Since the development of cardiac monitoring, Holter ECG monitoring, His Bundle electrogram and cardiac pacemaker, the cardiac conduction defect has been diagosed more precisely. Also SA block and sick sinus syndrome were well investigated recently. Author reviewed 10,084 cases of electrocardiograms for recent 3 years which were examined at korea University Hospital and analyzed the incidence of conduction defect, type of SA block, conduction defect in myocardial infarction and the relation of SA and AV conduction defect and Q-T(c). There were 5,390 cases of male and 4,694 cases of female with age range of 10 months to more than 80 years. In 60 cases, 24 hour Holter ECG monitoring were also carried out. The data were as follows; 1. There were 568 cases of cardiac conduction defect out of 10,084 cases and the incidence was 5.64% as a whole. Among the conduction defects, there was SA block in 0.36%, AV block in 2.12%(1st degree in 1.86%, Mobitz type I in 0.11%, Mobitz type II in 0.08%, complete block in 0.07%), bundle branck block in 2.52%(RBBB in 2.13%, LBBB in 0.39%), intraventricular conduction defect in 0.20%, left bundle hemiblock in 0.07%, bifascicular block in 0.05%, 1st degree AV block with BBB in 0.18%, W-P-W syndrome in 0.1% and L-G-L syndrome in 0.04%. 2. There were 36 cases of SA block among 10,084 cases(0.36%). In 26 cases, there were one case of Mobitz type I 2nd degree SA block, Mobitz type II in 20 cases, no P wave with nodal escape in 13 cases and 2 cases of transient sinus arrest associated with syncopal attack which were diagnosed by 24 hour Holter ECG monitoring. 3. There were 45 cases of conduction defect in 122 cases of acute or subacute myocardial infarction(36.9%). Among the 45 cases, there were 2 cases of SA block, 15 cases of 1st degree AV block, 2 cases of 2nd degree AV block, 2 cases of complete AV block, 10 cases of RBBB, 3 cases of LBBB, 4 cases of intraventricular conduction defect and 7 cases of left bundle hemiblock. These data showed lower incidence of critical conduction defect such as Mobitz type II and complete AV block in Korea than in United States. 4. The Q-T(c)interval were measured in 207 cases of SA block and AV block without BBB or IVCD. The values of Q-T(c)in cases of conduction defect were within normal limits. In cases of myocardial infarction, there were mild prolongation of Q-T(c)interval, however there was no difference of Q-T(c)interval between infarction with conduction defect and those without conduction defect. There was no correlation between P-R interval prolongation and Q-T(c)interval. These data suggested that the cardiac conduction defect is a specific involvement of conduction system by various causes rather than diffuse myocardial changes.
Atrioventricular Block ; Electrocardiography* ; Electrocardiography, Ambulatory ; Electrophysiologic Techniques, Cardiac ; Female ; Heart* ; Humans ; Incidence ; Infarction ; Korea ; Male ; Myocardial Infarction ; Sick Sinus Syndrome ; United Nations ; United States

PURPOSE: This study aimed to determine whether deep vein thrombosis (DVT) predominantly occurred on a particular side in the pelvic and lower extremity veins. MATERIALS AND METHODS: Among 259 consecutive patients with leg swelling, 65 were confirmed to have DVT in the pelvis and lower extremities, and enrolled in this study. The serum levels of initial D-dimer, antithrombin III, tissue plasminogen activator, factor VIII, proteins C and S, anticardiolipin antibodies immunoglobulin (Ig) G and IgM and lupus anticoagulant were measured and analyzed retrospectively. Lower extremity venous system was divided into 11 anatomic segments on each side, and thrombotic involvement in each segment was recorded to determine the laterality of thrombotic involvement for each patient. The presence of thrombus in a specific vein was assigned using a Thrombus Scoring System (TSS) score of 1. Predominant direction was determined based on the TpSS score for each side. RESULTS: Left-side predominat DVT (57%) was most frequent. Patients with both-side equivalent DVT had the highest total TSS score (P=0.022). The predominant side was significantly different between men (right 44.1%) and women (left 74.2%) (P=0.022). Patients with both-side equivalent DVT had the highest mean age (69.3+/-9.9 years) as well as the highest mean levels of initial D-dimer (13.8+/-20.7 microg/mL) and anticardiolipin antibody IgM (13.4+/-22.8 MPL) indicating increased coagulability. CONCLUSION: In the current study, left-side predominant DVT is most frequent in pelvis and lower extremities, and this phenomenon is more apparent in women. And both-side equivalent DVT is associated with the most advanced age and hypercoagulability.
Antibodies, Anticardiolipin ; Antithrombin III ; Factor VIII ; Female ; Humans ; Immunoglobulin M ; Immunoglobulins ; Leg ; Lower Extremity* ; Lupus Coagulation Inhibitor ; Male ; Pelvis ; Retrospective Studies ; Thrombophilia ; Thrombosis ; Tissue Plasminogen Activator ; Veins* ; Venous Thrombosis*

The purpose of this paper is to study the effects of anti-inflammatory agents on the blood-aqueous-berrier in experimentally induced uveitis. 10% solution of sodium fluorescein was injection intravenously in the ear vein of rabbits (0.25 ml/kg) and fluorescein curve was drawn after the method of Amsler and Huber. Experimental uveitis was induced by the injection of 0.2 ml of human serwn into the vitreous body. After uveitis had been induced. three kinds of anti-inflammatory agents-Prednisolone, Benzyron and Methotrexate-were Biven oralIy. In control animals in which no uveitis was induced, no changes in fluorescein curve were demonstrated before and after the administrations of drugs. In animals with uveitis, maked increases of the blood-aqueous barrier were noted. When Benoyron and Prednisolone were given to these animals, normaliration of the fluorescein curves were demonstrated. Methotrexate had no effects on the fluorescein curves in uveitis animals, showing no improvements in the permeability of uveal vessela. This ineffectiveness seemed to be due to the resistance of rabbits to methotrexate.
Animals ; Anti-Inflammatory Agents ; Blood-Aqueous Barrier ; Ear ; Fluorescein ; Humans ; Methotrexate ; Permeability ; Prednisolone ; Rabbits ; Uveitis* ; Veins ; Vitreous Body

Vertebral pedicle screws have been widely used for secure posterior spinal fixation. When postoperative CT scan films were made, the blurring of pedicle screws were observed and we could not figure nut the exact diameter of screw and canal encroachment. There is no information in the difference hetween actual diameter and measured diameter of pedcile screws in CT yet. In this study, we try to find out partial voiume averaging artifact of pedicle screws made of stainless steel and titanium. Partial volume averaging artifact occurs when the shape of an object changes within the thickness of the CT slice or when a relatively small object is only partially included within the slice. Four pig cadaveric spinal column including 6 vertebrae each were prepared and CT scans were performed after insertion of C-D screws(stainless steel) to the left and TSRH screws(titanium) to the right pedicle. Another CT scans were performed after insertion of C-D screws to the right and TSRH screws to the left pedicle. The third CT scans were made after removal of all the pedicle screws. Actual C-D screw diameter was 6mm and CT scanned diameter was 8. I 6+/-0.66mm. Actual TSRH diameter was 6.5 mm and CT scanned diameter was 6.59+/-0.34mm. In conclusion, stainless steel has more partial volume averaging artifact than titanium. Safety margin of pedicle screw made of stainless steel is about 2mm and that of titanium is about 1 mm.
Artifacts ; Cadaver ; Nuts ; Spine ; Stainless Steel* ; Titanium* ; Tomography, X-Ray Computed*

No abstract available.
Graft Survival* ; Humans ; Living Donors* ; Risk Factors* ; Transplants*

Bipotent progenitors for T and natural killer (NK) lymphocytes are thought to exist among early precursor thymocytes or liver lymphocytes. The identification of such a progenitor population or mature NK cells in such organs remains undefined. Here we report the identification of a novel receptor of NK cells, p58 (HLA class I-specific inhibitory receptors), in fetal thymocytes and fetal liver lymphocytes. Our finding suggests the NK cells mature in the developmental stage during feta1 ontogeny. Flow cytometric analysis revealed p58 positive cells in thymocytes or in fetal liver lymphocytes and reverse transcription PCR also showed amplification of p58 RNA. The result of single stranded conformational polymorphism (SSCP) showed it discriminates one or two base pair differences of the p58 gene. Although the question still remains as to whether the expression of p58 is due to the NK cells or natural T cells, it is clear the p58 is expressed in fetal thymocytes or liver lymphocytes. And SSCP analysis using appropriate sets of primers used in this study, is helpful to study the diversity of p58.
Base Pairing ; Killer Cells, Natural ; Liver* ; Lymphocytes* ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Reverse Transcription ; RNA ; T-Lymphocytes ; Thymocytes*

PURPOSE: We expected the motion fraction could be checked, with simple radiographic examination, according to the guide-line of fluoroscopic technique, and recovery of the function also could be correlated with the improvement of the motion fraction. MATERIALS AND METHODS: We measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement (thetaGH/thetaST) was 1.6 for the full range of motion in scapular plane. During arm elevation, scapular tilting from the coronal plane was decreased from 42 degrees to 20 degrees tilting as well as internal rotation (scapular extension). We also measured the motion fraction (thetaGH/thetaST) and functional recovery of the shoulder in 11 patients after operative treatment of the shoulder instability in 15 patients from December 1996 to August 1997. RESULTS: We could find out a significant correlation between the recovery of motion fraction and shoulder function. These results would be applied in planing rehabilitation program after treatment of the shoulder instability. CONCLUSIONS: The measuring technique of glenohumeral to scapulothoracic movement (thetaGH/thetaST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment
Arm ; Fluoroscopy ; Humans ; Outpatients ; Pathology ; Range of Motion, Articular ; Rehabilitation ; Shoulder*

Cystic nephroma (CN) is a benign cystic neoplasm composed of mixed epithelial and stromal elements. Less than 200 cases have been reported. We had a patient, a 41-year-old woman, who had a huge typical CN. The patient was admitted for a right renal mass that was found incidentally. On laparaoscopic right nephrectomy, there was an encapsulated 7 cm multilocular cystic mass at the upper pole. Microscopically, the cystic wall was lined by a single layer of low cuboidal or hobnail epithelium without a solid area. The thin septa were composed of bland, ovarian type spindle cells. The main differential diagnoses were mixed epithelial and stromal tumor (MEST), low grade multilocular renal cell carcinoma, and tubulocystic carcinoma. The results of immunohistochemical staining were cytokeratin 7/19(+/+) and CD10(-) in lining epithelium, estrogen receptor/progesterone receptor(+/+) in stromal cells. After surgery, she was free of recurrence for 10 months. We report this rare case and compare it with other cystic renal tumors, especially MEST.
Adult ; Carcinoma, Renal Cell ; Diagnosis, Differential ; Epithelium ; Estrogens ; Female ; Humans ; Keratins ; Kidney ; Nephrectomy ; Receptors, Estrogen ; Recurrence ; Stromal Cells

Thirty-seven cases of cardiac neurosis were treated with propranolol (Inderal(R)) and following results were obtained. 1) Symptoms, such as palpitation, dyspnea, chest tightness and chest pain were disappeared or improved in all cases. 2) Heart rate reduced significantly after treatment from 99.8 per minutes to 74.8 per minutes. 3) Systolic blood pressure reduced significantly after treatment from 147.6 mmHg to 131.4 mmHg. but diastolic blood pressure were not reduced significantly. These results indicated that propranolol is recommendable medicine for improving cardiac symptoms and tachycardia in cardiac neurosis.
Blood Pressure ; Chest Pain ; Dyspnea ; Heart Rate ; Neurocirculatory Asthenia* ; Propranolol* ; Tachycardia ; Thorax

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U. S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U. S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the difference in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated for its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed ad payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U. S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.
Classification ; Clinical Coding ; Delivery of Health Care ; Diagnosis* ; Diagnosis-Related Groups* ; Health Expenditures ; Health Personnel ; Health Services ; Humans ; Inpatients* ; Insurance ; Insurance Carriers ; Korea