• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.21-33
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• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.390-394
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• 1993

This study elvaluated clinically the surgical results of the thirty-eight patients who had exploratory thoracotomy for spontaneous pneumothorax between Jan. 1989 and Nov. 1992. Thirty three, or 86.8%, of the patients were male. The most frequent age of the spontaneous pneumothorax requiring thoracotomy was between fifteen years and twenty years. Sudden onset dyspnea and chest pain, which developed in thirty-five patients[89.5%], were the major chief complaints. Bleb and Bulla located in the both upper lobes were the most frequent causes of spontaneous pneumothorax for exploratory thoracotomy. There was no operative death. Postoperative morbidity included three cases of residual air space in the apical pleural space, tow cases of atrial fibrillation, and one each case of reoperation for bleeding, mediasitinitis, and sternal osteomyelitis. All postoperative complications were treated without any serious problems. This study suggests that early exploratory thoracotmy is desirable for patients with prolonged air-leak, massive air-leak, or multiple blebs and giant bullae on the computed tomography of the chest.

• Journal of Chest Surgery
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• v.1 no.1
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• pp.61-68
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• 1968

In the 10 years from 1958 through 1968, 23 patients have undergone 24 times of operation for constrictive pericarditis at this department. Follow-up data were available for periods varying several months to almost 10 years from examination at this department or follow-up letters. There were 21 males and 2 females in this series. Range of the age varied from 2 years to 53 years. Seven cases were below 15 years of age. There were two hospital death, one expired two weeks and another four weeks after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factors. Clinical and histological study showed tuberculous origin in 12 cases, non-specific chronic infiammatory changes in 8 cases and in 3 cases previous pyogenic pericardial infection by staphylococcus preceded to the constriction. In 11 cases bone tissue was noted microscopically in the pericardium: Sixteen patients[70 %]had pleural effusions, five cases had bilateral, 6 right, and 5 left. Calcification was seen along cardiac border in 9 cases. In 15 catheterized patients, 6 showed pressure gradients between vena cava and right atrium, ranging from 6 mmHg to 10 mmHg. One case was reoperated 3 months after the original operation resulting in marked improvement. In this reoperated case the original pericardiectomy seemed to be incomplete. In 21 cases. excluding 2 hospital death, symptoms and physical findings improved markedly in every patient

• Journal of Chest Surgery
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• v.27 no.2
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• pp.132-135
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• 1994

By the early half of the 20th century, the most common cause of spontaneous pneumothorax was considered to be tuberculosis. But recently ruptures of the subpleural emphysema and/or blebs are considered as the major causes of spontaneous pneumothorax. To evaluate the causes of spontaneous pneumothorax, the authors reviewed the 96 patients who were consecutively diagnosed and treated by thoracotomy for spontaneous pneumothorax at the Department of Thoracic and Cardiovascular Surgery, Seoul Advenist Hospital, from May, 1988 to April, 1993. The patients who had clinical and radiological evidence of tuberculosis or other specific parenchymal lung diseases were excluded from this review. All patients were negative for tuberculous bacilli on sputum studies. The pathologic results were as follows : subpleural emphysema[25], blebs[27], subpleural emphysema and blebs[25], pleural fibrosis[10], tuberculosis[8], and parasitic granuloma[1]. Three of the patients who were diagnosed to be tuberculosis by pathologic findings were progressed to active pulmonary tuberculosis on the follow-up chest PA films. The authors conclude that all patients with spontaneous pneumothorax must be evaluated periodically for tuberculosis and that patients who were diagnosed to be tuberculosis by postoprative pathologic report need the administration of the prophylactic antituberculous drug, because the prevalence of tuberculosis remains relatively high rate in our country.

• Korean Journal of Veterinary Service
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• v.45 no.4
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• pp.317-323
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• 2022

Dirofilariasis is a mosquito-borne parasitic infection that mainly causes symptoms such as chronic cough, respiratory distress, abnormal breath sounds, heart valve dysfunction, right heart hypertrophy, liver congestion and cirrhosis, ascites, and pleural effusion in dogs. In this study, from June to September 2021, we collected and identified mosquitoes in parks where citizens often take their dogs for a walk, and created pools from them by month, species, and location. These pools were checked for the infection of Dirofilaria immitis by PCR and the minimum infection rates (MIRs) were calculated. The MIR of all mosquitoes collected was 6.4, and the MIRs of mosquitoes from Daewangam Park, Yeocheoncheon Walk, Taehwagang National Garden, and Sinbulsan County Park were 9.7, 4.7, 2.1, and 0, respectively. It also confirmed that Aedes hatorii, Aedes vexans nipponii, and Ochlerotatus koreicus were major vectors of heartworm in Ulsan. Our results suggest that heartworm prophylaxis should be considered in Ulsan.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.65-71
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• 2006

Background : Hemoptysis, when massive and untreated, has a mortality rate of over 50 percents, is considered as one of most dreaded of all respiratory emergencies and can have a variety of underlying causes. Bronchial artery embolization (BAE) has become an established procedure in the management of massive and recurrent hemoptysis, and its efficacy is widely documented thereafter by number of articles. However, the long-term success rate of BAE is known to be unfavorable. Risk factors influencing that control failure are inevitably needed. Materials and methods : Seventy-five patients underwent bronchial artery embolization due to massive hemoptysis in Severance Hospital from Jan. 2000 to Jan. 2005. Nine patients' data were not available and could not be contacted with. Finally 66 patients' (48 males, 18 females) medical records were analyzed retrospectively during a mean follow up period of 20.4 months (ranging from 1 month to 54 months). Results : Among 66 patients whose data were available, 23(34.9%) patients had recurrent major hemoptysis. Patients' age, sex, underlying disease, previous intervention history, and number of feeding vessels had no statistical validity as risk factors of recurred major hemoptysis. But bilaterality of lesion, amount of hemoptysis, and pleural thickening were revealed as meaningful factors for predicting relapse (p = 0.008, 0.018, and 0.001, respectively). Conclusion : According to our series, patients presenting with larger amount of hemoptysis, pleural thickening of chest radiography and bilateral lesion are associated with increased risk of major hemoptysis in patients treated with BAE.

• Clinical and Experimental Pediatrics
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• v.50 no.12
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• pp.1180-1187
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• 2007

Systemic lupus erythematosus (SLE) is an episodic, multi-system, autoimmune disease characterized by widespread inflammation of blood vessels and connective tissues and by the presence of antinuclear antibodies (ANAs), especially antibodies to native (double-stranded) DNA (dsDNA). Its clinical manifestations are extremely variable, and its natural history is unpredictable. Untreated, SLE is often progressive and has a significant fatality rate. The most widely used criteria for the classification of SLE are those of the American College of Rheumatology (ACR), which were revised in 1982 and modified in 1997. The presence of four criteria have been diagnosed as a SLE. Rashes are common at onset and during active disease. The oral mucosa is the site of ulceration with SLE. Arthralgia and arthritis affect most children and these symptoms are short in duration and can be migratory. Lupus nephritis may be more frequent and of greater severity in children than in adults. The initial manifestation of nephritis is microscopic hematuria, followed by proteinuria. The most common neuropsychiatric symptoms are depression, psychosis(hallucination and paranoia) and headache. CNS disease is a major cause of morbidity and mortality. Pericarditis is the most common cardiac manifestation. Libman-Sacks endocarditis is less common in children. The most frequently described pleuropulmonary manifestations are pleural effusions, pleuritis, pneunonitis and pulmonary hemorrhage. During the active phase ESR, CRP, gamma globulin, ferritin and anti-dsDNA are elevated. Antibodies to dsDNA occur in children with active nephritis. Antibodies to the extractable nuclear antigens (Sm, Ro/SS-A, La/SS-B) are strongly associated with SLE. Specific treatment should be individualized and based on the severity of the disease. Sepsis has replaced renal failure as the most common cause of death.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.220-231
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• 1992

We have performed 28 single lung transplantation in mongrel dogs transplanting the left lung exclusively from November 1989 to September 1991, in the department of thoracic surgery of Seoul National University Hospital. In the donor dogs, the main pulmonary artery was divided proximal to its bifurcation, and the left atrium was incised freeing the left veins with a generous atrial cuff. We used cold saline in the first 7 transplantations and Euro-Collins or modified Euro-Collins solution in the remaining 17 transplantations as a lung preservatives. The bronchus was divided at two cartilage rings proximal to the upper lobe bronchus take off. In the recipient procedure, we used a Fogarty catheter as a bronchus block. Left atrial anastomosis was performed first using 5-O prolene and the pulmonary artery was anastomosed using 6-O prolene. The bronchus was anastomosed next with 4-O vicryl interruptedly and covered with a greater omentum which had been prepared previously. All dogs received cyclosporin A and azathioprine as immunosuppressants and were divided into two group. In the 10 Group I dogs, they survived within 6 days, mean survival time was 66.8$\pm$53.4 hours. In remainder 14 Group lI dogs, they survived above 6 days, mean survival time was 9. 5$\pm$5.6 days. The cause of death were as follows: 2 cases of sacrifice, 2 cases of respiratory insufficiency during operation, 2 cases of arrhythmia immediate postoperatively, 2 cases of bleeding, others in Group I, and 6 cases of sacrifice, 4 cases of sepsis, 3 cases of bleeding, others in Group lI. Results of bronchoscopic findings were obstruction above 50% in 12 cases of 16 performance cases within 5th day. Early chest radiologic haziness were showed, and total lung perfusion defect was frequently showed in both group within 7th day. Main autopsy findings were left atrial and pulmonary arterial thrombi and bronchial obstruction The major histologic findings of Group I were pleural exudate, hemorrhagic infarct, pulmonary congestion, and interesting histologic findings of Group II were 3 cases of perivascular or peribronchial lymphocyte infiltration, 3 cases of hemorrhage infarct, 2 cases of interstitial pneumonitis. The structual change of bronchioles, suggesting bronchiolitis obliterans was not observed due to improper preparation of proximal pulmonary tissue and short term survival times.

• Journal of Chest Surgery
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• v.21 no.4
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• pp.649-655
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• 1988

One hundred and one patients with tetralogy of Fallot who were older than 16 years of age underwent a total correction of the anomaly between May, 1964 and July, 1987. This group comprised 14.9% of the 679 consecutive patients who had repair of the tetralogy at our institution during the same period. Of the 101 patients, 8 had a previous shunt procedure for palliation. The preoperative mean hemoglobin value was 16.9*1.0% and the mean systemic oxygen saturation, 84.4*0.9%. In 76 patients[75.2%], a type II ventricular septal defect was seen whereas in 14 patients[13.9%], the defect was type I. In 72 patients[71.3%], other cardiac anomalies were present which included patent foramen ovale in 37.6%, atrial septal defect in 8.99b, vegetations in 6.9%, right sided aortic arch in 5.9% and coronary artery anomaly in 5.0%. The right ventricular outflow obstruction was caused most commonly by combination of infundibular and valvular stenosis[74.3%], followed by isolated infundibular stenosis[19.8%] and valvular stenosis [5.9%] alone in order. The preoperative mean diameter of the pulmonary valve ring size was 10.2*0.5 mm in diameter. A transannular patch enlargement of the right ventricular outflow tract was performed in 28 patients and, in 12 a pericardial monocusp was utilized. Major anomalous aorto-pulmonary vessels were encountered in 5 patients which were detected before or during the operation. In 3 patients, they were ligated beforehand to control the flooding of the operative field. Postoperatively, the mean systolic pressure gradient between the right ventricle and the main pulmonary artery was 16.2*2.3 mmHg and the mean systolic pressure- ratio between the right and the left ventricle was 45.3*2.0%. Perioperative complications including bleeding in 8.9%, pleural effusion in 7.9%, dysrrhythmia in 4.9%, and residual VSD in 4.0%. Operative mortality was 8.9%. There has been no operative death in the recent 65 cases since 1981. There were 2 late deaths, 68 and 113 months after surgery. There were 2 late detachment of the VSD patch during the follow-up period. Of the 6 patients with patch detachment found during the postoperative period, 3 had subacute bacterial endocarditis before or after the operation indicating The serious nature of this complication. Two of these patients subsequently underwent a successful reoperation.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.507-510
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• 2014

An 8 month-old female Pomeranian dog was presented with major complaints of heart murmur and cardiomegaly. Diagnostic study found the left-to-right patent ductus arteriosus (PDA) with moderate heart failure (ISACHC II). The PDA occlusion was successfully accomplished using a $5mm{\times}3loops$ embolic coil through right femoral artery. Two months later, the dog came back to clinic with marked hypotension, severe diarrhea and pleural effusion. Diagnostic study found severe pulmonary hypertension and tricuspid regurgitation. The clinical condition was controlled by the administration of sildenafil (3 mg/kg, PO, TID). However, the dog was expired by dislodged embolic coil and inconsistent medication by the owner. Postmortem study found the pulmonary hypertension was occurred by the abnormally dislodged embolic coil. Although the embolic coil is widely used for PDA occlusion in toy dogs with PDA, the more careful evaluation for the size and shape of PDA is necessary to minimize the risk of dislodgement of pre-placed coil.