We experienced a case of hemoptysis caused by bilateral upper lobe aspergilloma. He was 66 years old and had a history of old unclear pulmonary tuberculosis with irregular medication 20 years ago and intermittent hemoptysis for several years. In x-ray study, there was a bilateral upper lobe aspergilloma with cavity. He received bilateral wedge resection through thoracotomy with some interval to reduce postoperative complications. We selected the priorty of operation through the bronchoscope in the operation room. Both sides had the same pathology of aspergilloma and he was discharged after an uneventful postoperative course.
Aged ; Bronchoscopes ; Hemoptysis* ; Humans ; Pathology ; Postoperative Complications ; Thoracotomy ; Tuberculosis, Pulmonary

Pulmonary sequestration is a very rare congenital malfomation, especially when it is located in the infradiaphragmatic retroperitoneal space. The patient was a 56-year-old man with no respiratory symptom but had some postprandial epigastric discomfort for several days. Plain chest x-ray revealed mild elevation of left diaphragm and abdominal CT scan showed large cystic retroperitoneal mass with some calcification. We performed the operation through the thorachoabdominal incision and the mass was proven to be a pulmonary sequestration. Therefore, we report the case with review of literatures.
Bronchopulmonary Sequestration* ; Diaphragm ; Humans ; Middle Aged ; Retroperitoneal Space ; Thorax ; Tomography, X-Ray Computed

Esophageal duplication cysts are a very rare form of benign esophageal tumors and are frequently asymptomatic. Esophageal duplication cysts result from errors in coalescence of vacuoles during the normal secretion and vacuolization process in the 10-mm embryo. Recently, we experienced a case of long tubular esophageal duplication complicated with perforation into esophageal lumen. We report it with a review of literatures.
Embryonic Structures ; Vacuoles

Primary pulmonary artery sarcoma is a rare tumor and commonly misdiagnosed as pulmonary embolism. The prognosis of these tumors is very poor. The Median length of survival without surgical resection is approximately 1.5 months, but surgical resection has lengthened survival time to approximately 1 year. We encountered a case of primary pulmonary artery sarcoma, with a 55 year-old woman whose symptoms were exertional dyspnea, right chest pain, and hemoptysis. A preoperative chest CT scan revealed mass lesion mimicking pulmonary embolism. Pulmonary angioplasty and right pneumonectomy were performed on partial cardiopulmonary bypass. Postoperatively the mass was confirmed as undifferenciated sarcoma histopathologically. The symptoms were somewhat improved, but the patient died of unknown causes about 3 months after surgery.
Angioplasty ; Cardiopulmonary Bypass ; Chest Pain ; Dyspnea ; Female ; Hemoptysis ; Humans ; Middle Aged ; Pneumonectomy ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism ; Sarcoma* ; Tomography, X-Ray Computed

Sternal fracture is relatively common in chest trauma. Mediastinal hematoma secondary to sternal fracture is not in common, and it has minor symptoms such as mild dyspnea and chest tightness, which usually resolve spontaneously. We experienced two cases of extrapericardial tamponade by hematoma caused by sternal fractures. Two patients were diagnosed by chest CT scan and sent to the operating room within 2 hours after arriving at emergency room because of unstable vital signs. Cardiovascular signs were relieved immediatly after the operation. We report these cases with a brief review of the literature.
Cardiac Tamponade ; Dyspnea ; Emergency Service, Hospital ; Hematoma ; Humans ; Operating Rooms ; Sternum ; Thorax ; Tomography, X-Ray Computed ; Vital Signs

Sixty children were admitted to the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10- year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in 32% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45%), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severity Scale(MISS) score was measured in the multiple injured group. MISS score correlated significantly with the length of stay in the intensive care unit. One child(1.7%), involved in a traffic accident, died of sepsis.
Accidents, Traffic ; Child* ; Gyeongsangbuk-do ; Hospital Records ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Retrospective Studies ; Rib Fractures ; Sepsis ; Thoracic Injuries ; Thoracotomy ; Ventilation

Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.
Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Diagnosis ; Gyeongsangbuk-do ; Humans ; Incidence ; Infarction ; Korea ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Male ; Mastectomy, Segmental ; Mortality ; Needles ; Neoplasm Metastasis ; Pneumonectomy ; Respiratory Insufficiency ; Sputum ; Survival Rate ; Thoracotomy

Background: This study evaluated the efficacy and safety of add-on gemigliptin in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycemic control with metformin and dapagliflozin. Methods: In this randomized, placebo-controlled, parallel-group, double-blind, phase III study, 315 patients were randomized to receive either gemigliptin 50 mg (n=159) or placebo (n=156) with metformin and dapagliflozin for 24 weeks. After the 24-week treatment, patients who received the placebo were switched to gemigliptin, and all patients were treated with gemigliptin for an additional 28 weeks. Results: The baseline characteristics were similar between the two groups, except for body mass index. At week 24, the least squares mean difference (standard error) in hemoglobin A1c (HbA1c) changes was –0.66% (0.07) with a 95% confidence interval of –0.80% to –0.52%, demonstrating superior HbA1c reduction in the gemigliptin group. After week 24, the HbA1c level significantly decreased in the placebo group as gemigliptin was administered, whereas the efficacy of HbA1c reduction was maintained up to week 52 in the gemigliptin group. The safety profiles were similar: the incidence rates of treatment-emergent adverse events up to week 24 were 27.67% and 29.22% in the gemigliptin and placebo groups, respectively. The safety profiles after week 24 were similar to those up to week 24 in both groups, and no new safety findings, including hypoglycemia, were noted. Conclusion Add-on gemigliptin was well tolerated, providing comparable safety profiles and superior efficacy in glycemic control over placebo for long-term use in patients with T2DM who had poor glycemic control with metformin and dapagliflozin.