• Title/Summary/Keyword: Cephalic vein

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Clinical Outcomes of Arteriovenous Graft in End-Stage Renal Disease Patients with an Unsuitable Cephalic Vein for Hemodialysis Access

  • Son, Joung Woo;Ryu, Jae-Wook;Seo, Pil Won;Ryu, Kyoung Min;Chang, Sung Wook
    • Journal of Chest Surgery
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    • v.53 no.2
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    • pp.73-78
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    • 2020
  • Background: As the population of patients with end-stage renal disease has grown older, the proportion of patients with poorly preserved vasculature has concomitantly increased. Thus, arteriovenous grafts (AVG) have been used more frequently to access blood vessels for hemodialysis. Despite this increasing demand, studies of AVG are limited. In this study, we examined the surgical outcomes of upper-limb AVG creation. Methods: Among the arteriovenous fistula formation procedures performed between January 2014 and March 2019 at Dankook University Hospital, 42 cases involved AVG creation. We compared patients in whom the axillary vein was used (group A; brachioaxillary AVG [B-Ax AVG]; n=20) with those in whom upper limb veins were used (group B; brachiobasilic AVG or brachioantecubital AVG; n=22). Results: The 1-year primary patency rate was higher in group A than in group B (57.9% vs. 41.7%; p=0.262). The incidence of postoperative complications was not significantly different between groups. Conclusion: AVG using the axillary vein showed no major differences in safety or functionality compared to AVG using other veins. Therefore, accounting for age, underlying disease, and expected patient lifespan, B-Ax AVG can be considered an acceptable surgical method.

Expandability of Cephalic Veins after Brachial Plexus Block in Arteriovenous Fistula Formation for Hemodialysis

  • Chun, Sangwook;Ryu, Jae-Wook;Ryu, Kyoung Min;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.31-35
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    • 2021
  • Background: Arteriovenous fistula (AVF) for hemodialysis is essential for patients with end-stage renal disease. However, it is difficult to maintain AVF reliably. It is vitally important to select proper blood vessels for AVF formation. In a previous study, a minimum diameter of 3 mm for the autologous vein was proposed. However, patients who did not meet the minimum vascular diameter before anesthesia, but fulfilled other criteria, showed satisfactory venous dilatation after brachial plexus block (BPB). This study investigated the extent of vein expansion by BPB and the surgical outcomes of dilated veins after BPB. Methods: Sixty-one patients who underwent AVF formation using an autologous vein between August 2018 and December 2019 were included in the study. The clinical characteristics of the patient groups, hemodynamic parameters including the diameter of blood vessels before and after BPB, and complications were investigated. Based on the venous diameter measured by sonography before anesthesia, patients were divided into group A (26 patients) and group B (35 patients), with venous diameters <3 mm and ≥3 mm, respectively. Results: The venous diameter expanded after anesthesia by 41% overall, by 62% in group A, and by 25% in group B. This difference between groups A and B was statistically significant (p=0.001). No other variables showed statistically significant differences. Conclusion: Sufficient venous dilatation was observed after BPB. Therefore, if the vein is sufficiently dilated after BPB, even in patients with a pre-anesthesia venous diameter <3 mm, surgery may still be performed with an expected desirable outcome.

Pseudoaneurysms of Peripheral Arteries - A Report of 6 Cases- (말초동맥에 발생한 가성동맥류의 외과적 치료 -치험 6례-)

  • 류완준;조창욱
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.927-930
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    • 1996
  • We experienced six cases of pseudoaneurysm of the peripheral artery which occurred after stab wound or after diagnostic and operative procedures. Among 6 cases, 4 cases of pseudoaneurysm were developed in the femoral arteries, and others were the subclavian and the axillary artery. Two of 6 cases were combined with previous arterio enous fistula. Doppler imaging and angiogram were performed for the dignosis and an operation. Operative procedures were resection of the aneurysm, ligation of the involved arteries and reconstruction of the artery with the autogenous saphenous vein or the cephalic vein graft. Each operations were successfully performed without any disability.

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Prevalence of Babesia spp. in dogs of Seogwipo-si, Jeju-do, South Korea

  • Oh, Seung-Tae;Woo, Ho-Choon
    • Korean Journal of Veterinary Service
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    • v.32 no.4
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    • pp.377-380
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    • 2009
  • Dogs with canine babesiosis may present with wide variation in the severity of clinical signs, ranging from a hyperacute, shock-associated, hemolytic crisis to an inapparent, subclinical infection. Dogs typically present with the acute form of babesiosis, which is characterized by general findings such as pyrexia, weakness, mucous membrane pallor, depression, hemorrhagic anemia. This study was conducted to investigate the prevalence of babesia spp. infection in dogs of Seogwipo-si. A survey of canine babesia spp. infections among 173 dogs in Seogwipo-si was performed from July 2008 to August 2008. Blood samples were collected from dogs raised outdoors through cephalic or jugular vein and Babesia spp. was diagnosed by examination of blood smear stained with Giemsa stain. Of 173 dogs, 9 dogs (5.2%) were infected with the babesia spp. This result was a little lower than the prevalence of Babesia spp. in dogs of other areas.

Mondor's Disease Developed after Ultrasound-assisted Liposuction for Treatment of Axillary Bromhidrosis

  • Lee, Hee Jong;Kim, Eun Key
    • Archives of Reconstructive Microsurgery
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    • v.23 no.1
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    • pp.33-35
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    • 2014
  • Mondor's disease is an uncommon condition characterized by a palpable, cord-shaped structure, which causes pain when pressed. Its known pathophysiology is thrombophlebitis of the superficial venous system. Although reported repeatedly, its definite cause is unknown and various possible causes have been identified, including surgery, irradiation, infection, malignancy, and trauma. We diagnosed this case to be Mondor's disease of the antecubital venous system, probably due to thermal injury of the proximal tributaries of the basilic or cephalic vein. Risk of thermal injury to the skin flap or the portal site remains a common complication, and as thermal injury to the blood vessel might also be considered, attention must be given when suctioning the area near a large superficial vessel.

Videoscopic Surgery for Arteriovenous Hemodialysis Access

  • Jeong, Hyuncheol;Bae, Miju;Chung, Sung Woon;Lee, Chung Won;Huh, Up;Kim, Min Su
    • Journal of Chest Surgery
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    • v.53 no.1
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    • pp.28-33
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    • 2020
  • Background: When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions. Methods: Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed. Results: Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days). Conclusion: Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.

The Incidence of Venous Thromboembolism Following Shoulder Surgery: A Pilot Study

  • Cho, Chul-Hyun;Jang, Hyung-Gyu;Park, Ui-Jun;Kim, Hyoung Tae
    • Clinics in Shoulder and Elbow
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    • v.20 no.1
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    • pp.18-23
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    • 2017
  • Background: To assess the incidence of venous thromboembolism (VTE) following shoulder surgery and to evaluate the role of postoperative duplex ultrasonography. Methods: The study comprised a total of 224 patients who underwent shoulder surgery, including 180 shoulder arthroscopic surgeries, 28 shoulder arthroplasties, and 16 plate fixations for proximal humerus fracture between January 2014 and December 2014. The mean age of patients was 59.0 years, and there were 81 men and 143 women. Clinical data, including body mass index, blood tests, metabolic work-up for liver and renal function, previous, and present medical history, were evaluated. Duplex ultrasonography in the operative arm was performed on 2 to 4 days after surgery. Results: The overall incidence of VTE following shoulder surgery was 0.45% (1/224). One patient with open reduction and plate fixation for proximal humerus fracture had asymptomatic deep vein thrombosis that showed complete remission after anticoagulant medication during a 2-month period. Four patients had asymptomatic superficial cephalic vein thrombosis and complete remission without any treatment. There was no case of pulmonary embolism. Conclusions: The incidence of VTE following shoulder surgery was extremely low in Asians. Duplex ultrasonography may be not considered a routine follow-up of shoulder surgery and can be selectively performed in high-risk or symptomatic patients for VTE.

Huge Lymphangioma Developed After Arteriovenous Fistula for Hemodialysis -A case of report- (혈액투석을 위한 동정맥루 조성술후 발생한 거대림프관종 -1례 보고-)

  • 안상구;김우종
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1028-1030
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    • 1996
  • Arteriovenous fistula Is the most widely used mean of vascular access for long-term hemodialysis in patients with end-stage renal disease. Lymphangioma associated with arteriovenous fistula is very rare, seemed to be developed from Iymphatic fluid accumulation. Lymphangioma is benign neoplasm, arises de hobo or secondary to surge y or irradiation, and affects almost any part of the body served by the Lwphasic system. Treatment of choise for Iymphangioma Is surgical excision. We repo$\ulcorner$t a case of procedure using Gore-Tex graft between left brachial artery and cephalic vein for vascular access of hemodialysis in 59 year old female, with successful surgical removal.

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Influence of Clonidine on Renal Function of Dogs (Clonidine이 개의 신장기능에 미치는 영향)

  • 고석태;김기환
    • YAKHAK HOEJI
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    • v.27 no.4
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    • pp.271-282
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    • 1983
  • This study is an attempt to study the influence of clonidine, which has a central sympatholytic action, on the renal function in dogs and to elucidate its mechanism of action. Clonidine ($15\mu$g/kg) injected into a cephalic vein of the dog produced a marked increase in urine flow and in amounts of $Na^{+}$ and $K^{+}$ excreted in urine, and clearances of free water and osmolar substance, the reabsorption rates of $Na^{+}$ and $K^{+}$ in renal tubules were significantly decreased. Clonidine ($50.0]mu$g/kg) administered intravenouly elicited a transient reduction in urine flow, along with inhibition of all renal functions. Intravenous clonidine-induced diuretic effect was completely blocked by pretreatment with reserpine, and was lessened by water diuresis. Clonidine ($3.0\mu$g/kg) injected tnto a carotid artery revealed a transient diuresis with a increase in clearance of free water. Clonidine injected into a renal artery showed a significant antidiuretic effect and all functions of an experimental kidney were reduced. Antidiuretic action induced by clonidine given into a renal artery markedly suppressed by pretreatment with reserpine. The above results suggest that clonidine has dual mechanisms: 1) diuretic effect due to the central sympatholytic action and inhibition of release of antidiuretic hormone, and 2) antidiutetic effect indued by indirect symptheic stimulation in the periphery.

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