• Title/Summary/Keyword: 혈관침습

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Ligation of Thoracic Duct Via Extrapleural Approach for the Treatment of Chylothorax - Report of 1 case- (유미흉에서 늑막외층 접근법을 통한 흉관 결찰술 -치험 1예-)

  • 김성완;김덕실
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.883-885
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    • 2003
  • Traditional surgical management of chylothorax refractory to conservative treatment is thoracic duct ligation through a right open thoracotomy. A new surgical procedure of ligation of the thoracic duct via extrapleural approach is presented. Its advantages are less invasive, no need of a new drainage tube, and easier to expose the thoracic duct than the conventional transthoracic approach. We experienced a new surgical method in the treatment of the chylothorax and report it with literatures.

Videothoracoscopic Repair of Diaphragmatic Eventration -A Case Report- (흉강경을 이용한 횡격막 거상증 치험 1례)

  • Jeong, Yoon-Seop;Youm, Wook
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.330-332
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    • 1999
  • A 40-year-old woman underwent plication by video-assisted thoracoscopy for left diaphragmatic eventration. Normalization in the position of the left diaphragm and a marked improvement in the left lung expansion were identified on the chest X-ray. This technique offers the patients many advantages of the minimally invasive operation.

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Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1127-1130
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    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

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A Tuberculoma in the Left Lower Lobe of Lung That Was Erroneously Diagnosed as Ectopic Liver (이소성 간으로 오진된 좌폐 하엽의 결핵종)

  • Song, Dong-Seop;Han, Weon-Cheol
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.789-791
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    • 2009
  • Tuberculoma of the lungs is not an uncommon finding, but an ectopic liver in the lung is extremely rare. Pulmonary tuberculosis presenting as tuberculoma can be diagnosed radiologically, but its definite diagnosis is established by confirmation of the acid-fast bacillus or the unique histology. We report here on a case of tuberculoma of the left lower lobe that was erroneously diagnosed as ectopic liver by ultrasono-guided fine needle aspiration biopsy. An understanding of the normal variants of the liver can prevent a patient from undergoing an unnecessary invasive procedure.

Bronchoscopic Treatment of a Bronchopleural Fistula with using Coils and Fibrin Glue - A case report - (Coil과 Fibrin Glue를 이용한 기관지 내시경하 기관지 늑막강루의 치료- 1예 보고 -)

  • Cho, Seong-Joon;Ryu, Se-Min
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.648-650
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    • 2007
  • Bronchopleural fistula (BPF) is relatively rare, but it has high morbidity and mortality rates and it is associated with a prolonged hospital stay and high costs. Surgical treatment is the treatment of choice, but other minimal invasive forms of conservative management, and particularly bronchoscopy, have recently been investigated. We report here on the bronchoscopic treatment of a bronchopleural fistula accompanied necrotizing pneumonia, and we used coils and fibrin glue to treat the fistula.

Effectiveness of MDCT for the Followup of CABG Patients with LIMA to LAD and Saphenous Veins to Others (좌내흉동맥과 복재정맥편을 사용한 관상동맥우회로술 환자에서의 추적조사에서 MDCT의 유용성)

  • Kang Joon Kyu;Kim Hyung Tai;Park In Duk;Chung Young Mi;Lee Cheol Joo
    • 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.

Meningeal Hemangiopericytoma Treated with Surgery and Radiation Therapy - Case Report - (수막 혈관주위세포종 환자에서의 수술과 방사선치료 -증례보고-)

  • Jang Ji-Young;Oh Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.149-155
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    • 2006
  • Meningeal hemangiopericytoma (HPC) is an uncommon dura-based tumor and can recur not only locally but also distantly in the neural axis or extraneural sites. We report our experience of radiation therapy, one preoperative and one elective postoperative, In two patients with meningeal HPC and reviewed the role of radiation therapy. A 41-year-old man (Case 1) presented with a 3-month history of headache and right hemiparesis. The mass was nearly unresectable at the first and second operation and diagnosed as meningeal HPC. Preoperative radiation therapy was given with a total dose of 55.8 Gy/31 fractions to the large residual mass of left frontoparietal area. Follow-up computerized tomography (CT) showed marked regression of tumor after radiation therapy. The third operation was peformed to remove the residual tumor at 6 months after the radiation therapy and a $2{\times}2cm$ sized tumor was encountered. The mass was totally removed. The serial follow-up CT showed no evidence of recurrence and he is alive without distant metastasis for 4 years and 10 months after the first operation. A 45-year-old woman (Case 2) presented with suddenly developed headache and visual impairment. Tumor mass occupying right frontal lobe was removed with the preoperative diagnosis of meningioma. It was totally removed with attached sagittal sinus and diagnosed as meningeal HPC. Elective postoperative radiation therapy was peformed to reduce local recurrence with a total dose of 54 Gy/30 fractions to the involved area of right frontal lobe. She is alive for 5 years maintaining normal activity without local recurrence and distant metastasis.

Renal hemodynamics in dogs with experimental hydronephrosis treated with transarterial embolization of renal artery (신장동맥색전술을 실시한 개의 실험적 수신증의 혈동학)

  • Chang, Dongwoo
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.413-419
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    • 2001
  • This study was performed to evaluate the renal hemodynamics using color Doppler ultrasonography in dogs with unilateral experimental hydronephrosis treated with transarterial embolization of the renal artery (TAE-RA). Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. The mean resistive index (RI) value of kidney was significantly increased at 4, 9, 17 days after ligation of ureter. Unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$body temperature, pulse, and respiratory rate were within normal ranges during procedures. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. In color Doppler ultrasonographic findings, there was no blood flow into the embolized kidneys treated by TAE-RA, however, blood flow signal was found in contralateral normal kidney of dogs treated with TAE-RA compared to that of normal kidney in normal control group. It is concluded that TAE-RA does not affect the hemodynamics of contralateral normal kidney in dogs with experimental hydronephrosis and color Doppler ultrasonography is simple and non-invasive modality for the monitoring of the revascularization of the renal artery after TAE-RA.

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A Thoracolumbar Pure Spinal Epidural Cavernous Hemangioma - A Case Report - (흉요추부에서 발견된 경막외 해면상 혈관종 - 증례 보고 -)

  • Choi, Byeong Sam;Kim, Ju Yeon;Lee, Sungjoon
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.169-174
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    • 2018
  • Study Design: Case report. Objectives: We report a case of pure epidural cavernous hemangioma located at the thoracolumbar spine in a 53-year-old woman that mimicked a neurogenic tumor on magnetic resonance imaging (MRI). Summary of Literature Review: A pure spinal epidural cavernous hemangioma without bony involvement is a very rare lesion about which limited information is available in the literature. Materials and Methods: A 53-year-old woman visited our clinic for hypoesthesia with a tingling sensation in the left anterolateral thigh that had begun a month ago. No other neurologic symptoms or signs were present upon a neurologic examination. MRI from an outside hospital showed a $2.0{\times}0.5cm$ elongated mass at the T11-12 left neural foramen. The tumor was completely removed in piecemeal fashion. Results: The histopathologic examination revealed a cavernous hemangioma, which was the final diagnosis. The outcome was favorable in that only operation-related mild back pain remained, without any neurologic deficits, after a postoperative follow-up of 2 years and 3 months. No recurrence was observed on MRI at 2 years postoperatively. Conclusion: Pure epidural spinal cavernous hemangioma is very rare, and it is very difficult to differentiate from other epidural lesions. However, we believe that it should be included in the differential diagnosis of spinal epidural tumors due to its favorable prognosis.

Less Invasive Surgical Transcatheter Closure in an Old Patient with Patent Ductus Arteriosus Porstmann's Procedure- (노년 동맥관계존증에서의 경침습 외과적 도관폐쇄술)

  • Sun, Kyung;Kim, Jung-Taek;Kim, Kwang-Ho;Kim, Hyun-Tae;Kwom, Joon;Park, Keum-Soo;Lee, Woo-Hyong;Lee, Choon-Soo;Kumate, Munetaka
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.311-314
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    • 1998
  • Of several techniques for closure of the patent ductus arteriosus, the less invasive surgical ranscatheter closure without thoracotomy(the Porstmann's procedure) may have a place between the Rashkind procedure and thoracotomy. We describe here a 68 year old woman with calcified patent ductus arteriosus which was successfully closed by the Porstmann's procedure.

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