No abstract available.
Animals ; Borrelia burgdorferi* ; Borrelia* ; Murinae*

A malignant rhabdoid tumor of the kidney, an uncommon renal tumor of children, is one of the most lethal neoplasms in early life. It was considered to be a sarcomatous variant of Wilms' tumor; however, further studies of its histological and clinical characteristics have proven it to be a distinct entity. We report a case of malignant rhabdoid tumor of the kidney in a 3-month-old girl, with a left abdominal palpable mass that had developed over the previous month. A left radical nephrectomy, with a regional lymph node biopsy, and 4 cycles of adjuvant chemotherapy, was performed. On the 45th postoperative day, multiple metastasises in liver, contralateral kidney and left upper lobe of lung were found. The patient expired 2 months after the operation.
Biopsy ; Chemotherapy, Adjuvant ; Child ; Female ; Humans ; Infant* ; Kidney* ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Nephrectomy ; Rhabdoid Tumor* ; Wilms Tumor

BACKGROUND AND OBJECTIVES: Electrocardiography (ECG) is a cost-effective and useful method for diagnosing left ventricular hypertrophy (LVH) in a large-scale study or in clinical practice. Among ECG criteria, the Cornell product (Cor P) and Sokolow-Lyon criteria were adopted by the European Society of Hypertension-European Society of Cardiology Guidelines but have different performances among races. The aim of this study was to compare the diagnostic performance of two voltage criteria in Korean patients. SUBJECTS AND METHODS: Electrocardiography and echocardiographic LV mass of 332 (159 male, 173 female) consecutive patients were analyzed. Cornell voltage criteria and the Cor P were compared with Sokolow-Lyon voltage (Sok V) and the Sokolow-Lyon product (Sok P). The sensitivities and specificities were estimated using a receiver-operating characteristics (ROC) curve in relation to the LVH diagnosis. The sensitivities and revised cut-off values were derived at specificity levels of 90, 95, and 100%. RESULTS: The Cornell-based criteria generally showed better performance than that of the Sok V criteria and Sok P in the area under the ROC curve analysis. The revised cut-off values for the Cornell voltage criteria (20 and 16 mm for males and females, respectively) showed an improved sensitivity (19.7 and 30.3% for males and females, respectively), with a high specificity of 95%. CONCLUSION: The Cornell-based criteria had better performance than that of the Sokolow-Lyon criteria in both Korean men and women. However, revised cut-off values are needed to improve accuracy.
Cardiology ; Continental Population Groups ; Echocardiography ; Electrocardiography ; Female ; Humans ; Hypertrophy, Left Ventricular ; Male ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: Although the net atrioventricular compliance can be obtained by invasive catheterization (Ccath) in mitral stenosis (MS), feasibility of noninvasive echocardiographic calculation of the compliance (Cecho) and its hemodynamic significance were not tested. METHODS: Using valve area by 2D planimetry (A2D) and deceleration slope (dv/dt) of transmitral velocity decay in continuous wave Doppler echocardiographic tracing, Cecho was defined as -A2D/(gamma dv/dt), which was compared with Ccath obtained directly during the catheterization in 30 MS patients with sinus rhythm. Exercise Doppler echocardiography with symptom-limited treadmill was performed in 66 patients with moderate to tight MS: mean mitral gradient (MG) and peak pressure gradient of tricuspid regurgitation (PGTR) at baseline and immediately after exercise were obtained using continuous wave Doppler echocardiographic tracing. Hemodynamic variables including Cecho, MG, PGTR and mitral valve area were analyzed to determine the association with patients' exercise tolerance. RESULTS: Cecho in 30 patients with tight MS (valve area 0.9+/-0.2 cm 2) was 4+/-1 ml/mmHg (2-7 mmHg), which showed a significant correlation with Ccath (r=0.48, p=0.01). Exercise time in 66 patients with moderate to tight MS showed significant negative correlation with resting MG, resting and postexercise PGTR, and positive correlation with Cecho: exercise time in those patients did not show any significant correlation with resting valve area. In multivariate analysis, Cecho and postexercise PGTR were independent factors determining exercise time in MS. CONCLUSIONS: The net atrioventricular compliance in MS can be calculated by noninvasive echocardiography, and it is an important hemodynamic factor determining exercise tolerance in MS.
Catheterization ; Catheters ; Compliance ; Deceleration ; Echocardiography ; Echocardiography, Doppler ; Exercise Tolerance ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Multivariate Analysis ; Tricuspid Valve Insufficiency

High-dose aprotinin (Hammersmith regimen) has been widely used for years to control postoperative bleeding and reduce blood consumption in cardiac surgery but had known to cause some side-effects and had disadvantage in cost-effectiveness. The prospective controlled study of 33 patients undergoing cardiopulmonary bypass was performed to evaluate the efficacy for reducing postoperative bleeding and unfavorable effects of low-dose aprotinin. The level of hemoglobin and platelet in the blood and the amount of postoperative bleeding were assessed preoperatively, and postoperatively for the study of hemostatic function. The level of BUN and serum creatinine in the blood, levels of urine creatinine, total protein, albumin, alpha-1-microglobulin and creatinine clearance were assessed before and after the operation for the study of renal function. The aprotinin group had a significant reduction in chest tube drainage; 243+/- 123 ml versus 406+/-303 ml (P=0.037) during 6 hours immediate-postoperatively, 494+/-358 ml versus 869+/-570 ml (P=0.045) during 24 hours postoperatively. The ratio of alpha-1-microglobulin/creatinine and microalbumin/creatinine in the urine were slightly increased in the aprotinin group postoperatively in comparison with the control group but there were no statistically significant difference (55+/-23 versus 24+/-10 in the alpha-1-microglobulin/creatinine, 56+/-19 versus 38+/-25 in the microalbumin/creatinine at post- operative 3rd day). There were no significant difference between two groups in other parameters of renal function, too. This study showed that low-dose aprotinin is an effective means of reducing postoperative bleeding without inducing significant renal dysfunction.
Aprotinin* ; Blood Platelets ; Cardiopulmonary Bypass* ; Chest Tubes ; Creatinine ; Drainage ; Hemorrhage* ; Humans ; Prospective Studies ; Renal Insufficiency ; Thoracic Surgery

Acute eosinophilic pneumonia(AEP) was first described in 1989 and represents a clinical entity distinct from chronic eosinophilic pneumonia. AEP is characterized by acute respiratory insufficiency, hypoxemia, fever, diffuse radiographic infiltrates, and eosinophilia in bronchoalveolar lavage fluid or lung biopsies in the absence of infection, atopy, or asthma. Rapid response to corticosteroids is characteristic. We experienced a 47-year-old metal driller presenting typical clinical and radiological characteristics of AEP. We confirmed eosinophilic pneumonia with brochoalveolar lavage analysis and transbronchial lung biopsy. We report a case of AEP diagnosed by clinical, radiographic, and histologic findings with a brief review of the literature.
Adrenal Cortex Hormones ; Anoxia ; Asthma ; Biopsy ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils* ; Fever ; Humans ; Lung ; Middle Aged ; Pulmonary Eosinophilia* ; Respiratory Insufficiency ; Therapeutic Irrigation

A statistical observation was made on 856 in-patients with operative procedures in the Department of Urology, Catholic Medical College, During the period from January 1, 1971 to December 31, 1975.
Surgical Procedures, Operative ; Urology

BACKGROUND AND OBJECTIVES: The structural significance of the inappropriateness of left ventricular mass (iLVM) is known to be an important prognostic factor for cardiovascular events; however, the functional changes associated with iLVM have not been established. This study was performed to determine if diastolic dysfunction is associated with iLVM using a tissue Doppler technique. SUBJECTS AND METHODS: Three hundred sixty consecutive subjects, including 221 hypertension patients from the echocardiography database, were analyzed. Regarding the appropriateness of left ventricular (LV) mass, an observed/predicted ratio of LV mass (OPR) >130% was defined as inappropriate. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), isovolumetric relaxation time (IVRT), and E/early mitral annulus velocity (E'), were compared between the appropriate LV mass (aLVM) group and the iLVM group. RESULTS: Among transmitral flow parameters, only the E velocity was negatively correlated with the OPR when adjusted for age (adjusted r=-0.107, p=0.04). Based on multiple regression analysis, the OPR (beta=0.163, p=0.003), as well as age (beta=0.286, p=0.0001), systolic blood pressure (beta=0.120, p=0.019), fasting blood glucose (beta=0.098, p=0.042), and male gender (beta=0.157, p=0.002) were independent factors determining E/E'. The cholesterol level was not an independent factor (beta=-0.059, p=0.355). In the iLVM group (n=105), the adjusted E/E' was higher than in the aLVM group (n=255; 11.7+/-3.4 vs. 10.8+/-3.1, p=0.02), while the peak E flow velocity was significantly lower than in the aLVM group (70.9+/-15.1 vs. 75.5+/-17.6, p=0.03). CONCLUSION: Inappropriateness of LV mass is independently associated with increased E/E'. Thus, E/E' may be a useful parameter for the evaluation of diastolic dysfunction.
Blood Glucose ; Blood Pressure ; Cholesterol ; Deceleration ; Echocardiography ; Fasting ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Male ; Relaxation

BACKGROUND AND OBJECTIVES: The aim of the study was to evaluate the difference of temporal lability in myocardial repolarization between acute non-Q (NQMI) and Q-wave myocardial infarction (QMI), and to discern whether the locations of myocardial infarction influence such temporal lability. SUBJECTS AND METHODS: Twelve patients with NQMI and 28 with QMI, including 16 anterior (AMI) and 12 inferior MI (IMI) patients were enrolled. Twenty four-hour ambulatory ECG recordings of each patient were analyzed, and the digitized data was partitioned into 30-min sections. The QT intervals were measured using a template matching strategy. We then calculated the low (LF:0.03 - 0.15 Hz) and high frequency (HF:0.15 - 0.4 Hz) power of the QT interval variability using an algorithm capable of removing the influence of the RR-interval on QT interval variability (Normalized Idioventricular QT variability Index:IV-QT). RESULTS: For patients with QMI, the low frequency IV QT (LF IV-QT) was higher than that of NQMI (1.941+/-0.101 and 1.556+/-0.114 respectively, p<0.05). No difference was seen in the high frequency IV QT (HF IV-QT) of the two groups. For QMI patients, both the LF IV-QT and HF IV-QT were higher in day time (6AM-6PM) than in night time (6PM-6AM). Comparing the differences of these indices by the location of QMI, both the LF IV-QT and HF IV-QT of AMI were higher than those of IMI patients (2.231+/-0.135 vs 1.355+/-0.131 and 2.341+/-0.161 vs 1.346+/-0.145 respectively, p<0.0005). Both indices of each group also demonstrated a circadian change. CONCLUSION: In cases of QMI, the temporal lability in myocardial repolarization is larger than that seen in NQMI. Moreover, it was worse in AMI than IMI. Finally, such temporal repolarization lability tends to have a circadian pattern in QMI.
Electrocardiography ; Electrocardiography, Ambulatory ; Humans ; Myocardial Infarction*

BACKGROUND AND OBJECTIVES: Few studies have invasively assessed diastolic functional reserve and serial changes in left ventricular hemodynamics in euvolemic patients with exertional dyspnea. In this study, sequential changes in left ventricular end-diastolic pressure (LVEDP) to leg-raise exercise were measured invasively in patients with early heart failure with preserved ejection fraction (HFpEF) to determine the association between these serial changes and echocardiographic results or clinical features. SUBJECTS AND METHODS: During their hospital stay, 181 patients with early HFpEF underwent left cardiac catheterization, coronary angiography, and transthoracic echocardiography (TTE). Leg-raise exercise was performed in two stages: during cardiac catheterization and again during TTE. RESULTS: Compared with the initial values, all the invasively measured LVEDP values increased significantly during the leg-raise exercise, whereas the septal e/e' ratio remained unchanged. Active leg-raise led to increased LVEDP, which caused dyspnea. The severity of symptoms correlated with the level and extent of changes in LVEDP. At the end of active leg-raise, LVEDP decreased in 40 patients (22.1%), who were younger and had significantly lower e/e' ratios. On multivariate analysis to predict the response of LVEDP to active leg-raise, age and the septal e/e' ratio remained significant predictors. CONCLUSION: Despite having similar LVEDP values at rest, patients may respond to exercise with different LVEDP levels and clinical manifestations, depending on their diastolic capacity. The leg-raise exercise in early HFpEF can elucidate individual diastolic profiles, and the LVEDP response to the leg-raise test may serve as a useful criterion in stratifying patients with early HFpEF with respect to functional reserve.
Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Dyspnea* ; Echocardiography ; Heart Failure ; Heart Failure, Diastolic ; Hemodynamics ; Humans ; Length of Stay ; Multivariate Analysis ; Ventricular Function, Left