• Title/Summary/Keyword: cannulation

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Veno-venous Extracorporeal Membrane Oxygenation with a Double Lumen Catheter for Pediatric Pulmonary Support (급성호흡부전 환아에게 이중관 캐뉼라로 시행한 정맥간 체외막형산화장치)

  • Choi, Min-Suk;Yang, Ji-Hyuk;Jun, Tae-Gook;Lee, Young-Tak;Ahn, Kang-Mo
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.168-171
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    • 2010
  • The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.

Evaluation of Optimum Dietary Threonine Requirement by Plasma Free Threonine and Ammonia Concentrations in Surgically Modified Rainbow Trout, Oncorhynchus mykiss

  • Yun, Hyeonho;Park, Gunjun;Ok, Imho;Katya, Kumar;Heung, Silas;Bai, Sungchul C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.4
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    • pp.551-558
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    • 2015
  • This study was carried out to evaluate the dietary threonine requirement by measuring the plasma free threonine and ammonia concentrations in rainbow trout, Oncorhynchus mykiss after dorsal aorta cannulation. A total of 70 fish (average initial weight $506{\pm}8.2g$) were randomly distributed into each of the 14 net cages (5 fish/cage). After 48 hours (h) of feed deprivation, each group was intubated at 1% body weight with one of the seven L-amino acid based diets containing graded levels of threonine (0.42%, 0.72%, 0.92%, 1.12%, 1.32%, 1.52%, or 1.82% of diet, dry matter basis). Blood samples were taken at 0, 5, and 24 h after intubation. Post-prandial plasma free threonine concentrations (PPthr) of fish 5 h after intubation with diets containing 1.32% or more threonine were significantly higher than those of fish intubated with diets containing 1.12% or less threonine (p<0.05). Post-absorptive free threonine concentrations (PAthr) after 24 h of intubation of the fish with diets containing 0.92% or more threonine were significantly higher than those of fish intubated with diets containing 0.72% or less threonine. Post-prandial plasma ammonia concentrations (PPA, 5 h after intubation) were not significantly different among fish intubated with diets containing 1.12% or less threonine, except the PPA of fish intubated with diet containing 0.42% threonine. Broken-line model analyses of PPthr, PAthr, and PPA indicated that the dietary threonine requirement of rainbow trout should be between 0.95% (2.71) and 1.07% (3.06) of diet (% of dietary protein on a dry matter basis).

Percutaneous Radiofrequency Thermocoagulation Under Fluoroscopic Image-Guidance for Idiopathic Trigeminal Neuralgia

  • Son, Byung-Chul;Kim, Hyung-Suk;Kim, Il-Sup;Yang, Seung-Ho;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.50 no.5
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    • pp.446-452
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    • 2011
  • Objective : We retrospectively investigated the long-term results of percutaneous radiofrequency thermocoagulation (RFT) using fluoroscopic image-guidance for treatment of trigeminal neuralgia. Methods : A total of 38 patients diagnosed and treated with RFT as an idiopathic trigeminal neuralgia were investigated. To minimize the risks related to conventional technique based on cutaneous landmarks, and to eliminate the need to frequent reposition of cannula, we adopted a technique of image-guided fluoroscopic cannulation of the foramen ovale. To minimize sensory complication following thermal lesion, our target response was a generation of a lesion with mild to moderate hypalgesia rather than dense hypalgesia. Results : The immediate pain-relief was achieved in all patients underwent RFT. With mean duration of follow-up of 38.2 months (range,12-72), 11 (28.9%) experienced recurrence of pain. The mean timing of recurrence was 26.1 months (range,12-46). A 42.7% recurrence rate was estimated by Kaplan-Meier analysis for the 38 patients at 46 months; 20.2% within 2 years, 29.1% within 3 years. In the long-term, 27 patients (71%) and 6 patients (15.8%) showed Barrow Neurological Institute (BNI) score I and BNI score II responses. Three (7.9%) patients was assessed as BNI score III, 2 patients (5.3%) showed BNI score IV response. As a complication, troublesome dysesthesia occurred in 3 of 38 patients (7.9%), however, there was no permanent cranial nerve palsy or morbidity. Conclusion : These results indicates that RFT under fluoroscopic image-guided cannulation of foramen ovale is a safe, effective, and reliable means of treating trigeminal neuralgia.

Extracorporeal Membrane Oxygenation in the Patient with Cardiopulmonary Resuscitation Failure after Open Heart Surgery. - A case report - (개심술 후 심폐소생술 실패환아에서의 체외막산소화 치험 1례)

  • 전희재;성시찬;우종수;이혜경
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.53-57
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    • 1999
  • We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.

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Direct Cannulation of a Calvarial Diploic Vein for Embolization of a Symptomatic Intraosseous Arteriovenous Fistula: A Case Report (두개관 판사이정맥의 직접 관삽입술을 통한 유증상 골내 동정맥루의 색전술: 증례 보고)

  • Jung In Jo;Chang-Woo Ryu;Hak Cheol Ko;Hee Sup Shin
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.712-718
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    • 2022
  • Diploic arteriovenous fistulas (AVFs) or intraosseous dural AVFs are rare arteriovenous shunts. A diploic AVF is formed between a meningeal artery and an intraosseous diploic vein or the transosseous emissary vein, and the nidus is located exclusively within the bone. Currently, endovascular embolization with a transvenous approach is considered the treatment of choice for most dural AVFs. However, in the absence of an accessible venous channel, an alternate treatment approach should be considered. Herein, we report a case of a diploic AVF that was treated using embolization with transosseous direct cannulation.

Iatrogenic Iliac Vein Injury Following Extracorporeal Membrane Oxygenation Cannulation in a Patient with May-Thurner Syndrome: A Case Report and Literature Review (May-Thurner 증후군 환자에서 체외막산소공급 삽관 중 발생한 의인성 장골 정맥 손상: 증례 보고 및 문헌고찰)

  • Seok Jin Hong;Sang Min Lee;Jung Ho Won
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.244-249
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    • 2021
  • A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous cannulation through the left femoral vein, a vascular injury was suspected, and the patient's vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in a patient with an unrecognized anatomical variant, May-Thurner syndrome.

Comparative Enzymatic Hydrolysis of Bacillus amyloliquefaciens DS11 Phytase and Aspergillus ficuum Phytase in the Cannulated Pigs (Cannula를 장착한 돼지에서 Bacillus amyloliquefaciens DS11 Phytase와 Aspergillus ficuum Phytase의 역가 비교)

  • 장범수;박승춘;윤효인
    • Journal of Veterinary Clinics
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    • v.18 no.1
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    • pp.18-21
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    • 2001
  • In this study, we assessed the efficacy of a novel B. amyloliquefacience DS11 phytase (DS11 phytase) and that of a commercial Aspergillus ficcum phytase (AF phytase) through their bioavailabilities of phytin-posphorus and -calcium in the diet using cannulated pigs. For the purpose of evaluating the efficacy of the phytases in pigs, we determined phosphorous concentrations from serum and feces, in addition to ingesta obtained from the cannula at the terminal ileum. As results, phosphorus concentration was lower in feces from DS11 group and BASF group by 17% and 10%, and higher in serum from the respective groups by 34% and 20%, as compared to the control group. Both phytases are evaluated to enhance phosphorus availability to the great extent. Calcium concentration of feces were lower in DS11 group and BASF group by 31% and 10%, than that in the control. Calcium concentration of serum was higher in DS11 phytase group by 4% but lower in AF phyase group by 3%, then that in the control group.

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Retrograde Cerebral Perfusion in the Surgical Treatment of Ascending Aortic Aneurysm -Report of 4 Cases- (역행성 뇌혈 관류를 이용한 상행대동맥류 수술 -4례 보고-)

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.788-791
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    • 1995
  • Dissecting aortic aneurysm of ascending aorta is a life threatening condition which requires prompt surgical correction. With deep hypothermic circulatory arrest and retrograde cerebral perfusion via superior vena cava, we could replaced ascending aorta in 4 cases safely. All of 4 cases; femoral artery, right auricle were used as cannulation site. The duration of circulatory arrest were 28, 30, 45, 60 minute in each cases and rectal temperature was 2$0^{\circ}C$ at that time. At the time of retrograde cerebral perfusion, we maintained central venous pressure under 25mmHg. We resected all of dissecting portion and replaced it with Hemashield graft. There were no deaths but two of four reoperated because of bleeding.

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Avoiding Venous Anastomotic Dehiscence of an Arteriovenous Graft in a Super-Obese Patient

  • Bae, Miju
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.417-419
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    • 2020
  • Surgeons avoid creating arteriovenous fistulae in obese patients owing to deep vessels, cannulation complications, and inconsistent outcomes. We describe placing an arteriovenous polytetrafluoroethylene (PTFE) graft between the brachial artery and axillary vein to avoid these complications. A 39-year-old super-obese woman with end-stage renal disease had undergone several hemodialysis access procedures on both arms. We traced the course of the arteriovenous graft course with the patient sitting and lying down. The ideal course was more accurate with the patient sitting; thus, the patient sat when the course was drawn, before lying on the operating bed. The PTFE graft was placed between the right brachial artery and axillary vein, according to the course in the opposite arm. No anastomotic dehiscence or pseudoaneurysm has taken place during 2 years of follow-up. In super-obese patients, the ideal course for arteriovenous grafts should be drawn while they are sitting, avoiding skin folds. This tip could avoid anastomotic dehiscence and pseudoaneurysm between the axillary vein and a PTFE graft.

Delayed Treatment of Iatrogenic Brachial Arteriovenous Fistula

  • Youn, Young-jin;Kim, Chang Wan;Park, Il Hwan;Byun, Chun Sung
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.408-410
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    • 2020
  • Iatrogenic vascular injuries may occur during venipuncture, arterial cannulation, or catheterization procedures. Brachial arteriovenous fistula (AVF) resulting from antecubital vascular access is rare and develops slowly. We report the case of an 18-year-old man who had developed iatrogenic brachial AVF. He had a history of several venipunctures in the left arm at the age of 10 months. Doppler ultrasonography and computed tomographic angiography were used to establish a diagnosis of brachial AVF, and surgical correction of the AVF was performed. As our case indicates, delayed surgery can be considered as a treatment option and may be associated with a decreased risk of vascular complications in the management of iatrogenic brachial AVF in infants.