The use of intravacular catheterization for both diagnostic and therapeutic purposes increased the incidence of iatrogenic foreign bodies, which might cause many complications such as cardiac arrythmias, perforation of cardiac chamber or blood vessels, sepsis and thromboembolism. The authors experienced 5 cases of successful retrieval of intravascular iatrogenic foreign bodies: three cases of subclavian catheter wire and two cases of subclavian catheter. Subclavian catheter was introduced into right subclavian venous route for hyperalimentation or central venous pressure monitoring. The foreign bodies were located in superior vena cava and inferior vena in four cases and in left main pulmonary artery in the other case. We have successufully removed the foreign bodies by interventional procedures. The loop-snare technique is a safe and effective method for retrieval of iatrogenic foreign bodies in great vessels.
Arrhythmias, Cardiac ; Blood Vessels ; Catheterization ; Catheters ; Central Venous Pressure ; Foreign Bodies* ; Incidence ; Methods ; Pulmonary Artery ; Sepsis ; Thromboembolism ; Vena Cava, Superior

No abstract available.
Denture, Partial, Fixed*

Neuroarthropathy has infrequently been associated with diabetic patients. The initial presenting symptoms are in most cases the peripheral neuropathy involving chiefly the sensory components of peripheral nerves, leading to numbness, hyper-or paresthesia, and coldness of the extremity affected. The diabetic arthropathy, once occurred, is apt to show progressive deterioration of the function with destruction of both skeletal and supporting soft tissues Two cases of such arthropathy were presented here, the one was observed in a 29-year-old man with involvement of the left fourth and fifth tarsometatarsal joints and a large ulcer on the dorsal skin of the lesion, and the other in a 35-year-old man with destruction of the right ankle joint. Both of them showed remarkable remission of the symptoms with conservative measures such as arch support, cast immobilization and skin graft.
Adult ; Ankle Joint ; Extremities ; Humans ; Hypesthesia ; Immobilization ; Joints ; Paresthesia ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Skin ; Transplants ; Ulcer

PURPOSE: To find the rebleeding factors in bronchial arterial embolization for treatment of hemoptysis, a retrospective study was performed. MATERIALS AND METHODS:Medical records, anglographic findings and embolic materials of 35 patients who had undertaken arterial embolization for control of hemoptysis were reviewed. The period of follow-up for rebleeding was from 3 to 32 months after arterial embolization. We investigated the anglographic findings of extravasation, neovascularity, intervascular shunt, aneurysm and periarterial diffusion. Neovascularity was classified as mild(numerable neovascularity) and severe(innumerable). RESULTS: Rebleeding occured in 15(43%) among 35 cases. Only two of 11 cases with no past episode of hemoptysis showed recurrence, while 9 of 15 cases who had more than three episodes did. Severe neovascularity were seen in 11 of 15 recurred cases, but seven of 20 non-recurred cases showed severe neovascularity. More than three anglographic findings representing hemoptysis were seen on 11(73%) among recurred 15 cases and seven(35%) among non-recurred 20 cases. The lesion was supplied by more than two different arteries on 8(54%) of the recurred cases, but only three(15%) of the non-recurred cases. Six of seven cases persistent neovascularity after arterial embolization were recurred. CONCLUSION: The history of repeated hemoptysis, severe neovascularity, variable anglographic findings, and post-embolization persistency of neovascularity were the factors related with the rebleeding after arterial embolization for hemoptysis. Careful and active arterial embolization are required on these conditions.
Aneurysm ; Arteries ; Diffusion ; Follow-Up Studies ; Hemoptysis* ; Humans ; Recurrence ; Retrospective Studies

A 19-year-old man noticed a very slowly spreading erythematous macular lesion on his cheek when he was 5 years old. This asymptomatic and well circumscribed patch was covered with fine scales. He sought first medical attention at the age of 12 years and diagnosis was cutaneous tuberculosis was made by skin biopsy. Seven years after the second biopsy was made and it revealed a few spores within giant cells in the upper dermis. By mycologic study, it was identified as Paecilomyces lilacinus. The patient was put on the treatment of topical and oral antifungal agents. The skin lesion showed signs of improvement after 12 weeks of treatment.
Antifungal Agents ; Biopsy ; Cheek ; Child, Preschool ; Dermis ; Diagnosis ; Giant Cells ; Humans ; Paecilomyces* ; Skin ; Spores ; Tuberculosis, Cutaneous ; Weights and Measures ; Young Adult

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

Cerebrotendinous xanthomatosis(CTX) is a rare familial, autosomal disease which seems to be inherited as a Mendelian recessive. It was first described by van Bogaert et al, in 1937 and only about 30 cases have been reported in the literature. CTX is characterized by tendon xanthomas, bilateral juvenile cataracts, progressive dementia and cerebella ataxia. And deposition of cholestanol appears to be the primary lesion in this disease. We experienced a patient, 43-year-old man who sbowed bilateral cataracts, mold cerebellar dysfunction and multiple xanthomas, the tendinous xanthomatosis was confirmed pathologically and the brain CT scan abnormalities were correlated with neuropathologic findings of CTX. We performed extracapsular cataract extraction on both eyes with a significant improvement in corrected vision.
Adult ; Ataxia ; Brain ; Cataract ; Cataract Extraction ; Cerebellar Diseases ; Cholestanol ; Dementia ; Fungi ; Humans ; Tendons ; Tomography, X-Ray Computed ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous*

Cerebrotendinous xanthomatosis(CTX) is a rare familial, autosomal disease which seems to be inherited as a Mendelian recessive. It was first described by van Bogaert et al, in 1937 and only about 30 cases have been reported in the literature. CTX is characterized by tendon xanthomas, bilateral juvenile cataracts, progressive dementia and cerebella ataxia. And deposition of cholestanol appears to be the primary lesion in this disease. We experienced a patient, 43-year-old man who sbowed bilateral cataracts, mold cerebellar dysfunction and multiple xanthomas, the tendinous xanthomatosis was confirmed pathologically and the brain CT scan abnormalities were correlated with neuropathologic findings of CTX. We performed extracapsular cataract extraction on both eyes with a significant improvement in corrected vision.
Adult ; Ataxia ; Brain ; Cataract ; Cataract Extraction ; Cerebellar Diseases ; Cholestanol ; Dementia ; Fungi ; Humans ; Tendons ; Tomography, X-Ray Computed ; Xanthomatosis ; Xanthomatosis, Cerebrotendinous*

Two patients with clinical and biochemical evidences of islet cell hyperfunction underwent percutaneous transhepatic portal and pancreatic vein catheterization and hormone assays. Local step-ups of insulin level in the protal venous system, found in two patients with insulinoma, corresponded to tumor sites at surgery. One patients had single insulinoma and the other had malignant insulinoma and liver metastasis. Percutaneous transhepatic protal and pancreatic vein catheterization with measurement of radioimmunoactive insulin concentration is a safe and reliable method, and may play an important role in the localization of adenoma in patients with hyperinsulinism.
Adenoma ; Adenoma, Islet Cell* ; Catheterization ; Catheters ; Diagnosis* ; Humans ; Hyperinsulinism ; Insulin ; Insulinoma ; Islets of Langerhans* ; Liver ; Methods ; Neoplasm Metastasis ; Veins

Two patients with clinical and biochemical evidences of islet cell hyperfunction underwent percutaneous transhepatic portal and pancreatic vein catheterization and hormone assays. Local step-ups of insulin level in the protal venous system, found in two patients with insulinoma, corresponded to tumor sites at surgery. One patients had single insulinoma and the other had malignant insulinoma and liver metastasis. Percutaneous transhepatic protal and pancreatic vein catheterization with measurement of radioimmunoactive insulin concentration is a safe and reliable method, and may play an important role in the localization of adenoma in patients with hyperinsulinism.
Adenoma ; Adenoma, Islet Cell* ; Catheterization ; Catheters ; Diagnosis* ; Humans ; Hyperinsulinism ; Insulin ; Insulinoma ; Islets of Langerhans* ; Liver ; Methods ; Neoplasm Metastasis ; Veins