[Show abstract][Hide abstract] ABSTRACT: The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method.
Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated.
There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%).
Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.
Korean Journal of Thoracic and Cardiovascular Surgery 06/2013; 46(3):202-7. DOI:10.5090/kjtcs.2013.46.3.202
[Show abstract][Hide abstract] ABSTRACT: Leiomyosarcoma of the mediastinum and primary leiomyosarcoma of the spine are exceedingly rare. In most cases, spinal leiomyosarcoma is metastatic. In this report, we describe the case of a 58-year-old man who presented with a large leiomyosarcoma of the posterior mediastinum that extended into the adjacent spinal canal. The tumor was completely resected from the mediastinum, but only subtotally removed from the spinal canal because the spinal mass had tightly invaded the spinal cord. Because the patient's postoperative condition was poor, no adjuvant radiotherapy or chemotherapy was administered. He expired 3 months after the surgery due to relapse; the spinal and mediastinal tumor remained at the preoperative size.
Korean Journal of Thoracic and Cardiovascular Surgery 06/2012; 45(3):192-5. DOI:10.5090/kjtcs.2012.45.3.192
[Show abstract][Hide abstract] ABSTRACT: Tuberculous abscess of the chest wall is a very rare disease. Few articles have reported on it and those that have enrolled few patients. To determine the characteristics of this disease and to suggest an optimal treatment strategy, we reviewed patients treated by surgical management.
Between October 1981 and December 2009, 68 patients treated by surgical management for a tuberculous abscess of the chest wall were reviewed retrospectively.
Of 33 men and 35 women, 31 patients had a current or previous history of tuberculosis. The main complaints were chest pain, a palpable mass, pus discharge, and coughing. A preoperative bacteriologic diagnosis was performed in 12 patients. Abscess excision was performed in 54 cases, abscess cavity excision and partial rib resection in 13, and abscess excision and partial sternum and clavicle excision in 1 case. Postoperative wound infection was noted in 16 patients and a secondary operation was performed in 1 patient. Recurrence occurred in 5 patients (7.35%). Reoperation with abscess excision and partial rib resection was performed in all of the 5 cases.
Complete excision of the abscess and primary closure of the wound with obliteration of space would decrease postoperative complications. Anti-tuberculosis medication may reduce the chance of recurrence.
Korean Journal of Thoracic and Cardiovascular Surgery 06/2012; 45(3):177-82. DOI:10.5090/kjtcs.2012.45.3.177
[Show abstract][Hide abstract] ABSTRACT: Evidence suggests overexpression of COX-2 and its role in many human cancers, including lung. However, the regulatory mechanism underlying COX-2 overexpression in lung cancer is not fully understood. We herein investigated whether COX-2 is overexpressed in human airway cancer cell lines, including A549 (lung), Hep-2 (bronchial), and NCI-H292 (alveolar). When grown in cell culture medium containing 10% FBS (serum), of note, there was strong and transient induction of COX-2 protein and mRNA in NCI-H292 cells, but little or low COX-2 expression is seen in A549 or Hep-2 cells. Interestingly, strong and sustained activities of ERK-1/2, JNK-1/2, p38 MAPK, and PKB were also shown in NCI-H292 cells grown in presence of serum. Profoundly, results of pharmacological inhibition studies demonstrated that the serum-dependent COX-2 up-regulation in NCI-H292 cells is attributed to not only the p38 MAPK-, PI3K/PKB-, and ERK-1/2-mediated COX-2 transcriptional up-regulation but also the p38 MAPK- and ERK-1/2-mediated post-transcriptional COX-2 mRNA stabilization. Of further note, it was shown that the ERK-1/2 and PI3K/PKB (but not COX-2, p38 MAPK, and JNK-1/2) activities are necessary for growth of NCI-H292 cells. These findings collectively demonstrate for the first time that COX-2 expression is transiently up-regulated by serum addition in NCI-H292 cells and the serum-induced COX-2 expression is closely linked to the p38 MAPK-, ERK-1/2-, and PI3K/PKB-mediated COX-2 transcriptional and post-transcriptional up-regulation.
[Show abstract][Hide abstract] ABSTRACT: An azygos vein aneurysm is a very rare cause of a posterior mediastinal mass. Once the diagnosis has been confirmed, no treatment is usually required. However, the aneurysm can thrombose, and this may lead pulmonary thromboembolism, or the aneurysm may rupture. In these instances, the excision of the mass is recommended. Video-assisted thoracic surgery techniques have considerably improved. If it is necessary to remove the aneurysm, video-assisted thoracic surgery may be a good option for surgical treatment. We report a case of an aneurysm of the azygos arch that was successfully resected by video-assisted thoracic surgery.
Korean Journal of Thoracic and Cardiovascular Surgery 08/2011; 44(4):304-6. DOI:10.5090/kjtcs.2011.44.4.304
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts.
Twenty-four (n=24) patients with intrathoracic bronchogenic cysts were treated surgically between August 1990 and December 2009 at our institution. Patients were divided into two groups by bronchogenic cyst location: mediastinal or intrapulmonary. Symptoms at diagnosis, radiologic findings, locations, surgical methods, pathological findings, and surgical outcomes were investigated retrospectively from consecutive patient medical records.
There were 12 females (50.0%). The mean age was 26.8 (range, 5 to 64) years. The mean follow-up period was 27.3 (range, 1 to 121) months. There were 15 (62.5%) mediastinal and 9 (37.5%) intrapulmonary bronchogenic cysts. Symptoms occurred in 8 patients with mediastinal bronchogenic cysts (53.3%) and 5 patients with intrapulmonary bronchogenic cysts (55.6%) (p=1.000). On computed tomography (CT), 7 patients (46.7%) showed homogenous solid masses in mediastinal bronchogenic cysts and five (55.6%) patients exhibited heterogeneous cystic masses with air-fluid levels in intrapulmonary bronchogenic cystic masses. Open thoracotomy was performed in 17 (70.8%) patients, and video-assisted thoracic surgery was performed in 7 (29.2%) patients. On pathological findings, there were 16 (66.7%) complicated cysts, and in 13 symptomatic patients, 11 (84.6%) patients had complicated cysts. There was no operative death in this study. During the follow-up period, no recurrence was detected.
Intrathoracic bronchogenic cysts have a wide variety of clinical characteristics and radiologic findings. Even though some patients do not experience symptoms and signs caused by bronchogenic cysts, serious symptoms and complications may develop with the passage of time.
Korean Journal of Thoracic and Cardiovascular Surgery 08/2011; 44(4):279-84. DOI:10.5090/kjtcs.2011.44.4.279
[Show abstract][Hide abstract] ABSTRACT: Video-assisted thoracic sympathicotomy plays an important for the treatment of essential hyperhidrosis. Patients are usually satisfied with the surgical outcome at the early post-operative period, but suffer recurrence and compensatory sweating in the late post-operative period. There are many sympathicotomy methods to minimize recurrence and compensatory sweating. We compared the outcome of sympathicotomy methods above the third rib (R3) and the fourth rib (R4) with regards to symptoms, satisfaction, recurrence, and compensatory palmar and axillary hyperhydrosis.
From January 1999 to April 2009, 39 cases of thoracoscopic sympathicotomy at the third rib (R3), and 94 cases of thoracoscopic sympathicotomy at the fourth rib (R4) for palmar and axillary hyperhidrosis were compared for early and late post-operative satisfaction, compensatory sweating and recurrence.
There was no sex or age difference between groups. Early satisfaction was 94.9% and 98.9% in the R3 group and R4 group, respectively. There was no difference in early satisfaction (94.9% in R3 and 98.9% in R4), late satisfaction (84.6% in R3 and 89.4% in R4), or recurrence (17.9% in R3 and 17.0% in R4) between groups. There was significant difference in compensatory sweating (71.8% in R3 and 33% in R4, p=0.002).
R4 sympathicotomy demonstrated superior efficacy in the treatment of compensatory sweating compared to R3 in palmar and/or axillary hyperhidrosis.
Korean Journal of Thoracic and Cardiovascular Surgery 04/2011; 44(2):154-8. DOI:10.5090/kjtcs.2011.44.2.154
[Show abstract][Hide abstract] ABSTRACT: Bronchogenic cysts are developmental foregut anomalies usually located within the mediastinum or lung parenchyma. An isolated bronchogenic cyst of the diaphragm is very rare. Our case was a 56-year-old female patient who presented with pleuritic chest pain in her right chest. Chest and abdominal computed tomography revealed a large lobulated cystic mass that was accompanied with pleural effusion in the right lower hemithorax. The tumor showed focally calcified areas in the wall and abutted against the diaphragm. We performed complete excision of the cyst including a portion of the diaphragm attached to it. The pathological diagnosis was established as the bronchogenic cyst originating from the diaphragm. We report this case with a review of the literature.
Korean Journal of Thoracic and Cardiovascular Surgery 02/2011; 44(1):86-8. DOI:10.5090/kjtcs.2011.44.1.86
[Show abstract][Hide abstract] ABSTRACT: Constrictive pericarditis is a rare complication after coronary artery bypass grafting In most cases pericardiectomy is required as a definitive treatment. However, there are several types of constrictive pericarditis such as transient cardiac constriction. Some types of constrictive pericarditis can only be managed with medical therapy. We report a 72-year-old female patient who developed subacute transient constrictive pericarditis with persistent left pleural effusion as a result of postcardiac injury syndrome. The patient went through coronary bypass surgery that was successfully treated with postoperative steroid therapy.
Korean Journal of Thoracic and Cardiovascular Surgery 02/2011; 44(1):64-7. DOI:10.5090/kjtcs.2011.44.1.64
[Show abstract][Hide abstract] ABSTRACT: Overexpression of COX-2, an enzyme responsible fro the synthesis of prostaglandins, is well linked to human chronic lung diseases. The mechanism by which COX-2 expression is increased or enhanced in cancer cells remains largely unknown. Any compound which can reduce COX-2 expression may be considered as an anti-cancer agent.