• Journal of Chest Surgery
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• 제48권3호
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• pp.214-216
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• 2015

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.

• Journal of Chest Surgery
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• 제16권2호
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• pp.184-189
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• 1983

Between 1958 and 1982, 70 patients have undergone pericardiectomy for constrictive pericarditis at the Thoracic Department of Seoul National University Hosp. 58 males and 12 females, with an average age of 27 years [ranging 3 to 60 years], of which 55% were between 10 and 30 years old, were treated. Eight patients died, of whom 4 were in the immediate postoperative period, less that 24 hours after operation. The cause of death was myocardial failure in 3 patients and hypotension during operation in one patient. The remaining four deaths occurred between the fifth and eighteenth postoperative day, and the causes of death varied: bilateral phrenic nerves injury, congestive heart failure, dissemination of tuberculosis, and cardiac arrest. Two patients suffered from congestive heart failure pre-and postoperatively due to the associated valvular heart disease. There were 8 wound infections on which resulted in perichondritis of costal cartilages requiring segmental resection 2 months later. There was one postoperative bleeding requiring immediate reopening for bleeding control. Tuberculosis was confirmed as the cause of constrictive carditis in 27 patients [39%]. Acute pyogenic pericarditis was precursor in 8 patients [11%]. In 2 patients [2.9%], the constrictive pericarditis developed following OHS. Both suffered from congestive heart failure postoperatively due to the residual valvular heart disease. In the others, the cause of the constrictive pericarditis was considered idiopathic or non-specific inflammation.

• Journal of Chest Surgery
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• 제30권8호
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• pp.747-751
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• 1997

폐동맥협착을 시행한 환아에서 수술직후 변화하는 혈역학에 대응하기 위하여 피하조직에 위치시켜 쉽게 조절할 수 있는 기구를 개발하였다. stainless steel wire를 이용하여 스프링을 만든후 이것의 표면을 PTFE로 덮은 형태로 제작하였으며 스프링 내부로 wire를 통과시켜 이것을 올가미 형식으로 죄는 방법으로 협착을 할 수 있게 하였으며 협착의 정도를 피하조직으로 통하는 투명한 tube에 1mm간격으로 표시하여 알수 있게 하였다. 6마리의 개의 하행대동맥에 협착을 시행하였다. 수술후 1,2일째에도 이완과 협착을 효과적으로 유도 할수 있었으며 3개월후 어느정도의 혈관손상은 있었으나 큰 협병증 없이 유지함을 보였다. 비록 실험적인 연구이지만 인체에 삽입할수 있는 재료로 쉽게 기구제작이 가능하며 앞으로 피하를 열고 조절가능한 폐동맥협착술에 이용할 수 있으리라 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제77권3호
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• pp.145-148
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• 2014

Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

• Journal of Chest Surgery
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• 제22권3호
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• pp.402-415
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• 1989

Extracorporeal circulation leads to functional disorder and structural damage of organs, especially hematologic and pulmonary system, mainly by sequestration of neutrophils and deposition of macrophages at lung. Then, proteases are secreted, which insult vascular basement membrane of pulmonary capillary and alveolar septa of the lung. Among these, the most important protease at lung is elastase, because major component of lung is elastin. For prevention of lung injury, inactivators or antidotes to elastase should be necessary and Alpha 1-Proteinase Inhibitor is the elastase inactivator. Clinical experimental study was carried out to investigate the immediate postoperative change of serum Alpha 1-PI level following cardiopulmonary bypass for 20 heart cases [congenital 16 cases, acquired 4 cases] and 10 control [subtotal gastrectomy] cases. Also preliminary study was performed for 31 cases of open heart patients. The results were as follows: l. Immediate postoperative serum levels of Alpha 1-PI was significantly decreased at open heart surgery group [P< 0.005], but not decreased at control group. 2. There were no significant difference in change of serum Alpha 1-PI level between and membrane and bubble oxygenator group.Z 3. There were no significant difference in changes of serum Alpha 1-PI level between CHD and AHD. Alpha 1-PI is consumed at lung during cardiopulmonary bypass and increase after operation compensatedly and protect multiple organic damage especially lung. Therefore, Alpha 1-PI can be indicator for evaluation of prevention and treatment of pump-lung syndrome.

• Journal of Chest Surgery
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• 제30권6호
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• pp.636-640
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• 1997

기관 식도루의 발생은 대개 카프 주변의 압력에 의한 기관후벽의 궤양 및 괴사에 의한 식도와의 누공 발생에 의하여 생긴다. 본 교실에서는 23세의 여자 환자에서 심폐소생술을 위한 기관삽관후 12일째 발견한 기관식도루 1예를 치험 하였다. 기관식도루는 자연 치유가 드물어 수술로서 교정을 시행하여야 하며 진단 즉시 수술해야 하는 것이 원칙이나 본 예에서는 환자의 전신 상태가 쇠약하여 수술을 지연하였으며 기관 재건술후 재건 부위는 양호하였으나 위루관 제거부위 누출에 의한 복막염 및 패혈증으로 사망한 1예를 보고한다.

• Journal of Chest Surgery
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• 제47권3호
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• pp.302-305
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• 2014

Popliteal artery entrapment syndrome (PAES) is a non-artherosclerotic cause of claudication and acute ischemia of the legs in young athletic individuals. It is classified in terms of the abnormal anatomical relationship between the popliteal artery and surrounding structures. All types of PAES have the same pathophysiology. Repetitive arterial compression by surrounding structures causes progressive vascular injury. Bilateral PAES is reported in about 30% of cases. Bilateral PAES is usually of the same type in each artery; exceptions are rare. We report a case of a young athletic patient who suffered bilateral PAES of two different types.

• 대한기관식도과학회지
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• 제4권1호
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• pp.59-63
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• 1998

Background： Unilateral vocal cord paralysis(UVCP) by recurrent laryngeal nerve injury is one of the common laryngological diseases. Objectives : We attempted to study the clinical feature and the causes of UVCP and also tried to investigate what is to be the initial approach for determining the causes of unknown-origin UVCP Materials and methods The charts of 82 patients with the diagnosis of UVCP were reviewed. The records were analyzed for patient's gender and age, the status of paralysed vocal cord, the crucial tests for the diagnosis, and the etiologies. Results : forty-nine(59.8%) male and 33(40.2%) female patients were included in this study. The age group of sixth decade was most commonly involved. Most of the cases showed paramedian position of palsy, and the left side(59.8%) was more frequently attacked. The most common cause of UVCP in this series was the unknown origin, followed by the surgical trauma and neoplasms. The etiologies of the six(12.5%) unknown-cause cases were found with the further evaluation, with the most useful test being a CT scan. Conclusion： Chest X-ray, esophagography, and CT scan should be included in the mandatory initial investigation of patients with unknown-origin UVCP

• 대한임상독성학회지
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• 제16권2호
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• pp.176-180
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• 2018

Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

• Journal of Chest Surgery
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• 제55권4호
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• pp.325-331
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• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.