BACKGROUND: Increased left ventricular mass in patients with essential hypertension, coronary artery disease, chronic renal failure or in general population has been suggested as a useful predictor of increased cardiovascular morbidity and mortality. Many studies have reported that left ventricular mass is correlated postively with body size. Thereafter normalization of left ventricular studies, but it is uncertain which is appropriate. This study was designed to determine the appropriate method for normalization of left ventricular mass to exclude influence of body size in normal adults. METHODS: We measured left ventricular mass 100 normal adults by M-mode echocardiogram using ASE cube method without(Devereux and Reichek's method) and with correction(Devereux and Alonso's method). Left ventricular mass were normalized for body weight, height, body surface area, body surface area1.5, height2.0 and height2.7 RESULTS: 1) Left ventricular mass by Devereux and Reichek's method correlated well with that by Devereux and Alonso's method(r=1.0,p<0.001). 2) Corrected left ventricular mass correlated well with weight(r=0.64, p<0.001), height(r=0.49, p<0.05), body surface area(r=0.53, p<0.01) and body mass index(r=0.58, p<0.001). 3) Correlation coefficients of left ventricular mass/weight with weight, of ventricular mass/height with height, of ventricular mass/height2.0 with height, of ventricular mass/height2.7 with height, of ventricular mass/body surface area with body surface area and of ventricular mass/body surface area1.5 with body surface area were 0.12, -0.05, -0.29, -0.42, 0.13 and -0.11 respectively. 4) Peak systolic wall stress correlated with age and left ventricular mass, but end systolic wall stress did not correlated with left ventricular mass. CONCLUSIONS: The current indexation method of left ventricular mass for height may reduce the variability associated with body size. Furthermore, it could be used reliably in normal Korean adults.
Adult* ; Body Height ; Body Size* ; Body Surface Area ; Body Weight ; Coronary Artery Disease ; Echocardiography ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mortality

Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fractures of the elderly patients, but it has been rarely used in younger patients because of serious complications such as shortening and external rotation deformity. Authors already contended that the incidence of such complications had intimate connection with the quality of bone, and accordingly with the age. To substantiate the contention, we analyzed thirty-four cases with more than one year follow-up among forty cases of intertrochanteric fractures treated with Ender nails during the period from 1982 to 1989. And the results are summarized as follows;1. The average age was 39 yrs., and the most common cause of fractures was fall from a height. 2. According to the Kyle et al. clsssification, stable fractures(type I & II ) were 13 cases(38%), and unstable fractures (type III & IV) were 21 cases(62%). 3. According to the Singh's index, the good in bone quality(Grade 4, 5, & 6) were 31 cases(91 %), and the poor(Grade 1, 2, & 3) were only 3 cases(9%). 4. Postoperative complications occurred in 6 cases(17%), which included ROM limitation of knee joint in three cases(9%), proximal migrations of nails in two(5%), and distal migrations of nails in one(3%). Among them, 4 cases required revisional operations. There was no case with apparent external rotation deformity over 20 and shortening over 2cm. 5. It is thought that, contradictory to common beliefs, Ender nailingis a safe method for intertrochanteric fractures of femur in younger patients with good bone quality, but requires some experiences and cautions to prevent such complications as external rotation deformity and shorterning.
Aged ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Methods ; Postoperative Complications

Even the antituberculous drugs could cure the disease itself, it might not prevent progressive kyphosis and its sequelae. Therefore, radical curettage and anterior arthrodesis with autogenous strut bone graft has been used to prevent this deformity. From May 1982 to May 1989, twenty four cases of spinal tuberculosis treated with anterior arthrodesis were analysed about the progression of postoperative kyphosis. These cases were followed up for more than 1 year at least, and the following results were obtained; 1. Lumbar spine was most commonly involved. There was involvement of one disc space in 12 cases, only narrowing of disc space in 7 cases, and two disc spaces in 5 cases. 2. The degree of vertebral loss was under 1 in 15 cases, 0 (disc space narrowing only) in 7 cases, and over 1 in 2 cases. 3. Compared with immediate postoperative kyphotic angle, there was increase of kyphotic angle in 15 cases but most of them were under 10 degress. 4. Preoperative degree of vertebral loss of 15 incerased cases was 0.5 and that of 9 decreased of maintained cases was 0.2 in average. 5. Preoperative vertebral involvement of 15 increased cases was 1.3 and that of 9 decreased or maintained cases was 1.2 in average.
Arthrodesis ; Clinical Study ; Congenital Abnormalities ; Curettage ; Kyphosis ; Spine ; Transplants ; Tuberculosis, Spinal

PURPOSE: A crucial event in the acute regulation of steroidogenesis by tropic hormone is the delivery of cholesterol from cytosol into the mitochondrial inner membrane where it is converted to pregnenolone by the cytochrome P45O cholesterol side chain cleavage enzyme. Recently, it has been observed that the acute production of steroid hormone depends on a rapidly synthesized, cycloheximide sensitive and highly labile protein that appeared in response to tropic hormone. This protein was named as Steroidogenic Acute Regulatory(StAR) protein. The purpose of this experiment was to detect the StAR protein in human testicular tissue. MATERIALS AND METHODS: Human testicular tissues were obtained during the surgery in patients with cryptorchidism, infertility, and prostate cancer Northern blotting hyridization and RT-PCR were performed to detect the StAR mRNA in human testicular tissues. In addition, immunohistochemical staining was performed to test the presence of the StAR protein in human testicular tissues. RESULTS: The StAR mRNA was detected as a weak band in prostate cancer and infertility patients, but not detected in cryptorchidism patients by Northern blotting hybridization. In RT-PCR of human testicular tissues for StAR mRNA, RT-PCR products(about 2000p) were shown to have in cryptorchidism, infertility, and prostate cancer patients. In immunohistochemical staining of human StAR protein, immunoreactivity of human StAR protein was positive in the interstitial tissues of human testis. CONCLUSIONS: The StAR protein that plays a key role in the steroidogenesis was detected in human testicular tissues and this protein will be effective in pathogenesis and treatment of the diseases that are associated with steroid hormones.
Blotting, Northern ; Cholesterol ; Cholesterol Side-Chain Cleavage Enzyme ; Cryptorchidism ; Cycloheximide ; Cytochromes ; Cytosol ; Humans* ; Infertility ; Male ; Membranes ; Pregnenolone ; Prostatic Neoplasms ; RNA, Messenger ; Testis

In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.
Aged ; Decompression ; Female ; Humans ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Neurilemmoma ; Spinal Stenosis ; Spondylolisthesis ; Stress, Psychological

Among congenital brachymetatarsias fourth metatarsal bone shortening is most common form and unusually involves multiple metatarsal bones. We report a case of the patient with bilateral 1st and 4th multiple rays brachymetatarsia treated with callostasis. Twenty eight months after procedure, right side showed 1st metatarsal lengthening about 11.5 mm (29.23%) and 4th metatarsal 17.86 mm (35.87%). Twenty one months later, left side showed 1st metatarsal lengthening about 14.58 mm (36.8%) and 4th metatarsal 20.52 mm (43.01%). In healing index right side showed 1st metatarsal 3.4 month/cm, 4th metatarsal 2.5 month/cm and left side showed 1st metatarsal 4.2 month/cm, 4th metatarsal 2.3 month/cm. Final follow-up results presented excellent outcome in cosmetic problem, easy wear of shoes, and measurement of patient's self satisfaction.
Cosmetics ; Follow-Up Studies ; Humans ; Metatarsal Bones ; Osteogenesis, Distraction ; Shoes

Chronic hepatitis is one of the leading cause of hospitalization and death in kidney transplanted patient. Korea is one of the endemic area of chronic hepatitis B. The impact of hepatitis B virus (HBV) infection on the clinical course of renal transplant recipient has been controversial. We describe five Hepatitis B surface antigen (HBsAg) positive renal transplant recipients who transplanted at the KyungHee University Medical Center during the period of January 1992 to July 2000. All these patients have no clinical sign or symptom of chronic hepatitis at the time of transplantation. Mean follow up period was 70 month (range 7-57). Three of 5 patients developed liver cirrhosis with complications during follow-up period. One patient died of fulminant hepatitis due to reactivation of HBV. The remaining one patient is free of disease till now. Four of 5 patients maintained the function of transplanted kidney and only one patient restarted hemodialysis.
Academic Medical Centers ; Follow-Up Studies ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Hepatitis, Chronic ; Hospitalization ; Humans ; Kidney ; Kidney Transplantation* ; Korea ; Liver Cirrhosis ; Renal Dialysis ; Transplantation

STUDY DESIGN: Retrospective analysis OBJECTIVES: Loss of fracture reduction after posterior surgery to treat unstable thoracolumbar fractures can cause several complications. We analyzed the factors influencing postoperative loss of reduction. SUMMARY OF LITERATURE REVIEW: Controversy exists about the factors causing postoperative loss of reduction in thoracolumbar fractures during the follow-up period. MATERIALS AND METHODS: We analyzed the records of 59 patients who underwent posterior surgery for thoracolumbar unstable fractures and had completed a minimum follow-up of 1 year. Postoperative loss of reduction was defined as 30% or more loss of vertebral body height or 15° or more progression of the kyphotic angle at the 1-year follow-up compared to immediately after surgery. The associations between the patients??gender, age, level of fracture, injury of the posterior column, initial loss of fractured vertebral body height, load-sharing score, Thoraco-Lumbar Injury Classification and Severity score, number of fixed segments, type of pedicle screws, degree of postoperative reduction, degree of postoperative corrected kyphotic angle, changes in the insertion angle of the most proximal and the most distal pedicle screws, decreases in the upper and lower disc height of the fractured vertebral body, and postoperative loss of reduction were analyzed. RESULTS: Thirteen patients (22.0%) had postoperative loss of reduction. Age at the time of the operation (p=0.034), initial loss of fractured vertebral body height (p=0.042), and changes in the insertion angles of the most distal pedicle screws (p=0.021) were significantly associated with postoperative loss of reduction. However, the other factors did not show a significant relationship. CONCLUSIONS: In patients who underwent posterior surgery for unstable thoracolumbar fractures, the frequency of loss of reduction was high in patients more than 45 years old at the time of the operation, with a 50% or more loss of the initial fractured vertebral body height, and with changes of 5° or more in the insertion angles of the most distal pedicle screws.
Body Height ; Classification ; Follow-Up Studies ; Humans ; Pedicle Screws ; Retrospective Studies

A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.
Fascia ; Follow-Up Studies ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Humans ; Male ; Neoplasm Metastasis ; Quadriceps Muscle ; Recurrence ; Thigh

Failure in regression of fetal left common cardinal vein, commonly referred to as persistent left superior vena cava, is one of the most frequently encountered anomalies of the systemic venous return. We experienced a case of persistent left superior vena cava in a 60-year-old male who presented with exertional dyspnea and intermittent cough for 1 year. We found that the persistent left superior vena cava drained into right atrium via markedly dilated coronary sinus in transthoracic and contrast transesophageal echocardiography. The patient had also interruption of inferior vena cava, confirmed by venogram during right heart catheterization, so that the blood of inferior vena cava drained into left superior vena caba via hemiazygos vein. The patient improved with medical treatment and was discharged.
Cardiac Catheterization ; Cardiac Catheters ; Coronary Sinus ; Cough ; Dyspnea ; Echocardiography, Transesophageal ; Heart Atria ; Humans ; Male ; Middle Aged ; Veins ; Vena Cava, Inferior ; Vena Cava, Superior