• Journal of Chest Surgery
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• v.45 no.2
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• pp.110-115
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• 2012

Background: Pneumonectomy remains the ultimate curative treatment modality for destroyed lung caused by tuberculosis despite multiple risks involved in the procedure. We retrospectively evaluated patients who underwent pneumonectomy for treatment of sequelae of pulmonary tuberculosis to determine the risk factors of early and long-term outcomes. Materials and Methods: Between January 1980 and December 2008, pneumonectomy or pleuropneumonectomy was performed in 73 consecutive patients with destroyed lung caused by tuberculosis. There were 48 patients with empyema (12 with bronchopleural fistula [BPF]), 11 with aspergilloma and 7 with multidrug resistant tuberculosis. Results: There were 5 operative mortalities (6.8%). One patient had intraoperative uncontrolled arrhythmia, one had a postoperative cardiac arrest, and three had postoperative respiratory failure. A total of 29 patients (39.7%) suffered from postoperative complications. Twelve patients (16.7%) were found to have postpneumonectomy empyema (PPE), 4 patients had wound infections (5.6%), and 7 patients required re-exploration due to postoperative bleeding (9.7%). The prevalence of PPE increased in patients with preoperative empyema (p=0.019). There were five patients with postoperative BPF, four of which occurred in right-side operation. The only risk factor for BPF was the right-side operation (p=0.023). The 5- and 10-year survival rates were 88.9% and 76.2%, respectively. The risk factors for late deaths were old age (${\geq}50$ years, p=0.02) and low predicted postoperative forced expiratory volume in one second (FEV1) (< 1.2 L, p=0.02). Conclusion: Although PPE increases in patients with preoperative empyema and postoperative BPF increases in right-side operation, the mortality rates and long-term survival rates were found to be satisfactory. However, the follow-up care for patients with low predicted postoperative FEV1 should continue for prevention and early detection of pulmonary complication related to impaired pulmonary function.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.49-54
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• 2008

Background: Aortic diseases tend to involve the entire aorta. Hence, there is the constant possibility of the need for a secondary operation at the remnant aorta. This study analyzed our cases of secondary aortic surgery in order to determine its characteristics and problems. Material and Method: Between April 2003 and June 2007, 12 patients (6 male and 6 female) underwent thoracoabdominal aortic replacement as a secondary aortic operation. Their clinical courses were analyzed. Four of the patients underwent lower thoracobadominal aortic replacement under the normothermic femorofemoral bypass, and the others underwent an entire thoracobdominal aortic replacement under deep hypothermic circulatory arrest. Result: There was no death or paraplegia. As local complications, there were 3 cases of wound infection and 2 cases of an immediate reoperation caused by bleeding and one case of delayed wound. revision for a contaminated perigraft hematoma. As a systemic complication, there was one case of renal insufficiency, which required hemodialysis and one case of respiratory insufficiency that needed prolonged ventilator care. The mean admission period was $30{\pm}21$ days. All the patients were followed up for $626{\pm}542$ days without reoperation or other problems. Conclusion: Using properly selected patients and a careful approach, thoracoabdominal aortic replacement can be performed safely as a secondary aortic surgery.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.425-429
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• 2014

Two dogs were presented with a history of anorexia, respiratory distress, or epistaxis. On physical examination, the dogs showed difficulty breathing and open-mouth breathing and large masses were found on the hard palate and soft palate. Cardiac arrest happened in case 2 and the dog was stabilized with cardiopulmonary resuscitation and oxygen therapy. Computed tomography demonstrated that the mass occupied the oropharynx, intrapharyngeal ostium, and laryngopharynx including the hard palate and soft palate in case 1. Palliative surgery was decided to improve swallowing and breathing with owner's consent in two dogs. Buccal mucosal flaps were performed for reconstruction of defects using rotational and single-pedicle advancement flaps and bilateral 90 degree transposition flaps in cases 1 and 2, respectively. Histopathology results described the oral masses as amelanotic melanoma in two dogs. The owners reported that there was normal swallowing and breathing at 7 days postoperatively in two dogs. In case 1, recurrent tumor was identified caudal to the hard palate 4 weeks after surgery. The owner did not allow further treatment and the dog became lost to follow-up at 2 months postoperatively. In case 2, there was no clinical or radiographic evidence of a local recurrence or distant metastasis at 3 weeks after surgery. The owner informed that the dog died suddenly with no signs of anything particularly wrong at 7 weeks after surgery.

• Journal of the Korean Society of Marine Environment & Safety
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• v.29 no.7
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• pp.819-827
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• 2023

If respiratory arrest occurs or cardiopulmonary resuscitation (CPR) is performed for a long period on board ships, CPR with rescue breathing (not compression-only CPR) is required. Accordingly, ships must have resuscitation equipment for oxygen supply, and seafarers must have the maritime competence to use it. This study aimed to analyze the placement status of resuscitation equipment on ships and seafarers' intention to use them in order to increase the usability of resuscitation equipment on board ships and propose improvement measures. The study was conducted from February 2, 2023, to April 21, 2023, and a total of 340 seafarers were surveyed. The data were analyzed by frequency, percentage, and chi-square test using SPSS WIN 23.0. The results showed that the checking of resuscitation equipment was high among seafarers in the positions of officer, captain, deck department personnel, and ocean-going personnel. The intention of seafarers to use resuscitation equipment was low, and the main barrier was the lack of knowledge on how to use. Among the general characteristics of the study participants, those whose rank was that of officer or captain, whose working department was the deck, voyage who were ocean-going, and who managed a gross tonnage of 20,000 tons or more had a high intention to use resuscitation equipment. Participants who knew the necessity of rescue breathing and had received practice and equipment-based training were active in using resuscitation equipment. Therefore, a system should be developed so that all ships can be equipped with resuscitation equipment, and an environment must be created to increase accessibility to resuscitation equipment on board ships. In addition, an education system based on practical and resuscitation equipment training must be established to ensure that seafarers have maritime competence.

• Tuberculosis and Respiratory Diseases
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• v.58 no.5
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• pp.473-479
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• 2005

Background : Gefitinib targets the epidermal growth factor receptor r(EGFR), and Gefitinib has antitumor activity in patient with non-small cell lung cancer (NSCLC). However, only 10 to 20 percent of patients show a clinical response to this drug, and the molecular mechanisms underlying patient sensitivity to gefitinib are unknown. PTEN (Phosphatase and tensin homolog deleted on chromosome Ten) plays a role for the modulation of the phosphatidylinositol 3-kinase pathway (PI3K), which is involved in cell proliferation and survival, so that it can inhibit cell cycle progression and induce G1 arrest. Therefore, we analyzed the relationship between PTEN expression and gefitinib's responsiveness in patients having advanced non small cell lung cancer that had progressed after previous chemotherapy. Methods : The expression of PTEN was studied by immunohistochemistry in paraffin-embedded tumor blocks that were obtained from 22 patients who had been treated with gefitinib from JAN, 2001 to AUG. 2004. For the evaluation of the relationships between the PTEN expression, the clinical stage and the basal characteristics, those cases that showed the respective antigen expression in >50% of the tumor cells were considered positive. Results : The positive rate of PTEN staining was 55% of the total of 22 patients. There was a significant relationship between the increased expression of PTEN and the response group (p=0.039). However, there was no significant relationship between the expression of PTEN and other clinicopathologic characteristics. Conclusion: The expression of PTEN in patients with advanced non small cell lung cancer that has progressed after previous chemotherapy may play a role in gefitinib's responsiveness.

• Tuberculosis and Respiratory Diseases
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• v.50 no.1
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• pp.67-75
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• 2001

Background : Two tumor suppressor genes, p53 and p16, which have different roles in controlling the cell cycle and inducing apoptosis, are frequently inactivated during carcinogenesis including lung cancer. Single tumor suppressor gene therapies using either with p53 or p16 have been studied extensively. However, there is a paucity of reports regarding a combined gene therapy using these two genes. Methods : The combined effect of p53 and p16 gene transfer by the adenoviral vector on the growth of lung cancer cell lines and its interactive mechanism was investigated. Results : An isobologram showed that the co-transduction of p53 and p16 exhibited a synergistic growth in hibitory effect on NCI H358 and an additive effect on NCI H23. Cell cycle analysis demonstrated the induction of a synergistic G1/S arrest by a combined p53 and p16 transfer. This synergistic interaction was again confirmed in a soft agar confirmed in a soft agar clonogenic assay. Conclusion : These observations suggest the potential of a p53 and p16 combination gene therapy as another potent strategy in cancer gene therapy.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.573-579
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• 2002

Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.