BACKGROUND: It has been reported that sudden cardiac death can occur in postoperative tetralogy of Fallot (TOF) and this episode is related to the sustained ventricular tachyarrhythmia. However, the connecting mechanism of various clinical features and sudden cardiac death is not defined yet. Based on the reports that sudden cardiac death is related to the alteration of heart rate dynamics in some diseases, investigation of heart rate dynamics in postoperative TOF seems important to reveal the mechanism of sudden cardiac death. This study was done as a part of the project to investigate the alteration of heart rate variability and to identify the factors related to the sudden cardiac death in postoperative TOF. METHODS: Among the children with postoperative TOF, 13 asymptomatic children without significant hemodynamic disturbances (Doppler velocity for tricuspid regurgitation 2.5m/sec and mild pulmonary regurgitation) and ventricular arrhythmia were selected (10 boys, 3 girls; mean age, 9 year 3 months; mean duration after operation, 7 years). We evaluated the complexity and periodic dynamics of heart rate (HR) throughout 24 hours in these children and control group (mean age, 8 year 10 months). After examining each ECG data on 24-hour Holter ECG segmented into 1-hour length, we analyzed each HR time series and quantified the overall complexity of each HR time series by its correlation dimension. In addition, the power spectrum of HR and obtained low-frequency component (0.08-0.15Hz) and high-frequency component (0.15-0.4Hz) were calculated. RESULTS: This study showed that TOF group had lower correlation dimension and a nonlinear characteristics of HR time series than control group (4.055+/-0.4134 vs. 4.9310+/-0.2054, p<0.05). However, the difference was not significant in the low- (0.9864+/-0.5598 vs. 1.5560+/-0.8325, p<0.05) and high- (1.1168+/-0.1.1448 vs. 0.9271+/-0.6528, p<0.05) frequency components. CONCLUSIONS: It can be concluded that HR time series are more regular in postoperative TOF. The result was significant in correlation dimension analysis and not in the frequency domain analysis. Although the meaning of this finding in postoperative TOF is not clear at present, this may suggest the phenomenon related to the sudden cardiac death.
Arrhythmias, Cardiac ; Child* ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Tachycardia ; Tetralogy of Fallot* ; Tricuspid Valve Insufficiency

BACKGROUND: It has been reported that sudden cardiac death can occur in postoperative tetralogy of Fallot (TOF) and this episode is related to the sustained ventricular tachyarrhythmia. However, the connecting mechanism of various clinical features and sudden cardiac death is not defined yet. Based on the reports that sudden cardiac death is related to the alteration of heart rate dynamics in some diseases, investigation of heart rate dynamics in postoperative TOF seems important to reveal the mechanism of sudden cardiac death. This study was done as a part of the project to investigate the alteration of heart rate variability and to identify the factors related to the sudden cardiac death in postoperative TOF. METHODS: Among the children with postoperative TOF, 13 asymptomatic children without significant hemodynamic disturbances (Doppler velocity for tricuspid regurgitation 2.5m/sec and mild pulmonary regurgitation) and ventricular arrhythmia were selected (10 boys, 3 girls; mean age, 9 year 3 months; mean duration after operation, 7 years). We evaluated the complexity and periodic dynamics of heart rate (HR) throughout 24 hours in these children and control group (mean age, 8 year 10 months). After examining each ECG data on 24-hour Holter ECG segmented into 1-hour length, we analyzed each HR time series and quantified the overall complexity of each HR time series by its correlation dimension. In addition, the power spectrum of HR and obtained low-frequency component (0.08-0.15Hz) and high-frequency component (0.15-0.4Hz) were calculated. RESULTS: This study showed that TOF group had lower correlation dimension and a nonlinear characteristics of HR time series than control group (4.055+/-0.4134 vs. 4.9310+/-0.2054, p<0.05). However, the difference was not significant in the low- (0.9864+/-0.5598 vs. 1.5560+/-0.8325, p<0.05) and high- (1.1168+/-0.1.1448 vs. 0.9271+/-0.6528, p<0.05) frequency components. CONCLUSIONS: It can be concluded that HR time series are more regular in postoperative TOF. The result was significant in correlation dimension analysis and not in the frequency domain analysis. Although the meaning of this finding in postoperative TOF is not clear at present, this may suggest the phenomenon related to the sudden cardiac death.
Arrhythmias, Cardiac ; Child* ; Death, Sudden, Cardiac ; Electrocardiography ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Tachycardia ; Tetralogy of Fallot* ; Tricuspid Valve Insufficiency

Sulfuric acid can cause local or systemic effects after exposure by inhalation, ingestion, or topical application. Direct ingestion is the main exposure route for fatal sulfuric acid injury. Fatal accidents involving the inhalation of toxic sulfuric acid vapors are rare. Inhalation of sulfuric acid fumes causes severe irritation or corrosive damage to the upper respiratory tract. Consequently, severe congestion, edema, and inflammation of the mucous membranes of the upper respiratory passages hinder the entry of air into the lungs, possibly leading to fatalities in victims. A 35-year-old man died at his home after complaining of a severe sore throat. One day earlier, he had worked in a sulfuric acid tank in a copper-smelting plant while wearing an ordinary gas mask that offered no protection against sulfurous acid vapors. Upon autopsy, the larynx and epiglottis showed pronounced edema, congestion, and inflammation that histologically mimicked an acute bacterial suppurative inflammation, accompanied by severe pulmonary edema. A field analysis of the air inside the sulfuric acid tank revealed SO4(2-) positivity and a 40% sulfuric acid concentration.
Adult ; Autopsy ; Eating ; Edema ; Epiglottis ; Estrogens, Conjugated (USP) ; Humans ; Inflammation ; Inhalation* ; Larynx ; Lung ; Mucous Membrane ; Pharyngitis ; Plants ; Pulmonary Edema ; Respiratory Protective Devices ; Respiratory System ; Sulfur* ; Sulfuric Acids

Giant and complex aneurysm of the posterior circulation can pose several technical challenges with high operative morbidity. Recent advances in cardiac surgery have raised interest in the technique of deep hypothermic circulatory arrest for the management of giant and complex intracranial aneurysms of posterior circulation. The criteria for selecting patients for this procedure can be based on a preoperative analysis of available studies that suggests high risk with standard intervention. Using the technique of deep hypothermic circulatory arrest, we have successfully operated on a case of complex basilar tip aneurysm with MoyaMoya disease resulting in no significant neurological complications. We therefore suggest that patients with giant and complex intracranial aneurysms of posterior circulation might benefit from the use of deep hypothermic circulatory arrest technique.
Aneurysm* ; Cardiopulmonary Bypass ; Circulatory Arrest, Deep Hypothermia Induced* ; Humans ; Intracranial Aneurysm ; Moyamoya Disease* ; Thoracic Surgery

No abstract available.
Humans

BACKGROUND: Exposure to organic solvents becomes a common problem to workers of heavy industries in Korea. A number of volatile organic solvents which are frequently used in painting can cause various derangements of the nervous system, especially cognitive impairments and peripheral neuropathy. METHODS: This study was carried out on 190 workers as a control group who had never been exposed to organic solvents and on 674 spray painters with long-term exposure to organic solvent mixtures. The major components of organic solvent mixtures were determined. All subjects underwent neurological examination as well as routine physical check-up after completing questionnaires on general, musculoskeletal, neuropsychiatric and neurological systems. Subjects with abnormal findings on neurological examination related with the exposure of organic solvent mixtures took further neuropsychological and neurophysiological tests. RESULTS: The prevalence rates of cognitive impairments and of peripheral neuropathy in the exposed group were significantly higher than the control group (9.5% vs 2.1% and 2.1% vs 0%, respectively). High exposure group (more than 2.64 of cumulative exposure index, CEI) showed also higher prevalence of cognitive impairments and of peripheral neuropathy than low exposure group (cognitive impairments; 12.3% vs 6.4%, peripheral neuropathy; 2.3% vs 1.8%). Most common cognitive impairments were attentional deficit, and abnormal sense on the extremities or face was most common symptom of the peripheral nervous system. CONCLUSION: This study is the first large-scale, case-control study extensively evaluating cognitive impairments and peripheral neuropathy related with volatile organic solvent mixtures in spray painters working in a shipbuilding industry in Korea. The results show that the prevalence rates of cognitive impairments and of peripheral neuropathy are relatively low, but clearly related with the exposure extent of organic solvents.
Case-Control Studies ; Extremities ; Korea ; Metallurgy ; Nervous System ; Neurologic Examination ; Paint ; Paintings ; Peripheral Nervous System ; Peripheral Nervous System Diseases* ; Prevalence ; Surveys and Questionnaires ; Solvents*

PURPOSE: This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. PATIENTS AND METHODS: The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. RESULTS: The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. CONCLUSION: The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.
Diagnosis* ; Head ; Humans ; Hyperemia ; Joints ; Magnetic Resonance Imaging* ; Temporomandibular Joint Disc* ; Temporomandibular Joint*

Meningioma is generally regarded as benign and extracranial metastasis of intracranial meningioma is rare. About 60 cases of distant metastasis of meningioma have now been reported. Angioblastic meningioma, although a rare type, shows rapid growth and sarcomatous change frequently, and has higher incidence of metastasis than other types of meningioma. The authors report a case of malignant angioblastic meningioma arisen in left olfactory groove with multiple metastasis to skeletal system. The available literature regarding these tumors is reviewed.
Incidence ; Meningioma* ; Neoplasm Metastasis*

The present study was undertaken to investigate the infection status of Cryptosporidium parvum in the villagers and the reservoir hosts in several rural areas in Korea. A total 5, 262 fecal samples were collected from the inhabitants residing at Gangwon-do, Chungcheongbuk-do, Jeollanam-do, and Gyeongsangnam-do between the dates of September, 2001 to June, 2002. In addition, 1, 453 fecal samples were collected from livestock reared in Gokseong-gun, Jeollanam-do and Chungju-si, Chungcheongbuk-do. All the fecal smears were prepared by formalin-ether sedimentation, and examined by light microscopy after modified acid-fast staining. The overall positive rate of human cryptosporidiosis was 3.3%. Gokseong-gun, Jeollanam-do showed a 8.2% positive rate and appeared as the highest endemic area among the surveyed areas. Haman-gun, Gyeongsangnam-do showed a 0.4% positive rate and was the lowest endemic area. The positive rate of livestock infection in Gokseong-gun, Jeollanam-do was 94%, which was more than ten times higher than that of Chungju-si, Chungcheongbuk-do (9.3%). From these results, it was revealed that cryptosporidiosis was an endemic disease in some rural areas of Korea, and the livestock could be an important source of human infection.
Adolescent ; Adult ; Age Distribution ; Aged ; Animals ; Animals, Domestic/*parasitology ; Cattle ; Cattle Diseases/*epidemiology/parasitology ; Child ; Child, Preschool ; Cryptosporidiosis/*epidemiology/parasitology/veterinary ; Cryptosporidium parvum/*isolation & purification ; Feces/parasitology ; Female ; Human ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Middle Aged ; Parasite Egg Count ; Prevalence ; *Rural Population ; Support, Non-U.S. Gov't ; Swine ; Swine Diseases/*epidemiology/parasitology

No abstract available.
Hypnotics and Sedatives ; Light