3.Percutaneous Retrieval of Embolized Amplatzer Septal Occluder after Treatment of Double Atrial Septal Defect: A Case Report.
Jae Yeong CHO ; Kye Hun KIM ; Hyun Ju YOON ; Hyun Ju SEON ; Youngkeun AHN ; Myung Ho JEONG ; Jeong Gwan CHO ; Jong Chun PARK
Journal of Korean Medical Science 2015;30(9):1361-1366
Embolization of the occlusion device after percutaneous closure of atrial septal defect (ASD) is a potential disastrous complication. The usual site of embolization is the right side of the heart including pulmonary artery, but the device embolization to the extracardiac aorta is extremely rare. Here, we report a successful percutaneous retrieval case of the embolized Amplatzer Septal Occluder (ASO) to the descending thoracic aorta after the successful deployment of two ASO devices in a patient with double ASD. Competition between the two devices to obtain a stable position may be an explanation for the migration of ASO.
Adult
;
Device Removal/*methods
;
Embolism/*etiology/*surgery
;
Heart Septal Defects, Atrial/*complications/surgery
;
Humans
;
Male
;
Septal Occluder Device/*adverse effects
;
Treatment Outcome
4.Noninfectious Complications of Peritoneal Dialysis in Korean Children: A 26-Year Single-Center Study.
Ji Eun KIM ; Se Jin PARK ; Ji Young OH ; Ji Hong KIM ; Jae Seung LEE ; Pyung Kil KIM ; Jae Il SHIN
Yonsei Medical Journal 2015;56(5):1359-1364
PURPOSE: The aim of this study was to investigate noninfectious complications of peritoneal dialysis (PD), including mechanical and metabolic complications, at a single center in Korea. MATERIALS AND METHODS: We analyzed data from 60 PD patients aged < or =18 years (40 boys and 20 girls) during the period between 1986 and 2012. The collected data included gender, age, causes of PD, incidence of noninfectious complications, and treatment for the complications. RESULTS: The mean duration of PD therapy was 28.7+/-42.1 months (range 1-240 months). The most common cause of end-stage renal disease was glomerular disease (43.3%). There were no statistically significant differences between patients with and without mechanical complications regarding gender, age at the start of PD, and total duration of PD. Outflow failure was the most common catheter-related complication (14.3%), followed by leakage (10.0%) and hernia (8.6%). Metabolic complications, such as hyperglycemia and hypokalemia, were observed in three of 16 patients. The frequency of noninfectious complications of PD in our study was comparable with those in previous pediatric studies. PD was switched to hemodialysis (HD) in only three patients. CONCLUSION: Our results indicate that noninfectious complications of PD are common, though they hardly lead to catheter removal or HD in pediatric patients on PD.
Adolescent
;
Asian Continental Ancestry Group
;
Catheterization/*adverse effects
;
Child
;
Child, Preschool
;
Device Removal
;
Female
;
Humans
;
Incidence
;
Kidney Failure, Chronic/*therapy
;
Male
;
*Outcome and Process Assessment (Health Care)
;
Peritoneal Dialysis/*adverse effects/instrumentation/*methods
;
Renal Dialysis/adverse effects
;
Republic of Korea
;
Treatment Outcome
5.Lessons Learnt from an Atypical Mycobacterium Infection Post-Anterior Cruciate Ligament Reconstruction.
Stacy W L NG ; Dave Lee YEE HAN
Clinics in Orthopedic Surgery 2015;7(1):135-139
Infections following anterior cruciate ligament reconstruction are rare, with no previous reports citing Mycobacterium abscessus as the culprit pathogen. A 22-year-old man presented twice over three years with a painful discharging sinus over his right tibia tunnel site necessitating repeated arthroscopy and washout, months of antibiotic therapy, and ultimately culminating in the removal of the implants. In both instances, M. abscessus was present in the wound cultures, along with a coinfection of Staphyloccocus aureus during the second presentation. Though rare, M. abscessus is an important pathogen to consider in postoperative wounds presenting with chronic discharging sinuses, even in healthy non-immunocompromised patients. This case illustrates how the organism can cause an indolent infection, and how the removal of implants can be necessary to prevent the persistence of infection. Coinfection with a second organism is not uncommon and necessitates a timely change in treatment regime as well.
Anterior Cruciate Ligament/injuries/surgery
;
Anterior Cruciate Ligament Reconstruction/*adverse effects
;
Anti-Bacterial Agents/administration & dosage
;
Arthritis, Infectious/etiology/*microbiology
;
Arthroscopy
;
Coinfection
;
Device Removal
;
Humans
;
Male
;
Mycobacterium Infections, Nontuberculous/*microbiology
;
Recurrence
;
Reoperation
;
Staphylococcal Infections/*microbiology
;
*Staphylococcus aureus
;
Therapeutic Irrigation
;
Young Adult
6.Optimal Effect-Site Concentration of Remifentanil for Inhibiting Response to Laryngeal Mask Airway Removal during Emergence.
Sang Jin PARK ; Jong Yun BAEK ; Dae Lim JEE
Yonsei Medical Journal 2015;56(2):529-534
PURPOSE: This randomized, controlled, double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. MATERIALS AND METHODS: This study randomly assigned 128 patients to remifentanil effect-site concentrations (Ce) of 0 ng/mL (group R0), 0.5 ng/mL (group R0.5), 1.0 ng/mL (group R1.0), and 1.5 ng/mL (group R1.5) during emergence. The emergence and recovery profiles were recorded. Adverse events such as coughing, airway obstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. RESULTS: The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R1.0 and R1.5 groups than in the R0 group (p<0.05). Emergence agitation also decreased in the R1.0 and R1.5 groups (p<0.0083). The time to LMA removal was significantly longer in the R1.5 group than in the other groups (p<0.05). CONCLUSION: Maintaining a remifentanil Ce of 1.0 ng/mL during emergence may suppress adverse events such as coughing, breath-holding, and agitation following the removal of LMA without delayed awakening.
Adult
;
Airway Management/*methods
;
Anesthesia Recovery Period
;
Anesthetics, Intravenous/*administration & dosage
;
Cough/prevention & control
;
Device Removal
;
Dose-Response Relationship, Drug
;
Double-Blind Method
;
Female
;
Humans
;
Infusions, Intravenous
;
Laryngeal Masks/*adverse effects
;
Male
;
Middle Aged
;
Piperidines/*administration & dosage
;
Postoperative Complications/prevention & control
;
Psychomotor Agitation
;
Vomiting/prevention & control
7.Optimal Effect-Site Concentration of Remifentanil for Inhibiting Response to Laryngeal Mask Airway Removal during Emergence.
Sang Jin PARK ; Jong Yun BAEK ; Dae Lim JEE
Yonsei Medical Journal 2015;56(2):529-534
PURPOSE: This randomized, controlled, double-blind study was designed to determine the optimal dose of remifentanil for preventing complications associated with the removal of a laryngeal mask airway (LMA) without delaying emergence. MATERIALS AND METHODS: This study randomly assigned 128 patients to remifentanil effect-site concentrations (Ce) of 0 ng/mL (group R0), 0.5 ng/mL (group R0.5), 1.0 ng/mL (group R1.0), and 1.5 ng/mL (group R1.5) during emergence. The emergence and recovery profiles were recorded. Adverse events such as coughing, airway obstruction, breath-holding, agitation, desaturation, nausea, and vomiting were also evaluated. RESULTS: The number of patients with respiratory complications such as coughing and breath-holding was significantly lower in the R1.0 and R1.5 groups than in the R0 group (p<0.05). Emergence agitation also decreased in the R1.0 and R1.5 groups (p<0.0083). The time to LMA removal was significantly longer in the R1.5 group than in the other groups (p<0.05). CONCLUSION: Maintaining a remifentanil Ce of 1.0 ng/mL during emergence may suppress adverse events such as coughing, breath-holding, and agitation following the removal of LMA without delayed awakening.
Adult
;
Airway Management/*methods
;
Anesthesia Recovery Period
;
Anesthetics, Intravenous/*administration & dosage
;
Cough/prevention & control
;
Device Removal
;
Dose-Response Relationship, Drug
;
Double-Blind Method
;
Female
;
Humans
;
Infusions, Intravenous
;
Laryngeal Masks/*adverse effects
;
Male
;
Middle Aged
;
Piperidines/*administration & dosage
;
Postoperative Complications/prevention & control
;
Psychomotor Agitation
;
Vomiting/prevention & control
8.Suspected Bacterial Endophthalmitis Following Sustained-release Dexamethasone Intravitreal Implant: A Case Report.
Mucella ARIKAN YORGUN ; Melek MUTLU ; Yasin TOKLU ; Hasan Basri CAKMAK ; Nurullah CAGIL
Korean Journal of Ophthalmology 2014;28(3):275-277
A 58-year-old man admitted to our opthalmology department with the complaint of branch retinal vein occlusion. He was treated with intravitreal Ozurdex in the right eye. Two days after the injection, the patient presented with ocular pain and the visual acuity was hand movement. A diagnosis of endophthalmitis was made. We performed emergent pars plana vitrectomy (PPV) and the implant was removed from the vitreous cavity using a retinal forceps. A combination of vancomycin 1.0 mg and amikacin 0.4 mg was injected intravitreally. However, because of the blurring in the vitreus one week after the procedure, phacoemulsification and a repeat PPV was performed. Five days after the last procedure the signs and symptoms of endophthalmitis were resolved. Our case demonstrated that endophthalmitis could develop after intravitreal implantation of Ozurdex. Surgical removal of the implant and immediate vitrectomy seems to be a useful treatment option in these cases.
Device Removal/methods
;
Dexamethasone/administration & dosage/*adverse effects
;
Diagnosis, Differential
;
Drug Implants/*adverse effects
;
Endophthalmitis/diagnosis/*etiology/surgery
;
Eye Infections, Bacterial/diagnosis/*etiology/surgery
;
Glucocorticoids/administration & dosage/adverse effects
;
Humans
;
Intravitreal Injections/adverse effects
;
Male
;
Middle Aged
;
Retinal Vein Occlusion/diagnosis/*drug therapy
;
Vitrectomy
9.Application of acellular allograft dermal matrix in breast implants for secondary breast deformity post polyacrylamide hydrogel removal.
Xiao LONG ; Ming BAI ; Ang ZENG ; Ru ZHAO ; Xiao-jun WANG
Acta Academiae Medicinae Sinicae 2014;36(5):530-533
OBJECTIVETo evaluate the safety and efficiency of acellular dermal matrix combined with implant in correcting the secondary deformity post polyacrylamide hydrogel removal.
METHODSA retrospective study enrolling 23 female patients (42 breasts) who received breast deformity correction from June 2008 to June 2012 with acellular dermal matrix and implant were performed.
RESULTSOne patient suffered bilateral seroma and 1 patient suffered infection in one side. None of the implants were removed. Patients were followed up for (15.0±11.7) months (range: 3-36 months), and the results were satisfactory.
CONCLUSIONAcelluar dermal matrix and implant can be safely used simultaneously in correcting the secondary breast deformity post polyacrylamide hydrogel removal.
Acellular Dermis ; Acrylic Resins ; adverse effects ; Adult ; Allografts ; Breast ; abnormalities ; Breast Implantation ; methods ; Breast Implants ; adverse effects ; Device Removal ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies
10.Successful coronary stent retrieval from the ascending aorta using a gooseneck snare kit.
Ji Hun JANG ; Seong Ill WOO ; Dong Hyeok YANG ; Sang Don PARK ; Dae Hyeok KIM ; Sung Hee SHIN
The Korean Journal of Internal Medicine 2013;28(4):481-485
Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a case of stent dislodgement in the ascending thoracic aorta. The stent was mechanically distorted in the left circumflex artery (LCX) while being delivered to the proximal LCX lesion. The balloon catheter was withdrawn, but the stent with the guide wire was remained in the ascending thoracic aorta. The stent was unable to be retrieved into the guide catheter, as it was distorted. A goose neck snare was used successfully to catch the stent in the ascending thoracic aorta and retrieved the stent externally via the arterial sheath.
Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation
;
*Aorta, Thoracic/radiography
;
Cardiac Catheterization/*adverse effects/*instrumentation
;
Coronary Angiography
;
Device Removal/*instrumentation
;
Foreign Bodies/etiology/radiography/*therapy
;
Humans
;
Male
;
Middle Aged
;
Radiography, Interventional
;
*Stents
;
Treatment Outcome

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