http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
急性呼吸器系 Virus의 疫學的考察 : 韓國內에 있어서 Virus疾患을 中心으로
金慶浩,徐俊錫 대한감염학회 1977 감염 Vol.9 No.1
급성호흡기계환은 우리가 잘 아다시피 그 병원체가 세균, 리켓치아, 클라미디아, 진균 및 비루스에 의해 감염된다. 몇가지 병학적인 특징을 보면 급성호흡기계환은 그 발생솔의 차이는 있지만 범세계적으로 발생하고 있다. 백신이 널리 사용되고 있지 않고 병원체불명이 전체의 약 50%를 차지하고 있다.
혈액투석 환자에서 쌍내강 영구도관(Permcath) 사용의 임상적 고찰
서경석,김상준,이건욱,서준석,정중기,홍인규,권오중 대한혈관외과학회 1995 Vascular Specialist International Vol.11 No.1
Between October 1993 and December 1994, we have inserted 57 dacron cuffed double lumen catheters(Permcath, Quinton, Seattle, WA) in 55 renal failure patients for hemodialysis for a mean duration of 2.2 months (range 17 days to 13 months). 4 cases were inserted by surgical venotomy technique and 53 cases by percutaneous technique. Insertion complications were only local hematoma especially in percutaneous technique. Catheters were intentionally removed in 52 patients and two catheters were removed due to complications (infection one catheter, thrombosis one catheter) and the remaining 3 catheters are still placed to pateints. Minor flow problems occurred in 5 cases(9%) and required urokinase infusion (at least once). Local exit site infection occurred 4 cases (7%) and septicemia (at least once) in 3 case (5%). There is no clinical sign of central venous stenosis or thrombosis, such as arm swelling, prominent cataneous collateral veins or increased venous pressure at dialysis even in 3 casees using catheters more than 10 months. This study confirms the low rate of infection and obstruction of the catheter, so we concluded that Permcath is an acceptable vascualr assess device to acute renal failure patients and end stage renal disease patients for hemodialysis waiting for the maturation of arterio-venous fistula or synthetic graft and in whom it is impossible to create an arterio-venous fistula.
혈액 투석을 위한 이중내강카세터 (Dual Lumen Catheter; DLC)천자와 관련된 합병증
김상준,권오중,서준석,정중기,강한성 대한혈관외과학회 1998 Vascular Specialist International Vol.14 No.2
Introduction: Central venous catheterization by dual lumen catheter (DLC, Perm Cath^ⓡ) is used for temporary or permanent vascular access. Although it has many advantages such as rapid insertion, emergent usage or long-term maintenance, there are still clinically important complications associated with insertion procedure and maintaining period. Purpose: To define and manage the various kinds of complications is important to avoid repetition of them and to guide for selection of vascular access in long-term hemodialysis patients. Materials and Methods: Between May 1993 and April 1996, we experienced 95 cases of DLC in 88 uremic patients for the following reasons: 12 cases in 12 patients for ARF and 83 cases in 76 patients for ESRD. We used external or internal jugular veins and the method of insertion was percutaneous venipuncture in internal jugular vein (88 cases, Rt.=84, Lt.=4) and venotomy in external jugular vein (7 cases Rt=7). The complications and their therapeutic options were analyzed retrospectively. Results: Group I complication is associated with insertion procedure, including cardiac arrhythmia (n=65, 68.4%), minor air embolism (n=3, 3.2%), hematoma on puncture site (n=15, 15.8%) and difficult catheterization on multipunctured patients (n=3, 3.2%). Group II complication is associated with long term maintanence use of catheters(mean period=8.3 mos) and includes catheter thrombosis (n=15, 15.8%), inadvertent cuff exposure (n=10, 10.5%) and bacteremia (n=16, 16.6%). The management of complications were as followings. Cardiac arrhythmia occurred during guidewire insertion was completely resolved with wire retraction and clinically detected minor air embolism was recovered spontaneously in all cases. Hematoma on puncture site was controlled by compression in 13 cases and 2 cases were resolved after catheter removal. All of the difficult catheterization was solved with fluoroscopic guide insertion. Most of catheter thrombosis were controlled with urokinase infusion (n=13), but in 2 cases, catheter removal was required. All cases of inadvertent cuff exposure led to ascending infection, among them 6 cases were controlled with catheter removal and the rest of them was controlled with aseptic dressing and antibiotics. Five out of 16 cases (5.3%) with bacteremia were not controlled with antibiotics and resulted in catheter removal. Conclusion: To avoid unfavorable complications such as uncontrolled hematoma or bacteremia, fluoroscopic guide insertion and aseptic handling of exit site is important. And it should be remembered that location of cuff should be far from the exit site (>2 cm) to avoid inadvertent traction.