To recognize the hemodynamic change in the constrictive pericarditis, we have reviewed the Doppler echocardiography, cardiac catheterization, and pathology of 6 patients who were admitted to Pusan National University Hospital due to right-side heart failure, diagnosed as constrictive pericarditis and were undertaken pericardiectomy. Doppler echocardiographic findings showed that acceleration and deceleration of early diastolic rapid filling were increased, followed by shortening of duration but there was a tendency to decrease in velocity-time integral of early diastolic rapid filling compared to that of atrial contraction filling in the left ventricle. On the contrary, there was decrease in acceleration of rapid filling in right ventricle, but other indices were comparable to that of left ventricle. The integral of D wave increased relatively compared to that of S wave in superior vena canal flow. Also, there was decrease in peak flow velocity, acceleration and velocity-time integral of aortic and pulmonary arterial flow velocity. One patient who had increased fraction of integral of early diastolic rapid filling compared to that of atrial contraction filling in right ventricle showed that he had higher central venous pressure and D wave was dominant in superior vena caval flow. In conclusion, Doppler flow patterns showed characteristic diastolic filling inpairment and systolic dysfunction in constrictive pericarditis, so that Doppler echocardiography is believed to be a useful method of noninvasive diagnosis and follow-up of hemodynamic change in constrictive pericarditis.
Acceleration ; Busan ; Cardiac Catheterization ; Cardiac Catheters ; Central Venous Pressure ; Deceleration ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Follow-Up Studies ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Pathology ; Pericardiectomy ; Pericarditis, Constrictive*

A noninvasive method for assessing cardiac output was evaluated by comparing it with thermodilution determinations in 25 patients who admitted to Pusan national university hospital from March, 1985 to December, 1986. This method used M-mode & two dimensional echocardiography to measure the internal diameter of aortic valve anulus & pulmonary valve anulus and pulsed doppler echocardiography to obtain aortic & pulmonary blood velocity. Good correlations were observed between thermodilution and doppler echocardiographic measurements of cardiac output from aortic flow (r=0.98, p<0.05) & pulmonary flow (r=0.86, p<0.05). Linear regression analysis yielded y=0.91x0.14 for aortic flow and y=0.77x0.84 for pulmonary flow. These results indicate that accurate cardiac output can be measured by noninvasive & simple doppler echocardiography.
Aortic Valve ; Busan ; Cardiac Output* ; Echocardiography* ; Echocardiography, Doppler ; Echocardiography, Doppler, Pulsed ; Humans ; Linear Models ; Pulmonary Valve ; Thermodilution

We report an uncommon case of sebaceous adenoma in a 36-year-old male who had a solitary, well-de6ned, 0.5×0.8cm sized, round, erythematous nodule on the right side of his forehead. Microscopically, the nodule was composed of poorly developed sebaceous lobules that were irregular in size and shape in the deep reticular dermis. The lobules were composed of mature sebaceous cells in the center and undifferentiated basaloid cells at the periphery. In most lobules, the two types of cells occured in approximately equal proportions. We excised the lesion completely and no evidence of recurrence was observed for 2 years.
Adenoma* ; Adult ; Dermis ; Forehead ; Humans ; Male ; Recurrence

Cephalosporins are B-lactam antibiotics. They are usually bactericidal in action and act by inhibiting mucopeptide synthesis in the bacterial cell wall. Cephalosporins have been used widely in Korea. However, allergic contact dermatitis to cephalosporins has not been reported in the Korean dermatologiy literature. We report a case of allergic contact dermatitis due to cephalosporins in a 23-year-old nurse who suffered from itchy, erythematous patches and plaques with numerous fissures on both hands. A patch test with ceftriaxone and a prick test with cefotiam were positive.
Anti-Bacterial Agents ; Cefotiam ; Ceftriaxone ; Cell Wall ; Cephalosporins* ; Dermatitis, Allergic Contact* ; Hand ; Humans ; Korea ; Patch Tests ; Young Adult

Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.
Adrenal Cortex Hormones ; Arthritis ; Coma ; Diagnosis ; Diarrhea ; Drug Therapy ; Feces ; Helminths ; Humans ; Immunity, Cellular ; Intestines ; Opportunistic Infections ; Sepsis ; Sputum ; Strongyloides stercoralis* ; Strongyloides* ; Strongyloidiasis ; Thiabendazole ; Tropical Climate ; Tuberculosis, Pulmonary

Clinical observation was performed on 23 children with Guillain-Barre syndrome which were hospitalized at the Pediatric ward of Han Yang University Hospital, from July 1975 through May 1991.@ES The results were as follows: 1) The ratio of male patient to female was 2.8:1 and 47.8% of total GBS patients were between the ages 1 to 5 years. 2) The highest seasonal incidence of GBS was seen in summer and there was no significant variation of GBS annually.3) Preceding illness of GBS was found in 60% of the total patients, and upper respiratory infection was the most common (65%). 4) Muscular paralysis or weakness in extremities was the most common chief complaints on admission, and repiratory difficulty, vomiting, diarrhea, swallowing difficulty and myalgia were followed. 5) The sites of paralysis on admission were upper and lower extremities in 14 GBS patients (60.8%), lower extremities in 7 GBS patints (34.8%) and respiratory muscle in 4 GBS patints (17.3%), respectively. 6) The protein content of cerebrospinal fluid was elevated in 18 GBS patients of total (78.3%) on admission and remnant 5 GBS patients showed increased protein later. 7) There was a tendency that recovery time in 5 GBS patients with muscular fibrillation on E.M.G. was longer than in 4 GBS patients without muscular fibrillation. We thought further studies on critical evaluation and better treatment for GBS were needed.
Cerebrospinal Fluid ; Child* ; Deglutition ; Diarrhea ; Extremities ; Female ; Guillain-Barre Syndrome* ; Humans ; Incidence ; Lower Extremity ; Male ; Myalgia ; Paralysis ; Respiratory Muscles ; Seasons ; Vomiting

The ryanodine receptor/channel (RyR) mediates the release of calcium from the sarcoplasmic reticulum (SR) in both skeletal and cardiac muscle cells. There are three isoforms of the RyR: RyR1, RyR2, and RyR3. RyR1 is specifically expressed in skeletal muscles and RyR2 in cardiac muscles. RyR3 is yet another isoform found in non-muscle cells such as neuronal cells. Single channel recordings of RyR1 and RyR2 reconstituted in artificial lipid bilayer show that the characteristics of two isoforms are very distinct. RyR1 has a shorter mean open time and is activated at a higher concentration of Ca2+ than RyR2. In this study, we isolated the heavy SR membranes from canine latissimus dorsi muscles and investigated the single channel activities from the heavy SR membrane fraction using Cs+ as a charge carrier. Two different types of activities were observed. The fast-gating type (FG) with the mean open time of 0.9 ms was more frequently recorded (n = 12) than the slow-gating type (SG) with the mean open time of 269.2 ms. From the I-V relation, the slope conductance of the FG was calculated to be 514.7 pS and the SG, to 625.6 pS. The activity of the fast gating type increased by raising the concentration of Ca2+ in the cis-solution up to 100 microM. The appearance of the SG in the canine heavy SR membrane fraction suggests a possibility that two types of RyR isoform are co-expressed in mammalian skeletal muscle as well as in avian, amphibian and piscine fast twitch muscles.
Animal ; Calcium Channels/*metabolism ; Dogs ; *Ion Channel Gating ; Lipid Bilayers ; Microsomes/metabolism ; Muscle Proteins/*metabolism ; Muscle, Skeletal/*metabolism ; Ryanodine Receptor Calcium Release Channel ; Sarcoplasmic Reticulum/*metabolism ; Support, Non-U.S. Gov't ; Thorax ; Time Factors

Aconite is a common remedy of herb doctors and is widely used in the Far East. Clinical aspects of the visual disturbance produced by this drug have been described, but little is known about its pathology. Tinctura aconiti (0.6 mg of total alkaloid/kg 2x) was administered intraperitoneally in rabbits to evaluate its toxic effects on the visual system. The alteration in the visual evoked potential following aconite injection consisted of a delay in the onset and peak latency. Histopathologically, there were damages to the myelin sheath of the visual pathway, spinal cord and peripheral nerves. These findings suggest that aconite may cause primarily myelo-optic neuropathy.
Aconitum/administration & dosage/*toxicity ; Animals ; Evoked Potentials, Visual/*drug effects ; Injections, Intraperitoneal ; Myelin Sheath/*drug effects/ultrastructure ; Optic Nerve/*drug effects/ultrastructure ; Optic Nerve Diseases/*chemically induced/pathology ; Rabbits ; Spinal Cord/*drug effects/ultrastructure

There are several causes developing diplopia after cataract surgery. Among these causes, central fusion disruption may be developed in longstanding unilateral traumatic cataract and uncorrected aphakia. The pathophysiology is unknown, but time interval between sensory deprivation and optical correction is an important factor. The characteristic signs and symptoms are exotropic, hypotropic or excyclotropic deviation, and intractable diplopia with vertical bobbing movement of non-fixing eye, particularly near the angle of superimposition with prism or haploscopic device. The authors report two cases of central fusion disruption in longstanding unilateral traumatic cataract and uncorrected aphakia.
Aphakia ; Cataract ; Diplopia ; Sensory Deprivation

Optic nerve evulsion is a visually devastating and rare manifestation resulting in sudden visual loss after ocular trauma. The several hypothesis of mechanism include penetrating orbital injury causing a backward pull on the optic nerve, extreme rotation and forward displacement of the globe, and sudden increase in intraocular pressure causing rupture of the lamina cribrosa. The authors report a case of optic nerve evulsion in a 25- year old man who was struck in the right eye with a umbrella. The diagnosis was made by fundoscopic findings, fluorescein angiography, visual evoked potential, electroretinography, orbit computed tomography and magnetic resonance image.
Diagnosis ; Electroretinography ; Evoked Potentials, Visual ; Fluorescein Angiography ; Intraocular Pressure ; Optic Nerve* ; Orbit ; Rupture