The diffuse interstitial lung diseases are a heterogeneous group of diffuse inflammatory disorders of the lower respiratory tract characterized by derangements of the alveolar walls and loss of functional alveolar capillary units. The most common causes of diffuse interstitial lung diseases are idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disorders, hypersensitivity pneumonitis and pneumoconiosis. Especially, the miliary tuberculosis is also leading cause in Korea, but pulmonary tuberculosis presenting as diffuse interstitial lung disease except miliary tubercuaosis is rare. We report a case of pulmonary tuberculosis presenting as diffuse interstitial lung disease associated with the tyrnphadenopathy of mediastinum and abdomen.

Castleman's disease, giant lymph node hyperplasia, is a rare benign tumor which was originally reported by Castleman in 1956. It has two types of pathological characteristics of hyaline-vascular and plasma cell. Surgery is usually perferred because of the giant mass shadow on the chest roentgenogram rather than symptomes it causes. It is cured completely by resection without recurrence. We have experienced a case of Castleman's disease in the right anterosuperior mediastinum in a 36-year-old female. She was treated by surgical resection with good result She is well one year after surgeny.

Chronic tuberculous empyema thoracis was intially treated by anti-tuberculous medication. thoracentesis and closed tube thoracostomy. But when the empyema cavity was not completely closed. another more aggressive and extensive thoracic operations were needed.

Recently the author experienced the 4 kinds of the operations. which included 1) Decortication. 2) Thoracoplasty. 3) Open drainage and 4) Pleuropneumonectomy.

Postoperative courses uneventful in all 4 cases.

A 36-year-old male farmer was admitted due to exertional dyspnea for 15 years. Cardiac examination revealed mitral valvular stenosis. aortic valvular stenosis and regurgitation. Single pulmonary nodule was found in the left lower lung field in chest X-ray.

Concomitant double valve replacement and resection of pulmonary nodule were performed using mid-sternotomy simultaneously.

Postoperative course was uneventful and pathological diagnosis of pulmonary nodule was hamartoma.

Four single transplantations of left lungs in dogs were performed from October 1989 to June 1990 at the department of Thoracic and Cardiovascular surgery, Collge of Medicine, Ewha Womans University.

Under general endotracheal anesthesia, the donor dog was placed in right lateral decubitus position and the left anterolateral thoracotomy incision was made. Both lungs and heart were removed by division of superior vena cava, inferior vena cava, descending aorta and trachea. After trimming, left lung was immersed in a basin containing 4℃ normal saline and the pulmonary artery was flushed by the dripping of the heparinized cold saline with 60cm H₂O pressure.

In the recipient dog, left extrapericardial pneumonectomy was done as in usual manner. Prepared left lung of donor dog was placed in the left thoracic cavity of the recipient dog and pulmonary arterial anastomosis was made with continuous 5-0 Prolene^** suture. Recipient's pericardium was opened and anastomosis of the left atrial cuff was performed with continuous 3-0 Prolene suture. Air was evacuated from the left atrium by gradual release of left atrial clamp and inducing the back bleeding before completion of anastomosis.

Bronchial anastomosis was performed with interrupted 4-0 absorbable suture and knots were placed externally.

Throught upper mid-laporotomy incision, omentum was mobilized and retrieved through created retrosternal tunnel and anastomosised mainstem bronchus was completely wrapped.

After operations, 3 dogs died due to hemorrhagic shock, asphyxia and stenosis of left pulomnary artery at the anastomosis site. One had survived to postoperative 7th day in good condition.

Relief of the pain is important for reducing patient's discomfort and morbidity after thoracotomy. Post-thoracotomy pain was controlled by pharmacological blockage of the intercostal nerves with bupivacaine in 20 patients. Bupivacaine was infused intermittently through one inwelling cathter, which was placed in the pleural space during the thoracotomy. Pain was well controlled by this procedure.

Clinical analysis for 95 cases with spontaneous pneumothorax which were treated at the Department of Thoracic and Cardiovascular Surgery of Ewha Womans University Hospital from March, 1982 to February, 1988 had been done. Among 95 cases male was 81 and female was 14. Male to female ratio was 5.8:1. The youngest patient was 16 years old and the oldest was 73 years old. Most of the patients were between 21 and 40 years old. Ninety cases had unilateral pneumothorax and 5 cases had bilateral pneumothorax. Sudden dyspnea was appeared in 85.3% of all cases and chest pain was in 60% of patients. Initial treatment was bed rest with high oxygen therapy for 6 patients. Tube thoracostomy was done for the remaining cases. The results of initial treatment in 90 paients with unilateral pneumothorax as follow; Thoracotomy was done for 11 cases due to persistent air leak through the chest tube. initial treatment was sucessful in 79 cases but 22 cases were recurred. So recurrence rate was 27.8%. Among 22 cases, 13 cases were operated. There was no recurrence in thoracotomy cases. In 5 patients with bilateral pneumothorax, two cases were operated on one side. Bilateral thoracotomy was done for one patient.

The underlying causes of the spontaneous pneumothorax were bullae in 16 cases, bullae with pulmonary tuberculosis in 9 cases and pulmonary tuberculosis in 3 cases among 28 operations of 27 cases. Among 68 of non-thoracotomy patients, no definite causes were found in 31 cases and obstructive lung disease in 2 cases, lung cancer, lung abscess and pneumonia in 1 case each.

Relief of the pain is important for reducing patient's discomfort and morbidity after thoracotomy. Post-thoracotomy pain was controlled by pharmacological blockage of the intercostal nerves with bupivacaine in 20 patients. Bupivacaine was infused intermittently through one inwelling cathter, which was placed in the pleural space during the thoracotomy. Pain was well controlled by this procedure.

164 cases of cardiovascular surgery were performed at Ewha Womans University Hospital from March 1982 to October 1987. There were 119 cases of open heart surgery and 45 cases non open heart surgery. There were 112 congenital cardiac anomalies and 50 acquired heart diseases. Congenital cardiac anomalies were 35 PDA, 29 VSD, 21 TOF, 13 ASD, 3 ECD, 2 MR and 9 other rare anomalies. Acquired heart diseases were 24 mitral valvular diseases, 7 aortic valvular diseases, 14 multiple valvular diseases and 5 other rare diseases. We had 21 operative mortalities and 18 complications.