Retrospective Study for Morbidity and Mortality after Major Lung Resection / 대한흉부외과학회지

BACKGROUND: A retrospectiye study was done for understanding morbidity and mortality after major lung resection. MATERIAL AND METHOD: From June 1994 to August 1998, 203 patients received major lung resections for various causes. There were 142 males and 62 females with a mean age of 47.5 years. Initial complains were cough in 47.8%, sputum in 33.0%, hemoptysis or blood-tinged sputum in 23.2%, dyspnea in 18.2%, chest pain in 15.3%, weight loss in 10.8%, fever and chill in 4.9%. There were no complaints in 5.9% of the total patients. The underlying diseases were lung tumor(102 cases/50.2%), bronchectasis(28 cases/13.8%), aspergillosis(24 cases/1.8%), tuberculosis(20 cases/9.9%) and others (29 cases/66.5%) and pneumonectomy(68 cases/33.5%). The postoperative complications were classified as : empyema, BPF, respiratory problem, persistent air leakage over 7 days, arrhythmia, ventilator applied over 24 hours, bleeding, wound infection and chylothorax. The postlobectomy complications were revealed as follow: empyema(3.7%), BPF(2.2%), respiratory problem(5.2%), persistent air leakage over 7days(8.9%), arrhythmia(2.2%), ventilator applied over 24 hours(2.2%), bleeding(1.5%), wound infection(2.9%), chylothorax(0.7%). The postpneumonectomy complications were revealed as follow : empyema(5.9%), BPF (5.9%), respiratory problem(17.6%), persistent air leakage over 7days(0%), arrhythmia(5.4%), ventialtor apply over 24 hours(7.4%), bleeding (7.4%), wound infection(2.9%) and chylothorax(1.5%). Reoperation was done in 8 cases (4.0%). There were 5.8% operative mortalities in pneumonectomy and 0.7% in lobectomy.

Angiogenic Responce to Transmyocardial Mechanical Reveascularization ( TMMR ) with Polymer Myocardial Stent / 대한흉부외과학회지

BACKGROUND: Transmyocardial laser revascularization(TMLR) for revascularizing ischemic myocardium in patients was originally based on the assumption that laser channels remain their patency much longer. But recent studies show that laser channels did not remain open and that TMLR could achieve treatment benefits without long-term channel patency. The angiongencesis is currently thought to be induced by non-specific inflammatory response to mechanical tissue injury. This study is to evaluate hypothesis that various transmyocaridal mechanical revascularization(TMMR) may induce the angiogenic responses similar to that seen with TMLR, and transmyocaridal polymer stent revascularization(TMSR), the polymer stent in the myocardial tissue is hydrolyzed in 2 weeks, may enhance the non-specific inflammatory reaction resulting angiogenesis. Furthermore, polymer myocaridal stent channels remain long-term patency. MATERIAL AND METHOD: Eight domestic pigs underwent ligation of the proximal circumflex artery, and 2 weeks later they were randomized to undergo transmycardial acupunctural revascularization (TMPR, Group I) of the left lateral wall with 18-G needle(n=2), to undergo transmyocardial (TMDR, Group II) with industrial 2mm steel drill(n=2), to undergo transmyocardial polymer stent revascularization (TMSR, Group III) after drilling the infarcted myocardium(n=2), the stent is poly(lactic acid-co-glycolic acid), which is self-degradated in the myocardium, and to a control group the ischemic zone was unterated(n=2). All the pigs were sacrificed after 4 weeks TMMR. Sections from the ischemic zone were submitted for vascular endothelial growth factor (VEGF) ELISA and histology. RESULT: There were makedly increase in the VEGF immunoassay in the ischemic zone of the TMMR group compared to the ischemic zone of the control group(control: each 30.85 and 43.15pg/mg protein, TMPR: each 44.14 and 68.61 pg/mg protein, TMDR: each 65.92 and 78.65 pg/mg protein, TMSR: each 177.39 and 168.87 pg/mg protein). TMSR channels caused greatest VEGF expression than channels made by other group and the polymer stent channels remained vacuole after 4 weeks. CONCLUSIONS: Transmyocardial polymer stent revascularization promoted the most angiogenci response by the VEGF immunoassay, although our study did not show the statistical significancy. The channels remained but the flow patency was not verified. Transmyocardial polymer stent revascularization (TMSR) is desirable in future experimental trials and in view of the significant cost implications comparable to that of laser.

An Immunohistological and Immunogold Study on the Fibronectin Reacions in Rat Lung Differentiation / 대한흉부외과학회지

BACKGROUND: Fibronectins(FN) are large, dimeric glycoproteins present in the plasma, loose connective tissues, and some basal lamina in vivo and synthesized by a number of cells in vitro, including lung fibroblasts, and alveolar macrophages. FN can affect the migration, proliferation, differention, and even apoptosis of various cell types, all considered necessary for organogenesis. This study was undertaken to detect the changes of localization and activity of FN, a glycoprotein molecule, in stages of lung differentiation in rats. MATERIAL AND METHOD: The experimental animals(Sprague-Dawley strain) were divided into 8 groups, a control group(adult male rats), and experimental groups of 17th day fetus, 20th day fetus, first day newborn, second day newborn, 3rd day newborn, 5th day new born, 7th day newborn. We used the immunohistological stain method with gold particle to obtain the data for distribution of FN in the alveoli, blood vessels, terminal bronchioles, alveolar macrophages and type II pneumocytes. This study revealed the FN reactions at the light and electron microscopic levels. RESULT: At 17th day fetal stage, FN reactions in fetal lung were strong on the blood vessels and moderate on the stroma. At 20th day fetal stage, FN reactions were strong on the blood vessels. After birth, FN reactions in alveolar basement membrane were maximum in the 5th and 7th day newborns. FN reactions in the blood vessels were observed to be moderate in first and second day newborns, but decreased in third day newborns. FN reactions in alveolar macrophages increased after birth. FN reactions in terminal bronchioles gradually increased after birth. 6. In type II pneumocytes, FN reactions were observed to be moderate in 1st and 3rd day newborns. CONCLUSION: Immunohistochemical analysis of rat lungs at various developmental stages revealed increased deposition of FN during the pseudoglandular stage of lung development, coinciding with the period of branching morphogenesis. Also, FN is released from type II pneumocytes. This observation, together with the strategic location of FN, suggests a role in airway formation.

Primary Malignant Pericardial Mesothelioma (PMPM): A case Report / 대한흉부외과학회지

Primary malignant pericardial mesothelioma(PMPM) is more rare than heart tumor, and the term of mcsothelioma was first used by Adami in 1910, although the lesion was Hrst descripted by Wagner in 1870. Most of 1:le reported 40 cascs have becn diagnosed on autopsy. Antemortem diagnosis are rarely reported with only 40 cases in the world. According to Cohen, its incidence in 500,000 autopsies were 2.2. An analysis of the recent review shows that an antemortem diagnosis was made in only 19~25% of total cases. This report co sist of a case of our experience of PMPM.

Cor triatriatum-a calssic type and a type combined with atrial septal defect: Report of Two cases / 대한흉부외과학회지

No abstract available.