No abstract available.
Bronchi* ; Rupture*

No abstract available.
Ciliary Motility Disorders*

No abstract available.
Spinal Muscular Atrophies of Childhood*

No abstract available.
Cloning, Molecular* ; DNA* ; Helicobacter pylori* ; Helicobacter* ; Sequence Analysis, DNA* ; Urease*

BACKGROUND: We performed electrical cardioversion for the patients with chormic nonvalvular atrial fibrillation under the transesophageal echocardiographic guidance after anticoagulation to evaluate the safety of this procedure and the effects of electrical cardioversion on the atrial function. METHODS: After anticoagulation therapy with coumadine for three weeks, we tried chemical cardioversion with amiodarone first. Failed cases were included in this study. Pre-cardioversion transesophageal echocardiographic parameters were measured after exclusion of thrombi. After sedation with intravenous midazolam, direct-current cardioversion was done with the transesophageal echocardiographic probe in situ. Immediately after sinus conversion, we measured echocardiographic parameters again. Spontaneous echo contrast(SEC), left atrial appendage flow velocity, pulmonary vein flow velocity and time-velocity-integral(TVI), transmitral flow velocity, TVI and deceleration time were measured. All patients were anticoagulated for at least 4 weeks after cardiovesion. RESULTS: The total number of patients was forty one(24 males, 17 females) with the mean age of 58 years(range : 39-70). Mean duration of atrial fibrillation was 65 months(range : 1-360). Hypertension(12), dilated cardiomyopathy(10), cerebrovascular accidents(6), ischemic heart disease(2) and chronic lung disease(1) were associated. There were no complications. SEC increased or newly appeared in 18(43.9%) patients after sinus conversion. The left atrial appendage emptying velocity decreased(32.8+/-17.4 vs. 22.1+/-11.4cm/sec, p=0.020) and systolic TVI of both upper pulmonic vein increased significantly after sinus conversion. In two cases, early systolic forward flow(S1) of pulmonic vein appeared after sinus conversion. Transmitral E velocity decreased(86.9+/-28.8 vs. 76.3+/-30.6cm/sec, p=0.006) and the deceleration time increased(164+/-49 vs. 206+/-53msec, p=0.000) after sinus conversion. Transmitral A velocity was still low(34.9+/-19.5cm/sec) and E/A ratio was high(2.6+/-1.4) immediately after sinus conversion. CONCLUSION: After appropriate anticoagulation therapy and exclusion of left atrium and left atrial appindage thrombi with TEE we could perform electrical cardioversion safety without complications. The changes in transesophageal echocardiographic parameters after sinus conversion revealed the appearance of atrial mechanical activity in concordance with electrical activity. But these findings suggested atrial stunning or electromechanical dissociation which necessitates extended anticoagulation therapy until the full recovery of atrial mechanical function.
Amiodarone ; Atrial Appendage ; Atrial Fibrillation* ; Atrial Function ; Deceleration ; Echocardiography* ; Echocardiography, Transesophageal ; Electric Countershock* ; Heart ; Heart Atria ; Humans ; Lung ; Male ; Midazolam ; Pulmonary Veins ; Veins ; Warfarin

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Urease*

Although neuroendocrine differentiation is a characteristic feature of tumors of the adrenal medulla, cortical tumors may also rarely be differentiated into medullary element. Recently we experienced such a case of adrenal cortical tumor having features of both cortical and medullary tumor. The patient was an 11-year-old girl who was incidentally found to have a left adrenal mass. Laboratory results showed elevated serum cortisol, aldosterone, renin, and epinephrine with high excretion of urinary metanephrine. Urine vanillyl mandelic acid and 17-ketosteroid remained within normal limits. Histologic featuresof a 6 cm round yellowish tumor were ambiguous to decide the orgin of this neoplasm. Cortical element predominated in the tumor with minor areas of pheochromocytomatous feature. Immunohistochemically, the tumor cells were positive for vimentin, neuron specific enolase, and epithelial membrane antigen. Ultrastructural examination revealed scattered membrane bound dense core granules in the tumor cells of medullary differentiation, measuring 150~500 nm in average diameter. Cortical tumor element showed corresponding ultrastructural features. These results indicate that this is a case of adrenal cortical tumor with features of neuroendocrine differentiation.
Child ; Male ; Female ; Humans

Skull base surgery has developed through the evolution of imaging, anatomic research, surgical approach and reconstructive techniques. The basic disciplines of approaching skull base lesions are provide direct vision, minimizing brain retraction, excellent exposure and minimal blood loss. The focus of this report is to review the advantages of skull base approach in our cases and suggest some indications. We experienced 20 cases of skull base surgery by a team approach consisting of a neurosurgeon and plastic surgeon. The surgical approach were supraorbital osteotomy(5 case), orbitozygomatic osteotomy(8 case), orbitozygomaticoglenoid osteotomy (5 case ) and orbitozygomaticoglenoidocondylar osteotomy (2 case). In our experience, these approaches provided excellent exposure of the lesion, direct access to lesions and minimal brain retraction thereby better outcome.
Brain ; Osteotomy ; Skull Base* ; Skull* ; Surgery, Plastic*

No abstract available.
Genomic Library* ; Helicobacter pylori* ; Helicobacter*

We evaluated the results of twelve total elbow arthroplasties that had been performed from Feb. 1986 to Mar. 1993 in ten patients. The duration of follow-up averaged three years two months(range, one year to seven years one month). There were six females and four males. Two females had bilateral procedures. The average age at the time of the operation was 35.3 years(range, 22 to 53). Five patients had severe rheumatoid arthritis, four patients had fracture sequelae around elbows and one patient had sequele of tuberculous arthritis. Total elbow arthroplasty had been performed for improving the range of motion and relief of pain. Total elbow arthroplasties had been performed in six cases of total ankylotic elbows and in six cases who complained severe painful limitation of motion of the elbow joints. Preoperatively, ankylotic group were fixed by 30 degrees of flexion on an average. In painful elbow group, the average total range of motion was 68 degrees. The prosthesis which were used in total elbow arthroplasties were semiconstrained type in nine cases and noncostrained in three cases. Most of the patients had relief of pain. Postoperative complications were permanent ulnar nerve palsy in one case, superficial infection in one case and dislocation in one case. Total gain of range of motion(ROM) was 17 degrees in painful elbow group and 102 degrees in ankylotic elbows. Total elbow arthroplasty was effective method for improvement of range of motion in ankylotic elbows and relief of pain in elbows which had painful limitation of motion.
Ankylosis ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Ulnar Neuropathies