• Title/Summary/Keyword: 도관감염

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Epidural Space Identification Device Using Air-filled Catheter (공기도관을 사용하는 경막외강 자동탐지기구)

  • 강재환;김현식;김경아;김상태;배진호;임승운;차은종
    • Journal of Biomedical Engineering Research
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    • v.24 no.1
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    • pp.9-13
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    • 2003
  • An assist device was developed to identify the epidural space by continously monitoring the air-filled catheter pressure. The pressure signal appropriately amplified and filtered enabled to alarm the needle introduction into the epidural space by thresholding detection. Ten LEDs provided a visual change of catheter pressure before alarming for user convenience. Clinical trials were performed in 30 patients with 83% success rate at the first trial. When failed, the second trial was enough for successful anesthesia. The air volume introduced during each anesthesia was less than 1ml, causing side effects. Air filling of the catheter could also minimize infection possibility. Therefore, the present device guarantees safe anesthesia with user convenience.

Clinical Review of Totally Implantable Venous Catheter (완전 거치형 정맥도관의 임상분석)

  • Kim, Jung-Tae;Oh, Tae-Yoon
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.691-695
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    • 2007
  • Background: The introduction of central venous catheters in 1979 has aided the administration of chemotherapy to oncologic patients. We analyzed the clinical reviews and complications of totally implantable venous catheters in an effort to achieve optimal management. Material and Method: We retrospectively studied 100 cases with totally implantable venous catheter at our hospital and we report the results. Result: 100 totally implantable venous catheters were placed in the right subclavian vein in 74 cases (74%), the left subclavian vein in 21 cases, the right jugular vein in 3 cases, the left jugular vein in 1 case and the right femoral vein in 1 case. The immediate complications were 5 cases in malposition of the catheter and 5 cases of arterial puncture. The late complications were 1 case of subclavian vein thrombosis, which was treated with anticoagulation, and 2 cases of pinch-of syndrome. There were no other early or late complications. Conclusion: The low rate of complications in this study confirms the safety and convenience of using totally implantable venous catheter in patients undergoing prolonged chemotherapy. Yet because Infection, thrombosis, and catheter fracture are the most common long term complications of totally implantable venous catheters, early diagnosis and management of these problems can prevent severe complications.

Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.

Transovarial Transmissibility and Histopathology on the Gonad Ivfection with Nosema bombycis in the Silkworm, Bombyx mori, (집누에 생식소의 Nosema bombycis 감염과 경란전달성에 관한 조직병리학적 해명)

  • 한명세
    • Journal of Sericultural and Entomological Science
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    • v.36 no.1
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    • pp.69-75
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    • 1994
  • Through the histological and anatomical investigation of silkworm gonad, N. bombycis infection was found to begin from the peripheral region of ovarial sheath or testicular sheath, then, the pathogens spread to the inner portion. Peroral inoculation with purified spores of N. bombycis to 2nd instar larvae at dosages around 106-8/㎤ of artificial diet resulted in the extremely extended larval survival as long as 15 to 22 days of 4th instar. The growth of ovarioles was confirmed in the 10 to 14 day old larvae, oogonia developed into oocytes and nurse cell against heavy infection of the ovary. Gonads rarely obstructed oogenesis and spermatogenesis in the pupae failed in adult eclosion. Light infection of female hosts effected insignificantly on the ovarial development, however, recorded 100% transmission of the pathogens to the progeny populations. Conclusively, ovarial inflection of silkworm induce transovarial transmission begins around 2~3 day old pupae when ovarioles extruded out to hemocoel, and the infection period thought to be continued until the stage of eggs complete shell formation in the ovariole.

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Redo CABG Using Various Arterial Grafts (다양한 동맥도관을 이용한 재관상동맥 우회술)

  • Min, Ho-Ki;Lee, Young-Tak;Lee, Min-A;Kim, Wook-Sung;Park, Pyo-Won;Sung, Ki-Ick;Jun, Tae-Gook;Yang, Ji-Hyuk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.456-463
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    • 2009
  • Background: Although the reports on re-operative coronary revascularization (redo-CABG) have increased, there are only limited reports on redo-CABG using arterial grafts. The aim of this study was to analyze the safety and feasibility of using various arterial grafts for redo-CABG. Material and Method: A consecutive series of patients who underwent 33 redo-CABGs from March 2001 to July 2008 were retrospectively reviewed. We performed conventional CABG in 17 patients, on-pump beating CABG in 7, off-pump CABG in 7 and minimally invasive direct coronary artery bypass in 2. The grafted that were used included 34 internal thoracic arteries (ITA), 14 radial arteries, 14 right gastroepiploic arteries and others. Arterial composite grafts were constructed in 26 patients. Of these, a previously patent in-situ left ITA was re-used as the in-flow of a composite graft in 10 patients. Result: No hospital deaths or major wound problems occurred. The post-operative complications included 2 myocardial infarctions (6%), 1 intra-aortic balloon pump insertion (3%), 5 cases of atrial fibrillation (15.1 %) and 3 neurologic complications (9.1%). The meanfollow-up duration was 31.1$\pm$22.7 months and the 3 year survival rate was 86.4%. There were 4 late deaths (2 cardiac deaths) and no recurrent angina during the follow-up period. Conclusion: Redo-CABG with using various arterial grafts is currently a safe, feasible procedure, but further investigation and long term follow-up are needed.

The effect of 8 French catheter and chest tube on the treatment of spontaneous pneumothorax (자연기흉에 있어서 8 French 도관과 흉관의 삽입 치료 효과)

  • Kang, Yoon-Jeong;Koh, Hyoung-Gee;Shin, Jong-Wook;Lim, Seong-Yong;Choi, Jae-Sun;Yu, Ji-Hoon;Park, In-Won;Choi, Byoung-Whui;Hue, Sung-Ho;Seo, Seung-Cheon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.410-419
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    • 1996
  • Background : Spontaneous pneumothorax have been managed with a variety of methods. The technique most frequently used is chest tube drainage. Small caliber catheters were first used in the management of pneumothorax complicating the percutaneous needle aspiration lung biopsy, and the try to treat spontaneous pneumothorax also has been reported. However, the value of small caliber catheters in spontaneous pneumothorax has not been fully evaluated. So, we tried to elucidate the efficacy of 8 French catheter in the management of spontaneous pneumothorax. Method : From January, 1990, to April, 1994, 44 patients with spontaneous pneumothorax treated at Chung-Ang university hospital were reviewed. The patients were sub-divide into 8 French catheter insertion group (n=21) and chest tube insertion group (n=23). We compared the presence of underlying lung disease, the extent of the collapse, the duration of indwelling catheter and complication between two groups. Results : 1) The duration of indwelling showed no significant difference between 8 French catheter group and chest tube. But, complication after insertion as subcutaneous emphysema was developed in only chest tube group. (p<0.05) 2) In the primary spontaneous pneumothorax, all case of the pneumothorax of which size was less than 50% showed complete healing with 8 French catheter insertion. Whereas the success rate in patients with large pneumothorax (more than 50%) was tended to be dependent on the age. 3) In the patients with secondary spontaneous pneumothorax who were managed with 8 French catheter, the success rate was trended to be high if the underlying disease of pneumothorax was not COPD and if the patient was young. Conclusion : These results show that 8 French catheter insertion probably was effective in the pneumothorax less than 50%, the primary spontaneous pneumothorax, young age or secondary pneumothorax not associated with COPD.

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Risk Factor, Mortality and Infection Rate of Mediastinum After Delayed Sternal Closure in Congenital Heart Surgery Patients (선천성 심장수술 후 지연 흉골 봉합시 사망률 및 종격동 감염률 그리고 위험인자)

  • 이진구;박한기;홍유선;박영환;조범구
    • Journal of Chest Surgery
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    • v.35 no.7
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    • pp.517-522
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    • 2002
  • Background: Congenital heart surgery may lead to myocardial swelling and hemodynamic instability. Delayed sternal closure may be beneficial in this setting. The purpose of this study was to assess mortality and mediastinal infection rate associated with delayed sternal closure after congenital heart surgery and to evaluate the risk factors which affect mortality and mediastinal infection rate. Material and Method: We retrospectively reviewed 40 patients who underwent delayed sternal closure after repair of congenital heart disease at Yonsei Cardiovascular Hospital, from January 1994 to May 2001. In these patients, we assessed the mortality and mediastinal infection rate, and evaluated their risk factors including operation time, bypass time, aortic cross clamp time, duration to sternal closure and postoperative artificial ventilation time. Mediastinal infection was defined to have positive culture in mediastinum. Result: Hemodynamic instability was the most common indication for delayed sternal closure(n=36) and other indications included postoperative bleeding(n=2) and conduit compression(n=2). The median age at operation was $14.4{\pm}33.4$months old(range, 2days-12years). The patients with postoperative bleeding and conduit compression were much older than the others. The sternum was left open for $4.5{\pm}3.4$ days(range, 1-20days). Overall mortality was 25%(10/40) and mediastinal infection occured in 24.3%(9/37) (3 patients were excluded in mediastinal infection for early death). In risk factor analyses, only aortic cross clamp time had statistical significance for mortality in univariate analyses. However, multivariate analyses revealed that there were no significant predictors for risk of mortality and mediastinal infection. Conclusion: Delayed sternal closure after repair of congenital cardiac disease had relatively high mortality and mediastinal infection rate. But, in patients with hemodynamic instability, postoperative bleeding and conduit compression after repair of congenital cardiac disease, delayed sternal closure may be an effective life saving method.

Pacemaker Lead Endocarditis Combined with Rupture of Sinus Valsalva after Redo Aortic Valve Replacement (대동맥판막재치환술 후 발생한 발살바동 파열을 동반한 심박조율도관 심내막염)

  • Baek, Man-Jong;Na, Chan-Young;Oh, Sam-Se;Kim, Woong-Han;Whang, Sung-Wook;Lee, Cheol;Kang, Chang-Hyun;Chang, Yun-Hee;Jo, Won-Min;Kim, Jae-Hyun;Seo, Hong-Ju;Kim, Chong-Whan
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.780-783
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    • 2003
  • Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.

Effect of Seed Treatment and Observation of Seeds Infested with Fusarium moniforme by Scanning Electron Microscope (Fusarium moniliforme 감염벼종자의 소독과 주사전자현미경적 조직관찰)

  • Sung Jae Mo;Lee Soon Hyung;Yu Seung Hun;Shin Gwan Chull
    • Korean Journal Plant Pathology
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    • v.1 no.1
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    • pp.51-55
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    • 1985
  • This study was carried out to observe the propagule of Fusarium moniliforme on the surface of rice seed and in the vascular bundle of rice stem by scanning electron microscope. Spore and mycelium of F. moniliforme were observed on the surface of rice seed and in the vascular bundle of rice stem. After seed treatment with Benlate T and Busan 3D, F. moniliforme was not isolated from chaffs, but frequently from brown rice, irrespective of disinfection period.

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Liver Abscess Associated with Maternal Perinatal Infection in a Premature Infant (주산기 모체 감염과 미숙아 간농양 1례)

  • Lee, Ju-Hee;Seo, Bong-Ok;Seo, Eun-Sun;Kim, Sung-Mi;Kim, June-Hyoung
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.105-110
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    • 2008
  • Neonatal liver abscesses are rare, carry a high mortality rate, and are difficult to diagnose. The diagnosis of liver abscesses in the neonate cannot be established from the clinical presentation alone. Risk factors for liver abscesses in neonates are maternal infection, sepsis, umbilical venous catheterization, omphalitis, and necrotizing enterocolitis. In this report, we describe a preterm infant (32 weeks, 1,580 g) who presented with abdominal distension, respiratory difficulties, and a persistent inflammatory response in spite of broad spectrum antibiotic treatment; a large (6${\times}$5 cm) solitary pyogenic liver abscess was identified at 9 days of age. It appeared that the liver abscess had originated in the uterus and umbilical venous catheterization facilitated its spread. Percutaneous drainage under abdominal ultrasound guidance was performed and prolonged antibiotics were treated for 5 weeks, effecting a cure.