• Journal of Chest Surgery
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• v.23 no.1
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• pp.141-145
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• 1990

Author made a clinical study of 48 cases of primary mediastinal tumors experienced in the dept. of the thoracic and cardiovascular surgery of Pusan National University Hospital during the 12 years period from march 1978 to march 1989. There were 34 males and 14 females. Their age distribution was from 4 months to 70 years, with the mean age of 34.4 years. 8.3 % of the patients were younger than 15 years old. There were teratoma 14 cases[29%], thymoma 11 cases[23%], neurogenic tumor 10 cases[21 %], lymphoma 6 cases[13 %], benign cyst 6 cases[13 %], and one case of fibrous histiocytoma in the histological distribution. The malignant tumors were 12 cases[25 %]. The common symptoms were chest pain and discomfort[35.4], coughing[18.8], general weakness and dyspnea. 16.7% of the patients were asymptomatic at admission. The successful removal was done in all cases of benign mediastinal tumors. In malignant cases, the surgical removal could be done in 5 cases. There was not postop. mortality. The frequent complications were atelectasis, infection, bleeding.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.68-72
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• 2002

Congenital bronchoesophageal fistula is a rare anomaly that may cause fatal complications if it goes unnoticed for many years. This anomaly may have various symptoms such as respiratory infections, coughing bouts when eating or drinking and even hemoptysis. Surgical resection is the treatment of choice and is definitive in almost cases. We report a case of type I congenital bronchoesophageal fistula misdiagnosed as chronic empyema thoracis with literature review.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.544-547
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• 1987

Pulmonary vein wedge angiography was applied to two patients of 2 years old TOF with PFO. Left pulmonary artery was not visualized by standard right ventriculogram and catheter was not entered into main pulmonary artery. Through PFO and left atrium, pulmonary vein wedge angiography at left lower pulmonary vein was done. The ipsilateral pulmonary artery & its trees in both cases and the contralateral pulmonary artery in one case were well visualized. Dangerous complication, such as massive bronchoconstriction due to extravasation of contrast material into the bronchus, was not developed. Mild coughing was occurred, but well tolerable in both cases. We recommended a dose of 0.8 mL/Kg of contrast material at a rate of 2 to 3 mL/sec and 1 to 2 mL/Kg of flush solution at the same rate by the hand, and routine use of pulmonary vein wedge angiography in cyanotic patients whose pulmonary artery was not visualized by the standard angiography.

• Journal of Chest Surgery
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• v.26 no.8
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• pp.650-653
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• 1993

Congenital cystic adenomatoid malformation [ C.C.A.M.] is rare, but often fatal congenital lung bud anomaly that causes acute respiratory distress in the newborn infants. In those who survive infancy and early childhood, its clinical manifestations are not unusual to detect. Recently we experienced an infant with C.C.A.M. Type II. The patient was a 7-month-old male, and had been suffering from coughing and fever since 3 months ago. The symptom were not improved with medical treatment and then, exploratory thoracotomy was performed under the impression of infected C.C.A.M. or other congenital cystic disease.The left lower lobectomy was performed, and the postoperative course was uneventful.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.138-141
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• 1997

Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.384-389
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• 1993

A clinical analysis of pleural effusion was done on 100 patients who were between 5 and 67 years old. The etiologic diagnosis of pleural effusion at the time of discharge were pulmonary tuberculosis in 38 cases[38%],pneumonia in 20 cases[20%],lung carcinoma in 16 cases[16%],liver cirrosis in 9 cases[9%],congestive heart failure in 4 cases[4%],nephrosis in 3 cases[3%],Meig,s syndrom in 3 cases[3%].liver abscess 2 cases[2%],pancreatitis in 1 cases[1%] and other metastatic malignancy in 4 cases[4%]. Their chief complaints was chest pain in 89 cases[89%],dyspnea in 74 cases[74%],coughing in 46 cases[46%], fever in 13 cases[13%],weakness in 12 cases[12%] and dizziness in 11 cases[11%].

• Journal of Chest Surgery
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• v.16 no.1
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• pp.171-175
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• 1983

The authors made a clinical study of 107 cases of empyema who were treated at Department of Thoracic Surgery of Chungnam National University Hospital during the period of Jan. 1976 through Aug. 1982 and compared the empyema of infant and children with that of adults. Following was the remits: 1. Male was predominant to female with the ratio of 2.5 to 1 and adult to infant was 2.6 to 1. 2. The cardinal symptoms were dyspnea, coughing, chest pain and fever. 3. Positive remit of bacteriological culture study was reported in 57% and the most common causative organism was staphylococcus in infant and childhood, E. coil in adult. 4. Most frequent predisposing factors of thoracic empyema in infant and childhood was pneumonia [53%], and in adult was pulmonary tuberculosis [40%]. 5. Treatment were combined with antibiotics therapy and several surgical procedures for empyema. 24 cases [22.4%] required open thoracotomy. 6. The mortality rate was 7.4% [8/107]. 86 cases [80.4%] were discharged with recovery and improvement.

• Journal of Chest Surgery
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• v.16 no.1
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• pp.153-160
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• 1983

Adenoid cystic carcinoma is a rare primary tracheal tumor and this tumor behave slow growth, low-grade ma!ignancy, locally invasion and long-term host survival. Operation with the primary goal of complete excision is the treatment of choice but this tumor require excessive margins at surgical removal because of locally invasive cancer. A 45-years-old male patient had complained paroxysmal coughing from 1 year ago prior to admission and was diagnosed pre-operatively as endotracheal adenoma. He had been treated by operation, and combined with radiotherapy by 4 MeV. Lineal Accelerator. The tracheal mass was removed by tracheo-bronchotomy transpleurally and right total pneumonectomy was performed. There was post-operative course uneventfully and no post-operative complication. The patient Is free from cancer until post-operative 1 year clinically and alive with good healthy.

• Journal of Chest Surgery
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• v.32 no.8
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• pp.765-767
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• 1999

Tracheobronchial rupture following tracheal intubation is a rare complication. We experienced a case of tracheal rupture following double-lumen endotracheal tube intubation. A 76 year old female was admitted due to coughing and chest discomfort. The operation was performed with the diagnosis of congenital broncho esophageal fistula. During the operation, accidently the main trachea was ruptured longitudinally. There was no history of surgical trauma. The ruptured trachea was repaired with prolene and monofilament absorbable sutures. The cause of tracheal rupture was suspected overinflation of the cuff. The patient was discharged from the hospital without any significant complications.

• Journal of Chest Surgery
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• v.27 no.10
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• pp.888-892
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• 1994

Acquired, traumatic tracheoesophageal fistula [TEF] is rare and difficult problem to manage. This 55 years old man met with a roller accident of a tractor. During accident, he received a penetrating injury on the left upper sternal border. At local clinic, he received closed thoracotomy drainage [CTD]for relief of pneumothorax[left]. Three days after CTD, he complained abdominal pain and hematemesis. The endoscopy revealed large ulcer at the stomach, so he received subtotal gastrectomy. On 10th day post subtotal gastrectomy, he developed aspiration and coughing from a TEF. The esophagogram showed large TEF at the mid-trachea level. So he transfered to our hospital for operation. This patient was operated on for late TEF three weeks after injury. We have used absorble 4-0 Vicryl sutures to repair trachea. We repair all esophageal injuries with two layers of nonabsorbable silk suture. Where suture line on the esophagus, the strap muscle was interposed for reinforcement. And for feeding, the feeding jejunostomy was performed. Postoperatively the osteomyelitis of the manubrium site was developed, so on the 30th postoperative day, an ostectomy of manubrium, both clavicle and fight 1st, 2nd ribs, and the pectoralis major musculo-cutaneous flap coverage were performed.