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.
B-Lymphocytes* ; Lymphoma, B-Cell*

PURPOSE: The purpose of this study was to compare the accuracy of the implant master cast according to the type (pick-up, transfer) and the length (long, short) of the impression copings. MATERIALS AND METHODS: The metal master cast was fabricated with three internal connection type implant analogs (Osstem GS III analog), embedded parallel and with 10degrees of mesial angulation to the center analog. Four types of impression coping were prepared with different combinations of types (transfer, pick-up) and lengths (long, short) of the coping. The impressions were made using vinyl polysiloxane (one step, heavy + light body) with an individual tray, and 10 impressions were made for each group. Eventually, 40 experimental casts were produced. Then, the difference in the distance between the master cast and the experimental cast were measured, and the error rate was determined. The analysis of variance was performed using the SPSS (v 12.0) program (alpha = .05), and the statistical significance was set at P < .05. RESULTS: The ANOVA showed that the pick-up type impression coping exhibited a significantly lower error rate than the transfer type. However, no significant difference was observed with respect to the length of the impression coping. Additionally, no significant difference was observed between the parallel and mesial angulated groups. CONCLUSION: Within the limitations of this study, the pick-up type impression coping exhibited a more accurate implant master cast than the transfer type in parallel group. The accuracy of the implant master cast did not differ for different lengths of impression coping of at least 11 mm. Additionally, the accuracy of the implant cast was not different for the parallel and 10degrees mesial angulated groups.
Light ; Polyvinyls ; Siloxanes

Purpose: We report the clinical outcomes of retinal capillary hemangioma (RCH) after the application of various treatments. Methods: We performed a retrospective chart analysis of eight eyes treated for RCH between August 2009 and January 2018. During the follow-up period, the status and progression of the RCHs were checked by fundus photography, fluorescein angiography, and optical coherence tomography, and additional treatments were applied when necessary. Results: Three of the five patients had bilateral RCH, and two had unilateral RCH. Six eyes received laser photocoagulation; two eyes received cryotherapy, and one eye received intravitreal Avastin injection. Three eyes each had intravitreal triamcinolone injection, subtenon triamcinolone injection, and intravitreal dexamethasone injection to control inflammation. Also, two patients took oral prednisolone, and one patient used prednisolone eye drops to control inflammation. Two eyes underwent vitrectomy and scleral buckling due to deterioration of the epiretinal membrane and vitreal traction, respectively. As a result of those treatments, the tumors were stable in five of the eight eyes. However, one eye is now in a pre-phthisis state, and one patient who refused treatment showed progression of the tumor, epiretinal membrane, and traction. Conclusions Because RCHs vary in size, the degree of inflammation, and symptoms, this disorder should be actively treated on a case-by-case basis. Fluorescein angiography should be used periodically to determine recurrence of the tumor or inflammation, and the appropriate treatment should be repeated as necessary. Moreover, regular systemic screening tests for von Hippel-Lindau disease should be performed in RCH patients to ensure that they have no abnormalities other than in the eye.

PURPOSE: To evaluate the changes of axial length (AXL) in eyes with unilateral idiopathic central serous chorioretinopathy (CSC) after resolution of serous retinal detachment. METHODS: A total of 31 patients diagnosed with idiopathic unilateral CSC were included in this study. The changes of AXL according to serous retinal detachment were examined. The keratometric value and AXL were measured using partial coherence interferometry. Serous retinal detachment and central macular thickness (CMT) were measured by spectral domain optical coherence tomography. RESULTS: The mean age of the 31 CSC patients, including 19 males, was 42.7 years. The AXL was significantly increased from 23.41 to 23.58 mm after resolution of serous retinal detachment (p < 0.001). The CMT was significantly decreased from 413.4 to 226.8 µm after resolution of serous retinal detachment (p < 0.001). The differences in AXL correlated with CMT differences and subretinal fluid height (r = −0.616, p < 0.001 and r = −0.637, p < 0.001, respectively), and the best-corrected visual acuity was significantly different after resolution of serous retinal detachment (p < 0.001). CONCLUSIONS: In unilateral idiopathic CSC with serous retinal detachment, a shortened AXL in the acute phase was restored after resolution of serous retinal detachment.
Central Serous Chorioretinopathy ; Humans ; Interferometry ; Male ; Retinal Detachment ; Retinaldehyde ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: The aim of this study is to determine whether certain biomaterials have the potential to support cell attachment. After seeding bone marrow stromal cells onto the biomaterials, we investigated their responses to each material in vitro. METHODS: Rat bone marrow derived stromal cells were used. The biomaterials were deproteinized bovine bone mineral (DBBM), DBBM coated with fibronectin (FN), synthetic hydroxyapatite (HA), HA coated with FN, HA coated with beta-tricalcium phosphate (TCP), and pure beta-TCP. With confocal laser scanning microscopy, actin filaments and vinculin were observed after 6, 12, and 24 hours of cell seeding. The morphological features of cells on each biomaterial were observed using scanning electron microscopy at day 1 and 7. RESULTS: The cells on HA/FN and HA spread widely and showed better defined actin cytoskeletons than those on the other biomaterials. At the initial phase, FN seemed to have a favorable effect on cell adhesion. In DBBM, very few cells adhered to the surface. CONCLUSIONS: Within the limitations of this study, we can conclude that in contrast with DBBM not supporting cell attachment, HA provided a more favorable environment with respect to cell attachment.
Actin Cytoskeleton ; Animals ; Biocompatible Materials ; Bone Marrow ; Bone Substitutes ; Calcium Phosphates ; Cell Adhesion ; Durapatite ; Fibronectins ; Mesenchymal Stromal Cells ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Rats ; Seeds ; Stem Cells ; Stromal Cells ; Transplants ; Vinculin

INTRODUCTION: Adult stem cells generate differentiated cells beyond their own tissue boundaries. To prove that stem cells derived from bone marrow is capable of therapeutic application in cerebral ischemic patients, we performed this study. MATERIAL AND METHOD: We transplanted adult stem cells derived from bone marrow of the patient's iliac bone to 5 patients with cerebral infarction. Of 5 patients, two patients had internal carotid artery occlusion, two patients had severe stenosis of the middle cerebral artery, remaining one patient had occlusion of the branch of the middle cerebral artery. At first, we performed extracranial-intracranial bypass surgery in all patients, and then implanted bone marrow stem cell in the infarcted brain and boder zone area directly under the microscopic navigator and also injected bone marrow stem cells through the grafted vessel to the infarcted area. Two weeks after bypass surgery, we confirmed the patency of bypass graft with external carotid angiography. In the same setting, mesenchymal stem cells acquired from autologous bone marrow were superselectively injected into the bypass graft via a microcatheter. Postoperative evaluation of the patients was decided to the neurological status and the degree of reduction of the high signal area on the T2 image of the postoperative MRI. RESULT: All patients who underwent bypass surgery with stem cell implantation had an uneventful postoperative course and showed some improvement of preoperative neurologic dysfunction. Postoperative significant improvement of cerebral vasoreactivity to acetazolamide was showed in all patients. On postoperative 3 months MRI, three patients showed significant reduction of the high signal area on the T2 image, and also improved neurological status on those patients. Other one patient showed moderate degree of the reduction of the high signal area on T2 image of the postoperative MRI, but neurological status of that patient slightly improved. Remaining one patient who showed poor circulation via bypass graft does neither reduction of the high signal area on T2 image of the postoperative MRI nor improvement of the neurological status of that patient. CONCLUSION: In patients of fixed cerebral infarction with major neurologic deficit, EC-IC bypass surgery is not effective, even though infarcted area filled by grafted vessel extensively. In those patients, autologous bone marrow stem cell implantation combined with bypass seems to be expect neuronal regeneration.
Acetazolamide ; Adult Stem Cells ; Angiography ; Bone Marrow* ; Brain ; Carotid Artery, Internal ; Cerebral Infarction* ; Constriction, Pathologic ; Humans ; Magnetic Resonance Imaging ; Mesenchymal Stromal Cells ; Middle Cerebral Artery ; Neurologic Manifestations ; Neurons* ; Regeneration* ; Stem Cell Transplantation* ; Stem Cells* ; Transplants

PURPOSE: Hyponatremia is the most common electrolyte imbalance encountered in the hospital, there have been few studies about the clinical characteristics of hyponatremia in emergency patients. This study was performed to evaluate the causes and the initial symptoms of hyponatremia in emergency patients, the relationship between their ages and their initial symptoms and the relationship between the causes and the recovery time. METHODS: A total of 42 patients with hyponatremia, who were treated in the Emergency Department of Chonnam National University Hospital from 2000 to 2001, were studied by chart review. RESULTS: The initial symptoms were generalized weakness (33.3%), seizure (28.6%), mental change (21.6%), confusion (9.5%), dizziness (4.8%), and non-specific (2.4%). There was a significant difference in the initial symptoms between children and older. The initial symptom for younger patients was usually seizure. The most common causes of hyponatremia were dehydration and sodium loss (52.4%), other causes were hypothyroidism (11.9%), SIADH (7.1%), heart failure (7.1%), adrenal insufficiency (4.8%), polydypsia (4.8%), CRF (2.4%), nephrotic syndrome (2.4%) and unidentified causes (7.1%). There were significant differences in the recovery times among the causes of hyponatremia. CONCLUSION: The initial symptoms of hyponatremia in emergency patients were usually generalized weakness in older patients and seizure in the young. There were significant differences in the recovery times among the causes of hyponatremia. There were many more incidences of hypovolemic hyponatremia of emergency patients than normovolemic hyponatremia.
Adrenal Insufficiency ; Child ; Dehydration ; Dizziness ; Emergencies* ; Emergency Service, Hospital ; Heart Failure ; Humans ; Hyponatremia* ; Hypothyroidism ; Hypovolemia ; Inappropriate ADH Syndrome ; Incidence ; Jeollanam-do ; Nephrotic Syndrome ; Seizures ; Sodium

PURPOSE: The purpose of this research was to evaluate the factors predicting recurrence and the characteristics of patients who recurred after the treatment of spontaneous paroxysmal supraventricular tachycardia (PSVT) with adenosine. METHODS: From January 1999 to December 2001, 62 patients with PSVT were enrolled in this study. The conversion group included patients who had had a therapeutic response, which was defined as the occurrence of a change in the sinus rhythm after adenosine administration. The recurred group consisted of all patients who had not had a therapeutic response. Clinical features, the results of treatment, ECG findings, and the hemodynamic statuses were analyzed. RESULTS: The treatments were vagal maneuver (5 pts, 7.5 %), adenosine 6 mg (37 pts, 55.2 %), adenosine 12 mg (14 pts, 20.9 %), verapamil 5 mg (9 pts, 13.4 %), and cardioversion (2 pts, 3.0 %). Twenty-five of the 62 patients failed to have a therapeutic response, yielding a recurrence rate of 40.3 %. Atrioventricular reentrant tachycardia (AVRT) was more prevalent in the recurred group. The most common symptom at presentation was chest pain. The recurred group had increased heart rate, and increased blood pressure. When patients were monitered after adenosine, unifocal premature ventricular complex was the most common rhythm encountered in the conversion group, but atrial fibrillation, and multifocal premature ventricular complex was the most common rhythm encountered. CONCLUSION: Age, heart rate, difference in systolic blood pressure from presentation to discharge, previous history of heart disease, and rhythms encountered after adenosine administration were factors predicting recurrence.
Adenosine ; Atrial Fibrillation ; Blood Pressure ; Chest Pain ; Electric Countershock ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Heart Diseases ; Heart Rate ; Hemodynamics ; Humans ; Recurrence* ; Tachycardia ; Tachycardia, Supraventricular ; Ventricular Premature Complexes ; Verapamil

PURPOSE: Paraquat (1,1-dimethyl-4,4'-bipyridylium chloride) is widely a used non- selective herbicide. In spite of efforts to improve the outcome in patients poisoned with paraquat, the mortality rates still remains high. The purpose of this study is to identify initial stat laboratory parameters which can affect the survival rate of these patients. METHODS: A retrospective analysis by chart review was done on 67 patients who had ingested paraquat and who had presented to the Emergency Medical Center of Chonnam University Hospital from June 1997 to July 2001. RESULTS: The results were as follows: 1) Survivors were significantly younger than the nonsurvivors (38 years vs 44 years, p=0.03). The volume of paraquat ingested by survivors was significantly smaller than that ingested by the deceased (1 mouthful vs 3 mouthfuls, p<0.001). 2) The WBC count and the levels of serum AST, BUN and serum creatinine in the deceased were significantly higher than those in the survivors. The levels of serum potassium and bicarbonate, arterial pH, and base excess in survivors were significantly higher than those in the deceased. 3) A multivariate analysis revealed that serum creatinine, serum potassium, and arterial base excess were associated with the fatality rate. CONCLUSION: Initial stat laboratory parameters including arterial blood gas analysis, renal function test, and serum electrolytes could be used to predict the outcome of patients poisoned with paraquat. However, the development of readily applicable and reliable indices predicting outcome is desired for the future.
Blood Gas Analysis ; Creatinine ; Electrolytes ; Emergencies ; Humans ; Hydrogen-Ion Concentration ; Jeollanam-do ; Mortality ; Mouth ; Multivariate Analysis ; Paraquat* ; Potassium ; Retrospective Studies ; Survival Rate* ; Survivors