.5% in the instillation group and 35.3% in the noninstillation group. In the second episodes, 25.6% and 83.3%[p< 0.01], in the third episodes 25.0%, 100.0%[p< 0.05]. In total cases, 18.8% and 39.8%[p< 0.05] of recurrence rates were observed. Systemic or local reactions such as fever, chest pain, and pleural effusion were observed in 23 patients[71.9%] after instillation, but all were transient and benign without sequelae. In cases of systemic or local reactions the recurrence rate was lower than that with no reactions but with no statistical significance. In the four patients primarily treated with tetracycline pleurodesis who then underwent thoracotomy, mild alterations were shown in the pleurae except dense adhesions at the previous thoracotomy sites. There was no significant difference between the two groups in terms of durations of hospitalization and post-treatment recurrences.

• 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.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.317-320
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• 1998

Since Reiestad and Str$\ddot{o}$mskag reported interpleural installation of local anesthetic solutions as a technique for the management of postoperative pain in the patients undergoing cholecystectomy, renal surgery and breast surgery, many physician applied this technique for upper abdominal pain from various reasons such as technically simple, effective pain relief, less respiratory depression. So we tried interpleural analgesia in two patients who suffered from severe upper abdominal pain. One had upper abdominal pain due to chronic pancreatitis and the other had right upper abdominal pain after PTBD (percutaneous transhepatic bile drainage) for biliary cirrhosis and systemic jaundice. Both were injected 10 ml of 1% lidocaine and infused continuously with 1% lidocaine (2 ml/hr) using 2-Day Baxter$^{(R)}$ infusor. After bolus injection of lidocaine, pain scores (VAS 0~100) were recorded below 25mm and had not exceed that level during continuous infusion. After removing the catheters, two patients were all satisfied with this therapy. Our experiences with this technique showed that continuous infusion of local anesthetics through an interpleural catheter is effective in the control of refractory upper abdominal pain without any complication.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.1-17
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• 1993

고빈도 환기법은 최근에 개발되어 임상에 응용되면서 호흡생리학, 마취학, 집중치료의 학등의 분야에서 호흡부전의 새로운 치료법으로 관심이 집중되고 있는 환기법이다. 현재까지 고빈도 환기법중 고빈도 양압 환기와 제트 환기는 비교적 많은 연구가 되고 있고 임상적으로 사용되고 있으나 고빈도 진동 환기법은 제한적으로 사용되고 있다. 앞으로 고빈도 진동 환기법에 대해서도 더 많은 연구가 되어야 할 것이다. 또한 최근 개발되고 있는 고빈도 흉벽 진동 환기와 체표면 진동 환기에도 관심을 기울이면 호흡부전 환자의 치료에 바람직한 새로운 환기법이 될 수 있을 것으로 기대된다. 현재 고빈도 환기법의 몇몇 적용형태는 기관지-늑막루등의 폐압손상으로 인한 병변의 치료외에도 기관수술, 흉부수술, 뇌수술에서 수술부위의 움직임을 최소화시키면서 충분한 가스교환율 이룩할 수 있어서 효과적으로 이용되고 있다. 그러나 응급심폐소생술, 폐쇄성 폐질환, 성인 또는 영아 호흡곤란증후군등과 같은 질환에서의 적용은 더 규명되어져야겠다. 고빈도 환기법의 여러가지 문제점중 적절한 환기빈도의 결정, 충분한 습도를 공급하는 장치, 고빈도 환기의 정확한 감시장치의 개발등은 앞으로 우선적으로 해결해야 할 문제점이다. 또한 임상에 더욱 효과적으로 응용될 수 있는 새로운 환기법이 되기 위해서는 고빈도 환기법의 호흡생리와 안정성등에 관한 연구도 병행되어야겠다.