BACKGROUND AND OBJECTIVES: Intracardiac electrocardiographic finding using as a guide for selective catheter ablation in patients with AV nodal reentrant tachycardia (AVNRT) is not specific. Therefore, we evaluated the efficacy and safety of the anatomical approach for catheter ablation in patients with AVNRT. MATERIALS AND METHOD: Among the patients diagnosed as AVNRT by electrophysiologic study, total 66 patients (M:F=26:40) were included in this study. In the right anterior oblique radiographic view, the septal annulus of tricuspid valve, extending from the most posterior region of the annulus adjacent to coronary sinus ostium (posterior) to His bundle recording site (anterior), was divided into posterior (P), mid (M), and anterior (A) sites. Radiofrequency (RF) energies were applied from the posterior part to the anterior part sequentially along the septal annulus of tricuspid valve until successful ablation. RESULTS: Successful anatomical sites were located in posterior (11 patients), mid (48 patients), and anterior (7 patients) sites. The most patients (62 patients) were treated with slow pathway ablation except 4 patients in whom fast pathway was ablated. Probable slow potentials were observed in 8 patients (12%, 3 in posterior sites and 5 in mid sites). Transient complete AV block followed by first degree AV block and delayed complete AV block was occured in one case whose ablation site was A1. And another 3 patients had postablation first degree AV block. CONCLUSION: In patients with AVNRT, the ablated pathway were different according to successful anatomical site. And RF catheter ablation of atrioventricular nodal reentrant circuit guided by anatomical landmark is safe and efficacious.
Atrioventricular Block ; Bundle of His ; Catheter Ablation* ; Catheters* ; Coronary Sinus ; Electrocardiography ; Humans ; Tachycardia, Atrioventricular Nodal Reentry* ; Tricuspid Valve

No abstract available.
Urinary Retention*

OBJECTIVE: Immune hemolytic jaundice is caused by the destruction of antibody-sensitized erythrocytes and is associated with antibody-dependent cellular cytotoxic effects mediated by Fc receptor-bearing cells of the reticuloendothelial system. Intravenous immune globulin(IVIG) may have exerted its effect through Fc receptor blockade. We studied the effect of high-dose intravenous immune globulin(HDIVIG) in neonatal hemolytic jaundice unresponsive to phototherapy. METHODS: We selected only those with Coombs test(+) immune hemolytic jaundice who had admittcd at the NICU of the Dcpartment of Pediatzics of Dongsan Medical Center, Keimyung University between January 1995 and December 1998. They were unresponsive to phototherapy. Ten newborn infants(9 ABO incomplatibilities, l minor group incompatabillity due to anti-E) received HDIVIG therapy combined with phototherapy. IVIG was given as a dose of lg/kg for 6 hours, and serial hemoglobin, reticulocyte count, and bilirubin levels were evaluated. If the serum bilirubin level went up and reached the level above 22mg/dl, we conducted exchange transfusion for the patient. RESULTS: HDIVIG induced a significant decrease of serum billirubin levels in 8(80%, group I, HDIVIG responsive poup) of 10 cases and only 2 cases(group II, HDIVIG unreponsive group) required exchange tnnsfusions. No side effect was observed after HDIVIG therapy. CONCLUSION: We suggest HDIVIG may be effective in the treatment of phototherapy-resistant hyperbilirubinemia due to blood group incompatibility. More studies are needed to confirm the optimal dosage and therapeutic indication of HDIVIG in the therapy of neonatal immune hemolytic jaundice.
Bilirubin ; Blood Group Incompatibility ; Erythrocytes ; Humans ; Hyperbilirubinemia ; Immunoglobulins, Intravenous ; Infant, Newborn ; Jaundice* ; Mononuclear Phagocyte System ; Phototherapy* ; Receptors, Fc ; Reticulocyte Count

Paralytic hand is the ultimate result of permsnent damage of the central nervous system, failure of the functional repair of peripheral nerve injuries and extensive muscular or tendinous defect resulting in the impairment of hand function. There are a lot of controversies in the side of treatment methods in the paralytic hand, and it is very difficult to formulate the most adequate surgical reconstruction for a given pstient. At Depsrtment of Orthopedic Surgery, Seoul National University Hospital, 66 cases oi paralytic hands in 62 patients have been treated surgically with tendon transfers for 7 years from Jan, 1980 to Dec, 1986. 49 case in 46 patients were followed up for more than one year, and surgical method and its results were anslysed. They consist of CNS lesion (17), peripheral nerve lesion(23) and musulotenidinous defect(9). The methods of surgical reconstruction were opponenesplasty(12), standard set extensor reconstruction(9), Green and Bsnks FCU transfer(11), intrinsic reconstruction(7), pronator rerouting(7), adductorplasty (5) and so on. The mean follow-up was 2.2 years, and in 38 cases good or excellent results were obtained.
Central Nervous System ; Follow-Up Studies ; Hand ; Humans ; Methods ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Seoul ; Tendon Transfer

OBJECTIVE: The purposes of the present study were to investigate the effect of gamma-radiation on the expression of inhibin-alpha proteins and genes for inhibin alpha, betaA, and betain the ovary. METHODS: Immature mice were whole-body gamma-irradiated with 25% of a lethal dose. At time 0, 3, 6, 12, and 24 hours after the irradiation,the ovaries were collected and used for immunohistochemistry for inhibin-alpha, and RT_PCR for inhibin-alpha, betaA, and betaB. RESULTS: The expression of the immunoreactive inhibins-alpha was maintained at 12 hours post-irradiation and reduced thereafter. The expression of inhibin-alpha mRNA was significantly increased with the time after the irradiation. However there were no significant changes in the expression of betaA and betaB mRNAs. CONCLUSION: It might be thought that inhibin acts as one of the regulatory factors in the gamma-radiation-induced follicular atresia in mice
Animals ; Female ; Follicular Atresia ; Immunohistochemistry ; Inhibins* ; Mice* ; Ovary* ; RNA, Messenger

No abstract available.
Kidney Transplantation* ; Urinary Diversion*

Since the first report by Berberich and Hirsch in 1923, conventional angiography had been playing essential roles in diagnosis and treatment in the field of Orthopedic Surgery. Angiography is still the most definitive method for evaluating arterial disease, and is also an invaluable aid in the diagnosis of certain abnormalities which characteristically alter the normal vascular pattern. But the clinical use of conventional angiography as a routine diagnostic study has been limited by the risk associated with arterial catheterization cost, and poor patient acceptance. With improvement of radionuclide angiography and development of the methods for the identification and amplification of signals from small quantities of intravascular administered iodinated contrast agent and their combination with image subtraction (so called digital subtraction angiography, DSA), we have partially substituted the DSA and Radionuclide angiography for conventional angiography in diagnosis and post-operative evaluation of orthopedic patients. We have analyzed and compared the 197 cases who had taken conventional angiography from August, 1981 to July, 1985, and 16 cases who had taken radionuclide angiography from January, 1983 to July, 1985, and 21 cases who had taken DSA from October, 1983 to July, 1985 in Department of Orthopedic Surgery, Seoul National University Hospital. The results were as follow: 1. Conventional angiography is the most reliable and most widely used method in diagnosis of peri pheral arterial disease and evaluating the distribution of peripheral circulation of patient who need arterial reconstruction. But the clinical use of the angiography has been limited by the risk of complications. 2. DSA is simple, relatively non-invasive and can be done in out-patient basis. DSA is particulary useful and can replace the conventional angiography in post-operative assessment of peripheral vascular reconstruction, in the assessment of blunt and penetrating peripheral arterial trauma, and in the evaluation of peripheral aneurysm and vascular malformation. 3. Radionuclide angiography is also simple, and has no morbidity and useful in the patients who may be allergic to the contrast medium. Radionuclide angiography is useful in the evaluation of obstruction of major artery, deep vein thrombosis, and in repeated post-operative evaluation of arterial reconstruction.
Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Catheterization ; Catheters ; Diagnosis ; Extremities ; Humans ; Methods ; Orthopedics ; Outpatients ; Radionuclide Angiography ; Seoul ; Vascular Malformations ; Venous Thrombosis

No abstract available.
Ganglion Cysts* ; Knee Joint* ; Knee*

The authors made an attempt to classify the supracondylar extension-valgus fracture according to the direction and location of the fracture line based on the radiographic manifestation. This new classification helps to dictate the model of treatment, possible sequence of reduction and the causes of deformity of the elbow after treatment. During the last 12 years of this study, 200 supracondylar fractures of the humerus were treated in the Kyung Hee University Hospital. Of the cases 82 were extension-valgus fractures. The results were as follows: 1. The supracondylar extension-valgus fracture were classified into 5 types: Type I: fish-tail fracture (14 cases) Type II : obtuse fish-tail fracture (27 cases) Type III: oblique fracture (16 cases) Type IV: oblique fracture with comminution of lateral column (14 cases) Type V: Transverse fracture (11 cases) 2. The displacement of the distal fragment in the fish-tail fracture is severe but it can be reduced easily by manipulation. Once reduction has been obtained, the fracture is stable and maintained by a long arm cast with acute flexion of the elbow alone. There is no need of percutaneous pinning. Among 14 cases of type I fracture there was no cubitus varus deformity. 3. The line of the obtuse fish-tail fracture lies distal to fish-tail fracture. This is unstable so it is necessary to percutaneous pinning. 4. The oblique fracture is produced by the hyperextension of the elbow and degrees of the obliquity of the fracture line were 12 to 20 degrees (Av. 14 degrees). The valgus angles in opposit elbows were 9 to 25 degrees (Av. 16 degrees). The forearm must be pulled into valgus position during the reduction of the fracture. 5. Type IV fracture occures under 4 years old, and more commonly in girls. This is unstable, so it is necessary to percutaneous pinning.
Arm ; Child ; Classification ; Congenital Abnormalities ; Elbow ; Female ; Forearm ; Humans ; Humerus

No abstract available.
Estrogens* ; Humans ; Receptors, Estrogen* ; Thyroid Diseases* ; Thyroid Gland*