An analysis of echocardiograms was made in 50 patients with pericardial effusion of various origins, diagnosed by clinical and M-mode echocardiographic examinations. In these cases the estimated volume of pericardial effusion ranged between 40 ml and 999 ml. The width of echo-free space behind the left ventricular wall which reflect the amount of effusion showed a significant positive correlation with the systolic excursion and the diastolic mean velocity of both right and left ventricular epicardial surfaces. The echocardiographic patterns of so-called pseudo-mitral valve prolapse and a notch on the right ventricular epicardial surface during systole were found more frequently in patients with large pericardial effusion. Thus, in pericardial effusion, and echocardiographic examination is useful for the visualization of the abnormal motions of cardiac structures as well as for its diagnosis.
Diagnosis ; Echocardiography* ; Humans ; Pericardial Effusion* ; Prolapse ; Systole

PURPOSE: To diagnose the coronary artery disease, it is necessary to have a thorough knowledge on coronary anatomy and normal variations. We performed a morphological study on normal variations of coronary artery in Korean adults. MATERIALS AND METHODS: 1012 cases of coronary angiography were analyzed with particular emphasis on the normal variation of three coronary arteries and their major branches, including origin of conus artery, sinus node artery and atrioventricular node artery and the variation in posterior descending artery and ramus medianus. RESULTS: We found right dominance in 895 cases(88.4%), left domainance in 44 cases(4.3%), and balanced dominance in 73 cases(7.2%). Conus artery branched from right coronary artery in 468 cases(47.6%) and originated in right coronary sinus close to the os of right coronary artery in 515 cases(52.4%). Sinus node artery originated from left circumflex artery in 551 cases(54.4%), from right coronary artery in 442 cases(43.7%), and from both coronary arteries in 19 cases(1.9%). Atrioventricular node artery originated from right coronary artery in 943 cases(93.4%), from left circumflex artery in 59 cases(5.8%), and two atriovenricular node arteries from both arteries in 8 cases(0.8%). Posterior descending artery had the normal pattern in 505 cases(58.6%) and some variation in 357 cases(41.4%). We found short left main coronary artery, less than 2--3 mm, making it hard to cannulate in 172 cases(17.0%). Ramus medianus was found in 165 cases(16.5%) with marginal distribution in 84 cases(8.4%), diagonal distribution in 80 cases(8.0%) and coursing interventricular sulcus as double left anterior descending artery in 1 case(0.1%). Left main coronary artery gave off 4 branches in 8 cases(0.8%). Myocardial bridging was found in only 3 cases(0.3%). CONCLUSION: This study could provide basic morphological data on anatomy and normal variations of coronary arteries in Korean adults.
Adult ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Sinus ; Coronary Vessels* ; Humans ; Myocardial Bridging

The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consisitsof transposition of great arteries and ventricular inversion, and which is caused by abnormal developement ofconotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to getaccurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented,in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul NationalUniversity Hospital between Sep. 1976 and June 1981. The clinical, radiogrpahic ,and operative findings with theemphasis on the angiocardiographic findings were analized. The resuls are as follows; 1. Among 18 cases, 13 caseshave normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situsinversus and 1 case has levocardia with situs inversus. 2. Segmental sets are {S.L.L.} in 15 cases, and {I.D.D} in3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and bothsemilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5.Associated cardiac malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively.6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is anessential procedure.
Angiocardiography ; Aorta, Thoracic ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Cineradiography ; Conus Snail ; Dextrocardia ; Diagnosis ; Levocardia ; Mitral Valve Insufficiency ; Prolapse ; Seoul ; Situs Inversus ; Transposition of Great Vessels

The cardiac dimensions and functions were studied by analyzing simultaneously recorded M-mode echocardiograms and phonocardiograms in 24 cases of essential hypertension with no evidence of heart faliure, and also in 20 healthy adults for comparison. Thirteen hypertensives out of 24 had findings consistent with left ventricular hypertrophy on either routine chest roentgenograms or electrocardiograms or both(group II) and the remaining 11 had no such findings(group I). The posterior wall and septal thickness, and isovolumic relaxation time were significantly was increased even in the group I as well as in the group II. The isovolumic relaxation time was correlated well with the septal thickness in both groups. In contrast, a significant increase in left atrial and left ventricular systolic dimensions was noted only in the group II, and so was a significant reduction in the fractional shortening and mean velocity of circumferential fiber shortening. These findings suggest that the echocardiographic examination is useful in patients with essestial hypertension for the early dagnosis of the increased thickness of the posterior wall and the septum, and the abnormality during early diastolic relaxation of the left ventricle, prior to the appearance of the ventricular hypertrophy on the routine chest films amd/or electrocardiograms, and also that echocardiograms enable early detection of the systolic dysfunction of the hypertrophied left ventricle in the absence of apparent failure.
Adult ; Echocardiography* ; Electrocardiography ; Heart ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular ; Relaxation ; Thorax

The antihypertensive effect of trimazosin was studied in 24 cases of essential hypertension, which include 9 cases with pretreatment diastolic pressure of 114mmHg or more, for a period of 4 weeks. The average pretreatment systolic and diastolic blood pressures were approximately 175mmHg and 114mmHg, respectively. The treatment was started with 100mg of trimazosin daily in 2 divided doses and and the drug was titrated upward at weekly interval by 100mg up to 400mg/day depending on the response of the blood pressures. Routine blood counts, urinalyses, liver and kidney function tests, electrolyte balance, total serum cholesterol and triglyceride were determined before and at the end of treatment. The diastolic blood pressure fell 10mmHg or more in 20 out of 24 cases(83.3%), and in 12 cases out of 20 favorable responders it fell to 90mmHg or below. The pretreatment diastolic blood pressure in 4 nonresponders was all 115mmHg or more. The antihypertensive effect appeared during the first week of therapy and progressively increased until the end of treatment week without causing postural hypotension. Unpleasant symptoms appeared in 12 cases during treatment, which include dizziness, headache, numbness in the extremities and tinnitus in the decreasing order of frequency. However, these symptoms were mild and transient in all cases disappearing spontaneously despite continued medication. No significant biochemical changes in the blood were recorded after treatment. We conclude that trimzosin seems to be a safe and effective antihypertensive drug particularly useful for the treatment of mild to moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Extremities ; Headache ; Hypertension* ; Hypesthesia ; Hypotension, Orthostatic ; Kidney Function Tests ; Liver ; Tinnitus ; Triglycerides ; Urinalysis ; Water-Electrolyte Balance

A laboratory based study was performed to survey possible etiological relationship of herpes virus type II in carcinoma of the prostate. A total of 33 patients (20 with prostatic carcinoma and 13 with benign prostatic hyperplasia as control) who underwent transurethral resection of the prostate was studied. Paraffin embedded prostatic tissue materials were examined by immunocytochemical stain for herpes simplex virus-type II And the grade. stage of tumor and age of patient were recorded for the comparison with herpes simplex virus-type II expression. The results were as follows: 1. The average age of patient with prostatic cancer was 71.6 years +/- 5.2 years (mean+/-S.D.) and of patient with BPH was 67.7 years +/- 6.7 years (mean+/-S.D.). 2. Of the 20 blocks of prostatic carcinoma, 19 cases (95%) showed positive reaction and of the 13 blocks of benign prostatic hyperplasia, only 1 case (7.7%) demonstrated positive reaction to immunocytochemical stain for herpes simplex virus-type II . Antibody prevalence between prostatic cancer and benign prostatic hyperplasia group were significantly different (p<0.005). 3. The incidence of herpes simplex virus-type E antigen did not increase in proportion to grade and stage of prostatic carcinoma. From the above results, it is suggested that the demonstration of specific herpes virus type II antigen in patients with prostatic cancer supports an possible etiologic roles of herpes virus type II But epidemiological studies are recommended to define definite etiologic roles of herpes simplex type II virus in prostatic carcinoma.
Adenocarcinoma* ; Epidemiologic Studies ; Herpes Simplex* ; Humans ; Incidence ; Paraffin ; Prevalence ; Prostate* ; Prostatic Hyperplasia* ; Prostatic Neoplasms

The nephroptosis is a downward displacement of kidney beyond the normal range of mobility which may cause urinary tract infection, flank pain, nausea and vomiting. In patients who develop symptoms may require nephropexy or empirical supporting treatment with abdominal belt. Since the ordinary method of nephropexy and bring renal capsular tearing, we designed a method of transfixing sutures to the upper and lower poles of kidney to quadratus lumborum muscle in order to prevent renal capsular damage. Herein, we present 3 cases of nephropexy by applying transifixing modified method to those who developed severe symptoms with satisfying results.
Flank Pain ; Humans ; Kidney ; Nausea ; Reference Values ; Sutures ; Urinary Tract Infections ; Vomiting

Effects of thoracentesis on thoracic impedance and cardiac performance were studied in patients with uncomplicated unilateral tuberculous pleural effusion. The speed of the removal of the pleural effusion in thoracentesis was essentially similar to that of a generally used for therapeutic purpose in daily practice. Thoracic impedance was measured in 23 cases before, 4 and 10 minutes after thoracentesis to the amount of pleural effusion aspirated was observed. In 11 cases out of 23, the changes in cardiac performance as assessed by stroke volume, cardiac output, heart rate, heather index and ratio of pre-ejection period to left ventricular ejection time(PEP/LVET) were observed 4 minutes after 150 ml to 1,000 ml of thoracentesis. In these cases, stroke volume, cardiac output, and Heather index were determined from impedance cardiograms, and PEP/LVET from mechanocardiograms recorded simultaneously with the former. A significant increase in thoracic impedance was observed both 4 and 10 minutes after thoracentesis. There was a slight but a significant correlation between the changes in thoracic impedance and the amount of pleural fluid aspirated only 4 minutes after thoracentesis. Thoracentesis showed no consistent influence on cardiac performance as reflected to stroke volume, cardiac output, heart rate, heart index and PEP/LVET. These facts suggest that measurement of thoracic impedance may be a useful method reflecting alterations in pleural fluid volumes, particularly when it occurs in a relatively short period of time, and the effects of thoracentesis of less than one liter on the cardiac functions as determined by the above-mentioned parameters were variable.
Cardiac Output ; Electric Impedance* ; Heart ; Heart Rate ; Humans ; Pleural Effusion ; Stroke Volume

M-mode echocardiograms were recorded in 268 apparently healthy young male adults and the mitral valve motion during systole was analyzed. In 149 cases( 55.6%) out of 268 the predominant echo of mitral valve closure(CD line) was recorded as smooth line moving slowly anteriorly, in 48 cases(17.9%) the CD line showed an abrupt transient posterior motion during early systole, in 24 cases(9.0%) there were multiple additional echoes posterior to the CD line, 17 cases(6.3%) the mitral valve closure was recorded as pansystolic anteriorly concave echo deviating less than 2 mm from a drawn CD line, and 10 cases(3.7%) as curvilinear and anteriorly convex echo deviating from a drawn CD line. In the remaining 20 cases(7.5%), the mitral valve closure was recorded as pansystolic anteriorly concave echo deviating more than 2 mm from a drawn CD line, which was categorized to have mitral valve prolapse in the current study. However, there were no significant differneces in various echocardiographic dimensions of the heart and the aorta between those with and without mitral valve prolapse.
Adult ; Aorta ; Echocardiography* ; Heart ; Humans ; Male* ; Mitral Valve Prolapse* ; Mitral Valve* ; Systole

Effect of diltiazem hydrochloride on cardiac performance with particular reference to the antianginal action was studied in 17 patients with ischemic heart disease, including 12 cases of effort angina, by means of clinical and mechanocardiographic evaluations. All patients were kept on the same medications from at least 2 weeks prior to diltiazem administration until the end of the study, and were prescribed no other antianginal drugs except for liberal use of sublingual nitroglycerin. Diltiazem was given 90mg a day in three divided doses for two weeks. Clinical and mechanocardiographic evaluations, including calculations of pressure rate product(PRP), triple product(TP) and tension time index(TTI), were made before and at a weekly interval after diltiazem administration. After the medication, heart rate, blood pressure and the pre-ejection period(PEP) with its ratio to the ejection time tended to decrease, and the decreases in heart rate and the PEP at the end of two weeks were significant. The PRP, TP and TTI were also significantly decreased at the end of the second week, and the decrease in the TTI was significant even a week after the medication. An antianginal effect, which appeared within few days, was excellent to good in over 90 percent of the cases. These facts suggest that diltiazem hydrochloride has no negative inotropic action and its antianginal effecti in its early stage of the drug administration is primarily due to coronary vasodilation and, as the drug is continued, is contributed to possibly by the decrease in the myocardial oxygen consumption as well.
Angina Pectoris* ; Blood Pressure ; Diltiazem* ; Heart Rate ; Humans ; Myocardial Ischemia* ; Nitroglycerin ; Oxygen Consumption ; Vasodilation