• Title/Summary/Keyword: SVC syndrome

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Clinical Evaluation of the Mediastinal Tumors [26 Cases Report] (종격동 종양의 임상적 고찰: 26례 보고)

  • 김종진
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.844-848
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    • 1985
  • Mediastinal tumors which are originated in mediastinum or probably metastasized from other organs have long fascinated the surgeon because of difficulty of diagnosis and treatment. This report is the analysis of the 26 cases of mediastinal tumors, experienced in the Department of the Thoracic and Cardiovascular Surgery, Chosun University Hospital from January 1978 to January 1985. The result are as follows; 1. The age distribution was 10 months to 68 years old and the average mean age was 34.7 years old. 2. Subjective symptom were as follows: Dyspnea [69.2%], Coughing [42.3%], Chest pain [30.8%], Back pain [15.4%] and Numbness of extremities [15.4%]. Objective signs were as follows: Decreased breathing sound [53.3%], Pleural effusion and hemothorax [34.6%], Palpable neck mass [34.6%], SVC Syndrome [19.4%] and Bloody sputum [15.4%]. But, there were no definitive symptoms in 2 cases. 3. The malignant tumors were 19 cases [73.1%]. 4. The germ cell tumors were 2 cases [7.7%], the neurogenic tumor were 3 cases [11.5%], lymphoma were 8 cases [30.8%], thymoma were 2 cases [7.7%], mesenchymal tumor was 1 case [3.8%], cyst was 1 case [3.8%] and carcinoma were 5 cases [19.2%] among the 23 cases, histologically analyzed. 5. The successful complete removal was done in 5 cases among 7 cases of benign tumors. In malignant cases, the surgical removal had been 7 cases and inoperable cases were treated to radiation and chemotherapy.

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Investigation of Reportable Communicable Diseases and Parasites in Aquatic Organisms Living in the Estuary of the Han River (한강 하구에 서식하는 수산생물의 법정전염병 및 기생충 감염 조사)

  • Kim, Jin Hui;Song, Jun Young;Lee, Jung-Ho;Hur, Jun Wook;Kwon, Se Ryun;Kwon, Joon Yeong
    • Korean Journal of Ecology and Environment
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    • v.52 no.4
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    • pp.306-315
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    • 2019
  • The estuary of the Han River constantly suffers from pollutants and pathogenic microorganisms which could cause serious damage to aquatic organisms living there. Despite of this potential risk, it is hard to find any reliable scientific reports on the status of reportable disease infection to the organisms living in this area. In this study, cyprinid fish and crustaceans in Jeonryu-ri, a region of the Han River estuary, were investigated for the infection by representative reportable communicable diseases(SVC, spring viraemia of carp; KHVD, koi herpesvirus disease; EUS, epizootic ulcerative syndrome; WSD, white spot disease) and parasites. Peripheral fish and primary freshwater fish were observed in Jeonryu-ri with cyprinid caught most frequently. Crustaceans were mostly marine species. No positive bands to any of the reportable diseases were produced in any of the fish and crustacean examined in this study by PCR. No trace of Clonorchis sinensis, a liver fluke potential threat to human health, was detected in any of fish samples. However, many fish were infected by metacecaria of other flukes, and other various parasites such as nematode, cestode, copepod, monosite and acanthocephalan. These results suggest that important aquatic organisms in the Han River estuary is not seriously polluted yet. However, it is important to keep monitoring the diseases since the water quality in this region is constantly changing, and devastating influence of infectious diseases is unpredictable. Further, it is required to expand monitoring area toward upstream and increase the number of fish for examination.

Long-term Results Following Surgical Repair of Total Anomalous Pulmonary Venous Return (총폐정맥 환류 이상증에 대한 술후 장기성적 검토)

  • 원태희
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.565-570
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    • 1995
  • Seventy-three patients with isolated total anomalous pulmonary venous connection the patients associated with other major cardiac anomalies such as single ventricle, DORV[Double Outlet Right Ventricle and large VSD[Ventricular Septal Defect were excluded were underwent surgical repair from January 1980 through October 1993. There were 45 boys and 28 girls. The mean age at operation was 19.9 months[range 6 days to 24 years and mean body weight was 7.1kg[range 2.6kg to 45kg . The anomalous locations of connection were supracardiac in 38, cardiac in 21, infracardiac in 5, and mixed in 9. In 38 patients[52% , the venous drainage was obstructed. The obstruction ratios according to the connection type were as follows: 53%[28/38 in supracardiac, 52%[11/21 in cardiac, 100%[5/5 in infracardiac, 22%[2/9 in mixed type. The associated cardiac anomalies were persistent left SVC[2 , tricuspid valve regurgitation[3 , cor triatriatum[1 , and mitral cleft[1 . And associated noncardiac anomalies were imperforate anus[1 and Neil Weightman syndrome[1 . The operative mortality was 23%. The causes of death were pulmonary hypertensive crisis, perioperative myocardial failure, pneumonia with sepsis, arrhythmia and etc. The statistically significant factors in postoperative mortality were the pulmonary venous obstruction and age [p<0.01 . The operative mortality was high in groups of age under 1 month and pulmonary venous obstruction. The mean follow-up was 27.1 months. There were two late deaths. The first patient was three months old boy with supracardiac type and severe obstructive symptoms. The postoperative echocardiography was showed anastomotic stenosis and reoperations were performed twice but the patients expired due to pneumonia and sepsis. The second patient was three month old boy with supracardiac type and total correction was done and was doing well postoperatively. Eight years later, he expired suddenly due to arrhythmia. But all the other patients were in NYHA Fc I and received no medications. The 5-year survival rate excluding early expired patients is 97.1 $\pm$ 0.03 %. In conclusion, although the operative mortality of total anomalous pulmonary venous connection was relatively high compared to other major cardiac anomalies, we could expect excellent long-term results by early surgical correction.

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Clinical Evaluation of Mediastinal Tumors and Cysts - 50 cases report - (종격동 종양 및 낭종의 임상적 고찰: 50례 보고)

  • 오창근
    • Journal of Chest Surgery
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    • v.24 no.3
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    • pp.245-252
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    • 1991
  • For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors and cysts, 50 patients with mediastinal tumors and cysts treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January, 1978 to Mach, 1990 were reviewed. The results of this cases analysis were as follows; 1. of all 50 mediastinal tumors and cysts, 27 patients were male and 23 patients were female. There was no sex preference. The age distribution was from 10 months to 84 years, and mean age was 37 years old, and no age preference. 2. Subjective symptoms were as follows : Dyspnea[54%], Chest pain[44%], Coughing [34%] Fever[16%] and General malaise[12%]. Objective signs were as follows: Decreased breathing sound[46%], Pleural effusion and hemothorax[32%], Palpable neck mass[24%] and SVC syndrome[14%]. But, there were no definitive symptoms in 5 cases[10%]. 3. The most frequently encountered tumors were teratodermoid tumors[26%] followed by lymphomas[22%], thymomas[12%] and benign cysts[8%] in decreasing order of frequency. 4. Based on the subdivision of the mediastinum, 44% of the tumors were in the anterior mediastinum, 24% in the middle mediastinum, 18% in the superior mediastinum and 14% in the posterior mediastinum. 5. The malignant tumors were 25 cases[50%]. 6. The successful removal was possible in all the benign mediastinal tumors and cysts. In malignant cases, the surgical removal had been 12 cases and inoperable cases were treated to radiation and chemotherapy. 7. Postoperative complications were bleeding, wound infection, pneumothorax and vocal cord paralysis. The recurrence was 3 cases. 8. The most frequent mediastinal tumor in the west is neurogenic tumor but is teratoma in Korea.

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Community Analysis and Pathogen Monitoring in Wild Cyprinid Fish and Crustaceans in the Geum River Estuary (금강 하구 자연수계 생물체의 군집 분석 및 질병 원인체 검사)

  • Kim, So Yeon;Hur, Jun Wook;Cha, Seung Joo;Park, Myoung Ae;Choi, Hye-Sung;Kwon, Joon Yeong;Kwon, Se Ryun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.51 no.3
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    • pp.248-253
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    • 2018
  • Freshwater farms are primarily located adjacent to rivers and lakes, facilitating the introduction and spread of pathogens into natural systems. Therefore, it is necessary to continuously monitor natural aquatic organisms, the breeding environment, and infection rates by pathogenic organisms. Fish and crustaceans were sampled 4 times in the Geum River estuary in 2016. The samples were analyzed for the presence of pathogens for reportable communicable diseases, including KHVD (koi herpesvirus disease), SVC (spring viraemia of carp), EUS (epizootic ulcerative syndrome) and WSD (white spot disease); parasite abundance was also examined. The dominant fish species were deep body bitterling Acanthorhodes macropterus (21.4%), followed by skygager Erythroculter erythropterus (12.7%). For crustaceans, Palaemon paucidens and Chinese mitten crab Eriocheir sinensis were dominant. Sixty fish and 36 crustacean species were examined for reportable communicable diseases. When using a specific primer set for each disease, PCR analysis did not detect any reportable communicable diseases in the samples. Some instances of Dactylogyrus, copepods, nematodes and metacercaria were detected. However, the PCR results indicated that the metacercaria were not Clonorchis sinensis.

Monitoring Pathogen Infection of Freshwater Cyprinid Fish and Crustacean in Soyang Lake in 2016 (2016년 소양호에서 채집한 자연산 잉어과 어류와 갑각류의 법정전염병 및 기생충성 질병 모니터링)

  • Mun, Seong Hee;Hur, Jun Wook;Cha, Seung Joo;Hwang, Seong Don;Son, Maeng-Hyun;Kwon, Joon Yeong;Kwon, Se Ryun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.51 no.1
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    • pp.47-53
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    • 2018
  • The presence of pathogens in wild fish is a potential threat to the fish being raised nearby fish farm. Surveillance of these pathogens in the wild is, thus, highly important to keep fish in the farm safe from serious communicable diseases. Fish and crustacean were sampled 4 times at Soyang Lake in 2016. Pathogens for five reportable communicable diseases including KHVD (koi herpesvirus disease), SVC (spring viraemia of carp), EUS (epizootic ulcerative syndrome) and WSD (white spot disease), and parasites were investigated. In Soyang Lake, pale chub Zacco platypus was the most abundant. Forty seven pale chub, 8 Korea piscivorous chub Opsarichthys uncirostris, 3 oily shiner Sarcocheilichthys variegatus wakiyae and 2 crucian carp Cyprinus carassius were investigated for detection of target diseases of fish. Seventeen Caridina denticulata denticulata, 12 Oriental river prawn Macrobrachium nipponense and 1 Chinese mitten crab Eriocheir sinensis were used for detection of WSD. As the result, reportable communicable diseases were not detected in all the freshwater animals. Dactylogyrus was detected in Korea piscivorous chub. Copepoda was also detected in pale chub and Korea piscivorous chub. Metacercaria was detected in the pale chub sampled in September and October. Those were not metacercaria of liver fluke Clonorchis sinensis.

Clinical Analysis of Palliative Treatments in Occlusive Vascular Disease (폐쇄성 혈관 질환을 가진 환자의 고식적 치료에 관한 임상적 고찰)

  • 김학제;조원민;류세민;황재준;송영상;최영호
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.283-289
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    • 2002
  • Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.

Clinical Application Analysis of 3D-CRT Methods Using Tomotherapy (토모테라피를 이용한 3차원 입체 조형 치료의 임상적 적용 분석)

  • Cho, Kang-Chul;Kim, Joo-Ho;Kim, Hun-Kyum;Ahn, Seung-Kwon;Lee, Sang-Kyoo;Yoon, Jong-Won;Cho, Jeong-Hee;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.36 no.4
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    • pp.327-335
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    • 2013
  • This study investigates the case of clinical application for TomoDirect 3D-CRT(TD-3D) and TomoHelical 3D-CRT(TH-3D) with evaluating dose distribution for clinical application in each case. Treatment plans were created for 8 patients who had 3 dimensional conformal radiation therapy using TD-3D and TH-3D mode. Each patients were treated for sarcoma, CSI(craniospinal irradiaion), breast, brain, pancreas, spine metastasis, SVC syndrome and esophagus. DVH(dose volume histogram) and isodose curve were used for comparison of each treatment modality. TD-3D shows better dose distribution over the irradiation field without junction effect because TD-3D was not influenced by target length for sarcoma and CSI case. In breast case, dosimetric results of CTV, the average value of D 99%, D 95% were $49.2{\pm}0.4$ Gy, $49.9{\pm}0.4$ Gy and V 105%, V 110% were 0%, respectively. TH-3D with the dosimetric block decreased dose of normal organ in brain, pancreas, spine metastasis case. SCV syndrome also effectively decreased dose of normal organ by using dose block to the critical organs(spinal cord <38 Gy). TH-3D combined with other treatment modalities was possible to boost irradiation and was total dose was reduced to spinal cord in esophagus case(spinal cord <45 Gy, lung V 20 <20%). 3D-CRT using Tomotherapy could overcomes some dosimetric limitations, when we faced Conventional Linac based CRT and shows clinically proper dose distribution. In conclusion, 3D-CRT using Tomotherapy will be one of the effective 3D-CRT techniques.

Large Cell Carcinoma of the Lung - An analysis of clinical features and survival (대세포 폐암의 임상적 양상과 생존률에 대한 분석)

  • Yang Jin Yeong;Lee Hyung Sik;Moon Sun Rock;Kim Gwi Eon;Suh Chang Ok;Loh Jojn J.K;Oh Won Yong;Whang In Soon
    • Radiation Oncology Journal
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    • v.8 no.2
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    • pp.219-223
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    • 1990
  • This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan.1985 and Dec.1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, $78.8\%$. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor,19($57.6\%$) appeared in the right lung and 14 ($42.4\%$) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs.16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.),2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was $14.3\%$ while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).

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Surgical Treatment of the Aortic Dissection (대동맥박리증의 외과적 치료)

  • Jung, Jong-Pil;Song, Hyun;Cho, You-Won;Kim, Chang-Hoi;Lee, Jay-Won;Song, Meong-Gun
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1360-1365
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    • 1996
  • From September 1992 to May 1996, 38 patients ranging in age from 23 to 78, were operated for aortic dissection at Asan medical center There were 21 men and 17 women. The underlying aortic pathology were acute aortic dissection in 23, chronic aortic dissection in 15. Eight patients had Martian syndrome. In 34 cases of DeBakey type I, II patients, femoral artery and vein and/or right atrial auricle were used as cannulation site. With deep hypothermic c rculatory arrest (esophageal temperature 12 $\pm$ 2.5$^{\circ}C$) and retrograde cerebral perfusion of cold oxygenated blood through SVC, we replaced the ascending aorta and the part of arch if necessary. The mean duration of the total circulatory arrest time was 25 $\pm$ 1.7 mintstuts. In 4 cases of DeBakey type III patients, we replaced descending thoracic aorta or thoracoabdomlnal aorta without shunt or bypass under normothermia with an average 30: 1.5 minutesaortic cross clamp time. One death(2.6%) occurred on the twenty-second postoperative day owing to asphyxia related to ulcer bleeding. Postoperative complications were myocardial infarction with transient left peroneal palsy in 1 case, transient lower extremity weakness in 1 case and prolonged ventilatory support in 1 case. Two patients required reoperation due to retrograde extended dissection and aortic insufuciency. There was no late death with an average 25 months follow-up period.

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