Takayasu's arteritis is briefly as an inflammatory process of unknown etiology occuring dominantly in young female most commonly involving the great vessels arising from the aortic arch. The disease process results in stenosis and obliteration of involved vessels. Syncope in Takayasu's arteritis is known to result from decreased blood flow to brain because of stenosing blood vessels. We herein describe a case of paroxysmal atrioventricular block in a 40-year old man with Takayasu's arteritis. The patient presented with spontaneous recurrent syncope associated with paroxysmal AV block. Carotid sinus pressure repeatedly induced paroxysmal AV block and syncope. Carotid sinus pressure after pretreatment of atropine failed to induce AV block or syncope. Coronary angiogram was normal. We concluded that syncope in this patients was attributed to carotid hypersensitivity rather than decreased blood flow to the brain due to vessel stenosis.
Adult ; Aorta, Thoracic ; Atrioventricular Block* ; Atropine ; Blood Vessels ; Brain ; Carotid Sinus ; Constriction, Pathologic ; Female ; Humans ; Hypersensitivity ; Syncope ; Takayasu Arteritis*

Plasma cell cheilitis is a rare inflammatory disorder which shows a dense, band-like infiltrate of plasma cells in the upper dermis. Although the histological picture is shared with other diseases of the lips, plasma cell cheilitis is not associated with any known dermatoses. Some authors have shown the effectiveness of topical or intralesional corticosteroids; however, there have been many reports describing poor therapeutic response to topical steroids. We de-scribe two patients with plasma cell chielitis whose clinical condition responded rapidly to the intralesional injection of corticosteroids.
Adrenal Cortex Hormones* ; Cheilitis* ; Dermis ; Humans ; Injections, Intralesional* ; Lip ; Plasma Cells* ; Plasma* ; Skin Diseases ; Steroids

In this paper, course and complications of the 200 cases of cataract extractions and postoperative period as well as the visual acuity a t conclusion of period of observation are presented. The observation are made comparing with the types of corneo-scleral suture. The vision of preoperatively complicated cases are not so improved after successful cataract extraction. Vitreous loss during the operation and, vitreous protrusion into anterior chamber do not interfere thc post-operative vision. Massive and longstanding hyphema used to interfere the final vision. The average visual acuity after the operation revealed 0.34. All the above indicated observation are performed on the cases of average age 56.1 years old.
Anterior Chamber ; Cataract Extraction* ; Cataract* ; Dronabinol ; Hyphema ; Postoperative Period ; Sutures ; Visual Acuity

The systolic time intervals were measured in 25 normal controls and 23 patients with dilated cardiomyopathy by simultaneous recording of the aortic valve echocardiogram and ECG. These values were compared to corresponding ones obtained from the method using simultaneously recorded phonocardiogram, ECG, and indirect carotid pulse tracings. And we assessed left ventricular function by systolic time intervals in dilated cardiomyopathy. The results were as followings. 1) High degree of correlation(r> or =0.94) was found between the two methods for each intervals, EMS, LVET, PEP, PEP/LVET. 2) In normal controls, PEP/LVET obtained from echocardiographic measurement was 0.31+/-0.02. 3) In the patients with dilated cardiomyopathy, PEP/LVET(0.59+/-0.13) was significantly higher(p<0.001), PEP index was longer(p<0.05), LVET index was shorter(p<0.05) than in normal controls.
Adult* ; Aortic Valve ; Cardiomyopathy, Dilated* ; Echocardiography* ; Electrocardiography ; Humans ; Systole* ; Ventricular Function, Left

BACKGROUND: The catheter ablation usin radiofrequency(RF) energy in patients with atrioventricular nodal reentrant tachycardia(AVNRT) and atrioventricular reentrant tachycardia(AVRT) ahs been proved as a safe and effective nonpharmacologic therapeutic modality. The purpose of our study was to evaluate the success rate and complications of the initial experience and to determine the extent of myocardial damage of RF catheter ablation. METHODS: Electrophysiologic study was performed with the standard technique. Twenty five patinents(M:F=16:9, mean age:42 years old) underwent RF catheter ablation in St. May's Hospital from April to December in 1994. The RF generator in this study was RFG-3D model and catheters were 6F or 7F steerable catheters with 4mm kistal tip. In order to evaluate the extent of myocardial damage the WBC count, LDH, CK, and CK-MB fraction were checked before and after RF catheter ablation and the Tc99m myocardial scintigraphy was performed within 72 hours of the porcedure. RESULTS: Six of twenty five patients had AVNRT, in which the success rate of selective ablation of the slow pathway was 83.8%. Nineteen patients with AVRT had one accessory pathway. The ablation success rate of 14 accessory pathways in left free wall location was 85.7%, and that of 3 in left posteroseptal location was 66.6%. Two right sided accessory pathways were not ablated successfully. The level of CK-MB fraction after ablation was within normal limit. Only one case revealed grade 2 of hot spot in Tc99m myocardial scintigraphy. CONCLUSION: The RF catheter ablation in patients with AVNRT and AVRT is a safe and effective nonpharmacologic therapeutic modality. But right sided accessory pathways are more difficult to ablate than left sided accessory pathways, requiring more experiences and better technique. The extent of myocardial damage after RF catheter ablation reveals relatively minimal by cardiac enzyme study and Tc99mmyocardial scintigraphy.
Catheter Ablation* ; Catheters ; Humans ; Myocardial Perfusion Imaging ; Radionuclide Imaging ; Tachycardia, Supraventricular*

Primary cutaneous CD30 positive large cell lymphoma is a cutaneous T-cell lymphoma with a favorable prognosis, which is characterized by solitary or localized skin lesions with a tendency of spontaneous regression and frequent relapses. On the basis of the morphologic and immunophenotypic similarities between the large atypical cells in lymphomatoid papulosis and the neoplastic cells in primary cutaneous CD30 positive large cell lymphoma as well as their favorable prognosis, these two diseases are now regarded to be in a spectrum of primary cutaneous CD30 positive lymphoproliferative disorder. We present a borderline case of primary cutaneous CD30 positive lymphoproliferative disorder which recurred on the anatomic site different to the primary lesions despite multiple-agent chemotherapy.
Drug Therapy ; Lymphoma ; Lymphoma, T-Cell, Cutaneous ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders* ; Prognosis ; Recurrence ; Skin

Ventricular tachycardia is an important tachyarrhythmia which is encountered commonly in clinical field. The accompanying manifestations could be variable just from palpitation to sudden cardiac death. The classification of this arrhythmia has not completly settled yet, but in a broad way this arrhythmia is classified according to the prescence or abscence or underlying heart disease, especially coronary artery disease. Recently, therapeutic modalities for this arrhythmia have been changed a lot from classical antiarrhythmic drugs to radiofrequency ablation or ICD implantation although there are still some problems to overcome. We experienced a case of 34-year-old female having an incessant ventricular tacycardia which was abolished after endomyocardial biopsy performed to differentiate underlying myocardial pathology.
Adult ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Biopsy* ; Catheter Ablation ; Classification ; Coronary Artery Disease ; Death, Sudden, Cardiac ; Female ; Heart Diseases ; Humans ; Pathology ; Tachycardia ; Tachycardia, Ventricular*

The prevalence of right-sided infective endocarditis is increasing with a growing number of intravenous drug abusers. A case of right-sided endocarditis is reported in a 18-year-old female heroin addict. Tricuspid valve vegetation, septic pulmonary emboli and staphyloccus aureus in blood cultures are noted. During antimicrobial therapy, she developed remittent fever and skin rash due to vancomycin. After a change of the antibiotic to teicoplanin, she was freed from fever and discharged in an improved condition.
Adolescent ; Drug Users ; Endocarditis* ; Exanthema ; Female ; Fever ; Heroin ; Humans ; Malaria ; Prevalence ; Pulmonary Embolism* ; Teicoplanin ; Tricuspid Valve* ; Vancomycin

Atrial flutter, a common rhythm disturbance, was first described over 80 years ago. Despite extensive investigations, several important issues remain unresolved concerning its exact mechanism and management. Present therapeutic strategies often appear effective to prevent and terminate atrial flutter. However, controlled trial and definitive studies comparing the various treatment options are surprisingly scarce. Here we report on a study of 9 episodes of spontaneous atrial flutter(AF)(flutter wave cycle length 224+/-39 msec) treatedd by transesophageal atrial pacing(TAP) in 9 patients(7 men and 2 women; mean age 56.9 yrs). TAP was effective in 5 patients : sinus rhythm resumption was immediate in 3 patients and followed a short period of atrial fibrillation in 2 patients. TAP was unsuccessful in 4 patients. All the patients tolerated the procedure well. These data strongly support the immediate first choice use of TAP in AF therapy.
Atrial Fibrillation ; Atrial Flutter* ; Female ; Humans ; Male

After supratentorial infarction. Crossed cerebellar diaschisis has been described. And there was also a report of crossed cerebral diaschisis in cerebellar infarction as a rare phenomenon. We analyzed 36 patients with cerebellar ischemic stroke by using 99mTc-HMPAO single photon emission computed tomography (SPECT). All the patients showed depression of perfusion on the side of cerebellum. Among them, contralateral cerebral reduced uptake was also observed in 8 patients (22%). Uhich showed marked reduction in frontoparietal junction area (especially premotor area). SPECTs were done relatively earlier in those patients(diaschisis +: N=8) than the others(diaschisis -; N=28). They comprised 6 patients of posterior inferior cerebellar arterial territory infarction. One patient in anterior inferior cerebellar artery and one in superior cerebellar artery. Six patients were followed-up by second SPECT images. Most of the depressed perfusions (primary lesions and diaschisis areas) were improved with functional recovery at the follow-up SPECT images.
Arteries ; Cerebellum ; Depression ; Follow-Up Studies ; Humans ; Infarction ; Perfusion ; Stroke ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon