To assess the effects of regional wall motion abnormalities on left ventricular function, mitral annulus(MA) motion and left ventricular posteior wall(LVPW) motion were studied by M-mode and Doppler echocardiography in 13 normal subjects and 40 mitral valve replaced(MVR) patients. In MVR patients, mitral annulus motion showed significantly delayed contraction(DC) after A2 by 3.7+/-3.0mm in amplitude and 80+/-35 msec in time(normal control; 0.1+/-0.3mm, 35+/-15msec, p<0.01 for both) and reduction in systolic % thickening of LVPW(39.7+/-23.6 VS 63.2+/-18.4%, p<0.01). MVR patients were devied into 2 group according to the amplitude of MA motion, 4mm Group I(n=13, DC> or =4mm) showed increase epicardial excursion of LVPW compared with Group II(n=27, DC<4mm)(Group I vs Group II, 11+/-3.7 vs 8.6+/-2.6 mm, p<0.05). In mechanical prosthetic valve replaced patients(n=22), time relationship between valve opening, mitral flow, peak thining rate of LVPW and valve peak excursion were studied also and the phase difference that are observed in normal subjects, were lost. We interpreted these delayed contraction of mitral annulus motion and epicardial motion increment as muscle fiber architectural abnormalities which might effect on MVR patients as a factor of left ventricular systolic and diastolic dysfunction.
Echocardiography, Doppler ; Humans ; Mitral Valve* ; Ventricular Function, Left

Early diastolic left ventricular relaxation was determined in 20 patients by combined echopressure measurement. 7 normal control cases and 13 cases with valvular regurgitation were studied with reference to incremental delta elastance. The hemodynamic and echocardiographic data were analysed during the phase of decreasing left ventricular elastance (that is, when pressure is decreasing while volume is increasing). Starting from a fixed level of wall stress (40 kdyne/cm2), we determined Incremental Delta Elastance(ratio big up tri, Delta p/big up tri, Delta V) by a constant increase in LV volume(eg. 10 ml/M2 or 20 ml/M2). We named Incremental Delta Elastance at 10 ml/M2 and 20 ml/M2 of LV volume increase as d-E 10 and d-E 20 respectively. In valvular regurgitation, incremental delta elastances were statistically different from those of normal subjects(p<0.01). d-E10 was -1.67+/-0.69(versus -3.38+/-1.75 in normal subjects) mmHgm2/ml and d-E20 was -0.98+/-0.39(versus -1.69+/-0.84 in normal subjects) mmHgm2/ml. d-E 10 and d-E20 were compared with ejection phase indices(ejection fraction, meanVcf) in whole group(n=20). There was significant correlation between d-E and ejection fraction(d-E10 : r=-0.47, d-E20:r=-0.50) p<0.05. There was significant correlation between d-E and meanVcf(d-E10: r=0.53, d-E20: r=-0.57) p<0.05. d-E10 and d-E20 were compared with volume indices(end-diastolic volume index and end-systolic volume index) but no significant correlation was found. Because we evaluated that inotropic state or afterload would influence incremental delta elastance, further study, especially with reference to endsystolic volume index may be needed. The absolute values between d-E10 and d-E20 were different but they were simliar in property. We concluded that incremental delta elastance(d-E10 or d-E20) could be used as a useful index of early diastolic relaxation in chronic valvular regurgitation.
Echocardiography ; Hemodynamics ; Humans ; Relaxation*

Proliferative fasciitis is a benign pseudosarcomatous mesenchymal lesion occurring in the subcutis. The lesion occurs clinically as a tumorous mass that develops within a rather short time in elderly patients. We recently experiecened a case of fine needle aspiration cytology of proliferative fasciitis in the left anterior chest wall of a 72 year-old male patient. The smear revealed two types of cells. One was the large and mostly oval cell with one or two nuclei lying at the periphery of the cell body and abundant basophilic cytoplasm like the ganglion cell. The nuclei were round to oval, had vesicular chromatin and contained prominent nucleoli. The other was the spindle shaped fibroblast with an oval nucleus. The differential diagnosis includes a true tumor such as ganglioneuroma, rhabdomyosarcoma, and liposarcoma and therefore fine needle aspiration cytology is very much indicated in order to exclude these possibilities.
Actinomycosis ; Aged ; Basophils ; Biopsy, Fine-Needle ; Chromatin ; Cytoplasm ; Deception ; Diagnosis, Differential ; Fasciitis ; Fibroblasts ; Ganglion Cysts ; Ganglioneuroma ; Hematuria* ; Humans ; Intrauterine Devices ; Liposarcoma ; Male ; Mass Screening* ; Rhabdomyosarcoma ; Thoracic Wall

BACKGROUND: The generation of the invasiveness in transfromed cells represents an essential step of tumor progression. The primary cause of the scattering of the cells in invasive carcinoma is a loss of the integrity of the intercellular adherens junction often involving loss of a functional cell-cell adhesion molecule E-cadherin. Therefore, the perturbation of E-cadherin function causes diaggregation of tumor cells and may promote the invasion and metastases. OBJECTIVE: The reduction in E-cadherin activity seems to correlate with the infiltrative ability of tumor cells. The purpose of this study was to compare the E-cadherin expression among different cell lines which were normal to undifferentiated and to check the virtual relationaship between E-cadherin and invasiveness. METHODS: We used 5 cell lines, HaCaT, A431, C3, SiHa and HeLa cell. To check the expression patterns and amounts of E-cadherin in each cell line, immunofluorescence staining, Western blot anlysis and Northern blot analysis were done. An in vitro invasion assay using the collagen gel and MRC-5 fibroblast under the influence of HECD-1 antibody which block the E-cadherin function was done to measure the invasiveness of tumor cells. Collagenase activity in culture supernatants of each cell were analyzed by zymography. RESULTS: Immunofluorescence staining revealed a homogenously well preserved pattern in HaCat, A431, C3 cells. SiHa cells showed patch distribution but HeLa cells did not express the E-cadherin. Western blot analysis and Northern blot results largely corresponded with the immunofluorescence results. The in vitro invasion assay revealed invasion into the collagen matrix of the HeLa cells. When HECD-1 antibody was added to the medium, other cells showed partially disrupted stratification. The collagenolytic activity at 72 kDa sixe was detected in the HeLa cell line only. CONCLUSION: There is an inverse relationship between E-cadherin expression and tumor invasion. Therefore, through their regulation of cell adhesion and motility, cadherin plays a crucial role in the suppression of tumor invasion and metastasis.
Adherens Junctions ; Blotting, Northern ; Blotting, Western ; Cadherins* ; Cell Adhesion ; Cell Line* ; Collagen ; Collagenases ; Fibroblasts ; Fluorescent Antibody Technique ; HeLa Cells ; Humans ; In Vitro Techniques ; Neoplasm Metastasis

Authors analysed systolic pressure-volume-stress relations by combined echo-pressure-cineangiographic measurement in 10 normal subjects(Group I) and 37 patients with chronic valvular heart diseases. Patients with chronic valvular heart diseases were divided into 3 groups : Group II ; mitral stenosis(n=9), Group III ; mitral stenosis with aortic regurgitation(n=19). The aims of this study are to find useful left ventricular(LV) contractility indices and evaluate left ventricular contractility at various volume loading states. Studied LV contractility indices were maximal elastance of isovolumic contraction(Eiso), endsystolic pressure-volume ratio(Ees) and slope of regression line in late systolic stress-volume loop(A). Eiso was estimated using an isovolumic contraction model of Sunagawa and A was analysed in a single ejecting beat. Endsystolic volume index(ESVI), end diastolic volume index(EDVI), stress at peak pressure(Speak), cardiac index, Vmax, mean Vcf and ejection fraction were determined also. The obtained results were as follows. 1) Significant correlations were found in whole group(n=47) between Eiso and Ees(r=0.88, P<0.005), Elso and cardiac index(r=0.83, P<0.005), Ees and CI(r=<0.76, p<0.005). Further, these correlation coefficiencies were not different between any two groups of Group I, Group II, Group III, Grouop IV and whole group (p<0.05); that is Eiso or Ees had a constant significance at various loading state. 2) Significant correlation between A and cardiac index was noted in Group I+II+III(n=28, r=0.48, p<0.01), but this correlation coefficiency was significantly different from that of Group IV(n=19, r=0.08); p<0.05. 3) In Group II(patients with mitral stenosis), cardiac index* and EDVI* and stress at peak pressure** were decreased significantly(*:p<0.05, **:p<0.005). But Eiso, Ees, A and all the other idices were not decreased. These findings suggested that left ventricular contractility is not reduced in mitral stenosis. 4) In Group IV(patients with amitral regurgitation with or without aortic regurgitation), **EDVI and ESVI** were increased while Eiso**, Ees, Vmax*, mean Vcf* and cardiac index** were decreased significantly. But ejection fraction and A were not decrease. These findings suggested that ejection fraction and A may not be decreased at volume overload, despite of impaired left ventricular contractility. In summary; Eiso or Ees was evaluated as an useful contractility index which appeared not to be influenced by various volume loading state, while eiection fraction and A to be influenced. Patients with mitral stenosis as a group have reduced cardiac performance which is not due to impairment of left ventricular contractility(muscle function) but to reduced preload.
Constriction, Pathologic ; Heart Valve Diseases* ; Humans ; Mitral Valve Stenosis

No abstract available.
Humans

No abstract available.
Adenocarcinoma ; Neoplasm Metastasis ; Scrotum

No abstract available.

No abstract available.
Staphylococcal Scalded Skin Syndrome*

To evaluate the cardiac functions we examed the M-mode echocardiography with measurements of blood pressure, heart rate and body surface area in 55 normal Korean adults(male 30 persons, female 25 persons) of mean age, 41.7+/-12.3 years. (1) Interventricular septal thickness is 9.5+/-1.7mm and left ventricular posterior wall thickness are 8.6+/-1.5mm at end-diatole, 14.0+/-2.1mm at end-systole. (2) Diastolic and systolic left ventricular internal dimensions are 49.1+/-4.8mm and 31.3+/-5.0mm, respectively. (3) Left ventricular mass by Penn Convention method is 174.4+/-52.1g and left ventricular mass index is 103.2+/-28.8g/m2. (4) Relative wall thickness is 0.35+/-0.06. (5) Left ventricular volumes by Teichholz's method are 114.9+/-27.6ml at diastole and 40.2+/-17.2ml at systole. Therefore, stroke volume is 74.7+/-16.9ml and stroke volume index is 44.5+/-10.7 ml/m2. (6) Cardiac output is 4944+/-1058 ml/min and cardiac index is 2951+/-666 ml/min/m2. (7) Total peripheral resistance is 1454+/-356 dynes-sec-cm(-5) and total peripheral resistance index is 2472+/-623 dynes-sec-cm(-5).m2. (8) Fractional shortening is 36.5+/-6.0% and pressure-volume ratio is 3.27+/-1.19 mmHg/ml. (9) End-systolic wall stress is 61.3+/-19.7x10(3) dynes=cm2. (10) Atrial emptying index is 0.66+/-0.18.
Adult* ; Blood Pressure ; Body Surface Area ; Cardiac Output ; Diastole ; Echocardiography* ; Female ; Heart Rate ; Humans ; Stroke Volume ; Systole ; Vascular Resistance