A 45 year old man with a history of syncopal attacks of 3 days' duration showed complete heart block with occasional retrograde P waves following QRS complexes in the electrocardiogram. The site of A-V block seemed to be below A-V node judging from the QRS complexes when occasional capture occured. This may be a case of complete heart block progressing from right bundle branch block plus left posterior hemiblock. There was a rapid improvement of conduction with sublingual isoproterenol in a few days, EKG's showing normal A-V conduction and QRS complexes on discharge. The mechanism of the retrograde conduction in the presence of complete heart block is discussed with a review of literature.
Atrioventricular Node ; Bundle-Branch Block ; Electrocardiography ; Heart Block* ; Heart* ; Humans ; Isoproterenol ; Middle Aged

The electrocardiograms of a total of 12,796 patients taken in the past three years at Severance Hospital were reviewed for conduction disturbances which were found in 314 cases(2.46%). Th first degree atrioventricular block occurred in 65 cases, and second degree atrioventricular block with Wenckebach periodicity in 13. There were 9 cases of third degree atrioventricular block with nomal QRS complexes causing Adams-Stokes attacks which represented 2.9% of all conduction disturbances. It occurred equally in both sexes and predominantly after 6th decade of life. There were 99 cases of complete right bundle branch block(RBBB) and 12 cases of complete left bundle branch block(LBBB). The latter were mainly associated with significant heart diseases. As for the intraventricular conduction defects other than the simple bundle branch blocks, the findings were as follows; 1. Simple hemiblocks were found in 92 cases or 0.73% of total series and 29.3% of all conduction disturbances. Left anterior hemiblock(LAH) occurred 3 times more frequently than left posterior hemiblock(LPH). 2. Partial bilateral bundle branch block(BBBB) were found in 25 cases representing 0.2% of the total series and 8.0% of all conduction disturbances. Among the 25 cases of BBB, 11 had RBBB plus LAH, 10 RBBB plus LPH, 1 LBBB plus first degree A-V block, and 3 LBBB of diphtheritic cardic involvement. Trifascicular heart block causing Adams-Stokes attacks occurred in 9 of the 25 cases resulting in death in 7 cases. The underlying diseases were ischemic heart disease, hypertensive heart disease, congenital heart disease and diphtheritic carditis. This report represents the first electrocardiographical documentation of occurrence of trifascicular heart block progressing from BBBB in Korea.
Atrioventricular Block ; Bundle-Branch Block ; Electrocardiography* ; Heart Block ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Korea ; Myocardial Ischemia ; Myocarditis ; Periodicity

No abstract available.
Female ; Hepatitis B* ; Hepatitis* ; Humans ; Infant* ; Pregnant Women*

Many modalities of the treatment of fractures of distal 1/3 of tibia were introduced. But, May anatomical bone plate is considered to be a valuable method in treating distal 1/3 tibial fractures because of reduction potentiality by their contour, ability of firm fixation, decreased complications. Twenty two patients having distal 1/3 tibial fractures, were treated by May anatomical bone plate, at the Department of Orthopedic Surgery, Inchon Chirstian Hospital from January 1988 to December 1993. The results were follows; 1. Ninteen cases(86%) out of 22 were closed fractures and the remaining 3 cases(14%) were open fracrues, the comminuted fractures were 6 cases(22%) and the segmental fractures were 2 cases(9%). 2. Average interval from injuy to operation was 16.8 days and 21 cases had associated injuries. 3. The mean duration of bone union was 16.9 weeks. 4. Seven cases(31.8%) of delayed union and two cases(9.1%) of superficial infection were noted.
Bone Plates ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Incheon ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

To investigate the present status with its side effect of ocular tatooing for cosmetic purpose in our country, 150 patients with the eyelid and eyebrow tatooing who visited my clinic from July 1986 to October 1988 were enrolled in this study. Six patients who complained the early complications after the cosmetic tatooing were included in the tatooing group, and 150 patients without the tatooing were used as a control group for the statistical study. The following results were obtained: 1. The ages tatooed ranged from 19 to 68 years old age with the mean age of 39.65 +/- 9.46 years. Fourth and fifth decades consited of 76% of the total subjects tatooed. 2. At their first visit, blepharitis, external hordeolum, pingueculitis, subconjunctival hemorrhage and keratitis were more statistically frequent than the control gruop(p<0.05), but chalazion was not so. 3. Cosmetic tatooing was gradually noted after 1984 and was most frequently performed in 1986(41%). Thereafter, it reduced from 1987(35%) until now. 4. One half was tatooed once and 1 to 3 times of tatooing were added for the remainder. 5. Ninetyseven % of tatooing was done by non-medical doctor in beauty parlor or the other places excluding the hospital, and only 3% was performed by medical doctor in the hospital. 6. Eyelid tatiooing was noted in 96% of the total subjects tatooed and eyebrow tatooing was shown in over half of them(53%). 7. Early complication of the tatooing was confirmed by history taking in 29% of the total subjects tatooed, which consited of lid swelling(23%), subcutaneous hemorrhage of lid(4%), itching sensation(2%) and conjunctival redness(1%). Clinical Observations on Cosmetic Ocular Tatooing Six patients were treated for one to 10 days for the early complication of tatooing under the diagnosis of lid edema(100%), keratitis(83%), subcutaneous hemorrhage of lid(50%), blepharititis(33%), conjunctivitis(33%), corneal abrasion(33%) and conjunctival foreign body(17%). 8. Thirtysix % out of the patients confirmed by history taking was regretful after the cosmetic tatooing.
Aged ; Beauty ; Blepharitis ; Chalazion ; Diagnosis ; Eyebrows ; Eyelids ; Hemorrhage ; Hordeolum ; Humans ; Keratitis ; Pruritus ; Statistics as Topic

STATE MENT of PROBLEMS: Although some clinicians report long-term success with fixed partial denture (FPD) that contain cantilever pontic, the use of cantilever FPDs may be hazardous because of unfavorable leverages during mastication. PURPOSE of STUDY: This study aims to compare the stress induced in the periodontium with normal and reduced bone support, and to analyze the stress distribution patterns of anterior cantilevered FPDs using the finite element method. RESULTS: Cantilever bridge with a reduced bone level generated the highest peak stresses in the periodontium. In the models of reduced bone support, a cantilever bridge exhibited the greatest mobility and a 3-unit fixed restorations induced the smallest mobility of canine. The highest peak stress level of a 3-unit bridge in the periodontium is similar to the unrestored situation. But stress distribution in the bone is modified. CONCLUSION: In reduced bone support, a cantilever bridge exhibited the greatest mobility and stress.
Denture, Partial, Fixed ; Mastication ; Periodontium

No abstract available.
Fanconi Anemia*

PURPOSE: Despite the large number of analytical reports regarding the learning curve in the transition from open to robot-assisted radical prostatectomy (RARP), few comparative results with laparoscopic radical prostatectomy (LRP) have been reported. Thus, we evaluated operative and postoperative outcomes in RARP versus 100 simultaneously performed LRPs. MATERIALS AND METHODS: A single surgeon had performed more than 1,000 laparoscopic operations, including 415 cases of radical nephrectomy, 85 radical cystectomies, 369 radical prostatectomies, and treatment of 212 other urological tumors, since 2009. We evaluated operative (operation time, intraoperative transfusion, complications, hospital stay, margin status, pathological stage, Gleason score) and postoperative (continence and erectile function) parameters in initial cases of RARP without tutoring compared with 100 recently performed LRPs. RESULTS: Mean operation time and length of hospital stay for RARP and LRP were 145.5+/-43.6 minutes and 118.1+/-39.1 minutes, and 6.4+/-0.9 days and 6.6+/-1.1 days, respectively (p=0.003 and p=0.721). After 17 cases, the mean operation time for RARP was similar to LRP (less than 2 hours). Positive surgical margins in localized cancer were seen in 11.1% and 8.9% of cases in RARP and LRP, respectively (p=0.733). At postoperative 3 months, sexual intercourse was reported in 14.0% and 12.0%, and pad-free continence in 96.0% and 81.0% in patients with RARP and LRP, respectively (p=0.796 and p=0.012). CONCLUSIONS: Previous large-volume experience of LRPs may shorten the learning curve for RARP in terms of oncological outcome. Additionally, previous experience with laparoscopy may improve the functional outcomes of RARP.
Coitus ; Cystectomy ; Humans ; Laparoscopy ; Learning Curve* ; Length of Stay ; Nephrectomy ; Prostatectomy* ; Prostatic Neoplasms ; Robotics ; Treatment Outcome

The ventricular septal defect with aortic insufficiency is a relatively uncommon congenital heart disease. Once the prolapse of aortic cusp complicates the ventricular septal defect, the prolapse of the aortic cusp is a progressive, rather than static lesion. With the curent possibility of surgical correction in cases of ventricular septal defect and other abnormalities, the differential diagnosis assumes marked importance. vTwo cases of ventricular septal defect with aortic insufficiency are presented with a review of pertinent literature. These young female patients had long standing palpitation and dyspnea on exertion since childhood. The physical examination showed with pulse pressure, bounding carotid pulsation and a systolic ejection-type murmur and a decrescendo diastolic murmur at the upper left sternal border, which simulated "machinery" type murmur of patent ductus arteriosus. The ventricular septal defect with aortic insufficiency was demonstrated by cardiac catheterization and cineangiocardiography.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis, Differential ; Ductus Arteriosus, Patent ; Dyspnea ; Female ; Heart Defects, Congenital ; Heart Murmurs ; Heart Septal Defects, Ventricular* ; Humans ; Physical Examination ; Prolapse

PURPOSE: Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obsructive jaundice. METHODS AND MATERIALS: A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projecion imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. RESULTS: In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intraheparic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were dipicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography was successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases.
Bile Ducts ; Biliary Tract ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Dilatation ; Gallbladder ; Healthy Volunteers ; Humans ; Jaundice ; Jaundice, Obstructive* ; Pancreatic Ducts ; Volunteers