• Journal of Chest Surgery
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• v.23 no.2
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• pp.299-308
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• 1990

A review of 50 patients with primary mediastinal tumors or cysts has been done to evaluate clinical and pathological behavior of this heterogeneous group of tumors proved by either excision or biopsy from January 1980 to August 1989 at the cardiovascular department of surgery in Kyungpook National University Hospital. There were 30 males and 20 females in this series. The ages of patients ranged from 4 months to 64 years. The mean age of subjects was 30.4 years. Neurogenic tumors [14 cases, 28%] and teratoma [14 cases, 28%] were most frequently encountered and followed by thymoma [10 cases, 20%] and benign cysts [4 cases, 8%]. The anatomic location of the primary mediastinal tumors or cysts was classified as anterior mediastinum and middle or visceral mediastinum and paravertebral or costovertebral mediastinum on the basis of the Shields’ proposition. In 32 patients[64%], the tumors or cysts were located in anterior mediastinum and in 13 patients[26%], the tumors or cysts were located in paravertebral or costovertebral mediastinum. And the rest 5 patients[10%] had middle or visceral mediastinal tumors or cysts. One of the characteristic features of primary mediastinal tumors or cysts is that some mediastinal tumors or cysts have their own preferred location in the mediastinum. In our series, all of the 14 patients with teratoma and 10 patients with thymoma had the anterior mediastinal location, while 13 of the 14 patients with neurogenic tumors had the paravertebral mediastinal location. 14 patients[28%] were asymptomatic and they all were discovered via so-called “Routine” chest x-ray examination. 39 of 50 patients[78%] were benign. 11 patients[22%] were malignant and they were all symptomatic. 40 patients[80%] were treated with complete resection. 5 patients[10%] were treated with partial resection : 2 of malignant thymoma, 3 of lipoma, neuroblastoma, primary squamous cell carcinoma. The rest 5 patients[10%] were only biopsied: 2 of undetermined malignancy and 3 of hemangioma, lymphoma, primary squamous cell carcinoma. 4 of the 10 patients were treated with combination of irradiation and chemotherapy. Postoperative complications were as followings: Horner’s syndrome [4cases, ado], respiratory failure [3 cases, 6%], pleural effusion[3 cases, 6%], Wound infection[2 cases, 4%] and bleeding, pneumothorax, empyema. There were 5 postoperative deaths [10%]. One patient with neuroblastoma died from intraoperative massive bleeding, 3 patients died early postoperatively from respiratory failure with undetermined malignancy died late postoperatively from congestive heart failure due to direct invasion of the tumor to the heart.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.655-659
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• 2008

Intestinal pseudo-obstruction (IPO) is a rare and poorly understood manifestation of systemic lupus erythematosus (SLE), especially in children. The characteristic clinical feature of IPO is obstruction without an identifiable obstructive lesion. The authors a 13-year-old girl whose first symptom of SLE was IPO. The patient presented with a 3-day history of nausea, bilious vomiting, abdominal distention, and no bowel movement. Simple abdominal radiographs revealed mild dilatation with partial air-fluid levels in the small intestine. Abdominal CT and methylcellulose small bowel studies showed massive ascites, engorgement of the small mesenteric vessels, pleural effusion, and diffuse bowel wall thickening of the gastric antrum, duodenum. and jejunum. The delayed passage of contrast for 15 days after the methylcellulose small bowel studies was suggestive of decreased bowel motility. Laboratory findings were positive for ANA, anti-double-stranded DNA, anti-Smith and lymphopenia. After 10-day treatment with high-dose corticosteroids, the symptoms improved. IPO associated with SLE should be considered in the differential diagnosis for patients presenting with symptoms of intestinal obstruction. Early recognition of IPO in SLE and appropriate therapy are important for prevention of complications and unnecessary surgery. This case raises awareness among pediatricians that although rare, IPO can be the presenting symptom of SLE in children.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1138-1142
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• 1996

Video-assisted thoracic surgery is a new modality that allows visualization of and access to the intrathoracic organs without making a thoracotomy Incision. 52 patients underwent thoracic procedures using this technique. There were pneumothorax in 40 patients, diffuse interstital lung disease in 6 patients, hyperhidrosis in 3 patients, pulmonary tuberculoma in 1 patient, aspergilloma in 1 patient and localized fibrous tumor of pleura in 1 patient. We had performed a variety of procedures(36 wedge resections with mechanical pleurodesis, 8 wedge resections only, 4 mechanical pleurodeses, 3 bilateral sympathectomys and 1 segmentectomy). The period of chest tube indwelling and postoperative hospitalization were 2.00 $\pm$ 1.32 days(range : 0~6 days) and 3.55 $\pm$ 1.45 days(range : 1~8 days). Four postoperative complications occurred(2 pleural effusion, 1 recurrent pneumothorax and 1 high fever). Conversion to open thoracotomy was done in 1 p tient due to massive air leakage. Patients undergoing video-assisted thoracic surgery seem to have reduced postoperative pain, shorter hospitalization, and quicker recovery times.