Ectopic Intrapulmonary Thyroid: A Case Report

고호현,조성우,이희성,김형수,남은숙,조성진 대한흉부외과학회 2013 Journal of Chest Surgery (J Chest Surg) Vol.46 No.3

An ectopic thyroid is caused by abnormalities in migration of the thyroid during development and rarely occurs in the thoracic cavity or the abdominal cavity. We report the case of a 64-year-old female who had abnormal findings from a thyroid hormone test during follow-up after thyroid cancer surgery. Based on the radioisotope diagnostic test, an ectopic thyroid inside the thoracic cavity was suspected. Through surgical treatment, the patient was diagnosed with ectopic intrapulmonary thyroid. Ectopic intrapulmonary thyroid is reported to be very rare and the case is described along with a literature review.

당귀사역가오수유생강탕의 문헌적 고찰

이용현(Yong Hyun Lee),선승호(Seung Ho Sun),정종진(Jong Jin Jeong),박정수(Jeong Su Park),고호연(Ho Yeon Go),정기용(Ki Yong Jung),차윤엽(Yun Yeop Cha),송윤경(Yun Kyung Song),김태훈(Tae Hoon Kim),홍성인(Sung In Hong),최유경(You Kyung Ch 한의병리학회 2014 동의생리병리학회지 Vol.28 No.1

연령대별 요추 추간판탈출증 환자의 요근과 척추주위근 단면적에 대한 분석

공덕현 ( Deok Hyun Kong ),배광호 ( Kwang Ho Bae ),고호연 ( Ho Yeon Go ),강명진 ( Myung Jin Kang ),김준수 ( Jun Su Kim ),양기영 ( Kee Young Yang ),이재훈 ( Jae Hoon Lee ),은영준 ( Young Jun Eun ) 한방재활의학과학회 2010 한방재활의학과학회지 Vol.20 No.4

Objectives :This study was designed to evaluate the correlation of the cross-sectional areas(CSA) of paraspinalis(iliocostalis lumborum, multifidus, longissimus thoracis parts lumborum) and psoas muscle and sex, age, change of the VAS(visual analogue scale) and past history of chronic low back pain in patients suffering from HIVD(herniation of intervertebral disc). Methods :Medical records of 140 subjects with HIVD were retrospectively reviewed. The MRI(magnetic resonance imaging) findings on the patients were scanned and analyzed by PiView program to find the paraspinal and psoas muscle CSA and were evaluated by the correlation of sex, age, change of the VAS, and past history of chronic low back pain. Results :There was significant difference between groups in male and female, young-adults age and middle age, middle age and old age, young-adults age and old age. But the correlation of the paraspinal and psoas muscle CSA and past history of chronic low back pain were partially significant. On the other hand, the correlation of the paraspinal and psoas muscle CSA and change of the VAS were not significant. Conclusions :These results suggest that the cross-sectional areas(CSA) of paraspinalis and psoas muscle have relevance to sex and age.

Hemoglobin Level to Facilitate Off-Pump Coronary Artery Bypass without Transfusion

김건일,고호현,김형수,정재한,이원용 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.4

Background: Conservation of blood during cardiac surgery is important because of the shortage of donor blood, risks associated with transfusion, and the costs of allogeneic blood products. This retrospective study explored the feasibility of off-pump coronary artery bypass (OPCAB) without transfusion. Methods: One hundred and two consecutive patients underwent OPCAB from January 2007 to June 2012 at Hallym University Sacred Heart Hospital. Excluding 10 chronic renal failures patients, 102 patients were enrolled. Their characteristics, clinical data, and laboratory data were analyzed. We investigated the success rate of OPCAB without transfusion according to preoperative hemoglobin (Hb), and the cutoff point of the Hb level and the risk factors for transfusion. We implemented multidisciplinary blood-saving protocols. Results: The overall operative mortality and the success rate of OPCAB without transfusion were 2.9% (3/102) and 73.5% (75/102). The success rates in patients with Hb<11, 11 <Hb<14, and 14<Hb were 35.0%, 79.2%, and 89.7% (p=0.01), respectively. The risk factors for transfusion are age>70 years, diagnosis of acute myocardial infarction, preoperative Hb and creatinine levels, and operation time. The events precipitating the need for transfusion were low Hb level in 9 patients and hypotension or excessive bleeding in 18 patients. Conclusion: The preoperative Hb level of >11 facilitates OPCAB without transfusion. These results suggest that transfusion-free OPCAB can be performed by modifying the risk factors and correctable causes of transfusion and improving various blood salvage methods.

Correlation of Primary Spontaneous Pneumothorax and Air Pollution in Adolescents

구병모,고호현,라용준,이희성,김형수,이홍규 대한흉부외과학회 2021 Journal of Chest Surgery (J Chest Surg) Vol.54 No.1

Background: We aimed to investigate the characteristics of primary spontaneous pneu- mothorax (PSP) in adolescents and to analyze the relationship between the occurrence of PSP and air pollutants. Methods: Data pertaining to age, sex, body mass index, smoking status, initial pneumo- thorax volume, presence of bullae, treatment methods, and city of residence were retro- spectively obtained from January 2010 to December 2014. We investigated the association between short-term exposure to air pollutants (SO2, NO2, O3, CO, and PM10) and the occur- rence of PSP using a case-crossover design with conditional logistic regression. Results: We collected information from 598 patients who were admitted for PSP, with a mean follow-up duration of 62.9 months. The majority (91.1%) of the patients were male. In the case-crossover design, conditional logistic regression showed that no air pollutant was associated with the occurrence of pneumothorax. The results were consistent across all city subgroups (Anyang, Gunpo, Uiwang, and Gwacheon). Conclusion: In our study, the incidence rate of pneumothorax was 153.8 per 100,000 person-years in male adolescents and 16.7 per 100,000 person-years in female adolescents. The case-crossover design showed that PSP in adolescents is unlikely to be related to air pollution.

Guillain-Barré Syndrome after Lung Transplantation in the Immediate Postoperative Period: Case Report

구병모,고호현,이홍규,라용준,이희성,김형수 대한흉부외과학회 2021 Journal of Chest Surgery (J Chest Surg) Vol.54 No.5

A 58-year-old man, incapable of maintaining oxygen saturation with mechanical ventila- tion, was admitted to our hospital for veno-venous extracorporeal membrane oxygenation (ECMO) treatment. He was diagnosed with acute respiratory distress syndrome (ARDS) due to influenza A pneumonia. His condition stabilized with antibiotics and steroid adminis- tration, but weaning from ECMO failed due to post-infectious pulmonary sequelae. On day 84 after admission, he underwent bilateral lung transplantation. In the postoperative phase, he did not regain consciousness even after discontinuation of sedatives for 3 days. However, spontaneous pupillary reflex and eye movements were preserved, while com- munication and upper and lower limb movements were affected. The nerve conduction study was diagnostic of Guillain-Barré syndrome. He was managed with intravenous im- munoglobulins and plasmapheresis. Mild recovery of the facial muscles was seen, but he died 24 days post-surgery due to progressive ARDS and sepsis.

Right Coronary Artery Fistula and Occlusion Causing Myocardial Infarction after Blunt Chest Trauma

김건일,이원용,고호현,김형수,이희성 대한흉부외과학회 2014 Journal of Chest Surgery (J Chest Surg) Vol.47 No.4

Myocardial infarction (MI) secondary to coronary artery fistula and the subsequent occlusion of the distal right coronary artery (RCA) after blunt chest trauma is a rare entity. Here, we describe a case of coronary artery fistula and occlusion with an inferior MI that occurred following blunt chest trauma. At the initial visit to the emergency room after a car accident, this patient had been undiagnosed with acute myocardial infarction, readmitted five months after ischemic insult, and revealed to have experienced MI due to RCA-right atrial fistula and occlusion of the distal RCA. He underwent coronary surgery and recovered without complications.

Outcomes of Urgent Interhospital Transportation for Extracorporeal Membrane Oxygenation Patients

양준태,김형수,김건일,고호현,임정현,이홍규,라용준 대한심장혈관흉부외과학회 2022 Journal of Chest Surgery (J Chest Surg) Vol.55 No.6

Background: Extracorporeal membrane oxygenation (ECMO) can be used in patients with refractory cardiogenic shock or respiratory failure. In South Korea, the need for transporting ECMO patients is increasing. Nonetheless, information on urgent transportation and its outcomes is scant. Methods: In this retrospective review of 5 years of experience in ECMO transportation at a single center, the clinical outcomes of transported patients were compared with those of in-hospital patients. The effects of transportation and the relationship between insertion– departure time and survival were also analyzed. Results: There were 323 cases of in-hospital ECMO (in-hospital group) and 29 cases transferred to Hallym University Sacred Heart Hospital without adverse events (mobile group). The median transportation time was 95 minutes (interquartile range [IQR], 36.5–119.5 minutes), whereas the median transportation distance was 115 km (IQR, 15–115 km). Transportation itself was not an independent risk factor for 28-day mortality (odds ratio [OR], 0.818; IQR, 0.381–1.755; p=0.605), long-term mortality (OR, 1.099; IQR, 0.680–1.777; p=0.700), and failure of ECMO weaning (OR, 1.003; IQR, 0.467–2.152; p=0.995) or survival to discharge (OR, 0.732; IQR, 0.337–1.586; p=0.429). After adjustment for covariates, no significant difference in the ECMO insertion–departure time was found between the survival and mortality groups (p=0.435). Conclusion: The outcomes of urgent transportation, with active involvement of the ECMO center before ECMO insertion and adherence to the transport protocol, were comparable to those of in-hospital ECMO patients.

Analysis of Risk Factors for Conversion from Off-Pump to On-Pump Coronary Artery Bypass Graft

임정현,이원용,나용준,정재한,고호현 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.1

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was 55±26 months, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.

Extravascular Migration of a Fractured Inferior Vena Cava Filter Strut

임정현,이원용,나용준,정재한,박봉석,고호현 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.3

A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.