BACKGROUND: Radiofrequency catheter ablation was introduced the curative method of supraventricular tachycardia in patients with accessory pathways. The success of catheter ablation depends on the accurate localization of accessory pathway and the destruction of accessory pathways. METHOD: We analyzed the local electrograms in 35 patients to be underwent the successful catheter ablation and measured the catheter stability, A/V ratio, AV interval, Accessory pathway potential, and the interval from the onset of RF energy to loss of accessory pathway from local electrograms at the successful ablation sites. RESULTS: The ratio of A wave and V wave range from 0.06 to 6.33 and the mean of A/V ratio is 0.62. The shortest AoVo interval is 20 msec and the longest AoVo interval is 120 msec and the mean of AoVo interval is 58.23 msec. The shortest ApVp interval is 20 msec and the longest ApVp interval is 100 msec and the mean of this interval is 51.88 msec. The incidence of accessory pathway potential among 35 successful ablation sites in 25%. The mean of time from RF energy to loss of accessory pathway is 4.48 sec. CONCLUSION: We concluded that the finding of local electrogram during catheter ablation is very important for shortening of procedure time and the successful procedure.
Catheter Ablation* ; Catheters ; Electrophysiologic Techniques, Cardiac* ; Humans ; Incidence ; Tachycardia, Supraventricular

STUDY DESIGN: Thirteen patients with cervical interlocked facets dislocation in whom closed reduction by skull traction was failed were evaluated about the patterns of ruptured disc fragment. Objects : To evaluate the causes of failure at closed reduction, and the relation between ruptured discs and interlocked facets, and the treatment results through an anterior approach. SUMMARY OF LITERATURE REVIEW: In traumatic dislocation of the cervical facet joints, spinal cord or nerve roots injury associated with the ruptured disc fragment has been reported. However, there is few report evaluating the patterns of ruptured disc fragment as a cause of reduction failure. MATERIALS AND METHODS: Between 1988 and 1997, thirteen patients were treated by anterior fusion with plate after complete removal of the intervertebral disc through anterior approach and reduction of interlocked facets by O1iveira method. They have been followed for an average of 36 months(range : 12-96 months). The interlocking was bilateral in seven cases and unilateral in six cases. We assessed the types of ruptured disc fragment by preoperative MRI and CT and the clinical and radiological results. RESULTS: Ruptured disc fragment was found in all thirteen patients with interlocked facets dislocation. The patterns of ruptured discs were within the uncovertebral joints in 5 cases, posterioly under the posterior longitudinal ligament in 3 cases, anteriorly under intact anterior longitudinal ligament in 3 cases and combined under the anterior and posterior longitudinal ligament in 2 cases. The displacement of ruptured disc fragment were seemed to be the cause of failure in closed reduction. CONCLUSIONS: Intervertebral disc injury should be evaluated carefully with MRI and CT in the lower cervical interlocked facet dislocations before trial of reduction or decision makings of treatment.
Dislocations* ; Humans ; Intervertebral Disc ; Joints ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Skull ; Spinal Cord ; Spine* ; Traction ; Zygapophyseal Joint

No abstract available.
Alcoholics* ; Humans

No abstract available.
Fistula*

There have been increasing interests of diabetes in the realm of plastic surgery due to problems like foot ulcer as a complication, delayed wound healing or higher failure rates of flap surgery. Main pathology in diabetes is microvascular compromise as well as metabolic derangements. The disturbance in microvascular circulation results in ischemic environments in the body and acts as a main factor that determines the limit of reconstructive or aesthetic plastic surgery. A useful method to overcome such problems is the use of hyperbaric oxygen therapy, which is known to be effective in the treatment of ischemic skin ulcer or osteoradionecrosis. However, there have been few studies on the survival of diabetic random skin flap or the effects of hyperbaric oxygenation directed to increase survival of such flap. In our study, we supposed that the survival of diabetic random skin flap was diminished owing to compromised microvascular pathology and blood rheology, and metabolic derangements, so we hypothesized that hyperbaric oxygen therapy has both reversible and irreversible effects on the survival of ischemic random skin flap in Streptozotocin-induced diabetic rats. Increase of local transcutaneous oxygen concentration, O2 affinity in blood and dysmorphogenesis of red blood cells are reversible and relatively short-term effects and promotion of neoangiogenesis is irreversible or long-term effects. We intended to confirm that hyperbaric rats and to compare the effects between preoperative and postoperative hyperbaric oxygenation on the survival of such flap. And we expect the additional effects of hyperbaric oxygenation on metabolism in diabetic rat, such as lowering the blood glucose level and solving the arrested weight gain. We divided Streptozotocin-induced diabetic rats into three groups: the first was non-treatment diabetic group, the second was preoperative hyperbaric oxygen treated diabetic group(100% O2, 2 atm, 90min, 15sessions, twice a day), and the third was postoperative hyperbaric oxygen treated group(100% O2, 2atm, 90min, 15sessions, twice a day). After elevation of random skin flap on dorsum of diabetic rats, we evaluated the extent of flap survival by measuring the necrotic areas at 3rd, 7th, 10th, and 13th postoperative days. At that time, we intended to evaluate both effects on flap survival by preoperative and postoperative hyperbaric oxygen therapy. As a result, flap survival of non-treated diabetic group was 41% at 13th postoperative days. In diabetic groups with preoperative and postoperative hyperbaric oxygen therapy, flap survival were increased to 64.6% and 62.4% respectively. Diabetic groups with hyperbaric oxygen therapy have a tendency of meaningful decrement in blood glucose level. However, there were no meaningful differences between preoperative and postoperative hyperbaric oxygen therapy. Hyperbaric oxygen therapy has no effective correlations with body weight changes. We conclude that hyperbaric oxygen therapy has some useful effects on the survival of diabetic random skin flap.
Animals ; Blood Glucose ; Body Weight Changes ; Erythrocytes ; Foot Ulcer ; Hyperbaric Oxygenation* ; Metabolism ; Osteoradionecrosis ; Oxygen ; Pathology ; Rats* ; Rheology ; Skin Ulcer ; Skin* ; Surgery, Plastic ; Weight Gain ; Wound Healing

No abstract available.

No abstract available.
Rhinoplasty*

No abstract available.

Vitamin A and its metabolite, retinoic acid, have been recommended for the treatment of psoriasis, ichthyosis, acne vulgaris and Darier's disease which resulted from abaormal regulatory function of keratinocytes. In recent years retinoic acid analogs (retinoids) have been synthesized and shown to be more potent and less toxic than retinoic acid. Since these drugs are therapeutically effective for skin diseases, only with longterm adminiatration of large doses, their toxicities must be seriously considered. The liver is the main site for both storage and excretion of vitamin A and ita derivatives, which may produce injury to the liver and other organs as a result of excess of lysosomal enzyme control. Fatty vacuoles, infiltration of inflammatory cells, focal necrosis, increase in lysosomal enzymes, distension of the RER, decrease in the ribosomes, swelling of the mitochondria, and proliferation of the SER within the hepatocytes have been observed in livers of vitamin A- as well as retinoic acid-treated rats. Its excess may also cause mucous metaplasia of secretory cells of the pancreas. (countinued...)
Acne Vulgaris ; Amphotericin B* ; Animals ; Darier Disease ; Hepatocytes ; Ichthyosis ; Keratinocytes ; Liver ; Metaplasia ; Mitochondria ; Necrosis ; Pancreas ; Psoriasis ; Rats ; Ribosomes ; Skin Diseases ; Tretinoin ; Vacuoles ; Vitamin A ; Vitamins

Zielke introduced new anterior instrumentation by modifying Dwyer system and called it the ventral derotation spondylodesis(VDS) system in 1976. This system is a powerful device and when the excised disc spaces are compressed with it, stable fixation can be obtained. But proper patient selection, meticulous operative technique and good post-operative care are essential to minimize serious complications. No results of this technique had been published in English-language literature until Moe reported the results of 66 cases of Zielke instrumentation in 1983. Zielke instrumentation was carried out in 12 cases of scoliosis;8 in idiopathic scoliosis and 4 in congenital scoliosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 16 months from November 1984 to March 1986. Seven cases had been followed for more then 9 months and'following results were obtained. 1. Numbers of vertebrae involved in major curve and numbers of fused vertebrae were 6·3 respectively. 2. Average preoperative curve was 72.7 degrees and immediate postoperative curve was 17.6 degrees with 75.8% correction. There was only 1.0 degree loss of correction with an average follow-up of 14 months (9-16 months). 3. Zielke instrumentation has the advantage of shorter fusion and better correction in thoracolumbar and lumbar scoliosis.
Follow-Up Studies ; Orthopedics ; Patient Selection ; Scoliosis ; Seoul ; Spine