Occult Papillary Thyroid Carcinoma Presenting as a Huge Mediastinal Cystic Metastasis / 대한흉부외과학회지

The initial presentation of distant metastases in patients with papillary thyroid carcinoma is quite rare. Most distant metastases are solid nodular lesions. A 67-year-old man who complained of severe dyspnea underwent surgery due to a large mediastinal cystic mass compressing the trachea and great vessels. Pathologically, the cystic mass was a metastatic thyroid papillary carcinoma. The thyroid evaluations were compatible with a well differentiated thyroid carcinoma. An occult thyroid carcinoma presenting as a large mediastinal cystic lesion is extremely rare.

The Clinical Effects of Surgical Treatment for Hemoptysis due to Inflammatory Lung Disease / 대한흉부외과학회지

BACKGROUND: Many studies have demonstrated the various therapeutic options for treating hemoptysis caused by inflammatory lung disease. However, there is debate over the surgical management of the ongoing hemoptysis. Therefore, we evaluated the clinical results of pulmonary resection that was done due to hemoptysis in patients with concomitant inflammatory lung disease. MATERIAL AND METHOD: We performed a retrospective analysis of 75 patients who received pulmonary resection for hemoptysis and concomitant inflammatory lung disease between 2001 and 2007. The mean age was 52.1+/-12.5 years old, and the male; female ratio was 52:23. RESULT: The underlying disease was aspergilloma in 30 patients (40%), pulmonary tuberculosis in 20 patients, bronchiectasis in 18 patients and other causes in 7 patients. The surgical treatment included lobectomy in 55 patients, bilobectony in 2 patients, pneumonectomy in 17 patients and wedge resection in 1 patient. There were 3 early deaths, and the causes of death were pneumonia in 1 patient and BPF in 2 patients. The early mortality was statistically higher for such risk factors as a preoperative Hgb level <10 g/dL, COPD and an emergency operation. CONCLUSION: In conclusion, pulmonary resection for treating hemoptysis showed the acceptable range of mortality and it was an effective method for the management of hemoptysis in patients with inflammatory lung disease. However, relatively high rates of mortality and morbidity were noted for an emergency operation, and so meticulous care is needed in this situation.

Papillary Fibroelastoma of Pulmonary Valve with Congestive Heart Failure: A case report / 대한흉부외과학회지

Cardiac papillary fibroelastomas are the second most common primary tumor of the heart and they most commonly affect the left cardiac valves. However, occurrence of this tumor on the right side of the heart has been rarely reported, with only a few cases having been documented on the pulmonary valve. We present here a rare case of a papillary fibroelastoma that occurred on the pulmonary valve and this was successfully managed by replacing the pulmonary valve in a patient with congestive heart failure.

Intracardiac Varix in the Right Atrium: 2 case reports / 대한흉부외과학회지

Intracardiac varix is an endocardial, unilocular, blood-filled cyst that's lined by endothelial cells and it is filled with organizing thrombi. It has been reported that intracardiac varix is an extremely rare entity. We report here on two cases of intracardiac varix in the right atrium and these cases had been preoperatively misdiagnosed as myxoma.

The Early Results of Endovenous Radiofrequency Ablation Using the 7 Fr.VNUS ClosureFAST(R) System in Varicose Veins / 대한흉부외과학회지

BACKGROUND: Radiofrequency obliteration and endovenous laser therapy of the greater saphenous vein have recently been introduced as alternative, minimally invasive techniques for the treatment of saphenous vein incompetence. The 7 Fr. VNUS ClosureFAST(R) radiofrequency obliteration system was introduced in Gwang-Ju Veterans hospital. The purpose of this study is to evaluate the efficacy and complications of radiofrequency obliteration using the 7 Fr. VNUS ClosureFAST(R) system. MATERIAL AND METHOD: Between May 2, 2007 and May 31, 2008, we performed radiofrequency obliteration on 90 patients. The number of males was 67 and their mean age was 57.9+/-11.0 (range: 23~78) years old. The patients underwent follow up exams at 3 weeks after the procedures and then every 3 months. The effects of treatment and the complications were reviewed. RESULT: The postoperative complications were ecchymosis (94.4%), pain (27.8%), paresthesia (25.6%), bullous formation (8.9%), edema (6.7%) and phlebitis (2.2%). One patient showed good blood flow after 3 weeks and one patient showed good blood flow after 3 months. The one-year success rate of radiofrequency obliteration in varicose veins was 97.6%. CONCLUSION: Our data showed acceptable operative results and short-term clinical results for treating varicose veins with radio frequency obliteration. Long-term follow-up and comparison of radio frequency obliteration with high ligation and stripping, previous radiofrequency ablation and endovenous laser therapy are needed in the future.

Surgical Treatment for Isolated Aortic Endocarditis: a Comparison with Isolated Mitral Endocarditis / 대한흉부외과학회지

BACKGROUND: Infective endocarditis shows high surgical mortality and morbidity rates, especially for aortic endocarditis. This study attempts to investigate the clinical characteristics and operative results of isolated aortic endocarditis. MATERIAL AND METHOD: From July 1990 to May 2005, 25 patients with isolated aortic endocarditis (Group I, male : female=18 : 7, mean age 43.2+/-18.6 years) and 23 patients with isolated mitral endocarditis (Group II, male : female=10 : 13, mean age 43.2+/-17.1 years) underwent surgical treatment in our hospital. All the patients had native endocarditis and 7 patients showed a bicuspid aortic valve in Group I. Two patients had prosthetic valve endocarditis and one patientsdeveloped mitral endocarditis after a mitral valvuloplasty in Group II. Positive blood cultures were obtained from 11 (44.0%) patients in Group I, and 10 (43.3%) patients in Group II. The preoperative left ventricular ejection fraction for each group was 60.8+/-8.7% and 62.1+/-8.1% (p=0.945), respectively. There was moderate to severe aortic regurgitation in 18 patients and vegetations were detected in 17 patients in Group I. There was moderate to severe mitral regurgitation in 19 patients and vegetations were found in 18 patients in Group II. One patient had a ventricular septal defect and another patient underwent a Maze operation with microwaves due to atrial fibrillation. We performed echocardiography before discharge and each year during follow-up. The mean follow-up period was 37.2+/-23.5 (range 9~123) months. RESULT: Postoperative complications included three cases of low cardiac output in Group I and one case each of re-surgery because of bleeding and low cardiac output in Group II. One patient died from an intra-cranial hemorrhage on the first day after surgery in Group I, but there were no early deaths in Group II. The 1, 3-, and 5-year valve related event free rates were 92.0%, 88.0%, and 88.0% for Group I patients, and 91.3%, 76.0%, and 76.0% for Group II patients, respectively. The 1, 3-, and 5-year survival rates were 96.0%, 96.0%, and 96.0% for Group I patients, and 100%, 84.9%, and 84.9% for Group II patients, respectively. CONCLUSION: Acceptable surgical results and mid-term clinical results for aortic endocarditis were seen.