A single coronary artery is a rare congenital anomaly. The right coronary artery, originating from distal left circumflex, is an extremely rare variety of a single coronary artery. Our report is accompanied by a brief review of the literature.
Coronary Vessel Anomalies ; Coronary Vessels*

A coronary pseudostenosis is a characteristic angiographic image, which may appear as coronary winkles, or intussusceptions, due to a stiff guidewire during coronary interventions. Intravascular ultrasound (IVUS) plays a role in ruling out severe coronary stenosis, coronary dissections, thrombus or coronary spasm. We report a case of coronary pseudostenosis, which occurred during coronary interventions, diagnosed by intravascular ultrasound.
Coronary Stenosis ; Intussusception ; Spasm ; Thrombosis ; Ultrasonography*

No abstract available.

BACKGROUND: It was recently shown that human atherosclerotic plaque contains large numbers of T lymphocytes : this indicates that immune and inflammatory mechanism may be important factors in the pathogenesis of atherosclerosis. By measuring the soluble interleukin 2 receptor(sIL-2R) level we can evaluate the activation of T lymphocyte. The purpose of this study is to evaluate relationship between T cell activation and ischemic heart disease by measuring the soluble interleukin 2 receptor (sIL-2R) level in patient with ischemic heart disease. METHOD: Seventy-two patients(40 males and 32 female, mean age : 56.5+/-9.9 years) who were taken coronary angiography were included in this study. Among them, 49 patients showed abnormal coronary angiographic findings and 23 patients showed normal coronary angiographic findings. Ten mililiters of arterial blood was drawn at the time of coronary angiography. The blood was allowed to coagulate and then the serum was removed and tested in duplicate for soluble interleukin 2 receptor (sIL-2R) level by ELISA. RESULTS: 1) The soluble interleukin 2 receptor (sIL-2R) level was significantly different between abnormal coronary angiographic findings and normal coronary angiographic findings (P < 0.001). 2) According to clinical severity of ischemic heart disease (i.e. stable angina, unstable angina, acute myocardial infarction.), soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05), but showed increasing tendency with clinical severity. 3) According to numbers of involved coronary vessels, soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05). CONCLUSION: T lymphocyte activation, as reflected in elevated soluble interlekin 2 receptor (sIL-2R) level, is frequent in patient with ischemic heart disease. In the further we will investigate relationship between clinical diagnosis of ischemic heart disease of the numbers of involved coronary vessels and T cell activation.
Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Lymphocyte Activation ; Lymphocytes ; Male ; Myocardial Ischemia* ; Plaque, Atherosclerotic ; Receptors, Interleukin-2 ; T-Lymphocytes

A clinical analysis was carrried out on 306 pts c Gastric ulcer who have visited the Depart on Internal Medicine. Daegue Catholic Hospital during the period from August 1980 to June l982. The result were as follows: of the total 306 cases, 249(81%) cases were male and 57(19%) cases were female, Male to female ratio was 4. 3: 1. Thirsty two percent of the cases blonged to the 6 tb decade, 25.5% to 5 th and 19% to 7 th decade. (continue...)
Daegu ; Female ; Humans ; Internal Medicine ; Male ; Stomach Ulcer*

BACKGROUND: Radiofrequency (RF) catheter ablation of accessory pathways is generally accepted as the procedure of choice for symptomatic patients with tachycardia. The success rate of RF catheter ablation has been reported to be greater then 90%. Previous several studies have shown that the recurrence rate of accessory pathway function after initially successful ablation is about 10%. However, accessory pathway conduction may recur after apparently successful ablation, possibly due to transient modification of the pathway rather than permanent destruction of accessory pathway. During RF catheter ablation, prediction of permanent destruction of pathway , which means long-term success of catheter ablation, is very important. METHODS: All ablation procedures were performed using a 4 mm tipped deflectable catheter (Diag, Webster or EPT). RF energy was delivered using the RF generater (Radionics RFG-3C). After positioning the ablation catheter at the target site RF energy of 40-60V was applied for 30-60sec. After successful elimination of accessory pathway conduction, all patients underwent routine history taking, physical examination, and a 12 lead electrocardiogram recording at 1 week, 1, 2, 3, and 12 month after ablation. AV interval, AV ratio, presence of AP potential, and time from RF delivery to loss of delta were measured at the last local electrograms at the successful sites. Statistics: The continuous variables was evaluated by using an unpaired Student? T test and discrete variables, using chi-square test and fischer? exact test between groups with recurrence and without recurrence during follow-up. RESULT: RF catheter ablation was initially successful in 35 patients with Wolff-Parkinson-White syndrome. After initially successful RF ablation, follow-up examinations were done during 55 40 weeks. Time from RF delivery to loss of delta was shorter in the group without recurrence during follow-up. Times from RF energy to loss of delta less than 5 sec was for long- term success without recurrence. CONCLUSION: Time required to eliminate an accessory pathway conduction is a predictor for long term success. However, local electrogram characteristics during successful RF catheter ablation may not be useful to predict long term success of RF catheter ablation in patients with manifest accessory atrioventricular connections.
Angina, Unstable ; Catheter Ablation* ; Catheters ; Coronary Sinus ; Electrocardiography ; Follow-Up Studies ; Humans ; Interleukin-6 ; Physical Examination ; Recurrence ; Tachycardia ; Wolff-Parkinson-White Syndrome*

BACKGROUND AND OBJECTIVES: The optimal AV delay should allow for the completion of the atrial contraction prior to the ventricular contraction, and provide for the longest diastolic filling and maximal stroke volume. This study evaluated the effects of the AV delay on the changes in heart functions, in patients with a DDD pacemaker and normal systolic function. SUBJECTS AND METHODS: Nineteen patients were enrolled. The pacing rate was set at 70 beats/min. The AV delay was lengthened in 20-25 msec step, from 100 to 250 msec. The stroke volume and diastolic parameters were measured by echocardiography for each AV delay. RESULTS: The changes in the stroke volume associated with the changes in the AV delay were not statistically significant. However, when viewing each individual patient, the optimal AV delay for each patient could be found. When comparing the stoke volumes obtained just before, just after, and during the maximal AV delay, a statistically significant difference was found (p< 0.05). The absolute value of the E/A ratio was less than 1. The pulmonic vein flow pattern was dominated by the systolic flow, but the changes were not statistically significant. There was a tendency for the E wave propagation slope to decrease. However, the absolute value was less than 40 cm/s, and the E/E' absolute ratio was more than 8, but neither showed any significant differences. CONCLUSION: In patients with a DDD pacemaker and normal systolic function, the diastolic parameters were abnormal, and the stroke volume affected by the change in the AV delay.
Diastole ; Dichlorodiphenyldichloroethane* ; Echocardiography ; Heart ; Humans ; Stroke Volume ; Veins

BACKGROUND: Left ventricular diastolic dysfunction may precede systolic dysfunction and play a major role in producing the signs and symptoms of congestive heart failure. Ischemic heart disease can cause impairment of left ventricular filling without any alteration in systolic function so it is very important to evaluate relationship of left ventricular diastolic dysfunction and ischemic heart disease. The purpose of this study is to investigate left ventricular diastolic dysfunction during transient myocardial ischemia caused by balloon occlusion. METHODS: We prospectively studied 20 patients(11 males and 9 females, mean age : 58.5+/-5.9 years) who had been undergone coronary angiography and confirmed significant luminal stenosis(> or =75%)in proximal or middle portion of left anterior descending artery. After coronary angiography, percutaneous transluminal coronary angioplasty were performed all patients. We measured early propagation slope of left ventricular inflow, time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip and normalized TD(nTD) which dividing TD by the distance of mitral opening to apical region using color M-mode Doppler echocardiography, peak earaly diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave using pulsed wave Doppler echocardiography, left ventricular end diastolic pressure using left heart catheterization. A color M-mode Doppler echocardiography, pulsed wave Doppler echocardiography and left ventricular end diastolic pressure were recorded before, during 30sec, 60sec & 90sec and after 60sec & 180sec balloon occlusion. RESULTS: Early propagation slope of left ventricular inflow was significantly decreased during 30sec & 60sec balloon occlusion and significantly increased after 60sec & 180sec balloon occlusion, respectively (64.45+/-28.23cm/sec, 39.37+/-11.77cm/sec, 32.78+/-11.77cm/sec, 51.86+/-19.78cm/sec, 65.05+/-29.99cm/sec, p<0.05). Time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(60+/-20msec, 90+/-30msec, 110+/-30msec, 80+/-20msec, 60+/-20msec, p<0.05). Normalized time difference(nTD) was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(11.24+/-3.87msec/cm, 17.76+/-6.67msec/cm, 21.51+/-6.67msec/cm, 15.22+/-4.00msec/cm, 12.63+/-3.59msec/cm, p<0.05). Left ventricular end diastolic pressure was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(9.70+/-3.88mmHg, 14.15+/-6.49mmHg, 17.00+/-7.14mmHg, 10.20+/-3.68mmHg, 8.75+/-3.16mmHg, p<0.05). Peak early diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave were not significantly different(p>0.05). CONCLUSIONS: These data suggest that transient myocardial ischemia can cause left ventricular diastolic dysfunction and color M-mode Doppler echocardiography is very sensitive diagnostic method to detect early diastolic dysfunction compare to other echocardiographic diastolic indices.
Acceleration ; Angioplasty, Balloon, Coronary ; Arteries ; Balloon Occlusion ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Female ; Heart Failure ; Heart Ventricles* ; Humans ; Male ; Myocardial Ischemia* ; Phenobarbital ; Prospective Studies

We report two cases with delayed cerebellar hemorrhage developed after supratentorial burr-hole drainage, and review the literature. Burr-hole drainage was performed at both sides of bilateral chronic subdural hematomas. The total amount of drainage per day was more than 300ml of hematoma mixed with cerebrospinal fluid(CSF) and the differences in doses between the two sides were significant in both cases. The symptoms improved after drainage but abrupt deterioration of neurological status occurred with the development of cerebellar hemorrhage on postoperative day 4 and 5, in each case. Although both patients were elderly, 75 and 86 years old, they did not have any coagulation defect or episode of severe increase in their blood pressures during drainage. We believe that suprate-ntorial CSF overdrainage can cause cerebellar upward shift, with resultant injury of weakened cerebellar vessels in old age.
Aged ; Aged, 80 and over ; Drainage* ; Hematoma ; Hematoma, Subdural, Chronic ; Hemorrhage* ; Humans

BACKGROUND: The purpose of this study was to investigate the electrophysiologic characteristics and result of radiofrequency catheter ablation of patients with Wolff-Parkinson-White (WPW) syndrome associated with Ebstein's anomaly. METHODS: After performed radiofrequency catheter ablation in five (1 male, 4 females, average age 40.6) patients, we then evaluated their clinical manifestation, echocardiography and electrophysiologic characteristics. RESULTS: All patients had palpitation and two patients showed dizziness. In transthoracic echocardiography, all of the patients had severe tricuspid regurgitation and the mean distance of the septal tricuspid valve leaflet from the right atrioventricular annulus was 2.3 cm. In electrophysiologic study, eight accessary pathways were found in the 5 patients and all pathways were located on the right-side of the heart. Five manifest accessary pathways were found (one on the anterolateral, two on the lateral, one on the posterior, one on the posteroseptal wall) and three concealed pathways were found at posteroseptal wall. Three patients (60%) had multiple accessary pathways. The most common combination pattern was the manifest right lateral wall and concealed right posteroseptal wall accessary pathway. Catheter ablation of the concealed right posteroseptal accessory pathway was not successful in one patient with multiple accessary pathway. The average time of radiation was 56.0 minutes and the average time of procedure was 141.3 minute. CONCLUSION: WPW syndrome associated with Ebstein's anomaly had a high frequency of multiple accessary pathways and there was much difficulty in catheter ablation because morphologic and anatomical change of the heart structure. Further study will be necessary on the role of arrhythmia in atrialized right ventricle.
Arrhythmias, Cardiac ; Catheter Ablation* ; Dizziness ; Ebstein Anomaly* ; Echocardiography ; Female ; Heart ; Heart Ventricles ; Humans ; Male ; Tricuspid Valve ; Tricuspid Valve Insufficiency ; Wolff-Parkinson-White Syndrome*