• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.230-234
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• 2024

Interventional recanalization is an effective treatment option for postoperative portal vein occlusion. A transhepatic or transsplenic approach is preferred, whereas a percutaneous transmesenteric route enables antegrade cannulation. Here, we present a case of successful percutaneous transmesenteric recanalization in a patient with a postoperative portal vein graft occlusion.

• Journal of Chest Surgery
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• v.39 no.7 s.264
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• pp.505-510
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• 2006

Background: Small animal cardiopulmonary bypass (CPB) model would be a valuable tool for investigating path-ophysiological and therapeutic strategies on bypass. The main advantages of a small animal model include the reduced cost and time, and the fact that it does not require a full scale operating environment. However the rat CPB models have a number of technical limitations. Effective maintenance and control of core temperature by a heat exchanger is among them. The purpose of this study is to confirm the effect of rectal temperature maintenance using a heat exchanger of cardioplegia system in cardiopulmonary bypass model for rats. Material and Method: The miniature circuit consisted of a reservoir, heat exchanger, membrane oxygenator, roller pump, and static priming volume was 40 cc, Ten male Sprague-Dawley rats (mean weight 530 gram) were divided into two groups, and heat exchanger (HE) group was subjected to CPB with HE from a cardioplegia system, and control group was subjected to CPB with warm water circulating around the reservoir. Partial CPB was conducted at a flow rate of 40 mg/kg/min for 20 min after venous cannulation (via the internal juglar vein) and arterial cannulation (via the femoral artery). Rectal temperature were measured after anesthetic induction, a ter cannulation, 5, 10, 15, 20 min after CPB. Arterial blood gas with hematocrit was also analysed, 5 and 15 min after CPB. Result: Rectal temperature change differed between the two groups (p<0.01). The temperatures of HE group were well maintained during CPB, whereas control group was under progressive hypothermia, Rectal temperature 20 min after CPB was $36.16{\pm}0.32^{\circ}C$ in the HE group and $34.22{\pm}0.36^{\circ}C$ in the control group. Conclusion: We confirmed the effect of rectal temperature maintenance using a heat exchanger of cardioplegia system in cardiopulmonary bypass model for rats. This model would be a valuable tool for further use in hypothermic CPB experiment in rats.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.133-138
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• 2011

Extracorporeal membrane oxygenation (ECMO) has been utilized in congenital diaphragmatic hernia (CDH) patients with severe respiratory failure unresponsive to conventional medical treatment. We retrospectively reviewed 12 CDH patients who were treated using ECMO in our center between April 2008 and February 2011. The pre ECMO and on ECMO variables analyzed included gestational age, sex, birth weight, age at the time of ECMO cannulation, arterial blood gas analysis results, CDH location, timing of CDH repair operation, complications and survival. There were 9 boys and 3 girls. All patients were prenatally diagnosed. Mean gestational age was $38.8{\pm}1.7$ weeks and mean birth weight was $3031{\pm}499$ gram. Mean age at the time of ECMO cannulation was $29.9{\pm}28.9$ hours. There were 4 patients who survived. Survivors showed higher 5 min Apgar scores ($8.25{\pm}0.96$ vs. $7.00{\pm}1.20$, p=0.109), higher pre ECMO mean pH ($7.258 {\pm}0.830$ vs. $7.159{\pm}0.986$, p=0.073) and lower pre ECMO $PaCO_2$ ($48.2{\pm}7.9$ vs. $64.8{\pm}16.1$, p=0.109) without statistical significance. The hernia was located on the left side in 10 patients and the right side in 2 patients. The time interval from ECMO placement to operative repair was about 3~4 days in 5 early cases and around 24 in the remaining cases. There were 3 cases of post operative bleeding requiring re operation and 2 cases of abdominal compartment syndrome requiring abdominal fascia reopening. ECMO catheter reposition was required in 4 cases. Three cases of arterial or venous thrombosis were detected and improved with follow up. Our data suggests that ECMO therapy could save the lives of some neonates with CDH who can not be maintained on other treatment modalities. Protocolized management and accumulation of case experience might be valuable in improving outcomes for neonates with CDH treated with ECMO.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.3
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• pp.1178-1185
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• 2012

The 4th year medical students were randomly divided and designated as group HF and LF, representing high and low fidelity simulations respectfully. Both groups performed OSCE on 2 topics(adult intubation and IV cannulation) with each composed of the same scenario. Each scenario was developed by a faculty in charge of clinical skill education with supervision from 2 other faculty members. High fidelity simulations were designed as in-situ simulations in real OR. Low fidelity simulations had the same scenarios but the environment was simulated only with a simple task trainer in the classroom. All students participated in series of survey using a Likert scale before and after the simulations. The provided data was anlayzed with paired T-test and Mann-Whiteney test(p<0.05). The post simulations self evaluation score for group HF was lower than pre-simulation self confidence score for both topics of adult intubation and IV cannulation where as for group LF, it was lower only for adult intubation(p<0.05). In group HF, the needs for clinical training on both topics increased after the simulation. In group LF, there was no significant change of needs for clinical training between pre and post simulation survey. This suggest that fidelity may be a helpful factor to improve the motivation of the students and further study on economical aspect should be addressed.

• Journal of Aquaculture
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• v.21 no.2
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• pp.96-101
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• 2008

To induce of maturation and ovulation, ovary with different development stage of oocytes of sevenband grouper Epinephelus septemfasciatus(n=51, TL $69.1{\pm}1.0$ cm, BW $5.8{\pm}0.3$ kg) rearing indoor-tank in mature and spawning season(June to July) were investigated by cannulation. Female with yolk globule stage oocyte($300{\sim}500{\mu}m$) was injected with human chorionic gonadotropin(HCG, 500 IU/kg BW). Oocytes developed at diameter $300{\sim}700{\mu}m$ in 24 hrs after the HCG injection, and the distribution ratio of over $800{\mu}m$ of oocytes diameter in the cannulated eggs were $91.3{\sim}98.8%(95.1{\pm}3.7%)$ in 48 hrs after the HCG injection. Ovulation was induced from 7 out of 8 female after the HCG injection. The total volume of stripped eggs was 2,480 mL, and the volume of buoyant eggs was 1,360 mL. The fertilization and hatching rates of buoyant eggs were $56.2{\sim}94.9%$ and $70.7{\sim}97.9%$, respectively. These results suggested that HCG 500 IU/kg BW effects on maturation and ovulation of female sevenband grouper with yolk globule stage of oocyte.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.500-506
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• 2018

This study analyzed current prehospital emergency care for severe trauma patients administered by different number of 119 EMS (emergency medical services) teams. Out of 1,067 severe trauma patients transferred by 119 EMS teams in J province from January 1st to December 31st 2015, 438 were evaluated in this study. IBM SPSS Statistics 21.0 was used to analyze collected data. The number of patients with severe trauma during the period of study was higher in male with two and three ambulance crews of 119 EMS teams with 242 patients (70.6%) and 66 patients (69.5%) respectively. The percentage of transfers made to local emergency medical centers was highest in those two groups, being 44.0% (151 patients) and 49.5% (47 patients), respectively. Total time spent at the scene did not differ between ambulance crews of two and three, nor did the frequency of practicing advanced airway management and IV (intravenous) cannulation, or the success rate of IV cannulation (p=0.253, p=0.362, p=1.000). Overall, the results indicated that merely increasing the number of paramedics does not improve the quality of prehospital care for severe trauma patients. Measures such as securing professional paramedics, simplifying direct medical oversights, activating indirect medical oversights, and expanding the legally allowed work scope are required.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1342-1346
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• 1996

A right thoracotomy was used for the reoperation or mitral valve of 15 patients who had previously undergone a cardiac operation through a median sternotomy. In our experience. this approach provided dn excellent exposure of the nlitral valve and easy cannulations of both cavie with minimal dissection, ilvoiding any damage of cardiac and major vessels during re-sternotomy Arterial cannulation was performed in the ascending aorta in 13 patients And in the femoral artery in 2 patients. In earlier cases, venous cannulation was done in the SVC And IVC through the right atrium and snared. In later cases, this could be done without snaginly of both cavae or by placing a silgle light-angled catheter into the right atrium. Crystalloid cardioplegic solution was infused for myocardial protection. Hypothermia was controlled at 20\ulcorner$25^{\circ}C$. For defibrillation, internal paddles were used In one patient while sterilized external paddles were used in 10 patients. In the remaining four patients. however. the heart beat spontaneously The respirator could be weaned within 48 hours alter the operation and no pulmonary complication was observed. One out of the 15 patients expired due to sudden attack of ventricular tarchycardid developed ten days after the operation, but the rest of the patients were discharged with good condition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.131-141
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• 2020

The purpose of this study is to compare the effects on nursing students' knowledge, performance confidence, and skills from combined virtual IV simulator and mannequin arm IV cannulation training against training with a mannequin arm only. A non-equivalent control group pretest-posttest experimental study was carried out. Ninety-three sophomore nursing students who were just beginning their fundamental skills training were recruited. Participants were divided into two groups (46 for the combined group and 47 for the mannequin-only group). Data were collected from March 18-29. For the experimental group, both virtual IV simulator and mannequin-arm training were provided for 30 minutes (15 minutes each). For the control group, training for 30 minutes with a mannequin arm only was provided. After intervention, there was no statistically significant difference in the knowledge score between the two groups (F=2.52, p=.116). However, there was a significant improvement in performance confidence (t=2.14, p=.035) and nursing skills (t=5.34, p<.001) in the experimental group, compared with the control. Overall, this study provides empirical evidence that the combination of virtual IV simulator and mannequin arm training may further enhance nursing students' performance confidence and nursing skills.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.468-472
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• 2014

Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management.

• Advances in pediatric surgery
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• v.1 no.1
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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.