Objective To evaluate the safety and possibility of transesophageal emergency ventricular pacing with esophageal balloonelectrode catheter.Methods Sixty four patients with critical bradyarrhythmias were divided random...Objective To evaluate the safety and possibility of transesophageal emergency ventricular pacing with esophageal balloonelectrode catheter.Methods Sixty four patients with critical bradyarrhythmias were divided randomly to receive either transesophagealventricular pacing with esophageal balloon electrode catheter(balloon.catheter group,n=32),or transesophageai ventricular pacing withnormal esophageal electrode catheter(normal catheter group,n=32).Pulse width(ms),current output(mA),and the success rate werecompared between the 2 groups.Results Success rate in the balloon catheter group was 87.5%,which was significantly higher thanthat in the nodal catheter group(18.7%,X2=27.7,P＜0.01).The success rate oftransesophageal ventricular pacing with esophagealballoon electrode catheter was 87.5%.The average current output(mA)was significantly lower in the balloon catheter group than thatin the normal catheter group (24.5+2.5 mA VS 53±3.4mA,P＜0.05).Conclusions Esophageal balloon electrode catheter pacing couldbecome an available teclmiqBe for transesophageal emergency ventricular pacing.展开更多
Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved ...Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external展开更多
AIM: To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.METHODS: From September 2009 to March 2013, a total of 176 measurements of hepatic venous p...AIM: To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.METHODS: From September 2009 to March 2013, a total of 176 measurements of hepatic venous pressure gradient (HVPG) were done in 146 patients. Each transjugular HVPG was measured twice, first using an end whole catheter (EH-HVPG), and then using a balloon catheter (B-HVPG). The HVPG was compared with the endoscopic grade of esophageal varices (according to the general rules for recording endoscopic findings of esophagogastric varices), which was recorded within a month of the measurement of HVPG.RESULTS: The study included 110 men and 36 women, with a mean age of 56.1 years (range, 43-76 years). The technical success rate of the pressure measurements was 100% and there were no complication related to the procedures. Mean HVPG was 15.3 mmHg as measured using the end hole catheter method and 16.5 mmHg as measured using the balloon catheter method. Mean HVPG (both EH-HVPG and B-HVPG) was not significantly different among patients with different characteristics, including sex and comorbid factors, except for cases with hepatocellular carcinoma (B-HVPG, P = 0.01; EH-HVPG, P = 0.02). Portal hypertension (> 12 mmHg HVPG) occurred in 66% of patients according to EH-HVPG and 83% of patients according to B-HVGP, and significantly correlated with Child’s status (B-HVPG, P < 0.000; EH-HVGP, P < 0.000) and esophageal varies observed upon endoscopy (EH-HVGP, P = 0.003; B-HVGP, P = 0.006). One hundred and thirty-five endoscopies were performed, of which 15 showed normal findings, 27 showed grade 1 endoscopic esophageal varices, 49 showed grade 2 varices, and 44 showed grade 3 varices. When comparing endoscopic esophageal variceal grades and HVPG using univariate analysis, the P value was 0.004 for EH-HVPG and 0.002 for B-HVPG.CONCLUSION: Both EH-HVPG and B-HVPG showed a positive correlation with the endoscopic grade of esophageal varices, with B-HVPG showing a stronger correlation than EH-HVPG.展开更多
Esophageal atresia with tracheo-oesophageal fistula(TEF) occurs in 1 in 3500 live births. Anorectal malformation is found to be associated with 14% of TEF. Esophageal atresia with TEF is a congenital anomaly which cla...Esophageal atresia with tracheo-oesophageal fistula(TEF) occurs in 1 in 3500 live births. Anorectal malformation is found to be associated with 14% of TEF. Esophageal atresia with TEF is a congenital anomaly which classically presents as excessive frothing from the mouth and respiratory distress. Rarely gastric position of the feeding tube in a case of TEF can be obtained delaying the diagnosis of TEF. We had an uncommon situation where a nasogastric tube reached the stomach through the trachea and tracheo-esophageal fistula, leading to misdiagnosis in a case of esophageal atresia with tracheoesophageal fistula. By using a stiff rubber catheter instead of a soft feeding tube for the diagnosis of esophageal atresia and TEF, such situation can be avoided.展开更多
BACKGROUND Esophageal cancer is a common type of cancer and serious bleeding from esophageal tumors can occur in routine clinical practice.The arrest of bleeding from esophageal tumor is not a trivial task,which can s...BACKGROUND Esophageal cancer is a common type of cancer and serious bleeding from esophageal tumors can occur in routine clinical practice.The arrest of bleeding from esophageal tumor is not a trivial task,which can sometimes require non-standard solutions.We report a case of successful hemostasis of massive bleeding from esophageal tumor performed by a novel two-balloon catheter inserted endoscopically,with a local hemostatic treatment applied.CASE SUMMARY A 36-years old male patient with advanced esophageal cancer developed bleeding from the tumor following endoscopic stenting with a self-expanding metal stent.Due to the ineffectiveness of standard approaches,after a medical conference,the patient was treated with a novel method based on the use of a two-balloon catheter creating an isolated area in esophagus and locally dispersing hemostatic polysaccharide powder inside the isolated interior.Hemostasis was successful and subsequent endoscopic examination revealed the presence of organized clot and localized defect,which was coagulated in a planned manner.CONCLUSION The authors present a new catheter-based method of hemostasis of esophageal tumor bleeding.展开更多
AIM:To investigate the luminal esophageal temperature(LET) at the time of delivery of energy for pulmonary vein isolation(PVI).METHODS:This study included a total of 110 patients with atrial fibrillation who underwent...AIM:To investigate the luminal esophageal temperature(LET) at the time of delivery of energy for pulmonary vein isolation(PVI).METHODS:This study included a total of 110 patients with atrial fibrillation who underwent their first PVI procedure in our laboratory between March 2010 and February 2011.The LET was monitored in all patients.We measured the number of times that LET reached the cut-off temperature,the time when LET reached the cut-off temperature,the maximum temperature(T max) of the LET,and the time to return to the original preenergy delivery temperature once the delivery of energy was stopped.RESULTS:Seventy-eight patients reached the cut-off temperature.It took 6 s at the shortest time for the LET to reach the cut-off temperature,and 216.5 ± 102.9 s for the temperature to return to the level before the de-livery of energy.Some patients experienced a transient drop in the LET(TDLET) just before energy delivery.Ablation at these sites always produced a rise to the LET cut-off temperature.TDLET was not observed at sites where the LET did not rise.Thus,the TDLET before the energy delivery was useful to distinguish a high risk of esophageal injury before delivery of energy.CONCLUSION:Sites with a TDLET before energy delivery should be ablated with great caution or,perhaps,not at all.展开更多
文摘Objective To evaluate the safety and possibility of transesophageal emergency ventricular pacing with esophageal balloonelectrode catheter.Methods Sixty four patients with critical bradyarrhythmias were divided randomly to receive either transesophagealventricular pacing with esophageal balloon electrode catheter(balloon.catheter group,n=32),or transesophageai ventricular pacing withnormal esophageal electrode catheter(normal catheter group,n=32).Pulse width(ms),current output(mA),and the success rate werecompared between the 2 groups.Results Success rate in the balloon catheter group was 87.5%,which was significantly higher thanthat in the nodal catheter group(18.7%,X2=27.7,P＜0.01).The success rate oftransesophageal ventricular pacing with esophagealballoon electrode catheter was 87.5%.The average current output(mA)was significantly lower in the balloon catheter group than thatin the normal catheter group (24.5+2.5 mA VS 53±3.4mA,P＜0.05).Conclusions Esophageal balloon electrode catheter pacing couldbecome an available teclmiqBe for transesophageal emergency ventricular pacing.
文摘Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external
基金Supported by the Research Program of the National Research Foundation of Koreafunded by the Ministry of Education and Science and Technology No.2010-0011678and the Soonchunhyang University Research Fund
文摘AIM: To determine the correlation between the hepatic venous pressure gradient and the endoscopic grade of esophageal varices.METHODS: From September 2009 to March 2013, a total of 176 measurements of hepatic venous pressure gradient (HVPG) were done in 146 patients. Each transjugular HVPG was measured twice, first using an end whole catheter (EH-HVPG), and then using a balloon catheter (B-HVPG). The HVPG was compared with the endoscopic grade of esophageal varices (according to the general rules for recording endoscopic findings of esophagogastric varices), which was recorded within a month of the measurement of HVPG.RESULTS: The study included 110 men and 36 women, with a mean age of 56.1 years (range, 43-76 years). The technical success rate of the pressure measurements was 100% and there were no complication related to the procedures. Mean HVPG was 15.3 mmHg as measured using the end hole catheter method and 16.5 mmHg as measured using the balloon catheter method. Mean HVPG (both EH-HVPG and B-HVPG) was not significantly different among patients with different characteristics, including sex and comorbid factors, except for cases with hepatocellular carcinoma (B-HVPG, P = 0.01; EH-HVPG, P = 0.02). Portal hypertension (> 12 mmHg HVPG) occurred in 66% of patients according to EH-HVPG and 83% of patients according to B-HVGP, and significantly correlated with Child’s status (B-HVPG, P < 0.000; EH-HVGP, P < 0.000) and esophageal varies observed upon endoscopy (EH-HVGP, P = 0.003; B-HVGP, P = 0.006). One hundred and thirty-five endoscopies were performed, of which 15 showed normal findings, 27 showed grade 1 endoscopic esophageal varices, 49 showed grade 2 varices, and 44 showed grade 3 varices. When comparing endoscopic esophageal variceal grades and HVPG using univariate analysis, the P value was 0.004 for EH-HVPG and 0.002 for B-HVPG.CONCLUSION: Both EH-HVPG and B-HVPG showed a positive correlation with the endoscopic grade of esophageal varices, with B-HVPG showing a stronger correlation than EH-HVPG.
文摘Esophageal atresia with tracheo-oesophageal fistula(TEF) occurs in 1 in 3500 live births. Anorectal malformation is found to be associated with 14% of TEF. Esophageal atresia with TEF is a congenital anomaly which classically presents as excessive frothing from the mouth and respiratory distress. Rarely gastric position of the feeding tube in a case of TEF can be obtained delaying the diagnosis of TEF. We had an uncommon situation where a nasogastric tube reached the stomach through the trachea and tracheo-esophageal fistula, leading to misdiagnosis in a case of esophageal atresia with tracheoesophageal fistula. By using a stiff rubber catheter instead of a soft feeding tube for the diagnosis of esophageal atresia and TEF, such situation can be avoided.
文摘BACKGROUND Esophageal cancer is a common type of cancer and serious bleeding from esophageal tumors can occur in routine clinical practice.The arrest of bleeding from esophageal tumor is not a trivial task,which can sometimes require non-standard solutions.We report a case of successful hemostasis of massive bleeding from esophageal tumor performed by a novel two-balloon catheter inserted endoscopically,with a local hemostatic treatment applied.CASE SUMMARY A 36-years old male patient with advanced esophageal cancer developed bleeding from the tumor following endoscopic stenting with a self-expanding metal stent.Due to the ineffectiveness of standard approaches,after a medical conference,the patient was treated with a novel method based on the use of a two-balloon catheter creating an isolated area in esophagus and locally dispersing hemostatic polysaccharide powder inside the isolated interior.Hemostasis was successful and subsequent endoscopic examination revealed the presence of organized clot and localized defect,which was coagulated in a planned manner.CONCLUSION The authors present a new catheter-based method of hemostasis of esophageal tumor bleeding.
文摘AIM:To investigate the luminal esophageal temperature(LET) at the time of delivery of energy for pulmonary vein isolation(PVI).METHODS:This study included a total of 110 patients with atrial fibrillation who underwent their first PVI procedure in our laboratory between March 2010 and February 2011.The LET was monitored in all patients.We measured the number of times that LET reached the cut-off temperature,the time when LET reached the cut-off temperature,the maximum temperature(T max) of the LET,and the time to return to the original preenergy delivery temperature once the delivery of energy was stopped.RESULTS:Seventy-eight patients reached the cut-off temperature.It took 6 s at the shortest time for the LET to reach the cut-off temperature,and 216.5 ± 102.9 s for the temperature to return to the level before the de-livery of energy.Some patients experienced a transient drop in the LET(TDLET) just before energy delivery.Ablation at these sites always produced a rise to the LET cut-off temperature.TDLET was not observed at sites where the LET did not rise.Thus,the TDLET before the energy delivery was useful to distinguish a high risk of esophageal injury before delivery of energy.CONCLUSION:Sites with a TDLET before energy delivery should be ablated with great caution or,perhaps,not at all.
