ABSTRACT
A healthy 55-year-old man was referred for investigation of palpitations. During an episode of palpitation, the ECG documented two types of tachycardia with differing morphologies. One was a narrow QRS complex tachycardia with a heart rate of 140 beats/min. The other was wide QRS complex tachycardia with a heart rate of 210 beats/min. Transformation from one tachycardia to the other occurred spontaneously. Electrophysiological studies revealed two inducible tachycardia, which were shown to represent atrioventricular nodal reentrant tachycardia (AVNRT) and idiopathic left ventricular tachycardia. Radiofrequency catheter ablation of the slow atrioventricular nodal pathway resulted in alleviation of AVNRT. Following the ablation of AVNRT, the wide QRS complex tachycardia was induced during ventricular pacing. The mapping showed that the origin of the ventricular tachycardia was the mid-inferior wall of the left ventricle. Radiofrequency catheter ablation of the ventricular tachycardia resulted in mitigation cure of the idioventricular left ventricular tachycardia.
Subject(s)
Humans , Middle Aged , Catheter Ablation , Coronary Artery Disease , Electrocardiography , Heart Rate , Heart Ventricles , Stents , Tachycardia , Tachycardia, Atrioventricular Nodal Reentry , Tachycardia, VentricularABSTRACT
Colorectal varix (CRV) is a rare cause of lower gastrointestinal bleeding and usually associated with portal hypertension from liver cirrhosis or portal venous obstruction. Idiopathic CRV have no identifiable underlying cause and can only be diagnosed after the cause of portal or mesenteric vein circulation have been excluded. We report a case of idioipathic CRV presented with rectal bleeding for a week. Colonoscopy revealed markedly dilatated tortuous, and bluish veins in the rectum as well as coexistent adenomatous polyp and internal hemorrhoid. Despite extensive investigation, there was no evidence of portal hypertension or any other cause. Family history was also negative. Although blood transfusions were required, the patient remained asymptomatic without further rectal bleeding.
Subject(s)
Humans , Adenomatous Polyps , Blood Transfusion , Colonoscopy , Hemorrhage , Hemorrhoids , Hypertension, Portal , Liver Cirrhosis , Mesenteric Veins , Rectum , Varicose Veins , VeinsABSTRACT
Relapsing polychondritis is a rare multisystem rheumatic disease,characterized by recurrent and potentially destructive inflammatory lesions of cartilaginous structures.All types of cartilage & other proteoglycan-rich structures may be involved,resulting in auricular chondritis,laryngotracheal chondritis,ocular symptoms,vasculitis,cardiac abnormalities,skin lesions and glomerulonephritis. The disease may be associated with another connective tissue and autoimmune diseases such as rheumatoid arthritis,systemic lupus erythematosus,Sjogren's syndrome and systemic vasculitis. We experienced a 69-year-old female patient who had been previously diagnosed as Sjogren's syndrome,presenting respiratory tract involvement,episcleritis,auricular chondritis and vestibular dysfunction.
Subject(s)
Aged , Female , Humans , Autoimmune Diseases , Cartilage , Connective Tissue , Glomerulonephritis , Polychondritis, Relapsing , Respiratory System , Sjogren's Syndrome , Systemic VasculitisABSTRACT
PURPOSE: We undertook this study to evaluate the usefullness of radiologic placement of subcutaneous infusion ports (SIP). MATERIALS AND METHODS: Between August 1999 and May 2000 we performed 45 implantations of SIP in radiologic suite. Both sonography and fluoroscopy were used for venipuncture and to guide port insertion. We prospectively evaluated 45 systems in 45 patients with solid tumors. RESULTS: Median follow-up time was 189 days (61~352 days). Technical success rate is 100% without any venipuncture-related complications. Early complication rate within 30 days of procedure was 4.4%, including wound dehiscence (n=1) and pocket hematoma and local infection (n=1). Catheter-related infection rate was 6.7% and catheter-related venous thrombosis rate was 4.4%. Mean duration of catheter use was 208 96 days (total, 9,381 days). Overall port survival rate was 38.5%, and four systems (8.9%) were prematurely removed because of catheter tunnel infection (n=1), pocket infection (n=1), and central venous thrombosis (n=2). CONCLUSION: Radiologic placement of SIP had higher success rate and equal or lower complication rate compared with reported conventional surgical technique using anatomical landmarks. Moreover, clinical convenience, resulting from ease of scheduling could make it replace surgical method.