BACKGROUND: Radiofrequency(RF) catheter ablation has rapidly emerged as the treatment of choice for symptomatic reentrant arrythmia associated with accessory pathway or atrioventricular node conduction. Rarely RF catheter ablation therapy can produce the cardiac perforation, ventricular function insufficiency and arrythmia. So, the purpose of this study was to determine the correlation between the RF energy and muscle injury. METHODS: Bovine skeletal muscle was immersed in normal saline, and the entire chamber was heated to 36-37degrees C by water bath. The 4mm tip 7 Fr electrode catheter was placed horizontally on the skeletal muscle surface withoup pressure. RF energy was delicered to tissue for the pulse duration of 10, 20, 30, 40, 50, 60 seconds and voltage of 10, 15, 20, 25, 30, 35, 40, 45volt and total 432 lesions were produced. Horizontal, vertical lesion diameters and depths were measured, and the area and volume of lesion were calculated. RESULTS: Increasing voltage and duration of RF increased the horizontal and vertical diameter, depth, area and volume of lesion(p<0.0001). The RF pulse duration and voltages made lesion below 5mm depth were 45volt applied dbelow 20seconds, 40volt applied below 25seconds, 35volt applied below 32seconds, 30volt applied below 38seconds, 25volt applied during any duation of time. CONCLUSION: So, for prevention of undesirable tissue damage, the adequate pulse duration and voltage of RF must to be delivered to tissue.
Arrhythmias, Cardiac ; Atrioventricular Node ; Baths ; Catheter Ablation ; Catheters ; Electrodes ; Hot Temperature ; Muscle, Skeletal* ; Ventricular Function ; Water

BACKGROUND: Lipoprotein(a)(Lp(a))is known as an independent risk factor of the coronary artery disease(CAD). However, it is not clear whether the level of the Lp(a) is elevated in the presence of atherosclerotic peripheral vascular disease(PVD) of lower extremities. MATERIALS AND METHODS: Considering high prevalence of the coronary artery disease in PVD, the association between the serum level of Lp(a) and the presence of PVD was investigated by comparing Lp(a) level in PVD patients with CAD(PVD+CAD group, N=15), PVD patients without CAD(PVD-CAD group, N=12), and control group who had normal coronary angiograms and no clinical evidence of PVD(Control group, N=22). In all PVD patients coronary angiograms were performed simultaneously with peripheral angiograms. Clinical characteristics, lipid profiles and the level of lipoprotein(a) were compared between two PVD group. The serum level of Lp(a) was measured with ELISA technique. RESULTS: Serum levels of lipoprotein(a) in patients with PVD as a whole(20.4+/-18.7mg/dl, mean standard deviation) were not significantly higher than those in control group(14.9+/-10.5mg/dl). In patients with PVD and CAD, the levels were significantly higher(27.0+/-20.2mg/dl) than those in patients with PVD but without CAD(12.2+/-13.3mg/dl). There was no significant difference between two groups with PVD in age, sex, association of hypertension, smoking, and other lipid profiles. CONCLUSIONS: Lipoprotein(a) level might not be related to the presence of PVD, but rather associated with CAD.
Coronary Artery Disease ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypertension ; Lipoprotein(a)* ; Lower Extremity* ; Peripheral Vascular Diseases* ; Prevalence ; Risk Factors ; Smoke ; Smoking

The Peutz-Jeghers syndrome is an autosomal dominant disease characterized by hamartomatous polyps in the gastrointestinal tract and mucocutaneous melanin pigmentation. Although these polyps are believed to have little potential for malignancy, and the disease was believed to have a relatively benign course, it recently has been recognized that patients with this syndrome are at increased risk for the development of cancer at gastrointestinal and nongastrointestinal sites. A 33-year-old male patient was admitted because of vomiting and abdominal pain for 3 months duration. A diagnosis of Peutz-Jeghers syndrome was made 3 years ago by multiple hamartomatous polyps confined to the colon and mucocutaneous pigmentation. A barium study showed abrupt string like luminal narrowing at the 4th portion of the duodenum. On laparotomy, there was an annular constricting mass involving the serosa of duodenum with multiple metastasis to liver, so a segmental resection of small bowel followed by chemotherapy was performed. The histologic finding was adenocarcinoma.
Abdominal Pain ; Adenocarcinoma* ; Adult ; Barium ; Colon ; Diagnosis ; Drug Therapy ; Duodenum ; Gastrointestinal Tract ; Humans ; Laparotomy ; Liver ; Male ; Melanins ; Neoplasm Metastasis ; Peutz-Jeghers Syndrome* ; Phenobarbital ; Pigmentation ; Polyps ; Serous Membrane ; Vomiting

Coronary artery and valvular injuries after blunt chest trauma are an unusual condition. This diagnosis is very difficult to estabilish, but prompt diagnosis and proper management are important in life saving. We report one patient who develop left main coronary artery dissection, tricuspid insufficiency, mitral insufficiency and pericardial rupture following blunt chest trauma. One year ago, he had suffered a frontal impact in a traffic accident and recieved anti-tuberculosis medication for 10 months for chest discomfort. The correct diagnosis was confirmed noninvasively by transesophageal echocardiography and the patient was treated left main coronary artery dissection flap removal, mitral valve replacement, tricuspid valvuloplasty and repair of ruptured pericardium. The postoperative course was uneventful and the patient was fully recovered.
Accidents, Traffic ; Coronary Vessels* ; Diagnosis ; Echocardiography, Transesophageal ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Pericardium ; Rupture* ; Thorax*

There is a continuing debate among surgeons about whether postoperative adhesive small bowel obstruction is best managed operatively or nonoperatively. This retrospective study was designed to determine the factors influencing the treatment modality of postoperative small bowel obstruction. A clinical analysis was conducted on 112 cases of small bowel obstruction after previous abdominal operation, who were admitted to the department of general surgery of Korea Veterans Hospital from January, 1984 to December, 1994. The patients were divided into two groups according to the modality of treatment: operatively(N=35) and nonoperatively(N=77) treated groups. Clinical parameters such as age, sex, symptoms and signs, type of previous operation, interval between previous operation and admission due to obstructive symptoms, time period from onset of symptoms to admission, and interval from admission to operation, were compared between two groups. Among 112 cases, the conservative treatment was performed in 77 cases and operative management was performed in 35 cases. There was no significant difference in the distribution of age and sex between two groups. The previous operations leading to adhesive intestinal obstruction were appendectomy(18.8%), gastroduodenal operation(17.0%), operation for multiple organ injury(16.1%), and Obsetric & Gynecologic surgery(9.8%) in that orders. The interval between previous abdominal operation and admission was under 1 month in 20 cases, 1 to 6 months in 10 cases, 7 to 12 months in 16 cases, and 1 to 2 years in 16 cases. The major symptoms and signs were abdominal pain, abdominal tenderness, vomiting, abdominal distension, hyperperistalsis, and leukocytosis. Among the above signs and symptoms, continuous abdominal pain, leukocytosis, and tachycardia were significantly higher in the operative group compared to those of the nonoperative group. The most common procedures of operative management were adhesiolysis, small bowel resection, bypass surgery, and colon resection in that orders. The incidence of postoperative complications was 31.4% and the most common complication was wound infection. In conclusion, at admission, the presence of strangulating signs such as continuous abdominal pain, leukocytosis, and tachycardia in patients with small bowel obstruction after previous abdominal operation mandates early operative intervention rather than conservative treatment.
Abdominal Pain ; Adhesives ; Colon ; Hospitals, Veterans ; Humans ; Incidence ; Intestinal Obstruction ; Korea ; Leukocytosis ; Postoperative Complications ; Retrospective Studies ; Tachycardia ; Vomiting ; Wound Infection

PURPOSE: Angiogenesis plays an important role in the growth, progression and metastasis of solid tumors. Vascular endothelial growth factor (VEGF) was thought to be one such angiogenic factor and was also thought to be a selective mitogen for endothelial cells. The purpose of this retrospective study was to evaluate for prognostic significance of VEGF in stomach cancer. MATERIALS AND METHODS: The sections of formalin-fixed, paraffin embedded from 55 stomach cancer were stained immunohistochemically for VEGF. The rate of VEGF expression and correlation between expression of VEGF and other prognostic factor of stomach cancer were studied. RESULTS: There were 20 cases (36.4%) of VEGF-positive and 35 cases (63.6%) of VEGF- negative. There were no significant difference between VEGF expression and the histologic type, differentiation, depth of invasion of histologic stage, lymph node involvement. The frequency of hepatic recurrence was higher in patients with VEGF-positive tumor than that af patient with negative tumor (p=0.007). The prognosis of the patients with VEGF positive tumor was worse than that of patients with VEGF negative tumor (p=0.0214). CONCLUSION: There was a closely significant between positive expression of VEGF and a high incidence of hepatic metastasis, low survival rate. The expression of VEGF could be considered to be one of useful prognostic factor in human gastric carcinoma
Angiogenesis Inducing Agents ; Endothelial Cells ; Humans* ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms* ; Stomach* ; Survival Rate ; Vascular Endothelial Growth Factor A*

Idiopathic mediastinal fibrosis is very rare. We report two cases of a 41-year-old man and 65-year-old man who presented with backache and vocal cord palsy, subsequently confirmed to be idiopathic mediastinal fibrosis. Preoperative chest computed tomography showed a mediastinal mass and oracoscopic biopsy was preformed. The mass was hard, dense and partially calcified, and adhered the adjacent mediastinal structure. Postoperative medical treatment was not performed, and during 5 and 7 month follow-up has not demonstrated any complication.
Adult ; Aged ; Back Pain ; Biopsy ; Fibrosis* ; Follow-Up Studies ; Humans ; Mediastinal Diseases ; Thorax ; Vocal Cord Paralysis

We present a case of giant coronary arteriovenous fistula between left main coronary artery and pulmonary artery in a 60-year-old female who presented with anginal symptom. Dobutamine stress echocardiography and myocardial perfusion scan with (99m)Tc-MIBI revealed a reversible perfusion defect in the septal region. Coronary angiography demonstrated a giant coronary arteriovenous fistula origination from the left main coronary artery and draining into the pulmonary artery. This appears to be the first case in which dobutamine stress echocardiography and myocardial perfusion scan with (99m)Tc-MIBI demonstrated myocardial ischemia due to coronary steal in patient with a coronary arteriovenous fistula.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Vessels ; Dobutamine* ; Echocardiography, Stress* ; Female ; Humans ; Middle Aged ; Myocardial Ischemia ; Perfusion ; Pulmonary Artery ; Septum of Brain ; Tomography, Emission-Computed, Single-Photon*

Periodontal regeneration therapy with bone-substituting materials has gained favorable clinical efficacy by enhancing osseous regeneration in periodontal bony defect. As bone- substituting materials, bone powder, calcium phosphate ceramic, modified forms of hydroxyapatite, and hard tissue replacement polymer have demonstrated their periodontal bony regenerative potency. Bone-substituting materials should fulfill several requirements such as biocompatibility, osteogenecity, malleability, biodegradability. The purpose of this study was to investigate biocompatibility, osteo-conduction capacity and biodegradability of Na2O, K2O added calcium metaphosphate(CMP). Beta CMP was obtained by thermal treatment of anhydrous Ca2(H2PO4)2. Na2O and K2O were added to CMP. The change of weight of pure CMP, Na2O-CMP, and K2O-CMP in Tris-buffer solution and simulated body fluid for 30 days was measured. Twenty four Newzealand white rabbits were used in negative control, positive control(Bio-Oss), pure CMP group, 5% Na2-CMP group, 10% Na2O-CMP goup, and 5% K2O-CMP group. In each group, graft materials were placed in right and left parietal bone defects(diameter 10mm) of rabbit. The animals were sacrificed at 3 months and 6 months after implantation of the graft materials. Degree of biodegradability of K2O or Na2O added CMP was greater than that of pure CMP in experimental condition. All experimental sites were healed with no clinical evidence of inflammatory response to all CMP implants. Histologic observations revealed that all CMP grafts were very biocompatible and osseous conductive, and that in K2O-CMP or Na2O-CMP implanted sites, there was biodegradable pattern, and that in site of new bone formation, there was no significant difference between all CMP group and DPBB(Bio-Oss) group. From this result, it was suggested that all experimental CMP group graft materials were able to use as an available bone substitution.
Animals ; Body Fluids ; Bone Regeneration* ; Calcium* ; Ceramics ; Durapatite ; Osteogenesis ; Parietal Bone ; Polymers ; Rabbits ; Regeneration ; Transplants*

No abstract available.
Dentin* ; Hypersensitivity*