Jae-Bum Kim

Overexpression of cyclooxygenase‐2 in NCI‐H292 human alveolar epithelial carcinoma cells: Roles of p38 MAPK, ERK‐1/2, and PI3K/PKB signaling proteins

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. J. Cell. Biochem. 112: 3015–3024, 2011.

Bronchogenic Cyst of the Right Hemidiaphragm Presenting with Pleural Effusion

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.

Clinical Characteristics and Management of Intrathoracic Bronchogenic Cysts: A Single Center Experience

Background The aim of this study is to investigate the clinical characteristics and management of intrathoracic bronchogenic cysts. Materials and Methods 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. Results 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. Conclusion 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.

Part 2. Adult basic life support: 2015 Korean Guidelines for Cardiopulmonary Resuscitation.

1 Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 2 Department of Thoracic and Cardiovascular Surgery, Keimyung University School of Medicine, Daegu, Korea Department of Anesthesiology, Seoul National University Bundang Hospital, Seongnam, Korea Department of Emergency Medicine, Chung-Ang University College of Medicine, Seoul, Korea Department of Nursing Science, Baekseok University, Cheonan, Korea 6 Department of Emergency Medical Service, Namseoul University, Cheonan, Korea Department of Emergency Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea Department of Emergency Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea

Safety of a Totally Implantable Central Venous Port System with Percutaneous Subclavian Vein Access

Background 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. Materials and Methods 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. Patients profiles, indications of port system, early and delayed complications, and implanted period were evaluated. Results 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%). Conclusion 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.

Sutureless aortic valve replacement in stentless bioprosthesis failure

Reoperation for a failed stentless bioprosthesis is an extremely challenging procedure due to severe adhesion around the previous stentless graft and the severely calcified aortic root. Although rarely the subject of reports in the literature, sutureless aortic valve replacement allows a fast and simple implantation, which decreases the risk of cardiac ischaemia and cardiopulmonary bypass. Here we present the case of sutureless aortic valve replacement as a potentially simple and safe option for reoperation for a failed stentless bioprosthesis.

Leiomyosarcoma of the Posterior Mediastinum Extending into the Adjacent Spinal Canal

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 patients 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.

Transient Constrictive Pericarditis after Coronary Bypass Surgery

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.

Aortic retrograde type A aortic dissection following repair of a thoraco-abdominal aortic aneurysm

Retrograde type A aortic dissection (RAAD) may occur early or late following thoracic endovascular aortic/aneurysm repair procedures. We present images of a RAAD following an open repair of a thoracoabdominal aortic aneurysm (TAAA). A 59-year-old male underwent a repair of a 6-cm extent II TAAA which had progressively increased over 1 year following an acute type B aortic dissection (Figure 1). At the time of surgery, a left thoraco-abdominal incision was performed and the chest entered through the 6th interspace. Partial cardiopulmonary bypass (CPB) was instituted with left femoral artery and venous cannulation. The aorta was clamped between the left carotid and subclavian arteries, and a #26-mm Gelweave thoracoabdominal graft (Vascutek Ltd, Inchinnan, Scotland) was placed distal to the left subclavian artery extending to the infra-renal abdominal aorta. T9 and 10 segmental intercostal arteries as well as the visceral and renal arteries were re-attached to the graft. The patient tolerated the procedure well; however, on the evening of surgery, he developed cardiac tamponade, which required emergent pericardial drainage at the bedside. A computed tomography (CT) angiogram examination revealed a RAAD from the distal arch to the ascending aorta (Figure 2) and an echocardiogram demonstrated severe aortic insufficiency. The patient was taken to the operating room; a median sternotomy was

Catastrophic Bronchial Spasm Due to a Severe Anaphylactic Reaction to Protamine.

Fatal anaphylactic reactions to protamine sulfate during cardiac surgery are very rare. We report a case of catastrophic bronchial spasm due to an anaphylactic reaction to protamine. The patient was managed successfully using a bronchodilator, steroid treatment, and extracorporeal membrane oxygenation.