• Journal of Chest Surgery
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• v.24 no.8
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• pp.797-801
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• 1991

Reexpansion pulmonary edema following pneumothorax, atelectasis, massive pleural effusion are clinically uncommon, but sometimes life threatening progression. Reexpansion pulmonary edema is usually ipsilateral but rarely contralateral or both. Reexpansion pulmonary edema was occurred when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. The pathogenesis of the reexpansion pulmonary edema is unknown but is probably mutifactorial. The etiological factors of the reexpansion pulmonary edema are chronicity of the lung collapse, technique of the reexpansion, airway obstruction, loss of the surfactant, and pulmonary artery pressure changes. In the treatment of the chronically collapsed lung, physician must be remembered the possible events, and to prevent of the complication.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1066-1069
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• 1992

The bronchogenic cyst is not so rare in incidence, but it is rare for this cyst to cause compression of trachea and main bronchi. A 6-year old female child was evaluated for coughing, fever and left total atelectasis. This patient had a history of frequent upper respiratory symptom like bronchial asthma since 6month after birth. Fiberoptic bronchoscopy revealed external compression at distal trachea and both main bronchi. Computed Tomography revealed well demarcated homogeneous mass compressing distal trachea and main bronchi. The pathological examination showed bronchogenic cyst and this patient had uneventful recovery.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.484-488
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• 1986

Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

• Korean Journal of Bronchoesophagology
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• v.13 no.2
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• pp.61-64
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• 2007

Treatment choice for primary pulmonary sarcoma is complete surgical resection. A 69 year old man developed dyspnea due to left lung atelectasis. There was endobronchial tumor completely obstructing the left main bronchus. The tumor was resected completely by main bronchial resection via a left thoracotomy incision, and diagnosed as leiomyosarcoma. Bronchoscopy and computed tomography in 6 months after operation, there was no evidence of recurrence.

• Neonatal Medicine
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• v.18 no.2
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• pp.404-408
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• 2011

Scimitar syndrome (SS) is a rare congenital anomaly characterized by hypoplasia of the right lung and partially anomalous pulmonary venous drainage to the inferior vena cava. The term scimitar derives from the shadow created by the anomalous pulmonary vein on chest X-ray that closely resembles that of a curved Turkish sword. It rarely presents as an isolated abnormality. Various cardiac and non-cardiac anomalies have been association with SS, such as right lung hypoplasia, dextroposition of the heart, hypoplasia of the right pulmonary artery, systemic arterial blood supply to the right lower lung from the infra-diaphragmatic aorta, and a secundum type of atrial septal defect. However, an imperforate anus has not been reported previously in association with SS. We describe the first case of infantile scimitar syndrome accompanied with an imperforate anus in a newborn who presented with tachypnea and right pulmonary atelectasis.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.175-186
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• 1976

The cellular change of the pulmonary tuberculous lesions may be divided into two groups,exudative and proliferative form by their course and fate. In the most cases, the patients usually have very much complex type of cellular changes. Therefore, the shadows of the chest films in pulmonary tuberculosis are also much variable in nature. And Daniel said that knowledge of the pathology of tuberculosis and an appreciation of the method of progression and healing are essential to proper interpretation of the films. Author, having reviewed 33 cases of resected tuberculous lung obtained in N.M.T.H. for one year from Oct. '75 to Sep. '76 by surgical managements, classified the Pathological findings such as: 1) caseation only, 2) tuberculoma, 3) atelectatic lung 4) cavitary lesion and 5) atelectasis with cavity, and examined the relationship between the roentgenological characteristics of the chest films and the pathological process of tuberculous lesions of the resected lungs, The result were obtained as follows. (1) Tuberculoma was commonly appeared in $S_2$ segment in right and $S_6$ segment in left. (2) Atelectasis and destroyed lung were more commonly appeared in left lung than right, and their containing rate of cavity was 82%. (3) Cavities were mostly appeared in $S_1$ and $S_2$ segments of both lung and the appearance-rate of cavity on $S_6$ segment was higher in left than right. And among the cavitary lesions of the resected lung, cavity was not seen in the preoperative chest films in 22%. (4) The configuration, thickness and sharpness of the walls of cavities, which revealed the cavitary shadows in the preoperative chest films, were mostly depended on the degree of increased collagenous fiber of the wall, existence of perifocalitis, and more or less of the caseous masses on the inner surface of the cavity wall.

• Journal of Chest Surgery
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• v.20 no.1
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• pp.1-12
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• 1987

Respiratory care with oxygen inhalation is often a necessity to maintain life, and it is one of the important therapeutic adjuncts in respiratory disease and in intensive care after surgery. However, it has been reported that oxygen toxicity occurs after prolonged exposure to 100% 0, [Smith, 1899; Kistler et al. 1967; Schaffner et al. 1967; Rowland and Newman, 1969. Subjective symptoms of oxygen toxicity include tracheal irritation, frequent cough, some burning sensation in the trachea, tachypnea, severe dyspnea, etc. [Welch, 1963; Fisher et al, 1968; Milier et al, 1970; Clark and Lambertsen, 1971; Sackner, 1975]. Pathologic findings are atelectasis, injuries to the pulmonary capillaries and hemorrhage in the alveoli in gross specimens. There can be inflammation, proliferation of fibrin, thickening of alveolar membranes, degeneration of collagen fibers and interstitial edema in the microscopic findings. [Penrod, 1956; Cedergren, 1959; Bean, 1965; Schaffner, 1967]. Dubois and colleagues [1961] found that the amount of pulmonary surfactant was decreased in oxygen toxicity and atelectasis followed by the decreased pulmonary surfactant. Many authors reported that vital capacity, inspiratory force, pulmonary compliance, pulmonary capillary blood flow and pulmonary elasticity were deceased and arteriovenous shunting increased. [Comroe et al, 1945; Fuson et al, 1965; Kistler et al, 1966; Knowles and Blenner-hassett, 1967; Barber et al, 1978]. Many human volunteers were examined after prolonged exposure in a high oxygenated chamber and there were a few reports on animals with oxygen toxicity, subjects including rabbits. Gas partial pressures of alveoli and arteries were measured in rabbits exposed to 100% $O_2$ and the alveolar-arterial gas gradients were analyzed, which is the basis for the study of oxygen toxicity. These rabbits were divided into two groups; rabbits under natural respiration, and second group under artificial respiration with a respirator. The alveolar $PO_2$ [$P]AO_2$] and $PCO_2$ [$PACO_2$], and the arterial $PO_2$ [$PaO_2$] were measured under varying $O_2$ pressures; 15% $O_2$, 21% $O_2$ and 100% $O_2$.

• The Korean Journal of Physiology
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• v.28 no.1
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• pp.71-77
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• 1994

In the animal model of acute respiratory distress syndrome (ARDS) induced by N-nitroso-N-methylurethane (NNNMU) the secretory activity of alveolar type H cells during acute alveolar injury was investigated by determining phospholipid and pulmonary surfactant associated proteins in crude surfactant. The mechanism of the secretory change was studied by determination of DNA and RNA levels in the lung tissue. After induction of acute alveolar injury with NNNMU, pulmonary hemorrhage, atelectasis and gross hypertrophy were observed. Seven days after NNNMU treatment the level of total DNA in lung homogenate was increased markedly indicating that a hypertrophy was induced by cellular proliferation. Although the total DNA level increased, the RNA/DNA ratio was gradually decreased after NNNMU treatment. Seven days after NNNMU treatment the RNA/DNA ratio returned to the normal control level. During the acute alveolar injury, phospholipid and surfactant associated proteins were reduced significantly as compared with the control, implying that the secretory activity of alveolar type II cells was altered during acute alveolar injury induced by NNNMU. The protein content in crude surfactant during peak injury(7 days after NNNMU) was decreased significantly but phospholipid/protein ratios were identical in both control and NNNMU treatment groups. SDS-PAGE of proteins in crude pulmonary surfactant showed a decrease in major surfactant associated protein(M.W. 38,000) during acute alveolar injury. The present study may suggest that while alveolar type H cells proliferate markedly, transcription of alveolar type ll cell gene was inhibited by an unknown mechanism such as DNA methylation induced by NNNMU. Such an inhibition of transcriptional activity is thought to be associated with the decreased secretory activity of alveolar type ll cells, which may lead to pulmonary atelectasis and edema during the acute alveolar injury.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.483-486
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• 2014

A 76-year-old male underwent a left upper lobectomy with wedge resection of the superior segment of the left lower lobe using video-assisted thoracoscopic surgery (VATS) for non-small-cell lung cancer of the left upper lobe. He presented with shortness of breath, fever, and leukocytosis. Chest radiography showed atelectasis at the remaining left lower lobe. Bronchoscopy revealed narrowing of the left lower bronchus with purulent secretion, and computed tomography showed downward kinking of the left lower lobar bronchus. He underwent exploratory VATS, and intraoperative findings showed an inferiorly kinked left lower lobar bronchus with upward displacement of the left lower lobe. After adhesiolysis, the kinked bronchus was straightened, and bronchopexy was performed to the pericardium to prevent the recurrence of bronchial kinking. Also, the inferior pulmonary ligament was reattached to prevent upward displacement. Postoperative follow-up bronchoscopy revealed no evidence of residual bronchial obstruction, and chest radiography showed no atelectasis thereafter.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.621-625
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• 1996

"Middle lobe syndrome" which was described y Graham and associates at first is always caused by ex- ternal bronchial compression by Iymph nodes. Although the patients may not present any symptom, the most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic procedures includ chest X-ray bronchoscopy, brochography, chest CT, and the principal finding is the contracted middle lobe which is usually airless. We experienced fifteen cases of middle lobe syndrome from April 1990 to May 1995. Eleven patients were treated surgically. The surgical candidates for middle lobe syndrome are suspicious malignancy, fixed bronchiectasis, bronchostenosis, intractable to medical treatment, recurrent infection. Operations were right middle lobectomy (8), right middle and lower bilobectomy (2), right upper and middle bilobectomy (1). Postoperative histological findings were tuberculosis in six, chronic inflammation in three, malignancy in one, and focal hemorrhage in one. There were two cases of postoperat ve complications which were postoperative atelectasis and hepatopathy.patopathy.