BACKGROUND: Doppler echocardiography is a non-invasive technique that has been used to evaluate LV diastolic dysfunction. Impaired left ventricular diastolic filling is known to occur in patients with coronary artery disease. Compared with those in normal subjects, Doppler-derived transmitral blood flow velocities have been reported to be reduced during early diastolic filling and to be compensatory elevated subsequent to atrial systole in patinets with coronary artery disease. But stiffness of myocardium normalize the E/A ratio, and normal E/A ratio may reveal increased ventricular filling pressure. We tried to investigate left ventricular filling parameters by Doppler echocardiography in patients with early myocardial infarction, and to compare left ventricular diastolic function regarding infarct location on EKG, one or multivessel disease on coronary angiography, and treatment modality. METHODS: From September 1993 to August 1995, Pulsed wave Doppler echocardiography was performed in patients with early acute myocardial infarction(N=95) and control group(N=20) within 5 days after admission, and parameters of diastolic function was evaluated. RESULTS: Echocardiographic data showed significant differences in mean ejection fraction, mean left ventricular mass, and mean left ventricular mass index between two groups. There was no significant difference in E/A ratio, deceleration time, and isovolumetric relaxation time between two groups. Neither, there was significant difference in each diastolic parameter for infarct related wall on EKG. And there was no significant difference in deceleration time for one or multi vessel disease on coronary angiography, treatment modality(conservative treatment, thrombolytic therapy, or primary PTCA). CONCLUSION: In patients with early acute myocardial infarction, left ventricular diastolic dysfunction was absent. And there was no significant correlation between the presence of diastolic dysfunction and the location of infarct related wall on EKG, or one or multi vessel disease, or treatment modality.
Blood Flow Velocity ; Coronary Angiography ; Coronary Artery Disease ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Electrocardiography ; Humans ; Myocardial Infarction* ; Myocardium ; Relaxation ; Systole ; Thrombolytic Therapy

Dermatomyositis is a disease of unknown etiology characterized by inflammation and degeneration of skeletal muscles and cutaneous abnormalities. Cardiac involvement in dermatomyositis-polymyositis is thought to be rare. In recent year, however, there has been an increasing number of reports on cardiac abnormalities in adult dermatomyositis and polymyositis due to development of noninvasive diagnostic techniques. Categorically, these abnormalities have included electrocardiographic changes, cardiac arrhythmias, congestive heart failure, coronary artery disease, and pericarditis. A 56-year-old woman was admittied to the Ewha womans University Hospital with dyspnea and palpitation. She was diagnosed as having dermatomyositis and followed up our department of Dermatology. Electrocardiogram showed a paroxysmal supraventricular tachycardia at as rate of 195/min. The patient was treated with 240mg/day verapamil p.o, 60mg/day prednisone p.o, there was marked improvement of symptoms. Systematic study of cardiac function utilizing echocardiography, Holter monitoring, thallium-201-scan, and gated blood pool studies were conducted in five newly diagnosed patients with dematomyositis-polymyositis. A significant elevation of serum CPK-MB is indicative of cardiac involvement. Cardiac involvement is a serious prognostic sign. We report a case with the review of the literature.
Adult ; Arrhythmias, Cardiac ; Coronary Artery Disease ; Dermatology ; Dermatomyositis* ; Dyspnea ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Heart Failure ; Humans ; Inflammation ; Middle Aged ; Muscle, Skeletal ; Pericarditis ; Polymyositis ; Prednisone ; Prognosis ; Tachycardia, Supraventricular* ; Verapamil

No abstract available.

In order to evaluate the effecacy of 2D-Doppler echocardiography for the measurement of pulmonary flow(Qp), systolic flow(Qs), the ratio of pulmonary flow and systemic flow and systemic flow(Qp/Qs), 19 membranous ventricular septal defect patients were examined in the period from July, 1986 to October, 1987 at Ewha Women's university hospital. The measurement of Qp, Qs, Qp/Qs by 2D-Doppler echocardiography were compared with the results by the Fick's method of cardiac catheterization.The following results were obtained. 1) The total of the 19 patients consisted of 15 males and 4 females. The mean age of the patients was 8.2 years. 2) It was found that the Fick's method and 2D-Doppler measurements of Qp (n=19, r=0.67), Qs (n=19, r=0.88), and Qp/Qs ratio(n=19, r=0.62) were highly correlated(p<0.01). 3) It is understood that the measurement of Qp, Qs, Qp/Qs ratio by 2D-Doppler echocardiography were quite useful to the noninvative diagnosis of ventricular septal defect.
Cardiac Catheterization* ; Cardiac Catheters* ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Male

We report a case of 86-year-old woman with coronary artery fistula connecting the right coronary artery and left bronchial artery accompanied with cystic lung disease presenting with dyspnea and chest pain. Coronary angiography revealed that right coronary artery was anastomosed with the collaterals of left bronchial artery at the right hilum and tortuously ascended along the aortic arch and descended connecting with left pulmonary lobar artery at a certain site which is faintly opcified showing to and pro phasic movement. Chest CT scan shows the multicystic changes of the left lower lobe of the lung and hypertrophied bronchial artery of left lobar bronchus. Under the diagnosis of coronary artery fistula, hypertensive heart disease and multicystic lung disease, patient's symptoms and signs were improved by conservative treatment without surgical intervention.
Aged, 80 and over ; Aorta, Thoracic ; Arteries ; Bronchi ; Bronchial Arteries* ; Chest Pain ; Coronary Angiography ; Coronary Vessels* ; Diagnosis ; Dyspnea ; Female ; Fistula* ; Heart Diseases ; Humans ; Lung Diseases* ; Lung* ; Tomography, X-Ray Computed

BACKGROUND: Circadian rhythms have been described for acute myocardial infarction, sudden cardiac death, cerebrovascular disease, ischemic heart disease, and ventricular arrhythmia. Most of studies reported that the frequency of ventricular permature contractions(VPC's) shows a peak in day time. We tried to see that the circadian rhythm of VPC's in hypertension and ischemic heart disease(IHD) patients. And we will also studied the relationship between heart rate and frequencey of VPC's. METHOD: Twenty four hour holter monitoring was performed in hypertensive patients (N=23), ischemic heart disease patients(N=25), and normal control group(N=30). We tested the circadian pattern of VPC's and heart rates and the relationships of the frequency of VPC's and heart rates. RESULT: In hypertension group, a peak incidence of heart rate is between 5 and 8 P.M., in ischemic heart disease group, between 3 and 6 P.M.. In control group, the heart rate shows a peak beteen 1 and 3 P.M.. The frequency of VPC's in hypertension group shows the first peak between 4 and 10 P.M., and the second peak beteen 7 and 10 A.M.. In ischemic heart disease group, they show a peak between 2 and 8 P.M..In control group, there was no circadian variation for the frequency of VPC;s. Both in hypertension and IHD patients group, there was significant correlation between the frequency of VPC's and the heart rates. CONCLUSION: It seemed that VPC' were more frequently occurred in relation to the increase of heart rate in the afternoon, in hypertensive and ischemic heart disease patients.
Arrhythmias, Cardiac ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Hypertension* ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Ventricular Premature Complexes*

Disfiguring hyperpigmentation of the exposed areas may have impartant and lasting effects on the emotional well-being of the patient. And many attempts to treat areas of hyperpigmentation have been earried out, but all of them are not very successful. Recently 4-isopropylcatechol has been known to inhibit melanin pigmentation with a selective action on melanocytes either destroying or inactivating the melanocytes experimentally. There is no report on its clinical trial till now. In this study, 1% 4-isopropylcatechol cream was topieally applied to the hyperpigmented lesions of 29 patieots of melasma, freckle, and cafe-au-lait spot. The bleaching effect on meiasmas was very satisfactory in all patients but coantact dermatltis in 3 patients and reticular hyperpigmentation with areas of depigmented spots in one patient were developed as the side effects of the drug. Freckle and cafe-au-Iait spots were not bleached.
Cafe-au-Lait Spots ; Humans ; Hyperpigmentation ; Melanins ; Melanocytes ; Melanosis ; Pigmentation

It is well known that there is close relation of the left atrial pathology to atrial fibrillation(AF) in patients with mitral valvular disease. To evaluate such relation is existed or not in the right atrium, the right atrial wall biopsy was performed in 31 patients with mitral valvular disease during valve surgery. The specimens obtained were interpretated by the pathologist who had no information about the patients. The specimens were graded according to severity of morphological change. In Grade I, the atrial myocardium is degenerated and has moderate fibrosis in it. Grade II shows the atrial myocardial layer of the atrium and severe degenerated with pre and postoperative heart rhythm. Four patients had Grade I change and 3 patients among them had pre and postoperative AF. Eleven patients had Grade III changes and 9 among them had pre and postoperative AF. The results show there is strong tendency that the patients with pre and postopeative AF had Grade III change in the right atrium and the relation of the right atrial pathology to AF is same as that of the left atrium.
Atrial Fibrillation* ; Biopsy ; Fibrosis ; Heart ; Heart Atria ; Humans ; Myocardium ; Pathology*

A total of the 16 cases of rheumatic vavular heart desease were examined in order to compare fibrillatriy F wave with left atrial size and biopsy findings from October 1986 to April 1987 at the Ewha Womans University Hospital. The results were as follows : 1) Of the 16 patients, there were 5 males and 11 females. The mean age of the patients was 41.9+/-12.7 years old. 2) Among the 16 patients PTF-V1 was lesser than -0.04nn-sec, the left atrial size measured by M-mode echocardiography was 57.1+/-8.9mm. Inverse correlation between PTF-V1 and the left atrial size measured by M-mode echocardiography was observed(P<0.01). 3) No significant correlation between PTF-V1 and left atrial was found(P>0.01). 4) There was a tendency that the size of the left atrium was, the more degeneration, necrosis and fibrosis of the left atrial wall appeared through pathological findings.
Atrial Fibrillation ; Biopsy* ; Echocardiography ; Female ; Fibrosis ; Heart ; Heart Atria ; Heart Valve Diseases* ; Humans ; Male ; Necrosis

Pulmonary Aspergillomas usually arise from proliferation of Aspergillus in preexisting parenchymal cavities.202 college students (99 men, 103 women) aged 18% 26 years. Fasting blood samples were. The most common symptom in this disorder is hemoptysis, which may be minimal in amount or it may be massive & life threatening. The optimum therapy for pulmonary aspergilloma is controversial. The major options available include surgical resection of the lesion, a number of medical therapies, or simple observation of the patient for a time. Surgery is the most effective treatment but it is limited to some patient because most patients haute underlying pulmonary disease. Thus the various form of medical therapy was available with successful result. The authors present a case of percutaneous intracavitary amphoterician B injection for the treatment of pulmonary aspergilloma & its successful effect for the repetitive hemoptysis.
Amphotericin B* ; Aspergillus ; Fasting ; Hemoptysis* ; Humans ; Lung Diseases ; Male