• Journal of Chest Surgery
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• v.44 no.5
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• pp.361-363
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• 2011

A 39-year-old woman was admitted to the hospital due to a pulsatile mass on her right inner thigh that was evident for two months. She did not exhibit any risk factors of atherosclerosis, no evidence of vasculitis, or any signs of previous trauma history. Ultrasound and computed tomography revealed an adult fist-sized aneurysm on the distal superficial femoral artery. The aneurysm was resected and peripheral circulation was restored with the interposition of a saphenous vein graft. The resected aneurysm had three layers that showed atherosclerosis on histological examination.

• Journal of Chest Surgery
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• v.30 no.12
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• pp.1190-1196
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• 1997

Between July 1994 and August 1995, 78 patients underwent coronary artery bypass graft at Seoul National University Hospital. Coronary angiogram was performed one year after coronary artery bypass graft in 49 patients(62.8%) for evaluation of the graft patency and analysis of the risk factors for graft occlusion. The patency rates of both the internal mammary artery and the radial artery grafts were 100% , although three internal mammary artery grafts(5.0%) were narrowed(string sign). And that of the saphenous vein grafts were 85.2%. Multivariate analysis for the preoperative, operative, and postoperative factors was done between the widely patent and the narrowed internal mammary artery graft groups, and between the patent and the occluded saphenous vein graft groups by the general linear models procedure. Patient's age($\geq$60 years), postoperative intraaortic balloon pump insertion, bleeding, and acute renal failure were found to be the significant risk factors for internal mammary artery graft narrowing, and coronary artery size(< 1.5 mm) was the significant risk factor for the saphenous vein graft occlusion (p<0.05) . This study confirms that the arterial graft is superior to the vein graft at one-year patency rate, and suggests the risk factors for graft occlusion during the first postoperative year. Knowledge of this study may provide a basis for estimating the risk factors for graft occlusion, and thereby modifying surgical strategy and postoperative surveillance.

• Journal of Chest Surgery
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• v.40 no.2 s.271
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• pp.97-102
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• 2007

Background: Endovenous laser treatment has recently been introduced as a less invasive technique, with many good results reported, A 980-nm diode laser was used on the great saphenous vein (GSV) occlusions in patients with varicose veins, due to GSV reflux, and the therapeutic effects analyzed. Material and Method: Between September 2003 and February 2006, 238 patients (332 cases) with GSV reflux underwent endovenous laser treatment with a 980-nm diode laser. Operative procedures were simultaneous endovenous laser treatment and ambulatory phlebectomy. The preoperative clinical findings, postoperative complications and postoperative duplex US follow up results at 1 and 3 months were reviewed. Result: Postoperative complications were ecchymosis in almost cases, paresthesia 68 cases (20.5%) and skin burn in 3 cases (0.9%). Follow up duplex US revealed 26 and 10 cases at 1 and 3 months of GSV reflux or partial recanalization, with therapeutic success rates of 91.3 and 87.9%, respectively. Conclusion: The treatment of GSV occlusion with an endovenous laser is less invasive than traditional GSV stripping, but relatively high recanalization was experienced, possibly due to inadequate laser power, laser fiber pullback speed or an extremely dilated GSV. However, continuous attempts will be required to reduce the recanalization after the procedure, with accurate follow up using duplex US.

• Journal of Veterinary Clinics
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• v.38 no.3
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• pp.135-142
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• 2021

The aim of this study was to evaluate the contrast effect if a saline flush following low-volume contrast medium bolus improves vascular and parenchymal enhancement using a saphenous vein in abdominal CT for small animals. Six clinically healthy beagle dogs underwent abdominal contrast-enhanced CT. They were divided into nine groups (each group, n = 6), according to the volume of contrast medium 1, 2, and 3 mL/kg, and volume of the saline solution 0, 5, and 10 mL. Dynamic CT scanning was performed at the hepatic hilum level. The maximum contrast enhancement, time to maximum enhancement, and time to equilibrium phase were calculated from the time attenuation curves. Mean attenuation values for all groups were measured in the aorta, portal vein, and liver. After contrast enhancement, grading of image quality regarding surrounding artifacts and evaluation of the hepatic hilum structures was performed. For comparison of the effect of the contrast material and saline solution doses, differences in mean attenuation values between the contrast medium 2 mL/kg without saline flush group and the remaining groups, and between contrast medium 3 mL/kg without saline flush group and the remaining groups, were analyzed for statistical significance. There were no significant differences between with and without saline flushing at the same contrast medium dose groups. There were no significant differences in peak values between the 3 mL/kg dose of contrast medium alone and the 2 mL/kg dose of contrast medium with saline solution flush. However, there was a significant difference in peak values between the 3 mL/kg dose of the contrast medium without the saline flush group and the 2 mL/kg dose of the contrast medium alone group. Grades of the artifacts were not significantly different in the saline flush regardless of the dose of the contrast medium. Using 2 mL/kg of contrast medium with saline solution flush resulted in similar liver parenchyma attenuation, compared with using 3 mL/kg of contrast medium without saline solution flush. In CT evaluation of hepatic parenchymal diseases, using 2 mL/kg of contrast medium with saline solution flush may yield decreased risk of contrast nephropathy and cost-saving.

• Journal of Chest Surgery
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• v.38 no.6 s.251
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• pp.410-414
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• 2005

There are several options for choosing a graft in CABG, we routinely chose LIMA for LAD and great saphenous vein for other target vessels. To evaluate the posoperative graft patency, we have studied the results using a 16 slices multi-detector computed tomography. Material and Method: From 1995 to 2003, 80 CABG patients who did not complain any event of MACE have been examined by 16-MDCT, mostly in an out patient clinic. Result: There were 61 men and 19 women. MDCT was used as early as 7 days to 9 years post-operatively with a median follow-up period of 6.5 years, and mean follow-up peiod of $31.5\pm25.4$ months. Mean age was $58.4\pm12.6$ years old in men and $61.5\pm17.2$ years old in women. 72180 patients received LIMA to LAD, and all other patients received vein grafts for bypass. The target vessel of vein grafts were 8 in LAD, 47 in RCA, 60 in diagonals, and 61 in obtuse marginals. Among them 42 sequential anastomoses were performed. The mean graft number was $3.1\pm1.8$ grafts. 5 year graft patency rate of each grafts was as followings; $93.1\%$ in LIMA to LAD, $94.9\%$ in vein to diagonals, $92.1\%$ in vein to obtuse marginals, and $79.2\%$ in vein to RCA. Sequential grafting showed better graft patency than the isolated grafting $(95.2\%\;vs\;78.7\~95.0\%)$. Conclusion: In this study, CABG with LIMA and saphenous veins showed satisfactory longterm results. 16-MDCT provided good images for follow-up study after CABG. Additionally, as radiologic tools (64-MDCT, MRI) improve more in the future, they can be used for diagnosing preoperative anatomical coronary disease as well as cardiac functions.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.454-457
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• 1996

The Incidence of synovial sarcoma Is very low but sarcoma Is a well-defined entity, which occurs primarily around large Joints and usually in association with tendon sheaths, bursae or the capsule. Recently we experienced a case of synovial sarcoma which invaded the right femoral vein of 433 5-year-old man. The tumor was widely excised incl ding the invaded femoral vein, and vein reconstruction was done using saphenous vein graft. The postoperative course was uneventful without intractable edema nor disability.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.93-96
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• 2010

We report a case of 44 years old male patient with neuroma-in-continuity of ulna nerve. In the patient's past history, he had received operative treatment for the open supracondylar fracture of right distal humerus and ulnar nerve injury at 10 years ago, and neurolysis was tried 2 times due to severe neuropathic pain. Despite of these operations, the symptom was not improved. In operative field, we noticed neuroma-in-continuity and decided to resect the neuroma until normal nerve fascicle was noted. The nerve cable graft was done with auto sural nerve on the defect site and the nerve was wrapped with small saphenous vein. At post operative 7 months, pain was markedly decreased and sensory recovery was slightly improved and patient was satisfied with the result.

• Journal of Chest Surgery
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• v.13 no.2
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• pp.134-137
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• 1980

This represents a case report of the retained polyethylene catheter fragment in superior vena cava. A 39 year old male was admitted to this Korea University Hospital a short time after compression wound on abdomen with heavy cement material in emergency room, a polyethylene catheter was introduced into the right subclavian vein through a needle. But when the polyethylene catheter was attempted to withdraw the catheter was severed by the beveled tip of the needle. Later that day, chest X-ray disclosed the presence of the fragment extending from right subclavian vein to the superior vena cava. {Fig. 1 and Fig. 2]. Local exploration by way of an infraclavicular incision was unsuccessful in locating the catheter fragment. Another attempt was then made remove the catheter by means a biotome, which is originally a device for the biopsy of the myocardium, introduced through the right great saphenous vein. This procedure, though well tolerated by the patient, was in vain. After 11 days later, during that time he was taken a laparotomy with drain, another operation for removal of retained catheter fragment was performed through median sternotomy. After exposure of the right subclavian vein, innominate vein, and superior vena cava, an incision 1 cm in |length was made directly over the palpated catheter. The catheter immediately was picked upward and removed. The length of the catheter was approximately 8 cm. [Fig 3 ] There was no evidence of thromboembolism from the catheter or other complications. The patient made an uneventful recovery, and was discharged asymptomatic on the 9th postoperative day.

• Journal of Chest Surgery
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• v.44 no.6
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• pp.387-391
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• 2011

Background: The relationship between the degree of expression of matrix metalloproteinases or tissue inhibitor of metalloproteinases and venous reflux remains to be investigated. Materials and Methods: Primary varicose vein tissues were obtained from 23 patients, 18 females and 5 males, aged from 19 to 73. Cephalic or basilic veins were obtained for the control group from 10 patients who underwent vascular access for maintenance hemodialysis. Two operative techniques (high ligation with stripping or endovenous laser coagulation) were used. The expression of matrix metalloproteinase-2 and 13 and tissue inhibitor of metalloproteinase-4 in the varicose vein group and control group was assessed semi-quantitatively by immunohistochemical slides stained with primary antibodies. Results: Twenty (87%) of the varicose vein group patients had greater or lesser saphenous vein diseases with reflux. The focal weak (+) stain for matrix metalloproteinases-2, and 13, and tissue inhibitor of matrix metalloproteinase-4 was dominant in the varicose vein group; the focal or diffuse strong stain (++ or +++) was prevalent in the control group. The differences were statistically significant (p<0.01). The degree of reflux and the duration of symptoms were not significantly related to the expression of MMP-13 (p=0.317 and p=0.654, respectively). Conclusion: Further study should be performed to investigate the relationship between the clinical characteristics related to venous hypertension or reflux and expression of MMPs and TIMP in varicose veins.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.296-302
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• 1991

Coronary artery involvement and myocardial ischemic symptom in Takayasu`s arteritis is uncommon Its presentation as coronary artery narrowing is a potentially lethal but correctable problem. In this case report, a 17-year-old woman of Takayasu`s arteritis with unstable anginal and moderate heart failure is presented. Her coronary angiogram showed that the main trunk of the left coronary artery was moderately narrowed and the proximal portion of the circumflex branch was severely obstructed and the right coronary artery was also narrowed diffusely. Simultaneously the patient had the moderate degree of mitral regurgitation. In order to save her life, the coronary bypass surgery using the saphenous veins and the modified Wooler`s mitral annuloplasty were done urgently, Immediate recovery was uneventful and the postoperative exercise capacity was markedly improved. But the long-term prognosis seems to be uncertain because of 3 reasons: 1] natural progress and complication of Takayasu`s arthritis; 2] fate of the saphenous vein grafts in a relatively young patient with aortitis; 3] residual mitral regurgitation. So long-term follow-up should be needed.