• Journal of Gastric Cancer
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• v.18 no.4
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• pp.379-391
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• 2018

Purpose: Gastric cancer (GC) patients with peritoneal metastasis (PM) have poor prognosis. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in combination with systemic chemotherapy is a novel treatment option for patients in stage IV of the disease. Materials and Methods: Between November 2015 and June 2018, prospective data collection was performed in 24 patients with GC and PM (median age, 57; range, 44-75 years). These patients underwent 46 PIPAC procedures with a median number of 2 interventions per patient (range, 1-6). A laparoscopic access was used and a combined therapy of cisplatin and doxorubicin aerosol was administered. Results: The median peritoneal carcinomatosis index before the 1st PIPAC was 14 (range, 2-36), and the median ascites volume in patients before the 1st PIPAC was 100 mL (range, 0-6 mL, 300 mL). Eleven patients, who received 2 or more PIPAC procedures, had decreased and stable volumes of ascites, while only 3 patients displayed increasing volume of ascites. The median overall survival was 121 days (range, 66-625 days) after the 1st PIPAC procedure, while 8 patients who received more than 3 PIPAC procedures had a median survival of 450 days (range, 206-481 days) (P=0.0376). Conclusions: Our data show that PIPAC is safe and well tolerated, and that the production of ascites can be controlled by PIPAC in GC patients. Patients, who received 2 or more PIPAC procedures, reported a stable overall quality of life. Further studies are required to document the significance of PIPAC as a palliative multimodal therapy.

• Journal of Chest Surgery
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• v.51 no.5
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• pp.333-337
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• 2018

Background: Pinch-off syndrome (POS) is a rare complication after totally implantable venous access device (TIVAD) implantation. In cancer patients, it is important to prevent this rare complication and to recognize it early if it does occur. We present a case series of POS after TIVAD implantation and the results of a literature search about this complication. Methods: From July 2006 to December 2015, 924 permanent implantable central venous catheter implantation procedures were performed. The most common indication was vascular access for chemotherapy. Results: POS occurred in 5 patients in our clinic. Two patients experienced POS within 2 weeks, and the other 3 patients were admitted to department of surgery, Istanbul Faculty of Medicine at 6 to 14 months following implantation. The catheters were found to be occluded during medication administration, and all patients complained of serious pain. The transected fragments of the catheters had migrated to the heart. They were successfully removed under angiography with a single-loop snare. Conclusion: POS is a serious complication after TIVAD implantation. It is important to be aware of this possibility and to make an early diagnosis in order to prevent complications such as drug extravasation and occlusion events.

• Journal of Trauma and Injury
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• v.32 no.4
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• pp.243-247
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• 2019

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1-4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.

• Archives of Reconstructive Microsurgery
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• v.19 no.2
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• pp.112-119
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• 2010

The anterolateral thigh flap is a reliable and versatile flap. It has been extensively used for soft tissue reconstruction because minimal donor site morbidity is attractive feature of this flap. It can be harvested as a cutaneous, fasciocutaneous, muscluocutaneous flap. We can be used to form as desired shape and thickness. But variation of vascular anatomy make difficult for many surgeons. We review of vascular anatomy of the anterolateral thigh to be easier access to surgery. With understanding anatomic variation, it allows you to take advantage of this surgery using little more variable form.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.419-422
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• 2018

Hemangioendothelioma is a rare vascular tumor with involvement of the liver, brain, long bones, and lung. Among the 6 histological subtypes, epithelioid hemangioendothelioma (EHE) is the most aggressive. Its occurrence in the mediastinum is quite rare, and very few cases have been documented. The reported cases in the literature have described difficulties in the preoperative diagnosis due to the unusual histological appearance of the tumor. Immunohistochemistry remains the mainstay for a definitive diagnosis. Due to its low incidence, there is no standard treatment for mediastinal EHE, but curative resection is the preferred treatment option where possible, with chemotherapy used as an adjuvant treatment or in cases of widespread inoperable disease. The present case study describes an aggressive EHE occurring in an 18-year-old woman in the anterior mediastinum.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.128-142
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• 2013

Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.589-599
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• 2021

Purpose To analyze the success and complication rates and factors associated with technical failure of the ultrasound (US)-guided percutaneous thrombin injection of femoral artery pseudoaneurysms caused by vascular access. Materials and Methods Records of 30 patients with post-catheterization femoral artery pseudoaneurysms who had been treated with US-guided percutaneous thrombin injections in the department of radiology between March 2009 and June 2019 were retrospectively analyzed. The lesion was diagnosed based on US or contrast-enhanced CT. The characteristics of the patients and their lesions were analyzed. Results The mean patient age was 67.8 years. The mean diameter of the pseudoaneurysmal sac was 20.88 mm (5-40 mm). Twenty patients (66.6%) obtained complete thrombosis after the primary injection, while 10 patients (33.3%) obtained partial thrombosis. The number of patients with a low platelet count (< 130 k/µL) was significantly higher in the partial thrombosis group than in the complete thrombosis group (p = 0.02). No substantial procedure-related complications were found in any patient. Conclusion The US-guided percutaneous thrombin injection is considered an initial treatment option for pseudoaneurysms caused by vascular access because of its safety and efficacy.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.94-98
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• 2018

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

• Korean Journal of Bronchoesophagology
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• v.2 no.1
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• pp.120-124
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• 1996

Nasopharyngeal angiofibroma is rare highly vascular tumor and occurs almost exclusively in adolescent boy. This tumor is histologically benign but clinically malignant because of massive bleeding, destruction of surrounding tissue, difficulty in surgical access and recurrence. Preoperative embolization is required to decrease bleeding during operation Surgical method varies according to staging of angiofibroma. Recently, we had experienced a case of angiofibroma that was resected by transmaxillary approach after preoperative embolization.

• Korean Circulation Journal
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• v.53 no.4
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• pp.271-272
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• 2023