Mass screening of cardiomegaly by chest X-ray in 144,021 (male 55,491, female 88,530) students of primary, middle and high school (6~17 years of age) in Seoul was performed and electrocardiograms of 217 cases of cardiomegaly were studied. The results were as follows; 1) Cardiomegaly (cardiothoracic ratio over 0.5) was seen in 0.19% of each sex and it was higher in middle and high school ages (12~17 years) than primary school ages (6~11 years). 2) Incidences of abnormal electrocardiogram in cardiomegaly were 59.5% in male and 54.7% of female students. Major abnormal electrocardiograms in cardiomegaly were right ventricular hypertrophy (24.8%), left ventricular hypertrophy (11.6%), biventricular hypertrophy(4.8%), complete right bundle branch block (7.7%), incomplete right bundle branch block (8.7%), first degree A-V block (5.8%) and premature beat (4.3%). 3) Left ventficular hypertrophy was seen most frequently in high school ages (15~17 years) and decreased with decreasing age. Right ventricular hypertropy was seen most frequently in primary school ages (9~11 years) and decreased with increasing age. Biventricular hypertrophy was seen most frequently in primary school ages (6~8 years) and decreased with increasing age. 4) Complete and incomplete right vundle branch block were seen commonly in 12~17 years of age and first degree A-V block in 9~11 years of age.
Female ; Male ; Humans ; Incidence

No abstract available.
Hemodynamics* ; Hypertension, Pulmonary*

No abstract available.
Aortic Aneurysm, Thoracic* ; Aortic Coarctation*

No abstract available.
Cicatrix* ; Contracture* ; Syndactyly*

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

No abstract available.

A fifteen-year-old boy was transported to our hospital emmergency room due to sudden onset of chest pain, hemoptysis and dyspnea. He was diagnosed as persistent ductus arteriosus that had developed acute bacterial endocarditis with pulmonic valve vegetation and pulmonary embolism with pulmonary infarction. After conservative antibiotic therapy (vancomycin+aminoglycoside), we operated this patient successfully - patch closer of the ductus and pulmonary valve valvuloplasty - under the cardiopulmonary bypass.
Cardiopulmonary Bypass ; Chest Pain ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Dyspnea ; Embolism* ; Endocarditis, Bacterial* ; Hemoptysis ; Humans ; Male ; Pulmonary Artery* ; Pulmonary Embolism ; Pulmonary Infarction ; Pulmonary Valve

A fifteen-year-old boy was transported to our hospital emmergency room due to sudden onset of chest pain, hemoptysis and dyspnea. He was diagnosed as persistent ductus arteriosus that had developed acute bacterial endocarditis with pulmonic valve vegetation and pulmonary embolism with pulmonary infarction. After conservative antibiotic therapy (vancomycin+aminoglycoside), we operated this patient successfully - patch closer of the ductus and pulmonary valve valvuloplasty - under the cardiopulmonary bypass.
Cardiopulmonary Bypass ; Chest Pain ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Dyspnea ; Embolism* ; Endocarditis, Bacterial* ; Hemoptysis ; Humans ; Male ; Pulmonary Artery* ; Pulmonary Embolism ; Pulmonary Infarction ; Pulmonary Valve

BACKGROUND: The endothelium-dependent vasorelaxation has been largely accounted for by the release of nitric oxide (NO). Three distinct isoforms of NO synthases (NOS) have been characterized, i.e., brain(bNOS), inducible (iNOS), and endothelial constitutive (ecNOS). Although hypertension hasbeen associated with a vascular endothelial dysfunction, changes in the vascular expression of NOS isoforms have not been established. The present study was aimed at exploring the vascular expression of NOS isozymes in hypertension. MATERIAL AND METHOD: Two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertension were induced in rats. The expression of different NOS isozymes in the thoracic aorta was determined by Western blot analysis. The vascular tissue contents of nitrites were measured by colorimetric assay. RESULT: Arterial blood pressure was significantly higher in experimental groups of 2K1C and DOCA-salt rats compared with their corresponding control rats. The vascular expression of bNOS as well as that of ecNOS was decreased in both models of hypertension. iNOS was not changed in DOCA-salt hypertension, but was also decreased in 2K1C hypertension. The vascular contents of nitrites were significantly decreased in DOCA-salt as well as in 2K1C hypertension. CONCLUSION: These results suggest that 2K1C and DOCA-salt hypertension are associated with decreases in the vascular expression of NOS isozymes and nitrite contents.
Animals ; Aorta, Thoracic ; Arterial Pressure ; Blotting, Western ; Desoxycorticosterone ; Hypertension* ; Isoenzymes ; Nitric Oxide Synthase* ; Nitric Oxide* ; Nitrites ; Protein Isoforms ; Rats ; Vasodilation

Perimembranous ventricular septal defects(PMVSDs) are the most common type of ventricular septal defects(VSDs) and consist morphologically of deficiency of the membranous septum and variable portions of the adjacent muscular septum. Repair of VSD has begun via a right ventriculotomy. Even with this exposure, however, it mght lead to ventricular dysfunction. Transatrial exposure of VSDs is known to a versatile approach to PMVSDs and even malalignment defects can be repaired by this METHOD: Although transatrial exposure can be improved by taking down the atrioventricular valve at the annulus, surgeons have been hesitant to do so because of concern for valvular competence. Therefore, this study was undertaken to clarity the effects of transannular approach of tricuspid valve (TATV) at operation of PMVSD. During last 5 years, twenty eight cases from 96 patients of PMVSD were closed by TATV and follow up study was done from 3 months to 33 months and results were obtained as follows. 1. Age at operation was from 4 months to 38 years and most patients(17, 62%) were above 5 years. 2. Preoperative pulmonary-systemic flow ratio(Qp/Qs) was ranged from 1 to 2.8 and 22 patients(79%) were less than 2. 3. Peak systolic pulmonary artery pressure was below 30mmHg in 8, 30-50mmHg in 17, above 50mmHg in 3 patients and 25 patients(89%) were less than 50mmHg. 4. Preoperative tricuspid regurgitation(TR) is none in 12, trivial in 6, mild in 3, moderate in 5, severe in 2 patients but postoperative TR was none in 18, trivial in 6, mild in 4 patients, so TR in most patients had decreased or not. 5. Indications for operation were based on the presence of a significant shunt. However, in patients with small shunts, indications for operation were included additional factors, tricuspid valve pouch, RVOT obstruction(right ventricular outflow tract obstruction), subacute bacterial endocarditis and associated anomalies. 6. There were no hospital deaths and residual shunts in postoperative echocardiography. Therefore, TATV is especially a good method in PMVSD where patients have trcuspid valve pouch. And it is a safe and effective technique that improves exposure for PMVSD repair and does not adversely affect tricuspid valvular competence.
Echocardiography ; Endocarditis, Subacute Bacterial ; Follow-Up Studies ; Humans ; Mental Competency ; Pulmonary Artery ; Tricuspid Valve ; Ventricular Dysfunction