• Title/Summary/Keyword: Thoracic disease

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Video-assisted Thoracic Surgery [VATS] in Diagnosis and Treatment of Thoracic Diaseas; Report of 90 Cases (비디오 흉강경: 흉부질환의 진단과 치료;90례 보고)

  • 백만종
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.475-482
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    • 1993
  • 90 patients[75 men and 15 women] with the thoracic disease underwent video-assisted thoracic surgery[VATS] during the period March 1992 to February 1993. The thoracic diseases were classified into two groups of spontaneous pneumothorax and general thoracic patients and they were 66 and 24, respectively.The mean size of the tumor resected was 4.3 $\pm$ 2.0 cm x 3.3 $\pm$ 1.1 cm x 2.7 $\pm$ 1.0 cm. The mean time of anesthesia and operation were 90.0 $\pm$ 19.9 min and 43.7 $\pm$ 13.1 min in spontaneous pneumothorax group and 123.3 $\pm$ 40.3 min and 62.8 $\pm$ 32.2 min in general thoracic group. The mean period of postoperative chest tube drainage and hospital stay were 5.0$\pm$ 5.5 days and 6.6 $\pm$ 7.4 days in spontaneous pneumothorax group and 3.5$\pm$ 1.6 days and 9.5 $\pm$ 6.1 days in general thoracic group. The indications of VATS were 71 pleural disease[78.9%: 66 spontaneous pneumothorax; 3 pleural effusions ; 1 pleural paragonimus westermanii cyst; 1 malignant pleural tumor with metastasis to the lung], 9 mediastinal disease[10.0%: 5 benign neurogenic tumor; 2 pericardial cyst; 1 benign cystic teratoma; 1 undifferentiated carcinoma], 8 pulmonary parenchymal disease[8.9%: 3 infectious disease ; 3 interstitial disease ; 2 malignant tumor ], and 2 traumatic cases of exploration and removal of hematoma[2.2%]. The applicated objectives of VATS were diagnostic[ 7 ], therapeutic[ 67 ] and both[ 16 ] and the performed procedures were pleurodesis[ 66 ], wedge resection of lung[ 59 ], parietal pleurectomy[ 11 ], removal of benign tumor[ 9 ], excision and/or biopsy of tumor[ 4 ], pleural biopsy and aspiration of pleural fluid[ 3 ] and exploration of hemothorax and removal of hematoma in traumatic 2 patients. The complication rate was 24.2%[ 16/66 ] in the spontaneous pneumothorax group and 8.3%[ 2/24 ] in the general thoracic group and so overally 20.0%[ 18/90 ]. The mortality within postoperative 30 days was 2.2%[ 2/90 ], including 1 acute renal failure and 1 respiratory failure due to rapid progression of pneumonia. The conversion rate to open thoracotomy during VATS was 5.6%[ 5/90 ], including 2 immediate postoperative massive air leakage, 1 giant bullae, 1 malignant pleural tumor with metastasis to lung and 1 pulmonary malignancy. The successful cure rate of VATS was 75.8%[ 50/66 ] in the spontaneous pneumothorax group and 76.5%[ 13/17 ] in the general thoracic group and the successful diagnostic rate was 100%[ 7/7 ]. In conclusion, although prospective trials should be progressed to define the precise role of VATS, the VATS carries a low morbidity and mortality and high diagnostic and therapeutic success rate and now can be effectively applicated to the surgical treatment of the extensive thoracic disease.

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Adventitial Cystic Disease of the Common Femoral Artery: A Case Report and Literature Review

  • Kim, Sung Hwan;Lee, Chung Eun;Park, Hyun Oh;Kim, Jong Woo;Choi, Jun Young;Lee, Jeong Hee
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.150-152
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    • 2013
  • Arterial adventitial cystic disease is an uncommon type of non-atherosclerotic peripheral vessel disease. Most cases of arterial adventitial cystic disease occur in the popliteal arteries; however, fewer cases have been reported in the femoral arteries. A 59-year-old male patient visited the hospital with a complaint of a swelling on the lower extremity that had begun two months earlier. Suspecting deep vein thrombosis based on a physical examination and ultrasonography from another hospital, tests were performed. Magnetic resonance imaging (MRI) was performed for exact diagnosis because venous adventitial cystic disease was suspected by computed tomography venography. The MRI indicated venous adventitial cystic disease as well. Thus, a cystic mass excision was performed. In the end, a cystic mass compressing the common femoral vein that originated from the common femoral artery was diagnosed based on the macroscopic findings. This case is reported because blood circulation in the vein was impeded due to arterial adventitial cystic disease, and the symptoms improved after the cystic mass excision and polytetrafluoroethylene roofing angioplasty.

Thoracic (Bronchopulmonary) Actinomycosis : A Case Report (폐 Actinomycosis 치험 1례)

  • 강정호
    • Journal of Chest Surgery
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    • v.8 no.2
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    • pp.153-158
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    • 1975
  • Actinomycosis is a chronic suppurative granulomatous disease due to Actinomyces israelii characterized by multiple abscess and sinus tract formation with dense fibrous scarring. This disease, especially thoracic infection, is very rare in Korea so we are not famiIliar with to make diagnosis and treatment. Otherwise the unspecificity of the clinical symptoms and the lack of adequate examination recedure (as anaerobic fungus culture) are the causes of misdiagnosis. Thoracic actinomycosis is very similar to chronic infectious disease of the lung and chest or thoracic neoplasm. Recently we experienced a case of thoracic actinomycosis (bronchopulmonary) which had been confused with chronic lung abscess and pathologically confirmed as broncho-pulmonary actinomycosis. The purpose of this report is to review our experience more thorouly to enhance consideration of Artinomycosis.

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A Giant Pseudo-Aneurysm on the Anastomosis Site for a Redo Bentall Operation due to Behçet Disease Treated by Thoracic Endovascular Aortic Aneurysm Repair with a Custom-Made Stent Graft

  • Won, Jongyun;Jung, Jae Seung;Lee, Jun Hee;Jung, Young Ki;Son, Ho Sung
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.411-413
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    • 2020
  • A 34-year-old man who had undergone aortic valve replacement 8 years ago underwent an additional Bentall operation due to mechanical valve dehiscence 2 years later. Subsequently, he was diagnosed with Behçet disease and Batter syndrome. A week after being hospitalized again due to chest pain and dyspnea, a large pseudo-aneurysm was detected on computed tomography. Because of the excessively large size of the pseudo-aneurysm, surgical treatment seemed very risky. Therefore, we planned to perform thoracic endovascular aortic repair (TEVAR) and treated him successfully. However, the patient experienced recurrence of the same symptoms 4 months later, and was found to have type IV endoleak. He received a TEVAR procedure again, and it was successful.

Pulmonary Sarcoidosis (폐 유육종증 1례 보고)

  • 백효채
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.928-931
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    • 1995
  • Sarcoidosis is a granulomatous disease of unknown etiology. It frequently involves thoracic lymph node and pulmonary parenchyme characterized by non-caseating granulomas and varying degrees of fibrosis. We have experienced a pulmonary sarcoidosis in the left lower lobe of the lung in a 40 year old man who underwent left lower lobectomy by video-assisted thoracic surgery.

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2 Cases Report of Bullous Emphysema in Infancy. Treated by Surgery (영아에 발생(發生)한 거대(巨大) 기낭성폐기종(氣囊性肺氣腫) 2례(例) 보고(報告))

  • Kim, J.E.;Choi, S.S.;Lee, J.H.;Yoo, Y.S.;Yu, H.S.;Park, M.H.;Park, H.S.
    • Journal of Chest Surgery
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    • v.9 no.1
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    • pp.78-82
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    • 1976
  • Bullous emphysema is usually associated with extensive chronic obliterative pulmonary disease. It is the disease of old age but rare in children or infancy. The bulla in this disease is acquired one. In general the symptoms are due to not the mere presence of the bulla but the extent of underlying lung pathology as emphysema or bronchitis. Occassionally giant bulla of great size may cause symptoms and in this occassion it should be differentiated from other diseases. Especially in children or infancy pneumothorax, congenital pulmonary cyst of lobar obstructive-emphysema should be excluded. Recently we experienced 2 cases of bullous emphysema in infancy with severe respiratory symptoms because of bullae of great size. We felt difficulties in differentiating with other conditions. The purpose of this report is to review our cases thoroughly and enhance considerations of this disease.

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Coexistent Atrial Septal Defect with Mitral Valve Disease: a report of 6 cases (승모판막질환을 합병한 심방중격결손증의 수술요법6례 보고)

  • Jo, Sung-Rae;Chae, Hurn;Rho, Joon-Rhyang
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.339-345
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    • 1979
  • Mitral valve disease is the most common disease of the acquired heart diseases, and atrial septal defect is also one of common congenital heart diseases. Coexistence of these two lesions is rare, but of great hemodynamic interest. Among 443 cases with mitral valve disease and 90 cases with atrial septal defect experienced in the Department of Thoracic Surgery, Seoul National University Hospital, there were 6 cases with atrial septal defect complicated by mitral valve disease. 1. Of the 6 patients, four were female and two were male. The age was ranged from 18 to 46. 2. Atrial septal defect was ostium secundum type in all cases, and the mitral valvular lesions were regurgitation in four and stenosis in two. Type II ventricular septal defect was also combined in one of the cases. 3. The atrial septal defect was corrected by, primary closure and the mitral valve was replaced with the prosthetic or bioprosthetic valve in all cases. The combined ventricular septal defect was closed using Teflon felt patch. 4. The operative result was good except in one who was expired of bacterial endocarditis 4 months after hospital discharge.

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Characterization of Venous Involvement in Vasculo-Behçet Disease

  • Lee, Na Hyeon;Bae, Miju;Jin, Moran;Chung, Sung Woon;Lee, Chung Won;Jeon, Chang Ho
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.381-386
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    • 2020
  • Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

Treatment of phlegmonous esophagitis in various patients: a case series

  • Han Sol Lee;Chul Ho Lee;Yun-Ho Jeon
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.442-447
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    • 2023
  • Acute phlegmonous esophagitis (APE) is a rare and fatal disease. Phlegmonous infection involves the submucosal layer and muscularis propria but not the mucosal layer. Because surgery is not the first treatment option for this disease, an accurate diagnosis is crucial. Herein, we report three cases of APE with various clinical features. All patients were successfully treated with antibiotics and appropriate medical procedures.

CABG for an Adult with Coronary Disease due to Kawasaki Disease (성인기 가와사키병에 합병된 관상동맥 질환에서의 관상동맥 우회술)

  • Song, Hyun;Kim, Sang-Pil;Ryu, Sang-Wan
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.831-834
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    • 1999
  • The Kawasaki disease has been reported worldwide since the first description in 1967 in Japan. Approximately 20% of the children with untreated Kawasaki disease are believed to develop coronary artery aneurysm of which 2-3% progress to coronary artery stenosis. The Kawasaki disease rarely affects adults and accordingly, there have been only a few cases reported in literatures. The present case describes a successful surgical treatment of a 43-year-old female patient with coronary artery aneurysm and stenosis, which resulted from an episode of the Kawasaki disease that occurred 20 years earlier. The patient was well at 5 months followup.

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