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1.
The Korean Journal of Internal Medicine ; : 603-612, 2014.
Artigo em Inglês | WPRIM | ID: wpr-108341

RESUMO

BACKGROUND/AIMS: The clinical outcomes of some patients with pleural infection may be favorable with medical treatment alone, but in others, the disease progresses and requires additional surgical treatment. However, little is known about the factors affecting this difference. The aim of this study was to investigate the factors predictive of failure of medical treatment in patients with pleural infection. METHODS: A cohort of 127 consecutive patients who were admitted to the hospital with pleural infection was studied. Clinical manifestations and laboratory findings in patients in whom medical treatment succeeded or failed were reviewed. RESULTS: In univariate analysis, the significant factors associated with medical treatment outcome were age, smoking history, duration of chief complaint, serum albumin level, and pleural fluid glucose and lactate dehydrogenase levels (p < 0.05). Multivariate logistic regression analysis identified age and duration of chief complaint as independent predictive factors for failure of medical treatment, with odds ratios of 0.871 (p = 0.013) and 0.797 (p = 0.026), respectively. Receiver operating characteristic curve analysis determined cutoff values of 50.5 years for age and 4.5 days for duration of chief complaint. CONCLUSIONS: We demonstrated that a younger age < 50.5 years and shorter duration of chief complaint < 4.5 days were independent predictive factors for the failure of medical treatment in patients with pleural infection. This suggests their role as evaluative criteria in setting indications for the optimal treatment in patients with pleural infection. A larger, prospective study is required to confirm these findings.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Antibacterianos/uso terapêutico , Estudos de Coortes , Drenagem , Empiema Pleural/metabolismo , Glucose/metabolismo , L-Lactato Desidrogenase/metabolismo , Derrame Pleural/metabolismo , Albumina Sérica/metabolismo , Cirurgia Torácica Vídeoassistida , Falha de Tratamento
2.
Korean Journal of Pathology ; : 207-210, 2010.
Artigo em Inglês | WPRIM | ID: wpr-169484

RESUMO

We report here on a case of a rare, complex bronchopulmonary foregut malformation (BPFM) that was composed of an extralobar pulmonary sequestration communicating with an esophageal duplication cyst. A 33-year-old female presented with an incidentally detected chest mass. The computed tomography revealed a 7.5 x 4.0 cm sized heterogeneous, solid and cystic lesion in the right superior mediastinum. Surgical resection demonstrated the solid portion to be isolated lung tissue invested in its own pleura. A unilocular cyst was communicating with the bronchus of the sequestrated lung, and microscopically the cyst was lined by squamous epithelium overlying the thick layers of smooth muscle. This case is important for understanding the spectrum of BPFMs and for differentiating a mediastinal mass, especially one at the unusual location.


Assuntos
Adulto , Feminino , Humanos , Brônquios , Sequestro Broncopulmonar , Epitélio , Cisto Esofágico , Pulmão , Mediastino , Músculo Liso , Pleura , Tórax
3.
Journal of Korean Medical Science ; : 658-662, 2010.
Artigo em Inglês | WPRIM | ID: wpr-77816

RESUMO

Bronchiolitis obliterans (BO) or bronchiolitis obliterans organizing pneumonia (BOOP) is one of manifestations of graft-versus-host disease (GVHD), a complication of hematopoietic stem cell transplantation (HSCT). Recently there are reports about thoracic air-leakage syndrome (TALS), but real incidence, clinical course, and implications of TALS remain unclear. Retrospective review of 18 TALS patients among 2,177 patients who received allogeneic HSCT between January 2000 to July 2007 was done. Clinical manifestations, treatments, and outcomes of TALS were reviewed. The incidence of TALS was 0.83% (18/2,177). The onset of TALS was mean 425.9+/-417.8 days (60-1,825 days) after HSCT, and the duration was mean 16.3+/-21 days (2-90 days). The most common types of TALS were spontaneous pneumothroax (n=14), followed by subcutaneous emphysema (n=6), pneumomediastinum (n=5), interstitial emphysema (n=2), and pneumopericardium (n=1). TALS persisted in six patients, who died during the same hospitalization. The 12 patients recovered from TALS, but only 2 survived, while others died due to aggravation of GVHD. TALS may complicate BO/BOOP and be an initial manifestation of BO/BOOP. TALS is hard to be resolved, and even after the recovery, patients die because of aggravation of GVHD. We suggest specifically in HSCT patients, when once developed, TALS seems hard to be cured, and as a result, be related to high fatality.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Comorbidade , Doença Enxerto-Hospedeiro/mortalidade , Transplante de Células-Tronco Hematopoéticas/mortalidade , Hemotórax/mortalidade , Incidência , Coreia (Geográfico) , Pneumotórax/mortalidade , Prognóstico , Medição de Risco , Fatores de Risco , Análise de Sobrevida , Taxa de Sobrevida , Síndrome , Resultado do Tratamento
4.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 350-354, 2009.
Artigo em Coreano | WPRIM | ID: wpr-103139

RESUMO

BACKGROUND: Complicated pleural space occupying lesions (SOL) have been treated by thoracentesis, closed thoracotomy drainage (CTD) or surgical intervention with using a video thoracosocpe or open thoracotomy depending on the extent of the disease. With the development of video assisted thoracoscopic surgery (VATS), VATS pleural adhesiolysis and decortication have revealed good results as compared to those for open thorcotomy. To assess the effectiveness of VATS pleural adhesiolysis and decortication, we retrospectively analyzed the medical record and radiologic findings of the patients with complicated pleural SOL and who were treated by this surgery. MATERIAL AND METHOD: From May 1996 to April 2006, 64 patients (mean age: 41.8 years) with complicated pleural SOL underwent 65 VATS. To analyze the surgical outcome, we classified the postoperative findings on the simple chest X-rays into 4 classes as Class I: no or minimal pleural lesion, Class II: blunting of the cardiophrenic angle and mild pleural thickening, Class III: an elevated diaphgram or persistent lung collapse and Class IV: complicated or recurrent effusion. RESULT: Before VATS, the patients underwent the diagnostic or therapeutic procedures: single or repeat diagnostic tapping for 41, thoracoscotomy drainage for 11, pigtail catheter drainage for 10 and intrapleural fibrinolytics for 10. The mean duration between the onset of symptom and surgery was 18.4 days. There was neither mortality nor severe complications. The surgical outcomes were class 1 for 28, class 2 for 13, class 3 for 19 and class 4 for 5. There were statistically significant differences between the symptom duration and the classes, and between the operation time and the classes. CONCLUSION: VATS pleural adhesiolysis and decortication are effective, safe treatments for managing complicated pleural SOL, and an earlier operation is needed for obtaining a better surgical outcome.


Assuntos
Humanos , Catéteres , Drenagem , Prontuários Médicos , Derrame Pleural , Polimetil Metacrilato , Atelectasia Pulmonar , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida , Toracotomia , Tórax
5.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 388-391, 2009.
Artigo em Coreano | WPRIM | ID: wpr-103130

RESUMO

Well-differentiated fetal adenocarcinoma (WDFA) of the lung is a rare lung tumor that's composed of glycogen rich neoplastic glands and tubules that resemble the fetal lung at 10 to 15 weeks of gestation. Although WDFA is classified as a subtype of pulmonary blastoma or pulmonary adenocarcinoma, its prognosis is better than conventional pulmonary blastoma (biphasic blastoma) or pulmonary adenocarcinoma. It is important to identify this low grade malignancy tumor in younger patients because it is associated with low mortality. We report here on 3 cases of WDFA and the patients are all currently alive without tumor recurrence


Assuntos
Humanos , Gravidez , Adenocarcinoma , Feto , Glicogênio , Pulmão , Neoplasias Pulmonares , Prognóstico , Blastoma Pulmonar
6.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 72-78, 2009.
Artigo em Coreano | WPRIM | ID: wpr-85634

RESUMO

BACKGROUND: Mediastinal neurogenic tumors are generally benign lesions and they are ideal candidates for performing resection via video-assisted thoracoscopic surgery (VATS). However, benign neurogenic tumors at the thoracic apex present technical problems for the surgeon because of the limited exposure of the neurovascular structures, and the optimal way to surgically access these tumors is still a matter of debate. This study aims to clarify the feasibility and safety of the VATS approach for performing surgical resection of benign apical neurogenic tumors (ANT). MATERIAL AND METHOD: From January 1996 to September 2008, 31 patients with benign ANT (15 males/16 females, mean age: 45 years, range: 8~73), were operated on by various surgical methods: 14 VATS, 10 lateral thoracotomies, 6 cervical or cervicothoracic incisions and 1 median sternotomy. 3 patients had associated von Recklinhausen's disease. The perioperative variables and complications were retrospectively reviewed according to the surgical approaches, and the surgical results of VATS were compared with those of the other invasive surgeries. RESULT: In the VATS group, the histologic diagnosis was schwannoma in 9 cases, neurofibroma in 4 cases and ganglioneuroma in 1 case, and the median tumor size was 4.3 cm (range: 1.2~7.0 cm). The operation time, amount of chest tube drainage and the postoperative stay in the VATS group were significantly less than that in the other invasive surgical group (p<0.05). No conversion thoracotomy was required. There were 2 cases of Hornor's syndrome and 2 brachial plexus neuropathies in the VATS group; there was 1 case of Honor's syndrome, 1 brachial plexus neuropathy, 1 vocal cord palsy and 2 non-neurologic complications in the invasive surgical group, and all the complications developed postoperatively. The operative method was an independent predictor for postoperative neuropathies in the VATS group (that is, non-enucleation of the tumor) (p=0.029). CONCLUSION: The VATS approach for treating benign ANT is a less invasive, safe and feasible method. Enucleation of the tumor during the VATS procedure may be an important technique to decrease the postoperative neurological complications.


Assuntos
Feminino , Humanos , Formigas , Neuropatias do Plexo Braquial , Tubos Torácicos , Drenagem , Ganglioneuroma , Mediastino , Neurilemoma , Neurofibroma , Estudos Retrospectivos , Esternotomia , Cirurgia Torácica Vídeoassistida , Toracoscopia , Toracotomia , Paralisia das Pregas Vocais
7.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 523-526, 2008.
Artigo em Coreano | WPRIM | ID: wpr-173074

RESUMO

Minimally invasive repair of pectus excavatum using a metal bar, as advocated by Nuss, has been broadly accepted recently for its aesthetic aspect. There are many types of pectus excavatum, and various treatment methods, as well. Pectus excavatum may be accompanied by other congenital anomalies, so many modified repair methods have been developed and performed. We report a case of a 33-year-old woman with pectus excavatum and breast hypoplasia, which were simultaneously corrected with Nuss procedure using a substernal steel bar and mammoplasty.


Assuntos
Adulto , Feminino , Humanos , Mama , Implantes de Mama , Tórax em Funil , Mamoplastia , Aço , Parede Torácica
8.
Korean Journal of Pathology ; : 1-8, 2008.
Artigo em Coreano | WPRIM | ID: wpr-94450

RESUMO

BACKGROUND: Gefitinib is an EGFR tyrosine kinase inhibitor that has shown dramatic effectiveness in a subset of non-small cell lung cancer (NSCLC) patients. We evaluated the response rate to gefitinib, and the significance of the EGFR and HER2/neu status as predictive markers of the tumor response. METHODS: The EGFR and HER2/neu protein expressions, as determined by immunohistochemistry (IHC) and gene amplification via chromogenic in situ hybridization (CISH), were analyzed in biopsy specimens from 46 patients with advanced NSCLC. After their failure with the first-line treatment, all the patients had received gefitinib treatment. RESULTS: A partial response (PR) was achieved in 8 patients (17.4%). An EGFR overexpression was detected in 80.4% (37/46) of the tumors, and this was observed exclusively in patients with a PR (100% vs 75.3%, respectively; p=0.076). EGFR gene amplification was present in 47.8% of the tumors (22/46). HER2/neu was overexpressed in 13%(6/46) and it was amplified in 17% (7/46). The overall survival was prolonged in the female patients (p=0.007), and in patients with T1 and T2 disease (p=0.039), adenocarcinoma (p=0.010), a PR (p=0.022), an EGFR IHC+ status (p=0.033), an EGFR IHC+/CISH+ status (p=0.010), or an EGFR+/HER2/neu+ status (p=0.030). On multivariate analysis, gender, T disease and EGFR IHC/CISH remained the significant predictors of survival. CONCLUSIONS: Gefitinib showed a modest effect for the patients with chemotherapy-refractory advanced NSCLC. A combination of EGFR IHC and CISH might be important for identifying those patients who are most likely to benefit from gefitinib therapy.


Assuntos
Feminino , Humanos , Adenocarcinoma , Biópsia , Neoplasias Pulmonares
9.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 447-456, 2008.
Artigo em Coreano | WPRIM | ID: wpr-89147

RESUMO

BACKGROUND: Caspase-3 is a cysteine protease that plays a major role in the process of apoptotic cell death. The dysregulated expression of c-myc contributes to the tumorigenesis in a variety of human cancers. The aim of this study was to investigate the expressions of caspase-3 and c-myc and their significances as prognosis markers in patients with completely resected non-small cell lung cancer (NSCLC). MATERIAL AND METHOD: A total 130 consecutive patients who had undergone complete resection without pre-operative radio-therapy or chemotherapy between May 1996 and December 2003 for NSCLC were retrospectively reviewed. The median follow-up period of the patients was 50 months (range: 3~128 months). The expressions of caspase-3 and c-myc were immunohistochemically examined, and these were correlated with the clinico-pathologic data. RESULT: The prevalence of caspase-3 and c-myc expressions in the patients was 68% (88/130) and 59% (77/130), respectively. Significant association was found between the frequency of the expressions of caspase-3 and c-myc (p=0.025). The caspase-3 and c-myc expressions were not significantly associated with the prognosis in all the patients. However, according to stages, a positive caspase-3 expression was significantly correlated with a favorable prognosis for patients with stage IIIa disease (median survival period: 35 months vs. 10 months, p=0.021). Multivariate analysis showed the pathologic stage to be significantly correlated with a good prognosis in all the patients (p=0.024), and with a positive caspase-3 expression, well differentiated tumor and negative neuronal invasion in the patients with stage IIIa disease (p=0.005, p=0.003, p=0.004, respectively). CONCLUSION: Caspase-3 and c-myc were frequently expressed in NSCLC, suggesting its possible involvement in tumor development. The caspase-3 expression, as determined with performing immunohistochemical staining, may be a favorable prognostic indicator in patients with completely resected NSCLC of an advanced stage (IIIa).


Assuntos
Humanos , Carcinoma Pulmonar de Células não Pequenas , Caspase 3 , Morte Celular , Transformação Celular Neoplásica , Cisteína Proteases , Seguimentos , Análise Multivariada , Neurônios , Prevalência , Prognóstico , Estudos Retrospectivos
10.
The Korean Journal of Gastroenterology ; : 42-47, 2008.
Artigo em Coreano | WPRIM | ID: wpr-37069

RESUMO

Carcinosarcoma of the esophagus is a rare malignancy accounting for approximately 1-2% of all esophageal neoplasms. It presents as a bulky intraluminal polypoid lesion mainly in the mid to lower esophagus, which harbors both carcinomatous and sarcomatous components histologically. It often presents relatively early because of its rapid intraluminal growth. We report the case of a 69-year-old man who had suffered from dysphagia for 1 month. He was previously admitted to the hospital due to corrosive esophagitis caused by ingestion of acetic acid. Endoscopy and radiological studies revealed a bulky polypoid mass with superficial ulcerations and mucosal friability, measuring 10 cm in length approximately, in the mid-esophagus. Subtotal esophagectomy with esophagogastrostomy was done. Microscopically it was composed of sarcomatous component intermingled with squamous cell carcinoma. Immunohistochemical stains reveal cytokeratin, 34betaE12, and p63 positivity in the nests of carcinoma, and desmin and vimentin positivity in the spindle cells of sarcomatous stoma.


Assuntos
Idoso , Humanos , Masculino , Carcinossarcoma/diagnóstico , Neoplasias Esofágicas/diagnóstico , Esofagectomia , Esofagite/induzido quimicamente , Tomografia Computadorizada por Raios X , Biomarcadores Tumorais/imunologia
11.
Journal of Korean Medical Science ; : 373-376, 2007.
Artigo em Inglês | WPRIM | ID: wpr-111547

RESUMO

We report a surgical case of primary polymorphous low-grade adenocarcinoma (PLGA) of the minor salivary gland-type of the lung. A PLGA originating from the right upper lobar bronchial inlet was successfully treated by sleeve right upper lobectomy. PLGAs are thought to be indolent tumors that are preferentially localized to the palate, and they affect the minor salivary glands almost exclusively. Until now, two cases of distant metastases to the lung have been reported in the English literature. To the best of our knowledge, only one case of PLGA of minor salivary glandtype of the lung without evidence of a previous oropharyngeal primary tumor has been reported in the English literature. But the case was not a single lesion; it was bilateral tumors accompanied by tumors of the cervical lymph nodes. We report here the first case of a single primary PLGA of the minor salivary gland-type of the lung, which was successfully treated by sleeve bronchial resection of right upper lobe.


Assuntos
Humanos , Feminino , Idoso , Resultado do Tratamento , Neoplasias das Glândulas Salivares/patologia , Neoplasias Pulmonares/patologia , Brônquios/cirurgia , Adenocarcinoma/patologia
12.
Journal of Korean Medical Science ; : 318-325, 2007.
Artigo em Inglês | WPRIM | ID: wpr-148946

RESUMO

Non-small cell lung cancers (NSCLC) vary in their biologic behavior. Recurrence and tumor-related mortality may be attributable to molecular abnormalities in primary tumors. This study evaluated such immunophenotypes with regard to cell cycle regulation and proliferation, apoptosis, and angiogenesis, to determine their significance for patient outcome. Core biopsies from 219 patients with NSCLC were assembled on tissue microarrays, and the expressions of p16, p21, p27, cyclin B1, cyclin E, Ki-67, caspase-3, survivin, bcl-2, VEGF, and endostatin were evaluated by immunohistochemistry. Despite previously described prognostic relevance of some of the investigated molecules, many of those markers were not directly associated with recurrence or survival. However, there was a trend for p16 immunoreactivity to be associated with a good prognosis (57% vs. 42% in 5-yr survival) (p=0.071). bcl-2 expression was strongly correlated with a better outcome (65% vs. 45% in 5-yr survival) (p=0.029), and the hazard of death for bcl-2 positive patients was 0.42 times of that for bcl-2 negative patients (p=0.047). A multivariate analysis with Cox proportional hazards model confirmed that the lymph node status (p=0.043) and stage (p=0.003) were other independent prognostic factors. Our results suggest that p16 and bcl-2 provide prognostic information independent of the TNM stage in NSCLC.


Assuntos
Masculino , Humanos , Feminino , Idoso , Biomarcadores Tumorais/análise , Taxa de Sobrevida , Análise de Sobrevida , Estatística , Sensibilidade e Especificidade , Reprodutibilidade dos Testes , Prognóstico , Avaliação de Resultados em Cuidados de Saúde/métodos , Proteínas de Neoplasias/análise , Neoplasias Pulmonares/diagnóstico , Coreia (Geográfico)/epidemiologia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico
13.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 313-316, 2007.
Artigo em Coreano | WPRIM | ID: wpr-182509

RESUMO

Negative pressure pulmonary edema (NPPE) during anesthetic recovery is a rare, but potentially serious complication for patients who are undergoing different surgical procedures. The proposed mechanism is the generation of high negative pressure during markedly respiratory effort and upper airway obstruction from glottis closure and laryngospasm, and this all leads to pulmonary edema. We report here on a case of a healthy 26-year-old male who immediately developed NPPE and hemoptysis following extubation after partial rib resection due to benign rib tumor; the patient was treated conservatively. We also include a review of the review literatures.


Assuntos
Adulto , Humanos , Masculino , Obstrução das Vias Respiratórias , Glote , Hemoptise , Laringismo , Cuidados Pós-Operatórios , Edema Pulmonar , Costelas
14.
Tuberculosis and Respiratory Diseases ; : 217-222, 2007.
Artigo em Coreano | WPRIM | ID: wpr-194829

RESUMO

Talc pleurodesis is a safe and effective treatment for a recurrent malignant pleural effusion. However, acute hypoxemia, pulmonary edema or acute respiratory failure can develop in a small number of patients. We report 2 patients who developed fatal hypoxemia after talc pleurodesis which was necessary the control recurrent pleural effusion. The first case was an 18-year old male diagnosed with Ewing's sarcoma with bilateral lung metastases and pleural effusion. The performance status was ECOG (Eastern Cooperative Foncology Group) grade 3. Fever along with hypoxemia and leukocytosis developed 10 hours after the second talc pleurodesis on the right side for an uncontrolled pleural effusion, The patient died from respiratory failure after 13 days. The second case was a 66-year old female diagnosed with non-small cell lung cancer with a bone metastasis. Two weeks after systemic chemotherapy, she complained of dyspnea, and a pleural effusion was observed on the right side. Her performance status was ECOG grade 3. Talc pleurodesis was performed for recurrent pleural effusion, but hypoxemia developed 6 days after pleurodesis and she died from respiratory failure 10 days after pleurodesis. In conclusion, talc pleurodesis should be performed very carefully in patients with a poor performance status, in cases with repeated pleurodesis, bilateral pleural effusion, recent chemotherapy, radiotherapy and when there are parenchymal metastatic lesions present.


Assuntos
Adolescente , Idoso , Feminino , Humanos , Masculino , Hipóxia , Carcinoma Pulmonar de Células não Pequenas , Tratamento Farmacológico , Dispneia , Febre , Leucocitose , Pulmão , Metástase Neoplásica , Derrame Pleural , Derrame Pleural Maligno , Pleurodese , Edema Pulmonar , Radioterapia , Insuficiência Respiratória , Sarcoma de Ewing , Talco
15.
The Journal of the Korean Society for Therapeutic Radiology and Oncology ; : 230-236, 2006.
Artigo em Coreano | WPRIM | ID: wpr-40232

RESUMO

PURPOSE: To analyze the response, toxicity, patterns of failure and survival rate of patients with locally advanced non-small cell lung cancer who were treated with concurrent chemoradiotherapy with weekly paclitaxel. MATERIALS AND METHODS: Twenty-three patients with locally advanced non-small cell lung cancer patients who received radical chemoradiotherapy from October 1999 to September 2004 were included in this retrospective study. Patients received total 55.4~64.8 (median 64.8) Gy (daily 1.8 Gy per fraction, 5 days per weeks) over 7~8 weeks. 50 or 60 mg/m2 of paclitaxel was administered on day 1, 8, 15, 22, 29 and 36 of radiotherapy. Four weeks after the concurrent chemoradiotherapy, three cycles of consolidation chemotherapy consisted of paclitaxel 135 mg/m2 and cisplatin 75 mg/m2 was administered every 3 weeks. RESULTS: Of the 23 patients, 3 patients refused to receive the treatment during the concurrent chemoradiotherapy. One patient died of bacterial pneumonia during the concurrent chemoradiotherapy. Grade 2 radiation esophagitis was observed in 4 patients (17%). Sixteen patients received consolidation chemotherapy. During the consolidation chemotherapy, 8 patients (50%) experienced grade 3 or 4 neutropenia and one of those patients died of neutropenic sepsis. Overall response rate for 20 evaluable patients was 90% including 4 complete responses (20%) and 14 partial responses (70%). Among 18 responders, 9 had local failure, 3 had local and distant failure and 2 had distant failure only. Median progression-free survival time was 9.5 months and 2-year progression-free survival rate was 19%. Eleven patients received second-line or third-line chemotherapy after the treatment failure. The median overall survival time was 21 months. 2-year and 5-year survival rate were 43% and 33%, respectively. Age, performance status, tumor size were significant prognostic factors for progression-free survival. CONCLUSION: Concurrent chemoradiotherapy with weekly paclitaxel revealed high response rate and low toxicity rate. But local failure occurred frequently after the remission and large tumor size was a poor prognostic factor. Further investigations are needed to improve the local control.


Assuntos
Humanos , Carcinoma Pulmonar de Células não Pequenas , Quimiorradioterapia , Cisplatino , Quimioterapia de Consolidação , Intervalo Livre de Doença , Tratamento Farmacológico , Esofagite , Neutropenia , Paclitaxel , Pneumonia Bacteriana , Radioterapia , Estudos Retrospectivos , Sepse , Taxa de Sobrevida , Falha de Tratamento , Resultado do Tratamento
16.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 171-175, 2006.
Artigo em Coreano | WPRIM | ID: wpr-150252

RESUMO

Minimally invasive thoracic surgery has been one of the most important surgical advances recently. Congenital cystic adenomatoid malformation of the lung is a relatively rare anomaly and is clearly associated with various congenital anomalies such as pectus excavatum, cardiac and pulmonary vascular lesions. We have experienced a case that was treated with minimal invasive methods for congenital cystic adenomatoid malformation involving in the right lower lobe and pectus excavatum in a 5-year-old boy. We simultaneously performed thoracoscopic right lower lobectomy and Nuss procedure of pectus excavatum using a substernal steel bar. Therefore, a minimally invasive surgical treatment for this diseases is feasible and cosmetically excellent.


Assuntos
Pré-Escolar , Humanos , Masculino , Malformação Adenomatoide Cística Congênita do Pulmão , Tórax em Funil , Pulmão , Aço , Procedimentos Cirúrgicos Minimamente Invasivos , Cirurgia Torácica , Toracoscopia
17.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 387-393, 2006.
Artigo em Coreano | WPRIM | ID: wpr-69469

RESUMO

BACKGROUND: Esophageal perforation is an uncommon problem, but it is associated with high mortality. We performed a retrospective review of patients with instrumental esophageal perforation to assess the outcome of current management techniques. MATERIAL AND METHOD: We retrospectively analyzed all cases of instrumental esophageal perforation diagnosed at our hospital from January 1999 through to March 2005. The study group consisted of 12 patients (8 women and 4 men) with a mean age of 48.8 years (range, 21~83 years). We reviewed the effects of the surgical or medical treatments in various conditions of patients, such as of various sites of perforation and time delayed after injury. RESULT: Perforations were due to diagnostic endoscopy (50.0%, 6/12), esophageal bougination for benign stricture (33.3%, 4/12), endoscopic port insertion (8.3%, 1/12), and tracheal intubation (8.3%, 1/12). The perforated sites were thoracic in 7 patients and cervical in 5. The treatment included resection and reconstruction (5 cases), incision and drainage (4 cases), medical treatment (2 cases), and closed thoracostomy drainage only (1 case). Post-operative complications of transient pneumonia and wound infection were developed in 1 patient respectively. Both occurred in two patients with diffuse mediastinal abscess formation. The overall mortality was 8.3% (1/12) in one old patient who was managed medically for cervical esophageal perforation. CONCLUSION: We concluded that surgical treatment for esophageal perforations was safe and effective whether diagnosed early or lately.


Assuntos
Feminino , Humanos , Abscesso , Constrição Patológica , Drenagem , Endoscopia , Perfuração Esofágica , Intubação , Mortalidade , Pneumonia , Estudos Retrospectivos , Toracostomia , Infecção dos Ferimentos
18.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 80-84, 2006.
Artigo em Coreano | WPRIM | ID: wpr-44124

RESUMO

A combined anterolateral and posterior approach with thoracotomy has been recommended as the traditional surgical approach for the tumors of the thoracic spine. Recently, because of the morbidity associated with open thoracotomy, the thoracoscopically assisted surgical technique was introduced successfully in thoracic spinal surgery. Herein, we report a combined surgical technique for giant cell tumor of the thoracic spine (T10) consisting of bilateral thoracoscopic anterior release of the spine followed by a posterior en bloc spondylectomy and reconstruction by orthopedic surgeons. The thoracoscopic spinal surgery is safe and effective alternative for other open thoracotomic procedures in the approach to the anterior thoracic spine, avoiding the disadvantage inherent to thoracotomy.


Assuntos
Tumores de Células Gigantes , Ortopedia , Coluna Vertebral , Toracoscopia , Toracotomia
19.
Cancer Research and Treatment ; : 339-343, 2005.
Artigo em Inglês | WPRIM | ID: wpr-146448

RESUMO

PURPOSE: When used in the second-line setting, single- agent chemotherapy has produced response rates of more than 10% or median survival times greater than 4 months. We studied the safety and efficacy of using second-line single docetaxel (75 mg/m2) for advanced NSCLC patients who were previously treated with platinum-based chemotherapy in Korea. MATERIALS AND METHODS: Thirty-three patients with advanced NSCLC received chemotherapy from May 2002 to January 2005. We retrospectively reviewed the charts of these patients. The patients received 75 mg/m2 of doxetaxel on day 1 and this was repeated at 3-week intervals. RESULTS: The median age was 63 years (range: 42~77 years); 16 patients had adenocarcinoma and 8 patients had squamous cell carcinoma. The median number of cycles was 4 (range: 1~7 cycles). Of the 33 patients, 6 patients had partial responses, 13 patients had stable disease and 14 patients had progressive disease. The response rate was 18.2%. The median overall survival was 11 months (range: 7~15 months), and the median progression free survival was 5 months (range: 3~7 months). The median response duration was 5 months (range: 4~9 months). A total of 137 cycles were evaluated for toxicity. We observed grade 3 or 4 neutropenia in 79 cycles (57.6%), grade 3 or 4 leukopenia in 46 cycles (33.6%), and grade 3 febrile neutropenia in 2 cycles (1.5%). The median nadir day was day 9 (range: day 5~19), and the median number of G-CSF injections was 2 (range: 0~6). The most common non-hematologic toxicities were myalgia/arthralgia and neurotoxicity, but any grade 3 or 4 non-hematologic toxicity was not observed. The major toxicity of this therapy was neutropenia. The absolute neutrophil count decreased relatively rapidly, but neutropenic fever or related infection was rare. There were no treatment-related deaths. CONCLUSION: These results revealed a satisfactory response rate (18.2%) with using docetaxel as the second- line chemotherapy for NSCLC. The second-line docetaxel was an active and well-tolerated regimen in patients with advanced NSCLC pretreated with platinum-based chemotherapy.


Assuntos
Humanos , Adenocarcinoma , Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Escamosas , Intervalo Livre de Doença , Tratamento Farmacológico , Neutropenia Febril , Febre , Fator Estimulador de Colônias de Granulócitos , Coreia (Geográfico) , Leucopenia , Neutropenia , Neutrófilos , Estudos Retrospectivos
20.
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 776-779, 2005.
Artigo em Coreano | WPRIM | ID: wpr-166022

RESUMO

Anomalous origin of right coronary artery from left sinus of valsalva is associated with sudden unexpected death, syncope, arrhythmia and myocardial ischemia. The mechanism that explains the restriction of coronary flow in the anomalous coronary artery is unclear but several surgical methods have been proposed, such as coronary artery bypass graft, coronary reimplantation, translocation of pulmonary artery, and unroofing procedure. We reported the surgical correction of the anomalous origin of right coronary artery from left sinus of valsalva between the aorta and pulmonary trunk using the unroofing procedure.


Assuntos
Aorta , Arritmias Cardíacas , Ponte de Artéria Coronária , Vasos Coronários , Isquemia Miocárdica , Artéria Pulmonar , Reimplante , Seio Aórtico , Síncope , Transplantes
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