Search

Background Post-pneumonectomy syndrome (PPS) is a rare syndrome characterized by trachea-bronchial stenosis and severe dyspnea. In this study, we retrospectively evaluated the clinical outcomes in patients who underwent placement of tissue expanders for PPS. Methods Data from patients who underwent placement of tissue expanders for PPS were analyzed for preoperative characteristics, surgical techniques, and postoperative outcomes. Between 1997 and 2014, a total of 10 patients were treated for PPS by tissue expanders. Results The median age of the 10 patients was 45 years (range, 16–70). Four patients had undergone right pneumonectomy, three patients had undergone left pneumonectomy, and three patients had post-pneumonectomy-like syndrome. Preoperatively, seven patients initially received high oxygen therapy for hypoxemia but progressed to respiratory failure, and three patients required mechanical ventilator support. Among these three patients, one required intraoperative extracorporeal membrane oxygenation support because of sudden cardiac arrest during preparation for surgery. The median follow-up was 59.5 months (range, 2–204). The median interval between pneumonectomy and repositioning was 13 months (range, 8–581). Two patients underwent placement of a single tissue expander, and two tissue expanders were placed in eight of the 10 patients. The median volume of tissue expanders inflated with saline was 450 cc (range, 60–850 cc) per tissue expander. There was no perioperative mortality in our study. Complications occurred in four patients (40%). Conclusions Repositioning of the mediastinum with placement of a saline filled tissue expander for PPS is very effective for the relief of symptoms, with low mortality.

Background: Outcomes of antibiotic treatment for lung disease caused by nontuberculous mycobacteria (NTM) are unsatisfactory. The role of adjunctive surgery in the treatment of NTM lung disease is still unclear. Methods: We conducted a retrospective review of 70 patients who underwent pulmonary resection for NTM lung disease from March 2007 to February 2013. All patients received recommended antibiotic treatment before and after the surgery. Results: A total of 70 patients underwent 74 operations. The median age of the patients was 50 years. Of the 70 patients, 45 (64%) had Mycobacterium avium complex infection (24 M. intracellulare and 21 M. avium) and 23 (33%) had M. abscessus complex infection (15 M. abscessus and 8 M. massiliense). Thirty-eight (54%) patients had the nodular bronchiectatic form and 28 (40%) had the fibrocavitary form of NTM lung disease. The indications for surgery were a poor response to drug therapy (n=52), remnant cavitary lesions and severe bronchiectasis (n=14), and hemoptysis (n=4). Preoperative sputum acid-fast bacilli staining results were positive in 44 (63%) patients, and sputum culture was positive in 54 (76%). The surgery included lobectomy or lobectomy plus segmentectomy (n=50, 68%), segmentectomy (n=11, 15%), pneumonectomy or completion pneumonectomy (n=8, 11%), bilobectomy or bilobectomy plus segmentectomy (n=4, 5%), and wedge resection (n=1, 1%). Postoperative complications occurred in 15 (21%) patients, including one postoperative death and bronchopleural fistula in 5 patients with the fibrocavitary form of the disease. A negative sputum culture was achieved and maintained in 57 (81%) patients. Conclusions: Although adjuvant pulmonary resection is associated with a relatively high complication rate, this procedure may provide a high level of treatment success for selected patients with NTM lung disease, such as those with a poor response to antibiotic treatment alone.

Supplemental Digital Content is available in the text, Quantitative imaging using radiomics can capture distinct phenotypic differences between tumors and may have predictive power for certain phenotypes according to specific genetic mutations. We aimed to identify the clinicoradiologic predictors of tumors with ALK (anaplastic lymphoma kinase), ROS1 (c-ros oncogene 1), or RET (rearranged during transfection) fusions in patients with lung adenocarcinoma. A total of 539 pathologically confirmed lung adenocarcinomas were included in this retrospective study. The baseline clinicopathologic characteristics were retrieved from the patients’ medical records and the ALK/ROS1/RET fusion status was reviewed. Quantitative computed tomography (CT) and positron emission tomography imaging characteristics were evaluated using a radiomics approach. Significant features for the fusion-positive tumor prediction model were extracted from all of the clinicoradiologic features, and were used to calculate diagnostic performance for predicting 3 fusions’ positivity. The clinicoradiologic features were compared between ALK versus ROS1/RET fusion-positive tumors to identify the clinicoradiologic similarity between the 2 groups. The fusion-positive tumor prediction model was a combination of younger age, advanced tumor stage, solid tumor on CT, higher values for SUVmax and tumor mass, lower values for kurtosis and inverse variance on 3-voxel distance than those of fusion-negative tumors (sensitivity and specificity, 0.73 and 0.70, respectively). ALK fusion-positive tumors were significantly different in tumor stage, central location, SUVmax, homogeneity on 1-, 2-, and 3-voxel distances, and sum mean on 2-voxel distance compared with ROS1/RET fusion-positive tumors. ALK/ROS1/RET fusion-positive lung adenocarcinomas possess certain clinical and imaging features that enable good discrimination of fusion-positive from fusion-negative lung adenocarcinomas.

Early diagnosis and aggressive surgical drainage are very important for successful treatment of descending necrotizing mediastinitis (DNM). However, the surgical techniques used for DNM treatment remain controversial. The purpose of this study was to evaluate the effectiveness of video-assisted thoracoscopic surgery (VATS) and cervical drainage for the management of DNM. Nine patients diagnosed with DNM were treated from May 2001 to April 2004. The mean age of the patients was 51.1+/-15.0 years. VATS and cervical drainage, including debridement and drainage of the mediastinum and pleura, were performed simultaneously. The mean postoperative hospital stay was 20.6+/-6.6 days. One patient (11%) died of sepsis and renal failure on the 15th postoperative day. Minimal mastication difficulty developed in 2 patients (22%). The mean postoperative follow-up period was 28.7+/-14.7(5 to 52) months. All the survivors are in good health with no recurrences. VATS was safe, effective, and a less invasive surgical option for the management of DNM and should be considered as a good alternative therapeutic modality.

We previously reported that a methanolic extract of Coptis japonica, which is a well-known traditional oriental medicine, inhibits morphine-induced conditioned place preference (CPP) in mice. Berberine is a major component of Coptis japonica extract, and it has been established that the adverse effects of morphine on the brain involve dopamine (DA) receptors. However, to our knowledge, no study has investigated the inhibitory effects of berberine on morphine-induced locomotor sensitization and analgesic tolerance in mice. Here, we investigated the effects of berberine on morphine-induced locomotor sensitization and on the development of analgesic tolerance. Furthermore, we examined the effects of berberine treatment on N-methyl-D-aspartate (NMDA) receptor channel activity expressed in Xenopus laevis oocytes. Berberine was found to completely block both morphine-induced locomotor sensitization and analgesic tolerance, and reduce D(1) and NMDA receptor bindings in the cortex. Moreover, berberine markedly inhibited NMDA current in Xenopus laevis oocytes expressing NMDA receptor subunits. Our results suggest that the inhibitory effects of berberine on morphine-induced locomotor sensitization and analgesic tolerance are closely related to the modulation of D1 and NMDA receptors, and that berberine should be viewed as a potential novel means of attenuating morphine-induced sensitization and analgesic tolerance.

Recently perovskite niobates were paid much attention as lead-free piezoelectric materials to replace lead-based Pb(Zr,Ti)O3 or relaxor systems which cause much environmental problems. Piezoelectric and ferroelectric properties of electromechanical coupling coefficient and quality factor in (K0.5Na0.5)NbO3 ceramic were studied. Dielectric properties of niobates including Ag ion; AgNbO3 and (Ag0.5Na0.5)NbO3 were studied. Phase transitions and dielectric relaxations were studied from the frequency and temperature dependent dielectric constant measurements. The piezoelectric properties were hardly observed in silver niobate systems.

Ferroelectric SrBi 2 Ta 2 O 9 (SBT) with different Sr/Bi ratio were synthesized. Crystallized single-phases with Bi-layered perovskite structure was confirmed by X-ray diffraction (XRD). With increasing Bi/Sr ratio, the Curie temperature T c was increased and remanent polarization P r increased. The dielectric and ferroelectric properties were strongly influenced by the Bi/Sr ratio. The effect on dielectric properties and ac conductivity were investigated as functions of temperature and frequency.

Mossbauer spectra of Ti0.99 57Fe0.01O2 prepared with 57Fe enriched iron have been taken at various temperatures ranging from 80 to 300 K. The Mossbauer spectrum of Ti0.99 57Fe0.01O2 consists of a ferromagnetic (six-Lorentzian) and a paramagnetic phase (doublet) over all temperature ranges. Isomer shifts indicate Fe2+ for the ferromagnetic phase, but Fe3+ for the paramagnetic phase of Ti0.99 57Fe0.01O2 sample. It is noted that the magnetic hyperfine field of ferromagnetic phase had the value about 1.5 times as large as that of α-Fe. The XRD data for Ti0.99 57Fe0.01O2 showed a pure rutile phase with tetragonal structures without any segregation of Fe into particulates within the instrumental resolution limit. The magnetic hysteresis (M–H) curve at room temperature showed an obvious ferromagnetic behavior and the magnetic moment per Fe atom under the applied field of 1 T was estimated to be about 0.68 μB, suggesting a low spin configuration of Fe ions.

Nonstoichiometric SrBi2Ta2O9 (SBT) and SrBi2Nb2O9 (SBN) ceramics were prepared by a solid state reaction method. X-ray diffraction analysis showed that single-phase of Bi-layered perovskite was obtained. With different Sr/Bi content ratios of SBT and SBN, Curie temperature (T C ), electromechanical factor (K p ) and mechanical quality factor (Q m ) were measured. T C of SBN (SBT) rose from 414∘C (314∘C) to 494∘C (426∘C) when Sr/Bi content ratio was increased from 0.55/2.3 to 1.2/1.8. In the most Sr-deficient/Bi-excess ratio of 0.55/2.3, the maximum values of Q m were obtained approximately 1013 and 3325 for SBT and SBN, respectively.

Ionic doping effects of various ions in Bi-layered ferroelectric SrBi2Nb2O9 (SBN) ceramics were studied. Un-doped and doped SBN ceramics with Ba2+, Pb2+, Ca2+, Bi3+, La3+, Ti4+, Mo6+, and W6+ ions were made with solid state reactions. Temperature dependent dielectric constants were measured. Ferroelectric transition temperature (TC) decreased with Ba2+ and Pb2+ ions but increased with Ca2+ ion which substitutes the 12-coordinated Sr2+ site. TC increased with Ti4+, Mo6+, and W6+ ions which substitute the 6-coordinated Nb5+ sites. With trivalent Bi3+ and La3+ ions, TC increased with Bi3+ ion but much decreased with La3+ ion. These results showed that the ion size plays an important role in ferroelectricity of SBN ceramics.

Here, we describe an external tracheal stabilization technique used in a patient with tracheomalacia. A 56-year-old man presented with tracheomalacia due to prolonged mechanical ventilation. The malacic tracheal segment was approximately 2 cm in length. The malacic segment was covered with a silicone tube sutured in place using Prolene sutures (Ethicon, Somerville, NJ). Several anchoring sutures were placed between the tracheal mucosa and the silicone tube without violating the mucosal continuity. The patient was discharged on postoperative day 5 without complication. This method of external tracheal stabilization is a less invasive alternative for the management of this particular patient.

// Sang Yun Ha 1, * , So-Jung Choi 2, * , Jong Ho Cho 3, * , Hye Joo Choi 2 , Jinseon Lee 2 , Kyungsoo Jung 4 , Darry Irwin 5 , Xiao Liu 6, 7 , Maruja E. Lira 8 , Mao Mao 9 , Hong Kwan Kim 3 , Yong Soo Choi 3 , Young Mog Shim 3 , Woong Yang Park 10 , Yoon-La Choi 1, 4, 10 , Jhingook Kim 2, 3 1 Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 3 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea 4 Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University School of Medicine, Seoul, Korea 5 Agena Bioscience, Sequenom, San Diego, CA, USA 6 BGI-Shenzhen, Shenzhen, China 7 Department of Biology, University of Copenhagen, Copenhagen, Denmark 8 Oncoloy Research Unit, Pfizer Worldwide Research and Development, San Diego, CA, USA 9 WuXi AppTec, Shanghai, China 10 Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea * These authors contributed equally to this work Correspondence to: Jhingook Kim, e-mail: jhingookkim@gmail.com Yoon-La Choi, e-mail: ylachoi@skku.edu Keywords: non-small cell lung cancer, adenocarcinoma, never-smoker female, driver mutation, EGFR Received: August 07, 2014 Accepted: December 16, 2014 Published: March 09, 2015 ABSTRACT The aim of this study was to determine the distribution of known oncogenic driver mutations in female never-smoker Asian patients with lung adenocarcinoma. We analyzed 214 mutations across 26 lung cancer-associated genes and three fusion genes using the MassARRAY® LungCarta Panel and the ALK, ROS1 , and RET fusion assays in 198 consecutively resected lung adenocarcinomas from never-smoker females at a single institution. EGFR mutation, which was the most frequent driver gene mutation, was detected in 124 (63%) cases. Mutation of ALK, KRAS, PIK3CA, ERBB2, BRAF, ROS1, and RET genesoccurred in 7% , 4%, 2.5%, 1.5%, 1%, 1%, and 1% of cases, respectively. Thus, 79% of lung adenocarcinomas from never-smoker females harbored well-known oncogenic mutations. Mucinous adenocarcinomas tended to have a lower frequency of known driver gene mutations than other histologic subtypes. EGFR mutation was associated with older age and a predominantly acinar pattern, while ALK rearrangement was associated with younger age and a predominantly solid pattern. Lung cancer in never-smoker Asian females is a distinct entity, with the majority of these cancers developing from oncogenic mutations.

Background Rectal cancer has a higher risk of developing lung metastasis compared with colon cancer. It is unclear whether the prognosis after pulmonary metastasectomy for these distinct tumors is different. Methods Patients who underwent pulmonary metastasectomy for colorectal carcinoma were analyzed for survival and patterns of recurrence depending on the location of the primary colorectal cancer. Multivariate regression analysis was performed to identify clinical variables predictive of survival after pulmonary metastasectomy. Results Between 1985 and 2012, 698 patients underwent pulmonary metastasectomy for metastatic colorectal cancer. Complete information was available in 626 patients. These patients were divided into groups based on whether the primary tumor was colon or rectal in origin. Median follow-up was 45.5 months (range, 23 to 287 months). There were no statistical differences between the two groups in terms of number of lung metastases, tumor size, or lymph node involvement. There was no difference in overall survival ( p = 0.545). Five-year disease-free survival for colon cancer patients was 67.2% compared with 60.1% for rectal cancer ( p = 0.004). The most common sites of recurrence after pulmonary metastasectomy were liver in colon cancer and lung in rectal cancer. Multivariate Cox proportional hazards analysis indicated that rectal cancer (hazard ratio, 1.39; 95% confidence interval, 1.07 to 1.83; p = 0.015) and multiple metastases (>3; hazard ratio, 1.41; 95% confidence interval, 1.04 to 1.89; p = 0.027) were independent adverse risk factors affecting disease-free survival after pulmonary metastasectomy. Conclusions Disease-free survival and site of recurrence after pulmonary metastasectomy for colorectal carcinoma are dependent on the site of the primary tumor. Lung metastases from rectal cancer have a worse disease-free survival compared with colon cancer. This may influence treatment and follow-up strategies.

As an intermediate stage to understand the electric and structural properties during the transition from glass to crystal, the time dependence of growing mechanism measured using the synchrotron radiation for high statistics is presented for the LiTaO3 polycrystals in the matrix of LiTaO3-SiO2 glass. In the electric measurement of LiTaO3-SiO2 glass with heating, there appears anomalous dielectric effect in the glass phase. From the experiments with changing sample environment, it is found the large increase in dielectric constant is affected by air and the structural relaxation effect of the glass state appears in the dielectric response measured after heat treatment.

The crystallization in the flaked and the powdered glasses of bismuth germanium oxide(Bi4Ge3O12) has been studied. XRD was taken to get the crystal structure and crystallization process by changing annealing temperature and time. DTA was used to get various parameters involving crystallization with non-isothermal method by varying heating rates. The calculated activation energies and Avrami parameter by using modified Ozawa method were 5.95 ±0.47eV, 5.21±0.59eV and 1.52, 1.22, respectively.

Pleural epithelioid hemangioendothelioma (EHE) is a very rare disease with adverse clinical outcomes. Recently, CAMTA1 rearrangement has been introduced as a consistent genetic abnormality in EHEs of different anatomical locations. We report a 71-year-old man with pleural EHE harboring CAMTA1 rearrangement confirmed by fluorescence in situ hybridization on paraffin embedded tissue.

Sulforaphane is a natural chemopreventive isothiocyanate and abundantly found in various cruciferous vegetables. Although chemopreventive activity of sulforaphane is well documented, the detailed biochemical mechanism(s), underlying how it regulates the protein translation process to antagonize pro-inflammatory responses are largely unclear. In the present study, we show that lipopolysaccharide (LPS) or 12-O-tetradecanoylphorbol-13-acetate (TPA) treatment reduces cellular levels of PDCD4, and this event is mediated by affecting both transcription and proteolysis in RAW 264.7 cells. We show that LPS-mediated or TPA-mediated PDCD4 downregulation is catalyzed by the activation of intracellular Akt1 or S6K1 kinases and that sulforaphane suppresses LPS-induced or TPA-induced Akt1 or S6K1 activation, thereby resulting in the attenuation of PDCD4 downregulation in RAW 264.7 cells. We propose that sulforaphane suppression of PDCD4 downregulation serves as a novel molecular mechanism to control proliferation in response to pro-inflammatory signals.

e20030Background: The optimal treatment strategy for IIIa(N2) NSCLC remains uncertain with poor survival outcomes. Moreover, there have been few investigations about the pattern of failure, which a...

Accurate assessment of the lymphatic system has been limited due to the lack of optimal diagnostic methods. Recently, we adopted noncontrast magnetic resonance (MR) lymphangiography to evaluate the central lymphatic channel. We aimed to investigate the feasibility and the clinical usefulness of noninvasive MR lymphangiography for determining lymphatic disease. Ten patients (age range 42–72 years) with suspected chylothorax (n = 7) or lymphangioma (n = 3) who underwent MR lymphangiography were included in this prospective study. The thoracic duct was evaluated using coronal and axial images of heavily T2-weighted sequences, and reconstructed maximum intensity projection. Two radiologists documented visualization of the thoracic duct from the level of the diaphragm to the thoracic duct outlet, and also an area of dispersion around the chyloma or direct continuity between the thoracic duct and mediastinal cystic mass. The entire thoracic duct was successfully delineated in all patients. Lymphangiographic findings played a critical role in identifying leakage sites in cases of postoperative chylothorax, and contributed to differential diagnosis and confirmation of continuity with the thoracic duct in cases of lymphangioma, and also in diagnosing Gorham disease, which is a rare disorder. In patients who underwent surgery, intraoperative findings were matched with lymphangiographic imaging findings. Nonenhanced MR lymphangiography is a safe and effective method for imaging the central lymphatic system, and can contribute to differential diagnosis and appropriate preoperative evaluation of pathologic lymphatic problems.

A 62-year-old woman was referred to our hospital for evaluation of hemoptysis. Chest computed tomography demonstrated an accessory cardiac bronchus (ACB) arising from the carina with a well-defined mass approximately 3 cm in size. Fiberoptic bronchoscopy also revealed the presence of an ACB arising from the carina. We performed mass excision and en bloc resection of portions of the pericardium. Pathologic examination revealed that the tumor was an adenocarcinoma arising from an ACB.

Background The objective of this study was to compare outcomes of video-assisted mediastinoscopic lymph node biopsy in patients with non-small cell lung cancer (NSCLC) with outcomes of conventional mediastinoscopic lymph node biopsy in this same patient population. Methods All mediastinoscopies at one medical center from January 2008 to December 2009 were analyzed. Numbers of lymph nodes dissected, stations biopsied, remnant lymph nodes when major lung resection was performed after mediastinoscopic lymph node biopsy, and complications were recorded. Results Of 521 mediastinoscopies, 222 were in the conventional mediastinoscopic lymph node biopsy group (CM group) and 299 were in the video-assisted mediastinoscopic lymph node biopsy group (VAM group). Eleven complications (2.11%) occurred, with more occurring in the CM group (3.6%) than in the VAM group (1.6%; p = 0.030). The total number of dissected nodes was higher in the VAM group (mean, 8.53 ± 5.8) than in the CM group (mean, 7.13 ± 4.9; p = 0.004), and there was no statistically significant difference between the average number of stations sampled in the CM group (2.98 ± 0.7) and in the VAM group (3.06 ± 0.75; p = not significant). The number of remnant lymph nodes when major lung surgery was performed after mediastinoscopy was lower in the VAM group (mean, 5.05 ± 4.5) than in the CM group (mean, 7.67 ± 6.5; p Conclusions This study found that video-assisted mediastinoscopic lymph node biopsy had fewer complications than did the conventional method. More lymph nodes were examined and fewer lymph nodes remained after mediastinoscopy by video-assisted mediastinoscopy (VAM) than by conventional mediastinoscopy.

In an effort for better understanding on (Bi0.5Na0.5)TiO3, donors such as Nb5+ and W6+ were doped by a conventional solid state mixing process. Their doping effects on ferroelectric and piezoelectric properties of (Bi0.5Na0.5)Ti1-xDxO3 were investigated. The solubility limit of Nb (xles0.01) and W (xles0.008) was determined by the X-ray diffraction after a typical sintering at 1150degC for 2 hours in air. Microstructurally grain size decreased with doping within each solubility limit. As for ferroelectric and piezoelectric properties, coercive fields (Ec) and mechanical quality factors (Qm) decreased with doping while piezoelectric constant (d33) increased, which is a similar tendency observed in the typical donor doped Pb(Zr,Ti)O3 ceramics.

Objective The purpose of the present study was to determine the effects of the surgical excision of lateral marginal veins (LMVs) in patients with a venous malformation (VM) affecting the lower extremity. Methods Preoperative and postoperative air plethysmography (APG), CEAP classification C scores, and venous clinical severity scores (VCSS) of the 25 VM patients who underwent LMV excision were compared. Results After LMV excision, venous haemodynamic parameters revealed significantly increased ejection fraction (EF, 33.2 S.D.18.5% vs. 39.7 S.D.21.2%, P = .020), and reduced venous volume (VV, 235.0 S.D.141.8 ml vs. 198.0 S.D.114.1 ml, P = .016) and residual venous fraction (RVF, 62.4 S.D. 26.6% vs. 56.9 S.D. 25.3%, P = .046). Clinical assessments of affected limbs revealed significantly improved mean CEAP C scores and VCSS (preoperative score, 4.4 S.D.1.7 vs. postoperative score 2.4 S.D.1.7, P = .026) after LMV excision versus preoperative data. Conclusion Haemodynamic and clinical improvements were observed in patients with lower extremity VM after LMV excision.

Colorectal cancer (CRC) is one of the most common cancers worldwide, with 5%-15% of CRC patients eventually developing lung metastasis (LM). Despite doubts about the role of locoregional therapy in the management of systemic disease, many surgeons have performed pulmonary metastasectomy (PM) for CRC in properly selected patients. However, the use of pulmonary metastasectomy remains controversial due to the lack of randomized controlled studies. This article reviews the results of surgical treatment of pulmonary metastases for CRC, focusing on (1) current treatment guidelines and surgical techniques of PM in patients with LM from CRC; (2) outcomes of PM and its prognostic factors; and (3) controversial issues in PM, focusing on repeated metastasectomy, bilateral multiple metastases, and combined liver and lung metastasectomy.

흉강경 수술(video-assisted thoracic surgery, VATS)은 1910년 Jacobaeus가 흉강경을 고안하여 기흉 치료 목적으로 처음 사용한 이후 현재까지 많은 늑막 질환 이외에도 폐암 수술, 식도암 수술 등 대부분의 흉부외과 수술 영역에서 이용되고 있다[1-3]. 1992년에 Roviaro 등과 Lewis 등이 폐암환자에서 흉강경 폐엽절제술을 안전하게 시행할 수 있다고 보고하였는데[4,5], 현재까지도 재발 및 장기 생존율 등 기존의 개흉술에 비해 종양학적 안전성에 여전히 논란이 많으나, 2007 년 미국 Society of Thoracic Surgeons (STS) general thoracic surgery database (STS database)에 따르면, 원발성 폐암환자의 약 29%에서 비디오 흉강경 폐엽절제술이 시행되고 있었으며[6], 2011년 Danish Lung Cancer Registry에 따르면 병기 I 폐암환자 중 약 50%에서 흉강경을 이용하여 폐엽절제술이 시행되고 있을 정도로널리시행되고 있다[7]. 국내에서는 1993년도에 양성 폐종양에서 흉강경을 이용한 폐엽절제술이 처음 시도되었으며[8], 2003년 폐암에서 흉강경을 이용한 폐엽절제술이 국내에서 최초로 시행된 이래로 현재까지 국내 대다수 상급종합병원의 흉부외과에서 비디오 흉강경 폐엽절제술이 시행되고 있다[9]. 삼성서울병원에서 시행되고 있는 폐암수술은 최근 2010부터 2012년까지 총 683예에서 887예까지 지속적으로 증가 추세에 있으며, 약 60%에 가까운 환자들에 있어서 흉강경을 이용한 폐암 수술이 적용되고 있다(Fig. 1). 폐암환자에서 흉강경을 이용한 폐엽절제술은 개흉술에 비해 수술 후 통증조절의 향상, 조기 일상생활로의 복귀, 낮은 수술 후 합병증 및 사망률 등으로 인해 초기 폐암환자에서는 기존의 개흉술을 대신할 만한 최소 침습수술로 인정되고 있다[6,10]. 2013년에 발표된 American College of Chest Physicians evidence-based clini

Traumatic pulmonary pseudocyst is a rare complication of blunt chest trauma that usually appears immediately in children or young adults and is characterized by a single or multiple pulmonary cystic lesions on chest radiography and has spontaneous resolution of the radiologic manifestations. However, we experienced a case of a delayed complicated pulmonary pseudocyst in a 17-year-old boy following severe traumatic acute respiratory distress syndrome rescued by Veno-venous extracorporeal membrane oxygenation (ECMO). In this case, the pseudocyst appeared on the 12th day after trauma and transformed into an infected cyst. Veno-venous ECMO was successfully maintained for 20 days without anticoagulation.