• 제목/요약/키워드: Delayed drainage

검색결과 75건 처리시간 0.021초

The Utility and Benefits of External Lumbar CSF Drainage after Endovascular Coiling on Aneurysmal Subarachnoid Hemorrhage

  • Kwon, Ou-Young;Kim, Young-Joon;Kim, Young-Jin;Cho, Chun-Sung;Lee, Sang-Koo;Cho, Maeng-Ki
    • Journal of Korean Neurosurgical Society
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    • 제43권6호
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    • pp.281-287
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    • 2008
  • Objective : Cerebral vasospasm still remains a major cause of the morbidity and mortality, despite the developments in treatment of aneurysmal subarachnoid hemorrhage. The authors measured the utility and benefits of external lumbar cerebrospinal fluid (CSF) drainage to prevent the clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage in this randomized study. Methods : Between January 2004 and March 2006, 280 patients with aneurysmal subarachnoid hemorrhage were treated at our institution. Among them, 107 patients met our study criteria. The treatment group consisted of 47 patients who underwent lumbar CSF drainage during vasospasm risk period (about for 14 days after SAH), whereas the control group consisted of 60 patients who received the management according to conventional protocol without lumbar CSF drainage. We created our new modified Fisher grade on the basis of initial brain computed tomography (CT) scan at admission. The authors established five outcome criteria as follows : 1) clinical vasospasm; 2) GOS score at 1-month to 6-month follow-up; 3) shunt procedures for hydrocephalus; 4) the duration of stay in the ICU and total hospital stay; 5) mortality rate. Results : The incidence of clinical vasospasm in the lumbar drain group showed 23.4% compared with 63.3% of individuals in the control group. Moreover, the risk of death in the lumbar drain group showed 2.1 % compared with 15% of individuals in the control group. Within individual modified Fisher grade, there were similar favorable results. Also, lumbar drain group had twice more patients than the control group in good GOS score of 5. However, there were no statistical significances in mean hospital stay and shunt procedures between the two groups. IVH was an important factor for delayed hydrocephalus regardless of lumbar drain. Conclusion : Lumbar CSF drainage remains to playa prominent role to prevent clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage. Also, this technique shows favorable effects on numerous neurological outcomes and prognosis. The results of this study warrant clinical trials after endovascular treatment in patients with aneurysmal SAH.

식도천공의 자연폐쇄치료[경부식도루 조성술과 이중배액법에 의한]:1예 보고 (Spontaneous Closure of Delayed Esophageal Perforation: By temporary cervical fistulation with dual drainages)

  • 오봉석;최종범;이동준
    • Journal of Chest Surgery
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    • 제14권1호
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    • pp.77-82
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    • 1981
  • The esophageal perforation is the most rapidly fatal and most serious perforation of the gastrointestinal tract. The 53 year old male patient was admitted because of substernal and epigastric pain altar esophageal bougienage for the indigestion and the difficult swallowing before about 18 hours. On esophagogram, there was the extravasation of contrast media at the right side of the lower esophagus [retrocardiac segment]. The emergency thoractotomy, debridement and suture closure with drainage were performed. But after 7 days the esophageal leakage was complicated again with pus discharge, although primary repair was done. On the 13th hospital day, the temporary cervical esophageal fistulation with dual drainages was made under general anesthesia. On the 38th day after this procedure, the esophageal leakage was closed spontaneously. On the 63rd hospital day the cervical fistulation was repaired and ever since the esophageal passage was good without leakage or swallowing difficulty.

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Anal Extrusion of Distal V-P Shunt Catheter after Double Perforation of Large Intestine

  • Jang, Hyun-Dong;Kim, Min-Su;Lee, Nam-Hyuk;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제42권3호
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    • pp.232-234
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    • 2007
  • We describe the extrusion of a ventriculoperitoneal shunt catheter from the anus after double perforation of the large bowel in a 3-year-old girl with hydrocephalus. She was admitted because the tip of the peritoneal catheter protruded 10 cm from the anus and clear cerebrospinal fluid dripped from the tip. Emergency laparotomy was performed. The distal peritoneal catheter perforated and penetrated the sigmoid colon and re-perforated into the rectal cavity. The distal peritoneal catheter was removed, the proximal catheter was exposed for external drainage, and intravenous broad-spectrum antibiotics were administered for 2 weeks. After control of infection, the shunt system was completely removed. Bowel perforation by a peritoneal catheter is a rare complication. Diagnosis is often difficult, delayed, and its incidence is likely underestimated. Most bowel perforation is the result of infection as opposed to technical errors.

개심술후 발생한 종격동염의 치료 (Management of Mediastinitis after Open Heart Surgery)

  • 최세영
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.360-364
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    • 1995
  • Between January 1984 and January 1994, 13 patients developed mediastinitis after cardiac operations. There were 7 women and 6 men with a mean age of 24.2 years[range 0.7 - 61 . Initial operation included 7 valve replacements and 6 congenital cardiac repairs. The duration between initial operation and diagnosis was 13.5 days[range 4-57 . Organisms cultured from debridement material included S.aurus[n=9 , S.epidermidis[n=3 and Enterobacter[n=1 . Fever was the most frequent complaint and purulent drainage was noticed in 9 patients[69% . Seven patients were treated with radical debridement followed by closed irrigation. In other 6 patients, the wounds were managed by debridement, open granulation and delayed wound closure. Two hospital deaths [15.4% following open granulation method, resulted from sepsis. The 11 survivors were followed-up for 1-120 months, averaging 42 months and had healed wounds. One late death occurred due to massive hemorrhage.

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응급실로 내원한 외상성 화농성 근염 환자의 분석 (Clinical Analysis of Traumatic Pyomyositis in Emergency Patients)

  • 나지웅;송형곤
    • Journal of Trauma and Injury
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    • 제19권1호
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    • pp.81-88
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    • 2006
  • Purpose: Pyomyositis is a rare disease in temperature climate region. The diagnosis of pyomyositis is often delayed, and pyomyositis is often misdiagnosed in the emergency department. Methods: The medical records of 11 patients who were diagnosed as having traumatic pyomyositis in the emergency department at Samsung Medical Center in Seoul, Korea, between 2000 and 2006 were reviewed. Their clinical features, such as history, symptoms, clinical findings, duration from onset of symptoms to diagnosis, medical history, laboratory data, results of imaging studies and clinical course were collected. Results: The psoas muscles were most commonly involved. Computer tomography and magnetic resonance imaging aided in accurate diagnosis of the infection and of the extent of involvement. Incision, drainage, and antibiotics therapy eradicated the infectioin in all patients Conclusion: Pyomyositis should be a part of the differential diagnosis for patients with traumatic muscle pain. Radiologic evaluation, such as computer tomography and magnetic resonance imaging, must be considered in the diagnosis of traumatic pyomyositis.

Arthroscopic Treatment for Septic Arthritis of the Shoulders in Neonates: A Case Report

  • Park, Kyoung-Jin;Lee, Hyung-Ki
    • Clinics in Shoulder and Elbow
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    • 제19권3호
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    • pp.163-167
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    • 2016
  • Septic arthritis in neonates is a rare condition. A failure to make an early diagnosis of septic arthritis in neonates may leave a permanent disability as a result of a delayed treatment. Thus, septic arthritis, requires a prompt diagnosis and a timely treatment especially in this subset of patients. In this case report, we describe our treatment protocol for septic arthritis and concurrent osteomyelitis in the right shoulder of a 28-day-old newborn. Using 2.4 mm wrist arthroscopy, we performed an arthroscopic irrigation and drainage, to remove intra-articular debris and inflammatory tissue, and multiple drilling. We report a satisfactory clinical outcome without any postoperative complications or side effects.

근막간극감염에 의한 패혈증 연구 (Sepsis Developed from an Odontogenic Infection)

  • 정미애
    • 한국산학기술학회:학술대회논문집
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    • 한국산학기술학회 2011년도 추계학술논문집 1부
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    • pp.326-329
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    • 2011
  • Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant micro-organisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.

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농업가뭄의 평가를 위한 가뭄지수의 적용성 분석

  • 박기욱;김진택;주욱종;이용직
    • 한국관개배수논문집
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    • 제13권1호
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    • pp.72-81
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    • 2006
  • The objictive of this study is to analyze regional drought using agricultural drought indicator. Toforecast and evaluate the drought, the drought indices for agriculture were applied. In the present drought preparedness plans of Ministry of Agriculture and Forestry (MAF), it is prescribed that the preparedness levels should be classified by considering the precipitation, reservoir storage, soil moisture in paddy and upland, and the growing status of crops. There are many drought index to analyze and evaluate the drought. However, these indices do not exactly explain all drought events. Thus, we select 4 drought indices to evaluate agricultural drought:reservoir storage index, 3-month delayed SPI, mean rainfall index, and dry day index. Using these ineices, six drought stages are classified. The results show that agricultural drought could be apprppriately analyzed and evaluated by agricultural drought stage and four drought indices.

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볏짚의 시용(施用)이 수도(水稻)의 분벽(分蘖)에 미치는 영향(影響) (Effect of Rice Straw Application on the Tillering of Paddy Rice)

  • 허범량;이창덕
    • 한국토양비료학회지
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    • 제14권3호
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    • pp.146-156
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    • 1981
  • 볏짚 시용량(施用量) 차이(差異)가 수도분벽(水稻分蘗)에 미치는 영향(影響)을 알아보기 위(爲)하여 볏짚 시용량(施用量), 질소량(窒素量), 시용위치(施用位置) 및 배수(排水) 등(等)을 달리하여 시험(試驗)한 결과(結果)는 다음과 같다. 1. 볏짚 시용량(施用量) 증가(增加)는 초기분벽(初期分蘗)을 억제(抑制)하며, 최고분벽기출수기(最高分蘗期出穗期)를 지연(遲延)시키고 등숙율을 저하(低下)시켰다. 2. 볏짚 시용(施用)에 의(依)한 초기분벽기(初期分蘗期) 및 출수기(出穗期) 지연(遲延)을 단축(短縮)시켜 주지 못하였다. 3. 초기분벽(初期分蘗) 억제(抑制) 방지(防止)로서는 배수(排水)와 심층(深層) 시용(施用)이 효과적(效果的)이였다. 4. 볏짚 시용(施用)으로 토양(土壤)의 유기물(有機物) 및 칼륨의 증가(增加)가 현저(顯著)하였다.

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피압에 따른 연약지반의 압밀 거동 (Consolidation Characteristics of Soft Ground with Artesian Pressure)

  • 윤대호;김재홍;김윤태
    • 한국지반환경공학회 논문집
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    • 제17권2호
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    • pp.31-39
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    • 2016
  • 일반적으로 고함수비를 가진 연약지반의 경우 압밀 촉진을 원활히 하기 위하여 연직배수재를 주로 사용하고 있다. 부산 점토는 대심도 연약지반 아래에 존재하는 모래 및 자갈 대수층에 피압이 관측되었다. 그러나 연직배수재가 설치된 연약지반에 피압이 미치는 영향에 대한 조사나 연구는 미미한 실정이다. 따라서 본 논문에서는 연직배수재가 설치된 부산 낙동강 하구 연약지반에 피압의 작용 유 무에 따른 압밀 거동을 조사하기 위해 일차원 대형 컬럼 장치를 제작하여 점토지반의 압밀 거동 실험을 수행하였다. 실험 결과 최종 침하량은 피압이 작용하는 지반이 피압이 작용하지 않는 지반보다 더 크게 나타났다. 이는 피압의 상향침투로 인해 점토층의 유효응력이 감소하여 나타난 결과로 판단된다. 또한 피압이 작용하는 지반의 경우 과잉간극수압이 완전 소산되지 않고 잔류하는 것으로 나타났으며, 비배수 전단강도는 피압이 작용하지 않는 지반에 비해 상대적으로 낮은 값을 나타내었다.