• Title/Summary/Keyword: Venous

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Safety of a Totally Implantable Central Venous Port System with Percutaneous Subclavian Vein Access

  • Keum, Dong-Yoon;Kim, Jae-Bum;Chae, Min-Cheol
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.202-207
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    • 2013
  • Background: The role of totally implantable central venous port (TICVP) system is increasing. Implantation performed by radiologist with ultrasound-guided access of vein and fluoroscope-guided positioning of catheter is widely accepted nowadays. In this article, we summarized our experience of TICVP system by surgeon and present the success and complication rate of this surgical method. Materials and Methods: Between March 2009 and December 2010, 245 ports were implanted in 242 patients by surgeon. These procedures were performed with one small skin incision and subcutaneous puncture of subclavian vein. Patient's profiles, indications of port system, early and delayed complications, and implanted period were evaluated. Results: There were 82 men and 160 women with mean age of 55.74. Port system was implanted on right chest in 203, and left chest in 42 patients. There was no intraoperative complication. Early complications occurred in 11 patients (4.49%) including malposition of catheter tip in 6, malfunction of catheter in 3, and port site infection in 2. Late complication occurred in 12 patients (4.90%). Conclusion: Surgical insertion of TICVP system with percutaneous subclavian venous access is safe procedures with lower complications. Careful insertion of system and skilled management would decrease complication incidence.

Hepatic portal venous gas in paralytic ileus (마비성 장폐색증에 병발된 간문맥 내 가스)

  • Lee, Ji Eun;Sohn, Min Soo;Hur, Jun Ho;Cho, Sun Young;Choi, Sun Taek;Sung, Young Ho
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.56-60
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    • 2014
  • Hepatic portal venous gas (HPVG) is a rare radiographic finding associated with severe intra-abdominal disease and fatal outcome. Most cases of HPVG are historically related to mesenteric ischemia accompanied by bowel necrosis. The current spread of computed tomography scan promotes not only the early detection of related severe diseases but also the identification of other causes of HPVG. It has been reported in many non-fatal conditions, such as inflammatory bowel disease, intra-abdominal abscess, bowel obstruction, paralytic ileus, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, and gastric dilatation. Among these, paralytic ileus is a very rare condition, with no case yet reported in South Korea. Reported herein is a case of HPVG in paralytic ileus, which was treated well internally and was promptly resolved.

Effect of Caffeine on Coronary Circulation and Calcium Release in Isolated Guinea Pig Hearts (Guinea Pig Heart의 관상동맥 순환기능과 Calcium Release에 있어서 Caffeine이 미치는 영향)

  • 김은지
    • Journal of Nutrition and Health
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    • v.25 no.7
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    • pp.597-607
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    • 1992
  • The present study examined effects of caffeine on coronary circulation myocardial oxygen me-tabolism and calcium release in isolated perfused guinea pig hearts. Intracoronary caffeine({{{{ {10 }^{-5 } }}}}∼{{{{ { 10}^{-3 } }}}}M) was employed for 10 minutes to measure coronary perfusate flow(CF) and coronary vascular sresistance(CVR) at a constant coronary perfusion pressure of 80 cmH2O Perfusate myocardial oxygen consumption(MVO2) and percent oxygen extraction(%EC2) were calcula-ted. In addition calcium contents in both perfusate samples were measured to calculate calcium release in coronary venous effluent. Caffeine significantly decreased CF and increased CVR during 10 minutes of caffeine perfusion regardless of dose of caffeine perfused exhibiting time-response. While % EO2 was significantly enhanced with caffeine MVO2 was markedly reduced. The coronary venous perfusate pH dcreased during the perfusion with caffeine. These changes were consistent with caffeine-induced metabolic acidosis. Calcium release appeared to be dose-dependent and high dose of caffeine greatly increased venous calcium release even 2 minutes after perfusion with carffeine. These finding in dicate that caffeine produced coronary vasoconst-riction with increased calcium release in isolated perfused guinea pig hearts. Additionaly this vasoconstrictor response mignt be due tin part to the direct actions of caffeine.

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Mediastinitis after Central Venous Catheterization (중심정맥관 삽입후 발생한 종격동염-1례 보고)

  • Keum, Dong Yoon;Park, Nam Hee;Lee, Kee Tae
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.64-67
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    • 2005
  • We report here on an uncommon case of mediastinitis that occurred after central venous catheterization. A patient with colon and jejunal cancer complained high fever, right shoulder pain, chest pain, and limited motion of the affected shoulder just 6 days after central venous catheterization. Bacterial culture of the blood, shoulder abscess, and catheter puncture site revealed methicillin-resistent staphylococcus aureus. Right upper mediastinal widening on chest film also suggested mediatinitis. Mediastiotomy and pus drainage was performed along with adequate antibiotics therapy. In this case, it seems that initially formed bacteria from the puncture site migrated to the mediastinum through the tissue plane to start the mediastinitis. Careful dressing of puncture site and correct handling of catheter is important to prevent this serious complication.

Partial anomalous pulmonary venous connection with intact atrial septum in a child with ventricular septal defect: a case report

  • Kim, Young-Nam;Cho, Hwa-Jin;Cho, Young-Kuk;Ma, Jae-Sook
    • Clinical and Experimental Pediatrics
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    • v.55 no.1
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    • pp.24-28
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    • 2012
  • Partial anomalous pulmonary vein connection (PAPVC) is a rare congenital abnormal cardiac defect involving the pulmonary veins draining into the right atrium (RA) directly or indirectly by venous connection. Ninety percent of PAPVCs are accompanied by atrial septal defect (ASD). To our knowledge, there is no previous report of PAPVC with ventricular septal defect (VSD) without ASD in Korea, and in this paper, we report the first such case. A 2-day-old girl was admitted into the Chonnam National University Hospital for evaluation of a cardiac murmur. An echocardiogram revealed perimembranous VSD without ASD. She underwent patch closure of the VSD at 5 months of age. Although the VSD was completely closed, she had persistent cardiomegaly with right ventricular volume overload, as revealed by echocardiography. Three years later, cardiac catheterization and chest computed tomography revealed a PAPVC, with the right upper pulmonary vein draining into the right SVC. Therefore, correction of the PAPVC was surgically performed at 3 years of age. We conclude that it is important to suspect PAPVC in patients with right ventricular volume overload, but without ASD.

Umbilical Venous Catheter Complication Presenting as Chylous Ascites in a Newborn: Intraperitoneal Extravasation of Total Parenteral Nutrition Infusate

  • Lee, Hye Mi;Sung, Hyun Jung;Lee, Hyun-Seung
    • Neonatal Medicine
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    • v.25 no.4
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    • pp.196-201
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    • 2018
  • Umbilical venous catheterization (UVC) is a common practice in intensive neonatal care. However, a malpositioned UVC and its prolonged use may lead to various problems, including mechanical, infectious, and thrombotic complications in various organs such as the liver, lungs, and heart. Congenital chylous ascites is characterized by abnormally high levels of triglycerides in the peritoneal fluid of newborns, which originate from refluxed lymph within the abdominal cavity. Herein, we report a case of an UVC complication presenting as chyloperitoneum simulating congenital chylous ascites in a preterm neonate that resulted from total parenteral nutrition (TPN) extravasation from a malpositioned UVC. Biochemical analysis of intraperitoneal chylous fluid and TPN infusate could help confirm the origin of chyloperitoneum. This case suggests that TPN extravasation from UVC should be considered when chyloperitoneum develops in newborns with an indwelling catheter. UVC positions must also be carefully monitored at regular intervals to recognize associated complications early, particularly in cases with an inevitably malpositioned catheter related to the anatomy of the vessel course.

Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report

  • Se Jin Park;Haing-Woon Baik;Myung Hyun Cho;Ju Hyung Kang
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.101-106
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    • 2022
  • Nephrotic syndrome (NS) is a hypercoagulable state in which children are at risk of venous thromboembolism. A higher risk has been reported in children with steroid-resistant NS than in those with steroid-sensitive NS. The mortality rate of cerebral venous sinus thrombosis (CVST) is approximately 10% and generally results from cerebral herniation in the acute phase and an underlying disorder in the chronic phase. Our patient initially manifested as a child with massive proteinuria and generalized edema. He was treated with albumin replacement and diuretics, angiotensin-converting enzyme inhibitor, and deflazacort. Non-contrast computed tomography showed areas of hyperattenuation in the superior sagittal sinus when he complained of severe headache and vomiting. Subsequent magnetic resonance imaging revealed empty delta signs in the superior sagittal, lateral transverse, and sigmoid sinuses, suggesting acute CVST. Immediate anticoagulation therapy was started with unfractionated heparin, antithrombin III replacement, and continuous antiproteinuric treatment. The current report describes a life-threatening CVST in a child with steroid-dependent NS, initially diagnosed by contrast non-enhanced computed tomography and subsequently confirmed by contrast-enhanced magnetic resonance imaging, followed by magnetic resonance venography for recanalization, addressing successful treatment.

Clinical Utility of Portal Venous Circulating Tumor Cells in Pancreatic Cancer (췌장암에서 간 문맥 순환 종양 세포의 임상적인 유용성)

  • Seung Bae Yoon;Sung Woo Ko
    • Journal of Digestive Cancer Research
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    • v.11 no.1
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    • pp.21-29
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    • 2023
  • Despite recent advancements in the diagnosis and treatment of pancreatic cancer, clinical results remain dismal. Furthermore, there are no reliable biomarkers or alternatives beyond carbohydrate antigen 19-9. Circulating tumor cells (CTCs) may be a potential biomarker, but their therapeutic application is constrained by their rarity in peripheral venous blood. Theoretically, the portal vein can be a more appropriate location for the detection of CTCs, because the first venous drainage of pancreatic cancer is portal circulation. According to several studies, the number and detection rate of CTCs may be higher in the portal blood than in the peripheral blood. CTC counts in the portal blood are strongly correlated with several prognostic parameters such as hepatic metastasis, recurrence after surgery, and survival. The phenotypic and genotypic properties analyzed in the captured portal CTCs can assist us to comprehend tumor heterogeneity and predicting the prognosis of pancreatic cancer. The investigations to date are limited by small sample sizes and varied CTC detection techniques. Therefore, a large number of prospective studies are required to confirm portal CTCs as a valid biomarker in pancreatic cancer.

Intracerebral Hemorrhage Caused by Thrombosis of a Developmental Venous Anomaly with an Unusual Structure: A Case Report (특이한 구조의 뇌정맥발달기형 내 혈전증에 의해 생긴 뇌출혈: 증례 보고)

  • Sunhyang Lee;Dae Yoon Kim;Mi Kyung Kim;Hyun Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.199-205
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    • 2022
  • Developmental venous anomalies (DVAs) are common intracranial vascular malformations and they are generally do not cause clinical complications. In cases showing DVA and hemorrhage, the hemorrhage is usually associated with adjacent cavernous malformations. Very few cases of intracerebral hemorrhage (ICH) caused by thrombosis in DVA have been reported in the literature. In this case report, we present an interesting case of a large ICH caused by thrombosis within a DVA with an unusual structure that may have potentiated the thrombosis.

Superior Mesenteric Venous Thrombophlebitis with Terminal Ileal Diverticulitis: A Case Report (말단 회장의 게실염에 동반된 혈전정맥염: 증례 보고)

  • Yang Il Park;Young Han Kim;Byung Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1492-1496
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    • 2020
  • Mesenteric venous thrombophlebitis secondary to inflammatory processes such as diverticulitis and appendicitis is a rare disease; however, it can nonetheless cause bowel ischemia and infarctions. Radiologic diagnosis is vital for mesenteric venous thrombophlebitis complicated with diverticulitis due to its non-specific clinical presentation and very low incidence. We report a case of a 61-year-old woman with superior mesenteric vein thrombosis and ileocecal diverticulitis on CT, which was resolved after treatment with a combination of antibiotic therapy and right hemicolectomy.