Early diastolic left ventricular relaxation was determined in 20 patients by combined echopressure measurement. 7 normal control cases and 13 cases with valvular regurgitation were studied with reference to incremental delta elastance. The hemodynamic and echocardiographic data were analysed during the phase of decreasing left ventricular elastance (that is, when pressure is decreasing while volume is increasing). Starting from a fixed level of wall stress (40 kdyne/cm2), we determined Incremental Delta Elastance(ratio big up tri, Delta p/big up tri, Delta V) by a constant increase in LV volume(eg. 10 ml/M2 or 20 ml/M2). We named Incremental Delta Elastance at 10 ml/M2 and 20 ml/M2 of LV volume increase as d-E 10 and d-E 20 respectively. In valvular regurgitation, incremental delta elastances were statistically different from those of normal subjects(p<0.01). d-E10 was -1.67+/-0.69(versus -3.38+/-1.75 in normal subjects) mmHgm2/ml and d-E20 was -0.98+/-0.39(versus -1.69+/-0.84 in normal subjects) mmHgm2/ml. d-E 10 and d-E20 were compared with ejection phase indices(ejection fraction, meanVcf) in whole group(n=20). There was significant correlation between d-E and ejection fraction(d-E10 : r=-0.47, d-E20:r=-0.50) p<0.05. There was significant correlation between d-E and meanVcf(d-E10: r=0.53, d-E20: r=-0.57) p<0.05. d-E10 and d-E20 were compared with volume indices(end-diastolic volume index and end-systolic volume index) but no significant correlation was found. Because we evaluated that inotropic state or afterload would influence incremental delta elastance, further study, especially with reference to endsystolic volume index may be needed. The absolute values between d-E10 and d-E20 were different but they were simliar in property. We concluded that incremental delta elastance(d-E10 or d-E20) could be used as a useful index of early diastolic relaxation in chronic valvular regurgitation.
Echocardiography ; Hemodynamics ; Humans ; Relaxation*

Authors analysed systolic pressure-volume-stress relations by combined echo-pressure-cineangiographic measurement in 10 normal subjects(Group I) and 37 patients with chronic valvular heart diseases. Patients with chronic valvular heart diseases were divided into 3 groups : Group II ; mitral stenosis(n=9), Group III ; mitral stenosis with aortic regurgitation(n=19). The aims of this study are to find useful left ventricular(LV) contractility indices and evaluate left ventricular contractility at various volume loading states. Studied LV contractility indices were maximal elastance of isovolumic contraction(Eiso), endsystolic pressure-volume ratio(Ees) and slope of regression line in late systolic stress-volume loop(A). Eiso was estimated using an isovolumic contraction model of Sunagawa and A was analysed in a single ejecting beat. Endsystolic volume index(ESVI), end diastolic volume index(EDVI), stress at peak pressure(Speak), cardiac index, Vmax, mean Vcf and ejection fraction were determined also. The obtained results were as follows. 1) Significant correlations were found in whole group(n=47) between Eiso and Ees(r=0.88, P<0.005), Elso and cardiac index(r=0.83, P<0.005), Ees and CI(r=<0.76, p<0.005). Further, these correlation coefficiencies were not different between any two groups of Group I, Group II, Group III, Grouop IV and whole group (p<0.05); that is Eiso or Ees had a constant significance at various loading state. 2) Significant correlation between A and cardiac index was noted in Group I+II+III(n=28, r=0.48, p<0.01), but this correlation coefficiency was significantly different from that of Group IV(n=19, r=0.08); p<0.05. 3) In Group II(patients with mitral stenosis), cardiac index* and EDVI* and stress at peak pressure** were decreased significantly(*:p<0.05, **:p<0.005). But Eiso, Ees, A and all the other idices were not decreased. These findings suggested that left ventricular contractility is not reduced in mitral stenosis. 4) In Group IV(patients with amitral regurgitation with or without aortic regurgitation), **EDVI and ESVI** were increased while Eiso**, Ees, Vmax*, mean Vcf* and cardiac index** were decreased significantly. But ejection fraction and A were not decrease. These findings suggested that ejection fraction and A may not be decreased at volume overload, despite of impaired left ventricular contractility. In summary; Eiso or Ees was evaluated as an useful contractility index which appeared not to be influenced by various volume loading state, while eiection fraction and A to be influenced. Patients with mitral stenosis as a group have reduced cardiac performance which is not due to impairment of left ventricular contractility(muscle function) but to reduced preload.
Constriction, Pathologic ; Heart Valve Diseases* ; Humans ; Mitral Valve Stenosis

No abstract available.
Lithotripsy* ; Shock*

Cortical dysplasia is a cause of intractable epilepsy and a candidate for surgical resection to control epileptic attacks. The neuronal cytomegaly and balloon cell change are the diagnostic hallmarks of cortical dysplasia. Little research has been performed about the normal-sized dysplastic neuron which has complex arborizing dendrites and lacks in its polarity. The aim of this study was to define the histopathologic characteristics of the neurons in cortical dysplasia. Twelve cases of cortical dysplasia who underwent partial lobectomy for intractable seizures were selected and immunohistochemical staining for NF-M/H, MAP2, tau, and ubiquitin was performed. The perikarya and dendrite of dysplastic neurons were more intensely labeled with antibodies for the high and medium molecular weight neurofilament proteins (NF-M/H) than normal neurons. Immunoreactivity with the MAP2 antibody expressed mainly within the somatodendritic regions was present in the dysplastic or normal neurons without any significant difference in intensity. The complex arborizing dendrites of dysplastic neurons were easily identified due to pronounced immunoreactivity within the somatodendritic regions. Immunoreactivity with the primary antibody against tau and ubiquitin was present in the normal-looking neurons as well as the dysplastic neurons. This study suggests that the dysplastic neurons in cortical dysplasia are accompanied by changes of cytoskeletal neurofilaments, and the immunohistochemical stains for NF-M/H, MAP2, tau, and ubiquigin are useful to detect them.
Antibodies ; Coloring Agents ; Dendrites ; Epilepsy ; Malformations of Cortical Development* ; Molecular Weight ; Neurofilament Proteins ; Neurons ; Seizures ; Ubiquitin

No abstract available.
Trichothiodystrophy Syndromes*

No abstract available.
Female ; Humans ; Ovarian Diseases*

Chronic granulomatous disease (CGD) is an inherited immunodeficient disease characterized by recurrent infections and granuloma formation. Granulomatous obstruction of esophagus is one of the rare complications of CGD. The use of steroids and antimicrobials for esophageal obstruction by granuloma in CGD patients has been controversial due to the possibility of concomitant inapparent infection. We report a case of esophageal obstruction in an 8-year-old CGD patient showing the poor response to antibiotics therapy. However, dramatic improvement of symptoms and radiologic findings of esophageal obstruction were achieved after steroid therapy. One month after discontinuation of steroid, esophageal obstruction recurred and the patient was re-treated with steroid. After that time, he experienced one more recurrence of esophageal obstruction. This symptom subsided after antibiotics therapy without steroid and he has been followed up to the present without further relapse.
Anti-Bacterial Agents ; Child ; Esophageal Stenosis ; Esophagus ; Granuloma ; Granulomatous Disease, Chronic* ; Humans ; Recurrence ; Steroids

No abstract available.
ACTH Syndrome, Ectopic* ; Wilms Tumor*

The antihypertensive effects of tripamide was studied in 19 cases of essential hypertension. After 4 weeks treatment with daily dosage of Tripamide (Normonal(R)) 15mg, the dosage was adjusted to 30mg in 10 cases. Before and after treatment laboratory tests were performed in 11 cases. The obtained results were as follows: 1) After 4 weeks treatment with daily dosage of Tripamide 15mg, mean systolic and diastolic blood pressure was decreased by 25 mmHg (12.7%) and 9.7 mmHg (8.5%) respectively(p<0.01), and in 58% of the cases, good or fair control of blood pressure was resulted. 2) After final treatment, mean systolic and diastolic blood pressure was decreased by 29.7 mmHg(15.1%) and 15.0 mmHg(120.5%) respectively(p<0.005) and in 79% of the cases, good or fair control of blood pressure was resulted. 3) There was no significant changes in the values of sodium, potassium, BUN, creatinine, uric acid, cholesterol, SGOT, SGPT and calcium after treatment. 4) There was no significant side effect except one case of mild fatigue and tingling sense of extrmities which were subsided spontaneousely.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Calcium ; Cholesterol ; Creatinine ; Fatigue ; Hypertension ; Potassium ; Sodium ; Uric Acid

To evaluate croneal haze related to amount of correction, age and sex following excimer laser photorefractive keratectomy(PRK) in myopic eyes, 39months follow-up study on 358 eyes was performed prospectively. The preoperative spherical equivalent refraction ranged from -1.0D to 11.25D(mean -6.18D). The subjective corneal haze grading showed a maximum with mean grading of 0.92 at 2 months and a gradual decrease to 0.14 at 24 months after PRK. The degree of haze was statistically greater with higher amount of correction(p<0.05). No difference was found related to age and sex(p>0.05). Clinically significant corneal haze and scarring was frequent in higher myopia group(p<0.05). Individual variation in corneal haze after PRK was found. However, high myopia is a risk factor of the corneal haze following PRK, and further study to decrease the corneal haze after PRK is necessary.
Cicatrix ; Follow-Up Studies ; Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Risk Factors