For the evaluation of exercise induced R wave amplitude changes in lead V5 (big up tri, openR) and multiple leads(summation operatorR), we studied 20 normal subjects and 21 ischemic heart disease patients with positive exercise test. All underwent submaximal, multiple leads multistage treadmill exercise testing. 14 to 20 normal subjects(70%) there were decreased R wave amplitude in multiple leads on treadmill exercise testing. 16 of 21 patients(76%) there were increased R wave amplitude on treadmill exercise testing. In normal group, R wave amplitude between rest and exercise was significantly decreased in lead V5 and multiple leads. In patients grous, R wave amplitude between rest and exercise was significantly increased in lead V5 and multiple leads. It is suggested exercise induced R wave amplitude changes probably enhance the diagnostic reliability by ST segment changes on treadmill exercise testing.
Exercise Test* ; Humans ; Myocardial Ischemia

Hyperglycemic state frequently presents with neurologic manifestations including choreoathetosis, ballismus, dysphagia, seizures, and coma. Also, hyperglycemic hemianopia has been rarely reported to cause temporary damage to the visual cortex, resulting in homonymous hemianopia. A 65-year-old man was admitted because of right homonymous hemianopia accompanied by hyperglycemia. Brain single-photon emission computed tomography showed focal hyperperfusion in the left occipital lobe. Herein we report a case of reversible homonymous hemianopia with cerebral hyperperfusion associated hyperglycemia without seizure.

OBJECTIVE: To evaluate the fixation strength and tissue reaction of the glue fixation and self-stabilizing leg fixation methods and to compare the results with those of the conventional tagging suture fixation method. MATER AND METHODS: Twelve healthy rabbits were selected and three different methods of implanting the port chamber were employed on the back of each rabbit. A total of thirty six port chambers were implanted with these three different methods, viz. the glue fixation method using tissue adhesive, the self-stabilizing leg method using a self-expandable stabilizing leg, and the suture fixation method. The fixation strength and the gross and histopathologic changes of each fixation method were evaluated at three days, one week, two weeks and four weeks after port implantation. RESULTS: The glue fixation method showed a good fixation strength, which was similar to that of the tagging suture method (p=0.3486). Five of the six ports (83%) implanted with the glue fixation method which were examined after two weeks showed cracks on the external surface, but this had no adverse effects on their function. A large amount of granulation tissue reaction was found at the bottom of the chamber (p=0.0025). The fixation with the self-stabilizing leg showed relatively lower fixation strength (p=0.0043), but no turning-over of the chamber occurred. The fixation strength improved with time after the first week, and minimal granulation tissue reaction was observed with this method. CONCLUSION: The glue fixation method exhibited equal fixation strength compared to the suture fixation, but showed cracking and a large amount of granulation tissue, whereas the fixation with a self-stabilizing leg showed weaker fixation strength.
Alloys ; Animals ; Capillaries/cytology/metabolism/pathology ; Cell Proliferation ; Device Removal ; Enbucrilate/therapeutic use ; *External Fixators ; Fibroblasts/metabolism/pathology ; Granulation Tissue/blood supply/metabolism/pathology ; *Implants, Experimental ; Models, Animal ; Rabbits ; Sutures/*utilization ; Time Factors ; Tissue Adhesives/*therapeutic use

From August 1986 until June 1995, single aortic valve replacement was performed in 65 patients at the Chonnam National University Hospital. Forthy-eight were male and 17 were female patients, ranging from 19 to 68 years of age (median=43 years). The causes of the valve lesions were rheumatic in 29 patients (44.6%), bicuspid aortic valve in 6 patients (6.2%), endocarditis in 6 patients (6.2%), unknown in others. Concomitant surgical procedures were performed in 10 patients: repair of congenital defect in 5, pericardiectomy in 1, coronary artery bypass grafting in 1, noncoronary sinus plication in 1, Valsalva sinus aneurysmectomy in 1, subaortic membrane resection in 1. Used valves were St. Jude-Medical valve in 42, Duromedics valve in 22, Bjork-Shiley valve in 2, Carpentier-Edward valve in 1. There were 3 hospital deaths (4.6%), and 2 late deaths (3.2%). Follow-up was 95.2% complete. The 10-year acturial survival rate was 85.3%. Postoperative complications were low cardiac output in 8, arrythmia in 5, valve related hemolysis in 1, cerebral infarction in 1, and gastrointestinal bleeding in 2. Reoperation was performed in 4 for surgical bleeding, in 3 for paravalvular leak. The mean improvement in New York Heart Association functional class is from 2.79+-0.66 preoperatively to 1.25+-0.49 postoperatively (p<0.001) The change of cardiothoracic ratio from preoperative to postoperative is 0.57+-0.06 to 0.54+-0.05 (p<0.05). The left ventricular ejection fraction change is not significant perioperatively. There are no mechanical failures. This early and intermediate-term follow-up suggests that in adults in whom valve repair is not possible, the mechanical valve is a reliable and durable prosthesis with good hemodynamic function and a low rate of thromboembolic event.
Adult ; Aortic Valve* ; Arrhythmias, Cardiac ; Bicuspid ; Cardiac Output, Low ; Cerebral Infarction ; Congenital Abnormalities ; Coronary Artery Bypass ; Endocarditis ; Female ; Follow-Up Studies ; Heart ; Hemodynamics ; Hemolysis ; Hemorrhage ; Humans ; Jeollanam-do ; Male ; Membranes ; Pericardiectomy ; Postoperative Complications ; Prostheses and Implants ; Reoperation ; Sinus of Valsalva ; Stroke Volume ; Survival Rate

The prevalence of gastroesophageal reflux disease has been increased recently in Korea. The use of minimally invasive laparoscopic and thoracoscopic surgery has become popular in the operation of esophageal disease such as esophageal cancer or gastroesophageal reflux disorder. We experienced three cases of laparoscopic Nissen fundoplications and one case of laparoscopic Collis gastroplasty, and we will describe the technical aspect of these surgeries.
Esophageal Diseases ; Esophageal Neoplasms ; Fundoplication* ; Gastroesophageal Reflux ; Gastroplasty* ; Korea ; Laparoscopes ; Prevalence ; Thoracoscopy

Cardiac rhabdomyomas are the most common primary tumor in infancy and childhood and are frequently associated with tuberous sclerosis. Although spontaneous regression of cardiac rhabdomyoma has been reported , prognosis of this tumor associated with subaortic stenosis is still considered to be poor and surgery continues to be indicated. A 4-day-old female was admitted due to tachypnea and cyanosis. Single rhabdomyoma arising from the interventricular septum associated with severe subaortic stenosis was partially removed under cardiopulmonary bypass. Excised tumor size was 0.7 X 0.9 X 0.4 cm in dimension. The postoperative course was uneventful and the infant discharged on the 14th postoperative day.
Cardiopulmonary Bypass ; Constriction, Pathologic ; Cyanosis ; Echocardiography ; Female ; Heart Neoplasms ; Humans ; Infant ; Infant, Newborn* ; Prognosis ; Rhabdomyoma* ; Tachypnea ; Tuberous Sclerosis ; Ventricular Outflow Obstruction*

Cardiac rhabdomyomas are the most common primary tumor in infancy and childhood and are frequently associated with tuberous sclerosis. Although spontaneous regression of cardiac rhabdomyoma has been reported , prognosis of this tumor associated with subaortic stenosis is still considered to be poor and surgery continues to be indicated. A 4-day-old female was admitted due to tachypnea and cyanosis. Single rhabdomyoma arising from the interventricular septum associated with severe subaortic stenosis was partially removed under cardiopulmonary bypass. Excised tumor size was 0.7 X 0.9 X 0.4 cm in dimension. The postoperative course was uneventful and the infant discharged on the 14th postoperative day.
Cardiopulmonary Bypass ; Constriction, Pathologic ; Cyanosis ; Echocardiography ; Female ; Heart Neoplasms ; Humans ; Infant ; Infant, Newborn* ; Prognosis ; Rhabdomyoma* ; Tachypnea ; Tuberous Sclerosis ; Ventricular Outflow Obstruction*

BACKGROUND: Nitrous oxide is a safe analgesics which has analgesic and sedative effects without loss of consciousness. The advantage of Nitrous oxide is that it has a rapid onset time and that we can modulate duration of its action. The purpose of this experiment is to obtain the safe and effective concentration of Nitrous oxide in Emergency Department as use of analgesics and sedative drugs. METHODS: Twenty volunteers were investigated according to double blind method. Nitrous oxide was administrated to volunteer subjects at different concentrations ; 33%, 50%, 67% each. Then we evaluated the Pain score, Blood pressure, Heart rate, Respiratory rate, Oxygen saturation and its side effects. RESULTS: Pain Score were 8.4+/-2.1 at 33%, 6.1+/-1.5 at 50%, and 3.65+/-2.2 at 67% of Nitrous oxide. Pain Score is decreased significantly following administration of Nitrous oxide at concentration of 50%, 67%(P<0.05). There was no difference between preadministration group and postadministration group. While no remarkable change in systolic blood pressure, heart rate, and oxygen saturation. Respiratory rate showed significant increase when 679o of Nitrous oxide was administrated. There was no side effect in administration of 33% of Nitrous oxide. When 50% of Nitrous oxide was administrated, there were dizziness 5(25%), paresthesia 2(10%), nausea 1(5%), palpitation 1(5%) and hyperethesia 1(5%). At 679o of Nitrous oxide, there were nausea 7(35%), dizziness 6(30%), paresthesia 5(25%), headache 5(25%), diplopia 2(10%), dysphoria 2(10%), salivation 1(5%), dyspnea 1(5%), nystagmus 1(5%), tinnitus 1(5%) and euphoria1 (5%). Incidence of side effect increased as the concentration of Nitrous oxide was increased. CONCLUSION: We can conclude that safe and effective concentration of Nitrous oxide is 50% as analgesics and sedative drugs in the emergency department.
Analgesics ; Blood Pressure ; Diplopia ; Dizziness ; Double-Blind Method ; Dyspnea ; Emergency Service, Hospital ; Headache ; Heart Rate ; Hemodynamics* ; Hypnotics and Sedatives ; Incidence ; Nausea ; Nitrous Oxide* ; Oxygen ; Paresthesia ; Respiratory Rate ; Salivation ; Tinnitus ; Unconsciousness ; Volunteers

Anomalous systemic arterial supply to the normal basal segments with normal bronchial connection of the lung without sequestration is a rare anomaly. It was classified as a type of sequestration according to Pryce's terminology, but whether the term - one of the sequestration is appropriate or not, is controversial because of normal bronchial connection. We describe our experience with surgical treatments for anomalous arterial supply to the normal basal segments of the left lower lobe.
Lung ; Pulmonary Artery