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

Furfurol(Furfudol), a new anthelmintics, was administered to 7 adults and 21 children (6-12 years old) in total amounts of 15.6 mg(base) for 1 to 3 days. It has proven to be effective against hookworms. The anthelmintic effect against hookworms with a single dose of 15.6 mg of furfurol was similar to that of a single dose of 2.5 gm of bephenium hydroxynaphthoate. However, when a total of 15.6 mg of the base was given to both children and adult, the side reactions were so mild that the drug can be administered for therapeutic regimens in mass treatment. Minor abdominal discomfort was the only common side effect. This is the primary advantage of furfurol as compared with bephenium hydroxynaphthoate. These results have indicated that furfurol is safe in therapeutic dosage and is an effective agent to treat patients infected with hookworms.
parasitology-helminth-nematoda-hookworm ; chemotherapy-furfurol ; bephenium hydroxynaphthoate ; furfurol

As increasing demands for CCC (Continuous Curvilinear Capsulorhexis) fincreases, the incidence of capsule contraction syndrome is also increasing in cataract surgery. We tried to classify and treat this syndrome with 44 eyes who have capsule contraction. It is known that the basic mechanism of capsule contraction is fibrotic dysplasia of anterior capsule, and we found that capsular contraction can arise with glaucoma, diabetes mellitus, uveitis, retinitis pigmentosa, psuedoexfoliation syndrome and old aged group as ordered. It can also be frequently can be found in age 50 to 60. In order to decrease the complication of capsule contraction(IOL dislocation, retinal detachment, etc.), we incised the anterial capsule with Nd:Yag laser at the time of fibrotic change. For the case of weak zonules, we made a radial incision in the 12 o'clock direction after IOL insertion.
Cataract ; Diabetes Mellitus ; Dislocations ; Glaucoma ; Incidence ; Retinal Detachment ; Retinitis Pigmentosa ; Uveitis

PURPOSE: This study investigated the influence of patent ductus arteriosus (PDA) and its treatment on incidence and progression of retinopathy of prematurity (ROP). METHODS: The authors retrospectively reviewed the medical records of 408 infants who underwent screening examinations for ROP at the Neonatal Intensive Care Unit of our hospital. RESULTS: The total incidence of ROP was 23.5% (96 out of 408) and the patients that needed treatment were 7.4% (30 out of 408). The mean birth weight and gestational age was 1406.1 grams and 30.67 weeks in patients without ROP, and 979.8 grams and 27.46 weeks in patients with ROP, respectively. In both total and very low birth weight (VLBW) patients, the incidence of ROP was higher in the PDA group than the non-PDA group, but the PDA group was an independent risk factor only in the VLBW group (p = 0.033). The incidence of threshold disease was not significantly different between the PDA and control groups (p = 0.757). There was no significant difference of incidence of ROP and threshold disease among the 3 treatment groups for PDA. CONCLUSIONS: In VLBW patients, the presence of PDA increased the risk of ROP and its progression, thus more attention is needed for PDA patients. However, there was no significant difference in ROP incidence and progression according to different PDA treatment methods.
Birth Weight ; Diterpenes ; Ductus Arteriosus, Patent ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Mass Screening ; Medical Records ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors

No abstract available.
Ring Chromosomes*

STATEMENT OF PROBLEM: Fracture of the tooth-colored superstructure material is one of the main prosthetic complications in implant-supported prostheses. PURPOSE: The purpose of this in vitro study was to compare the fracture strength between the cement-retained implant-supported metal-ceramic crowns and the indirect composite resinveneered metal crowns under the vertical compressive load. MATERIAL AND METHODS: Standard implants of external type (AVANA IFR 415 Pre-mount; Osstem Co., Busan, Korea) were embedded in stainless steel blocks perpendicular to their long axis. Customized abutments were fabricated using plastic UCLA abutments (Esthetic plastic cylinder; Osstem Co., Busan, Korea). Thirty standardized copings were cast with non-precious metal (Rexillium III, Pentron, Walling ford, Conn., USA). Copings were divided into two groups of 15 specimens each (n = 15). For Group I specimens, metal-ceramic crowns were fabricated. For Group II specimens, composite resin-veneered (Sinfony, 3M-ESPE, St. Paul, MN, USA) metal crowns (Sinfony-veneered crowns) were fabricated according to manufacturer's instructions. All crowns were temporary cemented and vertically loaded with an Instron universal testing machine (Instron 3366, Instron Corp., Norwood, MA, USA). The maximum load value (N) at the moment of complete failure was recorded and all data were statistically analyzed by independent sample t-test at the significance level of 0.05. The modes of failure were also investigated with visual analysis. RESULTS: The fracture strength of Sinfony-veneered crowns (2292.7 +/- 576.0 N) was significantly greater than that of metal-ceramic crowns (1150.6 +/- 268.2 N) (P < 0.05). With regard to the failure mode, Sinfony-veneered crowns exhibited adhesive failure, while metal-ceramic crowns tended to fracture in a manner that resulted in combined failure. CONCLUSION: Sinfony-veneered crowns demonstrated a significantly higher fracture strength than that of metal-ceramic crowns in cement-retained implant-supported prostheses.
Adhesives ; Axis, Cervical Vertebra ; Busan ; Crowns* ; Plastics ; Prostheses and Implants ; Stainless Steel

No abstract available.
Knee* ; Magnetic Resonance Imaging*

No abstract available.
Headache* ; Humans

Adirect intracranial operative approach with clipping the neck of the aneurysm is generally considered to be the ideal treatment for the intracranial arterial aneurysms. Several strategies exist for treating unclippable aneurysms. Intravascular techniques, proximal occlusion of the parent artery or trapping of the aneurysm, microsurgical bypass of the involved arterial segment, and reinforcement or wrapping of the aneurysmal wall are frequently used. The authors report a case with long term(6 years) follow-up results of the circumferential wrapping with sutures-reinforcement for giant fusiform aneurysm of the internal carotid artery. The giant fusiform aneurysm and ideal wrapping materials were discussed with review of literature.
Aneurysm* ; Arteries ; Carotid Artery, Internal ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Neck ; Parents ; Sutures

It is important to recognize idiopathic osteonecrosis or avascular necrosis of the patella not only because of its rarity but because a majority of the patients remain asymptomatic without treatment. The etiology of osteonecrosis is unclear. Certain conditions and diseases have been associated with osteonecrosis of the patella including the systemic administration of steroids, a fracture of the patella, a total knee arthroplasty and other traumatic conditions. The diagnosis is usually made with radiographs, MR imaging and a radioisotopic bone scan. It is believed to have a benign course and a favorable prognosis. We report for the first time in Korea a patient with idiopathic osteonecrosis diffusely involving the whole patella without any obvious cause.
Arthroplasty ; Diagnosis ; Humans ; Knee ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Osteonecrosis* ; Patella* ; Prognosis ; Steroids