• Journal of Chest Surgery
• /
• v.18 no.1
• /
• pp.104-110
• /
• 1985

The anomalous systemic arterial supply to the lung without sequestration is an uncommon congenital anomaly characterized by the presence of a part of lung tissue which supplied by an aberrant artery from the aorta or its branch and normal communication with the normal bronchial tree, and it was reported by Huber in 1777 first. It differs from bronchopulmonary sequestration in having normal bronchial communication from the remainder lung and normal lung histology. We experienced a case of anomalous systemic arterial supply to the lung without sequestration, which was confirmed preoperatively. The patient was 16 year old male and came to us with complaints of mild fever and profuse sputum with coughing. Chest film showed a ring-like soft tissue shadow in Rt. middle lung field. Aortogram revealed an aberrant artery originated from abdominal aorta at 12th thoracic vertebral level and supplying a part of Rt. lower lobe of lung. At. the time of operation, an aberrant systemic artery which originated from the abdominal aorta supplying the Rt. lower lobe was noted, and the bronchial communications were normal. After division and ligation of the aberrant artery, Rt. lower lobectomy was performed The postoperative courses were uneventful and the patient was discharged with good condition.

• The Korean Journal of Physiology and Pharmacology
• /
• v.2 no.5
• /
• pp.591-600
• /
• 1998

We have examined 24 human aortas aged $46{\sim}90$ years obtained from autopsies. Most exhibited gross lesions of some degree on the lumenal surface. Using hot alkaline treatment (0.1 N NaOH) at $70{\sim}75^{\circ}C$ for 5 hours, we extracted and quantitated elastin portions from the aortic wall in 3 different segments (UTA=upper thoracic aorta, LTA=lower thoracic aorta, AA=abdominal aorta). We have found UTA had $70.6%{\pm}1.39$ (SE), LTA $61.6%{\pm}1.94$ (SE), AA $49.2%{\pm}1.84$ (SE) elastin respectively based on wet weight. The differences between segments are statistically significant (p＜0.05, 0.025). However, there is no significant correlation between the age of the patients and the relative amounts of elastin in each segment. We have also observed the structure of elastin in the internal elastic lamina (IEL) and tunica media (TM) with SEM (scanning electron microscopy), and discovered that the IEL shows various forms of elastolysis- broken sheets, discontinuity, various sizes of lumps, vesicles, and possible newly formed elastin in the aortic lesions (Song and Roach submitted to YMJ). From these studies we conclude that elastin in the aortic wall remains well balanced quantitatively with age in spite of evidence suggesting vigorous degeneration and regeneration in the atherosclerotic lesions.

• Journal of Chest Surgery
• /
• v.16 no.3
• /
• pp.301-309
• /
• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Journal of Chest Surgery
• /
• v.25 no.1
• /
• pp.105-111
• /
• 1992

Total atherosclerotic obstruction of the juxtarenal abdominal aorta is a relatively rarely encountered form of atherosclerotic vascsular disease, accounting for less than 5% of all arterial obstrutive disease. We have encountered two patients with such lesions, both of whom were admitted for intermittent claudication of the lower extremities and symptoms of vascular ischemia. Digital subtraction angiography[DSA] was performed on both patients, the results of which revealed total obstruction of the aorta just inferior to the renal arteries without involving the latter. Operative technique involved the use of the sup-raceliac aorta as the site of proximal anastomosis of aortofemoral bypass followed by a fem-orofemoral bypass graft with Smm sized Woven Dacron[Vascutek] through a subcutaneous tunnel within the retroperitoneal space. Both patients experienced restoration of blood flow distal to the obstruction postoperatively without any complications, and OPD follow-up one month postoperatively and postoperative DSA showed evidence of continued graft patency with persistent symptomatic improvement.

• Journal of Chest Surgery
• /
• v.34 no.3
• /
• pp.270-273
• /
• 2001

신동맥 사이 또는 신동맥 상부에 위치하는 대부분의 복부대동맥 축착은 흉복부절개의 접근으로 수술한다. 우리는 경흉막 후복막 접근으로 개복을 하지 않고 단측단측 흉복부대동맥의우회술을 시행한 1례의 수술을 소개하고자 한다. 경흉막 후복막 접근은 흉복부대동맥의 시야가 매우 좋으며 개복을 할 때보다 더 쉽게 흉복부대동맥의 우회술을 할 수 있고 복강내 장기를 노출하지 않는 장점이 있다.

• Journal of Chest Surgery
• /
• v.26 no.7
• /
• pp.568-570
• /
• 1993

Pulmonary sequestration is a congenital malformation in which a mass of pulmonary tissue is detached from the normal lung and receives its blood supply from a systemic arterys from the thoracic aorta or the abdominal aorta, or occasionally from an intercostal artery. We have experienced the three cases of the intralobar pulmonary sequestration. In the first case a 5 year old male was admitted of productive cough and abdominal distension, and chest film showed pneumonic infiltration in RLL. Second case was 26 year old male patient complaining Rt. chest discomfort and hemoptysis and chest X-ray revealed infiltration in Rt. LLF. Third case was 26 year old male patient whose complaint was hemoptysis. Chest x-ray showed hazy density in Lt. lower lung field. In the all cases, the aortograms were performed and the confirmed diagnosis was intralobar pulmonary seqeustration.

• Journal of Chest Surgery
• /
• v.26 no.10
• /
• pp.808-811
• /
• 1993

Leriche syndrome ia a common entity which causes ischemia of the lower extremities. Since the introduction of aortic resection and homograft replacement by Oudot in 1951, reconstructive procedures to restore distal blood flow by either endarterectomy or, later, with prosthetic graft have become standardized. Recently we experienced a case of Leriche syndrome. A 50 year-old male patient admitted with intermittent claudication, impotence, and symmetrical atrophy at lower extremities. Aortogram revealed complete obstruction at infrarenal abdominal aorta and Doppler sonogram revealed only minimal blood flow at left femoral artery.Successful surgical treatment was accomplished with endarterectomy at proximal left renal artery and a bypass from abdominal aorta at the level of both renal arteries to both external iliac arteries with bifurcated Gore-tex vascular graft. After bypass operation, we did palpate with arterial pulse at both popliteal artery.He was recovered without complication.

• Childhood Kidney Diseases
• /
• v.27 no.2
• /
• pp.89-96
• /
• 2023

Renal nutcracker syndrome (NCS) is the entrapment of the left renal vein between the abdominal aorta and superior mesenteric artery. Although uncommon in pediatric patients, early diagnosis is crucial to avoid potential severe complications, such as anemia or renal vein thrombosis. NCS presents a variety of symptoms, most commonly including "Triade's symptoms"-hematuria, proteinuria, and flank pain. Diagnosis and treatment include invasive and noninvasive management, although due to a lack of pediatric clinical studies, management is widely variable. Conservative diagnosis and treatment are recommended as a first-line option for pediatric patients; however, invasive surgical treatment may be recommended based on symptom severity. This review aims to provide a comprehensive overview of NCS in children to better understand the widely variable incidence, occurrence, and management from early on to allow for early-onset management.

• Journal of Chest Surgery
• /
• v.30 no.3
• /
• pp.340-343
• /
• 1997

We experienced a female patient with intramural hematoma of the aorta. This patient had a severe anterior chest pain radiating to interscapular area with choking sensation. CT revealed a intramural hematoma of the thoracic aorta and a part of the abdominal aorta but there was no evidence of intimal tearing. We did the eme gency operation under hypothermic circulatory arrest and retrograde cerebral perfusion. Ascending aorta was replaced and coronary artery bypass graft was done because of intimal tearing of the ostium of right coronary artery. She was discharged without any significant complication. We reported this case with consideration about necessity of emergency operation for intramural hematoma of the thoracic aorta.

• Journal of Chest Surgery
• /
• v.26 no.6
• /
• pp.492-495
• /
• 1993

We experienced one case of surgical treatment of abdominal aortic aneurysm using retroperitoneal approach. The transperitoneal route has been the standard surgical approach for elective and emergency treatment of aneurysmal or occlusive disease. Among its cited advantages for aortic reconstruction are familarity with the exposure, easy access to the infrarenal aorta and iliac vessels, possibility of simultaneous inspection of the intra-abdominal viscera, and speed of opening and closure.Despite the proved versatility of the transperitoneal approach, it is commonly associated with prolonged ileus, increased third space fluid loss, and significant pulmonary complications. The retroperitoneal approach, on the other hand, has many advantages; excellent exposure for the repair of juxtarenal or suprarenal abdominal aortic aneurysms and visceral vessel occlusive disease, fewer postoperative complications, decreased postoperative third-space fluid losses from intraoperative evaporation and ileus, and improved postoperative pulmonary function. Atherosclerosis was most common cause of abdominal aortic aneurysm. Dacron graft[18mm] was replaced successfully.Postoperative course was uneventful and he was discharged in good condition.