BACKGROUND: Methods for evaluating left ventricular diastolic function have been used exclusively in cardiac patients in sinus rhythm and have not been applied to atrial fibrillation because of large cycle variation in flow velocities and absence of atrial contraction. The utility of these rnethods in atrial fibrillation is unknown, especially M-rnode Doppler echocardiography and automatic border detection method. METHODS: Left Ventricular Normal group(LVN group, Ejection fraction> 40%) of 21 patients(mean age 67 years old, 12 men, 9 women) and Left Ventricular Dysfunction group (LVD group, EF ( 40%) of 15 patients(mean age 64 years old, 11 men, 4 women) were studied. We measured parameters in pulsed Doppler recordings of rnitral flow velocity and the flow propagation velocity in color M-mode recording of mitral flow, and peak filling rate from automatic border detection system. Measurements were averaged over 10 cardiac cycles. RESULTS: Mean heart rates were not different in both population(LVN 79+/-18/min, LVD 83+/-16/min). Left ventricular diastolic dimension were more dilated LVD group than LVN group(5.7+/-1.0crn, 4.6+/-0.7cm p < 0.05) but left atrial dimension were similar(4.4+/-0.8cm, 4.3+/-0.7cm). Deceleration time was significantly shortened in LVD group(158.4+/-24.4ms vs. 180.4+37.6ms, p < 0.05) but other parameters of mitral pulsed Doppler recording such as IVRT, acceleration time, acceleration rate and deceleration rate were not different. Flow propagation velocities were significantly decreased in LVD group(41.7+/-14.9cm/s vs. 53.0+/-11. 9cm/s, p < 0.05). Peak filling rates of automatic border detection system were significantly decreased in LVD group(3.4+/-1.2 EDV/s vs 5.4+/-1.1 EDV/s, p< 0.001). CONCLUSION: Echocardiographic measurements of diastolic function via color M-mode Doppler and autornatic border detection may be useful in presence of atrial fibrillation as sinvs rhythm.
Acceleration ; Aged ; Atrial Fibrillation* ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Heart Rate ; Humans ; Male ; Middle Aged ; Ventricular Dysfunction, Left

No abstract available.
Cervix Uteri* ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Follicular Fluid* ; Humans* ; Spermatozoa* ; Spouses*

No abstract available.
Bronchopulmonary Sequestration* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Lung*

No abstract available.

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

Endomyocardial fibrosis(EMF) is an unusual type of cardiomyopathy characterized by a restriction to the ventricular filling and an obliteration of the inflow portion in the ventricular cavity by a fibrosis and often by a thrombus formation. The atrioventricular valve may be involved, resulting in an atrioventricular valvular regurgitation. The only known effective treatments are endomyocardiectomy and replacement of regurgitant AV valves. We report the experience of a case of EMF which required surgical management.
Cardiomyopathies ; Endomyocardial Fibrosis* ; Fibrosis ; Thrombosis

Patients of choriocarcinoma with brain metastases are considered to have a very poor prognosis due to chemo-refractoriness and recurrence. So, selection and individualization of patients then followed by multimodality therapy are very important. We present a case of a patient who experienced twice of craniotomies due to intracranial hemorrhage and an emergent explorative laparotomy due to intestinal perforation of the metastatic sites of choriocarcinoma. She was treated with 12 cycles of high-dose MTX/EMA-CO, intrathecal MTX and WBRT. Eventually she has obtained a complete remission that ongoing for 2 years. So, we report this case with a brief review of the literatures.
Brain* ; Choriocarcinoma* ; Craniotomy ; Female ; Humans ; Intestinal Perforation ; Intracranial Hemorrhages ; Laparotomy ; Neoplasm Metastasis* ; Pregnancy ; Prognosis ; Recurrence

We report here on a case of a spinal extradural leiomyoma in a 67-year-old woman, and this tumor was in a very unusual location for a leiomyoma. Because the patient underwent hysterectomy for a uterine leiomyoma 20 years ago, we can speculate that the spinal lesion was a metastatic leiomyoma.
Aged ; Female ; Humans ; Hysterectomy ; Leiomyoma* ; Spinal Cord

OBJECTIVE: To compare the clinical outcomes between Day 2 and Day 3 embryo transfer(ET) groups in in vitro fertilization and embryo transfer(IVF-ET) with intracytoplasmic sperm injection(ICSI). METHODS: From May, 1997 to December, 1998, 174 cycles of IVF-ET with ICSI were performed and classified into two groups: Day 2 ET group(n=134) and Day 3 ET group (n=40). In Day 3 ET group, embryos fertilized after ICSI were cultured in vitro for further 24 hours in M3 media. RESULTS: There were no significant differences in the age and BMI of patients, basal serum FSH level, protocol of controlled ovarian hyperstimulation(COH), indication of ICSI, and source of sperm for ICSI between two groups. Only the number of the previous failed IVF-ET cycles was significantly higher in Day 3 ET group(p<0.05). Serum E2 level on hCG day, the numbers of oocytes retrieved after COH, oocytes fertilized after ICSI, and embryos transferred, and the rates of fertilization, cleavage, and implantation showed no significant differences. However, cumulative embryo score(CES) was significantly higher in Day 3 ET group(p<0.05). Although there were no significant differences in the rates of pregnancy per ET, spontaneous abortion, and live birth, the rates of biochemical and multiple pregnancy were significantly higher in Day 3 ET group(p<0.05). CONCLUSIONS: In IVF-ET with ICSI, the relatively higher CES may contribute to the higher risk of multiple pregnancy in Day 3 ET group, compared with the conventional Day 2 ET group.
Abortion, Spontaneous ; Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Multiple ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

PURPOSE: Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children, and have contended that hypotonic fluids be removed from routine practice. To assess current intravenous fluid prescription practices among Korean pediatric residents and to call for updated clinical practice education. METHODS: A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question supposed a unique scenario in which the respondents were to prescribe either a hypotonic or an isotonic fluid for the patient. RESULTS: Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy. CONCLUSION: In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.
Child ; Surveys and Questionnaires ; Fluid Therapy ; Hospitals, University ; Humans ; Hyponatremia ; Korea ; Pediatrics ; Prescriptions