PURPOSE: To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. MATERIALS AND METHODS: Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. RESULTS: The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheters were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted , namely the one case of thrombophlebitis. CONCLUSION: Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein.
Azygos Vein ; Catheter-Related Infections ; Catheters* ; Central Venous Catheters ; Constriction, Pathologic ; Embolism, Air ; Follow-Up Studies ; Humans ; Incidence ; Jugular Veins* ; Thrombophlebitis ; Thrombosis ; Venous Thrombosis

No abstract available.
Pregnancy, Heterotopic*

No abstract available.

Primary chondrosarcoma of the lung is an extremely rare tumor, and classified into two types, tracheobronchial & lung variety. The tracheobronchial variety is usually localized and lacked lymph nodal or distant spread with good prognosis. The lung variety tends to be more invasive associated with mediastinal lymph node involvement and thoracic metastasis. Authors experienced a case of primary chondrosarcoma, lung variety, of the lung involving left lower lobe with thoracic metastasis, not yet reported in Korean literatures. The patient was 55-year-old Korean female and chief complaints were cough, dyspnea & chest pain. Pathologically, it was confused with the metastatic adenocarcinoma in the first pleural fluid cytology. But bronchoscopic biopsy revealed typical morphology of chondrosarcoma with concentric growth encircling the bronchial tree and partial destruction of the bronchiols, suggesting its primary origin. Later pleural biopsy and aspiration materials during ches tube insertion revealed also metastatic chondrosarcoma. Radiologic studies were also campatible findings to chondrosarcoma. After admision, the patient underwent progressively downhill course & expired at 31st hospital day.
Female ; Humans ; Adenocarcinoma ; Biopsy ; Neoplasm Metastasis

Authors have performed patch test to evaluate the differences between the allergic contact dermatitis to topical medicaments and to the other substances including cosmetics. One hundred eighteen patients were evaluated according to age, sex, and causative agents of the disease. Furthermore, these patients were analysed as to the causative allergic contact factors by clinical inspection and history. The most common causative allergic contact factors by clinical, history and patch test were topical medicarnents(45.8%), cosmetics(24. 6%), rubbery(10.2%), and metals(8.59%.). The common etiogloic medicaments of contact dermatitis were Madecassol, Betadin, Tiger balm, Canesten, Mercurochrom, and Tego solution. The causative agents were confirmed by the patch test with Hollister-Stiers standard allergens in 57 patients from Jan. 1983 to Dec. 1984, 1 hirty eight among 57 patients were positive to patch test, Back ground possible explanation of the patch test results were discussed and a comparison was made between this report and others.
Allergens ; Clotrimazole ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Humans ; Hypersensitivity, Delayed* ; Patch Tests ; Skin Diseases* ; Tigers

Twin reversed arterial perfusion (TRAP) sequence is a rare specific anomaly of twin gestation with fused placenta and umbilical anastomosis. This syndrome occurs once in about 34,600 births and reported first by Beneditti in 1533. We report on prenatal diagnosis of a case of TRAP sequence with color Doppler sonography, this case is presented with a brief review of the literature.
Humans ; Parturition ; Perfusion ; Placenta ; Pregnancy ; Prenatal Diagnosis*

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

PURPOSE: To evaluate efficacy and the safety of percutaneous catheter drainage in patients with pneumothorax that is difficult to treat with closed thoracotomy. MATERIALS AND METHODS: We retrospectively reviewed effectivenss of percutaneous catheter drainage (PCD) in 10 patients with pneumothorax. The catheter was inserted under fluoroscopic guidance. Seven patients had spontaneous pneumothorax caused by tuberculosis (n=4), ruptured bullae (n=2), and histiocytosis-X(n=l). Three patients had iatrogenic pneumothorax caused by trauma (n=l) and surgery(n=2). All procedures were performed by modified Seldinger's method by using 8F-20F catheter. RESULTS: All catheters were inserted successfully. In 9 of 10 patients, the procedure was curative without further therapy. Duration of catheter insertion ranged from 1 day to 26 days. In the remaining 1 patient in whom multiple pneumothorax occurred after operation, catheter insertion was performed twice. CONCLUSION: Percutaneous catheter drainage under fluoroscopic guidance is effective and safe procedure for treatment of pneumothorax in patients with failed closed thoracotomy.
Catheters* ; Chest Tubes* ; Drainage* ; Fluoroscopy* ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracotomy ; Thorax* ; Tuberculosis

Bacillus Calmette-Guerin(BCG) has been widely used for the prophylaxis of superficial bladder tumor recurrence and for the treatment of bladder carcinoma in situ. More than 95% of patients who receive BCG instillation tolerate the treatment well and side reactions have been reported in less than 5% of patients. Most side effects are minor and self-limiting. However, a rear occurrence of severe systemic reactions have been reported. Among the severe systemic reactions, hypersensitivity pneumonitis should be considered in patients with pneumonic complications after BCG instillation in cases where the culture for mycobacteria is negative in the sputum, brochoalveolar lavage and blood specimen. In addition, a fiberoptic bronchoscopy with transbronchial lung biopsy demonstrates a fibrosis of the alveolar septums, where there is and an increased lymphocyte count without tuberculous inflammatory changes, the and CD4:CD8 ratio is increased and no symptomatic response to antituberculosis chemotherapy is observed. Here we report a 68 years old man with interstitial pneumonitis following intravesical BCG instillation.
Administration, Intravesical* ; Alveolitis, Extrinsic Allergic ; Bacillus ; Biopsy ; Bronchoscopy ; Carcinoma in Situ ; Drug Therapy ; Fibrosis ; Humans ; Lung ; Lung Diseases, Interstitial* ; Lymphocyte Count ; Mycobacterium bovis* ; Recurrence ; Sputum ; Therapeutic Irrigation ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Thirty-four patients with suspected ectopic pregnancy whose serum hCG levels had been measured by beta-hCG EIA before surgery were evaluated retrospectively. The results were as follows: 1. Final diagnosis of thirty- four patients with suspected ectopic pregnancy comprised twenty-eight tubal pregnancy, five ruptures of hemorrhagic corpus luteum and one tubo-ovarian abscess. One of the five patients with rupture of hemorrhagic corpus luteum was accompanied by missed abortion. 2. Range of serum hCG levels in twenty-eight patients with tubal pregnancy was 59-21, 980 mIU/ml and that of four patients with rupture of hemorrhagic corpus luteum and one patient with tubo-ovarian abscess was 0.6-6.6 mIU/ml. Serum hCG level of a patient with rupture of hemorrhagic corpus luteum who was accompanied by missed abostion was 200 mIU/ml. 3. Serum hCG levels in twenty-two of twenty-eight patients with tubal pregnancy were lower than 3,000 mIU/ml. Low serum hCG level below 100 mIU/ml and high serum hCG levl above 6,500 mIU/ml were noticed in four and six patients with tubal pregnancy recpectively. 4. Mean serum hCG levels (±SD) of twelve patients with tubal pregnancy who had intraabdominal free blood of less than 500ml and sixteen patients with tubal pregnancy who had intraabdominal free blood of more than 500ml were 4,131 (±7,801) mIU/ml and 3,208 (±5,081) mIU/ml, respectively. There was no statistical difference in the mean level of serum hCG between both group (P>0.05). 5. Mean serum hCG levels (±SD) of thirteen patients with unruptured tubal pregnancy and fifteen patients with ruptured tubal pregnancy were 2,628 (±5,448) mIU/ml and 4,449 (±6,938) mIU/ml, respectively. Mean level of serum hCG was statistically higher in ruptured tubal pregnancy (P<0.01). 6. Positive rate of urine pregnancy test in the diagnosis of ectopic pregnancy was 64% (16/25) and mean range of serum hCG level of nine patients with false negative result were 353 mIU/ml and 59­933 mIU/ml.
Abortion, Missed ; Abscess ; Corpus Luteum ; Diagnosis ; Female ; Humans ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Retrospective Studies ; Rupture