Clinical Analysis of Contralateral Bulla of Lung on HRCT in the Patients Having Video-Assisted Thoracoscopic Surgery for Unilateral Primary Spontaneous Pneumothorax / 대한흉부외과학회지

BACKGROUND: It is controversial whether the presence of bullae on the contralateral lung on HRCT plays a role in occurrence of contralateral primary spontaneous pneumothorax. We analyzed the significance of bullae on the contralateral lung and the risk factors associated with contralateral occurrence of primary spontaneous pneumothorax. MATERIAL AND METHOD: Three hundred ninety four patients who were undergone Video.Assisted Thoracoscopic Surgery for primary spontaneous pneumothorax between January 2004 and December 2009 were reviewed. The clinical features, HRCT and treatment of these patients were analyzed retrospectively. RESULT: Twenty eight of 394 patients had contralateral occurrence (7.10%). The average time was 13.06+/-9.79 months. A presence of contralateral bullae of lung on HRCT may not seem to be significant for occurrence of contralateral primary spontaneous pneumothorax (p=0.059). But bullae numbers were much more in contralateral pneumothorax patients (p=0.011). Younger than 20, being underweight (Body Mass Index<18.5 kg/m2) are independent risk factors for contralateral occurrence (odds ratio, 5.075 (1.679~5.339), 2.366 (1.048~5.339) respectively). CONCLUSION: The presence of bullae on the contralateral lung on HRCT was not significantly influenced the occurrence of contralateral primary spontaneous pneumothorax. However, age, body mass index, and the number of bullae were significant factors for the contralateral pneumothorax. We suggest that those high risk patients may require special attentions and general supportive care to prevent occurrence of contralateral primary spontaneous pneumothorax during the follow-up.

Endoscopic Radial Artery Harvest: Techniques & Results / 대한흉부외과학회지

BACKGROUND: The radial arteries are being used more often for coronary artery bypass grafting. We tried to the endoscopic radial artery harvest to reduce the cosmetic problems and neurologic complications of the conventional open harvesting and report the techniques and early results. MATERIAL AND METHOD: The 86 patients underwent coronary artery bypass grafting between May 2003 and April 2005 had their nondominant radial artery endoscopically removed through a 2 cm incision at the wrist. The radial pedicle was dissected and was divided at antecubial area through a 5 mm counterincision. RESULT: The 23 patients complained of neuralgias on territory of superficial raidal nerve but no one complained of neuralgias on territory of lateral antebrachial cutaneous nerve. There was no functional impairment of the hand. There was no wound complication except a localized hematoma. All patients were contacted by telephone after postoperative 7.9+/-3.6 months. The 4 patients still complained of neuralgia. All the patients were satisfied with the aesthetics of the wounds. The multidetectional tomography was done on the 66 patients for the estimation of early patency of radial artery. There were 2 cases of stenosis and a case of occlusion. CONCLUSION: Endoscopic radial artery harvest had no functional impairment of the hand, lesser rate of neurologic complications and outstanding aesthetics. The results of early patency of the radial artery was similar to conventional methods. Therefore, we think that endoscopic radial artery harvest is the optimal procedure.

Primary Malignant Melanoma of Lung : A case report / 대한흉부외과학회지

malignant melanoma of the lung is extremely rare. A 46-year-old lady was admitted with two month history of dry cough and blood-tinged sputum. Chest CT showed 4.5x5.0 cm sized mass at the right lower lobe. Repeated bronchoscopic and percutaneous biopsies showed no definite diagnosis. Preoperative evaluations revealed no systemic metastais. Primary So, we tried the surgical approach. Right lower lobectomy and lymph node dissection was done. The mass and lymph node were confirmed as primary malignant melanoma. The patient presented with right hemiparesis 40 days after operation. Brain MRI showed 1.5x2.0 cm sized mass lesion on the left parietal lobe. Mass excision was done. However, she expired 8 months later.

One-stage Repair of Interrupted Aortic Arch with Ventricular Septal Defect and Valvular Aortic Stenosis: A case report / 대한흉부외과학회지

A male neonate was referred to our hospital with facial cyanosis and tachypnea at 19 days of age. Two-dimensional echocardiography showed type B interrupted aortic arch, posterior malalignment ventricular septal defect and valvular aortic stenosis. A new surgical repair was done with biventricular repair and neo-aortic arch reconstruction. Left ventricular outflow track (LVOT) was consisted of aortic valve and pulmonic valve. Right ventricular outflow (RVOT) track was reconstructed with extracardiac conduit. Postoperative two-dimensional echocardiography showed no stenosis and turbulency flow on LVOT and RVOT.