Left ventricular remodeling index (LVRI) was assessed in patients with hypertensive heart disease (HHD) and coronary artery disease (CAD) by real-time three-dimensional echocardiography (RT3DE). RT3DE data of 18 patients with HHD, 20 patients with CAD and 22 normal controls (NC) were acquired. Left ventricular end-diastolic volume (EDV) and left ventricular end-diastolic epicardial volume (EDVepi ) were detected by RT3DE and two-dimensional echocardiography Simpson biplane method (2DE). LVRI (left ventricular mass /EDV) was calculated and compared. The results showed that LVRI measurements detected by RT3DE and 2DE showed significant differences inter-groups (P<0.01). There was no significant difference in NC group (P>0.05), but significant difference in HHD and CAD intra-group (P<0.05). There was good positive correlations between LVRI detected by RT3DE and 2DE in NC and HHD groups (r=0.69, P<0.01; r=0.68, P<0.01), but no significant correlation in CAD group (r=0.30, P>0.05). It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more superiority to LVRI derived from 2DE.
Cardiomegaly/etiology ; Cardiomegaly/pathology ; Cardiomegaly/*ultrasonography ; Coronary Artery Disease/pathology ; Coronary Artery Disease/*ultrasonography ; Echocardiography, Three-Dimensional/*methods ; Hypertension/*complications ; Hypertension/ultrasonography ; Ventricular Remodeling/*physiology

Our purpose was to evaluate the clinical significance of large (>5cm) placental chorioangioma. Obstetrical and neonatal records which were confirmed chorioangioma in pathology and greater than 5 cm in diameter, were reviewed retrospectively from April. 1, 1991, to March. 31, 1996. 11 cases of placental chorioangioma greater than 5 cm were diagnosed prenatally by ultrasonography except one. I'hey were associated with maternal or fetal complications-6 cases of polyhydramnios, 2 cases of PIH, 1 case of neonatal anemia, 2 cases of preterm birth, 2 cases of neonatal hyperbilirubinemia, 1 case of cardiomegaly, 1 case of IUGR and 1 case of oligohydramnios. Nevertheless, there were not remarkable neonatal morbidity and mortality. These uncommon large tumors were often associated with maternal or fetal complications. But, we could get good neonatal outcome through thorough antenatal surveillance.
Anemia, Neonatal ; Cardiomegaly ; Female ; Fetal Growth Retardation ; Hemangioma* ; Hyperbilirubinemia, Neonatal ; Infant, Newborn ; Mortality ; Oligohydramnios ; Pathology ; Polyhydramnios ; Pregnancy ; Premature Birth ; Retrospective Studies ; Ultrasonography

Tetrasomy 18p, one of the most commonly observed isochromosomes, consists of two copies of the p arms on chromosome 18[i(18p)]. It is known as a de novo occurrence of non-disjunction or centromeric mis-division during meiosis II in the vast majority of cases. It has a prevalence of 1/140,000-180,000 live births and affects both genders equally. A 28-year-old woman was referred at 33+2 weeks gestation to rule out fetal congenital heart disease. Her prenatal ultrasonography showed intrauterine growth retardation, cardiomegaly, and imperforate anus. Doppler ultrasonographic finding showed fetal anemia. Tetrasomy 18p was confirmed by conventional karyotyping and fluorescence in situ hybridization. Because of its very low prevalence rate, only several cases of tetrasomy 18p has been reported worldwide and it has not yet been reported in Korea before. Therefore, we report a case of prenatally diagnosed tetrasomy 18p.
Anemia ; Aneuploidy ; Anus, Imperforate ; Arm ; Cardiomegaly ; Chromosomes, Human, Pair 18 ; Coat Protein Complex I ; Female ; Fetal Growth Retardation ; Fluorescence ; Heart Diseases ; Humans ; In Situ Hybridization ; Isochromosomes ; Karyotyping ; Korea ; Live Birth ; Meiosis ; Pregnancy ; Prenatal Diagnosis ; Prevalence ; Tetrasomy ; Ultrasonography, Prenatal

Pericardial tamponade is a life-threatening condition, as accumulated fluid in the pericardial sac can ultimately lead to fatal shock. The clinical identification of cardiac tamponade can be difficult to determine. Accurate diagnosis and prompt intervention are important to prevent adverse outcomes. Unexplained hypotension, enlarged cardiac silhouette, chest pain or dyspnea in a patient with underlying comorbidities, such as cancer, uremia or trauma history, constitute a high-risk population for pericardial effusions. The identifying cause of pericardial effusion and the understanding of the disease process are also important to prevent recurrent pericardial effusions. We report a case of malignant pericardial effusion with tamponade as an initial presentation in a patient with lung adenocarcinoma. The patient had typical features of tamponade such as neck vein distension, hypotension, tachycardia, tachypnea, muffled heart sound and cardiomegaly on chest X-ray. The pericardial effusion was confirmed by bedside echocardiography. Subsequently, ultrasound guided pericardiocentesis was performed and malignant cells were detected in the effusion by cytology. Eventually, lung adenocarcinoma was detected by CT-guided tissue biopsy. Hemodynamic changes, associated underlying causes, clinical presentations, radiologic findings, and the emergency management of cardiac tamponade were reviewed with the current literature.
Adenocarcinoma* ; Biopsy ; Cardiac Tamponade ; Cardiomegaly ; Chest Pain ; Comorbidity ; Diagnosis ; Dyspnea ; Echocardiography ; Emergencies ; Heart Sounds ; Hemodynamics ; Humans ; Hypotension ; Lung Neoplasms ; Lung* ; Neck ; Pericardial Effusion* ; Pericardiocentesis ; Shock ; Tachycardia ; Tachypnea ; Thorax ; Ultrasonography ; Uremia ; Veins

In general, twin pregnancy represents a high-risk pregnancy. The monozygous twin of all twin pregnancy is a real challenge for the obstetrician due to the severe complications that may arise during its development. An extremely uncommon, severe complication of monozygous twin pregnancy, which we recently experienced in Soonchunhyang University Cheonan Hospital, was a monochorionic diamniotic twin pregnancy with acardiac twin-twin reversed arterial perfusion sequence. An acardiac twin presented no heart, underdeveloped inferior part of the body, being transfused by the other fetus (pumping twin) by umbilical vessels. We report a 33-year-old pregnant woman, with a history of in vitro fertilization-embryo transfer in the second pregnancy, who presented with generalized edema, abdominal discomfort, and high blood pressure at 33 weeks' gestation. By ultrasonography, one of the babies is normally developed but in the other baby, head, upper extremities, and cardiac activity cannot be detected. The pumping twin was cardiomegaly, polyhydramnios, absent diastolic wave on the umbilical artery, and small for gestational age. We decided to terminate the pregnancy by primary cesarean section after administration of corticosteroids. The comprehension of this case is compulsory in order to provide maximum survival opportunity to the viable baby.
Adrenal Cortex Hormones ; Adult ; Cardiomegaly ; Cesarean Section ; Chungcheongnam-do ; Comprehension ; Edema ; Female ; Fetus ; Gestational Age ; Head ; Heart ; Humans ; Hypertension ; In Vitro Techniques ; Perfusion* ; Polyhydramnios ; Pregnancy ; Pregnancy, High-Risk ; Pregnancy, Twin ; Pregnant Women ; Twins ; Ultrasonography ; Umbilical Arteries ; Upper Extremity

Wolf-Hirschhorn syndrome (WHS) is a congenital anomaly associated with partial deletion of distal short arm of chromosome 4, characterized by distinct facial anomalies ("Greek-Helmet"), mental and growth retardation and midline defects. The deletion of 2.2Mb area of 4p16.3 is thought to be the critical for WHS. It is reported that the sizes of 4p deletions are variable and the clinical findings are different from classic WHS according to the deleted portion. Recently proximal interstitial deletions have been infrequently reported. On fetal ultrasonography, a fetus of this case was found to have intrauterine growth retardation and multiple somatic anomalies including cleft palate, cleft lip, club foot, and hypoplastic thoracic cage with cardiomegaly, hypoplasia of right kidney and small stomach. At 36th week of gestation, the female baby was born by normal vaginal delivery, and her body weight was only 2.1kg. In spite of vigorous resuscitative measures, she died of respiratory failure on the second day of life. Karyotype was 46,XX,del (4) (p15.2). It is supposed that the size of deleted 4p in patients with WHS doesn't have substantial influence on the phenotype of the disease if the critical region in 4p16.3 is also deleted.
Arm ; Body Weight ; Cardiomegaly ; Chromosomes, Human, Pair 4 ; Cleft Lip ; Cleft Palate ; Female ; Fetal Growth Retardation ; Fetus ; Foot ; Humans ; Karyotype ; Kidney ; Phenotype ; Pregnancy ; Respiratory Insufficiency ; Stomach ; Ultrasonography, Prenatal ; Wolf-Hirschhorn Syndrome*