• Title/Summary/Keyword: the external drainage

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Percutaneous Tunnel Ventriculostomy for the Hydrocephalus Complicated with Ventriculitis - Case Report - (뇌실염이 합병된 수두증환자에서 피하터널 조루술 - 증례보고 -)

  • Hwang, Sung-Nam;Cho, Jae-Young;Park, Seung-Won;Kim, Young-Baeg;Choi, Duck-Young
    • Journal of Korean Neurosurgical Society
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    • v.30 no.7
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    • pp.939-942
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    • 2001
  • Thirty nine-year-old man who required urgent shunt operation due to rapidly deteriorating visual acuity suffered from ventriculitis after aneurysmal operation. Daily dose of 20mg of vancomycin and amikyn were given intraventricularly via external ventricular catheter after failure of various kinds of systemic antibiotics. The exit of the catheter was made on the upper chest wall to prevent superinfection. External ventricular drainage could finally be switched to ventriculo-peritoneal shunt and he was discharged with clinical improvement.

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Multiple Intracranial Calcifications as a Complication of External Ventricular Drain Placement

  • Ji, Cheol;Ahn, Jae-Gun
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.158-160
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    • 2010
  • The authors present a case of multiple intracranial calcifications after the procedure of external ventricular drain placement in a 50-year-old man with pericallosal artery aneurysm. We believe that calcifications formed dust that had fallen into the track during the external ventricular drain procedure. The clinical features and radiological findings are presented with review of literature.

General Inundation Modeling of Paddy Field Districts Considering Drainage Delay (배수지연을 고려한 논 지구의 범용 침수 모의 기법 개발)

  • Jun, Sang Min;Lee, Hyun Ji;Hwang, Soon Ho;Song, Jung-Hun;Choi, Soon-Kun;Kang, Moon Seong
    • Journal of The Korean Society of Agricultural Engineers
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    • v.61 no.4
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    • pp.87-96
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    • 2019
  • The objective of this study was to develop a general inundation modeling technique considering the effect of drainage delay in the paddy field districts. In most studies, farmland inundation simulations have been conducted using previously developed watershed models. However, the water cycle in the paddy fields has a different structure from that of the general watershed, and the effect of the drainage delay should be considered. In this study, the drainage delay algorithm was developed using water balance equation, and the inundation modeling was performed for inundation-prone paddy fields located near Doowol stream. As a result, the depth of inundation was 43.1 cm and 45.2 cm, respectively, due to the 100-year and 200-year frequency rainfall. With the operation of drainage pump ($0.1m^3/s$), inundation depths decreased by 5.8 cm and 6.0 cm, respectively, and inundation time reduced by 20 hours and 21 hours, respectively for the 100-year and 200-year frequency rainfall. The result showed that the general inundation modeling technique developed in this study could reflect the effect of drainage delay due to the rise of external water level and the flooding reduction effect by operation of drainage pump. The results of this study are expected to be useful to establish measures for damage caused by farmland inundation.

Chest Tube Drainage of the Pleural Space: A Concise Review for Pulmonologists

  • Porcel, Jose M.
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.106-115
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    • 2018
  • Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (${\leq}14F$) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains. Chest tube insertion should be guided by imaging, either bedside ultrasonography or, less commonly, computed tomography. The so-called trocar technique must be avoided. Instead, blunt dissection (for tubes >24F) or the Seldinger technique should be used. All chest tubes are connected to a drainage system device: flutter valve, underwater seal, electronic systems or, for indwelling pleural catheters (IPC), vacuum bottles. The classic, three-bottle drainage system requires either (external) wall suction or gravity ("water seal") drainage (the former not being routinely recommended unless the latter is not effective). The optimal timing for tube removal is still a matter of controversy; however, the use of digital drainage systems facilitates informed and prudent decision-making in that area. A drain-clamping test before tube withdrawal is generally not advocated. Pain, drain blockage and accidental dislodgment are common complications of small-bore drains; the most dreaded complications include organ injury, hemothorax, infections, and re-expansion pulmonary edema. IPC represent a first-line palliative therapy of malignant pleural effusions in many centers. The optimal frequency of drainage, for IPC, has not been formally agreed upon or otherwise officially established.

The Analysis of the Need Rate of Shunt and the Outcome in Hydrocephalus Following SAH - Relationship between the Outcome and the Duration, Daily and Total Amount of CSF Drainage at EVD - (자발성 지주막하출혈 후 발생하는 수두증에 대한 단락술의 필요성 및 예후에 관한 분석 - 뇌실외배액술의 기간, 일일배액량 및 총배액량과 예후관계 -)

  • Lee, Won Chang;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.99-107
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    • 2001
  • Objective : Hydrocephalus and vasospasm are the common complications following subarachnoid hemorrhage (SAH). In spite of development of perioperative management and operative technique, hydrocephalus cause neurological deficit and poor prognosis. Usually CSF drainage procedure(external ventricular drainage(EVD) or shunt) is needed in hydrocephalus following SAH. The aim of this study was to investigate whether the need for shunting and the outcome after shunting in hydrocephaus following SAH can be related to the duration, daily and total amount of cerebrospinal fluid(CSF) drainage at EVD. Material and Method : IVH is one of several factors which cause hydrocephalus. In this retrospective study, firstly we investigated the incidence of IVH in total cases and frequency of IVH according to aneurysmal site and then prognosis of IVH following SAH. Among 629 patients with SAH, hydrocephalus was diagnosed by CT scan and symptoms. And then those 102 hydrocephalus following SAH were divided into two groups which were hydrocephalus with IVH group and without IVH group. In these two groups, we investigated and compared the incidence of hydrocephalus in all case, frequency of hydrocephalus according to aneurysmal site, the outcome according to H-H grade on admission and the need rate of shunt, etc. Of those hydrocephalus, 100 EVD procedures were done. The duration, daily and total amount of CSF drainage at EVD were investigated. Fifty cases expired during EVD was excluded. We analyzed whether the need rate of shunt and the final outcome after shunting can be related to IVH, the duration and daily and total amount of CSF drainage. Result : The incidence of hydrocephalus following SAH was 20%(with IVH group ; 64%, without IVH group ; 11%). As H-H grade on admission was better, the outcome of hydrocephalus was also better. The mortality rate of hydrocephalus with IVH was 64% which was higher than 40% that of hydrocephalus without IVH. The need rate of shunt in all cases of hydrocephalus following SAH was 20%, but those with IVH group excluding expired patients before shunt was 40%. This was very similar to 41% of the need rate of shunt in hydrocephalus without IVH. The total amount of CSF drainage was statistically related to the need rate of shunt(total amount : need rate of shunt/<1000cc : 15%, 1000-2000cc : 40%, >2000cc : 50%). The duration and daily amount of CSF drainage were not statistically related to the need rate of shunt, but as daily amount of CSF drainage was more and duration was longer, the need rate of shunt was increased(daily amount : need rate of shunt /<100cc : 16%, 100-200cc : 25%, >200cc : 40%//duration : need rate of shunt/<1week : 8%, 1-2weeks : 30%, >2weeks : 47%), and also the final outcome after shunting was poor. Especially the total amount of CSF drainage was significant related to the final outcome after shunting(total amount : GOS/<1000cc : I&II(3/4), 1000-2000cc : II(2/4), III(2/4), >2000cc : III&IV(6/7)). Conclusion : This study revealed that the incidence and mortality rate of hydrocephalus following SAH were influenced by IVH. So SAH associated IVH has the higher incidence of hydrocephalus and poor outcome. As the CSF drainage amount was more and duration of drainage was longer, the need rate of shunt was increased and the final outcome after shunting was poor. Especially the total amount of CSF drainage were strongly related to the need rate of shunt and the outcome after shunting.

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Status of Water Infrastructure and Future Tasks in Jeollabuk-do Province(Focussed on the Mangyeong River and Dongjin River) (전라북도 물이용 체계 및 과제(만경강과 동진강 중심으로))

  • Kim, Boguk
    • Journal of Korean Society of Water and Wastewater
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    • v.36 no.5
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    • pp.289-296
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    • 2022
  • Mangyeong River and Dongjin River are highly dependent on external regions for domestic and agricultural water, and the agricultural water supply and use system of those rivers are very complicated. For smooth water supply, rivers are used as a supply system. Of the total river water use permits (as of 2019), agricultural water accounts for 97.5%, 80.4% in Mangyeong River and Dongjin River, respectively. The excessive intake of river water as agricultural purpose is causing the stream to dry out and to deteriorate the ecological health of the river. It is necessary to minimize the water use system that takes in and utilizes river water. In both rivers, the flow rate of agricultural drainage and the load of major water quality items that flowing into the main stream are similar to or higher than those of the major tributaries, indicating that management is necessary to improve the water quality of the river. It is necessary to understand the effect of agricultural drainage on river water quality by establishing a continuous monitoring system for the form of agricultural drainage.

The Role of Lumbar Drainage to Prevent Shunt-Dependent Hydrocephalus after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage in Good-Grade Patients

  • Yong, Cho-In;Hwang, Sung-Kyun;Kim, Sung-Hak
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.480-484
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    • 2010
  • Objective : To evaluate the role of lumbar drainage in the prevention of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by coil embolization in good-grade patients. Methods : One-hundred-thirty consecutive patients with aneurysmal subarachnoid hemorrhage in good-grade patients (Hunt & Hess grades I-III), who were treated by coil embolization between August 2004 and April 2010 were retrospectively evaluated. Poor-grade patients (Hunt & Hess grades IV and V), a history of head trauma preceding the development of headache, negative angiograms, primary subarachnoid hemorrhage (SAH), and loss to follow-up were excluded from the study. We assessed the effects on lumbar drainage on the risk of shunt-dependent hydrocephalus related to coil embolization in patients with ruptured intracranial aneurysms. Results : One-hundred-twenty-six patients (96.9%) did not develop shunt-dependent hydrocephalus. The 2 patients (1.5%) who developed acute hydrocephalus treated with temporary external ventricular drainage did not require permanent shunt diversion. Overall, 4 patients (3.1%) required permanent shunt diversion; acute hydrocephalus developed in 2 patients (50%). There was no morbidity or mortality amongst the patients who underwent a permanent shunt procedure. Conclusion : Coil embolization of ruptured intracranial aneurysms may be associated with a lower risk for developing shunt-dependent hydrocephalus, possibly by active management of lumbar drainage, which may reflect less damage for cisternal anatomy than surgical clipping. Coil embolization might have an effect the long-term outcome and decision-making for ruptured intracranial aneurysms.

The Utility and Benefits of External Lumbar CSF Drainage after Endovascular Coiling on Aneurysmal Subarachnoid Hemorrhage

  • Kwon, Ou-Young;Kim, Young-Joon;Kim, Young-Jin;Cho, Chun-Sung;Lee, Sang-Koo;Cho, Maeng-Ki
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.281-287
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    • 2008
  • Objective : Cerebral vasospasm still remains a major cause of the morbidity and mortality, despite the developments in treatment of aneurysmal subarachnoid hemorrhage. The authors measured the utility and benefits of external lumbar cerebrospinal fluid (CSF) drainage to prevent the clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage in this randomized study. Methods : Between January 2004 and March 2006, 280 patients with aneurysmal subarachnoid hemorrhage were treated at our institution. Among them, 107 patients met our study criteria. The treatment group consisted of 47 patients who underwent lumbar CSF drainage during vasospasm risk period (about for 14 days after SAH), whereas the control group consisted of 60 patients who received the management according to conventional protocol without lumbar CSF drainage. We created our new modified Fisher grade on the basis of initial brain computed tomography (CT) scan at admission. The authors established five outcome criteria as follows : 1) clinical vasospasm; 2) GOS score at 1-month to 6-month follow-up; 3) shunt procedures for hydrocephalus; 4) the duration of stay in the ICU and total hospital stay; 5) mortality rate. Results : The incidence of clinical vasospasm in the lumbar drain group showed 23.4% compared with 63.3% of individuals in the control group. Moreover, the risk of death in the lumbar drain group showed 2.1 % compared with 15% of individuals in the control group. Within individual modified Fisher grade, there were similar favorable results. Also, lumbar drain group had twice more patients than the control group in good GOS score of 5. However, there were no statistical significances in mean hospital stay and shunt procedures between the two groups. IVH was an important factor for delayed hydrocephalus regardless of lumbar drain. Conclusion : Lumbar CSF drainage remains to playa prominent role to prevent clinical vasospasm and its sequelae after endovascular coiling on aneurysmal subarachnoid hemorrhage. Also, this technique shows favorable effects on numerous neurological outcomes and prognosis. The results of this study warrant clinical trials after endovascular treatment in patients with aneurysmal SAH.

Clinical Analysis of External Ventricular Drainage Related Ventriculitis

  • Moon, Hong-Joo;Kim, Sang-Dae;Lee, Jang-Bo;Lim, Dong-Jun;Park, Jung-Yul
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.236-240
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    • 2007
  • Objective : The aim of this study is to analyze on the external ventricular drainage [EVD] related ventriculitis, especially on their risk factors, management, and prevention. Methods : From January 2003 to December 2005, a total of 174 EVD catheters were placed in 112 patients at our institution. Of these patients, EVD-related ventriculitis were developed in 15 cases. Clinical variables such as age, sex, prior clinical diagnosis, placement of EVD insertion, duration of EVD, total numbers of EVD per person, and outcome were analyzed in theses cases to verify the risk factors, causative agents and outcomes. Results : Fifteen cases of EVD related ventriculitis were noted presenting infection incidence of 13.39 % per patient and 8.62% per procedure. Of these, five patients died from sepsis, seven patients were recovered from infection but neurological complications remained and three patients were recovered without any complications. Microbes were obtained from cerebrospinal fluid only in six patients. Acinetobactoer baumanii was the most common pathogen in our study [4 cases]. Among the various risk factors, only the prior clinical diagnosis showed the statistical significance. Patients who underwent decompressive craniectomy after severe brain trauma showed unfavorable outcome because of possible contaminative environment compared with other cases. Conclusion : EVD is considered as a safe procedure with good control of intracranial pressure if meticulous care is provided for EVD procedure and maintenance. With regards to risk factors and prevention, the higher incidence and unfavorable outcome was seen especially in patients with severe head trauma. Thus, special attention is required in these clinical settings.

An experimental study on the effect of deterioration of drainage system on tunnel structures (배수시스템 수리기능저하가 터널구조물에 미치는 영향에 대한 실험적 연구)

  • Kwon, Oh-Yeob;Shin, Jong-Ho;Yang, Yu-Hong;Joo, Eun-Jung
    • Proceedings of the Korean Geotechical Society Conference
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    • 2006.03a
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    • pp.970-979
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    • 2006
  • Construction of underground structure requires higher standard of planning and design specifications than in surface construction. However, high construction cost and difficult working environment limit design level and construction quality. One of the most sensitive factors to be considered are infiltration and external pore-water pressures. Development of pore-water pressure may accelerate leakage and cause deterioration of the lining. In this paper, the development of pore-water pressure and its potential effect on the linings are investigated using physical model tests. A simple physical equipment model with well-defined hydraulic boundary conditions was devised. The deterioration procedure was simulated by controlling both the permeability of filters and flowrate. Development of pore-water pressure was monitored on the lining using pore pressure measurement cells. Test results identified the mechanim of pore-water pressure development on the tunnel lining which is the effect of deterioration of drainage system. The laboratory tests were simulated using coupled numerical method, and shown that the deterioration mechanism can be reproduced using coupled numerical modelling method.

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