• Tuberculosis and Respiratory Diseases
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• 제43권2호
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• pp.274-279
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• 1996

폐정맥 폐쇄성 폐고혈입증은 드문 질환이기는 하나 폐부종이 동반된 폐고혈압증에서 반드시 의심해야 하며 폐생검을 통해 확진할 수 있고, 폐조직 검사상 폐동맥의 침범이 있다해도 이질환의 가능성을 배제할 수 없다. 저자들은 폐부종을 동반한 폐고혈압증에서 심도자 검사상 폐동맥쐐기압이 정상이고 다른 심장 질환이 없는 것올 확인한 후 폐조직 생검으로 진단된 폐정맥 폐쇄에 의한 폐고혈압증을 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한영상의학회지
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• 제82권4호
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• pp.1018-1023
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• 2021

사행 폐정맥(meandering pulmonary vein)은 드물게 보이는 폐 혈관 이상으로, 사행성 주행을 보이는 폐정맥이 좌심방으로 배출되는 것을 특징으로 하는 질환이다. 우리는 조영증강흉부 전산화단층촬영 및 폐 혈관 조영술 후 우측 사행 폐정맥으로 진단된 55세 여성 환자를 보고하고자 한다. 조영증강 흉부 전산화단층촬영상 우상폐정맥으로 배출되는 구불구불한 사행성 경로를 보이는 혈관구조물이 우상엽에 있었고, 폐 동정맥 기형이 의심되었다. 진단 및 치료를 위해 폐혈관 조영술이 시행되었고, 폐혈관 조영술에서 먹이 동맥(feeding artery)은 보이지 않았고, 환자는 우측 사행 폐정맥으로 진단되었다. 조영증강 흉부 전산화단층촬영에서 사행 폐정맥과 다른 혈관 기형의 감별이 어려운 경우, 폐혈관 조영술 소견이 진단에 도움이 되며, 추가로 시행할 수 있는 진단도구가 되겠다. 사행 폐정맥의 혈관 조영 소견을 인식함으로써 불필요한 치료가 시행되는 것을 예방할 수 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권3호
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• pp.214-217
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• 2018

Inflammatory bowel disease (IBD) is a well-recognized risk factor for thrombotic events in adults but data on children are scarce. In the great majority of adult patients, thrombotic events are usually deep vein thrombosis and pulmonary embolism. Other sites such as jugular veins are extremely rare. We present a case of Lemierre syndrome in an adolescent girl with active ulcerative colitis and discuss possible risk factors. This is the first reported case of severe Lemierre syndrome with thrombus extension to cranial veins in a patient with ulcerative colitis. Early recognition of Lemierre syndrome in patients who present with rapidly worsening symptoms of neck pain, fever and signs of pharyngitis is imperative because it increases a chance of favorable prognosis. It is important for pediatricians treating IBD patients not to underestimate possible thrombotic events in children with IBD. Recognition of additional risk factors is crucial for prompt diagnosis and adequate treatment.

• Journal of Chest Surgery
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• 제22권2호
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• pp.308-314
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• 1989

Pulmonary sequestration is a congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two forms recognized: extralobar and intralobar. Extralobar form is a very rare congenital malformation, usually located in the lower chest, and may be found in newborn infants at the time a congenital diaphragmatic hernia is repaired. Large sequestrated segments may be cause acute respiratory distress in the neonate. The condition is asymptomatic in 15 per cent of patients. This report presents two cases of pulmonary sequestration which misdiagnosed a superior mediastinal tumor and a benign lung tumor. First case was 30-year-old male patient and chief complaints were dyspnea, dry cough and right chest pain. Chest X-ray showed a homogenous increased density of smooth margin at the right superior mediastinal area and suggested a benign mediastinal tumor. And so explothoracotomy was made without other special studies. Second case was 28-year-old male patient. One month ago, he had tracheostomy and right closed thoracostomy due to massive hemoptysis and spontaneous hemothorax. Chest X-ray showed a benign cystic lesion at RLL area. At the time of operation, in first case, a mass of adult fist size was placed medial to the right upper lobe and densely adhesive to trachea, SVC and esophagus. Blood supply of the mass was bronchial arteries of trachea and RUL bronchus and drained to SVC and azygos vein through anomalous systemic veins. There was no bronchial communication on Frozen biopsy. In 2nd case, large cystic lesion contained old blood hematoma was located in RLL and anomalous blood vessel from thoracic aorta was drained to posterior segment of RLL. In operation field, intralobar pulmonary sequestration was diagnosed, and RLL lobectomy was carried out.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.79-83
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• 1993

A 38-year-old female was admitted due to progressive exertional dyspnea and intermittent blood tinged sputum. Chest PA showed diffuse reticular infiltration accompanied by hyperinflation. $PaO_2$ was normal in resting state but profoundly decreased during exercise. Spirometry showed severe obstructive pattern but DLCO was markedly decreased. Lung volumes measured by helium equilibrium method was increased. On HRCT, numerous and relatively uniform sized cysts were evenly distributed throughout the bilateral lung fields. Open lung biopsy was performed and pulmonary lymphangioleiomyomatosis(LAM) was diagnosed based on the findings of abnormal proliferation of smooth muscle cells in the walls of lymphatic vessels, bronchioles, and small pulmonary veins. Immunohistochemical staining was negative for estrogen receptor but positive for progesterone receptor. Medroxyprogesterone therapy was initiated.

• Journal of Chest Surgery
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• 제32권1호
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• pp.58-61
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• 1999

노령에서의 삼심방심은 드문 질환이다. 본 증례는 66세된 남자로 관상동맥 질환과 삼심방심으로 진단되었다. 삼심방심의 수술소견상 좌심방을 두 방으로 나누는 10 mm 크기의 개구를 가진 막성중격이 있었고, 폐정맥들은 근위부에 위치하는 방에 연결되어 있었다. 그 외 폐정맥의 연결이상이나 심방중격결손등의 다른 기형은 없었다. 좌심방내의 막을 절제하고 카펜티어 에드워드링으로 승모판을 재건해 주었으며 관상동맥우회로술을 성공적으로 시행하였다.

• Journal of Chest Surgery
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• 제16권3호
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• pp.331-336
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• 1983

Cor triatriatum is a rare congenital malformation of the heart, in which a septum stretches in a transverse or oblique plane through the left atrium, thus separating it into two compartments. The upper one connects with the pulmonary veins, and the lower one connects with the left ventricle. Due to the rarity of, and great difficulty in-diagnosing, cor trlatrlatum, data On the surgery of this disease are of necessity very limited and so accurate pre-operative diagnosis was very difficult to make. `We experienced a case of the cyanotic congenital heart disease which was diagnosed as a large atrlal septal defect with streaming venous blood from inferior vena cava to left atrium through atrial septal defect in August, 1982. We found that there were transverse septum in the left atrium through atrlal septal defect, the pulmonary venous drainage were located in the upper chamber of the left atrium, and the lower chamber was connected with the left atrial appendage, mitral valve and `left ventricle. But our case had not any opening in this transverse septum and the right atrium was connected with the upper chamber of the left atrium through the upper part of the atrlal septal defect, and was communicated with the lower chamber of the left atrium through the lower part of the atrlal septal defect. We excised the transverse septum and repair this atrial septal defect with Woven Dacron patch accompanying with the drainage of coronary sinus to right atrium. The post-operative course was not eventful and he was discharged with good result on the post-operative 8th day, and has been in good .condition up to now for longer than 10 months.

• Journal of Chest Surgery
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• 제33권3호
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• pp.207-211
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• 2000

Backgroud: Conventional cardiac transplantation with each atrial anastomosis designed by Shumway and associates has been used widely in cardiac transplantation because of its simplicity and efficiency. There have been many reports about the postoperative atrioventricular value regurgitation resulting from the alteration in atrial geometry after cardiac transplantation by Shumway's technique. New surgical technique of direct anastomosis of superior vena cava, inferior vena cava, right pulmonary vein and left pulmonary vein was introduced to overcome the those problems. We performed this study to test the feasibility of this new surgical technique prior to application to clinical practice. Material and Method: Conventional cardiac transplantation was performed on 12 mongrel dogs(Group I) and cardiac transplantation with new surgical mthod of direct anastomosis of SVC, IVC, left and right pulmonary veins was performed on 11 mongrel dogs(Group II). After weaning from cardiopulmonary bypass, we compared the postoperative rhythm, hemodynamic data, and echocardiographic findings between two groups. Result : The cardiopulmonary bypass time and graft ischemic time were 119.0$\pm$4.4 minutes, 162.0$\pm$4.5 minutes respectively in group I, and 140.0$\pm$7.1 minutes, 180.5$\pm$5.4 minutes respectively in group II. The cardiopulmonary time and graft ischemic time in group II were longer than those of group I (p<0.05). There were 3 cases of failure to weaning from cardipulmonary bypass onein group I and two in group II, and this difference was not significant statistically. Sinus rhythm was regained postoperatively in 58% (group I) and 82%(group II), without statistical significant between 2 groups. Postoperative echolcardiography showed 2 cases of tricuspid value regurgitation and 1 case of mitral regurgitation in group I, and no regurgitation of atrioventricular value in group II. Conclusion: Although these was no statistically significant difference between 2 groups, there was tendency of less arrhythmia and less atrioventricular valvular regurgitation in group II. We suggested that the new surgical technique could be a useful strategy in heart transplantation, especially in the case of size mismatching between donor and recipient.

• Journal of Chest Surgery
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• 제55권3호
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• pp.214-224
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• 2022

Background: Studies of the prognostic role of circulating tumor cells (CTCs) in early-stage non-small cell lung cancer (NSCLC) are still limited. This study investigated the prognostic power of CTCs from the pulmonary vein (PV), peripheral blood (PB), and bone marrow (BM) for postoperative recurrence in patients who underwent curative resection for NSCLC. Methods: Forty patients who underwent curative resection for NSCLC were enrolled. Before resection, 10-mL samples were obtained of PB from the radial artery, blood from the PV of the lobe containing the tumor, and BM aspirates from the rib. A microfabricated filter was used for CTC enrichment, and immunofluorescence staining was used to identify CTCs. Results: The pathologic stage was stage I in 8 patients (20%), II in 15 (38%), III in 14 (35%), and IV in 3 (8%). The median number of PB-, PV-, and BM-CTCs was 4, 4, and 5, respectively. A time-dependent receiver operating characteristic curve analysis showed that PB-CTCs had excellent predictive value for recurrence-free survival (RFS), with the highest area under the curve at each time point (first, second, and third quartiles of RFS). In a multivariate Cox proportional hazard regression model, PB-CTCs were an independent risk factor for recurrence (hazard ratio, 10.580; 95% confidence interval, 1.637-68.388; p<0.013). Conclusion: The presence of ≥4 PB-CTCs was an independent poor prognostic factor for RFS, and PV-CTCs and PB-CTCs had a positive linear correlation in patients with recurrence.

• Journal of Chest Surgery
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• 제38권10호
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• pp.725-728
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• 2005

환아는 생후 18개월 된 여아로 반복적인 위급한 과량의 객혈을 주소로 입원하였다. 과거력상 생후 6개월에 중증의 심비대 소견을 보이는 심방중격결손증을 진단받았으며 폐정맥 협착이 심비대에 의한 압박으로 생긴 이차적인 병변일 것이라 추정하여 심방중격결손폐쇄술만 시행하였다. 술 후 환아는 심비대와 폐정맥 협착이 완화된 소견을 보였다. 그러나 추적 관찰 중 환아는 반복적인 다량의 객혈로 다시 입원하였고 전산화단충촬영 소견 상 폐정맥 협착이 다시 심해진 것으로 판독되었으며 기관지 주변에 성상을 알 수 없는 연조직 종괴들이 좌측 기관지를 압박하고 있었다. 정확한 위치를 알 수 없는 반복적인 객혈로 인해 시험적 개흉술이 불가피하였고, 수술 소견상 좌폐정맥은 하나였으며 외견상 협착의 소견을 보였다. 좌측 기관지 주변에는 다발성 임파절 비대가 기관지를 압박하고 있었다. 또한 수술 중 다량의 객혈이 발생하여 전폐절제술을 시행할 수밖에 없었다. 술 후 병리 소견은 폐정맥 협착과 일치하였다. 환아는 2일간의 중환자실 관리 후 6일째 합병증 없이 퇴원하였다. 2개월간 추적 관찰되었으며 증상 없이 양호한 경과를 보이고 있다. 그러나 향후 지속적인 추적 관찰이 필요할 것으로 생각한다.