• Journal of Chest Surgery
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• 제56권4호
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• pp.240-243
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• 2023

Background: Although there is no obvious recommendation for the management of pneumothorax recurrence after surgery, chemical pleurodesis with tetracycline has been applied as a significant treatment approach. The objective of this study was to evaluate the effectiveness of chemical pleurodesis with tetracycline for the management of postoperative recurrence of primary spontaneous pneumothorax (PSP). Methods: We retrospectively analyzed patients who underwent video-assisted thoracic surgery (VATS) as therapy for PSP at Hallym University Sacred Heart Hospital from January 2010 to December 2016. Patients who had ipsilateral recurrence after surgery were included in this study. Patients who underwent pleural drainage with chemical pleurodesis were compared with patients who only underwent pleural drainage. Results: In total, 932 patients who underwent VATS for PSP were analyzed, and ipsilateral recurrence after surgery occurred in 67 patients (7.1%). The treatment modalities for recurrence after surgery were observation (n=12), pleural drainage alone (n=16), pleural drainage with chemical pleurodesis (n=34), and repeated VATS (n=5). Eight of the 16 patients (50 %) treated with pleural drainage alone had recurrence again, while 15 of the 34 patients (44.1%) treated with pleural drainage and chemical pleurodesis experienced further recurrence. Chemical pleurodesis with tetracycline did not show a meaningful difference in the re-recurrence rate in comparison with pleural drainage alone (p=0.332). Conclusion: Chemical pleurodesis with tetracycline for the management of postoperative recurrence of PSP was not effective. Further research is required to identify alternative drugs that can significantly decrease the re-recurrence rate.

• Journal of Chest Surgery
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• 제24권11호
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• pp.1098-1106
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• 1991

Atelectasis may be defined as collapse of the lung due to absence of air within the alveoli. It may involve anatomic segments, lobes, or whole lungs but also may be a diffuse miliary process, as in the adult respiratory distress syndrome. The key to treatment are the anticipation and prevention of atelectasis in various clinical situations, the recognition and treatment of underlying disease, and the prompt initiation of vigorous treatment once atelectasis is found. Repeated assessment by physical examination is necessary to determine the presence of atelectasis and its response to treatment. During the period of January, 1981 to October, 1990, 100 patients with atelectasis were treated in the department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital. There were 70 males and 30 females ranging from 3 days to 79 years of age. The occurrence ratio of right to left side was 2.1 : 1. The underlying pathologic lesions of atelectasis were pneumonia with effusion(28), lung ca.(24), pulmonary tuberculosis(24), and chronic empyema(9), The treatment procedure for atelectasis were closed thoracostomy in 26 cases, ressection in 21 cases, therapeutic bronchoscopy in 14 cases and etc.

• Journal of Chest Surgery
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• 제21권5호
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• pp.899-904
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• 1988

In Behcet syndrome, cardiac involvements are rare and have been reported pericarditis, myocarditis, right heart endocardial fibrosis, right ventricle mural thrombus with pulmonary embolism, active endocarditis, granulomatous endocarditis, conduction disturbance, acute aortic insufficiency, mitral valve prolapse. Our three patients underwent AVR because of aortic insufficiency and ascending aorta enlargement combined with Behcet syndrome. Two patients had mitral regurgitation too. So one underwent MAP and the other underwent MVR concomitantly. One who underwent AVR have been well for 50 months. Another who underwent AVR+MAP and redo AVR due to aortic paravalvular leakage was died of congestive heart failure. The other who underwent AVR+MVR and repeated AVR three times because of aortic paravalvular leakage is in condition of aortic paravalvular leakage. Paravalvular leakage is considered to recur due to progressive dilatation and fragility of aortic root that is the result of pathologic change of Behcet syndrome in it. If Open heart surgery is needed in Behcet`s syndrome during inflammatory reaction is active, postoperative complications such as paravalvular leakage or suture line rupture may be prevented with pre- and postoperative anti-inflammatory management.

• 대한간호학회지
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• 제36권2호
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• pp.353-360
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• 2006

Purpose: This study was done to investigate the effects of backrest elevation of 0 degree and 30 degrees that minimize the risk of increasing ICP when CVP is measured. Methods: Subjects were sixty-four patients who stayed in the neurosurgical intensive care unit after brain surgery at two university-based hospitals. CVP, blood pressure, heart rate and ICP were measured along with position changes in order of backrest position with primary 30 degrees backrest position, 0 degree backrest position and secondary 30 degrees backrest position. For data analysis, one-group, repeated-measures analysis of variance design was used in SAS program. Results: Backrest elevations from 0 degree to 30 degrees did not alter the CVP without increasing the ICP. Therefore, 30 degrees backrest position is a preventive position without increasing ICP. Conclusion: 30 degrees backrest position might be appropriate for brain injury patients when CVP is measured.

• Journal of Chest Surgery
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• 제42권5호
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• pp.674-676
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• 2009

제1늑골의 피로골절은 드물다. 반복되는 근육수축으로 인한 뼈의 피로가 골절의 원인이라고 생각된다. 자세한 병력 조사와 컴퓨터 단층 촬영 및 전자기 공명영상 등으로 진단할 수 있다. 진통제 등 보존적 요법으로 치료한다. 농구를 취미로 하는 18세 남자 대학생 환자에서 운동연습으로 인한 제1늑골의 피로골절을 경험하였기에 문헌 고찰과 함께 이에 보고한다.

• Archives of Reconstructive Microsurgery
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• 제11권2호
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• pp.167-172
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• 2002

The only treatment method for crushed soft tissue injuries in the proximal leg involving the knee joint is the microsurgical free flap transplantation, especially latissimus dorsi myocutaneous free flap is useful to cover the extensive soft tissue defects, therefore prevents iatrogenic below knee amputation and facilitates early wound healing, early ambulation and shortens hospital stay. Authors have treated the open amputation with crushed soft tissue and bone injuries in the proximal leg, and the repeated abrasion and infectious wound with traumatic neuroma in the below knee with myocutaneous free flap and succeeded to wear below knee amputation prosthesis and return to normal activities of the daily living in the relatively shorter period than usual.

• Journal of Chest Surgery
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• 제14권4호
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• pp.331-338
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• 1981

The inhalation of a foreign body into the tracheobronchial tree is a child is a life-threatening accident. Forgotten foreign bodies In the airways cause chronic pulmonary infections, allergic asthma, bronchiectatic changes, and lung abscess Foreign bodies that cannot be grasped by bronchoscopic forceps should be removed by thoracotomy and bronchotomy. This report describes our experience In 16 patients who were treated to remove inhaled foreign bodies from the airways after repeated bronchoscopies had been unsuccessful from 1963 to 1981 at the department thoracic surgery of Seoul National University Hospital. The surgical procedures are as follows: 12 patients bronchotomy, 2 patient pneumonectomy, 2 patients lobectomy. In these cases, the foreign bodies are 8 metallic material, 3 plastic material, 1 bean, 1 black snail, and 3 cases of no records. Bronchotomy must be performed as soon as possible in order to avoid more advanced pathologic changes In the Involved lung, such as bronchiectasis, fibrosis or abscess.

• Journal of Chest Surgery
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• 제18권4호
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• pp.817-821
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• 1985

Benign tumor of the lung are relatively uncommon and leiomyoma among these is one of the rarest tumors. Because of salient features as well as the location of the leiomyoma, which led to the destruction of the lung and subsequent pneumonectomy, the importance of early diagnosis should be emphasized. Recently, authors experienced a leiomyoma of left main stem bronchus with complete atelectasis of the lung, resected with left thoracotomy and transverse bronchotomy in a 58 year old male. The tumor resected was composed of dense interlacing spindle cells by hematoxilin-eosin and also trichrome stains. At repeated bronchoscopic examination postoperatively, one and three months later, there was no evidence of any residual or recurrent tumors. For the universal rarity of the leiomyoma in the bronchus or lung and also there is no report in the reviews of the Journal of Korean Thoracic and Cardiovascular Surgery since volume one, 1968, authors report a case with the foreign literature reviews.

• Journal of Chest Surgery
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• 제22권5호
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• pp.731-738
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• 1989

The development of chylothorax and chylopericardium are serious and often life-threatening clinical entity. The ideal treatment of these problems is not well established to date. We reviewed our experiences with chylothorax or chylopericardium in 16 patients [17 cases] from July 1979 to May 1989. Ages ranged from 20 days to 41 years. The etiologies were traumatic in 10, congenital or idiopathic in 5, and tuberculous lymphadenopathy in one. In 8 patients, the chylothorax or chylopericardium occurred as a complication of cardiothoracic surgery. Eleven patients were treated nonoperatively with either repeated thoracenteses or chest tube drainage. Five patients underwent operative treatment: transthoracic thoracic duct ligation [three patients], thoracic duct ligation combined with decortication [one], and oversewn the defect of mediastinal pleura[one]. Duration of preoperative therapy ranged from 18 to 38 days. One of eleven [9.1 %] patients treated nonoperatively died. Of the surgically treated group, there were no deaths. All patients except one dead cured or improved either treated nonoperatively or operatively. Our experience suggests that surgical management of the chylothorax or chylopericardium is not always required, and each patient must be judged individually according to disease process.

• 대한치과의사협회지
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• 제57권5호
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• pp.279-287
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• 2019

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.