• Journal of Chest Surgery
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• v.29 no.12
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• pp.1401-1404
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• 1996

Central venous line insertion is an essential procedure in a cardiac operation. For this, percuteneous Insertion is usually done in the internal jugular vein or the subclavian vein. However, this method can create such complications as pneumothorax and hemothorax, and repeated failure in inserting the cathet r, especially in infant and child patients, can waste excessive time. Consequently, in our hospital, catheterization of the innominate vein was done after the completion of sternotomy in the cardiac operation of infant and child patients weighing under 1 Okg. During operation, the catheter was placed in the left atrium through the foramen ovate or pulmonary artery to be used for pressure monitoring. When the patient's hemodynamic became stabilized, the catheter was withdrawn to either the right atrium or superior vena casa to be used as the channel for fluid replacement or drug administration. In our hospital, this procedure has been used in 96 cases since 1989. No complications such as pneumothorax and hemothorax occilrred, and neither bleeding after the removal of the catheter was seen.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.657-663
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• 2004

As a chronic multisystemic inflammatory disorder, Behçet's disease may manifest vascular, cardiac, neurological and gastrointestinal abnormalities. However, involvement of large veins, such as thrombosis of the superior or inferior vena cava, is a very rare complication. Herein, a case of superior vena cava syndrome, due to the thrombotic obstructions of the subclavian and brachiocephalic vein, is reported in a 27-year old woman with chronic Behçet's disease.

• Journal of the Korean Society of Radiology
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• v.13 no.6
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• pp.879-887
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• 2019

The purpose of this study is to establish a physiological injection protocol according to body weight, in order to minimize amount of contrast medium and optimize contrast enhancement in pediatric patients performing thoracic CT examinations. The 80 pediatric patients under the age of 10 were studied. Intravenous contrast material containing 300 mgI/ml was used. The group A injected with a capacity of 1.5 times its weight, and groups B, C and D added 5 to 15 ml of normal saline with a 10% decrease in each. The physiologic model which can be calculated by weight about amount of injection of contrast medium and normal saline, flow rate and delay time were applied. To assess image quality, measured average HU value and SNR of superior vena cava, pulmonary artery, ascending and descending aorta, right and left atrium, right and left ventricle. CT numbers of subclavian vein and superior vena cava were compared to identify the effects of reducing artifacts due to normal saline. Comparing SNR according to the contrast medium injection protocol, significant differences were found in superior vena cava and pulmonary artery, descending aorta, right and left ventricle, and CT numbers showed significant differences in all organs. In particular, B group with a 10% decrease in contrast medium and an additional injection of saline showed a low degree of contrast enhancement in groups with a decrease of more than 20%. In addition, the group injected with normal saline greatly reduced contrast enhancement of subclavian vein and superior vena cava, and the beam hardening artifact by contrast medium was significantly attenuated. In conclusion, the application of physiological protocol for injection of contrast medium in pediatric thoracic CT examinations was able to reduce artifacts by contrast medium, prevent unnecessary use of contrast medium and improve the effect of contrast enhancement.

• Radiation Oncology Journal
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• v.23 no.2
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• pp.78-84
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• 2005

Purpose: The studied the effect of such variables as the symptom improvement rate, survival and prognostic factors on the treatment results of radiation therapy for Superior Vena Cava Syndrome (SVCS). Materials and Methods: From 1988 to 2003, seventy two patients with SVCS were treated with radiation therapy at the Department of Radiation Oncology, Keimyung University Dongsan Medical Center. The patients' ages ranged from 10 to 83 years old with the median age being 61, and sixty four patients were male. For the causes of the SVCS, 64 patients had lung cancer, four had metastatic lung cancer, two had malignant lymphoma and two had thymoma. The radiotherapy was delivered with 6-MV X-rays and all patients received above 900 cGy up to 6,600 cGy, with the median dose being 4,000 cGy The follow-up periods were from 1 to 180 months with a median of 5.6 months. Results: The main clinical manifestations were dyspnea ($84.7\%$), facial edema ($81.9\%$), arm edema ($22.2\%$), neck vein distension ($25\%$), hoarseness ($12.5\%$) and facial plethora ($5.6\%$). Eighty percent of patients achieved excellent to good symptom improvement and $19.4\%$ experienced minimal improvement. The median survival period was 5.1 months, and overall survival rates were $17.7\%$ at 2 years (2YOS) and $14.8\%$ at five years (5YOS) for all the patients. The median survival period, the two and five year disease free survival rates were 4.3 months, $16.7\%$ and $13.4\%$ for the lung cancer patients, respectively. The total tumor dose was a statistically significant survival factor on the univariate analysis for the patients with lung cancer (2YSR; > 30 Gy, $25.6\%$, $\leq$ 30 Gy $6.7\%$, p<0.01). On the multivariated analysis, a higher total tumor dose (p<0.01) and younger age (p<0.05) were statistically significant factors of survival for the lung cancer patients. Patients with NSCLC showed better survival than did the patients with SCLC, but this was not statistically significant (p > 0.05), Conclusion: Radiation therapy for the patients with SVCS due to malignancy could be an effective treatment. We considered that radiation therapy above 30 Gy of the total tumor dose may improve survival for SVCS due to lung cancer.

• Journal of Chest Surgery
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• v.36 no.12
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• pp.985-990
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• 2003

Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, corvical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an on-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.

• Journal of Chest Surgery
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• v.35 no.10
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• pp.740-744
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• 2002

Retrograde cerebral perfusion under hypothermic circulatory arrest is a simple and useful adjunct to avoid cerebral ischemic injury in the treatment of aortic arch pathology. In the surgery of distal aortic arch and proximal descending aortic lesions through the left thoracotomy incision, right atrium-retrograde cerebral perfusion (RA-RCP) through a venous cannula positioned into the right atrium is simpler than retrograde cerebral perfusion through superior vena cava. The time limits for RA-RCP during aortic arch reconstruction have yet to be clarified. We, herein, present a case with uneventful recovery after RA-RCP of 94 minutes during reconstruction of aortic arch and descending aorta. These data suggest that RA-RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RA-RCP exceeds 90 minutes.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.161-170
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• 2024

Purpose To assess the safety and feasibility of intentionally positioning the catheter tip in the right atrium (RA) without an abutment during implantation of a totally implantable venous access port (TIVAP). Materials and Methods We enrolled 330 patients who had undergone TIVAP implantation between January and December 2016 and postoperative chest CT. The TIVAP was placed using the single-incision technique to access the axillary vein directly from the incision line. To position the catheter tip in the RA without abutment, blood return was checked before cutting. Catheter length and complications were evaluated by retrospectively reviewing medical images and records. Results All patients achieved successful catheter tip positioning without abutment or dysfunction. The median tip position was 15.3 mm distal to the cavoatrial junction (CAJ) on fluoroscopy and 6 mm distal to the CAJ on CT. Catheter tips migrated a median of 10.4 mm cephalically on CT compared to fluoroscopy. Thromboses were detected in the RA and superior vena cava in one patient each. Conclusion Intentional catheter tip positioning in the RA without abutment is a safe and feasible technique with a low incidence of thrombosis and no observed dysfunction.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.177-183
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• 2006

Background: The bidirectional cavopulmonary shunt (BCPS) is one of the primary palliative procedures for complex congenital heart disease. It has many advantages, but it is known to have high risks in young infants. Material and Method: From 1995 to 2003, 48 infants under the age of one year underwent BCPS. All the patients were Fontan candidates due to functional univentricular heart physiology. There were no significant differences in preoperative variables, except in mean age (67.58$\pm$3.78 vs. 212.91$\pm$13.44 days), and mean body weight (4.51$\pm$0.29 vs. 6.62$\pm$0.27 kg), between group A (<3 months, n=12) and group B ($\ge$3 months, n=36). Result: In group A, the arterial oxygen saturations serially measured were significantly lower. Hospital mortality was $25\%$, and $19\%$, respectively. During follow up, there were 2 late mortalities in group A, and 5 in group B. Conclusion: This study showed that operative risk in young infants was comparable to that of older patients, and BCPS could be a good option as a primary palliative procedure, and may eliminate other repeated palliative procedures which could be the risk factors for Fontan candidates. However, in high-risk patients accompanying pulmonary hypertension, or heterotaxia syndrome, other palliative procedures should be considered.

• 대한핵의학회:학술대회논문집
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• 1981.05a
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• pp.122-123
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• 1981

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.368-371
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• 2004

Superior vena cava syndrome(SVCS) is most often encountered in patients with malignancies. Tuberculosis is nowadays an uncommon cause of SVCS. We report the case of a patient who presented with respiratory symptoms accompanied by SVCS due to tuberculous lymphadenitis. Treatment was instituted with isoniazid, rifampicin, pyrazinamide and ethambutol, and all symptoms disappeared. To our knowledge, no case of SVCS provoked by tuberculous lymphadenitis has been described previously in Korea.