• 제목/요약/키워드: Catheters

검색결과 232건 처리시간 0.036초

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

  • 배지훈;박기성
    • Journal of Chest Surgery
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    • 제41권6호
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    • pp.799-802
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    • 2008
  • 흉쇄골관절은 전신의 골관절염 중 매우 드물게 이환되는 부위로 주로 마약 중독자, 당뇨병, 만성 신부전, 폐혈증 환자, 및 중심 정맥 혈관 삽입 후에 주로 나타난다. 초기에는 항생제 치료, 단순 절제 및 배농술 등의 방법으로 치유될 수 있으나, 치료 시기를 놓치면 골수염으로 진행되어 광범위 절제가 필요하다. 그러나 재발할 가능성이 있으므로, 본원 흉부외과에서는 혈류를 유지한 대흉근판을 빈공간에 메워 넣어 재발 가능성을 줄여보고자 하였다. 골수염을 동반한 흉쇄골 관절염 환자를 성공적으로 치료하였기에 이에 보고하는 바이다.

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

  • 이영;박경신;박진석;임승평;김응중
    • Journal of Chest Surgery
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    • 제28권6호
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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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좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고- (Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report-)

  • 권중혁
    • Journal of Chest Surgery
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    • 제12권2호
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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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    • 제30권1호
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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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    • 제13권8호
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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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    • 제54권5호
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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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    • 제60권3호
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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.

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

  • 강문희;김동옥
    • 간호행정학회지
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    • 제18권2호
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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.

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

  • 조대현;홍지희;김명희
    • The Korean Journal of Pain
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    • 제19권2호
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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.

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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