No abstract available.
Thoracic Wall* ; Thorax*

The antiarrhythmic effect of Mexiletine was evaluated in five patients with recurrent ventricular tachycardia and in twelve patients with frequent premature ventricular contractions. Electrophysiologic study was performed on the the patients with recurrent ventricular tachycardia before and after the administration of Mexiletin(600-800mg/day). The antiarrhythmic effects of Mexiletine in the patients with frequent premature ventricular contraction was assessed by ambulatory electrocardiography. The results were as follows: 1) In all of the five patients with recurrent ventricular tachycardia, sustained ventricular tachycardia was induced by programmed ventricular stimulation. However, on repeated electrophysiologic study performed while receiving Mexiletine, ventricular tachycardia was not induced in four patients and non-sustained ventricular tachycardia was induced in one patients. 2) The number of premature ventricular contraction was decreased markedly in seven patients(58.3%) with frequent premature ventricular contractions. 3) Minimal side effects, mild indigestion and tremor, were recorded in 3 cases(23%) while receiving Mexiletine 600 mg/day. The higher dose was associated with more frequent and severe side effects.
Dyspepsia ; Electrocardiography, Ambulatory ; Humans ; Mexiletine* ; Tachycardia, Ventricular ; Tremor ; Ventricular Premature Complexes

It is not infrequent to observe the reeurrence of the Bakers cyst. Recurrence of the cystic lesions are more frequent in wide based type than in pedicle type due to difficult ,identification and inadequate eradication of the cyst wall. We injected methylene blue into the cyst after aspiration of the fluid. Blue stained wall enables the surgeons to idendify the whole inner surface of the cyst, and lessens the chance of missing a portion of it. We could reduce the recurrence rate near to zero percent after adopting this technique upto now. Broad based type is more prone to recurr and the whole recurred five cases were belong to this type.
Arthroscopy ; Humans ; Knee ; Methylene Blue ; Popliteal Cyst ; Recurrence ; Surgeons

In traumatic knee dislocation, vascular injury is one of the most serious complication. After pertinent management of acute vascular problems, we should take care of the ligamentous injury involving both the ACL and PCL which are the main causes of knee instability, and consequent traumatic degenerative changes. No standard technique of reconstruction has been reported concerning these ligamentous injuries up to now as far as we know. Authors tried a new management which reconstruction was done simultaneously on both the ACL and PCL injuries. Bone-Achilles tendon autograft was used as PCL substitute in all the cases, and which turned out to be a very efficient one for the control of anterior-posterior displasement as well as rotary instability. Bone-patellar tendon-bone autograft or bone-Achilles tendon autograft was good for the reconstruction of the ACL bone-patellar tendon-bone in two cases, bone-Achilles tendon in two cases, and semitendinosus tendon also in two cases. After 6 months of operation, all the patient returned to the previous level of walking without crutches. This management showed outstanding results in terms of knee stability and subjective symptoms.
Achilles Tendon ; Autografts ; Crutches ; Dislocations ; Humans ; Knee Dislocation ; Knee Joint ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Tendons ; Vascular System Injuries ; Walking

No abstract available.
Anterior Cruciate Ligament* ; Autografts* ; Tendons* ; Transplants*

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 antihypertensive effects of diltiazem was observed in 30 cases of essential hypertension, and following results were obtained. 1) Mean decrease in systolic and diastolic blood pressure by oral diltiazem was 42.0+/-2.5mmHg and 17.8+/-1.7mmHg. The results of antihypertensive therapy revealed good control in 50% fair control in 30% poor in 17% and failure in 3% of the cases. In 80% of the cases, good or fair control of Hypertension which means drop of diastolic pressure to the level of less than 100mmhg was observed. 2) Mean drop in heart rate was 21+/-2 beats/min. 3) Daily dose was 90-180mg. 4) The side effect of oral Diltiazem was mild headache and dizziness, respectively one case.
Blood Pressure ; Diltiazem* ; Dizziness ; Headache ; Heart Rate ; Hypertension

To determine the possible participation of genetic factors in the pathogenesis of Takayasu's arteritis and to investigate an association between HLA antigens and the disease, we performed HLA typing in twenty two patients confirmed by clinical findings and aortography, and in fifty normal Koreans as controls. HLA-A, B,C and DR antigens were tested by standard microlymphocytotoxicity method with HLA antisera, which were supplied by UCLA Tissue Typing Laboratory. The results were as follows: 1) Frequent antigens of HLA-A locus in patients were A 2(54.5%), Aw 33(31.8%), Aw 24(27.2%) and A26(13.6%) in decreasing order, and Aw 33 was more frequent in patients than in normal controls(18.0%)(relative risk: 2.1). 2) Frequent antigens of HLA-B locus in patients were Bw61(31.8%), Bw44(31.8%), Bw62(22.7%) and Bw52(13.6%) in decreasing order, and Bw61 was more frequent in patients than in normal controls(10%)(relative risk : 4.2). 3) Frequent antigens of HLA-C locus in patients were Cw3(54.5%), Cw6(50.0%) and Cw1(22.7%) in decreasing order. 4) Frequent antigens of HLA-DR locus in patients were DR6Y(36.4%), DR2(31.8%), DRw9(27.2%), DR4(27.2%) and DR28(22.7%) in decreasinng order. In MT system MT 3 was more frequent in patients(54.5%) than in normal controls(31.6%)(relative risk : 2. 6). However, the difference of HLA antigen frequencies between patients and normal controls was not statistically significant, and the association of specific HLA antigens with Takayasu's arteritis requires further studies to be confirmed.
Aortography ; Histocompatibility Testing ; HLA Antigens* ; HLA-A Antigens ; HLA-B Antigens ; HLA-C Antigens ; HLA-DR Antigens ; Humans ; Immune Sera ; Takayasu Arteritis*

BACKGROUND: During and immediately after percutaneous transluminal coronary angioplasty(PTCA), reversible ischemic electrocardiographic change and/of left ventricular dysfunction are developed. But it is not investigated whether there are potential myocardial cell damages following PTCA or not, and the clinical Significance of myocardial cell damage following PTCA. Recently cardiac Troponin-T has been developed as a new myocardial specific marker, especially myocardial damage. The object of this study is to investigate whether potential Myocardial damage following PTCA was occurred and the utility of cardiac Tropoin-T for predicting the complications during and immediately after PTCA. METHODS: The study group comprised 12 patients(M/F;8/4mean age;60 +/- 4year,AMI in 6) undergoing PTCA, Samples for Troponin-T were obtained before, directly after, after 2 hours, 6 hours, and after 12 hours and was determined by enzyme immunoassay on an ES 300 analyzer(Boehringer Mannheim). Discrimination limit for myocardial cell damage is 0.1 ng/ml in normal baseline level but if the baseline level is elevated such as acute myocardial infarction or unstable angina, myocardial cell damage is defined with further increase of cardiac Troponin-T(>0.1 ng/ml) compare to baseline level. RESULTS: 1) The mean duration of total balloon inflation is 10.7 +/- 2(3-22) minutes and the mean duration of single maximal inflation is 3.9 +/- 0.6(1-8) minutes. There are no significant change in concentration of Troponin-T by inflation time. None of the patients showed electroca rdiographic evidence for myocardial infarction. 2) Troponin-T were increased in 2 patients with unstable angina(0.01 vs 0.11 ng/ml) which were developed major dissection including acute closure during PTCA, and 2 patients with acute myocardial infarction(2.37 vs 3.73 ng/ml) which didn't developed dcomplication. The increase of cardiac Troponin-T were observed in 2 of 10 patients with uncomplicated PTCA(20%). 3)The subacute complications were not developed. CONCLUSION: The cardiac Troponin-T were increased significantly in two AMI patients with uncomplicated PTCA(2/10,20%). The increase of cardiac Troponin-T following PTCA is associated with periprocedural complications but the prognostic significance to detect postprocedural complication did not define in this study because there were no subacute complications after PTCA and may be limited value due to time course of complication(usaully within 1 hour after PTCA) and relatively long analytic time.
Angina, Unstable ; Discrimination (Psychology) ; Electrocardiography ; Humans ; Immunoenzyme Techniques ; Inflation, Economic ; Myocardial Infarction ; Troponin T* ; Ventricular Dysfunction, Left

The antihypertensive effects of once-daily 50mg dose of atenolol(Tenormin(R)) were observed in 28 cases of essential hypertension, and the results were as follows. 1. Mean drop in systolic and diastolic pressure were 19mmHg and 16mmHg respectively. 2. In 85.7% of the cases good or fair control of blood pressure was resulted. 3. Transient indigestion and fatigue were complained by 3 patients, but subsided spontaneously with continuous treament.
Blood Pressure ; Dyspepsia ; Fatigue ; Humans ; Hypertension