No abstract available.
Humans ; Stomach Neoplasms* ; Stomach*

No abstract available.
Intracranial Arteriovenous Malformations* ; Microsurgery*

BACKGROUND: Pacing-induced atrial electrical remodeling (AER) is characterized by shortening of atrial effective refractory period (A-ERP) and its altered rate adaptation. In paroxysmal atrial fibrillation (AF), periods of AF occur with interveneing normal sinus rhythm (NSR) when atria recover from the preceding AER. Previous episodes of AF may precondition the atrial myocardium and cause different time course of AER in subsequent episodes of AF. But the influence of the preceding AER on the subsequent AER has not been described. METHODS: Four mongrel dogs were anesthetized with enflurane. After thoracotomy, silicon band with 3 pairs of electrodes was sutured to the lateral wall of the left atrium. Atrial pacing was performed after 2 wks of recovery and autonomic blockade. Pacing protocol consisted of rapid atrial pacing (RAP) at 500 bpm (for 60 min) and recovery in NSR (for 60 min) which was repeated three times. A-ERP was measured every 10 min. The same pacing protocol was repeated after pretreatment with verapamil (0.1 mg/kg/hr). RESULTS: 1) With 60 min of RAP, A-ERP decreased significantly (126+/-6 ms vs. 105+/-7 ms, p<0.005). 2) After cessation of pacing, A-ERP returned to 98% of baseline value in 15 minutes. Recovery from AER occurred faster than AER (78 vs 21 ms/h). 3) After pretreatment with verapamil, RAP decreased A-ERP from 127+/-5 ms to 116+/-5 ms. AER, the reduction in A-ERP, was significantly attenuated by pretreatment with verapamil (deltaERp=17+/-7 vs. 9+/-0.2 %, p<0.05). 4) When RAPs were repeated, AER showed a tendency of acceleration, but it was not statistically significant (deltaERp=22 ms, 24 ms, 28 ms at the end of 60 min pacing for the 1st, 2nd, 3rd pacing). CONCLUSION: RAP induced AER in conscious dog atria and it was reduced by pretreatment with calcium channel blocking agent, verapamil. Upon repeated atrial stimulations, AER did not accelerate or decelerate when the atria recovered from the preceding AER.
Acceleration ; Animals ; Atrial Fibrillation ; Atrial Remodeling* ; Calcium ; Calcium Channels ; Dogs* ; Electrodes ; Enflurane ; Heart Atria ; Myocardium ; Silicones ; Thoracotomy ; Verapamil

PURPOSE: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. METHODS: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. RESULTS: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echocardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patientswere discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were 2.53+/-2.29 and 2.19+/-2.12, respectively (p=0.860). CONCLUSION: Cardiovascular manifestations occurafter acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant initself in the clinical course, and the short-term prognosis of cardiac toxicityis unlikely to be unfavorable in acute CO poisoning.
Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Echocardiography ; Electrocardiography ; Emergencies ; Humans ; Hypokinesia ; Hypotension ; Prognosis ; Retrospective Studies

No abstract available.
Health Care Reform* ; Human ; Korea

Neurilemmoma (Schwannoma) is a extremely rare benign tumor which origin is thought to be of nerve sheath of peripheral, cranial and sympathetic nerve. Here we report a case of orbital neurilemmoma which has grown more than two years in the female patient of thirty years old. She visited to our hospital because of decreased visual acuity and protrusion of the right eyeball. Surgery of the orbit revealed a wall-nut sized, well encapsulated, gray colored, egg-shaped tumor which was confirmed by biopsy.
Biopsy ; Female ; Humans ; Neurilemmoma* ; Orbit* ; Visual Acuity

INTRODUCTION: Limited mouth opening is a representative clinical symptom of temporomandibular disorders (TMD) with anterior disc displacement without reduction (ADDWOR). Various treatment methods have been proposed for patients with ADDWOR. This study examined the clinical effectiveness of template therapy for patients with mouth opening difficulty due to the ADDWOR. MATERIALS AND METHODS: A total of 14 patients (female 12, male 2, average age: 29.1+/-14.4), who had been treated in the template clinic, Sooncheonhyang University Bucheon Hospital, from January of 2006 to December of 2008, were enrolled in this study. The subjects were selected according to the following criteria: more than 2 weeks after the onset of locking, mouth opening range < 35 mm, and confirmed ADDWOR without a synovial pathology by magnetic resonance imaging (MRI). All patients were treated with the template appliance, instructed to wear it while sleeping and exercise for at least 10 hours per day. The maximum mouth opening (MMO) range and pain recognition scores before and after template therapy were recorded and compared. A paired t-test and Wilcoxon's signed rank test were used for statistical analysis. RESULTS: After the periodical follow up, significant improvement in the opening range was observed in the template treatment group. The average MMO range before treatment was 30.2+/-3.5 mm and the average MMO after treatment and follow up was 47.1+/-4.7 mm. The mean amount of mouth opening increment was 16.9+/-5.4 mm (P<0.01) and the pain recognition scores before and after treatment was also improved.(P=0.001) CONCLUSION: The template appliance proved to be efficient for the treatment of TMD with a closed lock and painful joint due to ADDWOR.
Displacement (Psychology) ; Follow-Up Studies ; Humans ; Joints ; Magnetic Resonance Imaging ; Male ; Mouth ; Range of Motion, Articular ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: The out-of-hospital cardiac arrest (OHCA) survival rate of patients in Korea is lower than the global average and it might be caused by an extremely low rate of return of spontaneous circulation in the prehospital field. The authors identified obstacles that disturb on-scene performance of cardiopulmonary resuscitation (CPR) for a certain period from 119 emergency medical technicians (EMTs) through a nation-wide paper survey. METHODS: A total of 1273 first grade EMTs and nurses were surveyed. CPR time performed on the scene (without transfer), CPR experiences, self-assessment of CPR skill performance, and both obstacles to performance of CPR on the scene and solutions to overcoming them for continuous on-scene CPR were investigated using a 28-item questionnaire. RESULTS: The average for work experience and the number of CPR experiences of subjects was 6.8+/-4.5 years and 1.9+/-1.7 times/month, respectively. Survey results for CPR times on the scene showed an average of 4.2+/-2.4 minutes, approximately two periods of CPR (30:2x5 cycles). Obstacles to CPR on the scene were investigated as complaints of family members in 791(62.1%) and fatigue lowering CPR quality due to lack of human resources in 536(41.0%); 627(49.3%) of the subjects answered that they had received complaints due to a long stay on the scene. CONCLUSION: In order to increase the survival rate of OHCA patients, CPR on the scene is needed during a certain period in order to achieve a return of spontaneous circulation. Education, amelioration of guidelines, and support for the EMT administrative system are also needed.
Cardiopulmonary Resuscitation* ; Education ; Emergencies* ; Emergency Medical Technicians* ; Fatigue ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Self-Assessment ; Survival Rate ; Surveys and Questionnaires

PURPOSE: The out-of-hospital cardiac arrest (OHCA) survival rate of patients in Korea is lower than the global average and it might be caused by an extremely low rate of return of spontaneous circulation in the prehospital field. The authors identified obstacles that disturb on-scene performance of cardiopulmonary resuscitation (CPR) for a certain period from 119 emergency medical technicians (EMTs) through a nation-wide paper survey. METHODS: A total of 1273 first grade EMTs and nurses were surveyed. CPR time performed on the scene (without transfer), CPR experiences, self-assessment of CPR skill performance, and both obstacles to performance of CPR on the scene and solutions to overcoming them for continuous on-scene CPR were investigated using a 28-item questionnaire. RESULTS: The average for work experience and the number of CPR experiences of subjects was 6.8+/-4.5 years and 1.9+/-1.7 times/month, respectively. Survey results for CPR times on the scene showed an average of 4.2+/-2.4 minutes, approximately two periods of CPR (30:2x5 cycles). Obstacles to CPR on the scene were investigated as complaints of family members in 791(62.1%) and fatigue lowering CPR quality due to lack of human resources in 536(41.0%); 627(49.3%) of the subjects answered that they had received complaints due to a long stay on the scene. CONCLUSION: In order to increase the survival rate of OHCA patients, CPR on the scene is needed during a certain period in order to achieve a return of spontaneous circulation. Education, amelioration of guidelines, and support for the EMT administrative system are also needed.
Cardiopulmonary Resuscitation* ; Education ; Emergencies* ; Emergency Medical Technicians* ; Fatigue ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest ; Self-Assessment ; Survival Rate ; Surveys and Questionnaires

College student volunteers (n = 142) completed a 580 km road march for 21 consecutive days. Each volunteer carried a backpack that weighed 14.1 +/- 1.4 kg on the average. We investigated the incidence and location of blisters associated with the road march using a foot map along with other injuries. Overall, 95.1% of the subjects (135 of 142) sustained one or more injuries. All injured subjects had foot blisters, and 18% had other foot injuries. The most common locations of blister development were the right 5th toe (61%) and the left 5th toe (57%). The little toes seem to have been subjected to the greatest friction and shearing forces. March-related injuries, excluding foot injuries, were ankle pain (12.7%), knee pain (12.7%) and Achilles tendon pain (7.7%). Six subjects (4.2%) needed extra medical treatment for more than 2 weeks prior to returning to their daily lives after completion of the march due to associated injuries. The present study observed a very high incidence rate of injuries (95.1%) associated with the 580 km university students grand road march. These injuries posed an obstacle against completion of the road march and against returning to daily life. Active preventive interventions such as physical therapy and customized reinforced shoes and education program are recommended for reducing incidence rate and severity of injuries.
Adult ; Blister/complications/*epidemiology ; Body Mass Index ; Female ; Foot Injuries/complications/*epidemiology ; Humans ; Incidence ; Male ; Pain/epidemiology/etiology ; Questionnaires ; Spine/radiography ; Students ; Time Factors ; Universities ; *Walking ; Young Adult