• Title/Summary/Keyword: 천자

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A Comparative Study of Two Different Heel Lancet Devices for Blood Collection in Preterm Infants (미숙아에서 채혈을 위한 발뒤꿈치 천자시 두 종류 천자 기구의 비교)

  • Lim, Hyo-Bin;Rhu, Mi-Joo;Jung, Ji-Mi;Jeon, Ga-Won;Sin, Jong-Beom
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.239-244
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    • 2010
  • Purpose: To evaluate two different heel lancet device in terms of pain response and success of the procedure in the preterm infants undergoing heel puncture. Methods: 100 preterm infants undergoing capillary blood gas analysis or capillary bilirubin monitoring underwent heel puncture, were randomly allocated to blood sampling from the heel with either a conventional manual lancet or an automatic incision device. Primary outcome measures included the Premature Infants Pain Profile (PIPP) score, total duration of procedure, number of heel puncture and number of bruise. The pain response was evaluated using PIPP score and the effectiveness was evaluated using three criteria: total duration of blood sampling, number of puncture, bruising of the heel or ankle. Statistical analysis was performed using the SPSS ver. 13.0 program. Difference between the groups were analysed with t test (continuous variables) and the Chi square test or Fisher test (categorical variables). Results: The mean PIPP score was 4.91 for the automatic lancet group compared with 5.84 for the conventional manual lancet group (P=0.0255).The number of pain scores above 7 during blood collection did not differ between two groups (P=0.2167). The procedure took less time to perform in the automatic lancet group (mean, 30.69 seconds) than in the conventional lancet group (mean, 48.92 seconds) (P<0.0001). Conclusion: This study demonstrated that the automatic lancet device causes less pain and a shorter procedure time than the conventional manual lancet in preterm infants undergoing heel puncture. On the basis of these results the automatic lancet device is very useful method for blood collection in preterm infants by heel puncture.

Analysis of the factors influencing headache and backache following lumbar puncture (요추 천자 후 발생하는 두통 및 요통에 영향을 주는 요인의 분석)

  • Lee, Sang Taek;Chung, Sochung;Park, Yong Mean;Bae, Sun Hwan;Yu, Jeong Jin;Lee, Ran
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.856-860
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    • 2008
  • Purpose : This study aimed to examine the factors influencing the appearance of headache and backache following diagnostic lumbar puncture in children, focusing on the need for strict bed rest after lumbar puncture. Methods : We studied 70 two-fifteen-year-old pediatric patients who underwent diagnostic lumbar puncture from July 2005 to July 2007 at Konkuk University Hospital. We divided them into two groups. Patients in the first group (n=24) were allowed free mobility and patients in the second group (n=46) were to have strict bed rest for four hours after puncture. Data were analyzed by age, sex, number of puncture attempts, cell counts and pressure in the cerebrospinal fluid (CSF), duration of bed rest, and occurrence of headache and backache. Results : The rate of complications was not significantly related to sex, age, presence of enterovirus, CSF pressure, or postural headache. The occurrence of headache was significantly correlated with white blood cell (WBC) count in CSF (P=0.043). Symptom frequency did not differ significantly between the groups. Backache was significantly related to the frequency of puncture attempts (P=0.046). Conclusion : Strict bed rest following diagnostic lumbar puncture in children does not influence headaches and backaches. These are respectively related to the WBC count on the CSF profile and the frequency of attempts. Therefore, after lumbar puncture, absolute bed rest is not necessary and patients are more comfortable with free mobility.

Clinical Value of fine Needle Aspiration Biopsy in Head and Neck Masses (두경부 종물에 대한 세침천자생검의 임상적 의의)

  • 김성근;강성호;김경래;이형석;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.103-103
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    • 1993
  • Fine needle aspiration biopsy(FNAB) is widely used in screening of head and neck(H&N) masses because it has high accuracy and few damage. The 235 cases of FNAB were performed on patient with H&N mass at the Department of Otolaryngology, Hanyang University Hospital during 1 years, from March 1985 to February 1992. The 188 of 235 were proven histologically, clinically. The results obtained were as follows ; 1) FNAB for malignant H&N mass shows sensitivity of 81.5% specificity of 96.8%. 2) FNAB for malignant LN shows sensitivity of 86.0%, specificity of 88.9%. 3) FNAB for salivary gland shows sensitivity of 66.7%, specificity 81.8%. 4) FNAB for soft tissues, bone, and intraoral lesions shows sensitivity of 90%, specificity 95.8%. 5) FNAB for tuberculosis shows false negative of 55.2%. 6) The result of FNAB was not closely related with location or size of neck nodes.

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Miocene Volcanic Rocks Over the Area of Chenonja-bong and Siru-bong, Jinhae (1): Petrography and Petrochemical Characteristics (진해 천자봉-시루봉 일원에 분포하는 마이오세 화산암 (1): 암석기재와 암석화학적 특징)

  • Ryoo, Sam-Hyung;Jeong, Yun-Gi;Lee, Sang-Won;Sung, Jong-Gyu;Ryoo, Chung-Ryul
    • The Journal of the Petrological Society of Korea
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    • v.17 no.2
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    • pp.108-131
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    • 2008
  • The Miocene andesite and basalt intruded into and/or extruded on the Cretaceous volcanic and granitic rocks over the area of Chenjabong and Sirubong in the vicinity of Jinhae, southern part of Kyongsang basin. The K-Ar ages of the younger volcanic rocks are from 16 Ma (Sirubong andesite) to 10 Ma (Cheonjabong basalt), which indicate the Miocene volcanism in the outer part of the Tertiary basin in the Korean peninsula. The volcanics are divided into Chenjabong andesite, Cheonjabong basaltic andesite, Sirubong andesite and Cheonjabong basalt. The Cheonjabong andesite is composed of phenocrysts of clinopyroxene and plagioclase ($An_{60{\sim}64}$) and groundmass with lath-like plagioclase ($An_{76{\sim}84}$) and glass. The Cheonjabong basaltic andesite is composed of plagioclase phenocryst ($An_{60{\sim}64}$) with plagioclase lath ($An_{65}$) and glass in groundmass. The Sirubong andesite is only consisted of plagiocalse lath ($An_{64{\sim}68}$) and glass with absence of phonocryst. The Cheonjabong basalt shows typical porphyritic texture with phenocrysts of olivine ($Fo_{69-84}$) and clinopyroxene. The groundmass of the Cheonjabong basalt is composed of microphenocrysts of olivine, clinopyroxene and plagioclase ($An_{66{\sim}71}$) and plagioclase laths ($An_{57{\sim}65}$) showing pillotaxitic and intergranular texture. The Cheonjabong andesite, Cheonjabong basaltic andesite, Sirubong andesite are belong to calc-alkialine but the Cheonjabong basalt is alkaline basalt. By tectonic discrimination diagrams the parental magmas of the volcanic rocks have occurred boundary.

Fungal Psoas Abscess Successfully Treated by Ultrasonographically Guided Percutaneous Aspiration - A Case Report - (진균성 요근 농양의 초음파 유도하 경피적 천자술을 통한 성공적 치료 - 증례보고 -)

  • Moon, Sang-Ho;Kim, Jin-Hak;Lee, Song;Ahn, Dong-Ki;Kim, Dae-Geun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.36-40
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    • 2012
  • Although surgical drainage has been performed in most reported cases of psoas abscess, ultrasonographically guided percutaneous drainage could be effective treatment for psoas abscess. However, utility of percutaneous drainge under ultrasound is less well established. We present a patient in whom fungal psoas abscess was managed by ultrasonographically guided percutaneous aspiration with literature review. Drainage was done by needle aspiration under ultrasound guidance and there was no procedural complication. After aspiration, Candida Albicans was found as a causing organism responsible for abscess and abscess could be successfully treated by repeated aspiration and appropriate antifungal therapy.

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Inadvertent Dural Puncture during Epidural Block (경막외 차단시의 경막천자)

  • Kang, Keum-Ye;Min, Ki-Chul;Kim, Dong-Chan;Choe, Huhn
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.203-206
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    • 1988
  • Evaluation of inadvertent dural puncture occuring among 308 epidural blocks done for the relief of pain from various conditions was performed. Dural puncture was suspected in 5 out of 308 epidural bloks. (1.6%) Aspiration of CSF was negative in 3 cases in which dural puncture was suspected only after developing spinal anesthesia. Of the 3 negative CSF aspirations, one case had a history of laminectomy. Adhesions of the adjacent tissues might result in the loss of flexibility and a decrease in potential epidural space which might cause dural tearing during injection and subarachoid injection of the local anesthetic followed by high spinal anesthesia. In another case, the needle tip was obstructed by tissue which led to negative aspiration of CSF and failure to feel loss of resistance. The second injection at the same site may cause subarachnoid injection of the local anesthetic through the previously perforated dura mater and in turn, lead to spinal anesthesia. In the last case, there was no reason to suspect dural puncture since the loss of resistance plus air rebound were definite and aspiration of CSF was negative, but dural puncture was suspected after the patient developed spinal anesthesia.

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Diagnostic Approach to a Patient with a Pleural Effusion Including Ultrasound-guided Paracentesis Performed by a Medical Resident (내과 전공의가 시행한 초음파 이용 흉수천자를 포함한 흉수의 진단적 접근)

  • Lee, Yun Young;Choi, Won Je;Yu, Chang Min;Suh, Seong O;Kim, Eun Sil;Ahn, Seok- in;Chung, Jun-Oh;Park, Sang Joon;Kim, Yun Kwon;Kim, Soyon;Kim, Young Jung;Lee, Se Han;Heo, Heon
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.439-444
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    • 2008
  • Background: A patient with a pleural effusion that is difficult to safely drain by a "blind" thoracentesis procedure is generally referred to a radiologist for ultrasound-guided thoracentesis. But such a referral increases the cost and the patient's inconvenience, and it causes delay in the diagnostic procedures. If ultrasound-guided thoracentesis is performed as a bedside procedure by a medical resident, then this will reduce the previously mentioned problems. So these patients with pleural effusions were treated by medical residents at our medical center, and the procedures included bedside ultrasound-guided thoracenteses. Methods: We studied 89 cases of pleural effusions from March 2003 to June 2005. A "blind" thoracentesis was performed if the amount of pleural effusion was moderate or large. Bedside ultrasound-guided thoracentesis was performed for small or loculated effusions or for the cases that failed with performing a "blind" thoracentesis. Results: "Blind" thoracenteses were performed in 79 cases that had a moderate or large amount of uncomplicated pleural effusions and the success rate was 93.7% (74/79 cases). Ultrasound-guided thoracentesis by the medical residents was performed in 15 cases and the success rate was 66.7% (10/15 cases). The 5 failedcases included all 3 cases with loculated effusions and 2 cases with a small amount of pleural effusion. All the failed cases were referred to one radiologist and they were then successfully treated. If we exclude the 3 cases with loculated pleural effusions, the success rate of ultrasound-guided thoracentesis by the medical residents increased up to 83% (10/12cases). Two cases of complications (1 pneumothorax, 1 hydrohemothorax) occurred during ultrasound-guided thoracentesis. Conclusion: Ultrasound-guided thoracentesis performed as a bedside procedure by a medical resident may be relatively effective and safe. If a patient has a loculated effusion, then it would be better to first refer the patient to a radiologist.

A Clinical Study on Relationship of Surgical Glove and Back Pain after Lumbar Puncture in Children (소아에서 요추천자 후 발생하는 요통과 수술용 장갑과의 관계에 대한 임상적 연구)

  • Han, Sung Ryoung;Choi, Wan Suk;Lee, Hae Jeong;Kim, Hyun Seok;Lee, Ju Suk;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.310-314
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    • 2005
  • Propose : In this study, we evaluated whether powder on surgical gloves is a cause of postpuncture backpain in children. Mothods : In 164 children with meningitis between July and September 1997, we did not remove powder from surgical gloves. However, in 149 children with menigitis between May and October 2001 the powder was removed from the surgical gloves. Results : Out of the 164 patients in 1997, 41 cases(25.00%) were found to have postdural puncture backpain. On the other hand, out of 149 patients in 2001, with whom we used gloves from which the powder was removed, we found only 8 patients(5.36%) with postdural puncture backpain. Conclusion : We conclude that the powder on surgical gloves is one of the main causes of postdural puncture backpain in children.