OBJECTIVE: Although cor pulmonale due to chronic lung disease was not uncommon, there was uncertainty in its diagnosis due to the difficulty in measuring functional and anatomical changes of right heart and pulmonary vascular system. Among various non-invasive diagnostic methods presented so far, no ideal standard diagnostic criterion has been established. The authors attempted to know positive diagnostic ratio of cor pulmonale and to study the presence of the relationship between these diagnostic criteria when electrocardiographic and echocardiographic diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease. And we investigated the usefulness of echocardiogaphic diagnostic criteria for the diagnosis. METHODS: One electrocardiographic and two echocardiographic diagnostic criteria were applied to 38 patients with chronic lung disease(21 pulmonary emphysema and 17 chronic advanced pulmonary tuberculosis) for the diagnosis of cor pulmonale. Comparison was also made in their relationship. Then pulmonary artery diameter, measurement of pulmonary function test and echocardiographic examination and radio-nuclear right ventricular ejection faction were compared between the groups to ensure each criterion was satisfied. RESULTS: 1) When the three diagnostic criteria for confirming the cor pulmonale, electrocardiographic rriterion(right ventricular hypertrophy), right ventricular dimension criterion(right ventricular end-diastolic dimension>25mm, RVDd>25mm), and right ventricular wall thickness criterion (right ventricular wall thickness>6mm, RVWT>6mm) were applied to the patients, the positive rate were 32%(12/37), 30%(10/33) and 17%(6/36) respectively. A statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion was found to exist. 2) Various parameters of pulmonary function test and echocardiographic examination were compared in the patient groups with and without cor pulmonale when each non-invasive diagnostic criterion was applied to all patients. Followings are the results. (1) In the positive group on electrocardiographic criteria, vital capacity, forced vital capacity, and arterial oxygen tension were significantly smaller than in the negative group on electrocardiographic criterion(p<0.05), and the echocardiographic parameters of right ventricle, ie. end-diastolic area, end-systolic area, end-diastolic dimension, end-systolic dimension, mid-ventricular short axis and maximal short axis in positive group were significantly larger than in the negative group. (2) In the positive group on right ventricular diastolic dimension criterion(RVDd>25mm), percentage forced expiratory volume in 1 second and forced expiratory flow 25-75% were significantly smaller than in the negative group on right ventricular diastolic dimension criterion. (3) In the positive group on right ventricular wall thickness criterion(RVWT>6mm), vital capacity, forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75% and arterial oxygen tension were significantly smaller than in the negative group on right ventricular wall thickness criterion. CONCLUSION: When several non-invasive diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease, there were some differences in its positive diagnostic ratio depending on the applied diagnostic criteria. There was also a statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion. When each diagnostic criterion was applied to the patients, significant differences were found in several parameters resulted from pulmonary function test and echocardiographic examination based on presence or nonpresence of cor pulmonale. But no difference in the ejection fraction measured by radio-nuclear method was shown between cor pulmonale group and non cor pulmonale group. Consequently it was suggested that applying echocardiographic criteria in addition to electrocardiographic criterion for the diagnosis of cor pulmonale in the patients with chronic lung disease is clinically useful.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Electrocardiography ; Forced Expiratory Volume ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Artery ; Pulmonary Emphysema ; Pulmonary Heart Disease* ; Respiratory Function Tests ; Uncertainty ; Vital Capacity

No abstract available.
Osteotomy*

Hysterosalpingography and Hysteroscopy have been used for the detection of intraute-rine pathology such as polyps, submucous myomas, intrauterine adhesion and endometrial hyperplasia or cancer. Recently the ultrasound has also been utilized for the detection of uterine pathology. Therefore the purpose of this study was to evaluate the diagnostic efficacy of SonoHysterography in detection of intrauterine pathology compared with HSG and Hysteroscopy. 32 patients underwent Sono-Hysterography and Hysteroscopy for the evaluation of the uterine pathology from september 1995 to January 1996. Nine of 32 patients had infertility problem and HSG performed prior to Sono-Hysterography and Hysteroscopy. The results are as follows : 1. The patients' ages ranged from 20 to 50 years(median 37.9). 2. All 9 patients with infertility who had positive HSG findings in uterine cavity showed the intrauterine pathology in Sono-Hysterography as well as Hysteroscopy. The detail findings are as follows :septated uterus(n=2), intrauterine adhesion :IUA(n=3), endometrial polyp(n=3), and IUA combined endmetrial hyperplasia(n=1). 3. Twenty two of 23 patients with abnormal uterine bleeding showed the intrauterne pathology and one patient had negative finding in Sono-Hysterography. However, Hysteroscopy revealed positive intrauterine pathology in 22 patients who had abnormal uterine bleeding. One patients who had positive finding in Sono-Hysterograply showed negative by Hysterography. In contrast, one patient who had negative finding in Sono-Hysterography had positive uterine pathology with polyp in Hysteroscopy. The histologic pathology in all 23 patients reported endometrial polyp(n=12), placental polyp(n=2), submucous myoma(n=1), endometrial hyperplasia(n=5), endometrial cancer(n=1), normal endometrial finding(n=2). 4. Sono-Hysterography, therefore, has a sensitivity and positive predictive value of 96.6%, 93.5% respectively. Our study showed a positive Sono-Hysterography is very predictive of the intrauterine pathology. Sono-Hysterography is safe, quick and minimal invasive procedure. So it is an invaluable technique in the evaluation of uterine cavity.
Endometrial Hyperplasia ; Female ; Humans ; Hysterosalpingography ; Hysteroscopy* ; Infertility ; Myoma ; Pathology* ; Polyps ; Ultrasonography ; Uterine Hemorrhage

Nasal dorsal suppor may be weakened or lost during the corrective rhinoplasty procedures such as resection of dorsal deviation, osteotomies and reposition of deviated nasal bones, and incision, fracture, resection or scoring of the dorsal septal strut especially in the small flat noses. Partial or total augmentation of the nasal dorsum has an important role in the correction of asymmetry and restoration of aesthetic balance in the considerable amount of traumatic nasal deformities. We reviewed medical records, pre- and postoperative photographs of 53 patients with traumatic nasal deformities, which had been corrected by augmentation rhinoplasties. The majority of the patients were male (70%), ages of twenties and thirties (79%), injection by automobile accident, fist blows, and sports activities (76%), and were operated more than 3 years after injury (74%). Types of deformities were deviation only (47%), depression only (23%), deviation and depression (19%), deviation and hump (8%), and depression and widening (6%). At least two corrective procedures were needed in the deviated deformities and one procedure in the depressed deformities. Materials for augmentation were silicone implants in 55% and autogenous tissues in 45%. In terms of postoperative complications, displacement and/or absorption were observed in 6 of 24 (25%) autogenous augmentations and displacement and/or swelling in 8 of 29 (27.6%) silicone augmentations.
Absorption ; Automobiles ; Congenital Abnormalities* ; Depression ; Humans ; Male ; Medical Records ; Nasal Bone ; Nose ; Osteotomy ; Postoperative Complications ; Rhinoplasty* ; Silicones ; Sports

Adult ; Humans ; Middle Aged ; Theory of Planned Behavior ; Vision Screening

BACKGROUND: Hyperlipidemia has been known as an independent risk factor in the develop-ment of coronary artery disease. This study was carried out to compare nutrient intakes, smo-king status, antioxidant vitamins, and plasma lipids in patients with coronary heart disease (CHD) and in normal healthy subjects among Korean population in Taegu. Possible causes of this dis-ease in patients are discussed. METHODS: Anthropometric assessments included mean intakes of nutrients, and the levels of plasma lipids (apolipoprotein [Apo] A - I, Lipoprotein [Lp] [a]), and antioxidant vitamins (such as vitamins A and E) were measured in female and male subjects with CHD against healthy con-trols. RESULTS: Dietary cholesterol and fat intakes were significantly higher in CHD groups in men and women. Total plasma cholesterol, LDL-C, triglyceride, thiobarbituric acid reactive subst-ance (TBARS), atherogenic index and Lp (a) levels were significantly higher in CHD patients than in the normal group in both men and women. Apo A-I, HDL-C and vitamin E levels were lower in CHD patients than in the normal group. The number of smokers was higher in CHD patients than in the normal group in both sexes of subjects. CONCLUSION: High fat and high cholesterol intakes seemed to be a major factor for the hyperlipidemia in the CHD patients. Their abnormal lipoprotein profile, which appeared in pati-ent plasma, corresponded well to dietary intake patterns. However, long term studies are need-ed to investigate the effects of smoking on lipid metabolism in CHD patients among the Korean population.
Apolipoprotein A-I ; Cholesterol ; Cholesterol, Dietary ; Coronary Artery Disease ; Coronary Disease* ; Daegu ; Female ; Humans ; Hyperlipidemias ; Lipid Metabolism ; Lipid Peroxidation ; Lipoprotein(a)* ; Lipoproteins* ; Male ; Plasma* ; Risk Factors ; Smoke* ; Smoking* ; Triglycerides ; Vitamin A ; Vitamin E ; Vitamins

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.
Adult ; *Cornea ; Corneal Stroma/cytology/*transplantation ; Corneal Transplantation/*methods ; Eye Neoplasms/diagnosis/*surgery ; Humans ; Male ; Myxoma/diagnosis/*surgery

A myxoma is a benign tumor found in the heart and in various soft tissues; however, a corneal myxoma is rare. A mucinous mass of unknown etiology was observed on the left cornea of a 32-year-old male patient. We performed deep anterior lamellar keratoplasty using acellular corneal tissue and concurrent amniotic membrane transplantation. Hematoxylin and eosin staining revealed vacuolation of the parenchyma and myxoid change in the corneal tissue that occurred in the anterior half of the corneal parenchyma. We identified a myxoid stroma by Alcian blue staining and observed collagen fibers with denatured stroma by Masson trichrome staining. The patient's visual acuity improved from light perception to 20 / 200, and the intraocular pressure remained within the normal range for one year after surgery. The transplanted cornea survived successfully with well-maintained transparency, and recurrence was not observed one year after surgery.
Adult ; *Cornea ; Corneal Stroma/cytology/*transplantation ; Corneal Transplantation/*methods ; Eye Neoplasms/diagnosis/*surgery ; Humans ; Male ; Myxoma/diagnosis/*surgery

BACKGROUND: Vancomycin-resistant Enterococci (VRE) infections are caused by Enterococcus faecium in about 90% of the cases but can also be caused by Enterococcus faecalis. Thus, this study investigates factors that cause a low isolation rate of vancomycin-resistant E. faecalis (VREfs). To this end, the authors study the clinical traits, resistant gene structure, genomic classification, and molecular characteristics of the virulent factor. METHODS: From January 2001 through September 2011, 17 vanA-containing E. faecalis isolates were collected from hospitalized patients at Ajou University Hospital in Korea. Identification, antimicrobial susceptibility testing, and PCR of van and esp genes were performed. Pulsed-field gel electrophoresis (PFGE) was used for strain typing. PCR and sequencing of the internal regions of Tn1546 were performed for structural analysis of the van gene. RESULTS: Of 4,235 VRE infections, 3,918 (92.5%) were caused by E. faecium, and 95 (2.2%) were caused by E. faecalis. In 67% of VREfs infections, there was a preceding occurrence of E. faecium infection. All isolates were of genotype vanA. Our isolates were divided into three types according to the distribution of IS elements integrated into Tn1546 (types I to IIb). The PFGE results showed no clonal relatedness among isolates. CONCLUSION: Our study found that VREfs infections affect patients who have experienced vancomycin-resistant E. faecium. (VREfm) infection or undergo invasive procedures. The VREfs seems to involve the horizontal transfer of Tn1546 transposon from VREfm.
Classification ; DNA Transposable Elements ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus faecalis* ; Enterococcus faecium ; Enterococcus* ; Epidemiology* ; Genotype ; Humans ; Korea ; Polymerase Chain Reaction

The purpose of the present study was to compare prapofol, newly introduced anesthetic agnet, & thiopental as to the characteristics of induction & recovery as well as the safety of both anents. Fifty patients who presented for termination of pregnancy were allocated at random to recieve either propofol 2 mg/kg IV or thiopental 4 mg/kg IV. In addition all patients recevied fentanyl, 1 ug/kg IV, one minute befor the induction. Repeated bolus doses of either propofol 20 mg or thiopental 50 mg were given, if the patient respond to surgical stimulation by moving. The result were as follows. 1) Both propofol and thiopental produced smooth and rapid induction, but caused significant respiratory depression. 2) There was more cardiovascular depression with propofol than with thiopental. 3) Postoperative recovery(time to ambulation) was faster with propofol than with thiopental (36.5+/-1.4 vs 72.9+/-5.1 min, p<0.001). 4) Propofol was associated with less side effects(Nausea, vomithing, and dizziness) than thiopental. These results suggest 1) that propofol has significant advantage over thiopental in outpatient surgery, where early ambulation and discharge is desirable, and 2) that both propofol and thiopental should be administered by expert anesthesiologist only when ventiatory assistant device with oxygen is immediately available.
Ambulatory Surgical Procedures* ; Anesthesia* ; Depression ; Early Ambulation ; Fentanyl ; Humans ; Oxygen ; Pregnancy ; Propofol* ; Respiratory Insufficiency ; Thiopental*