Which is better among FEV1/FVC and FEV1/SVC in obstructive airway disease?

Background: Forced expiratory volume in 1 second (FEV1) to forced vital capacity ratio (FVC) is being used to diagnose the obstructive lung diseases. Forced manoeuvre (FVC) or relaxed/slow manoeuvre (SVC) can be used to determine vital capacity (VC). In healthy individuals the difference between SVC and FVC (SVC-FVC) is minimal whereas in the presence of airway obstruction this difference will become significant. The present study was done with the objective to detect and compare the airway obstruction by determining the FEV1/FVC and FEV1/ SVC ratios.Methods: This was a prospective cross-sectional study done at OPD, Government Thiruvoteeswarar hospital of thoracic medicine/Kilpauk medical college during the period from September 2016 to February 2017among the patients presenting with symptoms of obstructive airway disease. The sample comprised of 353 patients who underwent spirometry according to standard of ATS/ERS guidelines. As per the criteria, the patients are classified into four groups, by spirometry.Results: The analysis of FEV1/FVC revealed the presence of airway obstruction in 131 (37%) individuals compared to 165 (46%) individuals by the analysis of Fev1/SVC ratio. In the obstruction and mixed groups, the difference in vital capacity SVC – FVC is statistically superior (p<0.05) when compared to normal and restriction groups.Conclusions: The FEV1/SVC ratio detected the presence of airway obstruction in more individuals than did FEV1/FVC ratio and hence FEV1/SVC considered as more reliable factor in the detection of obstructive airway diseases.

A Successful Case of Cardiac Operation and Chemotherapy for Primary Cardiac Malignant Lymphoma with Superior Vena Cava Syndrome / 日本心臓血管外科学会雑誌

Primary cardiac lymphomas are rare cardiac neoplasms with poor prognoses. We report a 61-year-old man who presented with superior vena cava (SVC) syndrome. Trans-thoracic echocardiography showed a 77×91-mm mass occupying the right atrium. The tumor obstructed the SVC. The deteriorating hemodynamics of our patient prompted a surgical intervention. We resected as much of the tumor as possible under cardiopulmonary bypass. The postoperative course was uneventful, and the SVC syndrome disappeared. Pathological examination was consistent with malignant lymphoma, diffuse large B-cell type. After cardiac operation, the patient was treated with rituximab, cyclophosphamaide, adriamycin, vincristin, and prednisone (CHOP-R). The patient has been in good health for 30 months without signs of recurrence.

CT Demonstration of the Extracardiac Anastomoses of the Coronary Veins in Superior Vena Cava or Left Brachiocephalic Vein Obstruction

CT scans in four cases of chronic superior vena cava or left brachiocephalic vein obstruction demonstrate a systemic-to-cardiac collateral venous pathway through anastomoses between the pericardial branches of systemic veins and the presumed adventitial veins of the ascending aorta and pulmonary trunk. These adventitial veins then drain into tributaries of the anterior cardiac veins or ventricular coronary veins.

Acute pulmonary edema during endovascular stenting of a patient with non-malignant superior vena cava syndrome: A case report / 대한내과학회지

The superior vena cava (SVC) syndrome results from the disturbance of blood flow in superior vena cava caused by the obstruction. The most common etiology of this condition is the external compression by a malignant tumor. Other causes include thrombus from a pacemaker, defibrillator or central venous catheters. The conventional treatment is radiation and chemotherapy. Recently stenting has been used as a first-line therapeutic strategy for non-malignant cases with balloon and self-expanding stents. In our report, a 77 year-old woman had the SVC syndrome without identification of an underlying disease. A percutaneous endovascular intervention was performed. The stent was placed successfully but just after the procedure, the venous return immediately increased and acute pulmonary edema developed. The patient improved after intravenous diuretics and oxygen. Here we report our experience and review the medical literatures for the management of the non-malignant SVC syndrome, with percutaneous endovascular intervention and the rare complication of pulmonary edema.

Effect of SVCⅢ on the proliferation and apoptosis of human cutaneous T-cell lymphoma Hut-78 cells / 第三军医大学学报

Objective To explore the inhibition and apoptosis of the human cutaneous T-cell lymphoma cell lines Hut-78 by traditional Chinese medicine SVCⅢ. Methods After Hut-78 cells were treated with SVCⅢ of different concentration, the inhibition and apoptosis of Hut-78 cells was determined by MTT, agarose gel electrophoresis of DNA fragment and FACS. Results SVCⅢ could inhibit remarkably Hut-78 cells growth and DNA ladder was seen by agarose gel electrophoresis. The proliferation of Hut-78 cells were inhibited in G_1 stage by FACS. Conclusion SVCⅢ can promote growth retardation and apoptosis of human cutaneous T-cell lymphoma cell lines Hut-78, which suggests SVCⅢ has antineoplastic function.

SVC Syndrome Caused by Leiomyosarcoma of SVC: A Case Report / 대한흉부외과학회지

Among the causes of SVC syndrome,intraluminal tumor,especially the leiomyosarcoma is very rare.We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission.On physical examination,facial edema and venous engorgement on upper extermities and upper chast wall were showed.The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC.Surgery was performed through median sternotomy.For complete resection of the tumor and thrombus,we used partial and total CPB.The follow up SVC cavogram revealed no abnormality 14 months after the operation.

Reconstruction Of Superior Vena Cave and Its Branches in the Treatment of Malignant Mediastinal or Pulmonary Tumors Through Anterior Mediastinotomy / 中国医师杂志

Objective To explore the operative method for reconstruction of superior vena cave (SVC) and its branches in the treatment of patients with malignant mediastinal or pulmonary tumors through anterior mediastinotomy. Methods From 2001 to 2004 year, 22 patients with malignant mediastinal tumor or lung cancer received the resection of tumors and the reconstruction of the superior vena cave and its branches through anterior mediastinotomy. The operative efficacy was followed up in all patients. Results There was neither severe operative complications nor operative death in this group of patients, and 2 patients died of tumor recurrence in one year of post-operation, while others survived till now. Only one artificial graft occlusion occurred one month after operation. Conclusion The complete resection of malignant mediastinal or pulmonary tumors and the reconstruction of superior vena cave and its branches through anterior mediastinotomy is simple and reliable, and can remarkably improve the survival time of the short-term and long-term of the patients with malignant mediastinal or pulmonary tumor invading SVC.

A Case of Absent Right Superior Vena Cava

Absent right superior vena cava in visceroatrial situs solitus is rare. It has been known the absent right superior vena cava is usually accompanied with persistent left superior vena cava. And this anomaly could be combined witk additional congenital heart disease and rhythm disturbances. We experienced one case of absent right superior vena cava accompanied by persistent left superior vena cava, secundum type atrial septal defect, and transient post-operative sinus node dysfunction.

A Case of Behcet's Syndrome with Superior Vena Cava Obstruction and Massive Pericardial Effusion

Behcet's syndrome has been known as multisystemic disease caused by nonspecific immune mediated vasculitis, but it's precise etiology is not yet identified. Among the various systemic manifestations, pericardial effusion is extremely rare, and pericardial tamponade caused by massive pericardial effusion in Behcet'sydrome has not been reported in the literature. We report a case of Behcet's syndrome manifested as SVC syndrome due to SVC and right atrial thrombus with massive pericardial effusion resulting cardiac tamponade with the review of the literature.

A case of Behcet's syndrome with superior vena cava syndrome

Behcet's syndrome has been known as a disease which has the triple symptoms such as recurrent orogenital ulceration and eye inflammation. The syndrome is now recogninized as a multisystem disease involving mucocutaneaous, cardiovascular, central nervous system, renal, articular and gastrointestinal system. The vascular involvement in Behcet's disease has been reported since Mischima first described the case in 1961, four types of vascular lesion are recognized ; arterial occlusion ; aneurysm ; venous occlusion ; and varices. Venous occlusion are frequently observed, most commonly in the inferior or superior vena cava. We report a case of Behcet's disease manifested as superior vena cava syndrome due to thrombus on both brachiocephalic veins.

A Case of SVC Obstruction in Behcet's Syndrome

The clinical triad of relapsing iritis, ulcers of the mouth and genitalia was first described in 1939 by Hulusi Behcet. This entity, originally confined to the above triad of symptoms appears to be systemic disease manifested by skin lesion, thrombophlebitis, neurologic, cardiovascular or visceral symptoms. The vascular involvement in Behcet's syndrome has been reported since Mischima first described a case in 1961, four types of vascular lesion are freuqnetly observed most commonly on the inferior or superior vena cava. Treatments consist of anticoagulation and administering oral steroids. We report a case of SVC obstruction in 36 years old female patient with Behcet's syndrome.

The Result of Radiation Therapy of superior Vena Cava Syndrome / 대한치료방사선과학회지

To access the result of radiation therapy for 8 years experiences, 21 patients who were treated with superior vena cava syndrome had been analysed according to dose fractionation and toal dose. The results are as follows; 1. In high fractionate dose group, six of eleven patients (54.5%) exhibited relief of symptoms in 1-2 days, and additional three patients of nine (81.7%) within 3-4 days, while standard fractionated dose treatment is not effective to achieve initial relief of symptoms. 2. Graded response by total dose was correlated with total dose rather than dose fractionation. 3. Overall one year survival rate with superior vana cava syndrome was 9.1% and mean survival was 4.2 months.