• 제목/요약/키워드: Catheters, Indwelling

검색결과 38건 처리시간 0.036초

Delftia acidovorans Isolated from the Drainage in an Immunocompetent Patient with Empyema

  • Chun, Jaeyoung;Lee, Jaechun;Bae, Jaeseok;Kim, Miyeon;Lee, Jae-Geun;Shin, Sang-Yop;Kim, Young Ree;Lee, Keun-Hwa
    • Tuberculosis and Respiratory Diseases
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    • 제67권3호
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    • pp.239-243
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    • 2009
  • Delftia acidovorans is a gram-negative motile rod found ubiquitously in soil and in water. Confirmed isolation from clinical infections is rare, and has been documented mostly in immunocompromised patients or those with indwelling catheters. A 53-year-old man was referred for the evaluation of a huge mass-like lesion found incidentally by chest X-ray. The lesion occupied more than half of the right lung and was diagnosed as a large loculated pleural effusion by CT scan. Bloody pus was drained through a percutaneous catheter, and D. acidovorans, identified by the Vitek GN card and confirmed by amplification of 16S ribosomal RNA and sequencing analysis, was isolated repeatedly from the drained pus. The patient was treated with imipenem/cilastatin to which the organism was sensitive. This is a rare report of chronic empyema associated with D. acidovorans in the respiratory system of an immunocompetent patient.

Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion

  • Lee, Seul;Lee, Heock;Lee, Dong Hyun;Kang, Bo Hyoung;Roh, Mee Sook;Son, Choohee;Kim, Sung Hyun;Lee, Hyun-Kyung;Um, Soo-Jung
    • Tuberculosis and Respiratory Diseases
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    • 제84권2호
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    • pp.134-139
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    • 2021
  • Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods: We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results: Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion: Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.

Effects of the Combination of Glucose, Chromium Picolinate, and Vitamin C on Lipid Metabolism in Steers

  • Lee, Hong-Gu;Yin, Jin-Long;Xu, Cheng-Xiong;Hong, Zhong-Shan;Lee, Zhe-Hu;Jin, Yong-Cheng;Choi, Chang-Weon;Lee, Do-Hyeung;Kim, Kyoung-Hoon;Choi, Yun-Jaie
    • Asian-Australasian Journal of Animal Sciences
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    • 제24권12호
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    • pp.1674-1680
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    • 2011
  • This study was conducted to examine the effects of glucose, chromium picolinate (CrP), and vitamin C (Vit C) on lipid metabolism in Korean native steers fitted with indwelling catheters. A total of 12 Korean native steers were randomly allocated to the following treatments: 1) normal control diet, 2) same as 1) +250 g of glucose by intravenous (IV) infusion, 3) same as 2)+13.5 g CrP administered orally, and 4) same as 3)+2.52 g Vit C by IV infusion. Glucose, Vit C, and CrP treatments were administered for five days. At days 1 and 3, serum insulin was higher in treated animals than in those fed the control diet (p<0.05). Serum non-esterified fatty acid (NEFA) concentration in the steers on treatment 2), control+13.5 g CrP, was lower than those on other treatments at 90 min post-infusion on days 1 and 3 (p<0.05). The expression of peroxisome proliferator-activated receptor-${\gamma}$ (PPAR${\gamma}$)2, stearoyl-CoA desaturase-1 (SCD), fatty acid synthase (FAS), and glucose transporter type 4 (Glut 4) in the longissimus muscle of steers on treatment 2 was higher than those on other treatments. In conclusion, the results suggest that CrP is associated with the regulation of gene expression involved in adipogenesis.

경막외 카테터의 고정방법과 수술후 카테터의 위치 변화와의 관계 (The Relationships between the Methods of the Epidural Catheter Fixation and the Postoperative Position Change of the Catheter)

  • 신우종;염종훈;김희수;김용철;이동호;김경헌;심재철;황정혜
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.64-68
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    • 1997
  • Background : Patients mover more as their post operative pain decrease. With the increase in movement there will be a tendency for the epidural catheter to migrate out of its original position. We studied 2 methods of fixation of the epidural catheter and the changes in position as related to patient movement. Methods : Patients were divided into two groups. Patients in Group A had their epidural catheter formed with a circular loop at the (skin) exit site then directed over the right shoulder. Group B had the epidural catheter flxed with Fixomull on the exit site without forming a circular loop. At the end of the operation, 3 mg of epidural morphine was injected via indwelling epidural catheter for postoperative pain control. Epidural catheter depth was measured 24 hours later. Results : The overall rate of migration of epidural catheter was 61.9%. In Group A, number of patients whose catheter migrated over 0.5 cm was 23(69.9%) with 14 inward migration and 9 outward migration. Group B had 16(53%) patients catheters migrate over 0.5 cm, with 2 patients having inward migration and 14 outward migration. Conclusions : Although the rates of migration of epidural catheter were similar for both groups, the number of inner migration of catheter, which could result serious complications, was significantly lower in Group B than Group A. Based on our results we recommend the epidural catheter be fixed without a circular loop.

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Evaluation of Fishmeal Supplement with Net Nitrogen Flux by the Portal-drained Viscera and the Liver in Mature Sheep

  • Fukuma, T.;Taniguchi, K.;Obitsu, T.
    • Asian-Australasian Journal of Animal Sciences
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    • 제18권9호
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    • pp.1255-1261
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    • 2005
  • The objective of this study was to evaluate the net flux response of nitrogen compounds (alpha-amino N, ammonia N, urea N, essential amino acids) across the portal-drained viscera (PDV), liver and total splanchnic tissues of mature wethers to increasing level of dietary fishmeal (FM) supplementation. Four wethers (average body weight, 64 kg) with chronic indwelling catheters into the portal, hepatic and mesenteric veins and the abdominal aorta were used in a 4${\times}$4 Latin square design. A basal diet consisting of 0.7 hay and 0.3 concentrate was fed twice daily with a fixed amount at 1.4 times maintenance energy (1.3 kg/day on a dry matter basis). The supplementation proportion of FM as treatment was 0, 0.03, 0.06 and 0.09 to the amount of the basal diet to contain 119, 137, 154 and 170 g crude protein per kg dietary dry matter, respectively. Blood flows through PDV and liver did not differ (p>0.05) among the treatments. Both net PDV release and hepatic uptake of alpha amino acid N increased linearly (p<0.05) in response to increased dietary FM, which resulted in similar total splanchnic release of alpha-amino N among the treatments. Similarly, increased dietary FM increased net PDV absorption and hepatic removal of ammonia N linearly (p<0.05). Hepatic synthesis and total splanchnic release of urea N increased linearly (p<0.01) with increased dietary FM, but PDV uptake of urea N did not respond to increased dietary FM. Linear regression equations between the increases in FM N intake and PDV net flux indicated that 0.34 and 0.30 of FM N was absorbed in the form of alpha-amino N and ammonia N, respectively. The results demonstrated that FM supplementation provides more alpha-amino N than ammonia N to the liver, but the alpha-amino acid N absorption is less than the expected metabolizable protein N from FM supplementation.

재가 중증 뇌병변 장애인의 기능상태 및 케어요구 목록 평가 (Analysis of Functional Status and Care Needs among the Community-Dwelling Disabled Persons with Cerebral Impairment)

  • 고려진;유원섭;이꽃메;이소나;김교현;오희영
    • 간호행정학회지
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    • 제14권4호
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    • pp.421-431
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    • 2008
  • Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

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메치실린 내성 황색포도상구균 세균성 심내막염에 의한 패혈성 폐색전증 1예 (A Case of Septic Pulmonary Embolism Associated with MRSA Infective Endocarditis)

  • 이기종;김나영;김자선;윤한결;오미정;김도훈;조상균;류한영;배영아;김대봉;신미경;진재용
    • Tuberculosis and Respiratory Diseases
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    • 제69권2호
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    • pp.124-128
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    • 2010
  • Septic pulmonary embolism is the process in which an infected thrombus becomes detached from its site of origin and lodges in a pulmonary artery, and is usually associated with infective endocarditis, especially right-sided, or infection-associated with indwelling catheters, peripheral septic thrombophlebitis, and periodontal diseases, etc. Here, we report a case of septic pulmonary embolism associated with tricuspid valve infective endocarditis. A 23-year-old female was admitted to our hospital, due to fever, sore throat, and myalgia. In her past medical history, she had undergone a surgical operation for closure of a ventricular septal defect, but was informed that the operation resulted in an incomplete closure. The initial chest radiograph demonstrated multiple rounded, parenchymal nodules in various sizes; several nodules had central lucency suggesting cavitations. Echocardiography demonstrated a large vegetation attached to the septal tricuspid valve leaflet, extending from right ventricular inflow tract to outflow tract. Computed tomography of thorax revealed bilateral peripheral nodules and wedge-shaped consolidation at various sizes, mostly accompanied by cavitations.

Intravenous administration of L-tryptophan stimulates gastrointestinal hormones and melatonin secretions: study on beef cattle

  • Lee, Sang-Bum;Lee, Kyung-Won;Wang, Tao;Lee, Jae-Sung;Jung, U-Suk;Nejad, Jalil Ghassemi;Oh, Young-Kyoon;Baek, Youl-Chang;Kim, Kyoung Hoon;Lee, Hong-Gu
    • Journal of Animal Science and Technology
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    • 제61권4호
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    • pp.239-244
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    • 2019
  • This study aimed to determine the effective dose of intravenous administration of L-tryptophan (L-T) on gastrointestinal hormones (GIH) secretions and melatonin using Hanwoo cattle. Three steers ($362{\pm}23kg$) fitted with indwelling jugular vein catheters were assigned in a $3{\times}3$ Latin square design. Treatments were intravenous administration of saline (control), 28.9 mg L-T/kg body weight (BW; low) and 57.8 mg L-T/kg BW (high) L-T for 1 day with 7 days of adaptation. Samples were collected after adaptation period at -60, 0, 30, 60, 90, 120, 150, 180, 240, and 300 min of sampling day. The levels of serum cholecystokinin (CCK) and secretin were higher (p < 0.05) in the high L-T group than those in the other groups. Serum Melatonin (MEL) levels were increased upon L-T administration (p < 0.05) in the high L-T group. Taken together, the effective dose of L-T administration was defined at 57.8 mg L-T/kg BW in order to stimulate increase of GIH and MEL.

정맥염 발생률에 근거한 말초 정맥관의 정규교환 시기 연장에 대한 연구 (Study on Prolonging Peripheral Intravenous Catheter Indwell Time Based on Phlebitis Rate)

  • 윤희숙;박미아;박은정;최진희;김미영;임지미;이승자;이창관
    • 임상간호연구
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    • 제16권1호
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    • pp.145-153
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    • 2010
  • Purpose: The purpose of this study was to re-assess the replacement time intervals of Peripheral Intravenous Catheters (PICs) by investigating phlebitis rates according to the indwelling times of PICs. Methods: The study was conducted on 340 patients in S hospital by an IV team. After PIC insertion, IV team members evaluated once a day. The PICs were replaced every 96 hours, and let them in situ when the patients wanted to, in the absence of any sign of complications, from 97 hours to 153 hours. Results: Total phlebitis rate was 19.6%. There were no significantly different factors associated with the occurrence of phlebitis. The incidence rates of phlebitis were 12.6% and 7.0% before and after 72 hours of PIC insertion, and recorded zero after 96 hours. Conclusion: It would be recommendable to maintain PIC in situ for longer than 72 hours if there is no sign of complication such as phlebitis in close monitoring of PIC insertion site.

자연기흉에 있어서 8 French 도관과 흉관의 삽입 치료 효과 (The effect of 8 French catheter and chest tube on the treatment of spontaneous pneumothorax)

  • 강윤정;고형기;신종욱;임성룡;최재선;유지훈;박인원;최병휘;허성호;서승천
    • Tuberculosis and Respiratory Diseases
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    • 제43권3호
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    • pp.410-419
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    • 1996
  • 연구배경 : 자연기흉은 장측 늑막이 파열되어 늑막강내에 공기가 누출되면서 폐의 일부 또는 전부가 허탈된 상태로, 치료 방법은 환자의 증상, 기흉의 크기, 원인, 과거 발생 여부 등에 따라 달라서, 산소흡입을 하면서 관찰하거나, 흉강천자, 흉관삽입술, 화학적 흉막유착술과 수술을 시행한다. 하지만, 크기가 20%~25% 이상인 자연 기흉의 치료에 있어서 가장 흔히 사용하는 방법은 흉관삽입술로, 이는 시술 중 통증이나, 감염, 출혈, 피하기종 등의 합병증을 동반할 수 있고, 일반적으로 외과의에 의해 시행되는 특별한 기술이 요구되는 방법이다. 그러나, 근래 경피적 주사 흡인 폐조직 검사와 같은 침습적인 진단방법에 의한 의인성 기흉이 늘면서 작은 직경의 도관 삽입이 시도되어 특별한 합병증 없이 좋은 결과를 나타냈으나 자연기흉의 치료에 있어서 작은 직경 도관의 유용성은 아직 확실하지 않다. 이에 본 연구에서는 자연기흉 환자들을 대상으로, 8 French 도관의 유용성을 보기 위하여, 8 French 도관 삽입 군과 흉관삽입군의 임상양상을 비교 연구하였다. 방법 : 1990년 1월부터 1994년 4월까지 중앙대학교 부속병원 내과와 흉부외과에서 치료받은 자연기흉 환자 44명을 대상으로 하여, 8 French 도관을 삽입한 군(21명)과 흉관을 삽입한 군(23명)사이에서, 자연 기흉의 발생 원인, 기흉의 크기, 도관 유치 기간과 합병증 등을 비교 분석하였다. 결과 : 1) 도관 유치 기간은 8 French 도관 삽입군과 흉관 삽입군에서 유의한 차이가 없었으나, 삽입 후 합병증은 8 French 도관 삽입군에서는 1예도 없었고 흉관 삽입군에서는 피하기종의 발생이 유의하게 높게 발생하였다. 2) 원발성 자연기흉에서 기흉의 크기가 50%이하인 경우엔 양 군에서 100%의 성공율을 보였고, 50% 이상이라도 나이가 적은 경우엔 8 French도관 삽입의 성공율이 높은 경향을 보였다. 3) 속발성 자연기흉에서 8 French도관을 삽입하였을 경우, 기저 질환으로서 만성 폐쇄성 페질환이 없고 나이가 적을수록 성공률이 높은 경향이 있었다. 결론 : 자연기흉의 치료에 있어서 기흉의 크기가 50% 이하이거나 원발성 자연기흉의 경우, 나이가 젊고 만성 폐쇄성 폐질환이 없는 속발성 자연기흉 환자의 경우는 8 French 도관 삽입을 고려해 볼만 하다고 생각된다.

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