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

No abstract available.
Fallopian Tubes* ; Female ; Infertility* ; Spermatozoa*

Fourteen healthy persons and 43 hypertensives were subjected to treadmill exercise testing to see responses of variable influenced by various degrees of hypertension. The hypertensive were subclassified into 3 groups, mild hypertension(diast. BP<104mmHg), moderate hypertension(diast. BP<129mmHg). 1) The attainability of maximal heart rate was inversely related with levels of basal blood pressure;92.8% of normal control group attained the maximal heart rate, 87.5% of mild hypertension, 69.2% of moderate hypertension and 66.7% of moderately severe hypertension. 2) As the exercise was geaded up, the rate of increase of heart rate was lower in higher blood perssure groups than in lower blood pressuer groups. 3) The rate and extent of rise in systolic pressure was inversely related with basal systolic pressure, the systolic pressure response being least in the group with highest pressure, that is, moderately severe hypertension group. The diastolic pressure seemed to decrease somewhat in early phase of exercise only to return back to basal level at the late phase of exercise. 4) Seven of 43 hypertensive showed significant ST depression during exercise, which may be due to imbalance between oxygen demand and supply caused sither by left ventricular hypertrophy or ischemic heart disease. 5) A case was characterized by very sluggish response in increase of heart rate despite progress in exercise grade and he fell into collase 12 minutes after the interruption of exercise. The tardy response in heart rate may be a hitherto unsuspected risk predictor in exercise test.
Blood Pressure ; Depression ; Exercise Test* ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Myocardial Ischemia ; Oxygen

No abstract available.
Asphyxia* ; Erythrocyte Count* ; Erythrocytes* ; Humans ; Hyaline Membrane Disease ; Infant, Newborn

PURPOSE: This study was performed to find out the natural history of lung cancer in Pusan-Kyungnam area and changing of that in previous report. MATERIALS AND METHOD: We studied retrospectively 508 patients with pathologically proven lung cancer from January 1991 to December 1995. We analysed age and sex distribution, initial symptoms before diagnosis, first method yielding histologic diagnosis, cell types of lung cancer, initial stage of lung cancer, schema of overall patients, survivial of lung cancer patients, and prognostic factors affecting survival of lung cancer patients.. RESULTS: The overall male to female ratio was 4.5: 1 and the age distribution ranged from 20 to 86 years, and the median age of overall patients was 60 years. Histologic classification revealed that the most prevalent type was squamous cell carcinoma (251 cases, 49.4%), followed by adenocarcinoma (141 cases, 27.8%), small cell carcinoma (91 cases, 17.9%), and large cell carcinoma (3 cases, 0.6%). In non-smali cell lung cancer 56.8% were stage IIIb and IV, therefore curative operation was done in 18.7% of all cases, but in small cell lung cancer 65.6% were extended disease. Meidan survival of overall patients was 11.8 months. There was a quite difference in survival among the stages. In non-small cell lung cancer, median survival was 59.7 months, 27.3 months, 18.5 months, 12.7 months, 5.9 months in stage I, II, IIIa, IIIb, IV in each. In small cell lung cancer, median survival of limited disese was 12.2 months and median survival of extended disease was 6.7 months. The stage and the performance status were independent prognostic factors in both small cell and non-small cell lung cancer. CONCLUSION: The prognosis of patients with lung cancer was still grave, but the survival was better than that of a previous report. This may be accorded to increase in early diagnosis and operation and advance in supportive care.
Adenocarcinoma ; Age Distribution ; Busan* ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Classification ; Diagnosis ; Early Diagnosis ; Female ; Gyeongsangnam-do* ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Natural History ; Prognosis ; Retrospective Studies ; Sex Distribution ; Small Cell Lung Carcinoma

Background: Predicting the risk of osteoporotic fractures is vital for prevention. Traditional methods such as the Fracture Risk Assessment Tool (FRAX) model use clinical factors. This study examined the predictive power of the FRAX score and machine-learning algorithms trained on FRAX parameters. Methods: We analyzed the data of 2,147 female participants from the Ansan cohort study. The FRAX parameters employed in this study included age, sex (female), height and weight, current smoking status, excessive alcohol consumption (>3 units/d of alcohol), and diagnosis of rheumatoid arthritis. Osteoporotic fracture was defined as one or more fractures of the hip, spine, or wrist during a 10-year observation period. Machine-learning algorithms, such as gradient boosting, random forest, decision tree, and logistic regression, were employed to predict osteoporotic fractures with a 70:30 training-to-test set ratio. We evaluated the area under the receiver operating characteristic curve (AUROC) scores to assess and compare the performance of these algorithms with the FRAX score. Results: Of the 2,147 participants, 3.5% experienced osteoporotic fractures. Those with fractures were older, shorter in height, and had a higher prevalence of rheumatoid arthritis, as well as higher FRAX scores. The AUROC for the FRAX was 0.617. The machine-learning algorithms showed AUROC values of 0.662, 0.652, 0.648, and 0.637 for gradient boosting, logistic regression, decision tree, and random forest, respectively. Conclusion This study highlighted the immense potential of machine-learning algorithms to improve osteoporotic fracture risk prediction in women when complete FRAX parameter information is unavailable.

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.

BACKGROUND: Bone mass changes in men is related to age, BMI, sex hormones and other factors. In prior studies, bone markers were negatively correlated with bone mineral density, free testosterone, and estrogen and was positively correlated with SHBG. In a study of sex hormones and bone markers in Korean men estradiol was negatively correlated with deoxypyridinoline. In this study, the relationship of testosterone, estradiol, calculated free testosterone, FEI and SHBG to bone turnover markers in adult men were investigated. METHODS: This was a cross-sectional study of 184 men who had undertaken a health screening program in one general hospital in Bundang from November, 2001 to February, 2003. We surveyed information concerning the past medical history, current medication, alcohol consumption amount per week and smoking amount by means of self questionnaire records. Serum total testosterone, estradiol, SHBG and osteocalcin, alkaline phosphatase were measured at a fasting state. Urine was tested for deoxypyridinoline. Free testosterone was calculated using albumin, SHBG, and total testosterone level. RESULTS: Deoxypyridinoline adjusted by age, BMI was negatively correlated with FEI (r=-0.17, P=0.020) and was positively correlated with smoking amount (r=0.20 P= 0.007). Osteocalcin was negatively correlated with calculated free testosterone and ethanol consumption amount (r=-0.186, P=.0.12, r=-0.186, P=0.012). Multiple regression analysis showed that the most powerful factor influencing deoxypyridinoline was smoking amount (R2= 0.046), followed by FEI, BMI, and the one influencing osteocalcin was BMI (R2=0.050), ethanol amount and calculated free testosterone. After adjusting for age, BMI, drinking amount and smoking amount FEI shown to be a predictor of deoxypyridinoline (beta=-0.08, p<0.01, R2=0.101). After adjusting for age, BMI, and drinking amount calculated free testosterone was shown to be a predictor of osteocalcin (beta=-0.570, P<0.01, R2=0.130) in multiple regression model. CONCLUSIONS: In adult men, FEI shown to be a predictor of deoxypyridinoline and calculated free testosterone to be a predictor of osteocalcin as an independent variable.
Adult* ; Alcohol Drinking ; Alkaline Phosphatase ; Bone Density ; Cross-Sectional Studies ; Drinking ; Estradiol ; Estrogens ; Ethanol ; Fasting ; Gonadal Steroid Hormones* ; Hospitals, General ; Humans ; Male ; Mass Screening ; Multiple Endocrine Neoplasia Type 1 ; Osteocalcin ; Regression Analysis ; Smoke ; Smoking ; Testosterone

OBJECTIVE: Decompressive craniectomy is widely used in cases of uncontrolled intracranial hypertension, including traumatic brain injury or acute stroke. Physiological monitorings, such as intracranial pressure or electroenecephalography (EEG) are critical for patients in the acute phase. We retrospectively reviewed our experience of continuous electrocorticography (ECoG) monitoring by subdural strip electrode in patients who performed decompressive craniectomy and assessed its clinical efficacy. METHODS: Patients who underwent decompressive craniectomy because of severe intracranial hypertension were included. 4 Channel strip electrodes were inserted on the frontal cortex before closure. 24-hour continuous monitoring of ECoG was done to identify abnormal electrical activity. The level of consciousness was assessed according to Glasgow Coma Scale (GCS). In patients with malignant intracranial hypertension, barbiturate coma therapy was considered. RESULTS: Fifteen patients (9 men and 6 women) were included and the mean age was 55.7 years (from 17 to 80). The initial mean GCS score was 7.9 (from 3 to 14). In six out of fifteen patients, abnormal spike activities were identified, and one of these six patients was diagnosed as nonconvulsive status epilepticus (NCSE). Cortical spreading depression (CSD) was suspected in five. Three patients underwent barbiturate coma therapy and ECoG monitoring of these patients showed typical burst suppression pattern, which was used for indicator of therapeutic level. The mean duration of strip electrode and ECoG monitoring was 3.5 days, and there was no complication. CONCLUSION: Continuous ECoG monitoring using subdural strip electrode was useful to detect abnormal brain activity in the acute period after decompressive craniectomy.
Barbiturates ; Brain ; Brain Injuries ; Coma ; Consciousness ; Cortical Spreading Depression ; Decompressive Craniectomy* ; Electrodes* ; Glasgow Coma Scale ; Humans ; Intracranial Hypertension ; Intracranial Pressure ; Male ; Retrospective Studies ; Status Epilepticus ; Stroke

OBJECTIVE: Seizures are common consequence of traumatic brain injury and have been reported in clinical series as an incidence of 15% to 22%. Among them, nonconvulsive seizures (NCS) are often unrecognized during the early period of neurosurgical hospitalization because their clinical presentations can be misunderstood as consequent symptoms of clinical course, and the diagnosis can be confirmed only by the electroencephalographic (EEG) recording. METHODS: We retrospectively reviewed our clinical database of traumatic brain injury (TBI) patients admitted between March 2008 and September 2012. Twenty one patients with suspicious symptoms of NCS, such as decrease of consciousness, aphasia or irritability, were included. Routine wake and sleep EEG or bedside continuous EEG monitoring were done in all patients. RESULTS: Ten out of twenty-one patients showed abnormal activities on EEG. Ictal discharges were documented on four patients. Based on clinical symptoms and EEG findings, these four patients were diagnosed as NCS. Two out of four NCS patients showed EEG findings of nonconvulsive status epilepticus (NCSE). Another six patients with abnormal EEG activities were considered as 'suspicious NCS' because only interictal activities were recorded on EEG but increasing dose or adding on antiepileptics relieved their symptoms. All NCS/NCSE were successfully controlled by appropriate antiepileptic therapy. CONCLUSION: Our result showed that NCS was diagnosed in about 20% of patients with suspicious symptoms. There's a possibility that actual NCS might have happened more. Because untreated NCS/NCSE might cause worse clinical outcome, careful observation and urgent EEG recordings should be considered in a patient with suspicious NCS symptoms.
Anticonvulsants ; Aphasia ; Brain Injuries* ; Consciousness ; Diagnosis ; Electroencephalography ; Hospitalization ; Humans ; Incidence ; Retrospective Studies ; Seizures* ; Status Epilepticus