• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.676-679
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• 1994

A 36-year-old man was studied because of signs and symptoms of superior vena caval syndrome. Chest computerized tomography showed $10{\times}8{\times}6$ cm sized lobulated anterior mediastinal mass, compressing superior vena cava. Fine needle aspiration cytology revealed seminoma. There was no detectable tumor mass in the testes. We report a case of primary mediastinal seminoma presenting with superior vena caval syndrome.

• Journal of Chest Surgery
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• v.22 no.4
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• pp.655-660
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• 1989

The unroofed coronary sinus syndrome is a spectrum of cardiac anomalies in which part or all the common wall between the coronary sinus and the left atrium is absent. This defect is part of a developmental complex which includes absence of the coronary sinus and termination of a persistent left superior vena cava in the left atrium. Recognition of this complex is important so that interruption or diversion of the left superior vena cava may be done to prevent subsequent central nervous system complications. Surgical correction uses an intraatrial baffle to divert flow from the left superior vena cava to right atrium and to close the atrial septal defect. This report describes a 7 years old female patient in whom the left superior vena cava was identified preoperatively and the complex [unroofed coronary sinus syndrome, common atrium, mitral valve cleft] recognized at the time of operation. Surgical correction, following repair of cleft mitral valve, utilized a Dacron patch baffle to route the left caval blood to the right atrium and included closure of the atrial septal defect

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.368-371
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• 2004

Superior vena cava syndrome(SVCS) is most often encountered in patients with malignancies. Tuberculosis is nowadays an uncommon cause of SVCS. We report the case of a patient who presented with respiratory symptoms accompanied by SVCS due to tuberculous lymphadenitis. Treatment was instituted with isoniazid, rifampicin, pyrazinamide and ethambutol, and all symptoms disappeared. To our knowledge, no case of SVCS provoked by tuberculous lymphadenitis has been described previously in Korea.

• The Korean Journal of Nuclear Medicine
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• v.22 no.1
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• pp.47-53
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• 1988

Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows : 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

• Journal of Chest Surgery
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• v.12 no.2
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• pp.140-144
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• 1979

This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube This is a report of a case of superior vena caval syndrome due to idiopathic mediastinal fibrosis, which was surgically treated. The patient was 35-year-old Korean male who progressively complained shortness of breath about for 40 days prior to operation. Phlebogram of SVC showed indentation of SVC at the site of cavoatrial junction. The operation was performed under impression of bronchogenic cancer of right hilum. After thoracotomy, it was found a irregular mass in the mediastinum at the level of cavoatrial junction, which was developed to surrounding with SVC, pericardium, trachea and bronchus and they fixed together to immobile. Bypass graft between SVC and right atrial appendage was performed using a pericardial roll tube [$1.3{\times}5$ cm]. After that SVC was decompressed very well. SVC pressure was markedly reduced from 32 cm $H_2O$ in preoperative to 21 cm $H_2O$in postoperative. Mediastinal fibrosis was confirmed by histopathological examination postoperatively. The postoperative course was uneventful.

• The Korean Journal of Nuclear Medicine
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• v.19 no.1
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• pp.145-148
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• 1985

A small number of pathologic entities such as Budd-Chiari Syndrome, cirrhosis, focal nodular hyperplasia, and superior and inferior vena cava obstruction has been reported to result in focal areas of increased uptake of radiocolloid on the hepatoscintigram. We recently studied a patient with focal accumulation of $^{99m}Tc-phytate$ at the inferior aspect of the liver, at the junction of the right and left lobe. The superior vena cava scintiangiogram was taken for the evaluation of the superior vena cava obstruction and collateral circulations. As a result of superior vena caval obstruction a considerable amount of blood flowed to the liver through the anterior parietal and periumblical venous channels. A certain fraction of radiocolloid delivered by the rete mirabile perfused to a localized area of the liver. This would explain the hot spot around the porta hepatis in this case.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.219-222
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• 1996

A 34-year-old man was admitted to the hospital because of ascites, abdominal fullness. computed tomography and cavography revealed inferior vena cavil occlusion just above the hepatic vein and diagnosed as Budd-Chiari syndrome. conservative medical therapy failed to control the symptoms produced from both portal hypertension and versa caval stasis. Therefore, under extracorporeal circulation with moderate hypothermia and normal cardiac contraction, membranoto y and inferior vena casa venoplasty with Gore-tex (10mm) was performed. Postoperatively, physical examination revealed oral ulceration, subcutaneous thrombophlebitis, folliculitic lesions. uveitis And increased reactivity of the skin to needle punctures. 10 month later, superior vena ciiva obstruction symptom was found. Hehcet's disease was diagnosed.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.10-19
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• 1976

One hundred and seventy-four patients were treated in this Department since 1956. One hundred and fifteen patients of them were surgically treated. They were classified on the basis of the disease entity as follows; 48 case of thrombo-angiitis obliterance, 8 cases of Leriche syndrome, 12 cases of arterial embolism, 36 arterial aneurysm, 5 arterio-venous fistula, 15 arterial and venous injuries, 8 pulseless diseases, 2 coarctation of aortas, 15 varicose veins, 12 thrombophlebitis, 9 superior venacaval syndromes, 2 inferior vena caval obstructions and Raynaud's diseases. All the cases of the Burger's diseases were males, and half of them were in the fourth decades, 39 cases underwent undergone unilateral or bilateral sympathectomies. All the Leriche syndromes were males aged over fifty. Three cases out of six were suffering from diabetes mellitus. 2 cases underwent aorto-femoral bypass graft with Y-shaped dacrons. And two embolectomies were performed in 2 cases. Eight cases of arterial embolisms among 12 had mitral valvular diseases with auricular fibrillation The most common site of lodgement of emboli was femoral artery. Nine out of 14 underwent embolectomies with Fogarty catheters. There were 14 peripheral arterial aneurysms, 16 thoracic and/or abdominal aortic aneurysms, and 4 dissecting aneurysms. Most frequent cause of peripheral arterial aneurysms were external trauma. Thoracic and abdominal aortic aneurysms were non-traumatic. And four cases of the dissecting aneurysms had significant hypertension and aged over fifty. Among 5 cases of arteriovenous fistulas, 2 cases hand typical Branham's sign, and they were normalized after operation. Eight cases of pulseless disease were females and aged from three to twenty-five. Three out of them were treated surgically using dacron prosthetic grafts, but the results of the surgery were variable and not satisfactory. A case of coarctation of aorta was treated surgically with an excellent result. Fourteen out of 15 varicose veins underwent ligation of the saphenous vein system, exstirpation of the varicose veins, stripping or some combination of these methods. Two cases of superior vena caval syndromes were operated by bypass graft between the left innominate vein and the right auricle. Two cases of inferior vena caval obstructions were operated upon through right atrial route using extracorporial circulation. All the four cases of vena caval obstructions showed excellent results postoperatively. Two cases out of 12 thrombophlebitis underwent thrombectomies. One of two Raynaud's diseases was surgically treated with an excellent result.

• Tuberculosis and Respiratory Diseases
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• v.63 no.4
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• pp.387-391
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• 2007

Fibrosing mediastinitis is a rare disease that is characterized by the proliferation of dense fibrous tissue of the mediastinum. The pathogenesis of fibrosing mediastinitis is unknown in most cases. However, histoplasmosis, tuberculosis, autoimmune disease, radiation therapy, and other idiopathic fibroinflammatory diseases have been implicated in some cases. Most clinical features are related to an obstruction or compression of the mediastinal structure. Fibrosing mediastinitis is often progressive and occurs diffusely throughout the mediastinum. We encountered a case of fibrosing mediastinitis of a very focal lesion without evidence of mediastinal involvement. The condition was confirmed by biopsy and graft bypass surgery was performed because of SVC syndrome.

• The Korean Journal of Nuclear Medicine
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• v.15 no.1
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• pp.45-49
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• 1981

The hot spot on liver scan was demonstrated by many authors in various conditions such as SVC obstruction, Budd-Chiari syndrome, liver abscess, hemangioma of liver, hepatic venoocclusive diseases, IVC obstruction, and tricuspid insufficiency. And the appearance of hot spot in SVC obstruction is due to unsual collateral circulation. But there was no report of this hots pot on liver scan in our country. We have recently observed one patient with SVC obstruction who shows well-defined area of increased radioactivity between right and left lobe of liver on liver scan using $^{99m}Tc-tin$ colloid, and demonstrated collateral circulations with RI venography using $^{99m}Tc-O_4$. The injection site of radiocolloid was left antecubital vein. This hot spot did not appear when the radiocolloid was injected into right leg vein. We report here this hot spot on liver scan in SVC obstruction with review of some liter atures.