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

No abstract available.
Female ; Ovary* ; Ultrasonics*

No abstract available.
Gastrectomy* ; Stomach Neoplasms*

In lepromatous leprosy, it is generally believed that there is not only defective CMl specific for M. leprae, but also generalized impairment of CMI and in erythema nodosum leprosum, an immune complex-mediated pathogenesis as well cell mediated immune pathogenesis have been proposed. Neopterin is a pyrazinopyrirnidine compound derived from GTP, its raised excretion has been related to activation of T-lymphocyte/macrophage axis. A study was performed to evaluate generalized CMI status in the LL and ENL and to investigate a relationship between levels of urinary neopterin and disease activity. Urinary neopterin was measured by high pressure liquid chromatography in 25 healthy subjects, in 25 patients with LL and in 25 patients with ENL. The results were as follaws 1. Urinary Neopterin levels of patients with LL was 188.9+147.3umol/mol creatinine, which was higher than that of control group(144.8+40.4umol/mol creatinine)(p<0.01). 2. Urinary Neopterin levels of patients with ENL was 884.1+970.5umol/mol creatinine, which was higher than of control group, and patients with LL(p<0.01, p<0.01). 3. Serial measurement of urinary neopterin from 1 week to 13 weeks after treatment of ENL in 4 cases of ENL showed good correlation between urinary neopterin levels and disease activity. In summary, it thus appears that measurement of urine neopterin in leprosy provides generalized CMI status and reliable index for activity of disease.
Axis, Cervical Vertebra ; Chromatography, Liquid ; Creatinine ; Erythema Nodosum* ; Erythema* ; Guanosine Triphosphate ; Humans ; Leprosy ; Leprosy, Lepromatous* ; Neopterin*

Iatrogenic Cushings syndrome is caused by administration of systemic steroids for some disorders, and is clinically characterized by truncal obesity, hypertension, fatigability, amenorrhea, hirsutism, abdominal striae, edema, glucosuria and osteoporosis. We report herein a case of iatrogenic Cushings syndrome in the treatment of atopic dermatitis. The patient, a 32-year-old male, had been diagnosed with atopic dermatitis and was intermittently treated with topical and systemic steroids for 12 years. He revealed facial edema, truncal obesity and striae distensae in both the axilla and abdomen. Steroids are one of the important agents in the treatment of atopic dermatitis but care must be taken in their administration.
Abdomen ; Adult ; Amenorrhea ; Axilla ; Cushing Syndrome* ; Dermatitis, Atopic* ; Edema ; Female ; Hirsutism ; Humans ; Hypertension ; Male ; Obesity ; Osteoporosis ; Steroids ; Striae Distensae

We observed a 55-year-old man who had granuloma pyogenicum on the medial border of the right fifth toe which developed after scratching of the wound. Histopathological findings showed many newly formed capillaries that had prominant endothelial cells and showed varying degrees of dilation without appearance of epidermal collarette signs. We tried intralesional treatment with triamcinolone acetonide (10mg%, 1/week*3). After 3 sessions of treatment, the lesion dramatically regressed nearly to normal size.
Capillaries ; Endothelial Cells ; Granuloma* ; Granuloma, Pyogenic* ; Humans ; Middle Aged ; Toes ; Triamcinolone Acetonide* ; Triamcinolone* ; Wounds and Injuries

OBJECTIVE: The pathogenesis of endometriosis is generally accepted that retrograde menstruation and alterations in the local pelvic immune environment. This study was performed to help elucidate what kind of role various cytokines might play in the pathogenesis of endometriosis. METHOD: Concentrations of peritoneal fluid cytokines were compared in 7 women with normal pelvic finding and 23 women with endometriosis by enzyme-linked immunosorbent assay(ELISA). The patterns of cytokine mRNA expression in 8 ovarian endometrioma and 12 superficial pelvic endometriosis lesions were investigated by reverse transcription-polymerase chain reaction(RT-PCR) amplification method. RESULT: Both IL-6 and IL-10 levels in peritoneal fluid specimens with endometriosis tended to be higher than normal. However, there were no significant differences between peritoneal fluid concentrations of IFN-gamma, TNF-alpha, IL-1beta, and IL-5 of women with and without endometriosis. The levels of IL-6 and IL-10 were significantly higher in peritoneal fluid of women with severe endometriosis compared to women with mild endometriosis. IL-1beta mRNA was expressed in all of 8 deep and 12 superficial endometriosis lesions. IL-5 and IL-6 mRNA were expressed in only two black lesions respectively, however, both were not expressed in the all deep lesions. Expressions of IL-10 mRNA occurred in one red and one black lesion while this was expressed in only one of the deep lesions. TNF-alpha mRNA was expressed in one red and one black lesion of 12 superficial lesions compared with four of the deep lesions. There was the difference between kinds of increased cytokines in the peritoneal fluid and those of expressed cytokines in the endometriotic lesions of patients with endometriosis. CONCLUSION: This study supports the concept that local immunologic factors may be important in the pathogenesis and pathophysiology of endometriosis. The pattern of cytokine mRNA expression of endometriotic lesions would seem to indicate that proinflammatory cytokines such as IL-1beta and TNF-alpha are responsible for the development or progression of endometriosis.
Ascitic Fluid ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunologic Factors ; Interleukin-10 ; Interleukin-5 ; Interleukin-6 ; Menstruation Disturbances ; RNA, Messenger* ; Tumor Necrosis Factor-alpha

PURPOSE: Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. METHODS: Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of < or =3 and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. RESULTS: Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst- suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). CONCLUSION: Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.
Apgar Score ; Asphyxia ; Electroencephalography ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mortality ; Seizures ; Survivors ; Ventilators, Mechanical

No abstract available.
Emphysema* ; Heart Septal Defects, Ventricular*

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*