• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.394-399
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• 1999

저자들은 갑작스런 흉통을 주소로 내원한 젊은 남자에서 AT III 결핍증에 의한 폐색전증을 진단하고 세 자녀 모두에서도 AT III 결핍이 확인됨으로써 폐색전증을 동반한 선천성, 가족성 AT III 결핍증을 경험하였기에 문헌고찰과 함께 보고한다.

• Clinical and Experimental Pediatrics
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• 제55권1호
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• pp.24-28
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• 2012

Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

• Journal of Chest Surgery
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• 제47권6호
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• pp.560-562
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• 2014

A case of a fistula running from the pulmonary vein to the esophagus after a staged hybrid procedure combining total thoracoscopic ablation and percutaneous radiofrequency catheter ablation has not been reported previously. We describe such a case in a 37-year-old man who was successfully treated by surgery.

• Journal of Chest Surgery
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• 제27권5호
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• pp.418-421
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• 1994

The usage of autosuture instruments and techniques in resection of bronchovascular structures gained increasing acceptance amongst surgeons in the recent years. The manipulation of these devices are simple, safe, and shortens operating time by avoiding numerous ties and sutures. We have been using autosuture instruments in most of pulmonary resections in Yongdong Severance hospital, and had a satisfactory results. However, we recently have experienced post-pneumonectomy rupture of left pulmonary vein on postoperative one day where the rupture site was in the border of left atrium and left pulmonary vein where the stapler was fired. The patient underwent emergency operation to control massive bleeding and successfully managed by left atrial suture.

• Journal of Chest Surgery
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• 제22권3호
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• pp.416-424
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• 1989

We have performed eight, single transplantations of right lung in dogs from September, 1988 to March 1989 at the Thoracic & Cardiovascular Surgical department, Yonsei University, College of Medicine, Seoul, Korea. We wrapped bronchial anastomosis site with great omentum and used cyclosporin in preoperative and postoperative periods in seven cases except one. The one without wrapping the bronchial anastomotic site with omentum and using cyclosporin died due to bronchial anastomotic site rupture in postoperative fourth day. If there is no reason to choose one side over the other, we would generally choose to do left-sided transplant as this is technically somewhat easier because of the long length of recipient bronchus and the ease of clamping the left atrium proximal to the pulmonary veins. The right atrium limits the amount of left atrium that can have incorporated into the clamp proximal to the pulmonary veins on the right side. But we had chosen to do right-sided transplant of lung because we must take variable technical experiences on right sided lung transplant in dogs. We have to anastomose one of pulmonary vein and left atrial wall on right-sided transplant easily only with double ligation of one pulmonary vein because right atrium limited the clamp of left atrium proximal to pulmonary veins with decreased venous return and cardiac output in some dogs. All seven dogs with right-sided lung transplant had survived more than one day with good condition except one. The one dog have to be sacrificed to evaluate the difference between the gas analysis in pulmonary venous and arterial blood in post-operative eight hours. We found hemorrhagic pulmonary edematous changes of contralateral left lung in this dog. And also all dogs have to be sacrificed for the evaluation of surgical problems, anytime in post-operative periods without any cardiopulmonary resuscitative efforts when the general condition would be worse progressively. We found no any surgical technical errors in seven dogs except one with thrombi in suture site of left atrium. There were hemorrhagic pulmonary edematous changes of transplanted right lung in one, of contralateral left lung in one, of contralateral left lung with double ligation of its pulmonary artery in one, thrombi around left atrial sutures sites in one, multiple air leakage in one bronchial rupture in one due to rejection or infection. There were accidental extubation and delayed intubation in one and unknown cause of death in one.

• Journal of Chest Surgery
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• 제38권10호
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• pp.725-728
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• 2005

환아는 생후 18개월 된 여아로 반복적인 위급한 과량의 객혈을 주소로 입원하였다. 과거력상 생후 6개월에 중증의 심비대 소견을 보이는 심방중격결손증을 진단받았으며 폐정맥 협착이 심비대에 의한 압박으로 생긴 이차적인 병변일 것이라 추정하여 심방중격결손폐쇄술만 시행하였다. 술 후 환아는 심비대와 폐정맥 협착이 완화된 소견을 보였다. 그러나 추적 관찰 중 환아는 반복적인 다량의 객혈로 다시 입원하였고 전산화단충촬영 소견 상 폐정맥 협착이 다시 심해진 것으로 판독되었으며 기관지 주변에 성상을 알 수 없는 연조직 종괴들이 좌측 기관지를 압박하고 있었다. 정확한 위치를 알 수 없는 반복적인 객혈로 인해 시험적 개흉술이 불가피하였고, 수술 소견상 좌폐정맥은 하나였으며 외견상 협착의 소견을 보였다. 좌측 기관지 주변에는 다발성 임파절 비대가 기관지를 압박하고 있었다. 또한 수술 중 다량의 객혈이 발생하여 전폐절제술을 시행할 수밖에 없었다. 술 후 병리 소견은 폐정맥 협착과 일치하였다. 환아는 2일간의 중환자실 관리 후 6일째 합병증 없이 퇴원하였다. 2개월간 추적 관찰되었으며 증상 없이 양호한 경과를 보이고 있다. 그러나 향후 지속적인 추적 관찰이 필요할 것으로 생각한다.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.240-244
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• 2018

Knotting of a pulmonary artery catheter (PAC) is a rare, but well-known complication of pulmonary artery (PA) catheterization. We report a case of a double-knotted PAC with a large loop in a patient with hepatocellular carcinoma (HCC) undergoing liver transplantation, which has been rarely reported in the literature. A PAC was advanced under pressure wave form guidance. PAC insertion was repeatedly attempted and the PAC was inserted 80 cm deep even though PAC should be normally inserted 45 to 55 cm deep. However, since no wave change was observed, we began deflating and pulling the balloon. At the 30-cm mark, the PAC could no longer be pulled. Fluoroscopy confirmed knotting of the PAC after surgery (The loop-formed PAC was shown in right internal jugular vein); thus, it was removed. For safe PA catheterization, deep insertion or repeated attempts should be avoided when the catheter cannot be easily inserted into the pulmonary artery. If possible, the insertion of PACs can be performed more safely by monitoring the movement of the catheter under fluoroscopy or transesophageal echocardiography.

• Tuberculosis and Respiratory Diseases
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• 제43권1호
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• pp.96-101
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• 1996

저자들은 과거력상 반복되는 구강내 아프타성 궤양 및 결절홍반양 피부병변이 있었고, 객혈을 주소로 내원한 37세 남자환자에서 혈관조영술상 다발성 폐동맥류, 심부 정맥의 협착 및 폐색소견이 관찰되었고, 조직학적으로는 폐혈관염 소견을 보여, Hughes-Stovin 증후군으로 진단하였으며, 코일을 이용한 폐동맥색전술로 폐동맥류를 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제45권4호
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• pp.896-901
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• 1998

Pulmonary arteriovenous malformation(PAVM) is an uncommon congenital anomaly. As pulmonary arteriovenous malformation is a direct communication between the branches of pulmonary artery and vein which originated from the malformation of capillary development, major disturbances in gas exchange can result. This malformation results in the several symptoms such as dyspnea, hemopyssis, cyanosis, and severe neurologic complaints. However, the most of patients are usually asymptomatic. Selective pulmonary angiography is well known the helpful diagnostic method. Recently, therapeutic embolization has been advocated as the treatment of choice for pulmonary arteriovenous malformations. We report a case of multiple pulmonary arteriovenous malformation, which was detected on the simple chest X-ray and successfully treated with coil embolization in a 19-year-old asymptomatic woman.

• Journal of Chest Surgery
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• 제22권1호
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• pp.151-154
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• 1989

We have experienced a case of intralobar pulmonary sequestration communicating with the esophagus. A 24 year old female patient was admitted of chronic cough related to food, purrlent sputum and left lower chest pain. Esophagography and bronchography revealed bronchoesophageal fistula and bronchiectasis with cystic lesion of the left lower lobe. There was multiple anomalous feeding vessels arinig from the intercostal arteries and no draining systemic vein on aortography. division of the bronchoesophageal fistula and left lower lobectomy was performed. Communication with the esophagus in rarely associated with intralobar pulmonary sequestration and esophagogram is useful method of diagnosis for this communication.