BACKGROUND: It has been suggested that mitral regurgitation(MR) of hypertrophic cardiomyopathy is associated with left ventricular outlet pressure gradient, systolic anterior motion of mitral leaflet, abnormal coaptation of mitral valve, malalignment of papillary muscle and elongation of mitral leaflet. To investigate the relation between the degree of MR and the several causing factors, we reviewed 35 patients with hypertrophic cardiomyopathy. METHOD: 35 patients with hypertrophic cardiomyopathy were classified into a group I(24 patients) without mitral regurgitation and with grade 1 MR or a group II(11 patients) with grade 2 and grade 3 MR. Measurement of mitral leaflet was performed on 2-D echocardiography. Distance between interventricular septum and systolic anterior motion(SAM) of the mitral leaflet was measured on M-mode echocardiography. RESULT: 1) Mitral regurgitation was observed in 22 patients(63%) among 35 patient. 2) Left ventricular outflow pressure gradient was 11+/-10mmHg in group I, 79+/-68mmHg in group II(p<0.05). Interventricular septum-SAM distance was 1.0+/-0.3cm in group I, 0.3+/-0.5cm in group II. 3) Anterior mitral leaflet length was 2.76+/-0.51cm in group V, 2.89+/-0.34cm in group II and posterior mitral leaflet length was 1.71+/-0.43cm in group I, 1.80+/-0.29cm in group II(p>0.05). 4) Mitral annulus circumference was 8.57+/-1.13cm in group I, and 8.58+/-0.92cm in group II(p>0.05). CONCLUSION: There was no correlation between the degree of mitral regurgitation and mitral leaflet length or mitral annulus circumference but, left ventricular outflow pressure gradient and interventricular septum-SAM distance were good correlated with degree of mitral regurgitation.
Cardiomyopathy, Hypertrophic* ; Echocardiography ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Papillary Muscles

The solid and hematologic cancer are occasionally accompanied by peripheral blood eosinophilia and suggest tumor necrosis or wide dissemination, but the mechanisms underlying this curious relationship remain obscure. The association of this eosinophilic leukemoid reaction with carcinoma seems to occur must frequently with bronchogenic carcinoma. Several mechanisms for this association were considered: eosinophil chemotactic factor, eosinophil mediated by T-lymphocyte, and eosinopoietic hormone. We are here reporting a case of bronchoalveolar cell carcinoma of lung associated with peripheral eosinophilia in a 60-year-old male patient.
Carcinoma, Bronchogenic ; Eosinophilia* ; Eosinophils ; Humans ; Leukemoid Reaction ; Lung* ; Male ; Middle Aged ; Necrosis ; T-Lymphocytes

STATEMENT OF PROBLEM: There are many studies focused on the effect of shape of fixtures on stress distribution in the mandibular bone. However, there are no studies focused on the effect of the abutment types on stress distribution in mandibular bone. PURPOSE: The purpose of this study is to investigate the effect of three different abutment types on the stress distributions in the mandibular bone due to various loads by performing finite element analysis. Material and method : Three different implant systems produced by Warantec (Seoul, Korea) were modeled to study the effect of abutment types on the stress distribution in the mandibular bone. The three implant systems are classified into oneplant (Oneplant, OP-TH-S11.5), internal implant (Inplant, IO-S11.5) and external implant (Hexplant, EH-S11.5). All abutments were made of titanium grade ELI, and all fixtures were made of titanium grade IV. The mandibular bone used in this study is constituted of compact and spongeous bone assumed to be homogeneous, isotropic and linearly elastic. A comparative study of stress distributions in the mandibular bone with three different types of abutment was conducted. RESULTS: It was found that the types of abutments have significant influence on the stress distribution in the mandibular bone. It was due to difference in the load transfer mechanism and the size of contact area between abutment and fixture. Also the maximum effective stress in the mandibular bone was increased with the increase of inclination angle of load. CONCLUSION: It was concluded that the maximum effective stress in the bone by the internal implant was the lowest among the maximum effective stresses by other two types.
Finite Element Analysis ; Titanium

A ciliated hepatic foregut cyst (CHFC) is a rare cystic lesion consisting of a ciliated pseudostratified columnar epithelium, subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. A CHFC is usually unilocular and occurs at a higher frequency in males. A predilection exists at the medial segment located at the left lobe of the liver. We report the first case of a ciliated hepatic foregut cyst mimicking hepatic metastasis on a CT scan of a patient concurrently afflicted with gastric cancer.
Cilia ; Connective Tissue ; Epithelium ; Humans ; Liver ; Liver Diseases ; Male ; Muscle, Smooth ; Neoplasm Metastasis ; Stomach Neoplasms ; Tomography, X-Ray Computed

The liver is a distinctly unusual locus for a primary leiomyosarcoma. In October 1994, a 64-year-old female patient was admitted with palpable mass at the right upper abdomen for 2 months. Ultrasonography and Computed Tomography revealed a big cystic nature tumor at the right lobe of the liver. A right lobectomy was undertaken. On gross examination of the specimen, the tumor size was measured a 7.5 cm 16.0 cm 4.5 cm. On a cut section, cystic degeneration was showed and the color of the solid component was grayish. Microscopic examination growth pattern of the tumor to be expansive with no capsule. Finally the leiomyosarcoma of the liver was diagnosed with 5 to 6 mitosis per 10 high power fields. In September 1995, follow-up Computed Tomography revealed a recurred mass on segment 4 of the liver. A tumonectomy was performed. Twenty-one months after the second operation, recurrence was noted on the remaining liver and intraabdomen. Debulking surgery of the intraabdominal mass with intraperitoneal chemotherapy was undertaken. We report this case of primary hepatic leiomyosarcoma with a review of the literatures.
Abdomen ; Drug Therapy ; Female ; Follow-Up Studies ; Hepatectomy ; Humans ; Leiomyosarcoma* ; Liver ; Middle Aged ; Mitosis ; Recurrence ; Ultrasonography

OBJECTIVE: There are few published studies which have documented psychopathological abnormalities in patients with of adolescent idiopathic scoliosis (AIS) The aim of this study was to evaluate the psychopathological influence of AIS in Korean 19-year-old males. METHODS: The authors compared the Korean military multiphasic personal inventory (KMPI) military profiles of 105 AIS cases (more than 10 degrees of Cobb's angle without surgical treatment) with the KMPI profiles of 108 normal controls. The AIS group was split depending on Cobb's angle to further evaluate this relation by the severity of AIS. RESULTS: A significantly decreased result on the faking-good response scale and an significantly increased result on the faking-bad response were observed in the AIS group compared to the control (p<0.012). The neurosis scale results, including anxiety, depression and somatization symptoms, were significantly increased in the AIS group compared to the control (p<0.010). The severity level of personality disorder and schizophrenia were also significantly increased in the AIS group (p<0.010). Differences in KMPI scale scores were not related to the severity of AIS. CONCLUSION: Young males with AIS tend to have abnormal results on the multiphasic personal inventory test compared to normal volunteers, suggesting that AIS may be related to psychopathology in the young male group in Korea. Although these psychopathology in AIS were differently observed compared to normal controls, but not interfered with military life. Clinicians are recommended to pay attention the psychopathological traits of patients with AIS.
Adolescent ; Anxiety ; Depression ; Humans ; Korea ; Male ; Military Personnel ; Personality Disorders ; Psychopathology ; Schizophrenia ; Scoliosis

OBJECTIVE: We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH). METHODS: We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group (> or = 48 hours, n = 34). Body weight, total intake and output, serum albumin, C-reactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis. RESULTS: The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH. CONCLUSION: These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.
Body Weight ; C-Reactive Protein ; Cerebral Hemorrhage ; Enteral Nutrition ; Glasgow Coma Scale ; Hospital Mortality ; Humans ; Incidence ; Intensive Care Units ; Intracranial Hemorrhage, Hypertensive ; Multivariate Analysis ; Pneumonia ; Retrospective Studies ; Serum Albumin

PURPOSES: The respiratory tract infection is one of the most prevalent and serious complications following hematopoietic stem cell transplantation (HSCT). Reports not only for the respiratory tract infection but, unlikely for bacteria or fungi, for the infections caused by the respiratory viruses have been rarely reported in Korea. During the winter of 2000~2001, authors wanted to know the prevalence rate of the respiratory tract infection and the kinds of causative microorganisms, especially the community respiratory viruses (CRV). Based on these data, we attempted to evaluate the clinical courses and prognosis of the patients. METHODS: From October 2000 to February 2001, specimens were collected from the patients who visited Catholic hemopoietic stem cell transplantation center, showing symptoms and signs of respiratory tract infection after HSCT. Standard methods have been applied to isolate and identify bacterial and fungal species. Measles was diagnosed based on the typical symptoms, rash, fever, and Koplik spot. For the four different CRV (adenovirus, RSV, influenza virus, parainfluenza virus), multiplex PCR and conventional culture method were used for the identification. RESULTS: Eighty-four specimens were collected from 66 patients for 4 month period. Average age of patients was 35+/-8 years. Sixty patients (90%) were received allogeneic HSCT. Sample collection was performed between 10 and 3,740 days (average 370 days, median 215 days) after HSCT. Forty-seven patients (71.2%) have been received immunosuppressants at the time of respiratory tract infection. Forty patients (60.6 %) were suffered lower respiratory tract infection and forty-four patients (66.7%) had community-acquired infection. Sixty microorganisms were identified from 45 patients out of total 66 patients. Identified microoganisms were bacteria accounting for 2 cases (3.4%), fungi for 11 (18.3%), tuberculosis for 5 (8.3%), and viruses for 42 (70.0%). Among viruses, 16 cases were measles (39%), 14 adenovirus (33%), 9 cytomegalovirus (21%), 2 parainfluenza virus (5%), 1 was influenza virus (2%). However, no RSV was identified. Most of patients showed good prognosis without any complications. Ten (15.2%) out of total 66 patients were expired. The direct cause of death for all 8 among 10 patients was pneumonia. CONCLUSION: Of the respiratory tract infection fol-lowing HSCT, most common causative microorganisms were viruses - measles, adenovirus in order. No case of RSV infection was found. No epidemic must be occurred by influenza virus because only 1 case was found. Fourteen patients were infected by more than one microorganisms. Overall mortality rate was 15.2%. This study is still undergoing and once accumulated data for more than 1 year, it might be possible to work out a strategies of treatment and prevention for respiratory tract infections. We also expect that these data might be able to provide the basis of efficient infection control in HSCT unit.
Adenoviridae ; Bacteria ; Bone Marrow Transplantation ; Cause of Death ; Community-Acquired Infections ; Cytomegalovirus ; Exanthema ; Fever ; Fungi ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Immunosuppressive Agents ; Infection Control ; Korea ; Measles ; Mortality ; Multiplex Polymerase Chain Reaction ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia ; Prevalence ; Prognosis ; Respiratory System* ; Respiratory Tract Infections* ; Stem Cell Transplantation ; Tuberculosis

BACKGROUND: Infections are still a frequent cause of morbidity and mortality in patients with hematologic malignancies. Antimicrobial prophylaxis in neutropenic patients has been practised for several decades. But, recently the rates of occurrence for pathogens have significantly changed (from predominance of gram-negative to gram-positive species) under selective pressure of antimicrobial prophylaxis, and novel resistance mechanisms have emerged. We investigated this study to assess the effectiveness of selective bowel decontamination for preventing infections in granulocytopenic patients who are receiving chemotherapy for acute myelogenous leukemia. METHODS: In a prospective, randomized trial, we evaluated the efficacy of oral ciprofloxacin (250 mg p.o. twice a day), roxithromycin (150 mg p.o. twice a day), fluconazole (50 mg p.o.) in 95 adult patients with acute myelogenous leukemia who undergone intensive chemotherapy. Prophylaxis was begun within 72 hours of initiation of the chemotherapy and continued until the onset of fever, signs or symptoms of infection, serious adverse effect, or recovery of the leukocyte count to > or = 1,000/mm3. RESULTS: 46 decontamination regimen treated patients and 49 control patients were assessable for efficacy. No difference was noted between the two groups in occurrence of fever during neutropenia, time to onset of first fever, sites of infection, duration of using systemic antimicrobials, overall infection rates, infection-related mortality, or hospitalization day. Decontamination regimen reduced the gram-negative infections, but increased the gram-positive infections. Among those who received decontamination regimen, the incidence of resistance to ciprofloxacin was 100% for gram-negative species. And resistance to erythromycin for gram-positive species, irrespective of decontamination, was very much high (90-100%). CONCLUSION: The approach of selective decontamination has not led to fewer febrile episodes or to a lower mortality in neutropenia after chemotherapy for acute myelogenous leukemia. It should be considered that we had better not prescribe decontamination regimen because of increment of infection due to gram-positive species and high resistance rate to fluoroquinolone and macrolide. Additional trials are needed to establish the efficacy of decontamination for other malignancies, aplastic anemia, or bone marrow transplantation.
Adult ; Anemia, Aplastic ; Bone Marrow Transplantation ; Ciprofloxacin ; Decontamination* ; Drug Therapy ; Erythromycin ; Fever ; Fluconazole ; Hematologic Neoplasms ; Hospitalization ; Humans ; Incidence ; Leukemia ; Leukemia, Myeloid, Acute* ; Leukocyte Count ; Mortality ; Neutropenia ; Prospective Studies* ; Roxithromycin