• Journal of Chest Surgery
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• 제53권2호
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• pp.73-78
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• 2020

Background: As the population of patients with end-stage renal disease has grown older, the proportion of patients with poorly preserved vasculature has concomitantly increased. Thus, arteriovenous grafts (AVG) have been used more frequently to access blood vessels for hemodialysis. Despite this increasing demand, studies of AVG are limited. In this study, we examined the surgical outcomes of upper-limb AVG creation. Methods: Among the arteriovenous fistula formation procedures performed between January 2014 and March 2019 at Dankook University Hospital, 42 cases involved AVG creation. We compared patients in whom the axillary vein was used (group A; brachioaxillary AVG [B-Ax AVG]; n=20) with those in whom upper limb veins were used (group B; brachiobasilic AVG or brachioantecubital AVG; n=22). Results: The 1-year primary patency rate was higher in group A than in group B (57.9% vs. 41.7%; p=0.262). The incidence of postoperative complications was not significantly different between groups. Conclusion: AVG using the axillary vein showed no major differences in safety or functionality compared to AVG using other veins. Therefore, accounting for age, underlying disease, and expected patient lifespan, B-Ax AVG can be considered an acceptable surgical method.

• Journal of Chest Surgery
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• 제54권1호
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• pp.31-35
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• 2021

Background: Arteriovenous fistula (AVF) for hemodialysis is essential for patients with end-stage renal disease. However, it is difficult to maintain AVF reliably. It is vitally important to select proper blood vessels for AVF formation. In a previous study, a minimum diameter of 3 mm for the autologous vein was proposed. However, patients who did not meet the minimum vascular diameter before anesthesia, but fulfilled other criteria, showed satisfactory venous dilatation after brachial plexus block (BPB). This study investigated the extent of vein expansion by BPB and the surgical outcomes of dilated veins after BPB. Methods: Sixty-one patients who underwent AVF formation using an autologous vein between August 2018 and December 2019 were included in the study. The clinical characteristics of the patient groups, hemodynamic parameters including the diameter of blood vessels before and after BPB, and complications were investigated. Based on the venous diameter measured by sonography before anesthesia, patients were divided into group A (26 patients) and group B (35 patients), with venous diameters <3 mm and ≥3 mm, respectively. Results: The venous diameter expanded after anesthesia by 41% overall, by 62% in group A, and by 25% in group B. This difference between groups A and B was statistically significant (p=0.001). No other variables showed statistically significant differences. Conclusion: Sufficient venous dilatation was observed after BPB. Therefore, if the vein is sufficiently dilated after BPB, even in patients with a pre-anesthesia venous diameter <3 mm, surgery may still be performed with an expected desirable outcome.

• Journal of Chest Surgery
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• 제29권8호
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• pp.927-930
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• 1996

인제의대 서울백병원에서는 1986년부터 1994년까지 말초동맥에 발생한가성동맥류환자 6례를 수술 치험하였다. 발생원인은 자상의 일차 봉합술 후 3례, 혈관에 도관삽입 후 2례, 골절상 후 고정 핀을 제거하기 위한 수술 후 1례였다. 발생부위는심부 대퇴동맥 2례, 총대퇴동맥 2례, 쇄골하동맥과 액와동맥에 각각 1례였다. 증상은 박동성 종괴가 4례에서 촉지되었고, 청진시 잡음은 3례, 동통과 종창이 2례, 압통이 1례에서 있었다. 이 중 5례에서 수술을 시행하였다. 수술은 2례에서 심부 대퇴동맥을 결찰하여 가성동맥류를 제거하였다. 단순 가성동맥류의 절제, 요피정맥을 연결하여 성형술, 복재정맥의 첩제를 이용한 성형술을 각각 1례에서 시행하여 가성동맥류를 제거하였다. 1례는 자연 치유되었다.

• 한국동물위생학회지
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• 제32권4호
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• pp.377-380
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• 2009

Dogs with canine babesiosis may present with wide variation in the severity of clinical signs, ranging from a hyperacute, shock-associated, hemolytic crisis to an inapparent, subclinical infection. Dogs typically present with the acute form of babesiosis, which is characterized by general findings such as pyrexia, weakness, mucous membrane pallor, depression, hemorrhagic anemia. This study was conducted to investigate the prevalence of babesia spp. infection in dogs of Seogwipo-si. A survey of canine babesia spp. infections among 173 dogs in Seogwipo-si was performed from July 2008 to August 2008. Blood samples were collected from dogs raised outdoors through cephalic or jugular vein and Babesia spp. was diagnosed by examination of blood smear stained with Giemsa stain. Of 173 dogs, 9 dogs (5.2%) were infected with the babesia spp. This result was a little lower than the prevalence of Babesia spp. in dogs of other areas.

• Archives of Reconstructive Microsurgery
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• 제23권1호
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• pp.33-35
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• 2014

Mondor's disease is an uncommon condition characterized by a palpable, cord-shaped structure, which causes pain when pressed. Its known pathophysiology is thrombophlebitis of the superficial venous system. Although reported repeatedly, its definite cause is unknown and various possible causes have been identified, including surgery, irradiation, infection, malignancy, and trauma. We diagnosed this case to be Mondor's disease of the antecubital venous system, probably due to thermal injury of the proximal tributaries of the basilic or cephalic vein. Risk of thermal injury to the skin flap or the portal site remains a common complication, and as thermal injury to the blood vessel might also be considered, attention must be given when suctioning the area near a large superficial vessel.

• Journal of Chest Surgery
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• 제53권1호
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• pp.28-33
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• 2020

Background: When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions. Methods: Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed. Results: Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days). Conclusion: Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.

• Clinics in Shoulder and Elbow
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• 제20권1호
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• pp.18-23
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• 2017

Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

• Journal of Chest Surgery
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• 제29권9호
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• pp.1028-1030
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• 1996

동정맥류 조성술은 말기 신장질환자의 치료에 이용하는 혈액투석을 위하여 매우 중요한 역할을하며 적절한 조성술 및 장기간의 개존상태 유지는 외과의사에게 흉미있는 문제이다 동정맥루 조성술후에 발 생한 림프관종은 매우 희귀하며 림프액의 축적으로 생 긴것므로 추측된다. 림프관종은 선천성으로 혹은 수술이나 방사선조사 등과 같은 후천적 원인으로 나타나는 양성종양이며 림프조직이 분포하는 신체의 어느부분에서도 생 길 수 있다. 동맥류와 세심한 감별을 요하며 치료는 수술적 제거이다. 저자들은 59세 여자환자에서 Gore-tex이식편을 사용하여 좌측전완동맥-요측퍼정맥 동정맥루 조성술 시행후 좌측 상 완에 발생 했던, 동맥류로 오인된 거대 림프관종을 수술적 치험하였기에 보고하는바이다.

• 대한수의사회지
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• 제26권7호
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• pp.432-437
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• 1990

1988년 7월부터 1989년 6월까지 서울시소재 동물병원에 내원한 환견 87두를 대상으로 질환별 혈액화학치검사를 실시한 결과 다음과 같은 결론을 얻었다. 1. 소화기계 질환군에서는 혈당치와 A/G비의 평균치는 각각 질환견이 $40.8{\pm}22.4$mg/dl와 $0.73{\pm}0.28$로서 건강견의 $60.4{\pm}22.0$mg/dl와 $1.06{\pm}0.17$보아 감소하였다(p<0.01). 2. 기생충 질환군에서는 GOT와 BUN의 평균치는 각각 질환견이 $29.4{\pm}72$IU/l와 $29.8{\pm}13.6$mg/dl로서 건강견의 $25.9{\pm}5.2$IU/l와 $17.3{\pm}4.9$mg/dl보다 증가하였다(p<0.01). 3. 필요기계 질환군에서는 BUN의 평균치가 질환견에서는 $49.5{\pm}16.7$mg/dl로서 건강견의 $17.3{\pm}4.9$mg/이보다 증가를 보여 1$\%$ 수준의 높은 유의성이 인정되었다. 4. 각 질환군에서 Total Protein치의 변동은 인정되지 않았다.

• 약학회지
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• 제27권4호
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• pp.271-282
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• 1983

This study is an attempt to study the influence of clonidine, which has a central sympatholytic action, on the renal function in dogs and to elucidate its mechanism of action. Clonidine ($15\mu$g/kg) injected into a cephalic vein of the dog produced a marked increase in urine flow and in amounts of $Na^{+}$ and $K^{+}$ excreted in urine, and clearances of free water and osmolar substance, the reabsorption rates of $Na^{+}$ and $K^{+}$ in renal tubules were significantly decreased. Clonidine ($50.0]mu$g/kg) administered intravenouly elicited a transient reduction in urine flow, along with inhibition of all renal functions. Intravenous clonidine-induced diuretic effect was completely blocked by pretreatment with reserpine, and was lessened by water diuresis. Clonidine ($3.0\mu$g/kg) injected tnto a carotid artery revealed a transient diuresis with a increase in clearance of free water. Clonidine injected into a renal artery showed a significant antidiuretic effect and all functions of an experimental kidney were reduced. Antidiuretic action induced by clonidine given into a renal artery markedly suppressed by pretreatment with reserpine. The above results suggest that clonidine has dual mechanisms: 1) diuretic effect due to the central sympatholytic action and inhibition of release of antidiuretic hormone, and 2) antidiutetic effect indued by indirect symptheic stimulation in the periphery.