• Tuberculosis and Respiratory Diseases
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• 제41권6호
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• pp.676-679
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• 1994

저자들은 안면과 경부의 부종을 주소로 내원한 36세 남자 환자에서 흉부 전산화 단층촬영과 폐 세침흡인검사를 통해 확진한 원발성 전종격동 정상피종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제22권4호
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• pp.655-660
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• 1989

The unroofed coronary sinus syndrome is a spectrum of cardiac anomalies in which part or all the common wall between the coronary sinus and the left atrium is absent. This defect is part of a developmental complex which includes absence of the coronary sinus and termination of a persistent left superior vena cava in the left atrium. Recognition of this complex is important so that interruption or diversion of the left superior vena cava may be done to prevent subsequent central nervous system complications. Surgical correction uses an intraatrial baffle to divert flow from the left superior vena cava to right atrium and to close the atrial septal defect. This report describes a 7 years old female patient in whom the left superior vena cava was identified preoperatively and the complex [unroofed coronary sinus syndrome, common atrium, mitral valve cleft] recognized at the time of operation. Surgical correction, following repair of cleft mitral valve, utilized a Dacron patch baffle to route the left caval blood to the right atrium and included closure of the atrial septal defect

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.368-371
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• 2004

저자들은 기침을 주소로 내원하여 우측 종격동 종괴로 인한 상대정맥증후군을 보였으며 비디오 흉강경을 이용한 종괴의 조직검사와 조직에서의 항산균 도말검사 양성으로 결핵성 림프절염으로 진단하고 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한핵의학회지
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• 제22권1호
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• pp.47-53
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• 1988

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows : 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

• Journal of Chest Surgery
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• 제12권2호
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• pp.140-144
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• 1979

This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube [$1.3{\times}5$ cm]. After that SVC was decompressed very well. SVC pressure was markedly reduced from 32 cm $H_2O$ in preoperative to 21 cm $H_2O$in postoperative. Mediastinal fibrosis was confirmed by histopathological examination postoperatively. The postoperative course was uneventful.

• 대한핵의학회지
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• 제19권1호
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• pp.145-148
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• 1985

A small number of pathologic entities such as Budd-Chiari Syndrome, cirrhosis, focal nodular hyperplasia, and superior and inferior vena cava obstruction has been reported to result in focal areas of increased uptake of radiocolloid on the hepatoscintigram. We recently studied a patient with focal accumulation of $^{99m}Tc-phytate$ at the inferior aspect of the liver, at the junction of the right and left lobe. The superior vena cava scintiangiogram was taken for the evaluation of the superior vena cava obstruction and collateral circulations. As a result of superior vena caval obstruction a considerable amount of blood flowed to the liver through the anterior parietal and periumblical venous channels. A certain fraction of radiocolloid delivered by the rete mirabile perfused to a localized area of the liver. This would explain the hot spot around the porta hepatis in this case.

• Journal of Chest Surgery
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• 제29권2호
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• pp.219-222
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• 1996

34세 남자가 복수 및 복부 팽 만감을 주소로 입원하였다. 단층촬영 및 하대정맥 조영술상 간정맥 직상부의 하대 정맥폐색이 의심되는 Budd-Chiari 증후군으로 진단되었다. 대증요법으로 간문맥고혈압과 하대정맥폐색증상이 호전이 안되어, 체외순환, 중등도저체온 및 정 상심박동하에 폐색부위절제술 및 하대정맥성형술을 10mm인조혈관을 사용하여 시행하였다. 술후 환자는 구강및 피부와 이학적 검사상 구강궤양, 피하 혈전성 정맥염, 모낭염성 병변, 피부의 자극성 항진 및 포도막염이 관찰되었고 상대정맥 폐색증상이 병발하였으며 Behcet씨 병으로 진단되었다.

• Journal of Chest Surgery
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• 제9권1호
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• pp.10-19
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• 1976

One hundred and seventy-four patients were treated in this Department since 1956. One hundred and fifteen patients of them were surgically treated. They were classified on the basis of the disease entity as follows; 48 case of thrombo-angiitis obliterance, 8 cases of Leriche syndrome, 12 cases of arterial embolism, 36 arterial aneurysm, 5 arterio-venous fistula, 15 arterial and venous injuries, 8 pulseless diseases, 2 coarctation of aortas, 15 varicose veins, 12 thrombophlebitis, 9 superior venacaval syndromes, 2 inferior vena caval obstructions and Raynaud's diseases. All the cases of the Burger's diseases were males, and half of them were in the fourth decades, 39 cases underwent undergone unilateral or bilateral sympathectomies. All the Leriche syndromes were males aged over fifty. Three cases out of six were suffering from diabetes mellitus. 2 cases underwent aorto-femoral bypass graft with Y-shaped dacrons. And two embolectomies were performed in 2 cases. Eight cases of arterial embolisms among 12 had mitral valvular diseases with auricular fibrillation The most common site of lodgement of emboli was femoral artery. Nine out of 14 underwent embolectomies with Fogarty catheters. There were 14 peripheral arterial aneurysms, 16 thoracic and/or abdominal aortic aneurysms, and 4 dissecting aneurysms. Most frequent cause of peripheral arterial aneurysms were external trauma. Thoracic and abdominal aortic aneurysms were non-traumatic. And four cases of the dissecting aneurysms had significant hypertension and aged over fifty. Among 5 cases of arteriovenous fistulas, 2 cases hand typical Branham's sign, and they were normalized after operation. Eight cases of pulseless disease were females and aged from three to twenty-five. Three out of them were treated surgically using dacron prosthetic grafts, but the results of the surgery were variable and not satisfactory. A case of coarctation of aorta was treated surgically with an excellent result. Fourteen out of 15 varicose veins underwent ligation of the saphenous vein system, exstirpation of the varicose veins, stripping or some combination of these methods. Two cases of superior vena caval syndromes were operated by bypass graft between the left innominate vein and the right auricle. Two cases of inferior vena caval obstructions were operated upon through right atrial route using extracorporial circulation. All the four cases of vena caval obstructions showed excellent results postoperatively. Two cases out of 12 thrombophlebitis underwent thrombectomies. One of two Raynaud's diseases was surgically treated with an excellent result.

• Tuberculosis and Respiratory Diseases
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• 제63권4호
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• pp.387-391
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• 2007

섬유화 세로칸염은 드문 양성질환으로 종격동 조직 내에 국소적이거나 광범위한 심한 섬유화성 병변을 유발하고 세로칸 내 장기들을 침범하거나 압박하여 증상이나 증후를 나타내는 질환이다. 그러나 저자들은 세로칸의 침범이 거의 없으면서 상대정맥 주위에 발생한 아주 국소적인 병변에 의하여 상대정맥증후군을 유발한, 혈관종양과 감별이 필요하였던 국소적 섬유화 세로칸염 1예를 경험하였기에 보고하는 바이다.

• 대한핵의학회지
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• 제15권1호
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• pp.45-49
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• 1981

The hot spot on liver scan was demonstrated by many authors in various conditions such as SVC obstruction, Budd-Chiari syndrome, liver abscess, hemangioma of liver, hepatic venoocclusive diseases, IVC obstruction, and tricuspid insufficiency. And the appearance of hot spot in SVC obstruction is due to unsual collateral circulation. But there was no report of this hots pot on liver scan in our country. We have recently observed one patient with SVC obstruction who shows well-defined area of increased radioactivity between right and left lobe of liver on liver scan using $^{99m}Tc-tin$ colloid, and demonstrated collateral circulations with RI venography using $^{99m}Tc-O_4$. The injection site of radiocolloid was left antecubital vein. This hot spot did not appear when the radiocolloid was injected into right leg vein. We report here this hot spot on liver scan in SVC obstruction with review of some liter atures.