• Title/Summary/Keyword: Fragment removal

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Early fragment removal on in vitro fertilization day 2 significantly improves the subsequent development and clinical outcomes of fragmented human embryos

  • Kim, Seok-Gi;Kim, Youn-Young;Park, Ji-Young;Kwak, Su-Jin;Yoo, Chang-Seok;Park, Il-Hae;Sun, Hong-Gil;Kim, Jae-Won;Lee, Kyeong-Ho;Park, Hum-Dai;Chi, Hee-Jun
    • Clinical and Experimental Reproductive Medicine
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    • v.45 no.3
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    • pp.122-128
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    • 2018
  • Objective: To determine whether fragment removal on in vitro fertilization (IVF) day 2 improved the subsequent development and pregnancy outcomes of fragmented embryos compared to similar-grade embryos without fragment removal. Methods: This study was a retrospective analysis involving 191 IVF cycles in which all embryos had over 10% fragmentation (grade 3 or 4) on day 2 of the IVF-embryo transfer cycle from March 2015 to December 2017. IVF cycles were divided into the fragment removal group (n = 87) and the no fragment removal group (n = 104) as a control cohort. Before fragment removal, embryos with fragmentation on day 2 were incubated in $Ca^{2+}$- and $Mg^{2+}$-free biopsy medium under paraffin oil for 30 minutes. Microsurgical fragment removal was performed with later-assisted hatching and a handmade suction micropipette that had an outer diameter of $30{\mu}m$. Results: There were no significant differences in the characteristics of the patients between the control and the fragment removal groups. After fragment removal and subsequent in vitro culture for 24 hours, the number of blastomeres ($7.1{\pm}1.7$ vs. $6.9{\pm}1.6$) was comparable between the transferred embryos in the two groups, but the morphological grade of the embryos in the fragment removal group ($1.9{\pm}0.7$) was significantly higher than that of the control group ($3.1{\pm}0.5$, p< 0.01). The clinical pregnancy (43.7%) and implantation rates (25.8%) in the fragment removal group were significantly higher than those in the control group (28.8% and 14.0%, respectively; p< 0.05). Conclusion: Early fragment removal on day 2 significantly improved the subsequent development and pregnancy outcomes of fragmented embryos.

Effect of Fragment Removal on Development of Human Fragmented Embryos in IVF-ET Program (IVF-ET 시술 시 파편제거가 파편화된 인간배아의 발달에 미치는 효과)

  • Chi, Hee-Jun;Koo, Jung-Jin;Lee, Ju-Ok;Ryu, Hyoung-Eun;Kim, Kwang-Rae;Park, Chan;Roh, Sung-Il
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.4
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    • pp.339-348
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    • 2010
  • Objective: To investigate the beneficial effect of fragment removal on the subsequent cell division and clinical outcome of the fragmented human embryos. Methods: A prospective study was performed in Hanna Women's Clinic and Mizmedi Hospital. Sixty couples undergoing In vitro fertilization-embryo transfer (IVF-ET) program were participated in the present study. The microsurgical fragment removal was performed in 106 fragmented embryos of 29 patients before the transfer. As a control group, 122 fragmented embryos of 31 patients were transferred without the fragment removal. Effects of fragment removal on morphological changes and clinical outcomes of fragmented embryos were investigated. Results: Mean morphological grade (G2.79) of fragmented embryos was significantly improved after the fragment removal(G1.63, p<0.001). Most of the fragmented embryos did not show a regeneration of fragments after the fragment removal during the subsequent development, and a beneficial effect of fragment removal on the development of the fragment removed embryos was observed. Implantation and pregnancy rates of fragment removed embryos were 12.3% and 31.3%, whereas the rates of control group embryos were 6.6% and 22.5%, respectively. There was no statistical significance in the rates between the two groups because of the low number of trials. Conclusion: Microsurgical fragment removal improved the subsequent development as well as the morphological grade of fragmented embryos. The fragment removal may be beneficial for neighboring blastomeres by repairing the intercellular communication and removing the secretion of the potential toxic materials by fragments.

Prevention and Solution of the Fracture of Nickel-Titanium Endodontic Instruments (니켈티타늄 전동파일 파절의 예방 및 처치)

  • Kim, Hyeon-Cheol
    • The Journal of the Korean dental association
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    • v.54 no.8
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    • pp.640-650
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    • 2016
  • Nickel-Titanium (NiTi) rotary instruments have brought a big step toward "efficient" practice of endodontic procedure. The rotary files help clinicians to reduce their working time and also increase the clinical success rate with minimal procedural errors. However, NiTi instruments still have a few drawbacks including unpredictable fatigue fracture. Clinicians may reduce the potential risk of instruments fracture by following some clinical guidelines for rotary instruments. In some clinical cases of instruments fracture, we may try to remove the instruments' fragments or bypass the fragment to reach the apical canal. In some limited cases, the fractured instruments' fragments would not jeopardize the clinical prognosis of root canal treatment. Nevertheless, it is impossible to be overemphasized that the prevention of file fracture is much easier than the removal of fracture fragment. Clinicians need to understand the fracture mechanisms and, in clinic, need to discard the used instruments timely.

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Effectiveness of a Hockey-Stick Probe to Localize a Catheter Fragment in a Dog

  • Kim, Kitae;Oh, Dayoung;Shin, Dongmin;Yoon, Junghee
    • Journal of Veterinary Clinics
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    • v.39 no.4
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    • pp.173-176
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    • 2022
  • Intravenous catheterization is a common procedure in human and veterinary medicine. Occasionally, a catheter might break within the blood vessel, and the fragment may cause embolization, infections, or other severe complications, and therefore must be removed promptly. For a successful and low-risk removal, the fragment should be localized accurately; however, ultrasound may be challenging to perform on small dogs due to inadequate probes. We report the case of a 2-year-old, 2.6 kg, intact female toy poodle that presented to the veterinary medical center owing to a recent onion intake; the owner requested to induce emesis. A 24 gauge peripheral intravenous catheter was inserted into the cephalic vein prior to the emetic injection. When the clinician removed the catheter, a device breakage was observed. A tourniquet was applied immediately proximal to the elbow. Ultrasonography was performed with a high-frequency small-footprint linear array transducer, also called a hockey-stick probe, to localize the fragment. An additional ultrasound was performed before surgery to confirm the location of the catheter piece, which migrated 5 cm proximally. Afterward, a surgical intervention allowed us to retrieve the fragment. This report highlights the effectiveness of a hockey-stick probe to determine the location of a catheter fragment in small breed dogs.

Structure of Bacterial Communities in Biological Nitrogen Removal System (Biological Nitrogen Removal System의 세균 군집 분석)

  • Kim, Kyung-Mi;Lee, Sang-Ill;Lee, Dong-Hun
    • Korean Journal of Microbiology
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    • v.42 no.1
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    • pp.26-33
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    • 2006
  • To understand the efficient process of biological nitrogen removal (BNR) system, the structure of bacterial communities in nitrification reactors was analyzed using PCR and terminal restriction fragment length poly morphism (I-RFLP) methods. In this study, we used an advanced treatment system with plotting media, Nutrient Removal Laboratory system, or the rumination type sequencing batch reactor (SBR) system. The terminal restriction fragments of ammonia-oxidizing bacteria (AOB) and other $\beta-proteobacteria$ were observed in all of three BNR systems. The nucleotide sequence analysis of terminal restriction fragments showed that Nitrosomonas and Nitrosolobus were major populations of AOB in SBR system, whereas uncultured $\beta-proteobacteria$ and Cardococcus australiensis were the predominant groups in other two BNR systems. Also the SBR system may be more efficient to enrich AOB. These results indicate that the different structure of bacterial community may be developed depending on the wastewater treatment systems, although the same influent is used.

Complete Fracture of Totally Implantable Venous Catheter (완전 거치형 정맥도관의 완전 절단)

  • Kim, Jung-Tae;Chang, Woon-Ha;Oh, Tae-Yoon
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.946-948
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    • 2006
  • The patient was a 42-year-old female with breast cancer who had an implantable central venous catheter inserted percutaneously into left subclavian vein for chemotherapy. The postinsertion chest x ray revealed that there was no compressive sigh of catheter. Three months after insertion of the catheter, the patient was admitted to the hospital for 4th chemotherapy. The port was accessed but blood could not be aspirated and the catheter could not be flushed. A chest x ray revealed that the catheter was completely transected at the point where the catheter passed under the clavicle. Percutaneous removal of the distal fragment of the catheter was accomplished. The patient was discharged after successful removal of fragment of catheter.

A Retained Polyethylene Catheter Fragment in Superior Vena Cava - A case report- (상대정맥내 폴리에틸렌관 잔존물 치험 1례)

  • 김주현
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.134-137
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    • 1980
  • This represents a case report of the retained polyethylene catheter fragment in superior vena cava. A 39 year old male was admitted to this Korea University Hospital a short time after compression wound on abdomen with heavy cement material in emergency room, a polyethylene catheter was introduced into the right subclavian vein through a needle. But when the polyethylene catheter was attempted to withdraw the catheter was severed by the beveled tip of the needle. Later that day, chest X-ray disclosed the presence of the fragment extending from right subclavian vein to the superior vena cava. {Fig. 1 and Fig. 2]. Local exploration by way of an infraclavicular incision was unsuccessful in locating the catheter fragment. Another attempt was then made remove the catheter by means a biotome, which is originally a device for the biopsy of the myocardium, introduced through the right great saphenous vein. This procedure, though well tolerated by the patient, was in vain. After 11 days later, during that time he was taken a laparotomy with drain, another operation for removal of retained catheter fragment was performed through median sternotomy. After exposure of the right subclavian vein, innominate vein, and superior vena cava, an incision 1 cm in |length was made directly over the palpated catheter. The catheter immediately was picked upward and removed. The length of the catheter was approximately 8 cm. [Fig 3 ] There was no evidence of thromboembolism from the catheter or other complications. The patient made an uneventful recovery, and was discharged asymptomatic on the 9th postoperative day.

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Shoulder Impingement Caused by Superiorly Displaced Glenoid Fracture Fragment at a Boy - A Case Report - (소아에서 생긴 견갑골 관절와 골절편의 상방 전위에 의한 견관절 충돌 운동 장애 - 증례 보고 -)

  • Jeong, Kyoung-Il;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Choi, Hun-Sik;Park, Gee-Kang
    • Clinics in Shoulder and Elbow
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    • v.9 no.2
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    • pp.231-234
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    • 2006
  • We experienced a case of impingement caused by a bone fragment which was impacted between acromion and humeral head in a child. The bone fragment came from antero-inferior glenoid fracture. Satisfactory clinical results and stability were obtained by arthroscopic bone fragment removal. In case that bone fragment is located in the upper shoulder joint and results in impingement, We must consider not only greater tubercle fracture but also glenoid fracture. Magnetic resonance imaging can assist in the preoperative diagnosis.

Posterior Epidural Migration of Thoracic Disc Fragment

  • Kim, Il-Sup;Lee, Sang-Won;Son, Byung-Chul;Sung, Jae-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.239-241
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    • 2008
  • Migration of a disc fragment to the posterior epidural space is rare, especially in the thoracic spine. Only four such cases of posterior epidural migration of thoracic disc fragments have been reported. The authors report a case of 66-year-old man who presented with back pain and right leg weakness due to posterior epidural migration of thoracic disc fragment. The patient was successfully treated by laminectomy and partial facetectomy with disc removal.

Field Studios of In-situ Aerobic Cometabolism of Chlorinated Aliphatic Hydrocarbons

  • Semprini, Lewts
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2004.04a
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    • pp.3-4
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    • 2004
  • Results will be presented from two field studies that evaluated the in-situ treatment of chlorinated aliphatic hydrocarbons (CAHs) using aerobic cometabolism. In the first study, a cometabolic air sparging (CAS) demonstration was conducted at McClellan Air Force Base (AFB), California, to treat chlorinated aliphatic hydrocarbons (CAHs) in groundwater using propane as the cometabolic substrate. A propane-biostimulated zone was sparged with a propane/air mixture and a control zone was sparged with air alone. Propane-utilizers were effectively stimulated in the saturated zone with repeated intermediate sparging of propane and air. Propane delivery, however, was not uniform, with propane mainly observed in down-gradient observation wells. Trichloroethene (TCE), cis-1, 2-dichloroethene (c-DCE), and dissolved oxygen (DO) concentration levels decreased in proportion with propane usage, with c-DCE decreasing more rapidly than TCE. The more rapid removal of c-DCE indicated biotransformation and not just physical removal by stripping. Propane utilization rates and rates of CAH removal slowed after three to four months of repeated propane additions, which coincided with tile depletion of nitrogen (as nitrate). Ammonia was then added to the propane/air mixture as a nitrogen source. After a six-month period between propane additions, rapid propane-utilization was observed. Nitrate was present due to groundwater flow into the treatment zone and/or by the oxidation of tile previously injected ammonia. In the propane-stimulated zone, c-DCE concentrations decreased below tile detection limit (1 $\mu$g/L), and TCE concentrations ranged from less than 5 $\mu$g/L to 30 $\mu$g/L, representing removals of 90 to 97%. In the air sparged control zone, TCE was removed at only two monitoring locations nearest the sparge-well, to concentrations of 15 $\mu$g/L and 60 $\mu$g/L. The responses indicate that stripping as well as biological treatment were responsible for the removal of contaminants in the biostimulated zone, with biostimulation enhancing removals to lower contaminant levels. As part of that study bacterial population shifts that occurred in the groundwater during CAS and air sparging control were evaluated by length heterogeneity polymerase chain reaction (LH-PCR) fragment analysis. The results showed that an organism(5) that had a fragment size of 385 base pairs (385 bp) was positively correlated with propane removal rates. The 385 bp fragment consisted of up to 83% of the total fragments in the analysis when propane removal rates peaked. A 16S rRNA clone library made from the bacteria sampled in propane sparged groundwater included clones of a TM7 division bacterium that had a 385bp LH-PCR fragment; no other bacterial species with this fragment size were detected. Both propane removal rates and the 385bp LH-PCR fragment decreased as nitrate levels in the groundwater decreased. In the second study the potential for bioaugmentation of a butane culture was evaluated in a series of field tests conducted at the Moffett Field Air Station in California. A butane-utilizing mixed culture that was effective in transforming 1, 1-dichloroethene (1, 1-DCE), 1, 1, 1-trichloroethane (1, 1, 1-TCA), and 1, 1-dichloroethane (1, 1-DCA) was added to the saturated zone at the test site. This mixture of contaminants was evaluated since they are often present as together as the result of 1, 1, 1-TCA contamination and the abiotic and biotic transformation of 1, 1, 1-TCA to 1, 1-DCE and 1, 1-DCA. Model simulations were performed prior to the initiation of the field study. The simulations were performed with a transport code that included processes for in-situ cometabolism, including microbial growth and decay, substrate and oxygen utilization, and the cometabolism of dual contaminants (1, 1-DCE and 1, 1, 1-TCA). Based on the results of detailed kinetic studies with the culture, cometabolic transformation kinetics were incorporated that butane mixed-inhibition on 1, 1-DCE and 1, 1, 1-TCA transformation, and competitive inhibition of 1, 1-DCE and 1, 1, 1-TCA on butane utilization. A transformation capacity term was also included in the model formation that results in cell loss due to contaminant transformation. Parameters for the model simulations were determined independently in kinetic studies with the butane-utilizing culture and through batch microcosm tests with groundwater and aquifer solids from the field test zone with the butane-utilizing culture added. In microcosm tests, the model simulated well the repetitive utilization of butane and cometabolism of 1.1, 1-TCA and 1, 1-DCE, as well as the transformation of 1, 1-DCE as it was repeatedly transformed at increased aqueous concentrations. Model simulations were then performed under the transport conditions of the field test to explore the effects of the bioaugmentation dose and the response of the system to tile biostimulation with alternating pulses of dissolved butane and oxygen in the presence of 1, 1-DCE (50 $\mu$g/L) and 1, 1, 1-TCA (250 $\mu$g/L). A uniform aquifer bioaugmentation dose of 0.5 mg/L of cells resulted in complete utilization of the butane 2-meters downgradient of the injection well within 200-hrs of bioaugmentation and butane addition. 1, 1-DCE was much more rapidly transformed than 1, 1, 1-TCA, and efficient 1, 1, 1-TCA removal occurred only after 1, 1-DCE and butane were decreased in concentration. The simulations demonstrated the strong inhibition of both 1, 1-DCE and butane on 1, 1, 1-TCA transformation, and the more rapid 1, 1-DCE transformation kinetics. Results of tile field demonstration indicated that bioaugmentation was successfully implemented; however it was difficult to maintain effective treatment for long periods of time (50 days or more). The demonstration showed that the bioaugmented experimental leg effectively transformed 1, 1-DCE and 1, 1-DCA, and was somewhat effective in transforming 1, 1, 1-TCA. The indigenous experimental leg treated in the same way as the bioaugmented leg was much less effective in treating the contaminant mixture. The best operating performance was achieved in the bioaugmented leg with about over 90%, 80%, 60 % removal for 1, 1-DCE, 1, 1-DCA, and 1, 1, 1-TCA, respectively. Molecular methods were used to track and enumerate the bioaugmented culture in the test zone. Real Time PCR analysis was used to on enumerate the bioaugmented culture. The results show higher numbers of the bioaugmented microorganisms were present in the treatment zone groundwater when the contaminants were being effective transformed. A decrease in these numbers was associated with a reduction in treatment performance. The results of the field tests indicated that although bioaugmentation can be successfully implemented, competition for the growth substrate (butane) by the indigenous microorganisms likely lead to the decrease in long-term performance.

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