Clinical EPS was performed in 16 normal adults without evidence of conduction disease on the surface standard 12 lead electrocardiogram in order to provide normal electrophysiological values of the sinus node function and AV conduction. EPS was also performed in 15 patients with sick sinus syndrome and 10 patients with AV conduction disturbance to evaluate the clinical usefulness of EPS in detecting sinus node dysfunction and AV conduction disturbance. The results were as follows. 1) The results of sinus node function test in the normal group were m-SNRT 853+/-198msec(range 800-1,560msec), c-SNRT 230+/-66msec(range 120-370msec), and %m -SNRT/SCL 127+/-11%(range 114-149%). 2) In 15 patients with SSS, the M-SNRT were ranged from 1,270 to 12,330msec and 10 patients(66%) had significantly increased m-SNRT exceeding 1,560msec. The c-SNRT were ranged from 230 to 10,730msec and 13 patients(83%) had significantly increased c-SNRT exceeding 370msec. The % m-SNRT/SCL were ranged from 136 to 770% and 12 patients(80%) had significantly increased % m-SNRT/SCL exceeding 150%. 3) The SACT in normal group were 84+/-14msec(range 70-105msec) measured by continuous atrial pacing method and 80+/-19 msec(range 60-115msec) measured by atrial extrastimulation method. 4) In SSS, the SACT measured by continuous atrial pacing method was ranged from 80 to 1,050msec and 11/12 patients(92%) had significantly increased SACT exceeding 112 msec. The SACT measured by atrial extrastimulation method was ranged from 90 to 310msec and 7/8 patients(88%) had significantly increased SACT exceeding 118 msec. 5) C-SNRT, % m-SNRT/SCL, and SACT were more useful in detecting sinus node dysfunction than m-SNRT. 6) The AV conduction intervals in normal group were PA interval 17+/-6(range 5-25msec), AH interval 96+/-18 msec(range 70-135msec), and HV interval 46+/-7msec(range 35-55msec). 7) Rapid atrial pacing induced Wenckebach type second degree AV block proximal to H at pacing rate of 90 to 190/min in 14/16 normal adults. 2 patients maintained intact AV conduction upto maximum pacing rate of 200/min. 8) His bundle electrogram showed the site of AV block in 9 of 10 patients with AV conduction disturbances. The sites of AV block were AV nodal area 1 case, intraHis bundle 4 cases, and infraHis bundle 4 cases. 9) EPS provided a good supportive information that was useful in selecting pacemaker therapy in a patient with chronic bifascicular block who revealed prolonged HV interval and infraHis bundle block at a pacing rate of 70min. 10) The refractory periods of AV conduction system in normal group were AERP 274+/-54msec (range 170-410msec), AVN-FRp 467+/-74msec(range 285-600msec), AVN-ERP 341+76msec(range 190-460), and V-ERP 280+/-25msec(range 240-320msec).
Adult ; Atrioventricular Block ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Humans ; Sick Sinus Syndrome ; Sinoatrial Node*

The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. Indication: anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time > or =0.5 seconds and distance from the skin > or =5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis > or =class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles' ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks.
Baths ; Catheter Ablation* ; Catheters ; Consensus* ; Heparin ; Knee Joint ; Lidocaine ; Saphenous Vein ; Sclerotherapy ; Skin ; Stockings, Compression ; Swimming ; Thrombosis ; Varicose Veins* ; Walking

No abstract available.
Humans ; Muscular Dystrophies*

No abstract available.
Muscle Spasticity* ; Paraplegia*

Myxoma is the commonest intracardiac tumor and it is well known to present in bizarre ways. Calcification of the tumor is uncommon, though probably more frequent in right than in left heart tumors. Diagnosis can be followed by surgery with satisfactory results. A 36 years old man with partially calcified right ventricular myxoma and a 51 years old man with calcified left atrial myxoma, which were revealed different echogenic densities on 2-dimensional echocardiogram and gross calcification on fluoroscopy, were treated with surgical removal. We report above two cases of calcified myxoma with literature review.
Adult ; Diagnosis ; Fluoroscopy ; Heart Neoplasms ; Humans ; Middle Aged ; Myxoma*

In order to observe the change of epicardial ECG(Eep), left ventricular pressure, left ventricular dp/dt and the development of arrhythmia during regional myocardial ischemia and reperfusion, proximal LAD was ligated for 30 minutes and reperfused suddenly for 30 minytes in eleven mongrel dogs which were grouped into control(n=6) and diltiazem(n=5) group. In diltiazem group, diltiazem infusion was started 10 minutes prior to reperfusion with the speed of 0.02mg/kg/min for 25 minutes. The amount of injury current was measured from TQ segment and ST segment changes of Eep, and its effect on the incidence of reperfusion arrhythmia was evaluated. Eep, LV pressure, LV dp/dt and ECG were simultaneously recoreded with the paper speed of 100mm/sec at predetermined time intervals, and 6 channel ECG(standard lead I, II, III, AVR, AVL, AVF) was recorded continuously with paper speed of 10mm/sec throughout the experiment. The results were as follows ; 1) After ligation of LAD, the polarity QRS of Eep changed to show monophasic shape from 3-4 minutes, TQ segment depressed to reach minumum level at 4-7 minutes and ST segment elevated to reach maximum level at 4-5 minutes. These changes recovered rapidly to pre-ligation state after reperfusion, and this tendency was not affected by diltiazem. 2) The absolute value of LV dp/dt max and LV dp/dt min decreased 10% at 2-4 minutes after LAD ligation, and began to recover from 7 minutes after reperfusion to reach peak recovery value at 20 minutes after reperfusion in control group. In diltiazem group, it decreased 15% after diltiazem infusion and began to recover from 1 minutes after reperfusion to reach peak recovery value at 7 minutes after reperefusion. 3) Ischemic ventricular fibrillation was observed at the time of maximum TQ depression and ST segment elevation and 4 out of 6 events were developed within 5 minutes after LAD ligation. The cases with Isch-Vf developed Rep-Vf without exception, which was observed in 8 out of 11 cases and was noted within 1 minutes after reperfusion except one. 4) Maximum ST elevation was significantly higher in group with Rep-Vf then in group without Rep-Vf(Rep-Vf(+);18.5+/-11.1, Rep-Vf(-);10.3e+/-6.9, p<0.05), and also maximum ST elevation was significantly higher in group with both Isch-Vf and Rep-Vf then in group with only Rep-Vf(Isch-Vf+Rep-Vf;28.5+/-7.8, Rep-Vf only;10,5+/-4.7, P<0.01). 5) The incidende of reperfusion ventricular fibrillation was 83% in control group(5 out of 6) and 60% in diltiazem group(3 out of 5), but the inhibitory effect of diltiazem on the reperfusion Vf could not be confirmed due to the difference of the incidence of ischemic Vf between the two groups(control group;67%(4 out of 6), ditiazem group;20%(1out of 5)). In conclusion, maximum injury current developed 4-7 minutes after coronary artery ligation, and maximum ST elevation value was significantly related with the development of ischemic Vf and reperfusion Vf, and the inhibitory effect of diltiazem on the reperfusion ventricular fibrillation could not be confirmed in this study.
Animals ; Arrhythmias, Cardiac* ; Coronary Vessels* ; Depression ; Diltiazem* ; Dogs ; Electrocardiography* ; Incidence ; Ligation* ; Myocardial Ischemia ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Pressure

Objectives: The present paper aimed to examine whether an aging workforce is associated with an increase in work-related fatal injuries and to explore the underlying reasons for this potential increase.Material and methodsAged workers were defined as those who were at least 55 years old. Work-related fatalities were assessed in aged and young workers who were registered with the workers' compensation system in 2021 in the Republic of Korea. Total waged workers, based on raw data from the Local Area Labor Force Survey in 2021, were used as the denominator to estimate the work-related fatality rates. Results: Most work-related fatalities in the aged workers occurred among individuals working in the “construction sector” (58.9%), those with “elementary occupations (unskilled workers)” (46.1%), and those with the employment status of “daily worker” (60.8%). The estimated incidence (0.973/10,000) of work-related fatalities among aged workers was about four times higher than that (0.239/10,000) among younger workers. “Falling,” “collision,” “struck by an object,” and “trip and slip” were more frequent types of work-related fatalities among aged workers relative to young workers. The category of “buildings, structures, and surfaces” was a more frequent cause of work-related fatalities among aged workers than among young workers. Conclusions Aged workers had a higher incidence of work-related fatalities than young workers. Frequent engagement in precarious employment and jobs, coupled with the greater physical vulnerability of aged workers, were likely causes of their higher level of work-related fatal injuries.

Assessment of Myocardial contractility is critically important task in the evaluation of patients with heart disease. In recent years many indices have been studied to evaluate myocardial inotropic state, applying the skeletal muscle mechanics to intact heart. Among such indices, Vmax(maximum velocity of shortening of the unloaded contractile elements) and Vpm(physiologic maximum observed velocity of myocardial shortening) provide a measure of myocardial contractility independent of preload or afterload. To obtain normal values in Korean adults, the left ventricular pressure data of 16 patients with normal physical activities were analyzed, using the digital computer. Seven patients had ventricular septal defect with Qp/Qs less than 2.0, one patient had mitral stenosis, another one patient had mitral stenosis and aortic regurgitation (grade I/IV and the remainder seven patients had no intrinsic cardiac disorder. But, the cardiac performances of all patients were apparently normal. The results were as follows: 1) Cardiac index was greater than 3.0 l/min/m2 in all patinets: 4.9+/-1.32(+/-S.D.)l.min/m2. 2) Ejection fraction was greater than 55% in all patients: 71.2+/-8.04(+/-S.D.)%. 3) Left ventricular end diastolic pressure(LVEDP) ranged from 3 mmHg to 12 mmHg. 4) Vmax: 48.1+/-9.41(+/-S.D.) sec(-1). 5) Vpm: 39.3+/-8.13(+/-S.D.) sec(-1).
Adult* ; Aortic Valve Insufficiency ; Computers ; Heart ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Mechanics ; Mitral Valve Stenosis ; Motor Activity* ; Muscle, Skeletal ; Reference Values ; Ventricular Pressure

BACKGROUND: Propafenone is a new class IC antiarrhythmic drug that has been found to be effective in both supraventricular and ventricular tachyarrhythmias. We studied the electrophysiologic and long-term effects of oral propafenone in the patients with paroxysmal supraventricular tachycardia(PSVT). METHODS: The electrophysiologic study was done in 15 patients with PSVT to assess the short-term efficacy of propafenone 450mg daily. For 10 patients with short-term efficacy, follow up study was done to assess the long-term efficacy of propafenone 450mg daily. RESULTS: The electrophysiologic mechanisms of PSVT were AV nodal reentry in 6 patients and AV reentry in 9 patients. During the electrophysiologic study, propafenone prolonged AH, HV and PR intervals significantly(p<0.05), but did not change the corrected SNRT, SACT, and the ERP of atrium, ventricle, AV node and accessory pathway(AP) significantly. The anterograde and retrograde 1:1 conduction capacity of AV node and AP seemed to decrease. Complete block of anterograde conduction over the AP was noted in 2 of 3 patients with manifest WPW syndrome and complete block of retrograde conduction was noted over the AV node in 1 patient with AV nodal reentry and over the AP in 1 patient with AV reentry. Propafenone was effective in 3 of 6 patients with AVNRT and 7 of 9 patients with AVRT. During long term administration for 3 to 11 months in 10 patients with short-term efficacy of propafenone, 7 patients did not report any episode of symptomatic tachycardia and 3 patients reported less frequent palpitation. There were no side effects during short-and long-term follow up except 2 patients with mild indigestion. CONCLUSIONS: Propafenone seems to be a safe, well tolerated and effective drug for short and long-term therapy of patients with PSVT, especially of orthodromic AV reentry.
Atrioventricular Node ; Dyspepsia ; Follow-Up Studies ; Humans ; Propafenone* ; Tachycardia ; Tachycardia, Supraventricular* ; Wolff-Parkinson-White Syndrome

The purpose of this study was to investigate the effects of smoking on adult periodontitis after non-surgical periodontal therapy. The study population consisted of 40 patients with moderate to advanced periodontitis. Smokers(n=20) were defined as individuals smoking at least twenty cigarettes per day at the time of the initial examination. The non-smoking group(n=20) consisted of individuals who were not smoking at the initial examination. The average age was 42.4 years for the smoking and non-smoking group. Examination regarding plaque index, gingival index, pocket depth and contrast phase microscope were performed. Evaluation were made at the first, the second and the fourth weeks after periodontal non-surgical therapy. The results were as follows: 1. Clinical indices including plaque index, gingival index, and pocket depth were decreased in both smoking and non-smoking group at the first, the second, and the fourth weeks. Especially, clinical indices of non-smokers were more significantly decreased than those of smokers. 2. Non-motile rods were increased and motile rods were reduced at the fourth week. spirochetes were reduced significantly in the non-smoking group at the fourth week. These results suggest that smoking play a minor role in adult periodontitis after non-surgical periodontal therapy.
Adult* ; Chronic Periodontitis* ; Humans ; Periodontal Index ; Periodontitis ; Smoke* ; Smoking* ; Spirochaetales ; Tobacco Products