• 한국산학기술학회논문지
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• 제19권6호
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• pp.275-279
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• 2018

뇌농양은 심각한 신경학적 후유증을 일으킬 수 있는 중추신경계 감염이다. 신경집중치료 발달에도 불구하고, 여전히 뇌농양은 특정 위험 환자에게 높은 사망률을 보이고 있다. 특히 세균성 뇌농양은 즉각 진단 및 적절한 항생제 치료가 필요한 응급 상황이다. 또한 드물게 뇌농양이 재발되는 경우도 있다. 본 연구에서는 두통으로 내원한 59세 남자환자를 대상으로 증례보고를 통해 동일 분야 연구에 활용하고자 자료분석을 하였다. 59세 남자가 두통을 주소로 내원하였고, 연속적으로 시행한 뇌자기공명영상과 뇌척수액 검사에서 우측 전두엽에 뇌농양을 확인하였고, 항생제 치료 및 수술적 치료 후 완치하였다. 퇴원 후 5개월 뒤 두통 및 경기 증상 있어 다시 촬영한 뇌자기공명영상에서 뇌농양의 재발이 확인되었다. 뇌농양 재발은 특정 조건, 즉, 농양 부위에 이물질이 남아 있거나 만성 부비동염, 동정맥루, 좌우션트 등이 있을 때 생길 수 있다.

• Archives of Plastic Surgery
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• 제34권3호
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• pp.399-402
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• 2007

Purpose: Arteriovenous fistula is one of high flow vascular malformations. Recently, arteriovenous fistula has been regarded as one of the type of arteriovenous malformations. The patients were diagnosed as arteriovenous malformation Schobinger clinical stage II. Even though arteriovenous fistula rarely occurs on head and neck, treatment of that is difficult due to frequent recurrence. In treating the arteriovenous fistula, chemical embolization, surgical excision and other treatment modalities were used, but the results were not satisfactory. The authors experienced three cases of arteriovenous fistula and treated them with surgical excision. Methods: In cases, warmth, enlargement, pulsation, thrill, and bruit were found. For the accurate evaluation before the operation, angiography and MRI were checked in advance. Incision was made on the site of pulsation. The artery and vein connected to the arteriovenous fistula were dissected widely, individually ligated, and divided. And then the entire mass was totally removed. Results: All surgical sites were healed well without complications and there was no evidence of recurrence in all cases up to for 2 years of follow-up examination. Conclusion: The arteriovenous fistula on face is a very rare disease and has difficulties in treatment. The authors experienced three cases of arteriovenous fistula with complete surgical removal and no recurrence was found in all cases.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.248-251
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• 2013

Introduction: A post-traumatic mesenteric arteriovenous fistula (AVF) is extremely rare. Case Report: A previously healthy 26-year-old male was injured with an abdominal stab wound. Computed tomography (CT) showed liver injury, pancreas injury and a retropancreatic hematoma. We performed the hemostasis of the bleeding due to the liver injury, a distal pancreatectomy with splenectomy and evacuation of the retropancreatic hematoma. On the 5th postoperative day, an abdominal bruit and thrill was detected. CT and angiography showed an AVF between the superior mesenteric artery (SMA) and the inferior mesenteric vein with early enhancement of the portal vein (PV). The point of the AVF was about 4 cm from the SMA's orifice. After an emergent laparotomy and inframesocolic approach, the isolation of the SMA was performed by dissection and ligation of adjacent mesenteric tissues which was about 6 cm length from the nearby SMA orifice, preserving the major side branches of the SMA, because the exact point of the AVF could not be identified despite the shunt flow in the PV being audible during an intraoperative hand-held Doppler-shift measurement. After that, the shunt flow could not be detected by using an intraoperative hand-held Doppler-shift measuring device. CT two and a half months later showed no AVF. There were no major complications during a 19-month follow-up period. Conclusion: Early management of a post-traumatic mesenteric AVF is essential to avoid complications such as hemorrhage, congestive heart failure and portal hypertension.

• Journal of Chest Surgery
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• 제36권4호
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• pp.280-284
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• 2003

양방향 상행대정맥-폐동맥 단락술 후 폰탄 수술의 위험이 큰 2명의 환자에서 청색증의 증가와 운동 능력의 감소를 보여 액와동정맥루 형성술을 시행하였다. 수술 후 두 환자 모두 수술 후 1일째 일반 병실로 전원되었으며, 수술 후 각각 4일, 3일에 퇴원하였다. 두 증례 모두 수술 후 volume loading의 소견은 없었고, 8개월째 추적 관찰 중이며 청색증의 감소와 운동 능력의 향상을 관찰할 수 있었다. 그러나 수술 후 6개월째 시행한 폐관류스캔이나 contrast심초음파 검사에서 폐동정맥루가 아직 충분히 경감되지 않아, 향후 이에 대한 면밀한 추적 관찰이 필요할 것으로 생각한다.

• Journal of Chest Surgery
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• 제40권3호
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• pp.228-231
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• 2007

흉부 외상은 단순 부정맥에서 심근 파열 등 심장에 다양한 합병증을 일으킬 수 있다. 그중 관상동맥 손상은 매우 드문 합병증이고 특히 좌측 관상 동맥의 동맥류는 우측에 비해서 발생빈도가 작은 것으로 되어있다. 흉부 둔상 후 관상 동맥 내벽의 동맥류 형성, 박리, 열상, 동정맥루 및 혈전 등이 매우 드물게 생길 수 있으며, 혈관이 막히고 심근 경색이 발생하면 환자에게 치명적인 손상을 일으킨다. 교통사고로 인한 흉부의 둔상 후 발생한 심근경색증을 진단받은 33세 남자에서 관상동맥 우회로술을 통해 좋은 결과를 얻었기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제31권4호
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• pp.409-412
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• 1998

\ulcorner증례는 매우 드물게 보고되는 질환인 체동맥에서 혈류공급을 받는 폐동정맥루의 수술례에 관한 보고이다. 이 체동맥 폐동정맥루는 수술시 부행혈관으로 인한 출혈과 폐의 울혈로 어려움을 겪기 쉽다. 환자는 재발성의 빈번한 객혈을 주소로 내원한 16세 여자 환자로 다발성의 공급혈관을 갖는 체폐동정맥루로 진단받고 수술 전에 동맥색전술을 시행한 후 수술을 시행한 경우이다. 우중엽과 우하엽에 걸친 15$\times$8 cm의 동정맥루로 우하엽 및 우중엽 절제술을 시행하였다. 수술시 심한 출혈과 폐울혈로 어려움을 겪었으나 수술후 15일째에 별 다른 합병증없이 퇴원하였다. 안전한 수술을 위해서는 비록 많은 수의 부행혈관으로 어려움이 있더라도 폐정맥의 결찰전에 이를 모두 결찰하는 것이 반드시 필요할 것으로 사료되어 보고하는 바이다.

• 대한간호
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• 제33권1호
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• pp.37-51
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• 1994

The cutaneous stimulation is an independent nursing intervention used in various painful conditions, and is explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation on reduction of arteriovenous fistula puncture pain of hemodialysis patients. One group repeated measurement post test research was designed. Forty-five hemodialysis patients who received arteriovenous fistula puncture regulary in hemodialysis units of an attacted D hospital to K university have been studied from August 16 to 21, 1993. First the arteriovenous fistula puncture pain of control period was measured, and then the arteriovenous fistula puncture pain of experimental period(with cutaneous stimulation) was measured. The instrument used for this study were visual analogue pain scale as subjective pain measurement, objective pain behavior checklist and Spielberger's Trait Anxiety Inventory as intervening variables. Analysis of data was done by use of paired t-test, t-test, ANOVA and Perarson correlation coefficient. The results of this study were summarized as follows; 1) The first hypothesis that the subjective pain score of arteriovenous fistula puncture pain in experimental period(with cutaneous stimulation) will be lower than in control period was partly supported. The subjective pain score of arterial line was rejected(paired t=-0.28, p=0.77) and the subjective pain score of venous line was supported(paired t=2.61, p=0.01). 2) The second hypothesis that the objective pain behavior score of arteriovenous fistula pain in experimental period(with cutaneous stimulation) will be lower than in control period was rejected(arterial line paired t=-0.45, p=0.65; venous line paired t=-0.36, p=0.72). 3) The third hypothesis that the cardiopulmonary signs of arteriovenous fistula puncture pain in experimental period(with cutaneous stimulation) will be lower than in control period was rejected(pulse paired t=-0.8, p=0.42; systolic BP paired t=0.98, p=0.33; diastolic BP paired t=0.43, p=0.66). Further experimental studies with simple intravenous injection patients will be recommended in order to identify the effect of cutaneous stimulation.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.153-158
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• 2001

Traumatic carotid-cavernous fistula is a rare complication of moderate to severe head injury. For the treatment of carotid-cavernous fistula, detachable balloon occlusion is the best method of choice. A 26 year old male patient was hurt with a left periorbital penetrating injury 20 years ago, and then left side exophthalmos, bruit and right hemiparesis developed 10 years later. We experienced the very rare case of direct carotidcavernous fistula with cavernous dural arteriovenous fistula. Brain MRIs and cerebral angiograms revealed that direct carotid-cavernous fistula was accompanied by cavernous dural arteriovenous fistula due to longstanding venous hypertension and development of collateral circulation. Detachable balloon occlusion and surgical internal carotid artery ligation were not enough to occlude fistular flow, so cavernous dural arteriovenous fistula embolization was necessary. The authors present a case of long-standing traumatic carotid-cavernous fistula with cavernous dural arteriovenous fistula, with review of the literature.

• 대한영상의학회지
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• 제84권4호
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• pp.846-854
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• 2023

상하지 혈관 손상은 높은 사망률과 관계가 있다. 사지 혈관 손상에 대한 전통적인 치료법은 수술이었으나 최근 기술과 시술법의 비약적인 발달로 인해 혈관 내 치료법(endovascular treatment)의 효용 및 임상 적용이 증가하고 있다. 상하지 혈관 손상에서 시행할 수 있는 혈관 내 치료는 크게 스텐트 그래프트(stent graft) 설치술과 색전술로 나눠볼 수 있으며 일반적으로 손상 혈관의 위치와 크기, 혈관 손상의 성격에 따라 치료법이 달라진다. 겨드랑-쇄골하동맥과 장골 동맥 손상의 경우 해부학적 위치상 수술적인 접근이 어려운 것으로 알려져 있으며 스텐트 그래프트 설치술이 수술을 대신할 수 있는 중요한 치료법으로 활용되고 있다. 활동성 출혈, 가성동맥류, 동정맥루 및 색전 시 허혈이 우려되지 않는 동맥의 손상에 대해서는 색전술을 고려해 볼 수 있다. 상하지의 혈관 손상에 대한 혈관 내 치료법은 최소침습적으로 진단과 치료를 동시에 할 수 있다는 장점이 있어 향후 그 적응증이 더 넓어질 것으로 기대된다.

• Journal of Chest Surgery
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• 제21권5호
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• pp.877-881
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• 1988

A coronary arteriovenous fistula represents an abnormal communication from a coronary artery that may enter any cardiac chamber, a pulmonary artery, the coronary sinus, the superior vena cava or the pulmonary vein. We had a successful experience with 46 year-old male who complained exertional dyspnea[NYHA classification II] and anginal pain since 5 years ago. In intensive study of cardiac catheterization and coronary cineangiography, multiple bilateral coronary arteriovenous fistulas and mitral stenoinsufficiency with left atrial thrombi were recognized. The coronary arterio-venous fistula of left coronary artery was revealed large tortuous aberrant vessels that were connected between just distal portion of first diagonal branch of left anterior descending artery and main pulmonary artery. Other fistula was small tortuous vessel which was originated from left atrial branch of left circumflex artery, was drained into left atrium. The fistula of right coronary artery was communicated conal branch of right coronary artery to main pulmonary artery. But there was no 0y step-up in the right cardiac catheterization. The operative procedure were suture-ligation of draining orifice of coronary arteriovenous fistula in main pulmonary artery, mitral valve replacement[Ionescu-Shiley 25mm] with removal of left atrial thrombi and plication of left atrium under the extracorporeal circulation. The postoperative course was uneventful without any complication and discharged without problem at 17th postoperative days.