• Clinical and Experimental Pediatrics
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• 제45권4호
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• pp.449-453
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• 2002

목 적 : 동맥혈 가스 분석은 신생아 집중 치료실에서 환아의 상태를 평가하기 위해 자주 시행하는 검사이나 제대 동맥 카테테르를 이용할 수 없는 경우에는 동맥 천자를 반복해야 되는데 기술적인 어려움과 위험성이 따르게 된다. 이에 저자들은 간편히 시행할 수 있는 모세혈 가스 분석 검사로 동맥혈 가스치를 추정하는 것이 타당성을 가지는지 조사하기 위해 이 연구를 시행하였다. 방 법: 2001년 4월부터 8월까지 방지거병원 신생아 집중 치료실에 입원하여 치료받은 환아 중 2주 이상된 신생아로서 동맥내 카테테르를 삽입하지 않은 상태에서 환기와 대사 상태 평가를 위해 혈액 가스 검사를 시행한 환아를 대상으로 하였다. 대상아들은 발뒤꿈치를 가온한 뒤 모세혈을 채혈하였고 곧 이어 동맥 천자를 시행하여 얻은 동맥혈과 함께 바로 검사실로 보내어 가스 분석하여 각 수치를 비교하였다. 결 과 : 1) 조사된 24명의 신생아의 재태 연령은 32-41주로 채혈은 모두 생후 2주일 이후에 시행되었다. 2) 모세혈과 동맥혈의 $pCO_2$, pH 사이에는 높은 상관 관계가 있었다(P<0.05). 3) 모세혈과 동맥혈의 $pO_2$ 사이에도 유의한 상관관계를 보였으나(P<0.05), 절대값의 차이는 92%에서 10 mmHg 이상이었다. 4) 모세혈과 동맥혈 가스의 상관 관계는 pH, $pCO_2$, $pO_2$의 순으로 유의하였다. 결 론 : 이상의 결과로 보아 동맥혈화된 말초혈액을 이용한 모세혈 가스 분석은 동맥혈 채혈이 어려운 경우에 유용한 대체 수단이 될 수 있을 것으로 생각된다.

• Journal of Chest Surgery
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• 제25권3호
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• pp.315-320
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• 1992

Pulmonary arteriovenous fistula is a rare congenital vascular malformation resulting from abnormal capillary development with incomplete formation of vascular septum normally dividing the primitive connections between the venous and arterial plexuses. Recently we have experienced a case of the bilateral pulmonary arteriovenous fistula in 7 years-old female patient. On admission, clinical manifestations were cyanosis of lips, clubbing and cyanosis of digits, and exertional dyspnea. The PO2 in arterial blood gas analysis was 43.3mmHg. In left upper and right lower lobe pulmonary arteriovenous fistulas were confirmed by bilateral pulmonary angiography. Left upper lobectomy and wedge resection of right lower lobe were performed respectively. Postoperative results were good.

• 대한전자공학회논문지
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• 제25권11호
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• pp.1335-1341
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• 1988

A pH-ISEFET microprobe for in vivo measurements has been fabricated by combining ISFET (SL-IIS) chip and capillary thin film reference electrode. A two-step TCE oxidation for the gate oxide layer and multilayer encapsulation using silicone rubber and epoxy were specially used for the improvement of the stability and temperature dependence of the ISFET's. The measured sensitivit, response time and temperature dependence of the pH-ISFET microprobes are 50 mV/pH, less than one second, and - 0.01 pH/$^{\circ}$ , respectively. By operating continuously more than 40 days, a long term stability of 0.016 pH/day is obtained. The result of pH monitoring of femoral arterial blood in a rabbit is fairly good agreement with the value of blood gas analysis.

• Journal of Chest Surgery
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• 제18권4호
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• pp.806-811
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• 1985

Pulmonary arteriovenous fistula is a rare congenital vascular malformation in the lung, resulting from erroneous capillary development, with incomplete formation or disintegration of the vascular septa that would normally divide the primitive connection between the venous and arterial plexus. The pathogenesis of its symptom is that unoxygenated and desaturated arterial blood enter into the pulmonary venous system directly. Recently we have experienced a case of multiple pulmonary arteriovenous fistula in a 15 year old male patient, who presented the symptom of cyanosis and dyspnea on exertion. The operation revealed well circumscribed and multilobulated aneurysmal lesion in left lower lobe with its subpleural and posterolateral basal location, and another aneurysmal lesion in inferior lingular segment of left lung. There was no abnormal connection between the fistula and systemic circulation. The left lower lobectomy was performed along with local extirpation of the inferior lingular segment of left lung. Both lesions showed angiomatous dilatation of the various sized vessels embedded in the parenchyma microscopically. Postoperative clinical course disclosed much improvement in symptoms and in the value of blood gas analysis. The patient was discharged without any complication.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.219-223
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• 2021

Background A micro-arteriovenous fistula (AVF) is a minute, short shunt between an artery and a vein that does not pass through a capillary. We investigated the association between micro-AVFs and lymphedema using computed tomography angiography (CTA) and venous blood gas analysis. Methods In 95 patients with lower limb lymphedema, the presence or absence of early venous return (EVR) was compared between patients with primary and secondary lymphedema. Furthermore, we investigated the difference in the timing of edema onset in patients with secondary lymphedema with or without EVR using CTA. In 20 patients with lower limb lymphedema with confirmed early EVR in a unilateral lower limb, the partial pressure of oxygen (PO₂) was compared between the lower limb with EVR and the contralateral lower limb. Results Secondary lymphedema with or without EVR occurred at an average of 36.0±59.3 months and 93.5±136.1 months, respectively; however, no significant difference was noted. PO₂ was 57.6±11.7 mmHg and 44.1±16.4 mmHg in the EVR and non-EVR limbs, respectively, which was a significant difference (P=0.005). Conclusions EVR and venous blood gas analysis suggested the presence of micro-AVFs in patients with lower extremity edema. Further research is warranted to examine the cause of micro-AVFs, to advance technology to facilitate the confirmation of micro-AVFs by angiography, and to improve lymphedema by ligation of micro-AVFs.

• Journal of Chest Surgery
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• 제33권2호
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• pp.125-131
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• 2000

Background: Hyperinflation during lung ischemia has been known to improve pulmonary functions after reperfusion which may be exerted through a pulmonary vasodilation and avoidance of atelectasis by an increased surfactant release and been known whether the improvement of pulmonary function was the effect of hyperinflation itself or the oxygen content in inflation gas. Therefore we attempted to clarify the effect of hyperinflation with oxygen in pulmonary inflation gas during warm ischemia on pulmonary function after reperfusion to solve the problem of ischemia-reperfusion injury after lung transplantation. Material and Method: sixteen mongrel dogs were randomly divided into two groups: the left lung was inflated to 30-35 cm H2O with 100% oxygen in oxygen group and 100% nitrogen in nitrogen group. The inflated left lung was maintained with warm ischemia for 100 minutes. Arterial and mixed venous blood gas analysis and hemodynamics were measured before ischemia and 30, 60, 120, 180 and 240 minutes afer reperfusion. Lung biopsy was taken for the measurement of lung water content after the end of reperfusion. Result: In oxygen group arterial oxygen tension the difference of arterial and mixed venous oxygen tension and the difference of alveolar-arterial oxygen tension at 30-minute after reperfusion were not significantly different from those before ischemia and were stable during the 40hour reperfusion. However in nitrogen group these values were significantly deteriorated at 30-minute after reperfusion. there was no significant difference between two groups in hemodynamic data peak airway pressure and lung water content. Conclusion : The results indicated that the oxygenation one of the most important pulmonary functions was improved by pulmonary inflation with 100% oxygen during warm ischemia but the hemodynamics were not. Oxygen as a metabolic substrate during warm ischenia was believed to make the pulmonary tissues to maintain aerobic metabolism and to prevent ischemic damage of alveoli and pulmonary capillary.

• Neonatal Medicine
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• 제17권2호
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• pp.239-244
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• 2010

목적: 효과적인 미숙아에서의 채혈방법을 모색하기 위해 미숙아에서 발뒤꿈치 천자시 새로운 자동화 천자기구(automatic lancet device)와 기존에 사용되던 고식적 수동식 천자침(conventional manual lancet device) 의 효과를 비교하여 임상에서의 유용성을 알아보고자 한다 방법: 재태 연령 37주 미만의 미숙아 총 100명을 대상으로 하였다. 연구 대상아들은 발뒤꿈치 천자시 무작위로 각 50명씩 고식적 수동식 천자 기구를 사용한 군(50명)과 자동화 천자 기구를 사용한 군(50명)으로 나누었으며, 발뒤꿈치 천자시 통증의 정도 및 천자 횟수, 검사 시간, 출혈의 여부 등을 평가하였다. 통증의 평가는 Premature Infant Pain Profile (PIPP) 점수와 최고 심장 박동수를 측정하였고, 검사시간은 발뒤꿈치 천자 시작으로부터 1개의 microtube에 채혈을 완료하는 시간까지를 측정하여 비교하였다. 천자횟수는 1개의 microtube를 혈액으로 채우기 위해 발뒤꿈치를 천자한 횟수를 측정하였다. 그리고 검사 12시간 이내에 발뒤꿈치 및 발목 주위에 출혈이나 멍 등을 관찰하였다. 결과: 통증을 나타내는 PIPP 점수의 평균은 자동화 천자기구군에서 4.91로 고식적 천자기구 군 5.84에 비해 유의하게 낮게 측정되었다(P=0.0255). 검사에 소요되는 시간은 고식적 천자군에서 평균 48.92초, 자동화 천자군에서 평균 30.69초로 자동화천자기구를 사용한 군에서 통계적으로 유의하게 짧았다(P<0.0001). 천자 횟수의 평균값은, 자동화 천자군에서 1.02로, 고식적 천자군 1.35에 비해 통계적으로 의미 있게 낮았다(P=0.0001). 검사후 출혈반점이나 멍 등은 고식적 천자기구 군에서 15례(30%), 자동화 천자기구 군에서 3례(6%)로 자동화 천자기구 사용 군에서 의미 있게 적게 나타남을 관찰할 수 있었다(P=0.0024). 결론: 자동화 절개형 천자기구(BD QuickHeel)는 검사 실패율이 낮으며, 짧은 시간에 채혈이 가능하고, 멍이나 출혈 같은 부작용이 적어 신생아, 특히 최근 생존율이 향상되어 증가되고 있는 미숙아에서 발뒤꿈치 천자에 의한 채혈에 유용한 도구가 될 수 있겠다.