BACKGROUND AND OBJECTIVES: Intracardiac electrocardiographic finding using as a guide for selective catheter ablation in patients with AV nodal reentrant tachycardia (AVNRT) is not specific. Therefore, we evaluated the efficacy and safety of the anatomical approach for catheter ablation in patients with AVNRT. MATERIALS AND METHOD: Among the patients diagnosed as AVNRT by electrophysiologic study, total 66 patients (M:F=26:40) were included in this study. In the right anterior oblique radiographic view, the septal annulus of tricuspid valve, extending from the most posterior region of the annulus adjacent to coronary sinus ostium (posterior) to His bundle recording site (anterior), was divided into posterior (P), mid (M), and anterior (A) sites. Radiofrequency (RF) energies were applied from the posterior part to the anterior part sequentially along the septal annulus of tricuspid valve until successful ablation. RESULTS: Successful anatomical sites were located in posterior (11 patients), mid (48 patients), and anterior (7 patients) sites. The most patients (62 patients) were treated with slow pathway ablation except 4 patients in whom fast pathway was ablated. Probable slow potentials were observed in 8 patients (12%, 3 in posterior sites and 5 in mid sites). Transient complete AV block followed by first degree AV block and delayed complete AV block was occured in one case whose ablation site was A1. And another 3 patients had postablation first degree AV block. CONCLUSION: In patients with AVNRT, the ablated pathway were different according to successful anatomical site. And RF catheter ablation of atrioventricular nodal reentrant circuit guided by anatomical landmark is safe and efficacious.
Atrioventricular Block ; Bundle of His ; Catheter Ablation* ; Catheters* ; Coronary Sinus ; Electrocardiography ; Humans ; Tachycardia, Atrioventricular Nodal Reentry* ; Tricuspid Valve

The monoclonal antibody Ki-1(CD30) was first described in 1982 and was reported to react selectively with Reed-Sternberg cells in Hodgkins disease, highly activated B and T cells and large cell lymphomas of both T-and B-cell origin. Lymphomatoid papulosis(LyP) is characterized by recurrent erythematous papules or nodules that undergo spontaneous healing with hyperpigmentation and scarring. Histologically, two major types of LyP can be distinguished: type A is characterized by the presence of variable numbers of Ki-1+ large, atypical lymphocytes with some Reed-Sternberg like cells and type B is characterized by Ki-1- atypical cerebriform mononuclear cells similar to those in mycosis fungoides. We report a case of Ki-1+ lymphomatoid papulosis which was histopathologically recognized as a type B lesion but represented a Ki-1 positive reaction.
B-Lymphocytes ; Cicatrix ; Hodgkin Disease ; Hyperpigmentation ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Mycosis Fungoides ; Reed-Sternberg Cells ; T-Lymphocytes

Hailey-Hailey disease(benign familial chronic pemphigus) is a rare autosomal dominant disorder characterized by blisters at sites of friction such as the neck, axillae and groin which are caused by suprabasal epidermal acantholysis. We report two cases of Hailey-Hailey disease in the one family. One of the two cases has asymptomatic multiple longitudinal white bands in the fingernails associated with typical skin lesions. The nail lesions have not been described until reported by Burge in 1992 and it may be a characteristic finding in Hailey-Hailey disease.
Acantholysis ; Axilla ; Blister ; Friction ; Groin ; Humans ; Nails ; Neck ; Pemphigus, Benign Familial* ; Skin

Kaposis sarcoma is a multicentric neoplastic vascular tumor involving the skin or internal organs. We report a case of classic Kaposis sarcoma in a 69-year-old male who had positive serum cytomegalovirus antibodies and disseminated multiple erythematous to purplish colored confluent papules and edema on both lower legs. The histopathological finding showed abnormally proliferated and dilated vessels, vascular spaces, spindle cells, and extravasated erythrocytes. He was treated with radiotherapy, but died due to ventricular tachycardia.
Aged ; Antibodies ; Cytomegalovirus ; Edema ; Erythrocytes ; Humans ; Leg* ; Male ; Radiotherapy ; Sarcoma, Kaposi* ; Skin ; Tachycardia, Ventricular

No abstract available.
Arthritis* ; Osteoarthritis* ; Transforming Growth Factor beta* ; Transforming Growth Factors*

OBJECTIVE: This study was performed to evaluate and compare the embryonic developmental capacity and pregnancy rates in conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with ejaculated sperm or testicular sperm cycles. MATERIALS AND METHODS: Fertilization was examined in the following morning after IVF (group I), ICSI (group II) or TESE-ICSI cycles (group III). Fertilized oocytes were co-cultured with Vero cells until embryo transfer (ET). On day 2 and 5~7, grades of embryos (<4- or > or =4-cell) and blastocysts (BG1, 2, 3 or early) were evaluated. Clinical pregnancy rate was determined by detecting G-sac with transvaginal ultrasonogram. We analyzed the results bychi2 and Student's t-test and considered statistically significant when P value was less than 0.05. RESULTS: Fertilization rate was significantly higher (p<0.05) in group I (79.0+/-21.2%) than in group II and III (56.8+/-21.6% and 36.7+/-25.3%). Cleavage and blastulation rate of group I (95.8+/-13.8% and 59.5+/-25.3%) were significantly higher (p<0.05) than those of group III (83.4+/-18.6% and 40.4+/- 36.5%). Clinical pregnancy rate was significantly higher (p<0.05) in group I and II (40.7% and 41.7%) than that in group III (12.5%). No differences were found in the rates of multiple pregnancy and abortion among three groups. Embryonic implantation rate was higher in group I (15.1+/-20.2%, p<0.05) and II (14.7+/-20.6%, NS) than that in group III (5.1+/-15.6%). However, embryonic implantation rate was increased in ET with blastocyst(s) among three groups. CONCLUSIONS: Fertilized oocytes obtained from TESE-ICSI were harder to be successfully cultured to blastocyst stage for 5~7 days than that from IVF cycles. However, all blastocyst(s) ET increased the embryonic implantation rate equally in IVF, ICSI and TESE-ICSI cycles.
Blastocyst ; Embryo Transfer ; Embryonic Development* ; Embryonic Structures ; Female ; Fertilization ; Fertilization in Vitro ; Oocytes* ; Pregnancy ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic* ; Spermatozoa ; Ultrasonography ; Vero Cells

We report a case of Darier's disease with typical cutaneous and nail lesions in a 50-year-old male patient. He has brownish hyperkeratotic papules on the ant.chest, back, both axilla and groins and verrucous surfaced hypertrophic plaques on the scalp, forehead and both postauricular areas, which were accompanied by a severe itching sensation and malodor. Also he has finger nail lesions such as subungual hyperkeratotic papules, distal wedge shaped notching and multiple longitudinal red lines on the nail plates. Histopathologic features taken from the inguinal area revealed hyperkeratosis, suprabasal clefts and lacuna, protruded villi lined with one layer of basal cells into the cavity and dyskeratotic cells such as corps ronds in the epidermis. Hyperkeratotic papules on the ant.chest, back, both axilla and groins disappeared after systemic treatment withe a low dose of oral etretinate but hypertrophic plaques on the scalp and both postauricular areas still remained clinically and histopathologically. We then the treated postauricular hypertrophic plaques with CO2 laser vaporization and severe malodor with oral isotretinoin and it resulted in a marked improvement.
Acitretin* ; Axilla ; Darier Disease* ; Epidermis ; Etretinate* ; Fingers ; Forehead ; Groin ; Humans ; Isotretinoin* ; Lasers, Gas* ; Male ; Middle Aged ; Pruritus ; Scalp ; Sensation ; Volatilization*

The Ehlers-Danlos syndromes(EDS) are a heterogenous group of inherited connective tissue disorders characterized clinically by skin fragility, skin hyperextensibility, joint hypermobility, and excessive bruising. At least 11 different subtypes of EDS have been classified based on genetic, biochemical, and clinical characteristics. We report a 25-year-old man with EDS type II who presented mild extensibility of skin and joint, skin fragility, and "cigarette paper" like atrophic scar. The EDS type II is more common than other different subtypes. While it may present with subtle clinical features, recognition is important so that good advice can be given to reduce the risks associated with certain careers and sports and to prevent the potential complications of pregnancy and surgery.
Adult ; Cicatrix ; Connective Tissue ; Ehlers-Danlos Syndrome ; Humans ; Joint Instability ; Joints ; Molecular Biology ; Pregnancy ; Skin ; Sports

We have experienced a reexpansion pulmonary edema(RPE) during general anesthesia. This patient has undertaken the decortication operation due to right sided massive pleural effusion and fibrothorax. Generally reexpansion pulmonary edema is believed to oceur only when a chronically collapsed lung is rapidly reexpanded by evacuation of large amount of air or fluid in pneumothorax and pleural effusion. The pathogenesis of RPE is unknown and is probably multifactorial. The implicated etiologies are chronicity of collapse, technique of reexpansion, increased pulmonary vascular permeability, airway obstruction, loss of surfactant and pulmonaty artery pressure changes. The outcome of RPE may be fatal, so physician treating lung collapse must be aware of the possible causes and endeavor to prevent the occurrence of this complieation.
Airway Obstruction ; Anesthesia, General* ; Arteries ; Capillary Permeability ; Humans ; Lung ; Pleural Effusion ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema*

Psoriasis is characterized by disregulation of keratinocyte growth with profound epidermal hyperplasia. Keratinocyte hyperplasia in psoriasis may be expained in part by overproduction of growth factor, and by altered metabolism of the epidemal growth factor receptors (EGFR) in affected skin. The expression of epidermal growth f ictor receptor was investigated by Northern blot and slot-blot analysis of total RNA extrated from biopsies of normal skin and psoriatic lesions. In Northern blot analysis, EGFR-specific mRNA transcripts from psoriatic tissues demonstrated the specificity of hybridizarion with a EGFR mDNA probe. The size of EGFR mRNA transcript was 6.7kb in psoriasis lesions which showed no change of quality. In slot-blot analysis, the levels of EGFR mRNA in poriasis revealed a 1.2 fold to 4.1 fold elevation when compared to normal skin. EGFR were present in all epidermal layers by immunoperoxidase staining, whereas in normal skin they were primarily present in the stratum basalis. These results indicate that the increased expresion of the EGFR gene may be, in part, responsible for the hyperproliferation of the epider nis and that retained EGFR may reflect incomplet; abnormal differentiation in active porasis. This altered process of EGFR metabolism may be involved in the pathogenesis of psoriasis.
Biopsy ; Blotting, Northern ; Epidermal Growth Factor* ; Genes, erbB-1 ; Hyperplasia ; Keratinocytes ; Metabolism ; Psoriasis* ; Receptor, Epidermal Growth Factor* ; Receptors, Growth Factor ; RNA ; RNA, Messenger ; Sensitivity and Specificity ; Skin