• Title/Summary/Keyword: Permanent drainage method

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Clinical Roles of Continuous Lumbar Drainage in Acute Hydrocephalus Patients (급성 수두증 환자에서 지속적 요추지주막하 배액의 임상적 역할)

  • Yang, Geun Jin;Kim, Mun Chul;Chung, Hoon;Lee, Sang Pyung;Choi, Gi Whan;Yeo, Hyung Tae
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.644-649
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    • 2000
  • Objective : Acute hydrocephalus can be caused by many pathologic conditions such as sub- arachnoid hemorrhage, intraventricular hemorrhage, inflammatory diseases. External ventricular drainage(EVD) through trephination of the skull is essential procedure for progressing or persistent symptomatic acute hydrocephalus. If the EVD can not be removed in short period, the chance of ventriculitis increases and periodic transposition of the draining catheter should be considered. Shunt procedure can not be performed in acute hemorrhage or infectious condition because of the risk of shunt malfunction or intra-abdominal spreading of the infection, respectively. The authors replaced EVD with continuous lumbar drainage(CLD) for the purpose of controlling acute hydrocephalus and preventing ventriculitis simultaneously, or treating ventriculitis more effectively in case of infection which had already broken out. CLD has many advantages over EVD, although, it can complicate disastrous downward brain herniation in patients with elevated intracranial pressure. The authors performed CLD with EVD maintained and then tested the possibility of the brain herniation with quite simple method. If the CLD was proven as safe through the test, EVD could be replaced with it without terrible herniation. Material and Method : Between September 1998 and April 1999, 10 patients underwent CLD in replacement of EVD. Among them, 5 were patients with aneurysmal subarachnoid hemorrhage, 2 were patients with thalamic hematoma and intraventricular hemorhage and 3 were patients with traumatic intracranial hemorrhage. Results : In eight of them the replacements were successfully done and one of them died on account of medical illness. In two of them the replacement could not be performed because of the risk of herniation and all expired owing to ventriculitis. Two patients required permanent shunt operation. Conclusion : This article provides a valuable alternative method of treatment for persistent symptomatic hydrocephalus which can not be managed with shunt operation immediately.

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Retrobulbar Hematoma in Blow-Out Fracture after Open Reduction

  • Cheon, Ji Seon;Seo, Bin Na;Yang, Jeong Yeol;Son, Kyung Min
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.445-449
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    • 2013
  • Retrobulbar hemorrhage, especially when associated with visual loss, is a rare but significant complication after facial bone reconstruction. In this article, two cases of retrobulbar hematoma after surgical repair of blow-out fracture are reported. In one patient, permanent loss of vision was involved, but with the other patient, we were able to prevent this by performing immediate decompression after definite diagnosis. We present our clinical experience with regard to the treatment process and method for prevention of retrobulbar hematoma using a scalp vein set tube and a negative pressure drainage system.

Analysis of a Weak Zone in Embankment Close to a Drainage using Resistivity Monitoring Data (전기비저항 모니터링을 이용한 저수지 제체 취수시설 취약성 해석)

  • Lim, Sung Keun
    • Geophysics and Geophysical Exploration
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    • v.21 no.1
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    • pp.8-14
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    • 2018
  • For the purpose of maintenance and prevention of earth fill dams against damage from natural hazards, automatic monitoring through various measuring instruments and resistivity survey has been carried out. Reservoirs and embankments have the structural vulnerability on the agricultural usages since most of them were built more than thirty years ago. The main aim to use monitoring method is to verify the safety and integrity of the dam. Resistivity survey can detect potential weaknesses, such as defective zones, anomalous seepages or internal erosion processes. Permanent resistivity monitoring systems were installed at a reservoir, which daily measurements have been taken every 6 hour. Using monitoring data for one year, anomalous seepage and structural defects were clarified for dam safety. Annual water level fluctuations are around 10 m. During their operation, reservoir dams are subject to a never-ending hydraulic load from the reservoir, which over the years may cause changes in the properties of the inner parts of the dam construction. Detailed analysis of the monitoring results was performed and showed that resistivities at most locations have been very stable over the full monitoring period excluding the effects of water fluctuation and seasons. To investigate the detectability of weak zone using the DC resistivity monitoring, numerical modeling with a simplified model for the drainage at a reservoir dam was also performed. The results showed that the seepage zone near drainage in a reservoir dam could be detected by resistivity response change.

Acute Spinal Epidural Abscess Presenting with Abdominal Pain in a Child (급성복통을 동반한 소아의 척추 경막외 농양 1예)

  • Jeong, Eun Young;Lee, Youn Kyung;Kim, Suck Heon;Kong, Byoung Gu;Kim, Kwang Woo;Park, Young Soo;Kim, Dong Won
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.107-113
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    • 2001
  • Spinal epidural abscess(SEA) is a rare condition in children. Classic symptoms are spinal ache, root pain, weakness and paralysis. The earliest symptoms of SEA in the pediatric age group are nonspecific and variable. Early diagnosis may be almost impossible when local spinal pain is inconspicuous or absent, when toxic epiphenomena divert attention from subtle signs of neurologic dysfunction and when the patient is an acutely distressed and uncooperative child. Failure to diagnosis and treat condition on a timely basis may lead to permanent neurolgic dysfunction or even death. This infection, usually located in the dorsal epidural space of the mid thoracic or lower lumbar regions, is the result of hematogenous dissemination of bacteria, usually Staphylococci, from foci of infection in the skin, or respiratory or urinary tracts. MRI was the diagnostic method of choice. A combination of antibiotics and surgical drainage remains the treatment of choice. Prognosis is excellent if surgery is performed before the development of neurologic deficit. We report a case of SEA in a child whose first presenting symptom was abdominal pain rather than spinal pain. A case is diagnosed by MRI and successfully treated with laminectomy and drainage and antibiotics.

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Analysis of Surface Displacement of Oil Sands Region in Alberta, Canada Using Sentinel-1 SAR Time Series Images (Sentinel-1 SAR 시계열 영상을 이용한 캐나다 앨버타 오일샌드 지역의 지표변위 분석)

  • Kim, Taewook;Han, Hyangsun
    • Korean Journal of Remote Sensing
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    • v.38 no.2
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    • pp.139-151
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    • 2022
  • SAGD (Steam-Assisted Gravity Drainage) method is widely used for oil recovery in oil sands regions. The SAGD operation causes surface displacement, which can affect the stability of oil recovery plants and trigger various geological disasters. Therefore, it isimportant to monitor the surface displacement due to SAGD in the oil sands region. In this study, the surface displacement due to SAGD operations of the Athabasca oil sands region in Alberta, Canada, was observed by applying Permanent Scatterer Interferometric Synthetic Aperture Radar (PSInSAR) technique to the Sentinel-1 time series SAR data acquired from 2016 to 2021. We also investigated the construction and expansion of SAGD facilitiesfrom Landsat-7/8 time seriesimages, from which the characteristics of the surface displacement according to the oil production activity of SAGD were analyzed. Uplift rates of 0.3-2.5 cm/yr in the direction of line of sight were observed over the SAGDs and their vicinity, whereas subsidence rates of -0.3--0.6 cm/yr were observed in areas more than several kilometers away from the SAGDs and not affected by oil recovery activities. Through the analysis of Landsat-7/8 images, we could confirm that the SAGDs operating after 2012 and showing high oil production activity caused uplift rates greater than 1.6 cm/yr due to the subsurface steam injection. Meanwhile, very small uplift rates of several mm per year occurred over SAGDs which have been operated for a longer period of time and show relatively low oil production activity. This was probably due to the compression of reservoir sandstone due to continuous oil recovery. The subsidence observed in areas except for the SAGDs and their vicinity estimated to be a gradual land subsidence caused by melting of the permafrost. Considering the subsidence, it was expected that the uplift due to SAGD operation would be greater than that observed by the PSInSAR. The results of this study confirm that the PSInSAR can be used as an effective means for evaluating productivity and stability of SAGD in the extreme cold regions.

Surgical Complications in Heart Transplant Recipients - A Single Center Experience - (심장이식후에 발생한 외과적 합병증 - 단일 센터 경험 -)

  • Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.719-724
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    • 2009
  • Background: As the patients who undergo heart transplantation have achieved better survival in recent years, growing number of recipients are at a risk for experiencing surgical complications in addition to rejection and infection. In this paper, we report on our experience with the surgical complications that occurred in heart transplant recipients. Material and Method: From April 1994 to September 2003, 37 heart transplantations were performed at our center by a single surgeon. The indications for transplantation were dilated cardiomyopathy, ischemic cardiomyopathy, valvular cardiomyopathy and familial hypertrophic cardiomyopathy. Result: Twenty postoperative complications required surgeries in 15 patients (41%). The types of operations required were; redo-sternotomy for bleeding (5), pericardiostomy for effusion (4), implantation of a permanent pacemaker (1), right lower lobe lobectomy for aspergilloma (1), removal of urinary stone (1), cholecystectomy for gall bladder stone (1), drainage of a perianal abscess (1), paranasal sinus drainage (1), total hip replacement (1), partial gingivectomy due to gingival hypertrophy (1), urethrostomy (1), herniated intervertebral disc operation (1) and total hysterectomy for myoma uteri (1). The locations of the complications were mediastinal in 10 (27%) cases and extramediastihalin 10 (27%) cases. Conclusion: The relatively high incidence of extrathoracic complications associated with heart transplantation emphasizes the importance of a multidisciplinary approach to the improve long-term survival when managing those complex patients.

GARRE'S OSTEOMYELITIS IN CHILDREN (소아에서의 Garre 골수염)

  • Woo, Se-Eun;Kim, Young-Jin;Kim, Hyun-Jung;Nam, Soon-Hyeun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.4
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    • pp.413-420
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    • 2011
  • Garre's osteomyelitis is associated with bacterial infection and bone necrosis resulting from obstruction of blood supply. The most common cause for Garre's osteomyelitis is odontogenic infection that originates from periodontal tissue or dental pulp. Subperiosteal abscess may also cause Garre's osteomyelitis in the progress of the infection. Mandible is more often affected than maxilla, most commonly in the permanent first molar region of mandible. Clinically, it results in a hard swelling over the jaw, producing facial asymmetry. Meanwhile, radiograph shows a characteristic feature of irregular pulpal cavity, showing new periosteal proliferation located in successive layers to the condensed cortical bone on stimulated site. The treatment method for Garre's osteomyelitis are removal of the infection source, root canal treatment, antibiotic medication, and incision and drainage. This report presents a case of Garre's osteomyelitis under 15 years old. The patient was successfully treated by antibiotic medication accompanied with root canal treatment. Since the symptom of pediatric patients is less severe than adult, careful diagnosis with history taking and clinical examination is necessary. Furthermore long-term follow-up examination is needed to prevent recurrence even after the symptom disapears.

Respiratory Assist by Use of Electrical Diaphragmatic Pacing (전기자극에 의한 횡격막 조율을 이용한 호흡보조장치)

  • 오중환;김은기;서재정;박일환;김부연;이상헌;이종국;이영희
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.441-446
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    • 2001
  • Background: Electrical breathing pacing has many advantages over mechanical ventilation. However, clinically permanent diaphragmatic pacing has been applied to limited patients and few temporary pacing has been reported. Our purpose is to investigate the feasibility of temporary electrical diaphragm pacing in explothoracotomy canine cases. Methods: Five dogs were studied under the general anesthesia. Left 5th intercostal space was opened. Self designed temporary pacing leads were placed around the left phrenic nerve and connected to the myostimulator. Chest wall was closed after tube insertion with underwater drainage. Millar catheter was introduced to the aorta and right atrium. Swan-Ganz catheter was introduced to the pulmonary artery. When the self respiration was shallow with deep anesthesia, hemodynamic and tidal volume were measured with the stimulator on. Results: Tidal volume increased from 143.3$\pm$51.3 ml to 272.3$\pm$87.4 ml(p=0.004). Right atrial diastolic pressure decreased from 0.7$\pm$4.0 mmHg to -10.5$\pm$4.7 mmHg(p=0.005). Pulmonary arterial diastolic pressure decreased from 6.1+2.5 mmHg to 1.2$\pm$4.8 mmHg(p<0.001). The height of water level in chest tube to show intrathoracic pressure change was from 10.3$\pm$6.7cmH$_{2}$O to 20.0$\pm$5.3 cmH$_{2}$O. Conclusion: Temporary electrical diaphragmatic pacing is a simple method to assist respiration in explothoracotomy canine cases. Self designed pacing lead is implantable and removable. Negative pressure ventilation has favorable effects on the circulatory system. Therefore, clinical application of temporary breathing pacing is feasible in thoracotomy patients to assist cardiorespiratory function.

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The Results of Extracardiac Fontan Operation in the Patients with Heterotaxy Syndrome (이소성증후군에서의 심장외도관 폰탄 수술의 결과)

  • Lim Hong Gook;Kim Soo-Jin;Lee Chang-Ha;Kim Woong-Han;Hwang Seong Wook;Lee Cheul;Oh Sam-Sae;Baek Man-Jong;Na Chan-Young;Kim Jae Hyun;Seo Hong Joo;Jung Sung Chol;Kim Chong Whan
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.529-537
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    • 2005
  • Background: Historically the Fontan operation in patients with single ventricle and heterotaxy syndrome has been associated with high mortality because of systemic or pulmonary anomalous venous drainage, incompetent common atrioventricular valve, right ventricle type univentricular heart, and arrhythmia. Material and Method: A retrospective review of 62 patients $(age:\;54.79\pm33.97\;months)$ with heterotaxy syndrome who underwent a extracadiac Fontan operation between 1996 and 2005 was performed. Twenty one patients had left atrial isomerism, and 41 had right isomerism. The Fontan procedure was staged in all but 2 patients, and a fenestration was less placed in left isomerism. Result: Left isomerism was associated more with interrupted inferior vena cava and pulmonary arteriovenous fistula, and right isomerism was associated more with anomalous pulmonary venous drainage, common atrioventricular valve and morphologic right ventricle. There were 3 hospital deaths$(4.8\%)$ and 3 late deaths $(5.2\%)$ with a follow-up duration of $48.8\pm31.0$ months. Eight-year survivals were $90.5\pm6.4\%$ in left isomerism and $88.6\pm5.4\%$ in right isomerism (p=0.94). At 8 years, freedom from reoperation was $73.9\pm11.3\%$ in left isomerism, and $82.3\pm6.7\%$ in right isomerism (p=0.87). Atrioventricular valve regurgitation progressed after Fontan operation in heterotaxy syndrome, and reoperation for pulmonary arteriovenous fistula and permanent pacemaker implantation for sinus node dysfunction were required more in left isomerism. Conclusion: The extracardiac Fontan operation can now be performed in patients with heterotaxy syndrome with excellent survival. However, morbidity in terms of postoperative atrioventricular valve regurgitation, arrhythmia, and pulmonary arteriovenous fistula remains significant.