No abstract available.
Cervix Uteri* ; Female ; Rhabdomyosarcoma*

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation

Facet joint synovial cysts are usually associated with osteoarthritis of the adjacent facet joint and/or spondylolisthesis. In between the conservative and operative ends of the treatment spectrum lie minimally invasive techniques such as cyst rupture using epiduroscopy. In this report, we describe an 82-year-old male patient presenting with low back pain radiating to his lower left extremity and associated paresthesia. Magnetic resonance imaging of the lumbar spine revealed a synovial cyst at left L4/5 facet joint. Using epiduroscopy, the cyst was mechanically ruptured by popping it with the tip of the scope. The patient remained symptom-free at his successive visits until 12 months after the procedure, and was opened for desired follow up.
Aged, 80 and over ; Extremities ; Follow-Up Studies ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Male ; Osteoarthritis ; Paresthesia ; Rupture ; Spine ; Spondylolisthesis ; Synovial Cyst ; Zygapophyseal Joint*

The coronary vasospasm has usually been readily reversible by sublingual, intravenous or intracoronary nitroglycerin. Relief of spasm, either spontaneous or following nitrate therapy, results in reperfusion. Occurence of ventricular tachyarrhythmia during release of coronary spasm is attractive as a possible cause of sudden death because of significant proportion of sudden death victims do not have acute myocardial infarction. Recently, we experienced a 36 year old man who developed spontaneous coronary vasospasm, and the patients suffered from repetitive reperfusion ventricular tachyarrhythmia, and died suddenly in spite of administration of isosorbide dinitrate, lidocaine and several trials of cardioversion and cardiopulmonary resuscitation, and we report.
Adult ; Cardiopulmonary Resuscitation ; Coronary Vasospasm ; Death, Sudden* ; Electric Countershock ; Humans ; Isosorbide Dinitrate ; Lidocaine ; Myocardial Infarction ; Nitroglycerin ; Reperfusion* ; Spasm ; Tachycardia*

BACKGROUND: This study was investigated risk factors of abdominal aortic aneurysm that correlation with an aortic diameter and necessity of ultrasonographic screening program through ultrasonographic examination of the aorta, additionally investigated prevalence of abdominal aortic aneurysm. METHODS: We conducted a prospective study of an aorta-proximal part, middle part, distal part with using abdominal ultrasography with 246 subjects more than 65 years old who visited the emergency department of chuncheon sacred hospital without symptoms during the period March 2004-February 2005. Also, examined risk factors (age, sex, smoking, hypertension, vascular disease) and did comparative analysis of relation between an aortic diameter and risk factors. RESULTS: The abdominal aortic diameter of them was 2.08+/-0.37cm in proximal part, 1.78+/-0.31cm in middle part, 1.55+/-0.31cm in distal part. The difference between male and female group was regarded(proximal part 2.20+/-0.35cm vs 1.99+/-0.36cm, the middle part 1.88+/-0.30cm vs 1.69+/-0.31cm, distal part 1.66+/-0.30cm vs 1.48+/-0.29cm). The difference of diameter in distal part was regarded in comparison of young old man and old old man (1.58+/-0.31cm vs 1.91+/-0.27cm). The difference of middle and distal aortic diameter between a smoking and non-smoking group was regarded (1.88+/-0.31cm vs 1.74+/-0.31cm, 1.62+/-0.32cm vs 1.53+/-0.30cm). The difference of distal aortic diameter between a hypertensive and non-hypertensive group(1.58+/-0.36cm vs 1.54+/-0.28cm) and between the groups which had a vascular disease or not(1.78+/-0.36cm vs 1.54+/-0.30cm) was regarded. There was no abdominal aortic aneurysm among them. CONCLUSION: The diameter of distal part increased with more ages, in male, smoker, and person with hypertension and vascular disease. In this study, abdominal aortic aneurysm wasn't found.
Aged ; Aorta ; Aortic Aneurysm, Abdominal ; Emergencies* ; Emergency Service, Hospital ; Female ; Gangwon-do ; Geriatrics ; Humans ; Hypertension ; Male ; Mass Screening ; Prevalence ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Ultrasonography ; Vascular Diseases

PURPOSE: Metabolic encephalopathy is not an infrequent condition. However it is very difficult to diagnose and treat because of its various causes and clinical manifestations. Our purpose was to clarify the cause of metabolic encephalopathy by evaluation of MR findings and clinical features. METHODS: We reviewed MR images and clinical features for 25 patients with metabolic encephalopathy who showed abnormal signal changes on the MR images with neurologic deterioration. RESULTS: The 25 patients had underlying diseases such as chronic liver disease (n=16) or renal failure (n=9). The MR findings showed significant differences in the involved sites according to the underlying disease. In 10 of the 16 patients with liver disease, corpus callosal involvement was observed. Red nucleus involvement was seen in 6 patients, dentate nucleus involvement in 5 patients. These lesions were seen to have a high signal intensity on the diffusion weighted image. Contrary to liver disease, encephalopathy with renal disease showed typical central pontine myelinolysis in 6 of the 9 patients and a relatively benign clinical course. CONCLUSION: Our results showed that the typically involved site and clinical manifestations depended on the underlying disease. We think that involvement of the corpus callosum, the red nucleus, and the dentate nucleus is a typical pattern of injury in metabolic encephalopathy with chronic liver disease and that these findings will be helpful for diagnosing and treating metabolic encephalopathy.
Brain Diseases, Metabolic* ; Cerebellar Nuclei ; Corpus Callosum ; Diffusion ; Humans ; Liver Diseases ; Myelinolysis, Central Pontine ; Red Nucleus ; Renal Insufficiency

Transesophageal echocardiography is a useful device to evaluate the posterior structure of heart with an advantage of enabling clearer images, as compared to transthoracic echocardiography. With intraoperative transesophageal echocardiography, we can reconfirm pre-diagnosed lesions, determine the success of the operation, and in particular, diagnose new lesions that are undetected in pre-operative evaluation. In the present case, undiagnosed patent ductus arteriosus was found on intraoperative transesophageal echocardiography during cardiopulmonary bypass. Subsequently, the patent ductus arteriosus was ligated successfully. With transesophageal echocardiography, we can diagnose the structural and functional abnormality of heart unidentified in the pre-operative evaluation. Also, transesophageal echocardiography can play the role of a rescuer to solve the problems that occur during cardiopulmonary bypass.
Cardiopulmonary Bypass* ; Ductus Arteriosus, Patent* ; Echocardiography ; Echocardiography, Transesophageal* ; Heart ; Humans

OBJECTIVES: This study aimed to investigate the associations between physical disorders and prevalent/incident insomnia in a community dwelling older population. METHODS: 1,204 people aged 65 or over evaluated at baseline. Insomnia was defined as difficulty in initiation or maintenance of sleep on at least three nights per week over the last month. Reported physical disorders covering 11 common and generally chronic health problems were ascertained. Covariates included were age, gender, education, housing, past occupation, current employment, and depression. Of 879 without insomnia at baseline, 651 (74%) were followed 2 years later, and incident insomnia was evaluated. RESULTS: Prevalent insomnia was significantly associated with 10 of 11 physical disorders. Incident insomnia was associated with 2 physical disorders: eyesight problems and hearing difficulty. Both prevalent and incident insomnia were significantly associated with increased number of physical disorders. CONCLUSION: Certain physical disorders were comorbid and precipitating factors of insomnia in elders.
Aged ; Aging ; Depression ; Employment ; Hearing ; Housing ; Humans ; Occupations ; Precipitating Factors ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

STUDY DESIGN: Retrospective analysis to evaluate predictive factors of low back pain after discectomy in lumbar disc herniation. OBJECTIVE: We analysed clinical and radiological predictive factors which possibly contribute to postoperative low back pain in herniated lumbar disc disease. SUMMARY OF LITERATURE REVIEW: There was no statistically significant factors which contribute to postoperative low back pain. MATERIALS AND METHODS: Ninety two patients with herniated lumbar disc who were treated by one level simple discectomy from June 1995 to June 2000 were included in this study. They were divided into two groups by severity of postoperative low back pain, back pain group and no back pain group. We analyzed clinical and radiological factors retrospectively in each group by medical records, preoperative radiographs and telephone interview. Then statistical analysis was performed with Chi-square test and logistic regression analysis. Confidence interval was 95%. RESULTS: Eighteen patients (19.6%) were in back pain group and seventy four patients (80.4%) were in no back pain group. Among patients over 50 years old and below 50 years old, the ratio of low back pain after discectomy was 33% and 13.8% respectively (Odds ratio=3.1, confidence interval 1.07~9.03). It was proved statistically that except age factor, such factors as follows did not affect postoperative lower back pain. Sex, smoking, preceeding low back pain before discectomy, level of discectomy, disc space narrowing, bony spur, grade of disc degeneration, presence of high intensity zone of disc. CONCLUSIONS: There was no other significant predictive factors of post-discectomy low back pain than the age over 50 years old.
Age Factors ; Back Pain ; Diskectomy* ; Humans ; Intervertebral Disc Degeneration ; Interviews as Topic ; Logistic Models ; Low Back Pain* ; Medical Records ; Middle Aged ; Retrospective Studies ; Smoke ; Smoking

BACKGROUND: Pulmonary venous flow velocity pattern (PVFVP) is widely used to assess LV diastolic function. It is known that the parameters of PVFVP have a significant correlation with the ratio of peak early diastolic filling velocity (E) to peak filling velocity at atrial contraciton (A) measured in the transmitral flow. However, the correlations between parameters of superior vena caval flow (SVCF) and transtricuspid E/A ratio have not been reported. Therefore the present investigation was performed to elucidate these correlations. METHODS: Fifty patients (26 men, mean age 63.1+/-11.1 years), who did not have significant tricuspid valvular disease and restrictive filling pattern on tricuspid and superior vena caval doppler, were included in this study. SVCF was recorded with the transducer positioned at subxiphoid area and the sample volume placed 2 cm within the superior vena cava. Blood flow across the tricuspid valve was obtained from standard four chamber view or modified parasternal four chamber view with the sample volume placed on leaflet tips. Recording was made during midexpiratory apnea. The following doppler parameters were measured: transtricuspid E and A velocity, E/A ratio: systolic (S) and diastolic (D) peak velocities and time velocity integrals (TVI), S/D velocity ratio, S/D TVI ratio, atrial reversal peak velocity (ArV) and TVI (ArTVI) in SVCF. RESULTS: 1) In SVCF, S velocity (63.7+/-11.8 cm/s vs 73.4+/-13.6 cm/sec, p<0.05), S TVI (17.4+/-3.6 cm vs 21.1+/-6.2 cm, p<0.05), ArV (30.0+/-6.9 cm/s vs 37.2+/-7.3 cm/s, p<0.005), and ArTVI (2.7+/-0.8 cm vs 3.3+/-0.8 cm, p<0.01) were significantly decreased in group E/A>1. And D TVI (7.1+/-3.0 cm vs 5.2+/-3.1 cm, p<0.05) and D/S TVI ratio (0.41+/-0.13 vs 0.26+/-0.14, p<0.05) were significantly increased in group E/A>1. 2) As E/A ratio increased, diastolic TVI (r=0.315, p<0.05) and D/S TVI ratio (r=0.448, p<0.001) increased, and ArTVI (r=-0.376, p<0.01) and ArV (r=-0.416, p<0.01) decreased. 3) As E peak velocity increased, SVCF D peak velocity increased (r=0.305, p<0.05). CONCLUSIONS: Tricusupid E/A ratio has positive correlations with D TVI and D/S TVI ratio, and negative correlations with ArTVI and ArV. But there were no correlations in S velocity, D velocity, and S/D velocity ratio as the relation of mitral E/A ratio with PVFVP.
Apnea ; Humans ; Male ; Transducers ; Tricuspid Valve ; Vena Cava, Superior