• Archives of Plastic Surgery
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• 제49권4호
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• pp.482-487
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• 2022

In lower abdominal flap representing transverse rectus abdominis musculocutaneous (TRAM) flap or deep inferior epigastric perforator (DIEP) flap, superficial inferior epigastric vein (SIEV) exists as superficial and independent venous system from deep system. The superficial venous drainage is dominant despite a dominant deep arterial supply in anterior abdominal wall. As TRAM or DIEP flaps began to be widely used for breast reconstruction, venous congestion issue has been arisen. Many clinical series in regard to venous congestion despite patent microvascular anastomosis site were reported. Venous congestion could be divided in two conditions by the area of venous congestion and each condition is from different anatomical causes. First, if venous congestion was shown in whole flap, it is due to the connection between SIEV and vena comitantes of DIEP. Second, if venous congestion is limited in above midline (Hartrampf zone II), it is due to problem in venous midline crossover. In this article, the authors reviewed the role of SIEV in lower abdominal flap based on the various anatomic and clinical studies. The contents are mainly categorized into four main issues; basic anatomy of SIEV, the two cause of venous congestion, connection between SIEV and vena comitantes of DIEP, and midline crossover of SIEV.

• 여성건강간호학회지
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• 제25권2호
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• pp.154-168
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• 2019

Purpose: The purpose of this study is to identify knowledge, awareness, and risk of occurrence of venous thromboembolism among pregnant women. Methods: Subjects were 106 pregnant women treated as inpatients and outpatients at a women's health hospital in a metropolitan city February 19-March 22, 2018. Instruments consisted of questionnaires that included knowledge, awareness, and risk of occurrence of venous thromboembolism queries. Collected data were analyzed by t-test, one-way analysis of variance, Mann-Whitney U test and Kruskal-Wallis test. Results: Mean score of subjects' knowledge of venous thromboembolism was 4.47 (0-15), mean score of subjects' awareness of venous thromboembolism was 66.98 (25-100), and mean score of subjects' risk factor of venous thromboembolism was 0.98 (0-44). Conclusions: Pregnant women's level of knowledge and awareness of prevention and risk factors on venous thromboembolism, is significantly low. To raise their awareness of risk symptoms and prevent occurrence of the disease, it is essential for nurses as well as medical staffs to: 1) provide an educational program on venous thromboembolism for patients; 2) assess and monitor pregnant women with a risk factor of venous thromboembolism; and 3) implement proper prophylaxis for patients.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.292-294
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• 2015

Central venous catheterization is one of the most important procedures for initial resuscitation of hemodynamically unstable patients including multiple trauma patients. Inadvertent arterial placement of the large caliber central venous catheter can results in resuscitation failure as well as unnecessary invasive treatment. Here, we report an arterial puncture during central venous catheterization which may lead to inadvertent arterial catheterization. We recommend that arterial catheterization should be evaluated before dilator insertion during Seldinger's method. Ultrasound can help in preventing the inadvertent arterial catheterization of central venous catheter.

• Advances in pediatric surgery
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• 제1권1호
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• pp.46-52
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• 1995

Percutaneous infraclavicular subclavian catheterization has been widely used for a total parenteral nutrition, hemodynamic monitoring and for venous access in difficult clinical situations. Many authors have claimed the infraclavicular cannulation of the subclavian vein in the tiniest infants can be performed with safety and ease, but there are always possibility of serious complications in this method. We present our experiences of peripheral venous cutdown with Broviac catheter. Author routinely introduced Broviac catheter into central vein via peripheral venous cutdown. There was no life threatening complications and no catheter related death. The complication rate was very low. The catheter related sepsis was documented in only two patient(4.7%). The average catheter longivity was 19.59 days. In view of the safety and low rate of complication, we think that peripheral venous cutdown with Broviac catheter should be the method of choice when central venous access is necessary in infants. The infraclavicular subclavian catheterization should be reserved in infants with few accessible peripheral vein.

• Investigative Magnetic Resonance Imaging
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• 제16권2호
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• pp.152-158
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• 2012

목적: 뇌내 정맥혈관을 평가하기 위한 조영 증강 자기공명 정맥촬영술의 arterial trigger 와 venous trigger 방법으로 시행한 영상의 차이점을 비교 분석하고자 한다. 대상과 방법: 건강검진을 목적으로 자기공명정맥촬영술을 시행한 41명의 환자들을 대상으로 해면부위의 내경 동맥에서 arterial triggering하여 6초 후에 얻은 영상 (n = 20) 과 상시상 정맥동에서 venous triggering (n = 21) 방법으로 시행한 영상을 후향적으로 분석하였다. 영상은 가돌리늄 조영제 ($Magnevist^{(R)}$, Schering, Germany)를 0.1 mmol/kg 정맥주입하여 시행하였고, 두개강 전반에 대하여 시상영상을 fast spoiled gradiend echo sequence로 시행하였다 (TR/TE 5.2/1.5, matrix $310{\times}310$, 절편수 124 절편, 두께 15 cm). 두 그룹의 영상을 해부학적 정맥 혈관 구조에 따라 17 정맥구역에 대하여 평가하였고, 정맥의 영상품질은 세 단계 (안보임, 일부 보임, 완전히 보임)로 나눠서 평가하였다. 결과: 정맥이 완전히 보인 구역은 arterial triggering 자기공명 정맥 촬영술에서 84% (272/323), venous triggering 자기 공명 정맥촬영술에서 91% (310/340) 이다. Venous triggering 자기공명촬영술과 arterial 자기 공명 정맥촬영술을 비교하였을 때 뇌내 정맥 구조를 평가하는데 있어 venous triggering 방법이 통계적으로 유의하게 높았다 (Fisher exact test, p<0.006). 결론: 조영 증강 자기공명 정맥 촬영술은 정맥 혈관 구조에 대한 고화질의 이미지를 제공하였고 arterial triggering 방법보다 venous triggering 방법이 뇌내 정맥 구조 평가에 우월한 것으로 나타났다.

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.30-39
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• 2022

Objective : There are different types of cerebral vascular malformations. Pial arteriovenous fistulas (PAVFs) and dural arteriovenous fistulas (DAVFs) are two entities; they consist of one or more arterial connections to a single venous outlet without a true intervening nidus. The high turbulent flow of PAVFs and aggressive DAVFs with cortical venous reflux can result in venous outflow varix and aneurysmal dilatation. They pose a significant challenge to transvenous embolization (TVE), stereotactic radiosurgery, and surgical treatment. We aim to share our centers' experience with the transarterial embolization (TAE) for arteriovenous fistulas (AVFs) with large venous pouches and to report the outcome. Methods : The authors' two institutions' databases were retrospectively reviewed from February 2017 to February 2021. All patients with intracranial high flow PAVFs and aggressive DAVFs with venous outlet ectasia and large venous varix and were treated by TAE were included. Results : Fifteen patients harboring 11 DAVFs and four PAVFs met our inclusion criteria. All patients underwent TAE in 17 sessions. Complete angiographic obliteration was achieved after 14 sessions in 12 patients (80%). Four patients (25%) had residual after one TAE session. Technical failure was documented in one patient (6.7%). Fourteen patients (93.3%) had favorable functional outcome (modified Rankin score 0-2). Conclusions : TAE for high flow or aggressive intracranial AVFs is a safe and considerable treatment option, especially for those associated with large venous pouches that are challenging and relatively high-risk for TVE.

• 한국임상수의학회지
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• 제15권2호
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• pp.251-254
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• 1998

This study was performed to investigate the blood contents of velvet antler and femoral venous blood in farmed elk (Cervus canadensis). Blood samples were collected from 12 young adult elk (3.5-4.5 years old) with a mixture of fentanyl-azaperone-xylazine (Fentazine$^{(R)}$). Values for hematological and clinicochemical components of the clinical healthy elk were determined. The results were grouped for comparison according to velvet antler and femoral venous blood. Lower mean platelet counts and fibrinogen values were found in the velvet antler than femoral venous blood (p<0.01). White blood cell count of velvet antler was significantly higher than that of femoral venous blood 0<0.05). The clinicochemical parameters (total protein, albumin, globulin, alanine aminotransferase, aspartate aminotransferasei blood urea nitrogens calciums magnesium and phosphonls) obtained in this study far farmed elk are consistent with the values between velvet antler and femoral venous blood.

• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.245-248
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• 2011

Venous thromboembolism represents as an obstruction of a vein by a blood clot in the blood stream. The most common manifestations of venous thromboembolism (VTE) are pulmonary embolism and deep vein thrombosis (DVT) of the lower extremity. This article reviews the recent advances in this spectrum and introduces new drugs that will be used in venous thromboembolism in the near future.

• Archives of Plastic Surgery
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• 제34권1호
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• pp.60-63
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• 2007

Purpose: Free transverse rectus abdominis musculocutaneous(TRAM) flap is one of the most popular methods of breast reconstruction. But if fat necrosis and fatty induration occur at the reconstructed breast, they can make the breast harder and make it difficult to differentiate a tumor recurrence from them. To expect and prevent these complications, we measured the pressure change of the superficial venous system whose congestion can be the cause of them. Methods: An intraoperative clinical study was done to compare venous pressure of superficial inferior epigastric vein(SIEV) before and after the elevation of free TRAM flap. Fourteen TRAM flaps were included and the pressures of SIEV were measured two times at the beginning of the elevation and just before the division of the inferior pedicle. Results: The venous pressure in free TRAM flap was significantly higher after the flap elevation at both contralateral side and ipsilateral(p=0.005 and p=0.026 respectively). The four cases with vertical scar shower significantly greater increase at contralateral side than ipsilateral side(p=0.020). Conclusion: Intraoperative venous pressure recording can be an objective data for evaluating the congestion of TRAM flap and can help to prevent the complications of fat necrosis and fatty induration with venous superdrainage.

• 대한영상의학회지
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• 제83권1호
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• pp.206-211
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• 2022

혈액투석 환자에서 중심정맥 협착은 비교적 흔한 합병증이다. 하지만 중심정맥 협착으로 인해 대뇌 정맥 고혈압과 이로 인한 신경학적 증상이 발생하는 것은 비교적 드물다. 중심정맥협착으로 인해 발생한 좌측 내경정맥으로부터의 역행성 혈류로 대뇌 정맥 고혈압이 발생한 63세 남성의 증례를 보고하고자 한다. 환자는 중심정맥 협착에 대한 치료를 받은 후 증상 및 치료 전 자기공명영상에서 역행성 혈류를 의미하는 time-of-flight 신호가 소실되었다.