Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. Though sudden cardiac death accounts for as much as 15% of all cause mortality in uremia, requiring permanent cardiac pacing in end-stage renal disease hemodialysed patients are very few. Most cases of sick sinus syndrome are idiopathic, and the cause can be multifac- torial. A-V conducton defects were attributed to extensive metastatic calcifications, involving the cardiac skeleton, conservative to severe hyperparathyroidism and inadvertent use of calcitriol and calcium carbonate as phosphate binders. If optimal hemodialysis is provided, benefits of permanent pacing are equal in uremic or non uremic patients and pacemaker implantation should be instituted. We report a case of sick sinus syndrome derived in elderly patient on hemodialysis.
Aged* ; Calcitriol ; Calcium Carbonate ; Death, Sudden, Cardiac ; Humans ; Hyperparathyroidism ; Kidney Failure, Chronic ; Mortality ; Renal Dialysis* ; Sick Sinus Syndrome* ; Skeleton ; Uremia

The management of fractures of os calcis remains highly controversial. The fractures involving subtalar joint may cause serious and persistent disabilities. Recently, the computed tomography (CT) scan has been shown to he superior in evaluating the intraarticular fractures of calcaneus and the most widely used classification is based on the number of fragments especially seen on. Although the classification of calcaneal fractures hy CT, tongue type and joint depression type fractures hy plain radiographic views have been commonly used. Generally, closed reduction and axial fixation with metallic pin for tongue type fractures and open reduction and internal fixation for joint depression type fractures have been performed. The authors did so. The 13 fractures were tongue types and 17 fractures were joint depression types. The intraarticular calcaneal fractures of 30 feet in 26 patients who were treated at Our Lady of Mercy Hospital were analyzed in clinical and radiological aspects from Mar.1991 to Apr.1996. The results were as follows: 1. Of 30 cases, 16 fractures were treated with closed reduction and pinning, and 14 fractures were treated with open reduction and internal fixation. 2. The preoperative, postoperative and the last follow-up average Bohlers angle were 6.0, 21.0 and 20.5 respectively. 3. The preoperative, postoperative and the last follow-up average Gissanes angle was 106, 129 and 126 respectively. 4. Based on assessment of the criteria of Salama et al 19), excellent results were 5, good results were 14, fair results were 6 and poor results were 5. 5. All the five cases of poor results were tongue type fractures and they were treated with closed reduction and axial pinning. 6. Of 7 fractures using autogenous iliac bone graft, 6 fractures were good, I fracture was fair and there was no poor results. Therefore, open reduction and internal fixation for joint depression type calcaneal fractures was thought to be a good method of treatment. But we must consider whether axial fixation with metallic pin for tongue type calcaneal fractures will be a good method of treatment.
Calcaneus ; Classification ; Depression ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tongue ; Transplants

No abstract available.
Magnetic Resonance Imaging* ; Myelography*

No abstract available.
Leukemia, Lymphocytic, Chronic, B-Cell*

No abstract available.
Lung*

Paroxymal ventricular tachycardia occurs most frequently during the first several months following myocardial infarction, although the risk of arrhythmia development continues for many years. Underlying disease was coronary artery disease, dilated or hypertrophic cardiomyopathy, valvular heart disease, myocarditis, and idiopathic. Idiopathic ventricular tachycardia may be the most common type in Korea and usually originates from either right ventricular outflow tract or left ventricular septum. For the emergency treatment of sustained, hemodynamically stable ventricular tachycardia, antiarrhythmic drugs are the therapy of choice(choice of therapy). Mostly class I antiarrhythmic drugs, such as lidocaine, are preferred. In hemodynamically unstable ventricular tachycardia, electrical defibrillation should be applied, in case of recurrences, followed by pharmacological treatment with class I antiarrhythmic drugs or amiodarone. We report a case of paroxymal ventricular tachycardia improved due to(by) electrical defibrillation was done repeaedly in patient with cerebral infarction.
Amiodarone ; Anti-Arrhythmia Agents ; Arrhythmias, Cardiac ; Cardiomyopathy, Hypertrophic ; Cerebral Infarction ; Coronary Artery Disease ; Emergency Treatment ; Heart Valve Diseases ; Humans ; Infarction* ; Korea ; Lidocaine ; Myocardial Infarction ; Myocarditis ; Recurrence ; Tachycardia, Ventricular* ; Ventricular Septum

BACKGROUND: The endothelium-dependent vasorelaxation has been largely accounted for by the release of nitric oxide (NO). Three distinct isoforms of NO synthases (NOS) have been characterized, i.e., brain(bNOS), inducible (iNOS), and endothelial constitutive (ecNOS). Although hypertension hasbeen associated with a vascular endothelial dysfunction, changes in the vascular expression of NOS isoforms have not been established. The present study was aimed at exploring the vascular expression of NOS isozymes in hypertension. MATERIAL AND METHOD: Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were induced in rats. The expression of different NOS isozymes in the thoracic aorta was determined by Western blot analysis. The vascular tissue contents of nitrites were measured by colorimetric assay. RESULT: Arterial blood pressure was significantly higher in experimental groups of 2K1C and DOCA-salt rats compared with their corresponding control rats. The vascular expression of bNOS as well as that of ecNOS was decreased in both models of hypertension. iNOS was not changed in DOCA-salt hypertension, but was also decreased in 2K1C hypertension. The vascular contents of nitrites were significantly decreased in DOCA-salt as well as in 2K1C hypertension. CONCLUSION: These results suggest that 2K1C and DOCA-salt hypertension are associated with decreases in the vascular expression of NOS isozymes and nitrite contents.
Animals ; Aorta, Thoracic ; Arterial Pressure ; Blotting, Western ; Desoxycorticosterone ; Hypertension* ; Isoenzymes ; Nitric Oxide Synthase* ; Nitric Oxide* ; Nitrites ; Protein Isoforms ; Rats ; Vasodilation

Thirty-one distal femoral and nine proximal tibial primary bone tumor patients who had prosthetic replacements were reviewed retrospectively. Average follow-up was thirty-eight months(range: 12- 109 months). There were thirty-two(osteosarcoma: 29, chondrosarcoma: 3) stage IIB lesions and eight 1B lesions(giant cell tumor). Twenty-nine patients were surviving at final follow-up. Overall prosthetic survival was 81%, 27% at 2 and 5 year respectively. Eleven prostheses were revised. The causes of revisions were infection(7), metal failure(2), fracture of host bone(1), and loosening(1). Eight revisions were successful, one was fair, and two patients needed an amputation. Prognostic factors which were analyzed for survival of prostheses were age, sex, location of primary lesion, percent of bone resected, and stage. Only the location of primary lesion showed statistical significance and diabolic pattern of survival curve was noted between two groups in resection length(<40% versus >40%). Average functional score was 26. The tibial side had worse prosthetic survival and a major threat to this procedure was due to infection.
Amputation ; Chondrosarcoma ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Prostheses and Implants ; Prosthesis Failure ; Retrospective Studies ; Sarcoma

No abstract available.
Fetus* ; Humans ; Male* ; Mesothelioma*

Gastric cancer occurs with high frequency and is a significant cause of cancer motality in Korea. The most common metastatic sites of gastric cancer are liver, lung, bone and adrenal gland. Intramuscular metastasis from gastric cancer is an rare case. Skeletal muscle is one of the most unusual sites of metastasis from any malignancy. We report an elderly patient with gastric cancer developing multiple metastasis in skeletal musle.
Adenocarcinoma* ; Adrenal Glands ; Aged* ; Humans ; Korea ; Liver ; Lung ; Muscle, Skeletal* ; Neoplasm Metastasis* ; Stomach Neoplasms