One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

We report a case of a 59 year-old female with hyperlipoproteinernia who had xanthoma tuberosum, xanthoma tendinosurn and xanthoma planum. Yellowish nodules appeared on the right elbow 26 years ago and the lesions gradually increased in size and spread to the elbow, hand, knee, foot and achilles tendon. Except for the skin lesion, she was normal on physical examination. The laboratory findings showed that the serum cholesterol, beta lipoprotein and total lipid were increased. The beta band was rnarkedly elevated on electrophoresis, which suggested type IIa hyperlipoproteinemia. Histopathological findings shc wed many aggregates of foam cells and foreign body giant cells were seen in the dermis.
Achilles Tendon ; Cholesterol ; Dermis ; Elbow ; Electrophoresis ; Female ; Foam Cells ; Foot ; Giant Cells, Foreign-Body ; Hand ; Humans ; Hyperlipoproteinemia Type II* ; Knee ; Lipoproteins ; Middle Aged ; Physical Examination ; Skin ; Temazepam* ; Xanthomatosis*

OBJECTIVES: On December 7, 2007, the Hebei Spirit oil tanker spilled out 12,547 kl of crude oil on the Yellow Sea 10 km away from the cost of Taean Province, Korea. As the coastline has been contaminated, local residents have been exposed to crude oil. Because the residents were showing many symptoms, we investigated the acute health effects of this oil spill on them. METHODS: We conducted a cross-sectional study consisting of the heavy and moderately oil soaked area in Taean and the lightly oil soaked area in Seocheon. Ten seashore villages were selected from each area, and 10 male and female adults were selected from each village. We interviewed the subjects using a structured questionnaire on the characteristics of residents, the cleanup activities, the perception of oil hazard, depression and anxiety, and the physical symptoms. The odds ratios and 95% confidence intervals were analyzed using logistic regression analysis. The logistic regression model was adjusted for age, gender, education, smoking, the perception of oil hazard and anxiousness. RESULTS: The more highly contaminated the area, the more likely it was for residents to be engaged in cleanup activities and have a greater chance of exposure to oil. The indexes of anxiety and depression were higher in the heavy and moderately oil soaked areas. The increased risks of headache, nausea, dizziness, fatigue, tingling of limb, hot flushing, sore throat, cough, runny nose, shortness of breath, itchy skin, rash, and sore eyes were significant. CONCLUSIONS: The results suggest that exposure to crude oil is associated with various acute physical symptoms. Long-term investigation is required to monitor the residents' health.
Aged ; Cross-Sectional Studies ; *Disasters ; Environmental Exposure/*adverse effects ; Female ; *Health Status ; Humans ; Logistic Models ; Male ; Middle Aged ; Petroleum/*toxicity ; Republic of Korea/epidemiology ; Water Pollutants, Chemical/*toxicity

Cerebral cavernous malformation with giant cysts is rare and literature descriptions of its clinical features are few. In this case study, the authors describe the clinical symptoms, radiological findings, and pathological diagnosis of cerebral cavernous malformations with giant cysts, reviewing the relevant literature to clearly differentiate this from other disease entities. The authors present a case of a 19-year-old male with a giant cystic cavernous malformation, who was referred to the division of neurosurgery due to right sided motor weakness (grade II/II). Imaging revealed a large homogenous cystic mass, 7.2x4.6x6 cm in size, in the left fronto-parietal lobe and basal ganglia. The mass had an intra-cystic lesion, abutting the basal portion of the mass. The initial diagnosis considered this mass a glioma or infection. A left frontal craniotomy was performed, followed by a transcortical approach to resect the mass. Total removal was accomplished without post-operative complications. An open biopsy and a histopathological exam diagnosed the mass as a giant cystic cavernous malformation. Imaging appearances of giant cavernous malformations may vary. The clinical features, radiological features, and management of giant cavernous malformations are described based on pertinent literature review.
Basal Ganglia ; Biopsy ; Caves ; Craniotomy ; Glioma ; Hemangioma, Cavernous, Central Nervous System ; Humans ; Male ; Neurosurgery ; Young Adult

OBJECTIVE: The purpose of this study was to examine the efficacy and perioperative complications associated with lumbar spinal fusion surgery, focusing on geriatric patients in the Republic of Korea. METHODS: We retrospectively investigated 485 patients with degenerative spinal diseases who had lumbar spinal fusion surgeries between March 2006 and December 2010 at our institution. Age, sex, comorbidity, American Society of Anesthesiologists (ASA) class, fusion segments, perioperative complications, and outcomes were analyzed in this study. Risk factors for complications and their association with age were analyzed. RESULTS: In this study, 81 patients presented complications (16.7%). The rate of perioperative complications was significantly higher in patients 70 years or older than in other age groups (univariate analysis, p=0.015; multivariate analysis, p=0.024). The perioperative complications were not significantly associated with the other factors tested (sex, comorbidity, ASA class, and fusion segments). Post-operative outcomes of lumbar spinal fusion surgeries for the patients were determined on the basis of MacNab's criteria (average follow up period : 19.7 months), and 412 patients (85.0%) were classified as having "excellent" or "good" results. CONCLUSION: Increasing age was an important risk factor for perioperative complications in patients undergoing lumbar spinal fusion surgery, whereas other factors were not significant. However, patients' satisfaction or return to daily activities when compared with younger patients did not show much difference. We recommend good clinical judgment as well as careful selection of geriatric patients for lumbar spinal fusion surgery.
Comorbidity ; Follow-Up Studies ; General Surgery* ; Humans ; Judgment ; Multivariate Analysis ; Republic of Korea* ; Retrospective Studies ; Risk Factors ; Spinal Diseases ; Spinal Fusion*

Pylephlebitis is defined as septic thrombophlebitis of the portal vein or one of its tributaries, and is usually secondary to an infection in the region drained by the portal venous system. Pylephlebitis is extremely rare today but high mortality still persists. It is a severe complication of acute appendicitis and other intraabdominal and pelvic infections. The patient presents with high fever, chills, leukocytosis, altered liver function, and sometimes jaundice. We describes two cases of pylephlebitis with acute appendicitis. One patient had pylephlebitis with multiple liver abscess and the other had superior mesnteric vein thrombi without liver abscesses. Both the patients had favorable outcomes with medical and surgical therapy. The early diagnosis and treatment with the timely administration of antibiotics and surgical therapy is most important for pylephlebitis.
Anti-Bacterial Agents ; Appendicitis* ; Chills ; Early Diagnosis ; Fever ; Humans ; Jaundice ; Leukocytosis ; Liver ; Liver Abscess ; Mortality ; Pelvic Infection ; Portal Vein ; Thrombophlebitis ; Veins

BACKGROUND: Successful revascularization and reperfusion of ischemia are associated with high systemic complication rates and severe tissue injuries. Such complications with nonfunction are primarily related to the injuries that occur in the reperfusion process, but to date the exact mechanism is not clear. Anoxia or hypoxia and reoxygenation are principal components of ischemia and reperfusion (I/R) and have distinctive effects on the tissue. In the I/R injury model, endothelial cell injury is known to be an initial event, the microvasculature is highly sensitive, and the hyperadhesiveness of leukocytes to endothelial cells contributes to I/R-induced tissue injury. METHODS: Experimental groups were divided into 4 groups: a control group without any treatment, an anoxia group (A-G) treated with anoxic air (93% N2, 5% CO2, 2% H2) for 20 minutes, reoxygenation group (RO-G) treated with 100% O2 for 90 minutes, and a superoxide dismutase (SOD) group treated with SOD just before reoxygenation. Endothelial cells were isolated from human umbilical vein and cultured in an M-199 medium. Their purity was determined by immunofluorescent staining of factor VIII related antigen, phase-contrast, and scanning electron microscopy. Using a microelectrode, radio immunoassay, and Emzyme-linked immunosorbent assay (ELISA), we studied the time-course changes of the levels of nitric oxide (NO), prostaglandin I2 (PGI2), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule (VCAM) of the 4 groups. RESULTS: 1) Endothelial cell detachment was found in the A-G and more detachment with lysis was found in the RO-G but no significant detachment and lysis were noted in the SOD group. 2) The concentration of NO in the A-G was lower than that of the control group (P<0.05). The NO concentration of the RO-G reached its highest level of 4809.01+/-444.69 nM/1x10(5) cells/ml at 30 minutes(P<0.005) and decreased after that. 3) The concentration of PGI2 in the A-G was higher than that of the control group (P<0.05). The PGI2 concentration of the RO-G reached its highest level of 64.25+/-2.39 pg/1x10(5) cells/ml at 45 minutes (P<0.005) and decreased after that. 4) The concentration of ICAM-1 in the A-G was higher than that of the control group (P<0.005). The ICAM-1 concentration of the RO-G reached its highest level of 7.18+/-0.62 ng/1x105 cells/ml at 15 minutes (P<0.005), then decreased to its lowest level of 2.53+/-0.31 ng/1x105 cells/ml at 60 minutes, but after 75 minutes increased again. 5) The concentration of VCAM in the A-G was higher than that of the control group (P<0.005). The VCAM concentration of the RO-G reached its highest level of 5.50+/-0.55 ng/1x10(5) cells/ml at 15 minutes (P<0.05), then decreased to its lowest level of 3.15+/-0.40 ng/1x10(5) cells/ml at 45 minutes, but after 60 minutes increased again. 6) The SOD group showed little change of NO, PGI2, ICAM-1, and VCAM concentration compared with both the A-G and the RO-G. CONCLUSION: This study showed that cell destruction in the reoxygenation group was more severe than that in the anoxia group and that the endothelial cell function of the reoxygenation group decreased signi ficantly compared with that of the anoxia group. In the anoxia and the reoxygenation groups, the levels of the two adhesion molecules ICAM-1 and VCAM increased faster than those of NO and PGI2 and the change in the level of ICAM-1 was more sensitive than that (in the level) of VCAM. In reoxygenation group, SOD treatment could inhibit the changes in the levels of NO, PGI2, ICAM-1, and VCAM.
Anoxia* ; Endothelial Cells* ; Epoprostenol ; Humans ; Immunoassay ; Intercellular Adhesion Molecule-1 ; Ischemia ; Leukocytes ; Microelectrodes ; Microscopy, Electron, Scanning ; Microvessels ; Nitric Oxide ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase ; Umbilical Veins* ; Vascular Cell Adhesion Molecule-1 ; von Willebrand Factor

Objectives: . Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations. Methods: . This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data. Results: . In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable results. Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, –11.351; 95% confidence interval, –21.491 to –1.212; P=0.028). Conclusion . This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations.

Giant cell arteritis (GCA) is a chronic vasculitis that mainly involves the cranial branches of arteries, and typically it presents with a cephalic sign such as a new headache, jaw claudication and/or visual symptoms. Although the tender, swollen or beaded arteries are adequate sites for biopsy, random temporal artery biopsy should be performed in all the patients suspected of suffering with GCA and even if cephalic signs are not present. Several cases of typical GCA have been reported in Korea, but so far there have been no reports of an atypical case presenting with Raynaud's phenomenon, and the patient was diagnosed by random temporal artery biopsy. Here we describe a case that showed the typical pathological findings of GCA in an asymptomatic temporal artery. The patient complained of only Raynaud's phnomenon and the patient was without any cephalic symptoms.
Arteries ; Biopsy ; Giant Cell Arteritis ; Giant Cells ; Headache ; Humans ; Jaw ; Korea ; Stress, Psychological ; Temporal Arteries ; Vasculitis

PURPOSE: This study was undertaken to evaluate the immunogenicity and reactogenicity of Td booster immunization in early preadolescents of Korea. METHODS: Healthy preadolescents, who had been vaccinated with 4 or 5 doses of DTaP vaccines until 6 years old age, were enrolled in this study from August 2006 to April 2007 . Diphtheria and tetanus anti-toxoid antibodies in sera were measured by ELISA just before vaccination and 4 weeks after vaccination to evaluate immunogenicity. Local and systemic adverse reactions observed for 4 weeks after vaccination to access reactogenicity. RESULTS: 183 preadolescents were enrolled and mean age was 11.40+/-0.51 years old. All subjects achieved seroprotective diphtheria and tetanus anti-toxoid antibodies (titers > or =0.1 IU/mL) after Td booster vaccination. Among 183 vaccinees, 73.8% showed local adverse reactions and 37.2% systemic adverse reactions. Pain at injection site (66.1%) was the most common local reaction, and the most commonly shown systemic reaction was myalgia (17.5%). The adverse reactions were spontaneously relieved within three days after vaccination. CONCLUSION: Td vaccine in this study was high immunogenic and showed an acceptable tolerance in Korean preadolescents. Td booster vaccination at 11 -12 years old is the most effective method to increase compliance of the vaccination and to decrease the incidence of diphtheria and tetanus.
Aged ; Antibodies ; Compliance ; Diphtheria ; Diphtheria-Tetanus Vaccine ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunization ; Immunization, Secondary ; Incidence ; Korea ; Tetanus ; Vaccination