No abstract available.
Fibroma, Ossifying* ; Nasal Cavity*

Assessment of Myocardial contractility is critically important task in the evaluation of patients with heart disease. In recent years many indices have been studied to evaluate myocardial inotropic state, applying the skeletal muscle mechanics to intact heart. Among such indices, Vmax(maximum velocity of shortening of the unloaded contractile elements) and Vpm(physiologic maximum observed velocity of myocardial shortening) provide a measure of myocardial contractility independent of preload or afterload. To obtain normal values in Korean adults, the left ventricular pressure data of 16 patients with normal physical activities were analyzed, using the digital computer. Seven patients had ventricular septal defect with Qp/Qs less than 2.0, one patient had mitral stenosis, another one patient had mitral stenosis and aortic regurgitation (grade I/IV and the remainder seven patients had no intrinsic cardiac disorder. But, the cardiac performances of all patients were apparently normal. The results were as follows: 1) Cardiac index was greater than 3.0 l/min/m2 in all patinets: 4.9+/-1.32(+/-S.D.)l.min/m2. 2) Ejection fraction was greater than 55% in all patients: 71.2+/-8.04(+/-S.D.)%. 3) Left ventricular end diastolic pressure(LVEDP) ranged from 3 mmHg to 12 mmHg. 4) Vmax: 48.1+/-9.41(+/-S.D.) sec(-1). 5) Vpm: 39.3+/-8.13(+/-S.D.) sec(-1).
Adult* ; Aortic Valve Insufficiency ; Computers ; Heart ; Heart Diseases ; Heart Septal Defects, Ventricular ; Humans ; Mechanics ; Mitral Valve Stenosis ; Motor Activity* ; Muscle, Skeletal ; Reference Values ; Ventricular Pressure

No abstract available.
Arteries* ; Atherectomy*

Coronary artery and valvular injuries after blunt chest trauma are an unusual condition. This diagnosis is very difficult to estabilish, but prompt diagnosis and proper management are important in life saving. We report one patient who develop left main coronary artery dissection, tricuspid insufficiency, mitral insufficiency and pericardial rupture following blunt chest trauma. One year ago, he had suffered a frontal impact in a traffic accident and recieved anti-tuberculosis medication for 10 months for chest discomfort. The correct diagnosis was confirmed noninvasively by transesophageal echocardiography and the patient was treated left main coronary artery dissection flap removal, mitral valve replacement, tricuspid valvuloplasty and repair of ruptured pericardium. The postoperative course was uneventful and the patient was fully recovered.
Accidents, Traffic ; Coronary Vessels* ; Diagnosis ; Echocardiography, Transesophageal ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Pericardium ; Rupture* ; Thorax*

Sinus of Valsalva aneurysms are rare cardiac anomalies and are usually caused by the separation of the aortic wall media from the valve ring tissue. These aneurysms frequently rupture into the low-pressure areas like the right ventricle and right atrium, rarely do they rupture into the left atrium, left ventricle, pericardial sac, or pulmonary artery. Cerebral infarction has been reported as a rare complication of unruptured sinus of Valsalva aneurysm. We experienced very rare two cases of Valsalva aneurysms of right coronary sinus dissecting into the interventricular septum in patients with cerebral infarction. In two cases these aneurysms ruptured into the left ventricle. These aneurysms were excised and the defect was closed with autopericardium. At the end of the surgical repair, coaptation was found to be insufficient and aortic valve replacement was undertaken.
Aneurysm* ; Aortic Valve ; Cerebral Infarction* ; Coronary Sinus ; Heart Atria ; Heart Ventricles ; Humans ; Pulmonary Artery ; Rupture ; Sinus of Valsalva*

Previous studies have shown that experimental canine coronary or rabbit cardtid qrtery stenosis that is associated with endothelial injury results in a typical pattern of blood flow characterized by gradual decreases in arterial flow followed by restorations of flow to normal values. This pattern of flow, called cyclic flow reduction(CFR), is the consequence of recurrent platelet aggregation at the site of the stenosis and endothelial injury and subsequent dislodgement of the thrombus. This study was designed to test the efficacy of verapamil in ingibiting in vivo platelet aggregation in a rabbit model of cardotid artery stenosis and ecdothelial injury. Carotid blood flow was measured continuously with a electromagnetic flowmeter probe that is positioned proximal to the constrictor. During placement of constrictor and angioplasty balloon, CFR developed in 8 of 20 rabbits with a mean frequency of 10.0+/-2.2 cycles/h. CFRs were observed for 30min, and IV verapamil was administered till declining of blood pressure(up to 100ug/kg). After intravenous verapamil, the mean frequency of CFR insignificantly decreased to 8.7+/-2.1 cycles/h(p=ns). After 20mg/kg of aspirin were given intravenously, the CFR were abolished in 5 rabbits, the mean frequency of CFR decreased in 1 rabbit, and no significant change was observed in 2 rabbits. It is concluded that verapamil is relatively ineffective in inhibiting in vivo platelet aggregation at doses that don't change hemodynamics significantly.
Angioplasty ; Arteries ; Aspirin ; Carotid Stenosis* ; Constriction, Pathologic ; Flowmeters ; Hemodynamics ; Magnets ; Platelet Aggregation ; Rabbits ; Reference Values ; Thrombosis ; Verapamil*

Marfan syndrome may be associated with various cardiovascular complications, but expanding abdominal aneurysm is a relatively rare complication. A 32 year old male patient was admitted to S.N.U.H. because of pulsating abdominal mass and back pain. The patient was diagnosed as a case of expanding abdominal aortic aneurysm and annuloectasia of aorta due to Marfan syndrome. Abdominal aneurysm was located from 3 cm below the origin of left renal artery to left common iliac artery. Abdominal aneurysm was operated successfuly. The size of abdominal aneurysm was about 2815cm. The pathological findings of surgically removed abdominal aortic wall showed loss of elastic fibers and fragmentation of fibers in media. A case of expanding abdominal aortic aneurysm due to Marfan's syndrome was reported with a review of literatures.
Adult ; Aneurysm* ; Aorta ; Aortic Aneurysm, Abdominal ; Back Pain ; Elastic Tissue ; Humans ; Iliac Artery ; Male ; Marfan Syndrome* ; Renal Artery

BACKGROUND: CarboMedics and St.Jude Medical bileaflet valves are in widespread use but few noninvasive studies about the two types of valves were performedd. The aim of this study was to assess the characterisics of the normally functioning CarboMedics and St.Jude Medical prosthesis in the mitral position. METHODS: Patients with normally functioning CarboMedics and St.Jude Medical valve in the mitral position were included. They underwent transthoracic and transesophageal echocardiography 7 to 14days after mitral valve replacement. With the use of color flow Doppler transesophageal echocardiography, we measured the length, width, and area of maximal physiologic regurgitation and by using 2-D transesophageal echocardiography, we measured the opening and closing angles of the bileaflet valves and we tried to elucidate whether spontaneous echo contrast is present in the left atrium. RESULTS: 31 pateints underwent mitral valve replacement with CarboMedics and 10 patients with St.Jude Medical. The length of maximal physiologic regurgitation ranged from 11mm to 44mm in carboMedics mitral valve and from 12mm to 36mm in St.Jude Medical mitral valve. The area ranged from 0.19cm2to 3.48cm2in CarboMedcs and from 0.58cm2to 4.49cm2in CarboMedics and The mean opening and closing angles are 83.2(+/-1.1)degrees, 22.3(+/-1.3)degrees in CarboMedics and 86.5(+/-1.2)degrees 26.2(+/-3.2)degrees in St.Jude Medical. Spontaneous echo contrast was positive in 66% of patients, of whom patioents with atrial fibrillation showed nuch higher revalence of SEC than patients with sinus rhythm. CONCLUSION: These finding valve will give us a reference valvue for the evaluation of prosthetic valve function in mitral position.
Atrial Fibrillation ; Echocardiography* ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Mitral Valve* ; Prostheses and Implants

Scanning with whole-body 131I scintigraphy after surgery has been a valuable diagnostic modality in the surveillance of patients with differentiated thyroid cancer. Radioiodine uptake is rarely observed in non-lactating breast tissue, which mimics thyroid cancer metastasis. We now report a case of a 45-year-old female thyroid cancer patient who underwent radioiodine therapy, and in whom breast uptake of radioiodine was observed on a post-therapy whole body scan. Her serum prolactin level was elevated to 328 ng/mL at the time of the radioiodine uptake, and the hyperprolactinemia was induced by her antipsychotic medications. Six months after she discontinued that medication, her serum prolactin level was normalized to 12.6 ng/mL and breast uptake of iodine was no longer present in a follow-up whole body scan.
Antipsychotic Agents ; Breast ; Female ; Follow-Up Studies ; Humans ; Hyperprolactinemia ; Iodine ; Middle Aged ; Neoplasm Metastasis ; Prolactin ; Thyroid Gland ; Thyroid Neoplasms ; Whole Body Imaging

BACKGROUND AND OBJECTIVES: Metabolic syndrome (MetS) increases the risk of heart failure (HF). The purpose of this study was to identify the prevalence of MetS in patients with HF and determine the syndrome's association with HF in clinical and laboratory parameters. SUBJECTS AND METHODS: A total of 3200 HF patients (67.6+/-14.5 years) enrolled in a nationwide prospective Korea HF Registry between Jan. 2005 and Oct. 2009. Patients were divided into two groups according to the presence or absence of MetS at admission: group I (presence, n=1141) and group II (absence, n=2059). RESULTS: The prevalence of MetS was 35.7% across all subjects and was higher in females (56.0%). The levels of white blood cells, platelets, creatinine, glucose, and cholesterol were significantly higher in group I than in group II. Left ventricular dimension and volume was smaller and ejection fraction was higher in group I than in group II. An ischemic cause of HF was more frequent in group I. The rates of valvular and idiopathic cause were lower in group I than in group II. The rate of mortality was lower in group I than in group II (4.9% vs. 8.3%, p<0.001). CONCLUSION: Despite the increased cardiovascular risks in MetS, MetS was found to be associated with decreased mortality in HF.
Blood Platelets ; Cholesterol ; Creatinine ; Female ; Glucose ; Heart ; Heart Failure ; Humans ; Korea ; Leukocytes ; Prevalence ; Prospective Studies