• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.860-862
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• 2005

We describe a case of pulmonary alveolar proteinosis in a male adult with lung cancer To achieve the successful operation of lung cancer, we used percutaneous veno-venous extracorporeal membrane oxygenation (ECMO) during whole lung lavage (WLL) of the contralateral lung. We performed successful WLL under ECMO support.

• The Journal of the Korean bone and joint tumor society
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• v.16 no.1
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• pp.1-7
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• 2010

Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.804-807
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• 2010

Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and. there were no thrormbotic complications. In conclusion， ventilatory SUpport using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.

• Journal of Chest Surgery
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• v.40 no.1 s.270
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• pp.56-59
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• 2007

A 65 year-old male had chest pain which was diagnosed as unstable angina needing urgent coronary artery bypass surgery. Physical examination demonstrated signs of severe anemia and hemoglobin level was 5.7 g/dL. Gastrofiberscopy showed a 4 cm sized fungating mass at the lesser curvature with active bleeding. The mass was adenocarcinoma by pathologic examination. Simultaneous coronary artery bypass surgery and total gastrectomy were planned due to bleeding of the mass. Off-pump coronary bypass grafting was done first, followed by total gastrectomy. The postoperative course was smooth. He was discharged from the hospital after 12 days and was on surveillance for 9 months. We report a rare case of simultaneous surgery for angina and gastric cancer.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.95-105
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• 2008

Purpose: To identify which is the best procedure in recycling autograft according to the resection & reconstruction type and recycling methods, and so when the recycling autograft is used in limb salvage surgery. Materials and Methods: We have treated fifty-eight patients (34 male, 24 female; age range 5 to 74 years, mean age 36.5 years), who had the malignant musculoskeletal tumors, with recycling autograft (47 patients with extracoporeal irradiation, 11 patients with pasteurization) from December 1995 to February 2006. The resection and reconstruction type was 3 cases with fragmentary, 8 intercalary, 23 rAPC (recycling-Autograft-Prosthesis composite), 18 osteoarticular, 5 total joint and 1 soft tissue (achilles tendon). The result was evaluated by the radiologic union at junctional site, the functional score by musculoskeletal tumor society score and complications according to the resection & reconstruction type and recycling methods. Results: The junctional union was obtained at 15.0 months in extracoporeal irradiation and 12.6 months in pasteurization. Also the mean radiologic union was shown at 6.0 months in fragmentary, 12.8 months in intercalary, 10 months in rAPC, 23.3 months in osteoarticular and 15.6 months in total joint. The functional score was 65.5% in fragmentary, 60.8% in intercalary, 62.8% in APC (except pelvis), 66.0% in osteoarticular and 66.6% in total joint. We have experienced 1 infection, 1 prutrusio acetabuli in pasteurization (18.1%) and other 22 complications (3 deep infections, 8 nonunions, 2 fractures, 2 epiphyseal problems, 5 joint instabilities, 2 local recurrence) in extracoporeal irradiation (46.8%). Also we have experienced 3 complications (3 nonunions) in intercalary (37.5%), 9 complications (4 nonunions, 1 deep infection, 1 periprosthetic fracture, 1 epiphyseal problem, 1 local recurrence, 1 protrusio acetabuli) in rAPC (50.0%), 6 complications (2 deep infections, 2 nonunions, 1 epiphyseal problem, 1 pathologic fracture) in osteoarticular (33.3%), 5 complications (5 joint instabilities) in total joint (100%) and 1 complication(1 local recurrence) in soft tissue (100%). Conclusion: In our experience, according to the resection & reconstruction type fragmentary and intercalary may have several advantages such as good radiologic and functional result and low rate of complication. And it seems that rAPC was available in case which have no sufficient residual bone stock. Also the pasteurization may have more advantages than that of the extracorporeal irradiation.

• The Journal of the Korean bone and joint tumor society
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• v.13 no.1
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• pp.31-36
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• 2007

Purpose: Recycling extracorporeal irradiated autograft is used as one of the reconstruction methods after limb salvage with malignant bone tumor. However, there were some problems such as joint instability, progressive arthritis, insufficient joint resection margin were found after intraarticular recycling autograft. Thus, we carried out a research in order to investigate the results of recycling total joint autotransplantation after extracorporeal irradiation that could resolve the problems. Materials and Methods: There were five cases of patients who were diagnosed as osteosarcom around the knee joint and underwent same operation from June 1997 to Feb 2006. All patients had been evaluated from 93 to 105 months (mean 100 months) and their mean age was 21.6. Results: The roentgenographic union of junctional sites began at 15.6 months (9~40 months) postoperatively. As regards to the orthopaedic functional results, we used the criteria of Ennecking et al. Overall mean functional result was 71.6%. Complication such as epiphyseal collapse (three cases) and joint instability (five cases) were noted respectively. In all the cases, tumor prosthesis was used to replace the knee joint. Conclusion: Because recycling total joint autotransplantation after extracorporeal irradiation does not prevent joint instability and progressive arthritis, tumor prosthesis is recommended in young adult.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.180-183
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• 2004

We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1MO). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival.

• Journal of Chest Surgery
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• v.36 no.10
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• pp.776-779
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• 2003

An eight-year-old boy was referred to our hospital with cough and high fever. His past medical history included a small sized ventricular septal defect (VSD) at birth. Transthoracic echocardiography disclosed a 10 x 6 mm vegetation on tricuspid valve, a small VSD and the moderate tricuspid valve insufficiency were found. Blood cultures grew methicillin-resistant staphylococcus aureus. Despite proper antibiotic therapy, fever was not controlled and his course was complicated by pulmonary infarction. The patient simultaneously underwent pulmonary resection and open heart surgery. Through the median sternotomy we performed open thrombectomy and lobectomy (right lower lobe) at first, and then vegetectomy, tricuspid valve repair, and direct closure of VSD were done under cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.36 no.4
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• pp.277-279
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• 2003

A 15 year-old boy was referred to us because of mild dyspnea on exertion and incidentally found heart murmur. On echocardiography, a mass involving mainly interventricular septum and causing left ventricular outflow tract obstruction was detected. Cardiac catheterization demonstrated a transaortic pressure gradient of 20 mmHg. Partial excision of the septal mass was performed via aortotomy under cardiopulmonary bypass. The pathologic diagnosis revealed myocardial hamartoma. The lesion was mainly composed of mature, severely hypertrophic myocytes and intervening fibrosis. During the 5 year of follow-up after the surgery, no evidence of arrhythmia or tumor recurrence was documented.

• Journal of Chest Surgery
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• v.29 no.5
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• pp.554-558
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• 1996

A case of distal aortopulmonary septal defect associated with aortic origin of right pulmonary ar- tery, patent ductus arteriosus and hypoplasia of aortic isthmus in a 50-day-old female infant is presented. Ligation of patent ductus arteriosus, resection and end-to-end anastomosis of hypoplasia of aortic isthmus, implantation of rlght pulmonary artery to main pulmonary artery and autologous peri- cardial patch repair of aortopulmonary septal defect were performed under cardiopulmonary bypass as one-stage approach. Deep hypothermic total circulatory arrest was applied during repair of hypoplasia of aortic isthmus. The p stoperative course was uneventful.