No abstract available.
Precursor Cell Lymphoblastic Leukemia-Lymphoma*

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*

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.
Blood Pressure*

PURPOSE: Hepatitis B virus infection is prevalent in Korea. Active immunization of Hepatitis B has been proceeded extensively for the last decade. This study was performed to estimate the negative rate of anti-HBs after immunization and to evaluate the effect of revaccination among Korean children between 1995 and 1997, as well as to determine a proper revaccination schedule. METHODS: Anti-HBs was measured with enzyme immunoassay. Hepatitis B revaccination was performed on nonresponders, those who were previously vaccinated and whose anti-HBs titers were under 10mIU/mL. Group A was revaccinated one dose of the same amount of the previous vaccine. Group B was given three doses of the same amount of the vaccine. Group C was given one double dose of the vaccine. The seroconversion rate and geometrical mean titer were measured one month later. RESULTS: Negative anti-HBs rate was 14.5% in children who had been vaccinated. The seroconversion rate was high in all revaccination groups(86.7-94.7%). Three doses of revaccination had no significant difference from one dose of revaccination. There was no positive effect of double dose of revaccination in comparison with the usual dose. CONCLUSION: In our study, one dose of hepatitis B vaccine is as effective as three doses or double dose of hepatitis B vaccine for the nonresponsive children. We recommend administering one dose of hepatitis B vaccine to those children whose three anti-HBs titer is under 10mIU/mL and examining of the anti-HBs titer one month later after revaccination.
Appointments and Schedules ; Child* ; Hepatitis B Vaccines ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Immunization, Secondary* ; Immunoenzyme Techniques ; Korea ; Vaccination

No abstract available.

This presentation is a case of osteomalacia, the cause of which was a nutritional deficiency. The patient was a 42-year-old female who had pseudofractures of ribs, ulnae, pelvic raml, the right second metacarpai bone and both femoral necks. Following treatment by medication combined with internal fixation of the femoral necks, the result was good.
Adult ; Female ; Femur Neck ; Humans ; Malnutrition ; Osteomalacia ; Ribs ; Ulna

No abstract available.
Seizures*

We immunized sixty two healthy subjects with the five different viral titers (300, 500, 1000, 1500 and 2000 plaque forming unit; pfu) of the MAV/06 strain of live attenuated Varicella-zoster virus (VZV) in order to gain sufficient information on safety and immuogenicity as a vaccine strain. Humoral immunity of all vaccine recipients was tested by the fluorescent antibody to membrane antigen (FAMA) assay and Enzyme-linked immunosorbent assay (ELISA) for the quantitative detection of IgG antibody. We tested neutralized antibody in 62 subjects by plaque reduction neutralization test (PRNT50). All of thirty two subjects with initial seronegative response had antibody by FAMA method at four weeks after immunization with four different preparations of dosage. The geometric mean titers (GMTs) of VZV antibody to membrane antigen was 160.9 in 6 subjects with 1500 pfu group; 83.3 in 14 subjects with 1000 pfu group: 116.2 in 7 subjects with 500 pfu groups and 72.0 in 6 subjects with 300 pfu group. Thirty subjects who had VZV antibody at the time before immunization demonstrated elevated antibody titer by FAMA assay and PRNT50 test. Side reactions of the vaccination was not demonstrated in all cases.
Chickenpox* ; Enzyme-Linked Immunosorbent Assay ; Herpesvirus 3, Human ; Immunity, Humoral ; Immunization ; Immunoglobulin G ; Membranes ; Neutralization Tests ; Vaccination