Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a case of stent dislodgement in the ascending thoracic aorta. The stent was mechanically distorted in the left circumflex artery (LCX) while being delivered to the proximal LCX lesion. The balloon catheter was withdrawn, but the stent with the guide wire was remained in the ascending thoracic aorta. The stent was unable to be retrieved into the guide catheter, as it was distorted. A goose neck snare was used successfully to catch the stent in the ascending thoracic aorta and retrieved the stent externally via the arterial sheath.
Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation ; *Aorta, Thoracic/radiography ; Cardiac Catheterization/*adverse effects/*instrumentation ; Coronary Angiography ; Device Removal/*instrumentation ; Foreign Bodies/etiology/radiography/*therapy ; Humans ; Male ; Middle Aged ; Radiography, Interventional ; *Stents ; Treatment Outcome

Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a rare case of dislodgement of two intracoronary stents. On withdrawal of two balloon catheters, one with a guide wire was mechanically distorted from the left main (LM) to the proximal left anterior descending artery (LAD) while the other was dislodged from the LM to the ostial left circumflex artery. The stent in the LAD could not be retrieved into the guide catheter using a Goose neck snare, because it was caught on a previously deployed stent at the mid LAD. A new stent was quickly deployed from the LM to the proximal LAD, because the patient developed cardiogenic shock. Both stents, including a distorted and elongated stent, were crushed to the LM wall. Stent deployment and crushing may be a good alternative technique to retrieving a dislodged stent.
Angioplasty, Balloon, Coronary/adverse effects/*instrumentation ; Cardiac Catheterization/adverse effects/*instrumentation ; Coronary Angiography ; Coronary Stenosis/diagnosis/*therapy ; Female ; Humans ; Middle Aged ; Prosthesis Failure ; Shock, Cardiogenic/etiology/therapy ; *Stents ; Treatment Outcome

OBJECTIVE: Carpal tunnel syndrome(CTS) is one of the compression neuropathy in long-term hemodialysis patients, that considerably caused by venous stasis or edema in the site of the vascular access, arterial steal syndrome and currently reported, amyloid deposit. CTS shows pain, paresthesia and weakness in the area that median nerve is distributed. We analysed the incidence and characteristics of nerve conduction test of CTS in the patients of hemodialyzed chronic renal failure. METHODS: Thirty hemodialyzed patients were enrolled and divided three groups in peripheral polyneuropathy(PNP) only, CTS only, and both by clinical manifestations and results of nerve conduction test. RESULTS: 1) In all thirty patients, two(7%) had a CTS only, seven(23%) had a PNP only and sixteen(54%) had combined PNP with CTS. 2) In al thirty patients(60 hands), 2 cases(two-3%) had a CTS with clinical manifestations, 25 cases (siteen-42%) had a CTS without clinical manifestation and 1 case(one-1.7%) showed clinical manifestations of CTS but was not diagnosed CTS by nerve conduction test. There was no significant correlation between clinical manifestations and development of CTS(p>0.05). 3) In all thirty patients(60 hands), 6 cases(four-10 %) had a CTS with edema, 21 cases(fourteen-35%) had a CTS without edema and 2 cases(two-1.7%) showed edema of hands but was not diagnosed CTS by nerve conduction test. There was no significant correlation between edema and development of CTS (p>0.05). 4) Among the eighteen patients with CTS, nine (50%) patients were involved in one hand, nine(50%) patients in both. 5) In the sixty hands, 33 hands had vascular access, in which 13 cases(39.4%) had CTS and 20 cases(60.6%) had not. In the 27 hands which had not vascular access, 14 cases(51.6%) had CTS and 13 cases(48.1%) had not. There was no significant correlation between vascular access and development of CTS(p>0.05). CONCLUSION: The incidence of CTS in the patients of hemodialyzed chronic renal failure was 60%. There was no significant correlation between CTS and vascular access, edema, duration of hemodialysis. Subclinical CTS was more frequent compared to the overt CTS.
Carpal Tunnel Syndrome* ; Edema ; Hand ; Humans ; Incidence ; Kidney Failure, Chronic* ; Median Nerve ; Neural Conduction ; Paresthesia ; Plaque, Amyloid ; Polyneuropathies ; Renal Dialysis*

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus

Premature menopause can be developed as a result of undesired nontarget ovary embolization during the performance of uterine fibroid embolization. The etiology of ovarian failure after uterine fibroid embolization is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. We report here on two cases in which superselective coil embolization of distal uterine artery collateral pathways to the ovary was performed during uterine fibroid embolization.
Angiography ; Embolization, Therapeutic* ; Female ; Leiomyoma* ; Menopause, Premature ; Ovary ; Uterine Artery ; Uterus

Background: We evaluated and compared South Korea’s total knee arthroplasty (TKA) reimbursement criteria set by Health Insurance Review and Assessment Service (HIRA) with other TKA appropriateness criteria to find additional criterion to improve its appropriateness by reviewing TKA inappropriate cases. Methods: Two TKA appropriateness criteria and HIRA’s reimbursement criteria for TKA were adapted for use on patients undergoing TKA in one institute from December 2017 to April 2020. Preoperative data including 9 validated questionnaires on knee jointspecific parameters, age, and radiography were used. We categorized cases into appropriate, inconclusive, inappropriate groups and analyzed each group. Results: Data on 448 cases that underwent TKA were examined. According to the HIRA’s reimbursement criteria, 434 cases (96.9%) were appropriate and 14 cases (3.1%) were inappropriate; superior to other TKA appropriateness criteria. The inappropriate group had Knee Injury and Osteoarthritis Outcome score (KOOS) pain, KOOS symptoms, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, and Korean Knee score total score with worse symptoms compared to the appropriate group classified by HIRA’s reimbursement criteria. Conclusions In terms of insurance coverage, HIRA’s reimbursement criteria was more effective in providing healthcare access to patients who had the most pressing need for TKA compared to other TKA appropriateness criteria. However, we found the lower age limit and patient-reported outcome measures of other criteria as useful tools in improving appropriateness of the current reimbursement criteria.

The quality factors (kQ,Q0) were evaluated by appling the results recently studied for the effect of central electrode in TRS-398 protocol. The PTW-31010 and IBA-CC13 chambers were used in this study. The quality factors were calculated as a function of beam quality for high energy electron and photon beams and compared with data currently used in TRS-398 protocol. In the PTW-31010 chamber using aluminium electrode, appling the new central electrode collections, the quality factors were 0.4% and 0.9% higher than current TRS-398 data for high energy photon and electron beams respectively. In the IBA-CC13 chamber using C-552 electrode, there are no variations in quality factors compared to TRS-398 data currently used.
Electrodes ; Electrons

OBJECTIVE: Pelvic inflammatory disease has been inclining over the years and high prevalence rates in teenagers is an upcoming issue. Our study is to research and analyze the PID patients of a certain region to give a better perspect of the disease for adequate prevention and management. METHODS: From March 1998 to December 2001, we underwent retrospective studies on medical records of 130 admitted PID patients in po-hang Dong-guk university hospital. RESULTS: Our of all gynecologic patients, 14.4% were PID patients. 17.7% of these were teenagers and patients who were in there twenties consumed up to 50.8%. The disease mostly occured within 8 days of the first menstruational day. Common etiology of the disease was unmarried state, using IUD as a contraceptive and previous artificial abortion. CONCLUSION: PID patients who are in their teens or twenties represented 68.5% of all PID patients. PID in younger ages keeps increasing and seems to be a trend. Secondary treatment of the disease is undoubtfully important, but primary prevention such as sexual education and birth control must also be considered.
Adolescent ; Contraception ; Education ; Female ; Gyeongsangbuk-do* ; Humans ; Medical Records ; Pelvic Inflammatory Disease* ; Prevalence ; Primary Prevention ; Retrospective Studies ; Single Person

PURPOSE: To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). MATERIALS AND METHODS: The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. RESULTS: The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II (p < 0.05). CONCLUSION: The global CT number measured by a non-contrast enhanced pelvic CT is a useful predictive factor of a successful uterine fibroid embolization.
Embolization, Therapeutic ; Female ; Humans ; Leiomyoma ; Myoma ; Prospective Studies ; Radiology, Interventional ; Tomography, X-Ray Computed ; Uterine Artery Embolization ; Uterine Neoplasms

A 67-year-old male patient was admitted with an abrupt sudden cardiac death. He represented with an extreme electrical storm of 30 times of ventricular fibrillation (VF) episodes on one day. External shocks were performed to terminate VF. Transient J-wave in the inferior-lateral leads and Brugada electrocardiography pattern on the right precordial leads appeared during the electrical storm. And J-wave disappeared after the termination of electrical storm. We report a case of the appearance of J-wave during electrical storm in a patient with Brugada syndrome.
Brugada Syndrome ; Death, Sudden, Cardiac ; Electrocardiography ; Humans ; Male ; Shock ; Ventricular Fibrillation