• Title/Summary/Keyword: 카테터 길이

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Guidelines for Determining Length of Tunneled Dialysis Catheter (터널식 투석관의 길이 결정 가이드라인)

  • Park, Ho-Sung;Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.16 no.3
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    • pp.241-248
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    • 2022
  • A guideline for determining the optimal catheter length according to the patient's physique during tunnel-type dialysis catheter insertion used in renal failure patients is presented, and the maintenance of the function of the dialysis catheter is evaluated. From October 1, 2015 to February 31, 2016, a total of 110 (male : female = 73 : 37) patients who underwent tunnel-type dialysis catheterization performed at our hospital were treated without using guidelines. The group was divided into A group, and the group treated using the guideline into B group. Results were analyzed statistically using SPSS 20.0. As a result of the dialysis catheter insertion procedure according to the use of guidelines, the function maintenance rate of group A was 81.8%, and the function maintenance rate of group B was 96.3%. In the case of tunnel dialysis catheter procedure, the function maintenance effect was statistically significant in the group treated using the guideline compared to the group not using it (p<0.05). It can be said that it is more effective when information on the patient's underlying disease is reflected in addition to the use of guidelines.

Feasibility and Safety of a Technique Intended to Place the Catheter Tip in the Right Atrium without Abutment Against the Cardiac Wall during Implantation of the Totally Implantable Venous Access Port (완전이식형 정맥 접근 포트 삽입 시 카테터 팁을 심벽에 닿지 않고 우심방 내 위치시키는 방법의 타당성과 안전성)

  • Hyejin Park;Tae-Seok Seo;Myung Gyu Song;Woo Jin Yang
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.161-170
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    • 2024
  • Purpose To assess the safety and feasibility of intentionally positioning the catheter tip in the right atrium (RA) without an abutment during implantation of a totally implantable venous access port (TIVAP). Materials and Methods We enrolled 330 patients who had undergone TIVAP implantation between January and December 2016 and postoperative chest CT. The TIVAP was placed using the single-incision technique to access the axillary vein directly from the incision line. To position the catheter tip in the RA without abutment, blood return was checked before cutting. Catheter length and complications were evaluated by retrospectively reviewing medical images and records. Results All patients achieved successful catheter tip positioning without abutment or dysfunction. The median tip position was 15.3 mm distal to the cavoatrial junction (CAJ) on fluoroscopy and 6 mm distal to the CAJ on CT. Catheter tips migrated a median of 10.4 mm cephalically on CT compared to fluoroscopy. Thromboses were detected in the RA and superior vena cava in one patient each. Conclusion Intentional catheter tip positioning in the RA without abutment is a safe and feasible technique with a low incidence of thrombosis and no observed dysfunction.

Bacterial Meningitis during Continuous Epidural Block (지속적 경막외 차단중 발생한 세균성 뇌막염)

  • Lee, Jung-Koo;Chung, Jung-Gil
    • The Korean Journal of Pain
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    • v.7 no.1
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    • pp.113-115
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    • 1994
  • Bacterial meningitis is a rare complication of epidural block. As epidural abscess, subarachnoid infection associated with epidural catheters are related to the treatment of pain in diabetic patient whose immune responses have been impaired. A 51-year-old male with non-insulin dependent diabetes came to the pain clinic with neuropathic gain on right thigh and amputated stump of right leg. Treatment consisted of continuous epidural block and subcutaneous tunnelling and epidural morphine with bupivacaine was given on an outpatient basis. Two months later, the patient noted a diffuse frontal headache, projectile vomiting and stiffness neck. These symptoms became more aggrevated over the following 24 h and temperature went up to $38.4^{\circ}C$. A diagnostic lumbar puncture revealed CSF total protein of 747 mg/dl, glucose of 43 mg/dl, and $4320\;WBC/mm^3$. Cultures of epidural catheter tip grew hemolytic staphylococcus epidermidis. A chest x-ray and brain CT scan were negative. Antibiotic therapy with penicillin G and chloramphenicol was given for 15 days. Recovery was uneventful.

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Transcatheter Intravascular Stent Placement in a Shih Tzu Dog with Refractory Pulmonic Stenosis (카테터를 통한 혈관스텐트 장착을 통한 심한 폐동맥협착증 치료 1례)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Lee, Joon-Soek;Nam, So-Jeong;Choi, Ran;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.48-53
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    • 2009
  • A 4-year-old intact male Shih Tzu dog (5.4 kg of body weight) was referred with primary complaints of heart murmur and exercise intolerance. Diagnostic studies found severe valvular pulmonic stenosis (peak velocity of 6.4 m/s, pressure gradient 165 mmHg). The dog was treated with 3 cm (length) ${\times}$ 1.5 cm (diameter) of Palmaz biliary stent. The outcome of stent placement was favorable and remarkably reduced the severity of PS (6.4 m/s to 3.0 m/s of peak velocity). Clinical condition was remarkably improved with the absence of cardiac murmur, although mild pulmonic regurgitation existed from the day of stent placement. To our best knowledge, this case is the first clinical trial for treating PS with intravascular stent in Korea.

Prognostic Analysis of Drug-Eluting Balloon Catheter and Drug-Eluting Stent for In-Stent Restenosis of Drug-Eluting Stent (스텐트 재협착 병변에서 약물코팅 풍선카테터과 약물용출 스텐트의 예후 분석)

  • Lee, Doo Hwan;Song, Jong Nam;Park, Sin eui;Choi, Nam Gil;Han, Jae Bok;Kim, In Soo
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.381-389
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    • 2019
  • Although the development of Drug-eluting stent (DES) improved the ISR significantly more than the Bare metal stent (BMS), the coronary stent restenosis (ISR) treatment still has a high recurrence rate. This study is compared the efficacy of DEB with that of DES implantation in patients with ISR. Among 4,316 patients who underwent coronary stent implantation at the Chonnam National University Hospital between November 2012 and December 2016, 187 patients developed ISR on follow-up coronary angiography ($66.3{\pm}11.0years$, 123 males) were enrolled and divided into two groups according to revascularization method as group I (DEB group; n=127) and group II (DES group; n=60). Primary end point was defined as major adverse cardiac events (MACEs), composite of cardiac death (CD), myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST) during two-year follow-up between the two groups. There were no differences in the baseline characteristics and angiographic findings except that prevalence of device length was shorter ($21.1{\pm}5.3$ vs. $25.3{\pm}9.6 mm$, p<0.002) in group I.Two-year MACE were not different in the two groups (8.7%vs.10.0%, p=0.789). The incidences of cardiac death (0%vs.0%, p=1.000), MI (1.6%vs.6.7%, p=0.085), TLR(8.7% vs. 10.0%, p=0.789) and ST (0% vs. 0%, p=1000). DEB demonstrated comparable risk reduction for MACEs compared with DES in patients with ISR during two-year follow-up. DEB might be good alternative for the treatment of ISR in patients with ISR.

An Inextensible Wire-shaped Deformation Model for Catheter Simulation (카테터의 거동을 시뮬레이션 하기 위한 고정된 길이를 유지하는 실 형상의 변형체 모델)

  • Han, Hyehyun;Lee, Doo Yong
    • Journal of Institute of Control, Robotics and Systems
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    • v.22 no.8
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    • pp.610-614
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    • 2016
  • This paper proposes an inextensible wire-shaped deformation model to simulate catheter behavior. The wire-shaped model consists of serially-connected mass points and massless rigid links. Torsional springs and dampers are employed to accommodate bending. Deformation is computed by updating the rotation angles from the global coordinates while maintaining the fixed length condition. Equations of motion is derived from double pendulum motion. Spring constant is computed using strain energy and potential energy stored in a torsional spring to reflect material property. Simulation is conducted to show deformation of wire model while maintaining inextensibility condition and including material properties. The proposed method guarantees inextensible constraint in the catheter simulation.

Fabrication of silicon piezoresistive pressure sensor for a biomedical in-vivo measurements (생체 in-vivo 측정용 실리콘 압저항형 압력센서의 제조와 그 특성)

  • Bae, Hae-Jin;Son, Seung-Hyun;Choi, Sie-Young
    • Journal of Sensor Science and Technology
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    • v.10 no.3
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    • pp.148-155
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    • 2001
  • A pressure sensor on the tip of a catheter which is utilized to measure the in-vivo pressure in a human body was fabricated and the characteristic of the pressure sensor as measured. To fit into a catheter with 1 mm caliber, samples of $150\;{\mu}m$(thickness) ${\times}$ (600, 700, 800, 900, 1000) ${\mu}m$(width) ${\times}2\;mm$(length) was fabricated. The thicker face with $450\;{\mu}m$ thickness of SDB wafer was made thin to $134\;{\mu}m$ thickness using KOH etchant and it made possible to fabricate sensor cell with the width shorter than 1 mm. Different to the whitstone bridge sensor, we formed one piezoresistor and one reference resistor in sensor. Therefore there are possibilities of reduction of the sensitivity, then by using the simulation tool ANSYS 5.5.1, the location and the type of the piezoresistor was optimized. Another piezoresistor type of sensor which contain one longitudinal and one transverse piezoresistor was fabricated at the same time, but the sensitivity was not improved very much. To get the output versus the pressure, a constant current source and a implementation amplifier was used. As a result, the maximum sensitivity of the sensor with one piezoresistor was $1.6\;{\mu}V/V/mmHg$.

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Cancer Pain Management with Epidural Tunnelling (암성 통증 치료를 위한 경막외 카테터 터널 거치법)

  • Lee, Jung-Koo;Chung, Jung-Gil;Cheun, Jea-Kyu
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.122-126
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    • 1991
  • Continuous epidural analgesia with intermittent morphine injection is a good technique for the management of intractabie cancer pain. Since epidural tunnelling was introduced for the first time to our institution in 1988, it has been widely used for the cancer pain management. Recently epidural tunnelling was introduced for the keeping an inserted catheter for a long period of time. Twenty-five patients with terminal cancer had been used an epidural tunnelling at the pain clinic of Dongsan Medical Center during the period of 3 months in 1991. Among the 25 patients, 14 were male and 11 were female, and most of them were at the ages of 6th decade. The causes of pain were from stomach cancer in 12, CBD cancer in 3, hepatoma in 2, pancreatic cancer in 2, uterine cervical cancer in 2, and miscellaneous cancer in 4 cases respectively. The outcome of treatment were excellent results in 14(56%), good in 9(36%), and moderate in 2.patients(8%). Accordingly satisfactory pain relief was achieved in 92% of the patients. It is suggested that this long-term management of intractable cancer pain by epidural bupivacaine and morphine with epidural tunnelling is satisfactory and reliable.

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Intrapelvic Urethral Anastomosis in a Dog with Complete Obstruction of Proximal Membranous Urethra (막성요도 근위부 완전폐쇄를 지닌 개에서 골반내 요도문합술)

  • Yoon Hun-Young;Kim Jun-Young;Han Hyun-Jung;Jang Ha-Young;Lee Bo-Ra;NamKung Hyo-Sun;Jeong Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.23 no.1
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    • pp.61-64
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    • 2006
  • A 4.65 kg 13-month-old male Pekingese dog was referred to veterinary teaching hospital of Konkuk University for evaluation of dysuria. On physical examination, severe distention of urinary bladder was found in abdominal palpation. Urinary catheter could not be guided into urinary bladder. On serum biochemistry, blood urea nitrogen (35.6 mg/dl) and creatinine (1.9 mg/dl) were increased. Obstruction part of proximal membranous urethra was founded on urethrogram. The length (13 mm) of obstruction part was callipered by cystourethrogram and urethrogram on operation. Surgical resection of obstruction part of urethra was performed without pubic osteotomy, and anastomosis was performed with 5-0 polyglycolic acid. Omentum was placed around the urethral anastomosis. On first day after surgery, appetite was good. On day 5, complete blood count and serum biochemistry showed normal range but mild urinary incontinence was showed after removing catheter. On day 7, urinalysis showed normal condition. On day 14, no leakage of surgical site was observed in excretory urogram. On day 21, no more urinary incontinence and good micturition were found. On 1 year later, the patient showed healthy condition without recurrence.

Comparison on the Error Rates of Calibration Modes in Intervention (인터벤션에서 Calibration Mode에 대한 오차율 비교)

  • Kong, Chang gi;Ryu, Young hwan
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.619-626
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    • 2020
  • This study aimed to identify the error rates in Catheter Calibration Mode, Auto Calibration Mode, and Segment Calibration Mode among many calibration modes as a quantitative evaluation tool used for predicting the diameter and length of balloon or stent in percutaneous intravascular balloon dilatation or stent insertion. Our experiment was conducted with Copper Wire of 2 mm × 80 mm (diameter × length) manufactured elaborately for quantitative evaluation in calibration and Metal Ball of 5, 10, 15, 30, and 40 mm and Acryl Phantom of 25 mm, 50 mm, 75mm, 100 mm, 125 mm, 150mm, 175 mm, and 200 mm. At each height, subtraction images were acquired with a cineangiograph and Stenosis Analysis Tool as a software provided by the equipment company was used for measurement. To evaluate the error rates in Catheter Calibration Mode, Copper Wire was put on each acryl phantom before shooting. Copper Wire of 2 mm in diameter was set as a diameter for catheter, and Copper Wire of 8 mm in length was measured with Multi-segments. As a result, the error rates appeared at 1.13 ~ 5.63%. To evaluate the error rates in Auto Calibration Mode, the height of acryl was entered at each height of acryl phantom and the length of 8 mm Copper Wire was measured with Multi-segments and as a result, the error rates appeared at 0 ~ 0.26%. To evaluate the error rates in Segment Calibration Mode, each metal ball on the floor of table was calibrated and the length of 8 mm Copper Wire on each acryl phantom was measured and the length of 8 mm Copper Wire depending on the changes of acryl phantom height was measured with Mutli-segments and as a result, the error rates appeared at 1.05 ~ 19.04%. And in the experiment on OID changes in Auto Calibration Mode, the height of acryl phantom was fixed at 100mm and OID only changed within the range of 450 mm ~ 600 mm and as a result, the error rates appeared at 0.13 ~ 0.38%. In conclusion, it was found that entering the height values in Auto Calibration Mode, among these Calibration Modes for evaluating quantitative vascular dimensions provided by the software was the calibration method with the least error rates and it is thus considered that for calibration using a metal ball or other objects, putting them in the same height as that of treatment sites before calibrating is the method that can reduce the error rates the most.