http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
증례보고 : 내경정맥을 통한 중심정맥도관 삽입 실패 후 초음파로 발견된 혈전
정종권 ( Jong Kwon Jung ),한정욱 ( Jeong Uk Han ),신헬렌키 ( He Len Ki Shinn ),정인준 ( In Jun Jung ),고두현 ( Du Hyun Ko ),임흥순 ( Heung Soon Im ),임현경 ( Hyun Kyoung Lim ) 대한마취과학회 2008 Korean Journal of Anesthesiology Vol.55 No.6
Right internal jugular vein catheterization is performed frequently as central venous catheterization by the landmark method. This procedure, however, might prove difficulty due to anatomic variations or thrombosis of internal jugular vein. We failed to catheterize right internal jugular vein by the landmark method in 70-year-old female patient. And then, we detected right internal jugular vein thrombosis by ultrasound scan. Left internal jugular vein catheterization was performed by the ultrasound guided technique. Central venous catheterization has possibility to fail despite several attempts by the landmark method. Then, ultrasound guided approach is a good choice to aid central venous catheterization when difficulties or complications have been encountered. (Korean J Anesthesiol 2008; 55: 744~6)
혈액투석을 위한 내경정맥 도관 삽입 중 발생한 상대 정맥 증후군
길욱현 ( Gil Ug Hyeon ),송호철 ( Song Ho Cheol ),백정선 ( Baeg Jeong Seon ),김진수 ( Kim Jin Su ),조근종 ( Jo Geun Jong ),이지인 ( Lee Ji In ),남유정 ( Nam Yu Jeong ),최의진 ( Choe Ui Jin ),장윤식 ( Jang Yun Sig ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.2
Most cases of superior vena cava (SVC) syndrome are secondary to malignant disease and subacute in their presentation. However, the exponential increase in use of indwelling central venous catheters and cardiac pacemakers over the last two decades has resulted in more patients with SVC syndrome. Internal jugular vein cannulation has become the preferred approach for temporary hemodialysis catheter placement following the reports of an increased in cidence of subclavian vein stenosis due to subclavian vein catheterization. We describe a patient who developed SVC syndrome after internal jugular vein catheterization. The patient had been swollen the left arm intermittently due to left central vein stenosis for 1 year and experienced balloon angioplasty and stent insertion for three times. We diagnosed the SVC syndrome through the both subclavian venography, which revealed complete obstruction of the left brachiocephalic vein with extensive collateral circulation and mild stenosis of the distal right internal jugular vein. Resolution of the clinical SVC sydrome occurred after catheter removal. (Korean J Nephrol 2004;23(2):349-352)
김영균,김기환,안창혁,임근우,박우찬,송병주,정상설,김정수,장은덕<SUP>1<.SUP>,이은정<SUP>1<.SUP>,Young Kyun Kim,M.D.,Kee Hwan Kim,M.D.,Chang Hyeok Ahn,M.D.,Keun Woo Lim,M.D.,Woo Chan Park,M.D.,Byung Joo Song,M.D.,Sang Seol Jung,M.D. 대한갑상선-내분비외과학회 2006 The Koreran journal of Endocrine Surgery Vol.6 No.2
Anaplastic thryoid carcinomas are very aggressive and lethal solid tumors; they sometimes show microscopic vascular invasions, but they rarely result in tumor thrombus in the internal jugular vein or in the other great veins of the neck. We encountered a 64-year-old woman with anaplastic thyroid carcinoma and a tumor thrombus that extended from the Lt. internal jugular vein to the innominate vein. Palliative total thyroidectomy, modified radical neck dissection and segmental resection of the Lt. internal jugular vein were done, along with removal of the intravascular tumor thrombus. We recommended postoperative radiotherapy and chemotherapy, but the patient refused additional treatments. We report here on this case for which we first experienced anaplastic thryoid carcinoma associated with tumor thrombus of the internal jugular vein. (Korean J Endocrine Surg 2006;6:102-105)
Roshan Kumar Verma,Deepak Sarahan,Gautamjeet Raj Kumar 대한갑상선학회 2020 International Journal of Thyroidology Vol.13 No.2
Follicular variant of papillary carcinoma thyroid is an aggressive variant of papillary carcinoma thyroid. It is morecommonly associated with extrathyroidal extension and regional lymphadenopathy. It can rarely be associated withmicroscopic vascular invasion but tumor thrombus into great veins is a rare phenomenon. We present a caseof 60-year-old male with follicular variant of papillary carcinoma thyroid with tumor thrombosis in superior thyroidvein and internal jugular vein (IJV). We report a case of a 60-year-old male who presented with a large swellingin the lower part of left side of neck for 4 months. Clinical examination revealed a hard swelling of 12x8 cmin left side of neck. Ultrasonography showed a solitary thyroid mass of the left lobe and a dilated left superiorthyroid vein and ipsilateral IJV. Fine-needle aspiration cytology revealed follicular variant of PTC cells. Totalthyroidectomy was done. A tumor thrombus was discovered in the superior thyroid vein and left IJV was foundto be dilated. The left IJV with superior thyroid vein was ligated and excised. The patient recovered well afterthe operation with no local or distant metastasis detected. Follicular variant of PTC commonly spreads to the lymphnodes. Vascular spread via direct intravascular extension through superior thyroid vein is extremely rare. Onpalpation cord like IJV is felt on the involved side. Neck ultrasound play important role in the diagnosis. Aggressivesurgical treatment with IJV ligation above and below the tumor thrombus is recommended to minimize the riskof potentially fatal complications of the intraluminal masses. Intravascular tumor extension into IJV of neck infollicular variant of PTC is rare and can be associated with serious consequences. Total thyroidectomy withthrombectomy with ligation of IJV must be done.
양훈식(Hoon Shik Yang),김용주(Yong Ju Kim) 대한두경부종양학회 1996 대한두경부 종양학회지 Vol.12 No.2
For advanced head and neck cancers that originate in midline structures, bilateral neck dissection should be considered even if the lymph nodes were negative clinically. But, many complications and mortalities may occur in synchronous bilateral neck dissection at sacrifing of both internal jugular vein. Therefore several types of bilateral neck dissection have been proposed, but the effective and safe methods were not determined yet. So, we have prefered the method of synchronous bilateral neck dissection with preserving one internal jugular vein at least. We operated 21 patients who might be expected high incidences of bilateral neck metastases with above type of neck dissection. We analyzed the data of 21 cases(42 sides) retrospectively. The results were as follows: 1) The primary sites were transglottic(33%), supraglottic(29%), hypopharynx(29%) and tongue base(9%). 2) Types of neck dissection were RND(4 sides), MND(7 sides), FND(16 sides), and SND (15 sides). 3) Postoperative complications were minimal and did not influenced morbidity. 4) Mean interval time of neck recurrence was 21 months. Overall neck recurrent rate after bilateral neck dissecton was 19%. In 19%, neck recurrence from positive lymph nodes was 63% and from negative lymph nodes was 37%. As a results, synchronous bilateral neck dissection with preservation of one internal jugular vein minimally should be done in cases which were suspected high incidence of bilateral lymph node metastases for cure and prevention of neck recurrence.
이용문,박재현,최준정,배금석,강성준 대한갑상선학회 2015 International Journal of Thyroidology Vol.8 No.1
A rare case of poorly differentiated thyroid carcinoma (PDTC) with gross intraluminal invasion to the internal jugular vein whose clinical manifestation was multiple lung metastases is described. A 66-year-old man was referred to the outpatient clinic of the Department of Internal Medicine, hemato-oncology subdivision for multiple lung nodules found by his regular health check-up. These lung nodules showed variable sizes with irregular shapes, and typical distributions throughout the parenchyma, which were consistent with metastatic nodules. Ultrasonography revealed a 4.5 cm sized hypoechoic mass with irregular shape in his left thyroid lobe and a huge thrombus in the left internal jugular vein. PDTCs associated with gross intraluminal invasion to the great cervical vein and multiple lung nodules as their first clinical manifestation are extremely rare. We would emphasize the importance of preoperative detailed evaluation of the disseminated disease by ultrasonography in suspected patients.
윤성호,진성민,강태구,이동훈 대한이비인후과학회 부산,울산,경남 지부회 2018 임상이비인후과 Vol.29 No.1
Internal jugular vein (IJV) thrombophlebitis is a rare complication of deep neck abscess. A 55-year-old male was diagnosed with retropharyngeal and mediastinal abscesses. In spite of treatment with surgical drainage and antibiotics, his deep neck abscess was aggravated and there was newly developed diffuse necrosis of the right IJV. We performed surgical drainage again with closure of the fistula on the posterior pharyngeal wall caused by the neck abscess and applied vacuum-assisted closure therapy. However, the patient’s condition deteriorated. Therefore, we decided to perform debridement of the necrotic tissue in the right IJV and ligate the vein. After that, intravenous antibiotics and vacuum-assisted closure therapy were continued and the patient was successfully treated. In case of deep neck abscess accompanied by IJV thrombophlebitis, ligation of the IJV and removal of the causative necrotic tissue would be effective.
임상연구 : 외경정맥: 이면성 초음파를 이용한 우측 내경정맥 천자지표로서의 유용성
조장은 ( Jang Eun Cho ),김원옥 ( Won Oak Kim ),이민정 ( Min Jeong Lee ),길혜금 ( Hae Keum Kil ) 대한마취과학회 2006 Korean Journal of Anesthesiology Vol.50 No.6
Background: Measuring the distance between internal jugular vein (IJV) and external jugular vein (EJV) on ultrasound image can give the information of the whereabouts of the IJV. We compared the success rate between carotid artery (CA)-guided and EJV-guided cannulation based on the information gathered from ultrasound. Methods: We studied 152 patients requiring central venous cannulation during anesthesia. Ultrasound images were obtained with 7.5 MHz probe on the right neck at 0°, 30°, and maximum rotation of the head in flat and 15° Trendelenberg (T) position. The horizontal diameter of the RIJV and % overlap of the CA with the RIJV at each position, and the horizontal distance of RIJV-REJV at 30° were measured on ultrasound images. In EJV group, the distance of RIJV-REJV was drawn along the cricoid level and the point of IJV was marked as the needle insertion site. Cannulation was performed with palpation of the CA in CA group and performed at the marked point in EJV group without palpation of CA. Results: Overall RIJV diameter was increased in T-position compared to flat position. Following head rotation, RIJV diameter was decreased and % overlap of CA was increased (P < 0.05). In 26.8% of patients at 30° in T position, CA overlapped 26-50% of RIJV. The success rate of cannulation at the first trial was 97.4% in CA group and 96.1% in REJV group. Conclusions: With the IJV identified on ultrasound image, the distance between the IJV and the EJV can be used as another landmark for RIJV cannulation provided the EJV is visualized with the naked eye. (Korean J Anesthesiol 2006; 50: 605~10)
Sungwoo Cho,Sangchul Yun 대한외과학회 2019 Annals of Surgical Treatment and Research(ASRT) Vol.97 No.5
The primary site for a hemodialysis catheter insertion is the right internal jugular vein (IJV) followed by the left IJV and subclavian vein. In cases when veins of the upper extremities are exhausted, femoral veins are an alternative insertion location. Femoral catheter insertions should only be used for short periods because of the increased risk of infection. There is a percutaneous technique to recanalize occluded central veins for hemodialysis catheter insertion. We experienced success with a cut-down method for permcath through a completely occluded IJV. We, therefore, find surgical recanalization to be better than percutaneous method in terms of cost and safety.