Since Thomas et al reported the first instance of successful removal of a broken intravascular guidewire without surgical intervention by using a bronchoscopic forceps in 1964, there have been a number of nonsurgical removal of intravascular or intracardiac foreign bodies using the bronchoscopic forceps, loop snare or basket stone catchers. We experienced a successful retrieval of accidentally broken subclavian puncture catheter from right atrium in 76 year old male patient with cerebral infarction admitted to this hospital on May, 1989. By percutaneous catheterization via right basilic vein, using a loop snare which is modified manually by guidewire for PTCA(USIC(R) Teflon coated PTCA Guide wire : ".014"), we removed successfully foreign body from right atrium. Therefore, we report a case of nonsurgical retrieval of foreign body from right atrium with the review of the literature.
Aged ; Catheterization ; Catheters ; Cerebral Infarction ; Foreign Bodies* ; Heart Atria ; Humans ; Male ; Ocimum basilicum ; Polytetrafluoroethylene ; Punctures ; SNARE Proteins ; Surgical Instruments ; Veins

Castleman's disease(CD) is rare in childhood. It is defined as a localized nodal hyperplasia in mediastinum or cervical area. It is also called angiofollicular lymph node hyperplasia, lymph nodal hamartoma, giant lymph node hyperplasia. It was first described in 1956 by Castleman et al. as a lesion of mediastinal mass. The etiology of CD is not clear. The histologic classification of CD is hyaline vascular and plasma cell type. The hyaline-vascular type is more frequent, and characterized by small hyaline-folliclees and interfollicular capillary proliferation. The plasme cell type is characterized by the large follicles with intervening sheets of plasma cells. The clinical classification of CD is solitary and multicentric type. The solitary type is usually asymptomatic but, the multicentric type is usually combined systemic manifestations, such as fever, anemia, hyperglobulinemia. Complete surgical resection of involved lymph nodes is both diagnostic and therapeutic. The prognosis of solitary type is good, in a general way. We experienced CD cases in five-year-old girl, who had a 4x3 cm solid mass in postrior triangle of neck, right. The mass was removed completely and confirmed Castleman's disease microscopically. The histopathologic finding was a proliferation of germinal centers with hyaline thickening of the wall and the interfollicular stroma showed hyperplastic vessels admixed with lymphocytes, plasma cells and eosinophils. She discharged after six days of operation and her prognosis was good.
Anemia ; Capillaries ; Classification ; Eosinophils ; Female ; Fever ; Germinal Center ; Giant Lymph Node Hyperplasia* ; Hamartoma ; Humans ; Hyalin ; Hyperplasia ; Lymph Nodes ; Lymphocytes ; Mediastinum ; Neck ; Plasma Cells ; Prognosis

OBJECTIVE: We examined the difference in responses to donepezil between carriers and non-carriers of the A allele at the +4 position of the choline acetyltransferase (ChAT) gene in Koreans. METHODS: Patients who met the criteria for probable Alzheimer's disease (AD) (n=199) were recruited. Among these, 145 completed the 12-week follow-up evaluation and 135 completed the 26-week scheduled course. Differences and changes in the Korean version of the mini-mental state examination (MMSE-KC) score, Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery (CERAD-K[N]) wordlist subtest score (WSS), CERAD-K(N) total score (TS), and the Korean version of geriatric depression scale (GDS-K) score between baseline and 12 weeks or 26 weeks were assessed by the Student's t-test. RESULTS: At 12 weeks, the changes in the MMSE-KC score, CERAD-K(N) WSS, and CERAD-K(N) TS from baseline were not significant between ChAT A allele carriers and non-carriers; however, at 26 weeks, these changes were significantly larger in ChAT A allele carriers than in non-carriers (p=0.02 for MMSE-KC and p=0.03 for CERAD-K(N) WSS respectively). CONCLUSION: Our findings in this study suggested that presence of the A allele at the +4 position of ChAT might positively influence the treatment effect of donepezil in the early stages of AD in Koreans.
Alleles ; Alzheimer Disease* ; Choline O-Acetyltransferase* ; Choline* ; Depression ; Follow-Up Studies ; Genotype* ; Humans ; Polymorphism, Single Nucleotide