• Title/Summary/Keyword: 혈관 확장

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Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass (정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예)

  • Park Han Gyu;Choi Chang Woo;Lee Jae Wook;Her Keun;Shin Hwa Kyun;Won Yong Soon
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.72-75
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    • 2006
  • In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).

Midterm results of aortic root enlargement with AVR in patients with narrow aortic root and AS (협소 대동맥 판륜을 가진 환자에서의 대동맥치환술시 판륜 확장술의 중기 성적)

  • 박광훈;김하늘루;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.285-289
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    • 2000
  • Background: For AVR using conventional prosthetic valves in adult patients with a narrow aortic root, aortic root enlargement is necessary to reduce postoperative pressure gradient across the aortic valve (ΔP). An evaluation of early and mid-term results of aortic root enlargement with AVR and echocardiographic follow up of ΔP and left ventricular function was performed. Method: From Aug. 1991 to Feb. 1998, eighteen patients aged 17 to 59 years(mean, 38$\pm$12 years) underwent Manouguian procedure with AVR. Aortic annular circumstance was enlarged 10.0mm to 18.0mm(mean, 12.6$\pm$6.3mm). Eight patients(44.0%) had NYHA class III status before operation, and seven cases of them underwent concomitant MVR. Valve pathology was ASr in 6 cases, AS in 4 cases, nd ASr+MSr in 8 cases. Replaced valve size was 21mm in 8 cases and 23 mm in 10 cases, and St. Jude Medical mechanical valve was used in 10 cases and Carbomedics in 8 cases. Result: Follow-up duration was 6 to 57 months (mean, 26$\pm$18 months), and total follow-up was 287 patient-year. There were one hospital death and one late death, therefore, actuarial survival rate was 85.7% at 56 months. Peak ΔP wad decreased significantly at postoperative mid-term period as 13$\pm$5mmHg, compared with thepreoperative one (42$\pm$8mmHg) (p<0.01). LVM(gm/$m^2$) was also diminished as 35.8%(115$\pm$36gm/$m^2$)at postoperative mid-term period, compared with preoperative one (179$\pm$56gm/$m^2$)(p<0.05). Conclusion: There were no specific complications related to the procedure. And we could have adequate enlargement of aortic annulus to suitable prosthetic valve that have no effect of patient-prosthese mismatch.

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A Case Report of Endobronchial Lipoma (기관지내 지방종 -체험 1례-)

  • Lee, Jong-Mok;Park, Jong-Ho;Baek, Hui-Jong;Jo, Jae-Il
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.116-118
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    • 1997
  • Endobronchial lipomas Are rare lesions that usually obstruct a major bronchus and cause irreversible pulmonAry damage distally. They are histologically benign tumors. But they can produce pulmonary damage or irreversible bronchiectasis if dignoses or tr atments are delayed. Whenever possible, the treatment of choice is resection by means of bronchoscopy. If endoscopic removal is not possible or lf the nature of the tumor is unclear, surgery is necessary. with lobectomy or pneumonectomy being required in most cases due to the extensively damaged pulmonary parenchyma . We present a case of endobronchial lipoma causing bronchial obstruction and peripheral organizing pneumonia with its clinical features. diagnosis find treatment methods.

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Computed Tomographic Findings of Segmental Caudal Vena Cava Aplasia in Two Dogs (개에서 컴퓨터단층촬영에 의해 진단된 후대정맥 분절 무형성증 2 례)

  • Lee, In;Choi, Soo-Young;Lee, Ki-Ja;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.196-199
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    • 2015
  • A 7-year-old intact female dachshund (Dog 1) and a 17-year-old intact male Yorkshire terrier (Dog 2) were presented for evaluation of mammary gland tumor and a regular checkup, respectively. Incidentally, segmental caudal vena cava aplasia was detected on CT images in both dogs. Absent postrenal segment (Dog 1) or discontinuation of caudal vena cava (Dog 2) were detected, but prerenal segment of caudal vena cava was continued to the dilated azygos vein. Segmental CVC aplasia should be considered when an abdominal vascular anomaly was evaluated with CT angiography in dogs.

Delayed Primary Repair of Esophageal Rupture (식도천공 후 만기 일차 봉합술의 성적)

  • 김길동;정경영;김창수;박한기
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.46-51
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    • 1998
  • Treatment of esophageal perforation when diagnosed late remains controversial. Ten consecutive patients since 1990 were treated late(later than 24 hours) for esophageal perforation with primary repair. Four perforations were iatrogenic, 3 were spontaneous, 2 were foreign body aspiraton and 1 was trauma. The interval from perforation to operation was 116 hours in mean and 48 hours in median value. The principles of repair included (1) a local esophagomyotomy proximal and distal to the tear to expose the mucosal defect and intact mucosa beyond, (2) debridement of the mucosal defect and closure, (3) reapproximation of the muscle, and (4) adequate drainage. The repair was buttressed with parietal pleura or pericardial fat in 9 patients. Associated distal obstruction was treated with dilation and esophagomyotomy intraoperatively. There was one mortality and cause of death was massive gastric bleeding due to gastric ulcer on 33rd day after operation. Five patients had leak at the site of repair and these cases were treated completely with conservative treatment except a mortality case. In conclusion, in the absence of malignant or irreversible distal obstruction, meticulous repair of perforated esophagus and adequate drainage are preferred approach, regardless of the duration from the injury to the operation.

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Middle Lobe Syndrome (중엽증후군)

  • 이용훈;김병철
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.621-625
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    • 1996
  • "Middle lobe syndrome" which was described y Graham and associates at first is always caused by ex- ternal bronchial compression by Iymph nodes. Although the patients may not present any symptom, the most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic procedures includ chest X-ray bronchoscopy, brochography, chest CT, and the principal finding is the contracted middle lobe which is usually airless. We experienced fifteen cases of middle lobe syndrome from April 1990 to May 1995. Eleven patients were treated surgically. The surgical candidates for middle lobe syndrome are suspicious malignancy, fixed bronchiectasis, bronchostenosis, intractable to medical treatment, recurrent infection. Operations were right middle lobectomy (8), right middle and lower bilobectomy (2), right upper and middle bilobectomy (1). Postoperative histological findings were tuberculosis in six, chronic inflammation in three, malignancy in one, and focal hemorrhage in one. There were two cases of postoperat ve complications which were postoperative atelectasis and hepatopathy.patopathy.

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Budd-Chiari Syndrome Due to Antithrombin, Protein C and Protein S Dficiency and the Complete Obstruction of SVC (항트롬빈, C 단백, S 단백 결핍에 의한 Budd-chiari syndrome과 상대정맥 폐색)

  • 김태윤;이원용;홍기우;김응중;신윤철;김건일;임종윤;유규형;최영진
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.239-243
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    • 2002
  • In this case, a 39 year-old man was admitted with Budd-Chiari syndrome associated with complete superior vena cava(SVC) obstruction causing general edema and hepatic failure. Conservative medical therapy was failed. And after the radiologist failed to invasive procedure of balloon dilatation, we attempted the inferior vena cava to right atrium bypass graft. Operation was done through median sternotomy and extended vertical oblique abdominal incision. A 24 mm Dacron tube was placed from the inferior vena cava just below the left renal vein to the right atrium without using the cardiopulmonary bypass pump. The patient's postoperative course was uneventful without signs of bleeding or any other complications. We used anticoagulants at the postoperative first day. At the postoperative 26th day, we performed abdominal Doppler sonography and we confirmed that the graft patency was good. The patient was discharged with SVC obstructive symptoms but we noticed relief of SVC obstructive symptoms in the course of follow-up.

A Case Report of Heart Transplantation Bridged by Bi-ventricular Assist Device in a Pediatric Patient of Prerenal Type ARF (소아환자에서 양심실 순환보조를 중개로 한 후 발생한 급성신부전 환자에서의 심장 이식수술 치험 1예)

  • Ra, Yong-Joon;Koak, Jae-Gun;Kim, Jin-Hyun;Oh, Se-Jin;Lee, Jae-Hang;Kim, Woong-Han
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.854-857
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    • 2006
  • The patient was an eight-year-old female. She was diagnosed as dilated cardiomyopathy. She was supported with bi-ventricular assist because of heart failure for 15 days. After 7 days, she was suffered from prerenal type ARF and support with continuous veno-veno hemodyalisis(CVVHD). And then heart transplantation was performed, heart donor's blood type was A. Immune suppressants were used after due consideration for renal toxicity. ARF was resolved on post operative $14^{th}$ day. She was discharged on post operative $52^{nd}$ day without any specific post operative complication. She has been followed up without any immune rejection reaction upto 14 months.

Surgical Repair of Left Coronary Artery Pseudoaneurysm 10 Years after a Bentall's Procudure (Bentall 수술 10년 후 발생된 좌관상동맥 가성동맥류의 수술 치료)

  • Lee, Sak;Kang, Meyun-Shick;Lim, Sang-Hyun;Chang, Byung-Chul;Hong, You-Sun
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.225-227
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    • 2007
  • The aortic inclusion technique is frequently used in the original Bentall's procedure for the control of excessive postoperative bleeding. Although this procedure has improved the outcome of patients with aortic root disease, there is a high incidence of both early and late complications, including coronary artery stenosis, kinking or pseudoaneurysm formation at the coronary suture lines. Pseudoaneurysm of the ascending aorta is a relatively rare, but fatal complication, which occurs after wrap-inclusion composite graft replacement. Herein, the case of a 45-year-old female, who developed a perigraft aortic pseudoaneurysm 10 years after a Bentall's procedure (wrap-inclusion technique), but was successfully managed using the Cabrol's method, is reported.

Vibro ordalii, the causative agent of massive mortality in cultured rockfish(Sebastes schlegeli) larvae (양식 조피볼락(Sebastes schlegeli) 치어의 대량폐사 원인인 비브리오병에 관하여)

  • Park, Sung-Woo;Kim, Young-Gill;Choi, Dong-Lim
    • Journal of fish pathology
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    • v.9 no.2
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    • pp.137-145
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    • 1996
  • A specific disease syndrome, which led to massive mortality on larve of rockfish(Sebastes schlegeli) in marine hatcheries at Chungnam area during the period 1995~1996 was studied. The causative agent isolated from the diseased or dead larvae was identified as Vibrio ordalii on the basis of biochemical and biological characteristics. In the experimental challenges aganist 0 and 1 summer fish conducted at two different temperatures as $18^{\circ}C$ and $25^{\circ}C$, Vibrio ordalii showed higher virulence to no summer fish at $18^{\circ}C$ than 1-summer fish at $25^{\circ}C$. These results were consistent to field data obtained during epizootic outbreaks in the farms. Moribund and died larvae presented telangiectasis of secondary gill lamella and brain, dissecting of respiratory epithelium, atrophy of hepatic cells and necrosis of kidney associated with the presence of the bacteria. But the digestive tissue of these fish showed no significant change.

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