• Tuberculosis and Respiratory Diseases
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• 제60권6호
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• pp.678-683
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• 2006

기관지 평활근종과 폐 격리증은 두 질환 모두 희귀한 질환으로 같이 동반된 증례는 현재까지 보고된 적은 없다. 저자들은 호흡곤란, 기침, 화농성 객담을 주소로 개인의원에서 폐렴 치료 후 호전 없어 본원으로 전원 후, 흉부 CT 촬영과 기관지내시경에서 좌폐하엽의 허탈을 동반한 좌측 주기관지의 말단부위에 1.5 cm크기의 종괴와 대동맥에서 나오는 이상 동맥을 발견하여 이상 동맥 결찰과 좌하엽 절제술을 시행하여 호전되었던 폐 격리증을 동반한 기관지 평활근종 1 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제34권4호
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• pp.283-286
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• 2017

A 4-month-old, female Maltese dog was referred with continuous heart murmur. Patent ductus arteriosus was diagnosed via radiography and echocardiography. The patient was untreated because of client's refusal. After 13 months, the dog was referred again with seizure and salivation. Laboratory examination revealed increased liver enzymes, hyperammonemia and decreased total cholesterol and total protein. Microhepatica was identified on abdominal radiography. CT angiography showed a shunt vessel that originated from the portal trunk to the prehepatic caudal vena cava and patent ductus arteriosus connecting proximal descending aorta with the main pulmonary artery. No portal vasculature toward liver is observed after shunt vessel. The patient was diagnosed as concurrent patent ductus arteriosus and congenital extrahepatic portosystemic shunt with suspected portal vein aplasia. In human, cardiac malformations are frequently observed in patients with congenital extrahepatic portosystemic shunt with portal vein aplasia. This report described concurrent patent ductus arteriosus and congenital extrahepatic portosystemic shunt with suspected portal vein aplasia in a dog.

• Journal of Chest Surgery
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• 제45권3호
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• pp.202-204
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• 2012

A 55-year-old woman who had a history of percutaneous vertebroplasty was referred to our institution with sudden onset of chest pain. Computed tomography (CT) scan demonstrated a long, linear, highly-attenuated segment in the right side of the heart and fragmented pieces in the right pulmonary artery. The CT scan and echocardiogram revealed no pericardial effusion or hemopericardium. Based on these findings, we performed surgery through right anterolateral thoracotomy without cardiac arrest. As a result, we safely removed the foreign body. This approach may be a feasible and effective procedure for selected cases.

• Journal of Chest Surgery
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• 제47권3호
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• pp.298-301
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• 2014

A 35-year-old man was admitted to Korea University Anam Hospital for evaluation of intermittent chest pain. Computed tomography of the chest showed enlargement of a previously identified anterior mediastinal mass and also a well-defined, circumscribed mass in the subcarinal area, surrounded by the roof of the left atrium, right pulmonary artery, and the carina. Complete resection of the intrapericardial tumor was performed through median sternotomy without cardiopulmonary bypass. Pathologic examination identified the tumor as schwannoma, of an ancient type, diffusely positive for the S-100 antigen. Unlike other reported cases, grossly, the tumor did not seem to be involved with any nerve.

• Korean Journal of Radiology
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• 제23권2호
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• pp.172-179
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• 2022

Objective: We aimed to evaluate the ostium of right coronary artery of anomalous origin from the left coronary sinus (AORL) with an interarterial course throughout the cardiac cycle on CT and analyze the clinical significance of the ostial findings. Materials and Methods: From January 2011 to December 2015, 68 patients (41 male, 57.3 ± 12.1 years) with AORL with an interarterial course and retrospective cardiac CT data were included. AORL was classified as high or low ostial location based on the pulmonary annulus in the diastolic and systolic phases on cardiac CT. In addition, the height, width, height/width ratio, area, and angle of the ostium were measured in both cardiac phases. After cardiac CT, patients were followed until December 31, 2020 for major adverse cardiac events (MACE). Clinical and CT characteristics associated with MACE were explored using Cox regression analysis. Results: During a median follow-up period of 2071 days (interquartile range, 1180.5-2747.3 days), 13 patients experienced MACE (19.1%, 13/68). Seven (10.3%, 7/68) had the ostial location change from high in the diastolic phase to low in the systolic phase. In the univariable analysis, younger age (hazard ratio [HR] = 0.918, p < 0.001), high ostial location (HR = 4.008, p = 0.036), larger height/width ratio (HR = 5.621, p = 0.049), and smaller ostial angle (HR = 0.846, p = 0.048) in the systolic phase were significant predictors of MACE. In multivariable cox regression analysis, younger age (adjusted HR = 0.917, p = 0.002) and high ostial location in the systolic phase (adjusted HR = 4.345, p = 0.026) were independent predictors of MACE. Conclusion: The ostial location of AORL with an interarterial course can change during the cardiac cycle, and high ostial location in the systolic phase was an independent predictor of MACE.

• Tuberculosis and Respiratory Diseases
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• 제61권1호
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• pp.65-69
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• 2006

저자들은 43세 남자환자에서 반복적인 구강궤양을 가지고 있으며 안증상으로 진단한 베체트병 환자에서 폐동맥 색전증, 폐동맥류, 상대정맥 협착등 다양한 폐혈관 침범과 함께 폐아스페르길루스종을 동반한 다발성 공동 형성을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제36권7호
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• pp.497-503
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• 2003

폐 국균종은 폐결핵 등 만성 폐질환으로 인하여 파괴된 폐조직에 국균이 2차적으로 기생하여 발생하는데, 치명적 각혈 등의 증상이 발생할 수 있기 때문에 상당수 증례에서 수술적 치료를 필요로 한다. 이에 최근 10년 간의 수술적 경험을 고찰하고자 한다. 대상 및 방법: 1992년 8월부터 2002년 7월까지 폐절제술 후 병리학적으로 폐 국균종으로 확진된 31명의 환자를 대상으로 호발연령 및 성비율, 주소, 술전검사, 술식의 종류, 지저질환, 술 후 합병증 등을 분석 검토하였다. 결과: 호발연령은 30대와 40대(64.5%)이었으며, 술 전 주요증상은 객혈이었다(27명, 87.1%). 31명 모두에서 술 전 항결핵제 투여경력이 있었으며 19명(61.3%)에서 단순 흉부 방사선 사진상 연부조직 음영이 있는 큰 공동이 관찰되었고 흉부 전산화 단층촬영에서는 31명 모두에서 관찰되었다. 국균객담검사상 37.9%, 혈청 면역 확산 검사상 83.3%의 양성률을 보였다. 폐상엽이 19예(61.3%)로 호발부위였으며 대부분에서 폐엽절제술을 시행하였다. 술 후 병리조직검사상 전 예에서 결핵과 동반되어 있었다. 주요 합병증으로는 농흉 3예(9.7%), 지속적인 공기 누출 2예(6.45%), 사강 2예(6.45%), 술 후 출혈 1예(3.23%) 등이었다. 술 후 사망은 1예(3.23%)로 양측성 폐 국균종에서 수술한 반대쪽의 대량출혈로 사망하였다. 결론: 성비, 나이, 임상증상, 폐결핵과의 연관성, 병변부위 및 수술방법, 합병증 등에 대해서 과거 1963년부터 1992년까지 수술받은 80예와 비교하여 볼 때 큰 차이는 없었다. 진단 기법상 혈청검사는 술 전 아주 높은 양성률을 나타내었고 흉부전산화단층촬영의 높은 진단율은 폐 국균종의 진단과 수술에 매우 중요하다고 사료된다. 복합형 폐 국균종의 경우 흉막유착과 폐문의 경화, 잔존폐의 불완전한 확장 때문에 수술에 어려움이 있어 많은 시간 약물요법과 기관지 동맥 색전술 등의 내과적 치료를 선호하게 되는 데 이와 더불어 공동절개술 등의 비교적 비침습적인 수술방법도 추천되며 최근 합병증의 감소와 더불어 단순형 폐 국균종은 조기에 수술을 적극적으로 고려함이 요구된다.

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.297-300
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• 2012

Symptomatic pulmonary arterial hypertension (PAH) in patients with isolated atrial septal defect (ASD) is rare during infancy. We report a case of isolated ASD with severe PAH in an infant who developed airway obstruction as cardiomegaly progressed. The patient presented with recurrent severe respiratory insufficiency and failure to thrive before the repair of the ASD. Echocardiography confirmed volume overload on the right side of heart and severe PAH (tricuspid regurgitation [TR] with a peak pressure gradient of 55 to 60 mmHg). The chest radiographs demonstrated severe collapse of both lung fields, and a computed tomography scan showed narrowing of the main bronchus because of an intrinsic cause, as well as a dilated pulmonary artery compressing the main bronchus on the left and the intermediate bronchus on the right. ASD patch closure was performed when the infant was 8 months old. After the repair of the ASD, echocardiography showed improvement of PAH (TR with a peak pressure gradient of 22 to 26 mmHg), and the patient has not developed recurrent respiratory infections while showing successful catch-up growth. In infants with symptomatic isolated ASD, especially in those with respiratory insufficiency associated with severe PAH, extrinsic airway compression should be considered. Correcting any congenital heart diseases in these patients may improve their symptoms.

• Journal of Chest Surgery
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• 제37권3호
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• pp.286-291
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• 2004

원발성 지방육종은 종격동에서 매우 드물게 발생하는 악성 종양으로 수술적 절제가 가장 효과적인 치료로 알려져 있다. 24세 남자 환자가 1개월 전부터 시작된 호흡곤란과 흉부 불편감으로 타 병원에서 좌측 혈흉을 의심하여 좌측 흉관삽관술을 시행받았다. 본원 입원 후 흉부 단순촬영에서 종격동 편위소견을 보였고 빈맥이 진행하였으며, 중심정맥압이 상승하는 양상보여 진단 및 혈괴제거를 위해 응급으로 좌측 개흉술을 시행하여 다량의 점액성의 혈성 흉수를 제거하였고, 조직검사 결과 골격계외 점액성 연골육종으로 진단되었다. 2주 후 좌측 개흉술로 횡격막 및 심낭의 일부를 포함하는 흉막외 좌측 전폐적출술과 함께 종격동 종양을 절제하였다. 조직검사에서 점액성/원형세포 지방육종으로 진단되었으며, 입원 54일만에 합병증 없이 퇴원하였다. 술 후 2개월째 1회의 항암화학요법(Ifosfamide+Adriamycin: IA) 후 종격동, 좌측 견갑골 부위 및 종격동 임파선에 재발하여, 약제를 바꾸어 (Etoposide+Ifosfamide+Cisplatin: VIP) 항암화학요법을 시행하였으나 복강전이로 술 후 10개월째 사망하였다. 종격동에 발생하는 원발성 지방육종은 매우 드문 질환으로 수술적 절제 및 항암요법 후 추적관찰한 1예를 문헌고찰과 함께 보고하는 바이다.

• 한국임상수의학회지
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• 제33권1호
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• pp.6-9
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• 2016

Bronchoarterial (BA) ratio is a commonly used criterion to define airway dilatation despite the lack of normative human and animals. The objective of our study was to compare the range of normal bronchial to accompanying arterial diameter ratio with previous reports on CT scan of the thorax in dogs and assess influence anesthetics on BA ratio in dogs. Dogs undergoing multidetector CT scan of the chest for nonpulmonary conditions at a single center were prospectively identified. High-resolution reconstruction was performed on those included and both airway lumen and vessel diameters were measured in the lobar bronchi of the left cranial (cranial and caudal parts), right cranial, right middle, left caudal, and right caudal lung lobes. Eight dog were included; Mean of the mean BA ratios was $1.43{\pm}0.24$ (95% CI = 1.36 - 1.50) in inhalation anesthetic group. In propofol group, the mean of the mean BA ratios was $1.13{\pm}0.29$ (95% CI = 1.04 - 1.22). In medetomidine group, the mean of the mean BA ratios was $0.89{\pm}0.19$ (95% CI = 0.83 - 0.95). Comparing individual lobes within anesthetic category, there was no signicant difference in mean BA ratio between lung lobes or between dog according to inhalation, propofol, and medetomidine group (P = 0.630, P = 0.878, and P = 0.508, respectively). The BA ratio in these clinically normal dogs was consistent and may be a useful tool in evaluating for bronchiectasis on CT images. However, some different criteria for bronchiectasis were applied by the anesthetic methods.