• 제목/요약/키워드: Catheter

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항암 화학요법을 받는 환자들에서의 중심정맥삽관술 (Central Venous Access for Chemoterapy in Patients with Malignant Disease)

  • 김욱성;김기봉
    • Journal of Chest Surgery
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    • 제26권6호
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    • pp.483-487
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    • 1993
  • From July 1990 to August 1992,78 Hickman catheters and 22 chemoports were inserted in 98 patients for chemotherapy.We analyzed the clinical data of these patients. The results were as follows: 1]Mean age of patients was 42.8$\pm$1.6[SE] years 2]Male to female ratio was 1.09:1 3]The diseases of the cases were leukemia[66] ,lymphoma[8], stomach cancer[8],uterine cervix cancer[5],ovarian cancer[4],lung cancer[3],aplastic anemia[2],maxillary gland cancer[1],pancreas cancer[1],malignant mesothelioma[1] and multiple myeloma[1] 4]Mean values of preoperative WBC counts,platelet counts,PT and APTT were 31,500$\pm$ 8,132[SE]/mm,104,000$\pm$ 12,200 [SE]/mm,82$\pm$ 1.9[SE]% and 32$\pm$ 0.8[SE] sec,respectively. 5]The average duration of catheter uses was 121.7$\pm$ 17.3[SE]days. 6]The complications were subcutaneous tunnel bleeding or hematoma[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1]. 7]The causes of catheter removal were patient`s death or hopeless discharge[22],completion of treatment[6],subcutaneus hematoma or bleeding[2],exit site or subcutaneous tunnel infection[2] and catheter related septicemia[1].So,we concluded that Hickman catheter and chemoport were useful vascular access for chemotherapy in patients with malignant diseases, with low rate of complication and longterm duration.

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AN IV CATHETER FRAGMENTS DURING MDCT SCANNING OF HUMAN ERROR: EXPERIMENTAL AND REPRODUCIBLE MICROSCOPIC MAGNIFICATION ANALYSIS

  • Kweon, Dae-Cheol;Lee, Jong-Woong;Choi, Ji-Won;Yang, Sung-Hwan;Dong, Kyung-Rae;Chung, Woon-Kwan
    • Journal of Radiation Protection and Research
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    • 제36권4호
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    • pp.195-199
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    • 2011
  • The use of intravenous catheters are occasionally complicated by intravascular fragments and swelling of the catheter fragments. We present a patient in whom an intravenous catheter fragments was retrieved from the dorsal metacarpal vein following its incidental CT examination detection. The case of demonstrates the utility of microscopy and multi-detector CT in localizing small of subtle intravenous catheter fragments as a human error. A case of IV catheter fragments in the metacarpal vein, in which reproducible and microscopy data allowed complete localization of a missing fragments and guided surgery with respect to the optimal incision site for fragments removal. These reproducible studies may help to determine the best course of action and treatment for the patient who presents with such a case.

2018 심방세동 카테터 절제술 대한민국 진료지침: PART I

  • 박형섭;정동섭;유희태;박희남;심재민;김주연;김준;이정명;김기훈;노승영;조영진;김영훈;윤남식
    • International Journal of Arrhythmia
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    • 제19권3호
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    • pp.186-234
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    • 2018
  • Catheter and surgical ablation of atrial fibrillation (AF) have evolved from investigational procedures to their current role as effective treatment options for patients with AF. Surgical ablation of AF is available in most major hospitals throughout the world. Catheter ablation of AF is even more widely available, and is now the most commonly performed catheter ablation procedure. Management of patients with AF has traditionally consisted of three main components: (1) anticoagulation for stroke prevention; (2) rate control; and (3) rhythm control. With the emergence of large amounts of data, which have both defined and called attention to the interaction between modifiable risk factors and the development of AF and outcomes of AF management, we believe it is time to include risk factor modification as the fourth pillar of AF management. Catheter and surgical ablation of AF are highly complex procedures, therefore a decision to perform catheter or surgical AF ablation should only be made after a patient carefully considers the risks, benefits, and alternatives to the procedure.

Central line-associated bloodstream infections in neonates

  • Cho, Hye Jung;Cho, Hye-Kyung
    • Clinical and Experimental Pediatrics
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    • 제62권3호
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    • pp.79-84
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    • 2019
  • Newborn infants, including premature infants, are high-risk patients susceptible to various microorganisms. Catheter-related bloodstream infections are the most common type of nosocomial infections in this population. Regular education and training of medical staffs are most important as a preventive strategy for central line-associated bloodstream infections (CLABSIs). Bundle approaches and the use of checklists during the insertion and maintenance of central catheters are effective measures to reduce the incidence of CLABSIs. Chlorhexidine, commonly used as a skin disinfectant before catheter insertion and dressing replacement, is not approved for infants <2 months of age, but is usually used in many neonatal intensive care units due to the lack of alternatives. Chlorhexidine-impregnated dressing and bathing, recommended for adults, cannot be applied to newborns. Appropriate replacement intervals for dressing and care sets are similar to those recommended for adults. Umbilical catheters should not be used longer than 5 days for the umbilical arterial catheter and 14 days for the umbilical venous catheter. It is most important to regularly educate, train and give feedback to the medical staffs about the various preventive measures required at each stage from before insertion to removal of the catheter. Continuous efforts are needed to develop effective and safe infection control strategies for neonates and young infants.

서브-밀리미터 직경의 카테터 표면 위 금속 마이크로 와이어 접착 공정 (Manufacturing of Metal Micro-wire Interconnection on Submillimeter Diameter Catheter)

  • 조우성;서정민;김택수
    • 마이크로전자및패키징학회지
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    • 제24권2호
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    • pp.29-35
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    • 2017
  • 본 논문에서는 서브 밀리미터 직경의 카테터 표면 위에 금속 마이크로 와이어를 접착하는 공정을 연구하였다. 최근 유연 전자 디바이스 분야는 유연한 평면 폴리머 기판과 그 기판 위의 마이크로 전극 공정이 계속해서 연구되고 있다. 하지만, 의료 분야에서는 카테터와 같이 곡면을 가진 기판이 중요하다. 특히 카테터 중에서도 여러 한계점을 가진 뇌혈관 수술을 개선하기 위한 서브 밀리미터의 직경을 가진 조향 가능한 카테터의 중요성이 대두되고 있다. 이러한 카테터를 구현하기 위해 조향을 위한 엑추에이터들은 연구가 되고 있지만 이를 구동하기 위한 배선 연구는 진행된 바가 없다. 그러므로 본 연구에서는 이러한 서브 밀리미터 카테터 위에 마이크로 금속 와이어를 접착하는 공정을 개발하였다. 적합한 지그를 설계함으로써 마이크로 와이어를 서브 밀리미터 직경의 카테터에 정렬한다. 그리고 자외선 경화 시스템과 상용품을 이용하여 공정 시간 및 공정 비용을 감소시켰다. 상용품으로 골드 마이크로 와이어, 자외선 경화 에폭시, 자외선 램프 그리고 서브 밀리미터 카테터를 이용하였다. 공정 후 카테터는 광학 현미경, 저항 측정기, 만능 시험기를 통해 분석하였다.

악성 담관 폐쇄 환자에서 경피경간 담도 배액술의 유증상 이탈 발생의 예측 인자 (Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction)

  • 유희정;박정구;정규식;서광일;박현준;윤종혁
    • 대한영상의학회지
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    • 제84권6호
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    • pp.1350-1360
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    • 2023
  • 목적 악성 담관 폐쇄 환자에서 경피경간 담도 배액술을 시행할 때 유증상 이탈을 유발하는 예측 인자에 대해 연구를 진행하고자 한다. 대상과 방법 2010년 1월부터 2015년 2월까지 572명의 악성 담관 폐쇄 환자에서 시행한 733건의 경피경간 담도 배액술을 대상으로 후향적 연구를 시행하였다. 카테터의 거치 기간, 접근 위치, 카테터 팁의 위치, 삽입 각도, 피그테일 루프의 유무, 도관 직경을 평가하였다. 결과 추적관찰 기간 동안 157명의 환자에서 224건(30.56%)의 도관 이탈이 발생하였다. 그중 146건(19.92%)가 유증상 도관 이탈이었다. 배액관 이탈 발생까지의 기간은 평균 30일(범위: 1-159일)이었다. 유증상 도관 이탈은 배액관의 교체(137명) 또는 담관 스텐트 삽입(9명)을 통해 치료하였다. 남성(교차비: 1.636, 95% 신뢰구간: 1.131-2.367, p = 0.009), 우측 접근(교차비: 1.567, 95% 신뢰구간: 1.080-2.274, p = 0.018), 도관 삽입 각도 증가(교차비: 1.015, 95% 신뢰구간: 1.005-1.026, p = 0.005), 불완전 피그테일 루프(교차비: 1.672, 95% 신뢰구간: 1.098-2.545, p = 0.016)가 독립적인 경피경간 담도 배액술 도관 유증상 이탈의 예측 인자였다. 결론 유증상 이탈을 유발하는 예측인자에는 남성, 우측 접근, 도관 삽입 각도 증가, 불완전 피그테일 루프가 있다.

혈관 삽입용 초소형 작동형 내시경의 개발(II) - 시스템 설계, 제작 및 체외 성능 분석 - (Development of Intravascular Micro Active Endoscope(II) -System Design, Fabrication and In-vitro Evaluation-)

  • 장준근;정석;이용구
    • Tribology and Lubricants
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    • 제15권3호
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    • pp.278-286
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    • 1999
  • To predict the behavior of the intravascular micro active endoscope in the real human vascular system, a human mock circulation system was developed. The intravascular micro active endoscope which consists of micro active bending catheter and micro drug infusion catheter was driven in the velocity, Re number and temperature controlled flow. The three SMA (Shape Memory Alloy) zigzag type spring in the micro active bending catheter was heated by the electric current generated by PWM controller, and the shape memory effect made the actuator bend to any direction. The micro drug infusion catheter was driven through the inner hole of the micro active bending catheter. A mock circulation system is shaped from Ascending Arota to Femoral artery according to a human data (the data contains many vascular sizes and hydrographs of many control points). We developed a vascular model with glass and silicone tubes, and set the flow system with circulation parts, flow settling parts, and lots of valves. The heater and heat-controller was added to the How system to centre! the temperature of the How at 36.5$^{\circ}C$. The result showed that the developed intravascular micro active endoscope could be induced to any point in the vascular model.

Ultrasound-guided internal jugular vein catheterization in critically ill pediatric patients

  • Yang, Eu Jeen;Ha, Hyeong Seok;Kong, Young Hwa;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • 제58권4호
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    • pp.136-141
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    • 2015
  • Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

유치도요관 환자의 방광 세척에 따른 요로 감염 발생 빈도에 관한 연구 (A Study on Incidence of Bacteriuria according to Bladder Irrigation in Patients with Indwelling Catheter)

  • 고경옥
    • 대한간호학회지
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    • 제20권1호
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    • pp.38-49
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    • 1990
  • The Purpose of this study is for clinical nurses to be aware of the significance of prevention against bacteriuria caused form foley catheterization, through probing variables related to the occurrence of bacteriuria which appears as the most frequent occurring infection, and try to lower bacteriuria by applying to nursing care at the clinical. For this study 46 patients with catheterization and the closed drainage system were sampled and investigated from among patients at Intensive Care Unit in Two hospitals affiliated to K University in Seoul. Those patients sampled had not shown bacteriuria before foley catheterization. The research design is to explore the effectiveness of prevention against bacteriuria in accordance with bladder irrigation and no bladder irrigation. Especially, the frequency of occurrence of bacteriuria examined so as to compare the effectiveness of bladder irrigation depending on the type of foley catheter between 2-lumen foley catheter and 3-lumen foley catheter. The results Were as follows. 1. The occurrence of bacteriuria in patient with bladder irrigation was 21.7%, while in patient without bladder irrigation 26.1%. 2. The occurrence of bacteriuria in patient without bladder irrigation according to duration of Indwelling catheter, was 4.3% after 48 h, 8.7% after 72 h and 21.7% after 96 h. 3. In case of 2-lumen foley catheter the occurrence of bacteriuria in patient with bladder irrigation was 0% after 72 h, and 4.35% after 96 h. In case of 3-lumen foley catheter, the occurrence of bacteriuria in patient with bladder irrigation was 13% after 48 h, 8.7% after 72 h and 4.3% after 96 h. 4. The occurrence of bacteriuria according to duration of catheterization was 8.7% after 48 h, 8.7% after 72 h and 15.2% after 96 h. In sex, female was 35% and male 15.4%. 5. The occurrence of bacteriuria according to mental state was 15% in clear state, while 29.6% in mental disorder. 6. In regard to a kind of microorganism induced bacteriuria, Gram negative bacteria was 63.7%, Gram positve bacteria 36.3%.

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팬텀을 이용한 다기능 위.십이지장관 코일 카테타의 유용성 평가 (Usefuless of Multi-functional Gastroduodenal Coil Catheter with Phantom)

  • 임진오;김태형;정양화;최원찬;신지훈;송호영
    • 대한방사선기술학회지:방사선기술과학
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    • 제26권4호
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    • pp.21-26
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    • 2003
  • 새로 개발된 다기능 위.십이지장관 코일 카테타의 유용성을 체외실험을 통하여 평가하고자 한다. 위.십이지장 코일 카테타는 전체길이가 150 cm되게 하여 두께 0.3 mm의 스테인레스 세선을 내경 1.3 mm 코일스프링으로 만들고 폴리에틸렌계의 열수축 튜브를 피복하였다. 카테타의 원위부 끝에서 2 0cm 지점까지 금 표식자 7개를 부착하여 방사선 투시상 길이 측정이 가능하게 하였으며, 원위부 7cm, 13 cm, 19 cm 지점에 조영제 분사가 가능하도록 측부 분사구를 제작하였다. 기존의 5 Fr. 혈관용 카테타와 새롭게 제작된 코일 카테타를 대상으로 방사선 불투과도와 조영제 분사능력을 평가하였다. 방사선 불투과도는 필름농도를 비교하였고, 조영제 분사능력은 아크릴을 이용하여 4개의 함을 제작하고 그 내부에 카테타를 위치시킨 후 자동주입기를 이용하여 생리식염수를 주입하여 카테타 내부에 안내철사를 삽입했을 경우와 하지 않았을 경우에서의 조영제 분사율을 측정하였다. 방사선 불투과도는 5 Fr. 혈관용 카테타에서 0.51, 새롭게 제작된 코일 카테타는 0.31이 측정되었고, 조영제 분사량은 5 Fr. 혈관용 카테타는 안내철사를 삽입한 경우와 삽입하지 않은 경우 동일하게 원위부에서만 99.5%분사하였다. 코일 카테타는 안내철사를 삽입한 경우 원위부로부터 각각 1.17%, 18.8%, 41.8%, 38.2%가 분사되었고 안내철사를 삽입하지 않았을 경우 원위부로부터 각각 19.5%, 32.6%, 27.7%, 20.3%가 분사되었다. 새로 개발된 위.십이지장 카테타는 기존의 카테타와 비교하여 방사선 투시상 확인이 용이하여 길이측정이 쉽고, 조영제 분사능력이 우수하여 위.십이지장의 중재시술시 유용하게 사용될 것으로 판단된다.

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