• Journal of Chest Surgery
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• v.18 no.1
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• pp.111-121
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• 1985

A clinical analysis was performed on 312 cases of the chest trauma experienced at department of thoracic surgery, Chosun University Hospital during the past 6 years 10 months period from January 1978 to October 1984. 1. The ratio of male to female patient of the chest trauma was 3.1:1 in male predominance and age from 20 to 50 occupied 71.2% of the total cases. 2. The most common cause of the chest trauma was traffic accidents [45.5%] in this series. 244 cases [78.2%]were injured due to non-penetrating injuries and the remainders [68 cases, 21.8%] were injured due to penetrating injuries. 3. The frequently injured site of the chest trauma was left side of the chest [56.4%], the right side was 33% and the both side was 10.6%. 4. The most common symptoms were chest pain and dyspnea, and common signs were diminished breathing sound and subcutaneous emphysema. 5. The Hemothorax, Pneumothorax, Hemopneumothorax, and Hemopericardium were observed in 190 cases [60.9%] of the total cases, and etiologic distribution revealed 76.5% due to penetrating injuries and 56.6% due to non-penetrating injuries. 6. The rib fractures were observed in 210 cases [67.3%] of the total cases and the most common site of the rib fracture was 6th rib 140 cases [19.2%]. The common site of the rib fracture was from 4th rib to 7th rib [63.8%]. 7. The lung injuries were observed in 150 cases [48.1%] and the other organ injuries were observed in 260 cases [83.3%]. 8. Conservative treatment including thoracentesis were performed in 153 cases [49.1%], Closed thoracotomy with water seal drainage were performed in 112 cases [35.9%], and open thoracotomy were performed in 45 cases [14.4%]. 9. The complications of the chest trauma were developed in 63 cases [20.2%] and the common complications were atelectasis, wound infection and pneumonitis etc. 10. Overall mortality was 0.96% [3 cases] and the cause of death was bacteremia, hypovolemic shock, heart failure and pulmonary edema.

• Journal of Chest Surgery
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• v.12 no.4
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• pp.312-317
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• 1979

1] During the period of Jan. 1959, to Aug. 1979, 47 patients of paragonimiasis have been treated in the department of Chest Surgery. 2] The total number of patients who has been admitted and treated in the department of Chest Medicine are 262 and annual distribution of number of patients has been decreased. However, since 1964, the number of patients has been stationary. On the other hand, the total number of patients who has been admitted and treated surgically in the department of Chest Surgery are 47 and the annual distribution of number of patients has not been decreased. 3] The peak age incidence lies in fourth decade [34%], and over halves of patients is in third to fifth decade. Male to female is 8.4 to 1. 4] The symptoms, which are mainly cough, chest pain, dyspnea and blood tinged sputum, developed mostly in two to five years after infestation by Paragonmius westermani. 5] Sputum tests for eggs of Paragonimus westermani were positive in 16 out of 43 patients [37%]. The 93% of patients were positive in skin test for Paragonimus westermani. The patients with negative skin test were 7%, but sputum or stool examination for Paragonimus westermani`s eggs were positive in these negative group of skin test. 6] Chest roentgenogram revealed pleural effusion [41 cases], hydropneumothorax [1 case], atelectasis [1 case] and mediastinal mass [1 case]. 7] All patients were preoperatively treated with Bithionol. The mode of surgery were decortication only [31 cases], pleuropneumonectomy [3 cases], decortication & lobectomy [2 cases], decortication & closure of bronchial fistula [1 case], thoracentesis [1 case] and postural drainage [1 case]. 8] Paragonimiasis is primarily medical disease and well treated by the administration of Bithionol. But the delayed diagnosis and missed diagnosis, especially as pulmonary tuberculosis, make the disease aggravated and chronic. Subsequently, surgical treatment is infrequently required. Chronic empyema due to Paragonimus westermani is much benign than tuberculous empyema thoracis.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.574-578
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• 1994

The incidence of traumatic rupture of the tracheobronchial tree has been increased considerably with advent of widespread mechanization and high speed era. Rupture of the bronchus is an unusual result of nonpenetrating trauma to chest. Early diagnosis and primary repair not only restore normal lung function but also avoid difficulties and complications associated with delayed diagnosis and repair. These complications are pneumonia, atelectasis and lung abscess secondary to the bronchial obtruction. We experienced a case of partial rupture on left main bronchus caused by nonpenetrating blunt chest trauma with rib fractures 1 year ago. He was suffered from progressively developing dyspnea on exercise and treated as bronchial asthma at other hospital. Bronchoscopic finding was the narrowed lumen of left main bronchus at 1cm from carina by web-like membrane. We confirmed by bronchogram and repaired by end to end anastomosis, which is rare delayed finding in bronchial rupture without pulmonary complications. We report a case of nonpenetrating traumatic bronchial rupture, manifested by bronchial web in bronchoscopy.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.179-190
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• 1989

The experimental study for extracorporeal preservation of the heart-lung preparation by autoperfusion system was performed in 10 dogs. Under intravenous Pentothal endotracheal anesthesia bilateral thoracotomies were performed. A 24F cannula connected to a plastic reservoir bag located 100 cm above the level of the heart was introduced into the aortic arch. Left subclavian, innominate artery, and descending aorta were ligated and divided. Both vena cavae were ligated and divided after the bag was half filled with blood. A 24F catheter inserted into right atrium and connected to the plastic bag in order to keep constant the preload. The thoracic trachea was intubated and the lungs were ventilated. The heart-lung preparations were removed en bloc and floated in a $34^{\circ}C$ bath of Hartmann solution. The preparations were observed for from 2 hours to 8 hours, with the average of 5.2 hours. Hemodynamic and hematologic variables were measured during preharvest and autoperfusion. The pH revealed severe respiratory alkalosis due to very low $PaCO_2$ during autoperfusion ; $PaO_2$ remained constant for 130-140 mmHg; $A-aDO_2$ increased markedly. The static inspiratory pressure [SIP] at late autoperfusion [6hr] increased significantly as compared with at early autoperfusion [2hr]. There was no difference between white blood cell counts from right atrium and those of left atrium. Heart rates remained constant for 110-120/min; cardiac outputs maintained to approximately 0.6L/min; mean aortic pressures, 75 mmHg; mean pulmonary arterial pressures, 15-18 mmHg; mean right atrial pressures, 9-13 mmHg; mean left atrial pressures, 12 mmHg lower than those of right atrium. Serum Na maintained with normal range during autoperfusion; K increased significantly; Ca decreased progressively. Hemoglobin and hematocrit decreased significantly during autoperfusion. The study demonstrated that stable hemodynamics could be maintained throughout the experiment and the preparation of the lung seemed to be inadequate, especially after 3-4 hours, such as high $A-aDO_2$, increased SIP, and scattered atelectasis and edema in their gross appearances.

• Tuberculosis and Respiratory Diseases
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• v.56 no.1
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• pp.103-108
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• 2004

Thymolipoma is rare benign tumor of the thymic gland and mostly occurs at anterior mediastinum. Thymolipoma comprises 2~9% of thymic tumor and less than 1% of mediastinal mass. Therefore, thymolipoma should be differentiated from anterior mediastinal tumor such as thymoma, germ cell tumor and lymphoma. These tumors resemble cardiomegaly, pleural effusion, basal atelectasis, pericardial tumor and cyst, pleural tumor, lung cancer and pulmonary sequestration, and differentiated from above mentioned diseases. Though most cases are asymptomatic, there can be dyspnea with compression of adjacent organ by mass effect, and myasthenia gravis. We experienced a thymolipoma simulating cardiomegaly and report the case with the review of literatures.

• Archives of Plastic Surgery
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• v.50 no.1
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• pp.10-16
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• 2023

Background The chest wall defects can be caused by various reasons. In the case of malignant tumor resection of the chest wall, it is essential to reconstruct the chest wall to cover the vital tissue and restore the pulmonary function with prevention of paradoxical motion. With our experience, we analyzed and evaluated the results and complications of the chest wall reconstructions followed by malignant tumor resection. Methods From 2013 to 2022, we reviewed a medical record of patients who received chest reconstruction due to chest wall malignant tumor resection. The following data were retrieved: patients' demographic data, tumor type, type of operation, method of chest wall reconstruction of the soft and skeletal tissue and complications. Results There were seven males and six female patients. The causes of reconstruction were 12 primary tumors and one metastatic carcinoma. The pathological types were seven sarcomas, three invasive breast carcinoma, and three squamous cell carcinomas. The skeletal reconstruction was performed in six patients. The series of the flap were eight pedicled latissimus dorsi (LD) myocutaneous flaps, two pectoralis major myocutaneous flap, two vertical rectus abdominis myocutaneous free flap, and one LD free flap. Among all the cases, only one staged reconstruction and successful reconstruction without flail chest. Most of the complications were atelectasis. Conclusion In the case of accompanying multiple ribs and sternal defect, skeletal reconstruction would need skeletal reconstruction to prevent paradoxical chest wall motion. The flap for soft tissue defect be selected according to defect size and location of chest wall. With our experience, we recommend the reconstruction algorithm for chest wall defect due to malignant tumor resection.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.590-599
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• 1996

Background : Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. Method : We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the clauses of rebleeding. Results : 1) Underlying causes of hemoptysis were pulmonary tuberculosis(n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=1), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), an6 recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new deeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured. Conclusion : Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and saute procedure in immediate bleeding control.

• Journal of Chest Surgery
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• v.29 no.10
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• pp.1133-1137
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• 1996

From September 1994 to October 1995, we are reporting clinical results of 67 patients whom underwent video-assisted trio rabic surgery(VATS). 1. They were diagnosed as spontaneous pneumothorax In )5, diffuse interstitial lung disease in 9, empyema in 7, hemothorax in 5, malignant pleural effusion in 3, hyperhidrosis in 3, foreign body in chest cavity in 2, mesothelioma in 1, miliary tuberculosis in 1 and organizing pneumonia in 12. In pneumothorax, bullectomy in 33 and open bellectoiny in 2 due to pleural adhesion was done Hemostasis in 5, irrigation in 7, foreign body removal in 2, talcum powder insufrlation in 3, sympathectomy 3 as done. Thoracoscopic biopsy watt done In 12 3. For pneumothorax, operation was indicated as recurrent pneumothorax in 18, persistent air leak in 12, visible bullae In chest X-ray in 5. 4 Thoracoscopic biopsy was done in 12. They were interstitial pulmonary fibrosis in 9, miliary tuberculosis in 1, mesothelioma in 1, and organizing pneumonia in 1 .Among interstitial pulmonary fibrosis, usual interstitial pneumonia were 2 and diffuse interstitial pneumonia were 7. 5. Wo complication was found in 6) patients among 67 patients. The complication was found in 4 patients (2 persistent air leak, 2 contralateral lung atelectasis). We concluded that VATS was safe and beneficial in reducing postoperative complication and the role of thoracic surgery will increase markefdly.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2717-2722
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• 2013

Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.161-166
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• 1985

Endobronchial tuberculosis is frequently associated with lymphadenopathy, bronchial stenosis, atelectasis which needs to be differentiated with other pulmonary disease. Authors are presenting 25 cases of endobronchial tuberculosis which were confirmed by bronchoscopic biopsy and AFB smear and/or culture. The study was done on patients who visited Yeungnam University Hospital from May 1983 to July 1985. The following results were obtained: 1. Of the 25 cases, 8 cases were male and 17 cases were female (male : female= 1 : 2). 32 percent of the cases was older than 60 years of age. 2. Abnormal findings on chest x-ray were seen on 22 cases of 25 cases (88%) and its most predilective site was right upper lobe.(24%). 3. Symptoms were coughing (56%), hemoptysis, hoarseness, chest pain, dyspnea and fever in orders. 4. The positive results were obtained in 73 percent of sputum AFB sme ar (11 cases of 15 cases), 60 percent of AFB culture (3 cases of 5 cases) and 58 percent of bronchoscopic biopsy (14 cases of 24 cases). 5. Complete pulmonary function test was done on 19 cases and showed normal result in 6 cases, restrictive pattern in 8 cases and small airway dysfunction in 5 cases. No case of obstructive airway disease was detected. 6. Associated disease were hypertension (2 cases), tuberculous meningitis (1 case), diabetes mellitus (1 case), and cataract (1 case). 7. The site of bronchoscopic lesion on bronchoscopic examination were as follows; 8. All 25 patients were treated with anti-tuberculosis theyapy and 6 patients were treated with additional steroid therapy because of severe respiratory symptom and showed dramatic improvement of symptom as well as lung function.