• Title/Summary/Keyword: Catheters

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Device for Catheter Placement of External Ventricular Drain

  • Ann, Jae-Min;Bae, Hack-Gun;Oh, Jae-Sang;Yoon, Seok-Mann
    • Journal of Korean Neurosurgical Society
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    • v.59 no.3
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    • pp.322-324
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    • 2016
  • To introduce a new device for catheter placement of an external ventricular drain (EVD) of cerebrospinal fluid (CSF). This device was composed of three portions, T-shaped main body, rectangular pillar having a central hole to insert a catheter and an arm pointing the tragus. The main body has a role to direct a ventricular catheter toward the right or left inner canthus and has a shallow longitudinal opening to connect the rectangular pillar. The arm pointing the tragus is controlled by back and forth movement and turn of the pillar attached to the main body. Between April 2012 and December 2014, 57 emergency EVDs were performed in 52 patients using this device in the operating room. Catheter tip located in the frontal horn in 52 (91.2%), 3rd ventricle in 2 (3.5%) and in the wall of the frontal horn of the lateral ventricle in 3 EVDs (5.2%). Small hemorrhage along to catheter tract occurred in 1 EVD. CSF was well drained through the all EVD catheters. The accuracy of the catheter position and direction using this device were 91% and 100%, respectively. This device for EVD guides to provide an accurate position of catheter tip safely and easily.

Pectoral Advancement Flap for the Treatment of Sternoclavicular Joint Infection (대흉근판 전이술을 이용한 흉쇄골 관절염의 치료)

  • Bae, Chi-Hoon;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.799-802
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    • 2008
  • Infection occurs very rarely in the sternoclavicular joint compared to other joints in the body. It occurs mainly in IV drug abusers, diabetics, chronic renal failure patients, septic patients and those with central vein catheters. In the early phase, it can be treated simply by antibiotics or incision, and drainage. However, when proper treatment is not begun. early, bone destruction can occur, and only en-bloc resection of the involved bone can cure it. To reduce the risk of recurrence, we advanced a pectoralis major flap into the resected area based on the feeding artery. We report a case of a patient with sternoclavicular osteomyelitis who was successfully treated using en-bloc resection and a pectoral advancement flap.

Surgical Intervention of the Complications of Cardiac Catheterization (외과적 치료가 필요했던 심도자 합병증에 대한 임상적 고찰)

  • Lee, Young;Park, Kyung-Sin;Park, Jin-Seog;Lim. Seung-Pyung;Kim, Eung-Joong
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.606-609
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    • 1995
  • We have experienced ten cases of emergent operation for the complications of cardiac catheterization during the period from 1985 to September 1994.Catheterization was done for the evaluation of the cardiac or vascular problem in 8 cases and 2 cases of neurosurgical problem. The extracardiac injection of contrast material have occurred in 3 cases[primum ASD,Trilogy,VSD . Six cases were unable to remove the catheter from femoral artery or vein. The catheters were knotted, coiled, impacted or broken. An embolectomy was done 40 years old man who suffered from chronic left subclavian artery obstruction a day after angiography. Open heart surgery was performed in 5 cases of cardiac perforation,impacted catheter in left inferior pulmonary vein and broken catheter of VSD. Arteriotomy was done in 4 cases to remove the knotted and coiled catheter. There was no complication or mortality for the emergent operation.

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Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report- (좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고-)

  • 권중혁
    • Journal of Chest Surgery
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    • v.12 no.2
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    • pp.119-126
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    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

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Two Cases of Spinal Epidural Abscess in Hemodialysis Patients

  • Kim, Young Hwan;Yoo, Jin Taek;Jung, Soon Myung;Kwon, Sang Chang;Ryu, Seung Min;Jang, Mun;Choi, Jung
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.36-38
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    • 2013
  • While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.

Response of Pancreatic Exocrine Secretion in Sheep Fed Different Type and Amount of Hay

  • Wang, X.B.;Taniguchi, K.;Obitsu, T.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.8
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    • pp.1044-1049
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    • 2000
  • Three wethers fitted with silastic catheters for collection of pancreatic juice, and cannulas located in the abomasum and the duodenum were used to investigate the effects of different hay and energy intake on pancreatic exocrine secretion. The wethers were fed Italian ryegrass hay or alfalfa hay at maintenance energy requirement and alfalfa hay ad libitum. High energy intake from alfalfa significantly increased abomasal flow of dry matter and both the concentration and daily secretion of ${\alpha}-amylase $. The high energy intake also tended to increase daily secretion of lipase, trypsin and chymotrypsin through the large volume of pancreatic juice. Compared with Italian ryegrass hay, alfalfa hay at the maintenance decreased abomasal dry matter flow, but increased concentration of ${\alpha}-amylase $ in the pancreatic juice, and tended to increase daily secretion of ${\alpha}-amylase $. The secretion of the other enzymes was not different between the two hays at maintenance intake. These results suggest that the kind of hay could change the concentration of ${\alpha}-amylase $ in the pancreatic juice, and that the intake level of alfalfa hay affects the ${\alpha}-amylase $ concentration and the juice volume secreted from the pancreas.

Usefulness of an Additional Mattress Suture for the Extracranial Drainage Catheter

  • Eom, Dong Woong;Kim, Jung Soo;Jeon, Kyoung Dong;Kim, Hoon;Choi, Byeong Sam
    • Journal of Korean Neurosurgical Society
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    • v.54 no.5
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    • pp.444-447
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    • 2013
  • In most intracranial surgery cases, a drain catheter is inserted to prevent the collection of the wound hematoma or seroma. A drain catheter is also inserted to drain the hematoma or the cerebrospinal fluid. The drain catheter itself does not cause complications; but many complications occur during its removal, such as hematoma, seroma, air collection and pseudomeningocele formation. To prevent these complications, neurosurgeons perform a suture on the catheter to remove the site. In this study, an additional horizontal mattress suture and an anchoring suture to the drainage catheter are proposed. This method maintains negative pressure in the catheter insertion site during the catheter removal, compresses the catheter tunnel site and attaches the external wounds strongly. The technique is easy and safe to perform, and does not require an additional suture to remove the catheter.

Multiloculated Hydrocephalus : Open Craniotomy or Endoscopy?

  • Lee, Yun Ho;Kwon, Young Sub;Yang, Kook Hee
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.301-305
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    • 2017
  • Multiloculated hydrocephalus (MLH) is a condition in which patients have multiple, separate abnormal cerebrospinal fluid collections with no communication between them. Despite technical advancements in pediatric neurosurgery, neurological outcomes are poor in these patients and the approach to this pathology remains problematic especially given individual anatomic complexity and cerebrospinal fluid (CSF) hydrodynamics. A uniform surgical strategy has not yet been developed. Current treatment options for MLH are microsurgical fenestration of separate compartments by open craniotomy or endoscopy, shunt surgery in which multiple catheters are placed in the compartments, and combinations of these modalities. Craniotomy for fenestration allows better visualization of the compartments and membranes, and it can offer easy fenestration or excision of membranes and wide communication of cystic compartments. Hemostasis is more easily achieved. However, because of profound loss of CSF during surgery, open craniotomy is associated with an increased chance of subdural hygroma and/or hematoma collection and shunt malfunction. Endoscopy has advantages such as minimal invasiveness, avoidance of brain retraction, less blood loss, faster operation time, and shorter hospital stay. Disadvantages are also similar to those of open craniotomy. Intraoperative bleeding can usually be easily managed by irrigation or coagulation. However, handling of significant intraoperative bleeding is not as easy. Currently, endoscopic fenestration tends to be performed more often as initial treatment and open craniotomy may be useful in patients requiring repeated endoscopic procedures.

Effects of a Short Message Service Intervention on Adherence to Maximal Sterile Barrier Precautions and Catheter-Related Blood Stream Infections (최대한의 멸균 차단법의 이행도와 중심정맥관 관련 혈류감염 발생에 대한 단문문자메시지 중재 효과)

  • Kang, Moon-Hee;Kim, Dong-Oak
    • Journal of Korean Academy of Nursing Administration
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    • v.18 no.2
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    • pp.244-250
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    • 2012
  • Purpose: The purpose of this study was to investigate the effect of a short message service intervention on adherence to maximal barrier precautions (MBP) and catheter-related blood stream infections. Method: The data were collected from March to September, 2008, at an 826-bed university-affiliated hospital in Daejeon. The study participants were 24 physicians who were inserting central catheters and 133 patients (control group 78 and intervention group 55) with central catheter insertions. The researcher sent the message (adherence to MBP and optimal recommendations) to each internal medicine doctor using the short message service (SMS) for cellular phones. Messages were sent monthly for 3 months. Data were analyzed by chi-square test and t-test using SPSS 12.0 windows program. Result: Adherence to maximal barrier precautions was significantly increased from 44.9% to 69.1% (p=.006) after the SMS intervention. But changes in the rate of CRBSI (catheter related blood stream infection) between the intervention group (1.89) and the control group (4.45) were not significant (p=.323). Conclusions: The results indicate that the SMS intervention is effective in increasing the adherence to maximal barrier precautions and the SMS intervention can be recommended for utilization in infection control nursing practice.

An Analysis of Infection-Related Complications after Epidural Block (경막외 차단술 후 발생한 감염 관련 합병증의 분석)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myuong Hee
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.164-167
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    • 2006
  • Background: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.