Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring.
Axillary Vein ; Catheters, Indwelling/*adverse effects ; Cough/*complications ; Device Removal/*methods ; Foreign-Body Migration/*etiology/radiography ; Heart Atria ; Humans ; Lung Neoplasms/drug therapy ; Male ; Middle Aged

No abstract available.
Child* ; Humans

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

Ovarian cysts in the newborn are uncormnon. Fetal ovarian cysts are being diagnosed with inaeasing fiequency with development of obstetrical sonography. Most of these cysts are found within the first few months of life and have no clinical significance. But, a large ovarian cyst would be founded antenatally with sonography. A large ovarian cyst can cause life-theatening complications during parturition and in the neonatal period. We have experienced a case of fetal ovarian cyst in a 32-year-old primiparous woman with antenatal sonography and report our experience with a brief review of literatures.
Adult ; Female ; Humans ; Infant, Newborn ; Ovarian Cysts* ; Parturition ; Ultrasonography

Supracondylar fracfture of the humerus is the most common fracture about the elbow joint in children. Early accurate reduction is very important to obtain good results. The authors reviewed 44 cases of supracondylar fractures treated at Inje Universsity Pusan Paik Hospital from January 1986 to December 1990. Average follow-up time was 1 year 6 months. The results were as follows; 1. Thirty cases were treated with closed reduction and percutaneous pinning, ten with manipulation and cast immobilization, three with skeletal traction and the rest one with open reduction and internal fixation. 2. If there was a difference of the angle within 10-degree in post-reduction X-ray, deformity did not follow at the last follow-up. 3. The common formula was that a change of 5-degree in Baumann's angle corresponded to a 2- degree change in the clinical carrying angle. 4. Baumann's angle did not change between that of initially accepted and that of the final follow up X-ray. So, the authors recommend post-reduction measurements of the Baumann's angle as the adequancy of reduction of supracondylar fractures in children.
Busan ; Child ; Congenital Abnormalities ; Elbow Joint ; Follow-Up Studies ; Humans ; Humerus ; Immobilization ; Traction

PURPOSE: This study was carried out to describe the process and evaluation of a critical thinking class for new community health practitioners. METHODS: The case study design was used to develop and evaluate a critical thinking class for 46 participants in the community health practitioners training program. The class was held two hours a week for 8 weeks. Critical thinking disposition was tested before and after the class and critical skill was graded according to the final test score. Data analysis was performed using descriptive statistics and paired t-tests using SPSS WIN 20.0. RESULTS: Clinical critical thinking competences were identified through the literature review. The case situations with questions guiding the problem-solving process were developed and used for group discussion. Critical thinking disposition of participants was determined to have increased slightly after having taken the class. 17.4% of the participants had a competency level high enough to solve a problem and half of them stayed at the level of understanding of critical thinking. Compared with the class's satisfaction with the relevance to their jobs, the satisfaction with the learning method and instructor was high. CONCLUSION: The findings of this research will serve as the basis for developing critical thinking classes for community health nurses in order to improve their critical thinking competence.
Education ; Learning ; Mental Competency ; Nurses, Community Health ; Primary Health Care ; Problem-Based Learning ; Statistics as Topic ; Thinking*

BACKGROUND/AIM: The lipo-PGE1, known for being more stable during pulmonary circulation and having more targeting effect, has been reported to inhibit ET-1 induced stellate cell contraction. We assessed the effect of lipo-PGE1 on the change of ET-1 concentration and the relationship between ET-1 concentration and the liver damage. METHODS: Mongrel dogs weighing about 25 kg were divided into a control (n=6) and a lipo-PGE1 (n=6) group. Partial liver allotransplantation was performed. In the lipo-PGE1 group, lipo-PGE1 was slowly infused through splenic venous cannulation during the donor liver harvesting procedure (50 microgram) and continuously infused (60 microgram/day) for 48 hours after reperfusion. The AST, ALP, LDH and ET-1 concentrations were monitored RESULTS: The AST and ALP levels of the lipo-PGE1 group were significantly lower than those of the control group both at 1 hour and 48 hours after reperfusion. The LDH level in the lipo-PGE1 group was lower at 1 hour and 48 hours after reperfusion. But there was no statistical difference between the two groups. The baseline ET-1 concentration of the lipo-PGE1 group was eight times higher than that of the control group. The ET-1 concentration was elevated gradually in the control group. There was no significant difference between the two groups at 48 hours. There was no correlation between ET-1 concentrations and AST, ALP, LDH levels. CONCLUSION: This study demonstrated the hepatoprotective effect of the lipo-PGE1 against ischemia-reperfusion injury in canine partial liver allotransplantation. However, the baseline ET-1 level was eight times higher in the lipo-PGE1 group than that of the control group in spite of the hepatoprotective effects of the lipo-PGE1.
Alprostadil* ; Animals ; Catheterization ; Dogs ; Endothelin-1* ; Humans ; Liver Transplantation* ; Liver* ; Pulmonary Circulation ; Reperfusion ; Reperfusion Injury* ; Tissue Donors

The aim of this study was to evaluate microchimerism after human liver transplantation (LT). This study included 13 female recipients who received hepatic allograft from male donors at Asan Medical Center. A nested PCR specific for Y-chromosome gene (DYZ3) was used to analyze the small number of male cells in the peripheral blood mononuclear cells of the female recipients. Microchimerism was observed in 6 of 13 recipients and 16 out of 35 samples. Only 3 patients showed microchimerism 3 months after LT. There was no statistical difference between the presence of microchimerism and clinical findings such as type of donor, type of immunosuppression, episode of rejection and age of recipient. This study did not show any clinical relevance of microchimerism and further larger study are needed to confirm the results.
Adolescence ; Adult ; Animal ; Child ; Child, Preschool ; Female ; Human ; Infant ; Liver Transplantation* ; Lymphocytes/immunology* ; Male ; Transplantation Chimera/immunology* ; Transplantation Chimera/genetics ; Y Chromosome

The aim of this study was to evaluate microchimerism after human liver transplantation (LT). This study included 13 female recipients who received hepatic allograft from male donors at Asan Medical Center. A nested PCR specific for Y-chromosome gene (DYZ3) was used to analyze the small number of male cells in the peripheral blood mononuclear cells of the female recipients. Microchimerism was observed in 6 of 13 recipients and 16 out of 35 samples. Only 3 patients showed microchimerism 3 months after LT. There was no statistical difference between the presence of microchimerism and clinical findings such as type of donor, type of immunosuppression, episode of rejection and age of recipient. This study did not show any clinical relevance of microchimerism and further larger study are needed to confirm the results.
Adolescence ; Adult ; Animal ; Child ; Child, Preschool ; Female ; Human ; Infant ; Liver Transplantation* ; Lymphocytes/immunology* ; Male ; Transplantation Chimera/immunology* ; Transplantation Chimera/genetics ; Y Chromosome

PURPOSE: Feeding intolerance is common in premature infants. It may extend the parenteral nutrition period and increase the risk of complications. We evaluated the efficacy of erythromycin and metoclopramide in neonates with feeding intolerance. METHODS: Between December 2006 to August 2011, 114 neonates with feeding intolerance were divided into two groups treated with either erythromycin or metoclopramide in the neonatal intensive care unit of Chung-ang University Hospital, a tertiary care center. We defined neonates with feeding intolerance as those who either could not be fully fed enterally (120 mL/kg/day) within 7 days or who skipped feeding more than twice per day because the gastric residual volume was >20% of each feed or more than 50% once. The time taken to achieve 50%, 75%, and 100% enteral feeding was estimated retrospectively. RESULTS: The erythromycin group achieved 50% feeding (P=0.047), 75% feeding (P=0.042), and 100% feeding (P=0.039) earlier than the metoclopramide group. The erythromycin group achieved 100% feeding earlier than the metoclopramide group among infants with birth weight > or =1,500 g (P=0.036) and those with gestational age > or =34 weeks (P=0.008). CONCLUSION: Compared with metoclopramide, erythromycin improves feeding in neonates with feeding intolerance, especially in infants with birth weight > or =1,500 g and in those with gestational age > or =34 weeks.
Birth Weight ; Enteral Nutrition ; Erythromycin* ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Intensive Care, Neonatal ; Metoclopramide* ; Parenteral Nutrition ; Residual Volume ; Retrospective Studies ; Tertiary Care Centers