There is no doubt that the diastolic dysfunction of the left ventricular plays an important role in the pathophysiogy of clinical heart faliure in some patients, if not all, and that many hypertensive subjects manifest diastolic dysfunction of the left ventricle in its early hypertensive stage. But yet, it is not clear which paramenter is most sensitive and/or specific, and consistent with pathophysiologic states. In order to have an insight into the problems, 30 hypertensives and 30 normotensive subjects were studied by phonocardiogram and pulsed Doppler echocardiogram at the left ventricular inflow and then isovolumic relaxation time(A2D time), early diastolic deceleration time(EDDT), early diastolic deceleration rate(EDDR), late diastolic time(LDT), E.A velocity ratio[E/A(v)]and E/A area ratioA(a)] were measured and calculated. And the values of each parameters of different groups were subgrouped according to the severity of the hypertension(Group A:mild, B:moderate and C:severe hypertension) and according to the LV mass(Group D:LVMI<125g/m2, GroupE:LVMI> or =125g/m2) were compared with those of the normal control subjects and also between each subgroups. The results were as follows : 1) In the 30 normotensive subjects, A2D time was averaged out 60.8+/-12.5msec, E/A(v) 1.55+/-0.59, E/A(a) 2.61+/-1.35, EDDT 1.35+/-37.8msec, EDDR8.3+/-4, 6m/sec2 and LDT 151+/-42.2msec. 2) In group A, A2D time was significantly prolonoged(82.5+/-26.0msec, p<0.005) and E/A(v) markedly decreased(1.12+/-0.40, p<0.05) compared to those of normotensive group. 3) In group B, A2D time was significantly prolonged(78+/-20.8msec, p<0.005), and E/A(v)(0.92+/-0.42, p<0.005) and EDDR(4.9+/-1.5m/sec2, p<0.05) were significantly decreased compared to those of the control group. 4) In group C, A2D and EDDT were increased(p<0.005, p<0.05 respectively) while E/A(v) and EDDR decreased(p<0.01, p<0.05 respedtively), while E/A(v) and EDDR decreased(p<0.01, p<0.005 respectively). 5) In group D, A2>D and EDDT were significantly prolonged(p<0.005), while E/A(v), E/A(a) and EDDR wer significantly decreased(p<0.005, p<0.05 respectively). 6) In group E, A2D and EDDT were significantly increased(p<0.005, p<0.05 respectively), while E/A(v) and EDDR significantly decreased(p<0.005, p<0.05 respectively). Above results suggest that diastolic function of the left ventricle can be deteriorated in the hypertensive subjects before systolic dysfunction is apparent even in the mild hypertensives and in the patients devoid of hypertensive hypertrophy of the left ventricle.
Deceleration ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Relaxation

The left ventricular hypertrophy(LVH) in the hypertensive patients is known to be associated with relatively higher risk for cardiovascular morbidity and mortality. In this sense the reversal of LVH with blood pressure control, if attained, could yeild an additional benefit of reducing cardiovascular morbidity and/or mortaility associated with hypertension. However pathogenesis of LVH, the attitude of the LVH to regerss with blood pressure control in a particular patient and whether the regression is really beneficial are not clear. In order to see the effect of angiotensin converting enzyme(ACE) inhibitors on LVH and the age group difference of the LVH regresion, if attainable, 26 hypertensive patients with LVH(LVMI:Left Ventricular Mass Index>125g/m2) were treated with enalapril or captopril for more than 12 weeks and the LVMI followed and the regression rates in younger group "A"(less than 50 years of age) and elder group "B" were compared(LVMI, level of blood pressure, kinds and dosage of enalapril or captopril were not different between the two groups). The LVMI was significantly decreased in both groups, in group A from 191.6+/-74.9g/m2 to 139.7+/-52.0g/m2, and in group B from 185.5+/-58.7g/m2 to 163.9+/-58.7g/m2. In group A the percent decrease of LVMI was significantly higher than that of group B(25.3+/-14.9% versus 10.3+/-8.6%, p<0.005). Above results suggest that enalapril and captopril are equally effective in reducing LVMI in hypertensive patients with LVH and the regression of the LVMI is more marked in the younger age group in this relatively short-term treated small population study.
Angiotensin-Converting Enzyme Inhibitors ; Angiotensins* ; Blood Pressure* ; Captopril ; Enalapril ; Humans ; Hypertension ; Hypertrophy, Left Ventricular* ; Mortality ; Peptidyl-Dipeptidase A*

Cystic dilatation of bile duct, so called choledochal cysts are a well documented abnormalities. Although choledochal cyst is a relatively rare disease, the number of reports have been increasing especially in tht Orient. It may be easily overlooked by the conventional diagnostic methods, such as upper gastrointestinal series, intravenous cholangiography and abdominal ultrasonogrsphy. Recent advances on diagnostic methods, such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography had been helpful in demonstrating choledochal cysts. 29 patients with choledochal cysts who had been admitted in Hanyang Universty Hospital between September l981 and August 1991 were reviewed and the clinical endoseopic and rediographic findings were discussed comparing with that from foreign literatures. (continue...)
Bile Ducts ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Dilatation ; Humans ; Rare Diseases

Von Meyenburg complexes (VMC) have many synonyms such as bile duct hamartomas and biliary hamartoma. These rare benign disorders are considered as congenital diseases caused by malformed differentiation of ductal plate. The diagnosis of VMC by common radiologic modality such as ultrasound and computed tomography was nearly impossible until the emergence of cholangiopancreatography by magnetic resonance imaging (MRCP) and the pathologic examination was the only way to confirm the diagnosis of VMC. But MRCP is now considered as most accurate noninvasive method for diagnosis of VMC. We report a histologically proven case of VMC associated with calculous cholecystitis, cerebral aneurysm and renal cortical cyst. To our knowledge, no comparable case has been reported and this would be the only second reported case of VMC, which was diagnosed by MRCP.
Bile Ducts ; Cholecystitis* ; Diagnosis ; Hamartoma ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Ultrasonography

No abstract available.
Adenocarcinoma* ; Neurofibromatoses* ; Pancreas*

Lipomas are among the most common of all benign neoplasma and occur more frequently over the back, between the shoulders, and on the back of the neck. They are usually subcutaneous in origin, and characteristically multilobulated masses of fatty tissue that vary from small nodules to large masses weighing several kilograms.A mass in the anterior part of the neck may be initially thought to be thyroid nodules and then other cervical masses should be considered. Ultrasonographic examination of benign lipoma demonstrates solid and echogenic mass and may differentiate nonthyroid from thyroid masses. When lipoma is clinically suspected, the use of CTs can establish the correct diagnosis without the use of thyroid hormone suppression or the need for urgent surgery.We experienced a case of anterior cervical mass in a 51-year-old male patient presenting a non-tender and soft mass rapidly growing for recent several months and moved with swollowing, and diagnosed his case as benign lipoma using ultrasonography, computed tomographic scan, and fine niddle asperation biopsy and therefore when we encounter patients with anterior neck mass, we should consider benign lipoma mimicking thyroid nodule.
Adipose Tissue ; Biopsy ; Diagnosis ; Humans ; Lipoma ; Male ; Middle Aged ; Neck ; Shoulder ; Thyroid Gland ; Thyroid Nodule ; Ultrasonography

Henoch-Schonlein purpura(anaphylactoid purpura) is a necrotizing vasculitis of small vessels in which systemic manifestation include palpable purpura on the lower extremities and buttocks due to leukocytoclastic vasculitis of dermal vessels; arthralgia of large joints, usually the knees and ankles; gastronitestinal involvement with colic and bleeding; and renal ievolvement, usually with a focal necrotizing glomerulonephritis. Gastrointestinal involvement occurs in about two thirds of all pediatric cases and in about,one third of adult cases, Any bowel segment may be involved, but the jejunum and ileum are most frequently affected. With a brief review of the literature, we report a case of H-S purpura involving stomach and duodenum.
Adult ; Ankle ; Arthralgia ; Buttocks ; Colic ; Duodenum ; Glomerulonephritis ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Joints ; Knee ; Lower Extremity ; Purpura* ; Stomach ; Upper Gastrointestinal Tract* ; Vasculitis

BACKGROUND: Complementary and alternative medicine (CAM) use is popular and current trend suggests a demand for CAM education during residency training. Our objective was to assess perception, the need and experience of CAM education for family practice residents by training faculty. METHODS: A questionnaire was administered to family physicians (n=262) who were registered in the Korean Academy of Family Medicine as residency training faculty between February and May 2006. RESULTS: One hundred and seven (40.8%) of 262 faculty completed the questionnaires. Eighty three (77.6%) respondents recognized the need of CAM education during residency training and fifty two (46.8%) respondents have already educated some kind of CAM. Thirty nine (36.4%) respondents replied that partial CAM educational contents were given out at conferences. Seventy eight (72.9%) respondents recognized the need for educating residents on the general outlines of CAM along with education on verified CAM. Sixty six (61.7%) respondents replied that the Korean Academy of Family Medicine should host such education. CONCLUSION: Most family practice training faculty recognized the need for providing CAM education for family practice residents during residency training, but about an half of family practice training faculty did not have experiences of CAM education.
Complementary Therapies ; Congresses as Topic ; Surveys and Questionnaires ; Education, Medical ; Family Practice ; Humans ; Internship and Residency ; Physicians, Family ; Republic of Korea

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) has been reported in a great variety of diseases and disorders of central nervous system (CNS). However, there has been only 7 cases of SLE reports in association with SIADH and correlation of SIADH and SLE has not been clearly demonstrated. Previous cases showed improvement of SIADH as lupus activity resolved during treatment. We report a case of SLE in association with SIADH which showed improvement during treatment with prednisolone and cyclophosphamide.
Central Nervous System ; Cyclophosphamide ; Humans ; Inappropriate ADH Syndrome ; Lupus Erythematosus, Systemic* ; Prednisolone

Background/Aims: Adenoid cystic carcinoma (ACC) is a rare salivary gland tumor characterized by indolence, with a high rate of local recurrence and distant metastasis. This study aimed to investigate the effect of concurrent chemoradiation (CCRT) on locally advanced unresectable ACC. Methods: We retrospectively analyzed clinical data from 10 patients with pathologically confirmed ACC of the head and neck who received CCRT with cisplatin in Seoul National University Hospital between 2013 and 2018. Results: Ten patients with unresectable disease at the time of diagnosis or with positive margins after surgical resection received CCRT with weekly cisplatin. Eight patients (80%) achieved complete remission, of which three later developed distant metastases without local relapse; one patient developed distant metastasis and local relapse. Two patient achieved partial remission without progression. Patients experienced several toxicities, including dry mouth, radiation dermatitis, nausea, and salivary gland inflammation of mostly grade 1 to 2. Only one patient showed grade 3 oral mucositis. Median relapse-free survival was 34.5 months (95% confidence interval, 22.8 months to not reached). Conclusions CCRT with cisplatin is effective for local control of ACC with manageable toxicity and may be an effective treatment option for locally advanced unresectable ACC.