• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.270-273
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• 2000

Ventriculoperitoneal(V-P) shunt has been used as a popular method for surgical treatment of hydrocephalus. But complications such as infection, mechanical obstruction and failure of flow rate sometimes make painful stress to neurosurgeons and patients. Of particular, migration of distal V-P shunt catheter to extraperitoneal space has rarely been reported. Even rarer is intracardiac migration of distal V-P shunt catheter. Authors report a such case and discuss the possible mechanism and preventive method.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.170-173
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• 2008

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

• Journal of Chest Surgery
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• 제43권6호
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• pp.739-742
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• 2010

투석중인 40세의 만성 신부전 환자가 우측 쇄골하정맥 협착증으로 지역병원에서 2개의 스텐트를 삽입하였다. 경과 관찰 중 한 개의 스텐트가 우심실로 이동하면서 삼첨판막 폐쇄부전이 발생하였다. 경피적으로 스텐트 제거를 시도하였으나 실패하여 개흉 성장수술로 제거하면서 삼첨판막 성형술을 시행하여 좋은 결과를 보였기에 보고하고자 한다.

• Journal of Chest Surgery
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• 제35권11호
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• pp.831-834
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• 2002

감염된 심박조율기의 부분적 제거 후에 발생되는 재감염율은 51%에서 77%에 이르기 때문에 심박조율기의 어느 부위라도 감염이 된다면 모든 심박조율기의 하드웨어는 제거되어야 한다. 심폐기 가동하에서 감염된 심박조율기를 제거하는 것은 감염과 증식물의 확산 뿐만 아니라 기계적 손상을 방지 할 수 있다. 저자 등은 좌쇄골하 정맥에서 심장내로 이동된, 감염된 경정맥 심박조율기 도관에 의해 발생한 심내막염의 1예를 보고 한다. 심장내로 이동된 심박조율기 도관과 증식물이 부착된 전극은 심폐우회를 이용하여 제거하였다.

• Applied Microscopy
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• 제22권2호
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• pp.118-126
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• 1992

The pathway and time course of fucose-containing glycoprotein synthesis and intracellular translocation in osteoclasts of the mice maxillary alveolar bone were investigated by electron microscopic radioautography. Male Balb-C mice weighing 17gm were anesthetized with Nembutal and injected via the external jugular vein with 2.5 mCi of $L-[6-^{3}H]-fucose$ (specific activity 16.8 mCi/mmol) in 0.1 ml of sterile saline solution. At 5, 10, 20, 35 minutes and 8 hours after administration of the $^{3}H-fucose$, animals were killed by intracardiac perfusion of 30ml of 2% glutaraldehyde in a modified Tyroid solution, pH 7.4. The maxillae were then removed and further fixed in Karnovsky fixative for an additional 3-4 hours. After rinsing in 0.1M cacodylate buffer for 10 minutes, the maxillae were demineralized for 2 weeks at $4^{\circ}C$ in ethylene diamine tetra acetate containing 2% glutaraldehyde. The first interdental areas were mesiodistally sectioned into slices of 1mm thickness and postfixed in osmium tetroxide. Tissues were then dehydrated and embedded in Poly Bed. To prepare electron microscopic radioautography, the dipping method of Kopriwa (1973) was employed. Thin sections were coated with a crystalline monolayer of ILford $L_4$ photographic emulsion. After exposure for 4 months at $4^{\circ}C$, the sections were developed Kodak Microdol-X and Phenidon (for compact grains), fixed in 30% sodium thiosulfate, stained with uranyl acetate and lead citrate and examined in the electron microscope (JEOL 1200 EX). At 5, 10 and 20 minutes after injection, $^{3}H-fucose$ was concentrated in Golgi cisternae of the osteoblasts. By 35 minutes the labels were observed over small vesicles in the suprannclear area of osteoclasts. At 8 hours, numerous silver grains were located on the ruffled border and cell membrane of osteoclasts. These results indicate that fucose molecules are added in the Golgi apparatus and small vesicles appear to be responsible for translocation of the glycoproteins to the marginal portion of osteoblasts. The glycoproteins are distributed on the osteoclast cell surface and especially over the ruffled border.

• Journal of Chest Surgery
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• 제43권1호
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• pp.100-103
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• 2010

저자들은 nutcracker syndrome을 치료하기 위해 삽입한 스텐트가 심장내 우심실로 이동하는 드문 합병증을 경험하였기에 보고하고자 한다. 29세 여자환자가 측복부 통증을 주소로 내원하였다. 복부 컴퓨터단층촬영에서 좌콩팥정맥이 복부대동맥과 상장간막동맥 사이에서 눌리는 것(nutcracker syndrome)이 발견되었다. Nutcracker syndrome을 치료하기 위해 자가확장 스텐트를 좌콩팥정맥에 삽입하는데 다음날 스텐트가 심장 내 우심실로 이동된 것을 발견할 수 있었다. 경피적 스텐트 제거를 시도하였으나 실패하여 심장수술로 제거하였다. 수술 후 6개월째 아무런 복부나 심장 증상없이 외래 추적관찰 중이다.