• Title/Summary/Keyword: 혈관침습

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Fistula of Ascending Aorta and Right Atrium Following Percutaneous Transcatheter Atrial Septal Defect Closure (경피적 카테타 심방중격결손 폐쇄술 후 발생한 상행 대동맥-우심방루)

  • Um Hong Gook;Seo Hong Joo;Kim Chong Whan;Kim Jun Seok;Lee Chang-Ha
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.150-153
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    • 2006
  • Percutaneous transcatheter closure of atrial septal defects as a therapeutic alternative in appropriate patients provides superior cosmetic results, is less invasive, and allows for shorter hospital stays. Unfortunately, however, such percutaneous procedures can be associated with catastrophic procedure complications that may require immediate surgical intervention. We report a case of aorta-to-right atrial fistula two months after transcatheter occlusion of an atrial septal defect by an Amplatzer septal occluder. Revealed by dyspnea, palpitation and hemolysis, this complication needed an emergency surgical operation. The fistula between the noncoronary Valsalva sinus of the aorta and the right atrium was repaired. The atrial septal defect was closed by patch. The cause of this serious complication appears to be erosion into the aorta by the right atrial disk.

A Case of Pulmonary Inflammatory Myofibroblastic Tumor (폐 염증성 근섬유 아세포종 치험 1예)

  • Na, Kook-Joo;Yu, Ung;Hong, Sung-Bum;Choi, Yong-Sun;Kim, Byong-Pyo;Kim, Sang-Hyung;Ahn, Byong-Hee
    • Journal of Chest Surgery
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    • v.37 no.1
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    • pp.102-104
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    • 2004
  • Inflammatory myofibroblastoma is a solid tumor, occurring mainly to children and young adults, and occupying 0.7% of total isolated pulmonary nodules. Since 1973, several cases about inflammatory myofibroblastoma have been reported. Firstly, this tumor was found in lungs. Then, tumors have been founded and reported in mesentery or cardioesophageal region. Histologically, this tumor can be classified as a benign tumor. However, since this tumor has two characteristics showing malignancy, that is, local invasion and recurrence, malignancy can not be completely excluded. Recently, a patient with pulmonary inflammatory myofibroblastoma underwent surgical resection without any signs or symptoms of recurrence.

Mediastinoscopic Resection of A Paratracheal Bronchogenic Cyst - A case report - (종격동경을 이용한 기관주위의 기관지성 낭종의 완전절제술 - 1예 보고 -)

  • Cho, Deog Gon;Kang, Chul Ung;Cho, Kue Do;Jo, Min Seop;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.120-123
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    • 2010
  • Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.

Hepatocellular Carcinoma with Right Atrial Invasion Detected by PET/CT (우심방에 침범한 간세포암을 PET/CT로 진단한 1예)

  • Kim, Ji-Hoon;Kim, Eun-Sil;Yu, Ji-Won;Ahn, Seok-Jin;Jung, Jun-Oh;Kim, So-Yon;Kim, Young-Jung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.414-418
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    • 2008
  • The role of positron emission tomography (PET) with F-18 fluorodeoxyglucose (F-18 FDG) in the diagnosis of hepatocellulcar carcinoma (HCC) has been limited because of a variable FDG uptake in HCC. However, the usefulness of PET/CT for detecting extrahepatic metastasis and monitoring of the treatment response in HCC has been reported. A 55-year-old man with a hepatitis B surface antigen-positive, was admitted to our hospital due to dyspnea, general weakness and body weight loss for one month. Chest X-ray showed multiple reticulo-nodular densities on both lower lung fields, which implies metastatic lesions. F-18 FDG PET/CT revealed consecutively intense hypermetabolic mass in right hepatic lobe, inferior vena cava and right atrium. We report a case of HCC with IVC and right atrium invasion identified by F-18 FDG PET/CT.

Infectious Pseudoaneurysm Caused by Group A Streptococcus in a Child without Underlying Disease (기저 질환이 없는 소아에서 A군 사슬알균 균혈증에 동반된 감염성 가성동맥류 1예)

  • Kim, Kyoung Ha;Lee, Hyunju;Oh, Chi Eun
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.183-187
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    • 2017
  • Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascular-related underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

Tricuspid Valve Repair in the Patients with Mitral Valve Replacement - Preoperative and Postoperative Evaluation by Doppler Echocardiography - (승모판 질환시 동반되는 삼첨판 폐쇄븟전증의 비침습적 치료판정 및 그 결과: 도플러 심에코에 의한 수술전후 판정)

  • Choe, Jong-Beom;Yun, Jae-Do;Jeong, Jin-Won
    • Journal of Chest Surgery
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    • v.24 no.4
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    • pp.323-330
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    • 1991
  • Residual significant tricuspid regurgitation after mitral valve operation may significantly increase postoperative morbidity and mortality. However, routine techniques to detect tricuspid regurgitation preoperatively and postoperatively are not accurate. Doppler echocardiography was performed preoperatively and postoperatively to assess its ability to evaluate and quantify the severity of tricuspid regurgitation. In 34 patients with tricuspid regurgitation secondary to mitral valvular disease the tricuspid regurgitations were semiquantified on a scale of 1 to 3+. The 34 patients were divided into two groups on the basis of severity of tricuspid regurgitation as assessed by preoperative Doppler echocardiography. Group I [8 patients] had mild[1+] regurgitation, and group II [26 patients] had moderate to severe[2 ~ 3%] tricuspid regurgitation. In all studied patients, preoperative Doppler echocardiographic studies for the degree of tricuspid regurgitation were correlated with clinical symptoms[including NYHA class] and hemodynamics[JVP and right ventricular systolic pressure], and used as the indicator to determine whether tricuspid annuloplasty should be performed or not. Patients with significant tricuspid regurgitation[group II ] had greater preoperative right ventricular systolic pressures and NYHA classes, although there was no correlation between them. The 8 patients with mild[1+] tricuspid regurgitation[group I ] didn`t undergo any procedure for the tricuspid regurgitation and their postoperative Doppler echocardiographic studies showed the less than mild[0 ~ 1+] tricuspid regurgitation, and the 26 patients with significant[>2+] tricuspid regurgitation, and the 26 patients with significant[>2+] tricuspid regurgitation[group II ] underwent tricuspid annuloplasty for the tricuspid regurgitation and the postoperative Doppler echocardiographic studies showed the findings similar to group I except 1 patient who underwent Carpentier`s ring annuloplasty and had severe right ventricular failure. Therefore, preoperative Doppler echocardiography can accurately assess the relative severity of tricuspid regurgitation. Importantly, postoperative Doppler echocardiography could conveniently determine the effect of tricuspid annuloplasty for the patients with significant tricuspid regurgitation. Doppler echocardiography may be an important diagnostic method both for evaluating the degree of residual tricuspid regurgitation after left heart operation as well as for determining which patients should undergo tricuspid valve repair.

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Budd-Chiari Syndrome Due to Antithrombin, Protein C and Protein S Dficiency and the Complete Obstruction of SVC (항트롬빈, C 단백, S 단백 결핍에 의한 Budd-chiari syndrome과 상대정맥 폐색)

  • 김태윤;이원용;홍기우;김응중;신윤철;김건일;임종윤;유규형;최영진
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.239-243
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    • 2002
  • In this case, a 39 year-old man was admitted with Budd-Chiari syndrome associated with complete superior vena cava(SVC) obstruction causing general edema and hepatic failure. Conservative medical therapy was failed. And after the radiologist failed to invasive procedure of balloon dilatation, we attempted the inferior vena cava to right atrium bypass graft. Operation was done through median sternotomy and extended vertical oblique abdominal incision. A 24 mm Dacron tube was placed from the inferior vena cava just below the left renal vein to the right atrium without using the cardiopulmonary bypass pump. The patient's postoperative course was uneventful without signs of bleeding or any other complications. We used anticoagulants at the postoperative first day. At the postoperative 26th day, we performed abdominal Doppler sonography and we confirmed that the graft patency was good. The patient was discharged with SVC obstructive symptoms but we noticed relief of SVC obstructive symptoms in the course of follow-up.

Assessment of the Optic-guided Patient Positioning for Spinal Stereotactic Radiosurgery Using Novalis ExacTrac System (노발리스 ExacTrac system을 이용한 척추 정위 방사선수술 방법 평가)

  • 이동준;손문준;최광영;이기택;최찬영;황금철;황충진
    • Progress in Medical Physics
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    • v.13 no.4
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    • pp.218-223
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    • 2002
  • Stereotactic radiosurgery for intracranial lesion is well established since the Lars Leksell first introduced radiosurgery concept in 1951 Its use in the treatment of spinal lesion has been limited by the availability of effective immobilization devices. The first clinical experience of the spinal stereotactic radiosurgery technique was reported by Hamilton AJ. in 1995. Recently, Optic-guided patient positioning technique for extracranial stereotactic radiosurgery was developed and reported. This study is for assess the target positioning accuracy of the optic guided patient positioning system Exactrac (BrainLab., Inc, Germany). We have designed phantom for assess the accuracy of spinal stereotactic radiosurgery The infrared reflective body markers attached to the relatively immobile part of the body and a series of 2 mm CT images was taken. The image sets were transferred to the planning computer. During the radiosurgery treatment, we measure the real-time display showing the positioning values from Exactrac computer. And we compare the isocenter deviation from irradiated center point of the film which was mounted on the lesion site of the phantom and pin hole site of that film. The accuracy of the ExacTrac system in positioning a target point shows enough for the clinical applications.

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Medullary Thyroid Carcinoma in a Maltese Dog (말티즈 개에서 발생한 갑상선수질암)

  • Hyun, Hee-Jin;Jung, Soo-Kyo;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.435-438
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    • 2014
  • An 11-year-old, 2.67 kg female Maltese dog with 3 weeks history of palpable cervical mass near trachea was submitted to a local animal hospital. Radiography and ultrasonography showed radiopaque mass adjacent trachea and vagus nerve. Surgically excised mass was solitary and approximately $3.5{\times}2{\times}0.8cm$ in size. Histopathologically, there were large neoplastic foci admixed with normal thyroid tissues. These neoplastic foci were composed of small to large packets of the neoplastic cells with plasmacytic morphology, and these packets were divided by fine fibrovascular septa. Immunohistochemically, most neoplastic cells in the thyroid mass showed positive reactions for cytokeratin (AE1/AE3), chromogranin A, neuron specific enolase (NSE) and the negative reaction for vimentin. Based on the gross, histopathologic and immunohistochemical characteristics, this dog was diagnosed as medullary thyroid carcinoma.

THE EFFECT OF GENISTEIN IN ORAL SQUAMOUS CELL CARCINOMA WITH RESPECT TO THE ANGIOGENESIS AND BASEMENT MEMBRANE INVASION (구강편평세포암종에서 신생혈관화와 기저막침습에 미치는 제니스타인의 효과)

  • Kim, Yong-Hun;Yun, Pil-Young;Myoung, Hoon;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.434-439
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    • 2002
  • Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers. OSCC generally has a poor prognosis due to its tendency towards a local invasion and subsequent metastasis, which is mediated by multiple proteolytic enzymes and angiogenesis. Soy products contain high levels of isoflavonoids, including the tyrosine kinase inhibitor, genistein, which has been identified as a potent inhibitor of cell proliferation and in vitro angiogenesis. The purpose of this in vitro study is to evaluate the anti-cancer effect of genistein with respect to the angiogenesis and basement membrane invasion in OSCC. The highly invasive OSCC cell line, HSC-3 cells were cultured in the presence of $10{\mu}M$ genistein for 24h. To evaluate the effects of genistein on the invasiveness and the gelatinolytic activity, in vitro invasion assay and zymography were performed. In order to evaluate the effect on the VEGF and bFGF mRNA expression, RT-PCR and northern hybridization reaction, and chemiluminescence detection were applied. The in vitro invasion assay showed that the genistein treatment reduced the cellular invasion through the artificial basement membrane and significant difference between the control group and the genistein treated group was shown in MMP-2 activity. Especially, the 62 kDa activated form of MMP-2 in the control group was 1.8 times higher than that in the genistein treated group. The results of the northern blot analyses indicated that VEGF mRNA expression in the genistein treated group was significantly down regulated. This study showed that genistein inhibits angiogenesis and reduces basement membrane invasion in OSCC. It seems to support the possibility of genistein as an anti-cancer agent.