A Rare Case of Bilateral Pulmonary Sequestration Managed with Embolization and Surgical Resection in a Patient

석준필,김영진,조현민,류한영 대한흉부외과학회 2013 Journal of Chest Surgery Vol.46 No.6

In this article, we report a rare case of a 22-year-old male with bilateral pulmonary sequestration, treated with embolization and surgical resection. The initial plan involved staged bilateral lobectomy for both lungs and prophylactic embolization of feeding vessels for preventing unexpected hemorrhage during operation. Symptomatic right lower lobe was resected with video-assisted thoracic surgery after embolization, and the patient refused surgery of left lower lobe upon symptomatic relief. The two-year follow-up examination revealed that the patient was healthy and had no relevant discomfort.

A Retrospective Clinical Study: Complications of Totally Implanted Central Venous Access Ports

석준필,조현민,류한영,황완진,송태은,김영진 대한흉부외과학회 2014 Journal of Chest Surgery Vol.47 No.1

Background: When managing patients who require repeated venous access, gaining a viable intravenous route has been problematic. To improve the situation, various studies on techniques for venous access have been conducted. The aim of this study is to evaluate the clinical results of complications following totally implanted central venous access port (TICVAP) insertion. Methods: A retrospective analysis was conducted on 163 patients, from December 2008 to March 2013. The occurrence of complications was studied in three separate periods of catheter use: the intraoperative period, postoperative period, and period during the treatment. Results: A total of 165 cases of TICVAP insertions involving 156 patients were included in the final analysis. There were 35 complications (21%) overall. Among these, 31 cases of complications (19%) occurred during the treatment period and the other 4 cases were intraoperative and postoperative complications (2%). There were no statistically significant differences in age and gender of the patients between the two groups to be risk factors (p=0.147, p=0.08). Past history of chemotherapy, initial laboratory findings, and the locations of TICVAP insertion also showed no statistical significance as risk factors (p>0.05). Conclusion: Because the majority of complications occurred after port placement and during treatment, meticulous care and management and appropriate education are necessary when using TICVAPs.

흉벽의 융기피부섬유육종의 수술적 치료

조현민,김영진,이태연,이찬규,석준필,이용해 대한흉부외과학회 2010 Journal of Chest Surgery Vol.43 No.6

77세 남자 환자가 좌측 전흉벽의 거대한 종괴를 주소로 내원하였으며 수술적 제거 후 융기피부섬유육종으로 진단되었다. 융기피부섬유육종은 피부의 중간엽 종양으로 연조직 육종의 2% 미만을 차지하며 병변은 진피에서 기원하여 피하조직까지 침범 할 수 있는 종양이다. 조직학적으로 방추세포의나선형 배열이 특징적이며 CD34의 면역조직 화학 특수 염색에서 양성소견을 보인다. 저자들은 광범위 절제술과 전층피부이식을 통한 흉부재건술로 거대한 흉부 융기피부섬유육종을 성공적으로 절제하였기에 보고하는 바이다.

Successful Endovascular Management of Post-Traumatic Phlegmasia Cerulea Dolens from Rupture of the External Iliac Vein

박찬용,조현민,여광희,석준필,이찬규 대한외상중환자외과학회 2017 Journal of Acute Care Surgery Vol.7 No.2

We report a rare case of a 47-year-old male with posttraumatic phlegmasia cerulea dolens caused by a ruptured right external iliac vein and treated with an endovascular venous stent graft. The patient was the victim of motor vehicle accident, and suffered direct injuries to the head and abdomen. The patient had a cyanotic and swollen right lower leg. Abdominal and lower extremity computed tomography angiography revealed a large retroperitoneal hematoma caused by a ruptured right external iliac vein, and grade I liver injury. The right external iliac vein rupture was successfully treated with a venous stent graft, followed by inferior vena cava filtering, because a venous thrombus was identified below the stent graft. He initially was hemodynamically unstable but recovered following treatment. The patient was comatose when presenting at the emergency department. He was discharged, fully recovered, on hospital day 18. (J Acute Care Surg 2017;7:87-89)

Geriatric Trauma Outcome Score for Predicting Mortality among Older Korean Adults with Trauma: Is It Applicable in All Cases?

한종희,Su Young Yoon,석준필,Jin Young Lee,Jin Suk Lee,Jin Bong Ye,설영훈,Se Heon Kim,Hong Rye Kim 대한노인병학회 2024 Annals of geriatric medicine and research Vol.28 No.4

Background: This study aimed to validate the Geriatric Trauma Outcome Score (GTOS) for predicting mortality associated with trauma in older Korean adults and compare the GTOS with the Trauma and Injury Severity Score (TRISS). Methods: This study included patients aged ≥65 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022. We used receiver operating characteristic curves and calibration plots to assess the discrimination and calibration of the scoring systems. Results: Among 3,053 patients, the median age was 77 years, and the mortality rate was 5.2%. The overall GTOS-predicted mortality and 1–TRISS were 5.4% (interquartile range [IQR], 3.7–9.5) and 4.7% (IQR, 4.7–4.7), respectively. The areas under the curves (AUCs) of 1–TRISS and GTOS for the total population were 0.763 (95% confidence interval [CI], 0.719–0.806) and 0.794 (95% CI, 0.755–0.833), respectively. In the Glasgow Coma Scale (GCS) ≤12 group, the in-hospital mortality rate was 27.5% (79 deaths). The GTOS-predicted mortality and 1–TRISS in this group were 18.6% (IQR, 7.5–34.7) and 26.9% (IQR, 11.9–73.1), respectively. The AUCs of 1–TRISS and GTOS for the total population were 0.800 (95% CI, 0.776–0.854) and 0.744 (95% CI, 0.685–0.804), respectively. Conclusion: The GTOS and TRISS demonstrated comparable accuracy in predicting mortality, while the GTOS offered the advantage of simpler calculations. However, the GTOS tended to underestimate mortality in patients with GCS ≤12; thus, its application requires care in such cases.

Prognostic Accuracy of Massive Transfusion, Critical Administration Threshold, and Resuscitation Intensity in Assessing Mortality in Traumatic Patients with Severe Hemorrhage: a Meta-Analysis

강우성,신인수,표정수,안소라,정승우,기영준,석준필,박찬용,이선도 대한의학회 2019 Journal of Korean medical science Vol.34 No.50

Background: The aim of this study was to assess the prognostic value of massive transfusion (MT), critical administration threshold (CAT), and resuscitation intensity (RI) for the mortality of trauma patients with severe hemorrhage. Methods: Seventeen relevant articles were obtained by searching the PubMed databases through February 15, 2019. The estimated mortality rates and injury severity scores were obtained through a meta-analysis. In addition, diagnostic test accuracy (DTA) reviews were conducted to obtain the sensitivity, specificity, diagnostic odds ratio, and the summary receiver operating characteristic curve. Results: At 24 hours, the estimated mortality rates were 0.194, 0.126, and 0.168 in assessments using MT, CAT, and RI, respectively. In addition, the pooled sensitivity of CAT (0.89; 95% confidence interval [CI], 0.82–0.94) was significantly higher than that of MT (0.63; 95% CI, 0.57–0.68) and RI (0.69; 95% CI, 0.63–0.75). Overall, the pooled specificity of MT and CAT was 0.82 (95% CI, 0.80–0.83) and 0.85 (95% CI, 0.83–0.88), respectively, while the pooled sensitivity was 0.49 (95% CI, 0.44–0.54) and 0.50 (95% CI, 0.38–0.62), respectively. Conclusion: CAT may be a more sensitive predictor for 24-hour mortality than other predictors. Furthermore, RI also appears to be a useful predictor for 24-hour mortality. Both MT and CAT showed high specificity for overall mortality.

Vacuum-Assisted Closure Therapy as an Alternative Treatment of Subcutaneous Emphysema

변천성,최진호,황정주,김도형,조현민,석준필 대한흉부외과학회 2013 Journal of Chest Surgery Vol.46 No.5

Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.