• Journal of Chest Surgery
• /
• 제36권9호
• /
• pp.695-698
• /
• 2003

복강동맥류(celiac trunk aneurysm)는 내장동맥류(Splanchnic artery aneurysm)의 4％밖에 이르지 않는 매우 희귀한 질병으로 다른 동맥류와는 달리 죽상동맥경화증과 혈관중막의 퇴행성 변화(medial degenerative change)가 주원인으로 알려져 있다. 대부분 특이 증상 없이 우연히 발견되는 복강동맥류는 파열시 약 80％의 사망률을 보이므로 진단 시 적극적인 치료의 개입이 요구된다. 저자들은 최근 2예의 복강동맥류 환자를 동맥류 문합술과 동맥류 제거술 및 우회로술로 치료하여 좋은 결과를 얻었다.

• Journal of Trauma and Injury
• /
• 제34권2호
• /
• pp.130-135
• /
• 2021

Celiac artery compression is a rare condition in which the celiac artery is compressed by the median arcuate ligament. Case reports of compression after trauma are hard to find. Blunt traumatic pericardium rupture is also a rare condition. We report a single patient who experienced both rare conditions from a single blunt injury. An 18-year-old woman was brought to the trauma center after a fatal motorcycle accident, in which she was a passenger. The driver was found dead. Her vital signs were stable, but she complained of mild abdominal pain, chest wall pain, and severe back pain. There were no definite neurologic deficits. Her initial computed tomography (CT) scan revealed multiple rib fractures, moderate lung contusions with hemothorax, moderate liver injury, and severe lumbar spine fracture and dislocation. She was brought to the angiography room to check for active bleeding in the liver, which was not apparent. However, the guide wire was not able to pass through the celiac trunk. A review of the initial CT revealed kinking of the celiac trunk, which was assumed to be due to altered anatomy of the median arcuate ligament caused by spine fractures. Immediate fixation of the vertebrae was performed. During recovery, her hemothorax remained loculated. Suspecting empyema, thoracotomy was performed at 3 weeks after admission, revealing organized hematoma without pus formation, as well as rupture of the pericardium, which was immediately sutured, and decortication was carried out. Five weeks after admission, she had recovered without complications and was discharged home.

• 대한방사선과학회:학술대회논문집
• /
• 대한방사선과학회 1995년도 춘계학술대회
• /
• pp.131-132
• /
• 1995

• Journal of Chest Surgery
• /
• 제46권2호
• /
• pp.146-149
• /
• 2013

Mesenteric ischemic symptoms appear only when two of the three major splanchnic arteries from the abdominal aorta are involved. Recently, we encountered a case of chronic mesenteric ischemia in a 50-year-old female patient caused by atherosclerotic obstruction of the celiac trunk and superior mesenteric artery. She was treated with a retrograde bypass graft from the right common iliac artery to the superior mesenteric artery (SMA) in a C-loop configuration. Complete revascularization is recommended for treatment of intestinal ischemia. When the celiac trunk is a not suitable recipient vessel, bypass grafting to the SMA alone appears to be both an effective and durable procedure for treating intestinal ischemia.

• Journal of Chest Surgery
• /
• 제50권2호
• /
• pp.105-109
• /
• 2017

Coronary arterial involvement in Takayasu arteritis (TA) is not uncommon. Herein, we describe a case of TA with celiac trunk and superior mesenteric artery occlusion combined with coronary artery disease. Bilateral huge internal thoracic arteries (ITAs) and the inferior mesenteric artery provided the major visceral collateral circulation. After percutaneous intervention to the right coronary artery, off-pump coronary artery bypass grafting for the left coronary territory was done using a right ITA graft and its large side branch because of its relatively minor contribution to the visceral collateral circulation.

• Anatomy and Cell Biology
• /
• 제56권2호
• /
• pp.276-279
• /
• 2023

The arterial support of the liver is most commonly from the celiac trunk via the proper hepatic artery (PHA). The PHA divides into left and right branches: the right hepatic artery (RHA) supplies the right and caudate lobes while the left hepatic artery (LHA) supplies the left and quadrate lobes. Aberrant hepatic arteries are relatively common, and the most frequent contributors are the superior mesenteric artery and left gastric artery. Herein we present findings from postmortem dissection of an abdominal cavity that revealed a rare combination of reported variations. Specifically, this subject had three extrahepatic arteries - a replaced LHA (rLHA), a PHA, and a replaced RHA (rRHA). The rLHA originated from the left gastric and the rRHA originated from the superior mesenteric artery. Knowledge of these variations is important for surgical and radiological procedures to avoid complications during treatment and improve patient outcomes.

• 대한한의학회지
• /
• 제18권1호
• /
• pp.385-398
• /
• 1997

The location and local arrangement of motor, sensory neurons within brain stem, nodose ganglia, spinal ganglia and sympathetic ganglia projecting to rat's kidney and meridian point BL 23, GB 25 were investigated by HRP immunohistochemical methods following injection of 5% WGA-HRP into left kidney and meridian point BL 23, GB 25. Following injection of WGA-HRP into left kidney, anterogradely labelled sensory neurons were founded within either nodose ganglia and spinal ganglia. The sensory neurons innervating rat's left kidney were observed within spinal ganglia $T_{7}{\sim}L_3$. Sympathetic motor neurons innervating rat's left kidney were labelled within left suprarenal ganglia, either celiac ganglia, superior mesenteric ganglia, and sympathetic chain ganglia $T_{1}{\sim}L_3$. Sympathetic chain ganglia were concentrated in $T_{12}{\sim}L_1$. The sensory neurons innervating rat's meridian point BL 23 were founded within spinal ganglia $T_{2}{\sim}L_2$. They were numerous in spinal in ganglia $T_{10}{\sim}T_{12}$. Sympathetic motor neurons innervating rat's meridian point BL 23 were observed in suprarenal ganglia and greater splanchnic trunk, sympathetic chain ganglia from $T_1$ to $L_3$. They were concentrated in $T_{12}{\sim}L_3$. The sensory neurons innervating rat's meridian point GB 25 were labelled within spinal ganglia $T_{6}{\sim}T_{13}$. They were numerous in from T10 to $T_{12}$. Sympathetic motor neurons innervating rat's meridian point GB 25 were labelled within greater splanchnic trunk and sympathetic chain ganglia $T_{12}{\sim}L_3$. They were concentrated in $T_{13}{\sim}L_1$. This results neuroanatomically imply that the location of rat's motor and sensory neurons innervating meridian point BL 23 and GB 25 were closely related that of innervating kidney.

• Journal of Yeungnam Medical Science
• /
• 제13권1호
• /
• pp.134-140
• /
• 1996

1986년부터 1995년까지의 10년간 영남대학교 의과대학 부속병원에서 절제술이나 세침 생검을 시행하여 조직 병리학적으로 확진된 신경아세포종 23례 중 전산화단층촬영을 시행한 16례를 대상으로 후향적으로 분석한 결과 신경아세포종은 소아에서 많이 발생하며, 부신에서 호발하고, 임상적인 주 증상은 만져지는 종괴였다. 전산화단층촬영소견은 과반수 이상에서 작고 고밀도이거나 곡선 모양의 석회화를 보이며, 중앙선을 침범하며, 분엽상의 모양과 분명한 경계를 보이고, 내부에 낭성 변화를 보이며, 불균등한 조영 양상을 보이고, 주위 중요 혈관과 림프절을 침범한 소견을 보였다. 이와 같은 전산화 단층촬영소견들은 소아 복부 종양에서 신경아세포종의 진단과 감별에 도움을 줄것으로 생각된다.

• Journal of Chest Surgery
• /
• 제5권1호
• /
• pp.13-18
• /
• 1972

In 1835,Schlesinger first described a case of subisthmlc lower thoracic aortic coarctation. Since Olim`s unsuccessful reconstructive surgery in 1949 and Beattie`s first successful resection with homograft replacement on such a lesion in 1951 were reported,about 20 cases of atypical aortic coarctation had been treated by definitive surgery until 1964. In Korea, only 2 cases of atypical aortic coarctation treated by bypass graft were reported until now. This is the third case-report treated by reconstructive surgery. The patient,11 year old girl who had 2 year history of headache, visual weakness, intermittent claudlcation, and general weakness, was first diagnosed of having the hypertension due to atypical coarctation by the findings of high blood pressure[170/110mmHg] at the upper extremity and weak pulsation on both femoral artery,murmur on the epigastrium, absence of aortic knob, and aorto graphy. Aortography demonstrated the isolated segmental narrowing[length 5cm, diameter 0.4cm] at the level of aortic hiatus 2cm above celiac arterial origin, the dilated right 9th, 10th, 11th intercostal arteries with multiple dimunitive collaterals and no associated abnormalities in the other arteries. Preoperatlve positive findings were strong positive mantoux test, high AST[720 units]. transient mild cardiomegaly with right lung infiltration on chest X-ray and suggestive left ventricular hypertrophy on ECG. On December 1970, through separate left thoracotomy and abdominal approach, bypass graft between descending thoracic aorta and abdominal aorta below renal artery was performed. The operation was first successful with satisfactory reduction of hypertension on the upper trunk[postoperatlve 130/80mmHg] and strong pulsation on the lower extremities[postop. O, postop. 140/100mmHg]. However,6 weeks after surgery, she expired of sudden hemoptysis and shock due to anastomotic leak within the thorax. Operative finding disclosed that the affected aorta was firm, with rich periaortic fibrosis and the outer diameter of stenotic site was not attenuated. Histopathology of the resected specimen was also compatible with primary arteritis.

• 대한방사선기술학회지:방사선기술과학
• /
• 제38권2호
• /
• pp.107-114
• /
• 2015

간 역동적 CT(Liver Dynamic Computed Tomography; LDCT) 검사에서 일반적으로 사용하는 프로토콜과 관전압을 낮게 설정한 후 프로토콜을 변화시켰을 때 방사선량과 영상의 질을 비교하여 영상의 질을 유지하면서 방사선량을 감소시킬 수 있는 방안을 알아보고자 하였다. LDCT를 시행한 환자 중 신체질량지수(body mass index; BMI)가 18.5~24인 환자 40명을 대상으로 일반적인 복부 CT 검사 프로토콜을 적용한 A그룹 20명(관전압: 120 kVp, SAFIRE strength1)과 관전압을 낮게 설정한 B그룹 20명(관전압: 100 kVp, SAFIRE strength 0~5 적용)이었다. 영상의 질 평가는 동맥기의 간 실질 조직, 대동맥, 상장간막동맥, 복강동맥, 내장지방 그리고 백그라운드에 관심영역(region of interest; ROI)을 설정해 잡음(noise), 신호대 잡음비(signal to noise ratio; SNR), 대조도 대 잡음비(contrast to noise ratio; CNR), CT number를 측정 비교하였다. 또한 정성적 평가는 경험이 풍부한 영상의학과 전문의 2명이 0~3점까지로 평가하였다. 방사선량은 총 DLP(dose length product)와 유효선량, CTDIvol(volume computed tomography dose index)을 비교하였다. 관전압 100 kVp에서 SAFIRE가 높을수록 잡음은 감소하고, CT number는 증가하였다. 따라서 SNR과 CNR은 SAFIRE 단계가 높을수록 증가하였다. 관전압 120 kVp와 비교하여 잡음, SNR, CNR이 SAFIRE strength 2, 3에서 가장 유사하였다. 정성적 평가는 SAFIRE strength 2가 가장 많았고 관전압이 100 kVp일 때 영상의 질이 더 좋다고 평가한 경우는 SAFIRE 1이었다. 방사선량은 120 kVp에 비해 100 kVp에서 21.69% 감소하였다. BMI가 비교적 높지 않은 LDCT 검사의 경우 공장에서 출고될 당시에 관전압이 높게 설정되어 있어 불필요한 방사선피폭이 우려되고 있는 현실을 고려하면, 본 연구 결과에 따라 관전압을 낮게 설정하고 SAFIRE strength를 2로 조정하면 영상의 질 저하 없이 방사선량도 감소시킬 수 있을 것으로 사료된다.