Accelerated idioventricular rhythm(AIVR) describes ventricular rates slower than usual tachycardia rates but faster than the ventricular escape rhythm. Ventricular rates of 40- 120 beats/min are usual. Accelerated idioventricular rhythm probably represents enhanced automaticity in the ventricles and manifests itself when sinus rates slow. This arrhythmia has been reported in association with acute myocardial infarction, digitalis excess, cardiomyopathy, and rheumatic heart disease. Only rare case of AIVR without underlying heart disease has been described. It is transient and intermittent, with episodes lasting a few seconds to a minute, and does not appear to seriously affect the patient's clinical course or the prognosis. Suppressive therapy is rarely necessary. Recently, we have experienced four cases of AIVR in children without underlying heart disease with benign clinical course.
Accelerated Idioventricular Rhythm* ; Arrhythmias, Cardiac ; Cardiomyopathies ; Child* ; Digitalis ; Heart Diseases ; Heart* ; Humans ; Myocardial Infarction ; Prognosis ; Rheumatic Heart Disease ; Tachycardia ; United Nations

Choroidal metastatic carcinoma is very rare. We recently experienced a case of lung adenocarcinoma which presented to the clinic with ocular symptoms. This 57-year-old Korean male patient visited the department of ophthalmology due to decreased visual acuity and pain of the left eye. On MRI scan, a nodule was attached to the retina of the left eyeball. On simple chest radiograph, a large amount of pleural effusion was noted in the left pleural cavity. Emergency enucleation of the left eyeball was done with an impression of malignant melanoma causing an intractable ocular pain. Grossly, the lesion in the eyeball was rising from the choroid. On histologic examination, tumor cells formed many irregular, small gland-like structures. The tumor cells showed alcian blue-positive mucin in the cytoplasm and glandular lumens and were positive for CEA. Chest CT scan was performed postoperatively and showed a huge mass in the left lower lobe and multiple nodular opacities in both lung fields. Bronchoscopic biopsy revealed moderately differentiated adenocarcinoma similar to that of the eyeball.
Adenocarcinoma* ; Biopsy ; Choroid* ; Cytoplasm ; Emergencies ; Humans ; Lung Neoplasms ; Lung* ; Magnetic Resonance Imaging ; Male ; Melanoma ; Middle Aged ; Mucins ; Neoplasm Metastasis* ; Ophthalmology ; Pleural Cavity ; Pleural Effusion ; Radiography, Thoracic ; Retina ; Tomography, X-Ray Computed ; Visual Acuity

Carotidynia is defined as an atypical craniofacial pain syndrome caused by the dilatation or distension of the extracranial arteries. We report an unusual case of carotidynia mimicking trigeminal neuralgia caused by an arterioscle-rotic tortous carotid artery. A 68-year-old woman suffered from frequent episodes of severe electrical shock-like radiating pain around her left ophthalmic and maxillary division of the trigeminal nerve for 5 years. Initially, under the impression of trigeminal neuralgia, carbamazepine was tried. She was reevaluated due to an unsatisfactory pharmacological response. On examination, no abnormalities were found on the craniofacial region except for a tortous pulsating tender mass on the region of the left carotid artery. Routine laboratory findings and a connective tissue study were normal. Neck sonography and a 4-vessel angiography showed a tortous left internal carotid artery with stenosis extending near to the skin. The patient was treated for 2 weeks with a nonsteroidal anti-inflammatory agent, steroids, a prophylctic beta blocker, and a TCA antidepressant. The pain gradually subsided.
Aged ; Angiography ; Arteries ; Carbamazepine ; Carotid Arteries ; Carotid Artery, Internal ; Connective Tissue ; Constriction, Pathologic ; Dilatation ; Facial Neuralgia ; Female ; Humans ; Neck ; Skin ; Steroids ; Trigeminal Nerve ; Trigeminal Neuralgia*

Deep palmoplantar warts (Myrmecia) are frequently tender papules or plaques caused by HPV-1. Myrmecia are usually misdiagnosed as paronychia or digital mucous cysts. They occur not only on the palms and soles but also on the lateral aspects and tips of the fingers and toes. We report a rare case of deep palmoplantar wart occurring on proximal nail fold, unusual site of right 5th finger in an 11-year-old girl.
Child ; Female ; Fingers ; Humans ; Paronychia ; Toes ; Warts*

No abstract available.
Posterior Cruciate Ligament*

Discoid medial meniscus was first reported in l930 by Watson-Jones. Discoid medial menisci are very rarely reported although the presence of discoid lateral menisci are not uncommon. From Jan. 1989 to Dec. 1994, we have experienced five cases who had discoid medial menisci with pain due to substance tear following knee injury in arthroscopy. There were three complete type anct two incomplete type. Out of flve cases, longitudinal tea1 and bucket-handle type tear were two, respectively. The remained one was a compound tear.
Arthroscopy ; Knee Injuries ; Menisci, Tibial*

The anterior cruciate ligament(ACL) is one of the major stabilizers of knee motion. The ACL does not heal once torn, unlike many other biological tissues. Its absence can lead to severe joint instability which can lead to disruptions of secondary restraints around the knee and then progress to degenerative joint disease. Thus many authors advocate surgical intervention for a torn ACL in order to restore stability to the joint. Yet, there is still controversy as to best treatment for the ACL injuries. It is desirable to be considered for the patients age, the severity of the injury, and the future activity level of the patient to decide treatment. We analyzed thirty ACL acute injuries of twenty seven patients who had an ACL injury and treated surgically between Apr. 1986 and Dec. 1991 at St. Pauls Hospital. The results were as follows: 1. There were twenty five males and two females. The mean age was 33.4 years ranged, 15 to 52 years. 2. The anterior cruciate ligaments were torn at proximal portion in twenty two cases, at midportion and distal portion in four, respectively. 3. Two knees had isolated ACL injuries and twenty eight had combined injuries. 4. Twenty one out of twenty six cases treated with primary repair, and three out of four cases treated with reconstruction had good-excellent results.
Anterior Cruciate Ligament ; Female ; Humans ; Joint Diseases ; Joint Instability ; Joints ; Knee ; Male

Almost all colorectal carcinomas have been thought to develop from pre-existing adenomas. However, some colorectal carcinomas can arise directly from normal flat mucosa, and usually form infiltrative mass at the early stage. The carcinogenesis of this infiltrative carcinoma may be different from the well-known adenoma-carcinoma sequence, which usually forms a polypoid mass. The purpose of this study is to investigate the different expression of various oncogenes in polypoid carcinoma and infiltrative carcinoma. We performed immunohistochemical staining on p53, bcl-2, c-erbB-2 and MIB-1 in 29 polypoid carcinomas arised from adenomas, and 21 infiltrative carcinomas. The average tumor size of infiltrative carcinomas (5.5 cm) was larger than that of polypoid carcinomas (3.1 cm), and the polypoid carcinomas were differentiated more than the infiltrative carcinomas. The results of p53, bcl-2, c-erbB-2, and MIB-1 antisera immunoreactivity in the polypoid carcinoma were 79%, 17%, 21%, and 100%, and those in the infiltrative carcinoma were 71%, 29%, 29%, and 100%, respectively. However the diffuse positivities of p53 and MIB-1 antisera were slightly higher in the infiltraive carcinomas (62%, 76%) than in the polypoid carcinomas (55%, 41%) (p=0.63, 0.01). And the results of p53 and c-erbB-2 immunoreactivity in the adenomas were 52% and 17%, respectively, which is significantly lower than that in the polypoid carcinoma(p=0.03, 0.74). The immunoreactivty of bcl-2 in the adenoma was 72%, which was significantly higher than that in the polypoid carcinoma (17%) (p<0.01). In summary, we did not show the significant difference in expression of p53, bcl-2, c-erbB-2, and MIB-1 proteins between polypoid and infiltrative carcinomas. However, the tendency of infiltrative carcinomas having a more aggressive nature suggests another carcinogenetic mechanism is involved in the colorectal carcinogenesis.
Adenoma ; Carcinogenesis ; Colorectal Neoplasms* ; Immune Sera ; Ki-67 Antigen ; Mucous Membrane ; Oncogenes