• Journal of Chest Surgery
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• 제7권1호
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• pp.85-92
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• 1974

During the years 1959 to 1974, 99 patients with patent ductus arteriosus were admitted to National University Hospital. These includes 5 patients with additional cardiovascular and 5 patients with severe pulmonary hypertension. All were operated upon except three refused operation. In all instances, the diagnosis was made by history and physical, roentgenological and electrographic examinations. In addition, in 53 patients, special diagnostic procedures were carried out either for diagnosis or for evaluation of pulmonary hypertension and associated cardiovascular anomalies. Right cardiac catheterization was resorted to in 51 patients. In one of these patients catheterization was incorrectly interpreted [ventricular septal defect]. Retrograde aortogram was performed in two patients. In both cases the ductus itself was visualized on the x-ray film. An additional vascular anomaly, namely the persistent left superior vena cava, was confirmed by retrograde angiogram in one of them. In 5 cases the pulmonary arterial pressure was elevated well over 80 mmHg. In these instances,the operative mortality was 80% [4 out of 5 patients]. The management of patent ductus arteriosus when associated with severe pulmonary hypertension. and/or other cardiac anomalies is controversial. Opinions differ as to how to close the ductus and to repair the cardiac anomalies as well as to whether a one-staged or two-staged procedure should be resorted to. The author is of the that each case must be evaluated individually before any specific surgical treatment is ou.tlined. The literature on the subject is reviewed in this paper.

• The Korean Journal of Pain
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• 제9권1호
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• pp.271-274
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• 1996

Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

• The Korean Journal of Pain
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• 제19권2호
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• pp.164-167
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• 2006

Background: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.

• Journal of Trauma and Injury
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• 제28권2호
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• pp.83-86
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• 2015

Central venous cannulation is one of the most commonly performed procedures for critically ill patients in the emergency room. Serious complications like a rupture of subclavian artery may occur during this procedure. We report a case of successful stent graft deployment for iatrogenic ruptured subclavian artery after attempted right subclavian vein catheterization in a 31 year-old female patient with hypovolemic shock due to cervical os laceration during vaginal delivery.

• 대한수의학회지
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• 제56권3호
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• pp.177-181
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• 2016

Mini-pigs have been widely employed in preclinical studies to explore new therapeutic strategies for diseases of the human urinary system; however, the normal reference of the renal artery has not been clearly investigated in the mini-pig model. Therefore, we aimed to establish a normal reference of the radiological morphology of the renal artery in mini-pigs by renal angiography via catheterization of the carotid artery. The renal angiographies obtained from 15 mini-pigs were evaluated to determine the orifice from the aorta, facing direction, size and the number of branches of renal arteries. Cranio-laterally facing renal arteries with 2 distal branches were mainly observed in the renal artery of mini-pigs. Both sides of the renal artery presented symmetrical sizes; however, the right renal artery orifice from the aorta was located more cranially than the left counterpart. The results of this study will contribute to radiological diagnosis of the renal artery as well as preclinical studies of mini-pigs.

• 재활간호학회지
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• 제3권1호
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• pp.71-79
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• 2000

The purpose of this study was to examine the knowledge and practice of the Clean Intermittent Self Catheterization (CIC) conducted by Spinal Cord Injury Patients (SPIC) or their significant others as an activity of daily living at their homes or working places. Forty-seven patients were participated in this study. Three questionnaires developed by researchers for this study were used to collect demographic data, knowledge and practice skill of CIC. Descriptive statistics and ANOVA were used to analyze the data. Nineteen (19) patients experienced Urinary Track Infection (UTI) during the last one years and two of them have had several times of UTI. Knowledge level of the participant was not high enough to perform correct CIC. Some evidences indicated that the knowledge did not apply to their practice. Systematic analysis and development of educational content based on this study results was recommended and the systematic instructional design before actual patient education was strongly recommended.

• Journal of Chest Surgery
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• 제23권3호
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• pp.430-437
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• 1990

We clinically evaluated 121 cases of ventricular septal defect which we operated from April, 1986 to December, 1989 at Inha General Hospital, Seong-Nam, Department of Thoracic and Cardiovascular Surgery, College of Medicine, Inha University. These patients were occupied 54.8% of all congenital heart diseases operated on its same period. Of the 121 patients, 63 patients were male[52.1%] and 58 patients were female[47.9i]. The two most common symptoms were frequent upper respiratory infection and dyspnea on exertion. By Kirklin s anatomical classification, type I constituted 34.7%, type II 61.98%, type III 0.03% and type IV not occupied. Associated cardiac anomalies were found in 34 cases, and PDA was most common associated anomaly, occupied in 22 cases. On the cardiac catheterization data, there were statistically significant correlation between VSD size[cm2 /BSAm2] and systolic pulmonary arterial pressure[sPAP], pulmonary to systemic flow ratio[Qp/Qs] & pulmonary to systemic pressure ratio[Pp/Ps] respectively, Type II [r=0.53, p<0.01] was more correlated than type I [r=0.49, p<0.05] between VSD size and Qp /Qs. We could not found the correlationship between age and Qp/Qs [Type I; r=0.16, Type II; r=-0.15] All cases were operated under cardiopulmonary bypass and 58 cases[46.3%] were operated through the right atrial approach, and 34 cases[28.1%] through the pulmonary arterial approach. Operative mortality rate was 4.13%[5 cases].

• Journal of Chest Surgery
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• 제27권8호
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• pp.656-663
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• 1994

Evaluation of heart function is of importance in assessing the results of valvular heart surgery. Information on volume and functional change of heart chamber can be obtained by cardiac catheterization and echocardiography. We studied 41 patients with mitral stenosis[MS] and 23 patients with mitral regurgitation[MR] using M-mode echocardiography before and after mitral valve replacement[MVR] at Pusan Paik Hospital. Preoperative cardiac catheterization was available in 56 cases, and the results were obtained as follows. 1. In patients with MS, preoperative average LV end-diastolic dimension[EDD] and end-systolic dimension[ESD] were remained within normal range, but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative and postoperative LV ejection fraction[EF] were remained within the normal range and no significant change[P>0.05]. The preoperative left atrial dimension[LAD] was enlarged considerably above normal[P<0.01], but was significantly decreased after surgery[P<0.001]. The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05]. 2. In patients with MR, preoperative average end-diastolic dimension[EDD] and end-systolic dimension[ESD] were significantly greater than normal[P<005], but postoperative EDD and ESD were significantly decreased[P<0.01]. The preoperative LV ejection fraction[EF] and fractional shortening[FS] were within normal range, and no significant change after surgery[P>0.05].The preoperative left atrial dimension[LAD] was enlarged considerably above normal [P<0.01], but was significantly decreased after surgery[P<0.001].The preoperative LV posterior wall thickness[PWTh] was within normal range, and no significant change after surgery[P>0.05].

• Safety and Health at Work
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• 제10권2호
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• pp.166-171
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• 2019

Objective: This study explored personal protective equipment (PPE) availability and PPE utilization among interventionalists in the catheterization laboratory, which is a highly contextualized workplace. Methods: This is a cross-sectional study using mixed methods. Participants (108) completed a survey. A hyperlink was sent to the participants, or they were asked to complete a paper-based survey. Purposively selected participants (54) were selected for individual (30) or group (six) interviews. The interviews were conducted at conferences, or appointments were made to see the participants. Logistic regression analysis was performed. The qualitative data were analyzed thematically. Results: Lead glasses were consistently used 10.2% and never used 61.1% of the time. All forms of PPE were inconsistently used by 92.6% of participants. Women were 4.3 times more likely to report that PPE was not available. PPE compliance was related to fit and availability. Conclusions: PPE use was inconsistent and not always available. Improving the culture of radiation protection in catheterization laboratories is essential to improve PPE compliance with the aim of protecting patients and operators. This culture of radiation protection must include all those involved including the users of PPE and the administrators and managers who are responsible for supplying sufficient, appropriate, fitting PPE for all workers requiring such protection.

• Journal of Chest Surgery
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• 제37권11호
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• pp.897-902
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• 2004

배경: 관상동맥조영술 또는 중재술에 사용된 요골동맥을 관상동맥우회술시 우회도관으로 사용하는 경우가 늘고 있으나 이로 인한 요골동맥도관의 개존성 및 환자의 임상성적에 미치는 영향에 대해 체계적인 연구는 보고되고 있지 않다. 이에 본 저자들은 관상동맥조영술에 사용된 요골동맥을 우회도 관으로 사용한 환자들의 임상성적과 술 후 개존도를 그렇지 않은 환자들과 비교 분석하고자 하였다. 대상 및 방법: 2000년 1월 부터 2004년 2월까지 관상동맥조영술에 사용된 요골동맥을 동맥도관으로 사용한 49예를 I군으로, 관상동맥조영술에 산이지 않은 요골동맥을 동맥도관으로 사용한 44예를 II군으로 정하여 두 군간에 성비, 나이, 술 전 위험인자, 과거력, 임상진단, 수술방법, 수술성적, 우회도관의 개존도 등을 후향적으로 비교 분석하였다. 결과: 두 군 간 남녀비, 연령, 진단명, 수술 위험인자, 심박출률 등의 유의한 차이는 없었다. 술 전 관상동맥조영술은 I군에서는 전예에서 좌측 요골동맥을 이용하였고 II군에서는 대퇴동맥 혹은 우측 요골동맥을 이용하였다. 수술은 전예에서 인공심폐기를 이용한 관상동맥우회술을 시행하였으며 수술사망은 양군에서 모두 없었고 주요합병증은 I군은 5예(10%), II군은 3예(7%) 있었다. 수술에 이용된 우회도관으로는 양군에서 내흉동맥, 요골동맥, 대복재 정맥을 주로 이용하였고 I군은 환자당 평균 3.7$\pm$1.1원위부문합, II군은 3.7$\pm$0.9원위부문합을 시행하였고 요골동맥절편은 I군에서 환자당 평균 1.2$\pm$0.4원위부문합, II군에서 1.3$\pm$0.5원위부문합을 시행하였다. 요골동맥의 원위부문합은 양 군에서 회선지 부위가 가장 많았고 근위부문합은 두군에서 모두 상행대동맥, 내흉동맥, 대복재정맥 후드 순이었다. 수술 후 관상동맥조영술상 양군에서 내흉동맥과 요골동맥은 모두 100%의 개존도를 보였으며 대복재정맥은 I군 85%, II군 86%의 개존도를 보였다. 요골동맥절편에서 완전개존이 I군에서 93%로 II군의 81%보다 오히려 높게 나왔으나 유의하지는 않았다. 결론: 술 후 시행한 관상동맥조영술에서 양군에 개존율에 큰 차이는 없었으며 수술 전 관상동맥 조영술에 사용된 요골동맥도 비교적 안전하게 관상동맥우회술의 우회도관으로 사용할 수 있다고 판단된다.