A 3-month-old, female Persian cat was presented with sclera mass. The mass was detected after cat's squeals during the playing with a dog before 2 days. On ophthalmic examination, a $2{\times}5mm$ dark purple colored raised mass was observed 1 mm behind the limbus in the right eye. Anterior chamber was filled with blood and epithelial defect was detected at 2 o'clock in the right central cornea. After general anesthesia, resection of the protruded iris was performed with iris scissors and bipolar cautery. Ruptured sclera and conjunctiva were closed with simple interrupted and simple continuous suture, respectively. Also, irrigation and aspiration (I/A) of the anterior chamber was performed to remove blood clot with bimanual I/A handpiece in the right eye. Four months after the surgery, the right eye was recovered completely and menace response was positive in spite of the retinal lesions.
These studies were performed to investigate the complications affecting the vision after extracapsular lens extraction(ECE), the effects of an I/A (irrigation & aspiration)device and a viscoelastic material used on the vision, the occurrence of complications and the effective corneal incision method to reduce the corneal opacity in dogs. ECE was performed bilaterally with 3 different methods using clinically normal twele mixed dogs; the method in which I/A device and viscoelastic material were not used, the method in which I/A device was used but viscoelastic material not, and the method in which I/A device and viscoelastic material were used. Postoperative complications were observed as followed; conjunctival injection, uveitis, corneal opacity due to endothelial cell loss, hyphemia, remnants of lens cortex, vitreous loss, synechia and capsular opacity. Preservation rate of vision was lower significantly in the cases showing signs of synechia, capsular opacity, or remnants of lens cortex than the cases not showing the above signs(p<0.01). There were significant reduction of the complications such as corneal opacity, clot in anterior chamber in the group using I/A device compared to the group in which I/A device was not used(p<0.01). Groups using I/A device showed slightly higher vision than the group not using I/A device (75%; 42%). There were no significant differences in the occurrence rate of complications and the preservative rate of vision between the groups with and without viscoelastic material. The present study indicated that the postoperative complications of posterior synechia, capsular opacity, uveitis and vistreous loss were important factors affecting the vision and that I/A device was applicable to extract the lens cortex and effective to elevate the success rate after ECE in dogs.
Renal ischemia-reperfusion injury is great clinical important because viability of the transplanted organ depends on the tolerance of the graft to ischemia-reperfusion injury, an inevitable processing during surgery. The purpose of this study was to investigate the effects of irrigation-aspiration in ischemia-reperfusion injury model induced by cross-clamping of renal vessels. Blood samples were collected from these dogs for measurement of kidney function and antioxidant enzyme activity, and RI at the intrarenal artery was measured at different time intervals. And the kidneys were taken for histopathologic evaluation at day 14. Kidney function (Cr and BUN) showed a significant increasing in untreated group compared to treated group. Resistive index of intrarenal artery was no significant difference among the groups. Activity of antioxidant enzymes in plasma was significant decrease in untreated group compare to control group while in treated group was no significant difference compared to control group. In histopathologic finding, treated group was showed less damage than that of untreated group. This result suggests that the processing of irrigation-aspiration is useful to reducing ischemia-reperfusion injury.
Kim, Dong-Hee;Oh, Joo-Suk;Kyoung, Yeon-Young;Choi, Se-Min;Oh, Young-Min;Choi, Kyoung-Ho;Park, Kyu-Nam
Journal of The Korean Society of Clinical Toxicology
/
v.7
no.2
/
pp.127-136
/
2009
Purpose: It is known that aspiration pneumonitis is associated with high mortality and morbidity following overdose. However, until now, few domestic studies on this subject have been conducted. The main aim of this study is to investigate the risk factors associated with aspiration pneumonitis in intubated patients following overdose. Methods: Among 654 adult overdosed patients who visited our institution from Jan. 2006 to June 2008, we enrolled 70 intubated patients within 24 hours after their overdose, and we reviewed the medical records to collect the data. This data was processed by univariate analysis, followed by multiple logistic regression analysis. P values <0.05 were deemed statistically significant. Results: In our study, a high incidence of pneumonitis was seen in the patients with an older age, a lower GCS and a high poisoning severity score or a high comorbidity score (p<0.05). Compared with the non-pneumonitis group, the pneumonitis group had a higher incidence of intubation (6% vs 61.8%, respectively, p<0.05). The main cause of intubation was a decreased mentality (68.6%). Older age, a high comorbidity score, irrigation without airway protection, relative hypoxemia and hyperkalemia were the risk factors of aspiration pneumonitis in the intubated overdosed patients (p<0.05). Among these factors, age, a high potassium level and airway protection might be significant predictors of aspiration penumonitis (p<0.05). Conclusion: Older age, a high potassium level and irrigation without proper airway protection may be the significant factors that can predict aspiration pneumonitis in patients who are intubated within 24 hours after overdose, although the further investigations on this are needed.
Kim, Il-Man;Son, Eun Ik;Kim, Dong Won;Yim, Man Bin
Journal of Korean Neurosurgical Society
/
v.29
no.6
/
pp.738-743
/
2000
Objectives : The less invasive stereotactic surgery of hypertensive intracerebral hematoma has been preferred. Many techniques were developed to facilitate aspiration of a dense blood clot in acute stage. Authors describe a method for evacuation of putaminal hematoma via computerized tomography(CT)-aided free-hand stereotactic infusion of urokinase and frequent negative pressure aspiration. Patients and Methods : A total of ten patients with spontaneous putaminal hematoma underwent surgery with negative pressure aspiration in the three-year period. All procedures were performed within 12 hours of insult. A silicone ventricular catheter was inserted into the center of hematoma through a burr hole at the Kocher's point under local anesthesia. In a typical case of putaminal hematoma, the trajectory of catheter was pointed the center of hematoma parallel to sagittal plane vertically and the external auditory meatus posteriorly. Immediately after the first trial of hematoma aspiration low-dose urokinase solution(2,000IU/5ml saline) was administrated through the catheter and drain was clipped for 30 minutes. Subsequently, the partially liquified hematoma was manually aspirated using a 10ml syringe with a negative pressure of less than 2 to 3ml. The procedure was carefully repeated every 1 hour until the hematoma was near totally evacuated. Results : The patients population consisted composed of 4 men and 6 women with a mean age of 61.6 years. All had major neurological deficits preoperatively. The mean hematoma volume was 44.3 ml and hematoma was drained for 20 to 48 hours. No complications such as rebleeding, meningitis, or malplaced catheter were noted. Outcome was moderately disabled in four patients and good recovery in three patients. Conclusion : Although the frequent negative pressure aspiration and low-dose urokinase infusion has the disadvantage of possbility of rebleeding and infection, it is consisdered to be an effective method because it allows a simple, safe, and complete removal of hematoma.
Nam, Cheon Hyun;Kang, Jae Kyu;Doh, Jong Oung;Lee, Chun Dae
Journal of Korean Neurosurgical Society
/
v.30
no.2
/
pp.156-162
/
2001
Objective : The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. Methods : The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows : age & sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. Results : The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows : good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age & sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. Conclusion : Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.
Kim, Jong-Man;Lee, Jae-Yeon;Jeong, Seong-Mok;Park, Chang-Sik;Kim, Myung-Cheol
Journal of Veterinary Clinics
/
v.27
no.5
/
pp.553-558
/
2010
The purpose of this study was to investigate the effects of premedicated ascorbic acid and hepa-saline irrigation/aspiration on attenuation of ischemia-reperfusion (I/R) injury and recovery of renal function in canine nephrotomy model. In the canine model, nine mixed dogs were subjected to renal nephrotomy with premedicated ascorbic acid and hepa-saline irrigation-aspiration (treatment group 2), and only hepa-saline irrigation-aspiration (treatment group 1). The level of renal function and antioxidant enzymes after nephrotomy were measured. And the expression pattern of TNF-${\alpha}$ and INF-${\gamma}$ was examined in the renal tissue at $7^{th}$ day after nephrotomy. BUN and creatinine levels significantly decreased in the treatment group 1 and 2 compared to that of control group at the $3^{rd}$, 5th and $7^{th}$ day after reperfusion (p < 0.05). And, there was significant difference between treatment group 1 and 2 at the $3^{rd}$ day after reperfusion (p < 0.05). The activities of antioxidant enzymes in plasma was significantly increased in the treatment group 1 and 2 compared to that of control group at the $3^{rd}$, $5^{th}$ and $7^{th}$ day after reperfusion (p < 0.05). And, there was significant difference between treatment group 1 and 2 at the $3^{rd}$ day after reperfusion (p < 0.05). TNF-${\alpha}$ was decreased and INF-${\gamma}$ was increased in treatment groups. The result of this study suggested that irrigation-aspiration has effects on attenuation of renal ischemia-reperfusion injury, and the exogenous ascorbic acid has a role in the attenuation of renal ischemia-reperfusion injury and recovery of renal function in canine nephrotomy model.
Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.
A 13-year-old, castrated male Yorkshire terrier was presented with acute blepharospasm 2 months after phacoemulsification with intraocular lens implantation in the left eye. Menace response was weakly positive in the left eye. Intraocular pressure (IOP) was 98 mmHg in the left eye. On ophthalmic examination using slit lamp biomicroscope, episcleral injection and corneal edema were observed in the left eye. Aqueous flare (1+) and iris bombe with peripheral anterior synechia were also detected in the left eye. In spite of medical treatments, IOP was remained more than 50 mmHg. Synechiolysis and radial iridectomy with irrigation/aspiration of anterior chamber were performed in the left eye. One week after the surgery, tissue plasminogen activator was injected to resolve the blood and fibrin clot in the left anterior chamber. Menace response was recovered completely 1 month after the surgery and IOP was maintained less than 20 mmHg more than 6 months.
Kim, Myung-Jin;Lee, Soo-Jin;Park, Chang-Sik;Son, Hwa-Young;Jun, Moo-Hyung;Jeong, Seong-Mok;Kim, Myung-Cheol
Journal of Veterinary Clinics
/
v.24
no.2
/
pp.94-98
/
2007
This study was to investigate the effects of ascorbic acid and alpha-tocopherol on the attenuation of renal ischemia-reperfusion (IR) injury in pigs. Ten pigs were subjected to 60 minutes of warm unilateral renal ischemia followed by removal of contralateral kidney and then divided into two groups. Treatment group was performed ascorbic acid and alpha-tocopherol pretreatment 2 days before operation and ascorbic acid with heparin-saline solution irrigation-aspiration. Otherwise, control group used only irrigation-aspiration of heparin-saline solution. Blood samples were collected from these pigs for measurement of serum blood urea nitrogen (BUN) and creatinine values, antioxidant superoxide dismutase (SOD) at pre, day 1, day 3, day 7 and day 14. The kidneys were taken for histopathologic evaluation after euthanasia on postoperative day 14. The levels of BUN were significantly increased in the control group on day 1, day 3 and day 7 (P<0.05). And the level of creatinine was significantly increased in the control group on day 3 (p<0.05). Activity of antioxidant enzymes in plasma revealed significant difference (p<0.05) between control and treatment group at day 14. In histopathologic findings, treatment group was showed less damage than that of control group on the basis of renal tubular damage. It was concluded that ascorbic acid and alpha-tocopherol attenuated renal I/R injury in the pigs.
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