Intussusception is the most common cause of acquired intestinal obstructions during infancy and early childhood. Barium reduction and pneumoreduction have been sued widely as nonsugical method of treatment in radiologic department. In the past, attempts at barium reduction of intussusception were contraindicated in the presence of frank intestinal obstruction, shock, fever, dehydration, bowel perforation, peritonitis and longstanding symptoms. At present, however, there is no agreement on the contraindications, except for shock, peritonitis and bowel perforation. Especially, there is no consensus regarding its application on patient presenting with sign of frank intestinal obstruction. The authors analyzed the effect of pneumoreduction in the intussusception with sign of frank intestinal obstruction. Pneumoreduction was attempted in 53 cases of intussusception with sign of frank intestinal obstruction. Reduction was successful in 43 cases(81%). The mean fluroscopic time was 15.1 minutes and mean maximal pressure was 121.8mmHg in successful reduction. As complications, two cases of bowel perforation were observed, but could be treated surgically without any significant problem. In conclusion, pneumoreduction is a useful substitute for barium reduction in the management of pediatric intussusception with sign of frank intestinal obstruction.
Barium ; Consensus ; Dehydration ; Fever ; Humans ; Intestinal Obstruction* ; Intussusception* ; Methods ; Peritonitis ; Shock

Identification of patients with combined valvular prolapse has important clinical imlications, because such patients appear to be early surgical candidates. Detection of combined valvular prolapse became more feasible with development of 2-dimentional echocardiography and the incidence of combained mitral and valve prolapse is reported to be variable from 3% to 24%. The authors found a case of combined mitral and aortic valve prolapse detected by 2-dimensional echocardiography. This 30-years-old male patient who admitted because of peptic ulcer bleeding revealed a prolapse of anterior mitral leaflet with regurgitation and also a prolapse of the right coronary cusp into the left ventricular outflow tract but without evidence of aortic regurgutation by Doppler echocardiogram. he discharged without surgical intervention and needs further observation.
Aortic Valve Prolapse* ; Aortic Valve* ; Echocardiography ; Hemorrhage ; Humans ; Incidence ; Male ; Mitral Valve ; Peptic Ulcer ; Prolapse

BACKGROUND: As an airplane has been developed, the man could experienced the new environment. In these circumstances, the research of human's physical changes in the air was commended. About 80% of airplane's accidents was occurred by human factors and about 4% was related to the pilot's physical state. According to the many studies, the most common cause of the permanent grounding of the pilot is coronary artery disease(CAD). Therefore the tool of prevention and early detection for CAD was needed. PURPOSE: The purpose of this study is to evaluate the effect of routine and regular Exercise Treadmill Test(ETT) to the civil airline pilots especially 1) in decreasing the correctable risk factors of coronary artery disease 2) in reducing the medical disqualification rate of pilots. METHOD: Routine ETT has been performed to the Asiana Airlines' pilot during his regular physical check up. When the pilot showed abnormal resting ECG or abnormal ETT results, Echocardiography, 24hour Holter monitoring, Cardiac SPECT or Coronary angiography were done to rule out coronary artery disease. Review the medical records from June 1993 through December 1998. Compare the medical disqualification rate between Asiana Airlines pilot & other pilot groups. Compare the individual correctable risk factors of coronary artery disease and the numbers of risk factors between pilot and non-pilot group using SPSS 8.0 t-test. RESULTS: 1. The results showed no evidence of CAD and there was no case of CAD as a pilot's disqualifying conditions. 2. The levels of cholesterol and the numbers of risk factors of pilot had a statistically significantly lower than non-pilot group. CONCLUSIONS: Routine and regular ETT will be effective in educating the pilot to do his best to decrease the correctable risk factors of CAD.
Aircraft ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Exercise Test* ; Humans ; Medical Records ; Risk Factors ; Tomography, Emission-Computed, Single-Photon

PURPOSE: To clarify the chracteristic sonographic features of benign soft tissue tumors and to evaluate the usefulness of sonographic imaging. MATERIALS AND METHODS: We retrospectively reviewed ultrasonographic images of 70 cases in 68 patients with histologically proved benign soft tissue tumors. RESULTS: The tumors included 33 lipomas, 11 hemangiomas. 11 lymphangiomas, 7 neurilemmomas, 4 epidermold cysts, 2 fibromas, 1 mesenchymoma, and 1 myxoma. The SOhographic appearances of the lesions were mainly solid in 53 cases(33 lipomas, 8 hemangiomas, 2 lymphangiomas, 7 neurilemmomas, 2 fibromas and 1 mesenchymoma), mainly cystic in 14 cases(1 hemangioma, 8 lymphangiomas, 4 epidermoid cysts, and 1 myxoma), and mixed in 3 cases(2 hemangiomas and 1 lymphangioma). Although an accurate histologic prediction could not be made in most cases, certain patterns appeared to be characteristic of specific tumor types. 26 cases(78%) of lipoma were seen as lentiform, iso- or hyperechoic, solid mass. Hemangioma had variable appearance and chacteristic calcifications were seen in 3 cases. Unicameral or multiseptated cystic mass with variable thickness of echogenic septa and solid portion was the characteristic finding of lymphangioma. Neurilemmoma showed Iobulated, oval to round, relatively hypoechoic mass with or without internal cystic portion. CONCLUSION: Sonographic evaluation of benign soft tissue tumros is useful in demonstrating the location, size, extent, and internal characteristics of the mass. A relatively confident diagnosis can be made when the characteristic features of the benign soft tissue tumor are present on sonographic imaging.
Diagnosis ; Epidermal Cyst ; Fibroma ; Hemangioma ; Humans ; Lipoma ; Lymphangioma ; Mesenchymoma ; Myxoma ; Neurilemmoma ; Retrospective Studies ; Ultrasonography

BACKGROUND: In order to investigate the efficacy and safety of cilazapril, a recently developed angiotensin converting enzyme inhibitor, a clinical study was performed in the patients with mild to moderate essential hypertension. METHODS: The study subject consisted of 31 patients with diastolic blood pressure of 95mmHg~115mmHg (mean age : 56.0+/-8.1 years, 16 males and 15 females). Cilazapril was administered orally in a daily dose of 2.5mg~5.0mg Q.D. for 8 weeks. During cilazapril medication, anti-hypertensive efficacy, side effects and laboratory changes were monitored. RESULTS: Cilazapril decreased blood pressure from baseline value of 162.2+/-4.7/98.4+/-2.8mmHg to 144.6+/-10.0/89.7+/-5.7mmHg after 4weeks of medication (p<0.05) and 138.2+/-4.5/87.8+/-4.0mmHg after 8 weeks of medication (p<0.05). Heart rate change was not significant (72.3+/-4.7/min vs 71.7+/-3.6/min). Body weight change was not significant (66.6+/-9.8 Kg vs 66.8+/-9.9 Kg). There were no significant change in blood chemistry and hematologic examination except mild elevation of alanine transaminase and serum creatinine values but these date were within normal ranges. The side effects were dry cough (4 case, 12.9%), headache (2 case, 6.4%), indigestion (1 case, 3.2%) and dry mouth (1 case, 3.2%). One patient dropped out due to severe dry cough but others were mostly mild in nature. CONCLUSIONS: Cliazapril 2.5mg~5.0mg once daily regimen was effective and well tolerated in patients with mild to moderate essential hypertension.
Alanine Transaminase ; Blood Pressure ; Body Weight Changes ; Chemistry ; Cilazapril* ; Cough ; Creatinine ; Dyspepsia ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth ; Peptidyl-Dipeptidase A ; Reference Values

Left ventricular false tendon, also called moderator bands, anomalous cords, accessory bands or false chordae tendinae, has been known as simple anatomical without clinical importance. But the possible relationship with Still's type murmur and ventricular arrhythmia were reported recently. The incidence of false tendon was known as 0.5-6.1% variably. In Korea, there are no reports about left ventricular false tendon till now. The authors examined 2,052 patients' echocaediograms and clinical manifestations retrospectively to find the incidence and potent clinical significance of false tendons. The incidence in present study was 1.02% and there was no specific relationship between false tendon and cardiovascular diseases. The authors observed Still's type musical murmur in 5 patients out of 21 and ventricular premature beats in 2 patients out of 10 without other cardiovascular diseases. One of them showed nonsustained ventricular tachycaedia during Holter ECG monitoring. The most frequent echocardiographic site of attachment was from basal inter-ventricular septum to lelft ventricular free wall and false tendon attached to papillary muscle was least frequently observed.
Arrhythmias, Cardiac ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Korea ; Music ; Papillary Muscles ; Retrospective Studies ; Tendons*

No abstract available.
Cardiomyopathy, Dilated* ; Carnitine* ; Estrogens, Conjugated (USP)*

Left ventricular hypertrophy is a compensatory response to hemodynamic overload secondary to an increased systemic resistance. This increase, however, is not the only cause of hypertrophy, and there are other factors which can have a significant effect on its incidence. To determine whether chronic antihypertensive therapy by enalapril modifies the cellular and subcellular changes of left ventricular hypertrophy observed in spontaneously hypertensive rats(SHR), 20-weeks-old SHR were treated for 22 weeks with enalapril(2mg/kg) and compared with normotensive Wister-Kyoto rats and not-treated SHR. Systolic blood pressure in enalapril-treated SHR was significantly lowered after 22 weeks compared with that of untreated control SHR group. Myocytes were reduced in size and fibrination seen in cardiac muscle fibers of control SHR was decreased in treated SHR group. Myofibrils appeared to be irregular in shape and myofilaments are decreased in control SHR but in enalapril-treated SHR the diameter and length of the myofilament became turned to regular forms. These results suggest that, enalapril, angiotensin converting enzyme inhibitor, may regress hypertrophy and some subcellular changes may be modified by enalapril.
Animals ; Blood Pressure ; Enalapril* ; Fibrin ; Hemodynamics ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Incidence ; Muscle Cells ; Myocardium ; Myofibrils ; Peptidyl-Dipeptidase A ; Rats ; Rats, Inbred SHR*

In single atrial and ventricular cells isolated from the guinea-pig and the rabbit heart, action potentials and membrane currents were recorded by using the whole cell voltage clamp technique. In rabbit atrial cells the repolarization showed two distinctive phases, referred as the early and late phases(early and late plateau phase), but in guinea-pig atrial cells there was a maintained plateau and less distinctive two phases of repolartization. Increasing intracellular sodium or reducing external sodium by replacement with lithium suppressed the late phase of the action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricle and guinea-pig atrial cells. Reducing external sodium decreased Ca-current and late inward current in voltage clamp. Ouabain in the concentration of 10(-5)M shortened the duration of action potential and shifted the holding current level to outward direction, decreased Ca-current and moved late inward current to outward direction. Ryanodine 10(-6)M which is known to be an inhibitor of Ca-release in the intracellular store, suppressed the late phase of action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricular cells. Ryanodine also decreased Ca-current and shifted late inward current to outward direction. It is concluded that an inward current activated by intracellular calcium contributes to the late Phase of the action potential in rabbit atrial cells and to the late plateau in rabbit ventricular cells and in guinea-pig atrial cells. It may be carried by the Na-Ca exchange precess and/or by calcium-activated non-specific channels but preferably Na-Ca exchange machanism.
Action Potentials* ; Calcium ; Heart* ; Lithium ; Membranes* ; Myocytes, Cardiac ; Ouabain ; Ryanodine ; Sodium

The effect of ketanserin, serotonin antagonist, among 19 korean patients over 55 years with essential hypertension was assessed in an open clinical trial for three months. patients were given Ketanserin 20mg bid with monthly follow-up visits. Mean values of systolic/diastolic blood pressures fell from 169+/-17/104+/-10mmHg to 155+/-14/94+/-9mmHg at 2 weeks(p<0.01) and to 147+/-10/87+/-6mmHg at end of treatment 12 weeks after(p<0.001). There was no significant change in heart rate. Transient mild side effects were observed in 5 patients. We conclude that Ketanserin is an effective and safe drug for the treatment of elderly hypertensives.
Aged ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Middle Aged* ; Serotonin