• 제목/요약/키워드: Irrigation and aspiration

검색결과 14건 처리시간 0.02초

어린 고양이에서 발생한 안구내출혈을 동반한 공막 파열의 수술적 치료 (Successful Surgical Treatments of Scleral Rupture with Hyphema in a Young Cat)

  • 박영우;정예찬;임재현
    • 한국임상수의학회지
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    • 제32권1호
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    • pp.127-129
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    • 2015
  • 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.

개에서 Irrigation/Aspiration장비와 점탄물질이 수정체 낭외적출술후의 합병증에 미치는 효과 (Effects of Irrigation/Aspiration Device and Viscoelastic Material on Complication after Extracapsular Lens Extraction in Dogs)

  • 우흥명;권오경;남치주
    • 한국임상수의학회지
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    • 제14권1호
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    • pp.56-64
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    • 1997
  • 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.

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개에서 신장의 허혈-재관류 손상에 대한관류-흡인의 감소효과 (Amelioration Effects of Irrigation-Aspiration on Renal Ischemia-Reperfusion Injury in Canine Model)

  • 이재일;손화영;정성목;김명철
    • 한국임상수의학회지
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    • 제25권4호
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    • pp.257-262
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    • 2008
  • 신장의 허혈-재관류 손상은 수술하는 동안 부득이하게 발생하는 허혈-재관류 손상에 대한 이식조직의 내성에 따라 이식된 장기의 생존력이 달려있기 때문에 임상적으로 아주 중요하다. 본 연구의 목적은 신장 혈관을 차단하여 유발한 허혈-재관류 모델에서 관류-흡인의 효과를 알아보고자 실시하였다. 신기능과 항산화 효소를 검사하기 위해 혈액 샘플을 채취하였고 신장내 동맥의 혈류저항을 측정하였다. 14일째 신장을 절제하여 조직검사를 실시하였다. 신기능(Cr, BUN)은 처치군에 비해 비처치군에서 유의성 있는 상승을 보였다. 신장내 혈류 저항은 두 그룹 사이에 유의성이 없었다. 항산화 효소 활성은 대조군에 비해 비처치군에서 유의성 있는 감소를 보였으나, 처치군에서는 대조군과 유의성이 없었다. 조직검사 결과에서도 처치군이 비처치군에 비해 적은 조직손상을 보였다. 이러한 결과는 관류-흡인 과정이 신장의 허혈-재관류 손상을 감소시키는데 유용한 단계임을 시사한다.

약물중독 후 흡인성 폐렴의 발생에 미치는 인자에 대한 고찰 (Evaluation of the Risk Factors for Aspiration Pneumonitis Following Drug Intoxication)

  • 김동희;오주석;경연영;최세민;오영민;최경호;박규남
    • 대한임상독성학회지
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    • 제7권2호
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    • pp.127-136
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    • 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.

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자발성 뇌내혈종의 음압배액술 (Negative Pressure Aspiration of Spontaneous Intracerebral Hematoma)

  • 김일만;손은익;김동원;임만빈
    • Journal of Korean Neurosurgical Society
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    • 제29권6호
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    • pp.738-743
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    • 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.

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자발성 시상부 출혈에서 뇌정위적 흡인술 및 보존적 치료의 임상분석 (Clinical Analysis of Stereotactic Aspiration and Conservative Management in Spontaneous Thalamic Hematoma)

  • 남천현;강재규;도종웅;이춘대
    • Journal of Korean Neurosurgical Society
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    • 제30권2호
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    • pp.156-162
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    • 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.

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개의 신장에 있어서 Ascorbic Acid에 의한 허혈/재관류 손상의 감소에 관한 연구 (Attenuation of Renal Ischemia-Reperfusion (I/R) Injury by Ascorbic Acid in the Canine Nephrotomy)

  • 김종만;이재연;정성목;박창식;김명철
    • 한국임상수의학회지
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    • 제27권5호
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    • pp.553-558
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    • 2010
  • 본 연구의 목적은 개의 신장 절개술 모델에서 ascorbic acid를 전처치 하거나 관주 및 흡인시에 있어서, 허혈/재관류 손상의 감소와 신장 기능의 회복에 대한 효과를 평가하는데 있다. 성숙 잡종견 9두에서 신장절개술을 실시하였으며, hepa-saline 관주 및 흡인군와 ascorbic acid로 전처치 한 후 hepa-saline 관주 및 흡인한 군을 각각 실험군 1, 2로 놓았다. 신기능 검사와 항산화 효소 검사를 위해 신장절개술 후 0, 1, 3, 5, 7일에 혈액 샘플을 채취하였다. 그리고 7일 후 TNF-alpha, INF-gamma 검사를 위해 신장을 적출 보관하였다. 신장의 기능 검사에서 처치군 1과 2는 재관류 후 3, 5 그리고 7일째에 대조군과 비교하여 유의성 있게 감소 하였으며(p < 0.05), 처치군 2는 재관류 후 3일째에서 처치군 1과 비교하여 유의성있게 감소하였다(p < 0.05). 혈장에서의 항산화 효소의 활성치는 처치군 1과 2는 재관류 후 3, 5 그리고 7일째에 대조군과 비교하여 유의성 있게 증가 하였으며(p < 0.05), 처치군 2는 재관류 후 3일째에서 처치군 1과 비교하여 유의성있게 증가하였다(p < 0.05). TNF-alpha는 감소하고, INF-gamma는 증가하였다. 본 연구의 결과 신장의 관주 및 흡인의 과정은 신장의 관주 및 흡인의 과정은 신장의 허혈 및 재관류 손상을 감소 시키는 데에 효과가 있음을 시사하며, 또한, 외인성 ascorbic acid의 투여는 개의 신장 절개술에서 허혈 및 재관류의 손상을 감소시키며 신기능의 회복에 효과가 있음을 시사한다.

감염된 만성창상에서 국소음압세척치료의 이용 (Vacuum Assisted Wound Closure Appliance and Continuous Irrigation on Infected Chronic Wound)

  • 정진욱;김준형;정영진;박무식;손대구;한기환
    • Archives of Plastic Surgery
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    • 제37권3호
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    • pp.227-232
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    • 2010
  • 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.

초음파 유화흡인술 후 발생된 난치성 동공 차단 녹내장의 수술적 치료 (Surgical Managements for Refractory Pupillary Block Glaucoma after Phacoemusification in a Dog)

  • 박영우
    • 한국임상수의학회지
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    • 제32권1호
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    • pp.130-134
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    • 2015
  • 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.

돼지의 신장에서 Antioxidant Vitamins에 의한 허혈 및 재관류 손상의 감소에 관한 연구 (Attenuation of Renal Ischemia-Reperfusion Injury by Antioxidant Vitamins in Pigs)

  • 김명진;이수진;박창식;손화영;전무형;정성목;김명철
    • 한국임상수의학회지
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    • 제24권2호
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    • pp.94-98
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    • 2007
  • 돼지에서 신장의 허혈-재관류 손상의 감소에 대한 비타민 C와 E의 영향을 알아보기 위하여 본 연구를 실시하였다. 돼지 10두를 2개의 군으로 구분하여, 60분 동안 체온과 같은 허혈을 한쪽 신장에 유발하고 반대쪽 신장은 절제하였다. 처치군은 수술 2일전 비타민 C와 E를 이틀 동안 전처치하고, 그 뒤에 수술 중 비타민 C와 heparin이 첨가된 생리식염수를 관주-흡인하였다. 대조군은 heparin이 첨가된 생리식염수의 관주-흡인만을 하였다. Blood urea nitrogen, creatinine 및 antioxidant superoxide dismutase (SOD)를 측정하기 위하여 수술 전, 수술 후 1, 3, 7, 14일에 혈액 샘플을 채취하였다. 수술 후 14일에 안락사를 시키고, 병리조직검사를 위하여 신장을 적출하였다. BUN은 대조군과 처치군 사이에 수술 후 1일, 3일 또는 7일에 유의성이 있는 차이가 인정되었다. (p<0.05). Creatinine은 대조군과 처치군 사이에 수술 후 3일에 유의성이 있는 차이가 인정되었다. (p<0.05). 혈장에서의 항산화 효소의 활성은 대조군과 처치군 사이에서 수술 후 14일에 유의성이 있는 차이가 인정되었다. (p<0.05). 병리조직 검사 결과에서 처치군이 대조군 보다 더 적은 신장 세뇨관에서의 손상의 정도를 보였다. 비타민 C와 E는 돼지에서 신장의 허혈-재관류 손상을 감소시켰다.