Takotsubo Cardiomyopathy Associated with Chronic Psychiatric Stress in Major Depressive Disorder in an Elderly Patient

Takotsubo cardiomyopathy (TC) is a transient form of acute heart failure that most often occurs in postmenopausal women, typically triggered by a preceding emotional or physical stressor. A 74-year-old woman who suffered from chronic psychiatric stress visited National Medical Center for dyspnea. Acute emotional or physical stress could not be identified despite careful history taking. An electrocardiogram showed diffuse T-wave inversions with prolonged QT interval, and the echocardiogram showed akinesia of mid and apical segments of the left ventricle with hyperkinesia at the base. There was no significant stenosis on coronary angiography. Differing from the typical case of TC, which follows acute stress triggers, our case indicates that underlying chronic psychiatric illness exacerbation can lead to TC. We suggest that cardiologists and psychiatrists be aware of this predisposition to TC, especially in the circumstances of acute heart failure.

A Case of Klippel-Trenaunay Syndrome with Acute Submassive Pulmonary Thromboembolism Treated with Thrombolytic Therapy

Klippel-Trenaunay syndrome is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous hemangiomas, soft tissue and bony hypertrophy of limb. Potential complications such as deep venous thrombosis and pulmonary thromboembolism have not been reported in Korea to date. We demonstrate the case of a 48-year-old woman with Klippel-Trenaunay syndrome with extensive varicose veins on right lower limb, hypertrophy of left big toe and basilar artery tip aneurysm, complicated with acute submassive pulmonary thromboembolism treated successfully with intravenous thrombolytic therapy.

Exposure Assessment Suggests Exposure to Lung Cancer Carcinogens in a Painter Working in an Automobile Bumper Shop

A 46-year-old man who had worked as a bumper spray painter in an automobile body shop for 15 years developed lung cancer. The patient was a nonsmoker with no family history of lung cancer. To determine whether the cancer was related to his work environment, we assessed the level of exposure to carcinogens during spray painting, sanding, and heat treatment. The results showed that spray painting with yellow paint increased the concentration of hexavalent chromium in the air to as much as 118.33 microg/m3. Analysis of the paint bulk materials showed that hexavalent chromium was mostly found in the form of lead chromate. Interestingly, strontium chromate was also detected, and the concentration of strontium chromate increased in line with the brightness of the yellow color. Some paints contained about 1% crystalline silica in the form of quartz.

Clinical Experience of VNUS(R)Closure fast in Treatment of Varicose Vein: Comparison with Traditional Radiofrequency Ablation / 대한흉부외과학회지

BACKGROUND: Radiofrequency endovenous ablation of incompetent saphenous vein has gaining popularity over the conventional ligation and stripping as a minimally invasive technique. The latest version of radiofrequency endovenous catheter, VNUS(R)Closure fast VNUS medical Technologies, San Jose, CA, adopted a segmental ablation system, instead of continous pullback, is designed to reduce treatment time in comparison with the previous model-VNUS(R)Closure plus VNUS medical Technologies, San Jose, CA. The purpose of this study is to compare the difference between two endovenous radiofrequency ablation systems in terms of treatment efficacy and complication rates. We analyze the initial efficacy and complication rates of VNUS(R)Closure fast with VNUS(R)Closure plus. MATERIAL AND METHOD: Between June 2006 and August 2009, VNUS(R)Closure plus was performed to treat varicose vein on 59 limbs in 41 patients and VNUS(R)Closure fast was performed on 76 limbs in 67 patients. We retrospectively compared in both group with sex, mean treatment time, mean treatment diameter, conjugated treatment, and complications after the procedure. RESULT: All patient were symptomatic and diagnosed as varicose vein and underwent level 2 clinical classification with color duplex scan. The mean treatment time for the great saphenous vein was significantly less with VNUS(R)Closure fast (17.0+/-6.5 min) than VNUS(R)Closure plus (62.7+/-29.8 min). There was no significant difference in 1 yr closure rate between groups (p=0.32). Minor complications such as skin burn, thrombophlebitis, ecchymosis, hematoma, cellulitis, tenderness, and there were not different between the groups. CONCLUSION: Both VNUS(R)Closure fast and VNUS(R)Closure plus are effective methods of endovenous saphenous ablation. VNUS(R)Closure fast is superior to the previous model with less treatment time preserving compatible efficacy and complications. The efficacy of VNUS(R)Closure fast for long term closure rate remains to be established.

Low-intensity Oral Anticoagulation Versus High-intensity Oral Anticoagulation in Patients with Mechanical Bileaflet Prosthetic Heart Valves / 대한흉부외과학회지

BACKGROUND: All the patients with mechanical valves require warfarin therapy in order to prevent them from developing thromboembolic complications. According to the ACC/AHA practice guidelines, after AVR with bileaflet mechanical prostheses in patients with no risk factors, warfarin is indicated to achieve an INR of 2.0 to 3.0. After MVR with any mechanical valve, warfarin is indicated to achieve an INR of 2.5 to 3.5. But in our clinical experience, bleeding complications (epistaxis, hematuria, uterine bleeding, intracerebral hemorrhage etc.) frequently developed in patients who maintained their INR within this value. So, we retrospectively reviewed the patients with bileaflet mechanical heart valve prosthesis and we determined the optimal anticoagulation value. MATERIAL AND METHOD: From January 1984 to February 2007, 311 patients have been followed up at a national medical center. We classified the AVR patients (n=60) into three groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II and an INR from 2.5 to 3.0 in Group III. We classified the MVR (n=171) and DVR (n=80) patients into four groups as follows: an INR from 1.5 to 2.0 in Group I, an INR from 2.0 to 2.5 in Group II, an INR from 2.5 to 3.0 in Group III and an INR from 3.0 to 3.5 in Group III. We compared the groups for their thromboembolic and bleeding complications by means of the Kaplan Meier method. RESULT: In the AVR patients, 2 thromboembolic complications and 4 bleeding complications occurred and the log rank test failed to identify any statistical significance between the groups for thethromboembolic complication rate, but groups I and II had lower bleeding complication rates than did group III. Thirteen thromboembolic complication and 15 bleeding complication occurred in the MVR and DVR patients, and the log rank test also failed to identify statistical significance between the groups for the thromboembolic complication rate, but groups I and II had lower bleeding complication rates that did groups III and IV. CONCLUSION: The thromboembolic complication rate was not statistically different between groups I and II and groups III and IV, but the bleeding complication rates of groups I and II were lower than those of groups III and IV. So this outcome encouraged us to continue using our low intensive anticoagulation regime, that is, an INR of 1.5 to 2.5.

Redo CABG through a Left Posterolateral Thoracotomy: A case report / 대한흉부외과학회지

We report there on a 46-year-old male patient whose angina recurred after a coronary bypass graft (CABG). Occlusion of the first diagonal branch was found on performing a coronary angiogram (CAG), and this occlusion had not previously been present. So, a redo-off pump CABG was performed via a left posterolateral thoracotomy. The anastomosis was made between the descending thoracic aorta and the diagonal branch by using the right radial artery. On the Multi-detector computerized tomography (MDCT) coronary angiogram conducted after the operation, it was confirmed that there was no abnormality in the anastomosis site. A Redo-CABG was successfully performed via left posterolateral thoracotomy in the patient whose disease was only at the diagonal branch.

The Surgical Treatment for Aorto-cutaneous Fistula after Open Heart Surgery: A case report / 대한흉부외과학회지

Aorto-cutaneous fistula is a rare complication after performing open heart surgery, but if this develops, it is a fatal condition. So, prompt diagnosis and aggressive surgical treatment is needed. We report here on a patient who had two mechanical double valves placed during heart surgery and she was treated for repeated sternal wound infections for about 5 years. She visited the ER due to abrupt bleeding at the sternal wound. She was diagnosed as having an aorto-cutaneous fistula by performing an aortogram and we then performed cardio-pulmonary bypass surgery. The patient is currently doing well and is under follow up 24 months after the repair.

Surgical Results for Treating Postpneumonectomy Empyema with BPF by Using an Omental Pedicled Flap and Thoracoplasty / 대한흉부외과학회지

BACKGROUND: Postpneumonectomy empyema (PPE) due to bronchopleural fistula (BPF) can be a surgical challenge for surgeons. We analyzed the follow-up outcomes after performing omentopexy and thoracoplasty for the treatment of PPE with BPF after pneumonectomy. MATERIAL AND METHOD: Between December 1991 and January 2006, 9 patients underwent BPF closure using an omental pedicled flap for the treatment of PPE with BPF after pneumonectomy. There were 7 males and 2 females (mean age: 45.9+/-9 years). The patients were followed up for a mean of 58 months (median: 28 months, range: 6~169). When we performed omentopexy, the surgical procedures for empyema were thoracoplasy for 8 patients and the Clagett procedure for 1 patient. Thoracoplasty was performed for the latter patient due to recurrence of empyema. RESULT: For the 8 patients who were treated by omentopexy and thoracoplasty, there was 1 operation-related death due to sepsis. During follow up, 1 patient, who was treated by omentopexy and a Clagett procedure, died of acute hepatitis 40 months postoperatively. The early mortality was 11.1% (8/9). Of the 8 patients, including the 1 late death patient, successful closure of the BPF were achieved in all patients (8/9) and the empyema was cured in 7 patients (7/8). CONCLUSION: The BPF closure using an omental pedicled flap was an effective method for treating PPE with BPF due to TB-destroyed lung, and thoracoplasty with simultaneous omentopexy was effective and safe for removing dead space if the patient was young and in a good general condition.

The Use of Greater Saphenous Vein In Situ Graft in Arterial Occlusive Disease of Lower Extremity / 대한흉부외과학회지

BACKGROUND: Distal anastomosis using artificial vascular graft is difficult when luminal size mismatch occurred owing to severe occlusion of popliteal artery and its branches. So we reconstructed blood flow to ischemic lower limb by using autologous greater saphenous vein in situ graft (GSVISG) as vascular graft material. MATERIAL AND METHOD: From July 2000 to July 2005, 26 patients treated using GSVISG. We analyzed clinical results retrospectively by chart review. RESULT: There was no in hospital or early postoperative death and 6 late deaths occurred during follow up period. Postoperative complications were 5 cases of early graft obstruction, 2 cases of wound dehiscence, 1 case of graft aneurysmal change, 1 case of seroma formation at inguinal wound and 1 case of graft injury during valvulotomy. Overall patency rate during follow up period was 69.3%. CONCLUSION: Greater saphenous vein in situ graft is acceptable vascular graft for arterial occlusive disease of lower extremity.

Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age / 대한흉부외과학회지

The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Case Report of Partial Endocardial Cushion Defect with Mild Pulmonary Hypertension in Old Age / 대한흉부외과학회지

The partial endocardial cushion defect including ostium primum atrial septal defect and anterior mitral leaflet cleft, presents less significant clinical symptoms than complete endocardial cushion defect. But, as mitral insufficiency develops, cardiomegaly, congestive heart failure, pulmonary arterial hypertension appear. So, partial endocardial cushion defect has poor prognosis and is rarely seen in elderly patients. A 67 years old woman admitted at our hospital for operative treatment with partial endocardial cushion defect. She had increased pulmonary pressure of 45/22 mmHg, mean 32 mmHg. She had repair of ostium primum defect with patch, and the mitral valve was treated with valve replacement. Because advanced atrioventricular block developed postoperatively, she received permanent pacemaker.

Clinical Analysis of Arteriovenous Fistula in Chronic Renal Failure Patients / 대한흉부외과학회지

BACKGROUND: Owing to the fact that the average life span has increased and the progress in medical science has been made, the number of patients with chronic renal failure (CRF) who have to take hemodialysis (HD) has been going up gradually. Accordingly, it is considered to be as a significant issue to obtain blood vessels which can be used repetitively and supply enough blood flows. Therefore, there have been various kinds of study on an inosculation rate andfactors influencing it following an arteriovenous fistula (AV fistula) and lots of studies are ongoing for the purpose of escalating the inosculation rate. The authors analyzed the effects of short-term result, age, sex, diabetes and hypertension on arteriovenous inosculations in 134 anatomical snuffbox operated subjects among the patients who have taken an AV fistula at this center. MATERIAL AND METHOD: Based on 134 patients who underwent an AV fistula at the department of thoracic surgery of this center from July, 2000 to May, 2004, the difference in arteriovenous inosculation rate was compared and analyzed depending on age (discriminated by 65-year-old), sex and the condition of the presence or absence of diabetes and hypertension. Correlation analyses were conducted for each parameter and statistical tests were performed by using SPSS for windows Release 11.0.1, which were determined to be statistically significant if p value was below 0.05. RESULT: The total number of operations was 169 including 35 of re-operations. The male/female rate was 70:64 (52%:48%). The average age was 56.3+/-12.26 years and there were 33 (24%) old aged patients above 65-year-old; there were 103 (71%) patients with hypertension and 90 (67%) patients with diabetes. Overall arteriovenous inosculation rate was 93+/-2.4%, 91+/-2.7%, 89+/-3.0% at 6, 12, 24 months, respectively. The arteriovenous inosculation rate of above 65-year-old patient group was 85+/-4.8%, 80+/-5.8%, 80+/-5.8% and below 64-year-old patient group's was 85+/-4.8%, 80+/-5.8%, 80+/-5.8% at given time points, respectively, which showed higher inosculation rate in below 64-year-old patient group with a statistical significance (p=0.0034). However, no statistical significance was found between the patients with hypertension and diabetes and the patients with no complication. In addition, there was no statistical significance in inosculation rate between male and female. CONCLUSION: The arteriovenous inosculation ratewas higher in the treated patient below 64-year-old than in the treated patient above 65-year-old. Thus it is advantageous for increase in long-term inosculation rate to obtain hemodialysis routes at an early age. The conditions of sex and the presence or absence of diabetes and hypertension do not make statistically significant effect on the arteriovenous inosculation rate.

Lung Cancer Incidentally Found on Surgery of Spontaneous Pneumothorax: A case report / 대한흉부외과학회지

Spontaneous pneumothorax is rarely occurred as an initial sign of primary lung cancer. As a lot of these cases have already advanced, even then surgical resection is performed, the prognosis is often undesirable. We happened to find a ruptured cavity on a 65-year-old male patient who had suffered from pulmonary tuberculosis in the past, while performing VATS bullectomy for simple spontaneous pneumothorax. Then, as a result of frozen biopsy, it was diagnosed as squamous cell cancer. Because the tumor was infiltrated from the upper lobe into the lower lobe passing by fissure, we should remove by pneumonectomy and the pathologic stage was found stage I (T2N0M0). When we made an follow-up observation for one year and a half, there was neither relapse nor complication. When there appears spontaneous pneumothorax to the high risk group for lung cancer who were smokers over forty-year old, with chronic bronchitis or pulmonary emphysema, it needs to have a closer observation on a base lung disease such as lung cancer through chest CT, and it is also necessary to make more active approach by performing the surgical operation through a thoracoscopy when there is a continued air release.

Curved Axillary Thoracotomy in Patent Ductus Arteriosus / 대한흉부외과학회지

Muscle sparing thoracotomy is known as alternative of posterolateral thoracotomy because of less postoperative pain, preservation of muscle power and better cosmetic outcome. Curved axillary thoracotomy (CAT) is a type of muscle sparing thoracotomy. Between July 2003 and August 2004, 5 patients diagnosed as pure patent ductus arteriosus (PDA) treated by CAT and we reviewed results retrospectively by clinical record. The operative procedures were ligation of ductus in 4 cases and division of ductus in 1 case. There were no postoperative complication. Curved axillary thoracotomy is considerable alternative for surgical treatment of PDA with merits of muscle sparing effect and cosmetic benefit.

Risk Factor Assessment Using Surface Electromyography and Electrogoniometer among Automobile Part Manufacturers / 대한산업의학회지

OBJECTIVES: As automobile part manufacturing is characterized by high speed and high repetition, observation methods which are usually utilized for static posture are inappropriate to evaluate musculoskeleatal risk factors. This study quantified the risk factors of musculoskeletal disorders on the forearm and suggested exposure limits by estimating the risk factors using surface electromyography (EMG) and electrogoniometer. METHODS: Ten percent of the total workers at 3 automobile part manufacturing factories were randomly selected, and 99 male workers were recruited as study subjects. The study was conducted during May 2003 to September 2004. The workers were equipped with electrogoniometers on the wrist and the elbow, surface EMGs on the skin of the flexor digitorum superficialis (FDS) and extensor carpi radialis (ECR) muscles, and the heart beat recorder during work as indicators of joint movement, local muscle tension and physical work load, respectively. RESULTS: After controlling for age, body mass index and job stress, wrist flexion maximum angle, FDS relative activity (RA) and ECR RA were significantly associated with forearm musculoskeletal symptoms. The odds ratios of the forearm were 5.0(95% CI: 1.1-22.7), 14.0(95% CI: 1.5-128.8) and 7.3(95% CI: 1.1-49.4) for wrist flexion maximum angle more than 76 degrees, FDS RA more than 2.8%, and ECR RA more than 3.5%, respectively. CONCLUSIONS: Joint angle and focal muscle activity were associated with forearm musculoskeletal symptoms. To reduce forearm musculoskeletal symptoms among automobile part manufacturers, the wrist flexion angle, and FDS and ECR activity need to be reduced below the guidelines recommended in this study.

Evaluation of Indoor Air Quality in a Department of Radiation Oncology Located Underground / 대한방사선종양학회지

PURPOSE: Indoor air quality (IAQ) in the radiation treatment center which is generally located underground is important to the health of hospital workers and patients treated over a long period of time. This study was conducted to measure and analyze the factors related to IAQ and subjective symptoms of sick building syndrome, and to establish the causes influencing IAQ and find a solution to the problems. METHODS AND MATERIALS: Self administrated questionnaire was conducted to check the workers' symptoms and understanding of the work environment. Based on a preliminary investigation, the factors related to IAQ such as temperature, humidity, fine particulate. carbon dioxide, carbon monoxide, formaldehyde, total volatile organic compounds (TVOC), and radon gas were selected and measured for a certain period of time in specific sites where hospital workers stay long in a day. And we also evaluated the surrounding environment and the efficiency of the ventilating system simultaneously, and measured the same factors at the first floor (outdoor) to compare with outdoor air quality. All collected data were assessed by the recommended standard for IAQ of the domestic and international environmental organizations. RESULTS: Hospital workers were discontented with foul odors, humidity and particulate. They complained symptoms related to musculo-skeletal system, neurologic system, and mucosal-irritatation. Most of the factors were not greater than the recommended standard, but the level of TVOC was third or fourth times as much as the measuring level of some offices in the United States. The frequency and the amount of the ventilating system were adequate, however, the problem arising in the position of outdoor-air inlets and indoor-air outlets involved a risk of the indraft of contaminated air. A careful attention was a requirement in handling and keeping chemical substances including a developing solution which has a risk of TVOC emissions, and repositioning the ventilating system was needed to solve the contaminated-air circulation immediately. CONCLUSION: We verified that some IAQ-related factors and inadequate ventilating system could cause subjective symptoms in hospital workers. The evaluation of IAQ was surely needed to improve the underground working environments for hospital workers and patients. On the basis of these data, from now on, we should actively engage in designs of the department of radiation oncology or improvement in environments of the existing facilities.

The Effect of Pinitol on Cataractogenesis and Anti-oxidative effect in Streptozotocin Induced Diabetic Rats

PURPOSE: Pinitol, a natural extract of soybeans, is metabolized to chiroinositol in the body. We evaluated the ability of pinitol to protect diabetic cataracts from oxidative stress in streptozotocin (STZ)-induced diabetic rats. METHODS: We used Sprague-Dawley rats (n=80). Diabetes was induced with STZ (60 mg/kg, i.p.). These STZ-injected rats were administered pinitol or chiroinositol, each 20 mg/ml, and given access to regular chow. The efficacies of pinitol and chiroinositol were studied by monitoring a series of lens opacity and corneal lesion by photodocumentation. Aqueous humor and lens samples were collected at the 2nd week, 4th week, and 12th week. We measured glutathione, malondialdehyde (MDA) and used ELISA to evaluate its antioxidant effect. RESULTS: STZ-diabetic rats showed typical Y sutural lens opacity beginning on the 3rd day and progressed diffusely to more cortical opacity from the 1st week. However, in pinitol-treated diabetic rats, these cataractous changes were remarkably decreased. Corneal edema and opacity also remarkably reduced in the pinitol-treated group. Glutathione level markedly increased compared to that of the non-treated diabetic group (230.12+/-10.96 micrometer, 156.42+/-5.09 micrometer, respectively). This resulted in a decrease in peroxidized MDA product in the treated group. Similarly, the anti-cataractogenic and anti-oxidative effects of pinitol were also observed in the chiroinositol-treated group. CONCLUSIONS: These results suggest that pinitol could be effective in preventing cataract and cornea edema caused by oxidative stress in a hyperglycemic environment.

Clinical Analysis of the Early Result of Coronary Artery bypass Graft / 대한흉부외과학회지

BACKGROUND: Recently, coronary artery obstructive disease and coronary artery bypass graft surgery have increased, and the operative result has been improved. We reviewed 154 cases of coronary artery bypass graft surgery from Jan. 1985 to Jun. 2004. MATERIAL AND METHOD: We reviewed 148 patients, 154 cases of coronary artery bypass surgery from Jan. 1985 to Jun. 2004. This investigation is designed to illustrate the preoperative diagnosis, severity of disease, operative method, the kind of used bypass graft used, number of distal anasomosis, associated surgery, and postoperative morbidity and mortality. RESULT: There were 84 males, 64 females and the average age was 58.9+/-8.3 years old. Preoperative clinical diagnosis were unstable angina in 97 cases (63.0%), stable angina in 31 cases (20.1%), acute myocardial infarction in 12 cases (7.8%) and postinfartion angina in 14 cases (9.1%). Preoperative angiographic diagnosis were three-vessel disease in 68 (44.2%), two-vessel disease in 39 (25.3%), one-vessel disease in 35 (22.7%), and left main disease in 12 (7.8%) cases. There were 78 cases of on-pump coronary artery bypass graft surgery and 76 cases of off-pump coronary artery bypass graft surgery. The total distal anastomoses number was 319, mean number of anastomoses was 2.06+/-0.96. There were 10 concomitant procedures. Postoperative intra-aortic balloon pump was used in 21 (13.6%) cases, but only 4 cases were used at off-pump coronary artery bypass surgery. Total early mortality was 7.8%. The mortality was decreased as 4.5% from Jan. 2001 to Jun. 2004. Post operative complication was perioperative myocardial infarction in 9 cases (5.8%), low cardiac output syndrome in 17 cases (11%), and arrhythmia in 30 cases (19.5%) cases. CONCLUSION: Since 1985, The result of coronary artery bypass graft surgery has been improved because of more refined technique, use of off-pump coronary artery bypass surgery, use of internal thoracic artery and radial artery as bypass graft. We should study the long-term follow up more for better operative results.

Pulmonary Arteriovenous Fistula with Hemothorax: A case report / 대한흉부외과학회지

Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4x4x3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

Clinical Analysis of Bronchogenic Cyst / 대한흉부외과학회지

BACKGROUND: Bronchogenic cyst is a rare and benign disease. Because of its complication or associated disease, Bronchogenic cyst requires surgical treatment. Recently, with the development of diagnostic methods, its incidence has increased. So we reviewed our results from the past 30 years. MATERIAL AND METHOD: We reviewed 27 cases surgically treated from March 1971 to March 2003. This investigation is designed to illustrate the peak age incidence, sex ratio, symptoms, anatomic location, radiologic imagings, associated diseases, operative methods, postoperative pathologic findings and postoperative complications. RESULT: The peak age incidence laid in the 1st to 3rd decade and the ratio of male and female was 1:1.5. The most common complaints were cough and dyspnea, but some had hemoptysis. There were 22 cases (81%) of Intrapulmonary bronchogenic cysts and 5 cases(19%) of mediastinal bronchogenic cysts. Thirteen cases (48.1%) showed cystic lesion in simple chest X-ray. Ten cases showed cystic lesion among 13 cases that had taken computed tomography. We found associated disease in 15cases (56%). The inflammatory diseases from infection were many in intrapulmonary bronchogenic cysts and especially, one case showed carcinosarcoma. Mitral regurgitation and Bronchial obstruction could be seen in mediastinal bronchogenic cysts. The 13 cases (48%) were managed by lobectomy, and cystectomy, pneumonectomy, and segemental resection were done in 7 cases (26%), 4 cases (15%), 3 cases (11%) respectively. Cystic contents were mucus in 9 cases, pus in 9 cases, blood in 2 cases, and carcinosarcoma in 1 case. Bronchotracheal communications were in 13 cases (48%). Five cases showed Postoperative complications, which were pneumothorax, empyema, bleeding. Postoperative death could not be found. CONCLUSION: Almost all patients had clinical symptoms. Severe complications could be associated with bronchogenic cysts. Recently, With the development of diagnostic methods, preoperatively accurate diagnosis is possible; therefore, invasive study has decreased. Bronchogenic cyst is a benign disease. However, because of its clinical symptoms, complications, and possibility of malignant change, immediate surgical treatment is needed.