Successful Control of Double Tarchycardia Using Radiofrequency Catheter Ablation

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.

A Case of Splenic Infarction after Histoacryl(R) Injection in Gastric Varix Bleeding / 대한소화기내시경학회지

Histoacryl(R) (n-butyl-2-cyanoacrylate) has been used successfully for the treatment of gastric variceal bleeding. The reported complications of Histoacryl(R) injection therapy include bleeding, perforation, stenosis and embolism. Here we describe a case of splenic infarction as an unusual complication of Histoacryl(R) injection. A 51-year-old male patient with liver cirrhosis was admitted due to acute gastric varix bleeding. Sclerotherapy was successfully carried out using Histoacryl(R) mixed with lipiodol (2.6 mL). 4 days later, he complained left upper quadrant pain and developed a fever of 38.2degrees C. Abdominal CT showed wedge-shaped hypodense area in the spleen compatible with infarction. He was treated conservatively. The fever and abdominal pain gradually subsided and he was discharged without significant problems.

A Case of Pneumatosis Cystoides Intestinalis Presented with Nonspecific Symptom / 대한소화기내시경학회지

Pneumatosis cystoides intestinalis is a relatively rare condition, characterized by multiple gas-filled cysts of varying size in the wall of gastrointestinal tract. Although the etiology of pneumatosis intestinalis remains uncertain, the possibility that both the gas-forming bacteria and mechanical theories develop pneumocysts has recently been advocated. We experienced a case of pneumotosis cystoides intestinalis found by colonoscopy in a 31-year old woman with intermittent abdominal pain.

A Case of Cured Diabetes Mellitus after Pheochromocytoma Removal / 대한내분비학회지

Pheochromocytoma is usually associated with a combination of various clinical manifestations caused by the overproduction of catecholamines. It is frequently accompanied by impaired glucose tolerance operating through 2-and-adrenergic mechanisms. A 41-year-old-woman was admitted to the hospital because of poorly-controlled diabetes mellitus and hypertension. She had suffered intermittent paroxysmal attacks of headache and chest discomfort and had been treated intermittently over a 2 year period for diabetes mellitus and hypertension. At admission, the levels of serum epinephrine, norepinephrine urinary excretion of total metanephrine, and VMA were all abnormally elevated. Adrenal CT showed a well-defined, homogenous mass in the right adrenal region and the tumor was diagnosed as pheochromocytoma. After tumor resection, the increased blood level of catecholamines, the urinary excretion of total metanephrine, and VMA were normalized, as was the hyperglycemia state. Diabetes mellitus of the patient was considered permanently resolved after tumor removal by the result of glucose tolerance in 75g oral glucose tolerance test.

Radiologic Placement of Subcutaneous Infusion Ports in Cancer Patients: Analysis of 45 Cases / 대한암학회지

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.

A Case of Nonbacterial Thrombotic Endocarditis in Small Ventricular Septal Defect

Nonbacterial thrombotic endocarditis is characterized by the presence of valve-leaflet or endocardial vegetation composed chiefly of fibrin and trapped platelets, without an associated inflammatory reaction or evidence of microorganism. Recent emphasis has been affixed to the significant morbidity and mortality rates as a results of major systemic arterial embolization and infective endocarditis. It is seen most commonly in patients with malignant neoplasms, disseminated intravascular coagulopathy, uremia, burn, SLE, cardiac valve disease. We experienced a case of nonbacterial thrombotic endocarditis developed in patient with small congenital ventricular septal defect, and vegetation on the left ventricular septum other than right ventricle as known most commonly affected.