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*

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

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

Authors analysed a series of 175 patients with aneurysmal subarachnoid hemorrhage(SAH) who have undergone the treatment for subarachnoid hemorrhage from July, 1990 to May, 1994 to assess the clinical factors related to clinical vasospasm. This investigation revealed following conclusions. 1) The severity of subarachnoid hemorrhage as seen on computed tomography seemed to be correlated with the appearance of clinical vasospasm. Patients with severe SAH on initial CT scan were at higher risk or clinical vasospasm. 2) Patients with history of hypertension had more significant clinical vasospasm than did normotensive patients after aneurysmal SAH. 3) Aneurysms of the anterior communicating artery were showen to have the highest incidence of clinical vasospasm. 4) Patients with moderate to severe diffuse vasospasm on cerebral angiography had more significant clinical vasospasm than patients with no or local vasospasm. These conclusions suggest that clinical vasospasm after aneurysmal SAH are related to the followi ng predictable factors;amount of blood on the initial CT scan;angiographic vasspasm;history of hypertension and location of aneurysm. Proper management of these factors may diminish the incidence and severity of clinical vasospasm and reduce the morbidity and mortality rate.
Aneurysm* ; Arteries ; Cerebral Angiography ; Humans ; Hypertension ; Incidence ; Infarction ; Mortality ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

Isolated pulmonary stenosis, a relatively common congenital anomaly that accounts for about 10 percent of all congenital heart disease, is characterized by stenosis of pulmonary valve itself, infundibulum or both of them. Since cardiac catherterization was applied to man by Cournand and Ranges, pulmonary stenosis had been easily diagnosed and many clinical studies had been investigated. It has a wide clinical spectrum depending on the degree of stenosis. The electrocardiogram, phonocardiogram and chest X-ray have proved useful in estimating the severity of hemodynamic facotrs in individual cases. This series comprises 47 cases in whom the clinical diagnosis of isolated pulmonary stenosis was confirmed by right heart catheterization with cardiac cineangiography at Severance Hospital, Yonsei University. An attempt was made to correlate the electrocardiographic, phonocardiographic, chest X-ray findings, and types of stenosis with the hemodynamic data in these cases. 1. Of 47 patients, 33 were male and 14 female. Their ages ranged from 2 to 42 years: the mean age was 19.1 years. 2. The incidence was 5.9 percent of all 797 catheterized congenital heart disease cases. The pulmonary valvular stenosis was 30 (68.3%), infundibular 7 (14.6%) and combined 10 (21.6%) cases. 3. The correlation between electrocardiogram and hemodynamic data were as follows. i) The regression equation between right ventricular sysytolic pressure (RVSP) and height of R wave in V1 lead (RV1) was RVSP=3.32 RV1+48.2: its correlation coefficient was 0.818 and it was very significant (p=0.000). ii) The higher the RVSP, the more the frontal axis of QRS complex shifted to the right side (r=0.55. p=0.001). iii) The RVSP of the groups with positive ECG findings such as p-pulmonale, right ventricular hypertrophy or right ventricular strain were much higher than the RVSP of the groups without such findings (p=0.032.0.000, 0.000). iv) The group with RV1 higher than 20 mm showed much more elevated mean of RVSP than the group with lower RV1 (p=0.000). v) The groups with the above mentioned positive ECG findings showed good correlation with the severity of RVSP which was arbitrarily classified as 49 or less, 50~100, and 100 mmHg or more (chi-square=8.96, 26.69, 19.06; p=0.011, 0.000, 0.000). 4. The group with late occurrence of the maximum intensity of the ejection systolic murmur showed higher mean of RVSP than the group with early peak of the murmur (p=0.014). 5. The means of RVSP of the groups with chest X-ray findings such as decreased pulmonary vascularity, were much higher than the means of RVSP of the groups without such findings (p=0.000, 0.005, 0.015). The groups with above mentioned positive chest X-ray findings showed good corelations with the severity of RVSP which was classified as above limits (chi-square=7.55, 10.94, 13.36; p=0.022, 0.004, 0.001). 6. Combined pulmonary valvular and infundibular stenosis showed more severe systolic pressure gradient and higher mean of RVSP than the isolated types (p=0.000).
Axis, Cervical Vertebra ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Electrocardiography ; Female ; Heart Defects, Congenital ; Hemodynamics* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax

No abstract available.
Immobilization* ; Rib Fractures* ; Ribs*

No abstract available.

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