• Title/Summary/Keyword: Central venous

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Extraneural Metastasis of Glioblastoma Multiforme Presenting as an Unusual Neck Mass

  • Seo, Young-Jun;Cho, Won-Ho;Kang, Dong-Wan;Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.147-150
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    • 2012
  • Glioblastoma multiforme(GBM) is the most aggressive intracranial tumor and it commonly spreads by direct extension and infiltration into the adjacent brain tissue and along the white matter tract. The metastatic spread of GBM outside of the central nervous system (CNS) is rare. The possible mechanisms of extraneural metastasis of the GBM have been suggested. They include the lymphatic spread, the venous invasion and the direct invasion through dura and bone. We experienced a 46-year-old man who had extraneural metastasis of the G8M on his left neck. The patient was treated with surgery for 5 times, radiotherapy and chemotherapy. He had survived 6 years since first diagnosed. Although the exact mechanism of the extraneural metastasis is not well understood, this present case shows the possibility of extraneural metastasis of the G8M, especially in patients with long survival.

MR Images of Spontaneously Involuted Atretic Cephalocele Concomitant with Persistent Falcine Sinus in an Adult (성인에서 지속적인 낫형동을 동반한 자연퇴축된 위축뇌탈출증의 MR영상소견)

  • Cho, Joon;Roh, Hong-Gee;Moon, Won-Jin;Kim, Mi-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.117-120
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    • 2006
  • Atretic cephalocelces are defined as skin-covered midline subscalp lesions that contain meninges and rest of glial and/or central nervous system tissue. When the straight sinus is absent or rudimentary, the falcine sinus can be recanalized to enable venous drainage. Although the atretic cephalocele or persistent falcine sinus has largely been described in the pediatric population, it is a rarely observed in the adult population. We report a unique case of spontaneously involuted atretic cephalocele coexistent with persistent falcine sinus in an adult. MR images and MR venography were useful for diagnosis and accurate anatomical depiction.

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Changes of Pituitary Hormones after Injection of Naloxone in the Hypotensive Phase of Korean Hemorrhagic Fever (한국형 출혈열 저혈압기에서 Naloxone 투여후 뇌하수체 홀몬의 변동)

  • Lim, Sang-Moo;Cho, Bo-Youn;Lee, Hong-Gyu;Lee, Jung-Sang;Koh, Chang-Soon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.79-84
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    • 1986
  • The opiate antagonist, naloxone, was injected for the reversal of hypotension due to Korean hemorrhagic fever, and the authors observed changes in pituitary hormones. In the hypotensive phase of the Korean hemorrhagic fever, the f-endorphin was high, and normalized granually in the diuretic and convalescent period. The naloxone raised the pulse rate and the blood pressure within 30 minutes without change in the central venous pressure. Around 30 minuted after the injection of the naloxone, the $\beta-endorphin$, ACTH and cortisol rose. The prolactin fell down 60 minutes after the naloxone injection.

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Characteristics and Mortality Risk Factors in Geriatric Hospital Patients visiting One Region-wide Emergency Department (일 권역응급의료센터를 방문하는 요양병원 환자들의 특성 및 사망 위험요인)

  • Kim, Kyoung Wan;Jang, Soongnang
    • Research in Community and Public Health Nursing
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    • v.27 no.4
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    • pp.327-336
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    • 2016
  • Purpose: This study was to examine the clinical characteristics and mortality risk factors of geriatric hospital patients who visited one region-wide emergency department (ED). It's basically meant to develop criteria for the patient management of geriatric hospitals and to provide related information. Methods: A retrospective research study was implemented using electronic medical records. The subjects in this study included 484 geriatric hospital patients who were selected from among 15,994 patients that visited one region-wide ED between January 1, 2014, and December 31, 2015. Results: There were significant differences in death, a change for the better and no change for the better, which were results of treatment, according to the length of stay in hospital, hospitalization in a general ward, not having an operation or surgery, the presence or absence of malignant neoplasm, the insertion of foley catheter, intubation, ventilator and the insertion of central venous catheter. Conclusion: The results of this study suggest that a patient management system is necessary in geriatric hospitals and that competent healthcare workers who can properly respond to emergencies are required as well.

Level of Knowledge on Evidence-based Infection Control and Influencing Factors on Performance among Nurses in Intensive Care Unit (중환자실 간호사의 근거기반 감염관리 지식과 수행 수준 및 영향 요인)

  • Yoo, Jae-Yong;Oh, Eui-Geum;Hur, Hea-Kung;Choi, Mo-Na
    • Korean Journal of Adult Nursing
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    • v.24 no.3
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    • pp.232-243
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    • 2012
  • Purpose: This study was to identify the level of knowledge and performances on evidence-based infection control and influencing factors on performance among nurses in intensive care unit. Methods: A descriptive cross-sectional survey design was used. Two hundred thirty-nine nurses at intensive care units were conveniently recruited from seven hospitals located in Seoul and Kyounggi province. Data were collected with a questionnaire survey about evidence-based infection control. Data were analyzed using SPSS/WIN 17.0 program. Results: Both level of knowledge (mean 9.15 out of 19) on preventing ventilator-associated pneumonia and central venous catheter induced bloodstream infection, and performance on evidence-based infection control (1.94 out of 4) were moderate. Performance of evidence-based practice for infection control was related to reading research articles regularly, professional satisfaction, and taken education course. Conclusion: These results indicate that systematic and organizational strategies for enhancing evidence-based infection control are needed to improve quality of intensive nursing care.

A study of Chronic Constrictive Pericarditis (만성 교약성 심낭염의 임상적 고찰)

  • 하종곤
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.676-682
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    • 1990
  • From August, 1978, to August, 1989, 22 patients underwent pericardiectomy for chronic constrictive pericarditis on the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Keimyung University. There were 14 male and 6 female patients ranging from 11 years to 70 years old[mean age, 44. 1 years]. All patients underwent radical pericardiectomy through a median sternotomy. There was 1 postoperative death[4.s%]. This patient died of low cardiac output 7 days after pericardiectomy. Postoperative complications were hemothorax[2 patients], low cardiac output[2 patients], generalized seizure[1 patient], wound infection[1 patient] and pneumonia[1 patient]. Clinical and pathological findings showed tuberculous origin in 12 patients[54.6%], unknown etiology in 8 patients[36.4%] pyogenic pericarditis in 2 patients[9.1%]. Three hemodynamic responses to pericardiectomy were observed: [1] rapid response, where central venous pressure[CUP] fell below 10 cmH2O by 24 hours in 6 patients; [2] delayed response. Where CVP fell below 10 cmH2O by 48 hours in 12 patients; and [3] no response of CVP in 4 patients. Follow-up ranged from 6 to 62 months with an average of 35.3 months. Postoperative Functional Class was obtained for 21 surviving patients and showed 18 patients[81.8%] to be New York Heart Association functional class I or II.

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A Case of Valsalva Retinopathy Associated with Straining at Stool

  • Lee, Tae-Yoon;Chang, Woo-Hyok
    • Journal of Yeungnam Medical Science
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    • v.23 no.2
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    • pp.227-231
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    • 2006
  • The Valsalva maneuver is described as an expiratory effort against a closed glottis or airway. It leads to elevation of retinal venous pressure and may result in retinal hemorrhage. A fifty two- year-old man presented with an acute reduction of central visual acuity in his right eye which occurred after considerable straining at stool. Detailed past medical history revealed that he suffered from chronic constipation and hypertension. There were one disc sized subhyaloid hemorrhage and three small intraretinal hemorrhages around the fovea at the dilated fundus examination. After three months of follow-up without any treatment, the retinal hemorrhages resolved without any sequelae. Here we report a patient with sudden visual loss and retinal hemorrhage.

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Rapid Atypical Progression of Neuro-Behçet's Disease Involving Whole Brainstem and Bilateral Thalami

  • Lee, Sang-Kook;Choi, Sung-Jae;Kim, Sang-Dae;Lim, Dong-Jun
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.68-71
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    • 2011
  • We present a case of Neuro-Behçet's disease with an unpredictable clinical course. A 47-year-old man was admitted to the neurosurgery department of our hospital with a mild headache. Three days after admission, his consciousness suddenly decreased and respiratory distress progressed rapidly. A brain MRI revealed that the previously observed abnormal signal had extended markedly to both the thalamic areas and the entire brain stem, and the surrounding brain parenchyma were compressed by cerebral edema. Based on the patient's symptoms of recurrent oral and genital ulcers, skin lesions, and uveitis, a rheumatologist made a diagnosis of Behçet's disease with CNS involvement. The patient was treated with high-dose methylprednisolone with respiratory assistance in the intensive care unit for 9 days and his neurologic symptoms improved remarkably. Neuro-Behçet's disease must be considered in the differential diagnosis in rapidly deteriorated young neurological patients along with a stroke, low-grade glioma, multiple sclerosis, and occlusive venous disease.

Pre- and Postoperative Hemodynamic Studies in the Patients with Constrictive Pericarditis (수축성 심막염에 대한 심막절제술 전후의 수술방법에 따른 혈역학적 비교)

  • 조인택
    • Journal of Chest Surgery
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    • v.19 no.1
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    • pp.68-74
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    • 1986
  • 15 patients with constrictive pericarditis who underwent interphrenic pericardiectomy from January, 1981 to April, 1983 and 11 patients who underwent radical pericardiectomy from May, 1983 to September, 1984 were compared to the clinical improvement and the results of pre- and postoperative cardiac catheterization. In the group of partial pericardiectomy the pericardium was removed anteriorly from the left phrenic nerve to the right phrenic nerve and in the group of radical pericardiectomy the pericardium was removed from almost entire surface of the heart including diaphragmatic surface and posterior wall of the left ventricle. The following results were obtained. 1. Both group of the patients showed marked symptomatic improvement early after operation. 2. The central venous pressure was decreased significantly after operation in both group of the patients. 3. The right atrial mean pressure and pulmonary arterial mean pressure decreased significantly after operation in both group of the patients and there was no significant difference in the amplitude of decrease between the two groups. 4. The right ventricular end-diastolic pressure and left ventricular end-diastolic pressure were decreased postoperatively in both group of the patients and the patients of the radical pericardiectomy showed more decrease than the patients of interphrenic pericardiectomy, and in the group of radical pericardiectomy the right and left ventricular end-diastolic pressure were normalized postoperatively but in the group of partial pericardiectomy they showed abnormally high pressure persistently. 5. The ejection fraction showed normal level pre- and postoperatively in both group of the patients.

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Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report

  • Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.212-217
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    • 2021
  • Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.