OBJECTIVES: This study evaluates the change of the left atrial appendage function before and after electrical cardioversion to understand the mechanism involved in systemic thromboembolism of atrial fibrillation. BACKGROUND: Systemic thromboembolism associated with electrical cardioversion of atrial fibrillation is thought to originate from the left atrium or left atrial appendage, or both.However, the mechanism involved is poorly understood. METHOD: We studied left atrial appendage function funcction with transesophageal echocardiography in 15 patients with atrial fibrillation before and after successful electrical cardioversion. We measured left atrial appendage emptying and filling velocities and left atrial appendage areas. Also we analysed the characteristic Dopper flow pattern of LAA. RESULT: Left atrial appendage emptying velocities before cardioversion were greater in patients without(32.0+/-13.2cm/sec) than in those with(21.4+/-7.6cm/sec) spontaneous echo contrast(SEC). Furthermore emptying velocities after cardioversion were significantly reduced group with (21.4+/-7.6 vs 12.2+/-9.6, p<0.05) and the groupwithout(32.0+/-13.2 vs 18.1+/-10.2, p<0.05)SEC. CONCLUSION: After electrical cardioversion for atrial fibrillation left atrial appendage function is impaired. These observations suggest that stunned left atrial appendage after cardioversion may predispose to thrombus formation, which may play a role in the mechanism involved in the occurrence of thromboembolism after cardioversion.
Atrial Appendage* ; Atrial Fibrillation* ; Echocardiography, Transesophageal* ; Electric Countershock* ; Heart Atria ; Humans ; Thromboembolism ; Thrombosis

Dural arteriovenous fistula (DAVF) of anterior cranial fossa is a rare entity. The authors report a 57 year-old man presented with retro-orbital headache caused by a large hematoma in the right frontal lobe. Angiography demonstrated a DAVF of anterior cranial fossa fed by branches of middle meningeal and anterior ethmoidal artery. Endovascular therapy using N-butyl cyanoacrylate was tried, however, was failed to occlude the fistula. After than, the lesion was successfully obliterated by surgical means. The therapeutic roles and pitfalls of endovascular treatment and surgical treatment for the anterior fossa DAVF are discussed.
Angiography ; Arteries ; Central Nervous System Vascular Malformations* ; Cranial Fossa, Anterior* ; Cyanoacrylates ; Fistula ; Frontal Lobe ; Headache ; Hematoma ; Humans ; Middle Aged

No abstract available.
Female ; Ovulation* ; Pregnancy*

Malakoplakia of the bladder is an extremely rare condition in which there are multiple round or oval, plaque like or occasionally polypoid projections of the mucosa and submucosa which may be mistaken for cancer. It is believed to be infectious in origin, secondary to a deficiency of intracellular lysosomal digestion. There is often a clinical history of urinary tract infection, and the condition is considered to be an atypical form of granulomatous response to Gram negative coliform infection. We report a case of malakoplakia of the bladder clinically simulating malignant tumor, which was treated successfully with transurethral resection and antibiotics.
Anti-Bacterial Agents ; Digestion ; Malacoplakia* ; Mucous Membrane ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract Infections

No abstract available.
Constriction, Pathologic*

Among multple injured patients, the incidence of head injuries combined with long bone fracture is high. In adults who present with long bone fracture and concomitant head injury, the exuberant callus at fracture site was formed. The authors analyzed 26 cases of lower extremity fracure with severe head injury from January 1987 to December 1988. For the control group, we analyzed each 20 patients of only femur and tibia fractures. The results of this study are as follows:1. The mean age of experimental and control group were 38.4 yrs old and 40.1 yrs old, respectively. The sex ratio between male and female of experimental and control group were 2.3:1 and 2.7:1, respectively. 2. The initial level of consciousness by Glasgow coma scale was mild impairement 12%, moderate impairement 65% and severe impairement 23%. 3. Serum calium and phosphate level were no specific difference between the head injury with lower extremity fractured patients and only lower extremity fractured patients, but there was increment of serum alkaline phosphatase level on post-trauma 1 month in head injury cases. 4. The pattern of callus formation in experimental group was different compared with control group. 5. The formation of callus was exuberant in the severe head iniury with femur fracture. 6. In experimental group, there was evidence of early bony union time compared with control group, but there was no statistical significance (p<0.05). In conclusion, the callus formation was exuberant in the head injury with femur fractured patient, there was different healing response compared with control group.
Adult ; Alkaline Phosphatase ; Bony Callus ; Consciousness ; Craniocerebral Trauma ; Extremities ; Female ; Femur ; Fractures, Bone ; Glasgow Coma Scale ; Head ; Humans ; Incidence ; Lower Extremity ; Male ; Sex Ratio ; Tibia

We assessed cyst fluid of 14 cases of simple renal cyst. The aspirates were analyzed for color, lipid. protein, glucose, lactic acid dehydrogenase(LDH), amylase, electrolytes and Papanicolaou smears and cell blocks were performed. A clear amber fluid with minimal lipid content, LDH lower than that of blood and a normal cell pattern on Papanicolaou stain and cell block which are characteristics of transudate were seen in all cases. Although the number of cases are insufficient, it would appear that the content of simple renal cyst is identical to that of transudate.
Amber ; Amylases ; Cyst Fluid ; Electrolytes ; Exudates and Transudates ; Glucose ; Lactic Acid ; Papanicolaou Test

We describe 6 case of ectopic ureteral orifice was on vaginal wall and the most frequent symptom of ectopic ureteral orifice was incontinence. Vagino-gram and indigo carmine test was very important in diagnosis of ectopic ureteral orifice and identification of ectopic ureteral orifice and then nephrectomy, partial nephrectomy with ureterectomy was rational in treating ectopic ureteral orifice combining loss renal function.
Diagnosis ; Indigo Carmine ; Nephrectomy ; Ureter*

The muscular branches of the ophthalmic artery have been described as the superior muscular artery and the inferior muscular artery. However, the definition of the muscluar arteries and their distribution has not been clarified. Therefore, the muscular branches of the ophthalmic artery in 80 orbits of Korean adults were observed under the surgical microscope. The inferior muscular artery was observed in 87.5% of the materials and the superior muscular artery was observed in 32.5%. The commen muscular branch distributing to the adjacent two muscles was observed more frequently(81.3%). The superior muscular artery and the common muscular branches were similar in their distribution according to their site of origin. Therefore, they were classified into the superolateral and superomedial arteries. The superolateral muscular artery was observed in 58.6%. and the superomedial muscular artery was observed in 71.3%. This study suggests that the ocular muscular arteries are better classified into 3 groups, namely inferior, superolateral, and superomedial muscular arteries.
Adult ; Arteries* ; Humans ; Muscles ; Ophthalmic Artery ; Orbit

The muscular branches of the ophthalmic artery have been described as the superior muscular artery and the inferior muscular artery. However, the definition of the muscluar arteries and their distribution has not been clarified. Therefore, the muscular branches of the ophthalmic artery in 80 orbits of Korean adults were observed under the surgical microscope. The inferior muscular artery was observed in 87.5% of the materials and the superior muscular artery was observed in 32.5%. The commen muscular branch distributing to the adjacent two muscles was observed more frequently(81.3%). The superior muscular artery and the common muscular branches were similar in their distribution according to their site of origin. Therefore, they were classified into the superolateral and superomedial arteries. The superolateral muscular artery was observed in 58.6%. and the superomedial muscular artery was observed in 71.3%. This study suggests that the ocular muscular arteries are better classified into 3 groups, namely inferior, superolateral, and superomedial muscular arteries.
Adult ; Arteries* ; Humans ; Muscles ; Ophthalmic Artery ; Orbit