Echocardiography was done with Ekoline 20 model of Smith Kline Instrument in 91 patients of mitral valvular heart disease, 46 with mitral stenosis, 10 with mitral insufficiency, 38 with mitral stenoinsufficinency and 115 normal controls. The results obtained are as follows. 1. Right ventricular dimension was 13.61+/-5.61 mm/sq m. in normal controls, 16.50+/-5.06mm/sq m. in mitral stenosis, 20.17+/-3.28mm/sq m. in mitral insufficiency, 18.61+/-8.48mm/sq m. in mitral stenoinsufficiency revealing significant increment in all mitral valvular disease groups but there was no significant difference btw. each disease groups. 2. Left ventricular end-diastolic dimensions was 29.83+/-7.06mm/sq m. in normal controls, 41.57+/-7.77mm/sq m. in mitral insufficinency, 38.48+/-10.22mm/sq m. in mitral stenoinsufficiency revealing significant increment but there was no significant difference btw. mitral stenosis and normal controls. 3. Left atrial dimension was 17.57+/-4.96mm/sq m. in normal controls, 33.22+/-5.32mm/sq m. in mitral stenosis, 35.96+/-7.35mm/sq m. in mitral insufficiency, 35.00+/-8.22 in mitral stenoinsufficiency revealing significnat increment in whole mitral valvular disease. 4. E-F slope was 90.76+/-30.20mm/sec in normal controls 18.08+/-10.3mm/sec in mitral stenosis, 29.52+/-19.3mm/sec in mitral stenoinsufficiency revealing marked decrement. In mitral insufficiency, it was 65.3+/-45.4mm/sec revealing significant decrement but not so severe as previous. 5. There was no significant difference between normal controls and mitral valvular disease in valve excursion. 6. Left atrial dimension to aortic root size was 1.13+/-0.31 in normal controls, 1.77+/-0.63 in mitral stenosis, 1.56+/-0.60 in mitral regurgitation and 1.82+/-0.56 in mitral stenoinsufficinecy revealing significant increment in whole mitral valvular heart disease.
Echocardiography* ; Heart Valve Diseases* ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis

Lidocaline if frequently administered as a component of an anesthetic : for local or regional nerve blocks, to mitigate the autonomic response to laryngoscopy and tracheal intubation, to suppress the cough reflex, and for antiarrythmic therapy. Diazepam dectease the potential central nervous system (CNS) toxicity of local anesthetic agents but -may modify the sitmulant action of lidocaine in addition to their own cardiovascular depressant. The potential cardiovascular toxicity of local anesthetics may be enhanced by the concomitant administration of diazepam. This study was designed to investigate the effects of lidocaine dose and pretreated diazepam to cardiovascular system and plasma concentration of lidocaine. Lidocaine in 100 mcg/kg/min, 200 mcg/kg/min, and 300 mcg/kg/min was given by sequential infusion to dogs anesthetized with halothane-nitrous oxide (Group I). And in group II, after diazepam pretreatment, lidocaine was infused by same way when lidocaine was administered in 100 mcg/kg/min, the low plasma levels (3.97+/-0.22-4.48+/-0.36 mcg/ml) caused a little reduction in cardiovascular hemodynamics. As administered in 200 mcg/kg/min, 300 mcg/kg/min, the higher plasma levels (7.50+/-0.66-11.83+/-0.59 mcg/ml) reduced mean arterial pressure (MAP), cardiac index (CI), stroke index (SI), left ventricular stroke work index (LVSWI), and right ventricular stroke work index (PVSWI) and incresed pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), systemic vascular resistance index (SVRI), but was assciated with little changes of heart rate (HR), mean pulmonary artery pressure (MPAP), and pulmonary vascular resistance index (PVM). When lidocaine with pretreated diazepam was administered in 100 mcg/kg/min, the low plasma level, the lower level than when only lidocaine administered. reduced MAP, but was not changed other cardiovascular hemodynamics. While lidocaine was infused in 200 mcg/kg/min, 300 mcg/kg/min in dogs pretreated diazepam, the higher plasma level (7.64+/-0.79-13.79+/-0.82 mcg/ml) was maintained and was associated with reduced CI, SI, LVSWI and incresed PAWP, CVP, SVRI but was a little changes of HR, MPAP, PVRI. After CaCl2 administeration, CI, SI, SVRI, LVSWI was recovered but PAWP, UP was rather incresed than recovered. The foregoing results demonstrate that pretreated diazepam imposes no additional burden on cardiovascular system when a infusion of large dose of lidocaine is given to dogs anesthetized with halothanenitrous oxide. But caution may be advised if the addition of lidocaine is indicated in subjects who have impared autonomic nervous system and who are in hypercarbic, hypoxic, or acidotic states.
Anesthetics ; Anesthetics, Local ; Animals ; Arterial Pressure ; Autonomic Nervous System ; Cardiovascular System* ; Central Nervous System ; Central Venous Pressure ; Cough ; Diazepam* ; Dogs* ; Heart Rate ; Hemodynamics ; Intubation ; Laryngoscopy ; Lidocaine* ; Nerve Block ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reflex ; Stroke ; Vascular Resistance

OBJECTIVES: The purpose of this study is to investigate the factors related to long-term hospitalization of schizophrenia. METHODS: The subjects were inpatients with schizophrenia who were constantly hospitalized for more than 12 months and their caregivers. They were compared with schizophrenia with no previous experience of sustained hospitalization for more than 12 months and their caregivers. Demographic and clinical data, Korea version of the Positive and Negative Symptom Scale, functional disability and family burden scale were analyzed. RESULTS: In this study long-term hospitalization of schizophrenia was influenced by the following measures. First, primary caregivers variables such as parents/non-parents and cohabitation with patients, second, negative symptom severity of passive/apathetic social withdrawal and lack of spontaneity and flow of conversation, and third, functional disability of go to hospital/take a dose regularly and using public transportation/facilities were associated with long-term hospitalization. And they were significant in logistic regression analysis. CONCLUSION: The above results suggest that long-term hospitalization of schizophrenic patients in Korea might be affected by caregiver's factor, negative symptoms, and functional disability.
Caregivers ; Hospitalization* ; Humans ; Inpatients ; Korea ; Logistic Models ; Schizophrenia*

No abstract available.
Anemia, Hypoplastic, Congenital*

BACKGROUND: Cyclosporin A (CsA), a potent immunosuppressant, has been reported to be effective in the treatment of severe atopic dermatitis (AD). OBJECTIVE: The aim of this study was to evaluate the efficacy and side-effects of CsA in Korean patients with severe AD. MATERIALS AND METHODS: 16 patients with recalcitrant AD took CsA for at least 6 weeks. Among them, 11 patients were followed up for more than 16 weeks. Initial dose was 5mg/kg/day (maximum 300 mg/day) and the dose was reduced according to their therapeutic responses. SCORAD (Scoring AD) was used to evaluate clinical efficacy of CsA. During the 1st month of therapy, the therapeutic efficacy and side-effects were evaluated every 2weeks and after 1 month, every month. We checked blood pressure and laboratory abnormalities including liver function test, blood urea nitrogen (BUN), creatinine (Cr) and urinalysis at each visit in addition to observing clinical adverse effects. RESULTS: Significant reduction of SCORAD was noted in 15 patients after 6 weeks of CsA therapy. Only one patient stopped CsA therapy because of the elevation of blood pressure. Three patients showed albuminuria, which disappeared after CsA dose reduction. CONCLUSION: CsA can be used effectively and safely in severe Korean AD patients. Albuminuria seems to be a peculiar side-effect in Korean patients.
Albuminuria ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Cyclosporine* ; Dermatitis, Atopic* ; Humans ; Liver Function Tests ; Urinalysis

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Humans* ; Sarcoma, Kaposi*

No abstract available.
Sturge-Weber Syndrome*

Addiction to illicit drugs is one of today's most important social issues. Most addictive drugs lead to irreversible parenchymal changes in the human brain. Neuroimaging data bring to light the pharmacodynamics and pharmacokinetics of the abused drugs, and demonstrate that addiction is a disease of the brain. Continuous researches better illustrate the neurochemical alterations in brain function, and attempt to discover the links to consequent behavioral changes. Newer hypotheses and theories follow the numerous results, and more rational methods of approaching therapy are being developed. Substance abuse is on the rise in Korea, and social interest in the matter as well. On the other hand, diagnosis and treatment of drug addiction is still very difficult, because how the abused substance acts in the brain, or how it leads to behavioral problems is not widely known. Therefore, understanding the mechanism of drug addiction can improve the process of diagnosing addict patients, planning therapy, and predicting the prognosis. Neuroimaging approaches by nuclear medicine methods are expected to objectively judge behavioral and neurochemical changes, and response to treatment. In addition, as genes associated with addictive behavior are discovered, functional nuclear medicine images will aid in the assessment of individuals. Reviewing published literature on neuroimaging regarding nuclear medicine is expected to be of assistance to the management of drug addict patients. What's more, means of applying nuclear medicine to the care of drug addict patients should be investigated further.
Behavior, Addictive ; Brain* ; Diagnosis ; Hand ; Humans ; Korea ; Neuroimaging* ; Nuclear Medicine* ; Pharmacokinetics ; Prognosis ; Street Drugs ; Substance-Related Disorders ; Tomography, Emission-Computed, Single-Photon

We report an autopsy case of the brain stem glioma that extended extensively in the brain stem itself and cephalad. This 18-year-old boy first presented with dizziness, vomiting and left side weakness with left facial palsy. Brain MRI revealed a diffusely infiltrative tumor involving whole medulla, pons and lower midbrain. A total of 4000 R was given with some alleviation of respiratory difficulty. He died one year after the onset. Autopsy revealed the tumor involving pons, a portion of medulla oblongata, and cerebellum. The tumor showed diffusely infiltrative pattern and extended along the periventricular area to the thalamus and corpus callosum. The cut surface was grayish white and solid. It also showed areas of myxoid degeneration and necrosis probably related to radiation therapy. Microscopically the tumor was a cellular and pleomorphic glioma that showed some astrocytic differentiation. It was diffuse without geographic necrosis.

PURPOSE: Purpose: To report a case of modified capsular tension ring scleral fixation and in-the-bag toric intraocular lens (IOL) implantation in a pediatric patient with severe crystalline lens subluxation due to homocystinuria. CASE SUMMARY: A 9-year-old male diagnosed with homocystinuria and crystalline lens subluxation presented with progressive decrease of visual acuity. Uncorrected distant visual acuity (UDVA) and corrected distant visual acuity were 0.03 and 0.6 in the right eye and 0.01 and 0.5 in the left eye, respectively. Slit-lamp examination showed severe crystalline lens subluxation toward the inferiomedial side in both eyes. Corneal astigmatism in the right eye and left eye was 2.75 diopters (D) and 3.00 D, respectively based on keratometry. A combination of subluxated crystalline lens aspiration, scleral-fixated modified capsular tension ring insertion and in-the-bag toric IOL implantation were performed in both eyes. After continuous curvilinear capsulorhexis, nucleus and cortex of the crystalline lens were removed by irrigation and aspiration. A modified capsular tension ring with 2 fixation hooks (Model 2-L) was inserted into the capsular bag and fixed at the scleral wall. Next, toric IOL was inserted into the capsular bag. UDVA was 0.8 in the right eye and 0.9 in the left eye and 3 months postoperatively, the IOL rotation was less than 3 degrees from intended axis in both eyes. CONCLUSIONS: In a patient with severe congenital crystalline lens subluxation and moderate to severe corneal astigmatism, scleral fixation of modified capsular tension ring and in-the-bag toric IOL implantation is a possible surgical option.
Astigmatism ; Axis, Cervical Vertebra ; Capsulorhexis ; Child ; Homocystinuria* ; Humans ; Lens Implantation, Intraocular* ; Lens, Crystalline ; Lenses, Intraocular ; Male ; Visual Acuity