1.Comparison of Noninvasive Criteria for Diagnosing Cor Pulmonale - With Particular Reference to Comparison of Electrocardiogrhphic Diagnostic Criteria and Echocardiographic Diagnostic Criteria.
Tae Kyung KANG ; Wee Hyun PARK
Journal of the Korean Society of Echocardiography 1999;7(1):63-74
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
2.A Case of the Centrineurogenic Acute Respiratory Distress Syndrome Following by Near-hanging Injury.
Hyun Kyung PARK ; Young Gwan KO
Journal of the Korean Society of Emergency Medicine 1999;10(3):487-492
In suicidal hanging, a death often occurs within minutes. f rescued, most victims later succumb to the respiratory failure secondary to pulmonary edema, bronchopneumonia, delayed airway obstruction, and acute respiratory distress syndrome(ARDS). Out of these, non-cardiogenic pulmonary edema is likely due to neurogenic factors or negative intrathoracic pressure. A 36-year-old female was brought to the Department of Emergency Medicine after the suicidal hanging attempt. She was unconscious but responsive to painful stimuli. A laryngeal stridor was present. The lung sound of the patient's was dear. Fourteen hours after admission, a chest X-ray showed bilateral diffuse interstitial infiltrates in both lung fields, which was compatible with ARDS. The patient was intubated and placed on a volume respirator with PEEP. She improved over the next 48 hours and a repeat chest X-ray aim showed marked clearing of the infiltrates. We report on the pathophysiologic results of this pulmonary complication and the implication of this finding, regarding the treatment of the patient.
Adult
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Airway Obstruction
;
Bronchopneumonia
;
Emergency Medicine
;
Female
;
Humans
;
Lung
;
Pulmonary Edema
;
Respiratory Distress Syndrome, Adult*
;
Respiratory Insufficiency
;
Respiratory Sounds
;
Thorax
;
Ventilators, Mechanical
3.An electron microscopic study on the nasal mucosa in cadmium chloride treated rat.
Hyun Young PARK ; Kyung Rae KIM ; Kyung Sung AHN
Korean Journal of Otolaryngology - Head and Neck Surgery 1993;36(3):425-434
No abstract available.
Animals
;
Cadmium Chloride*
;
Cadmium*
;
Nasal Mucosa*
;
Rats*
4.A Case of Tattooing Following the Acupuncture in Oriental Medical Clinic and Other Place.
Kyung Duck PARK ; Hyun CHUNG ; Joon Soo PARK
Korean Journal of Dermatology 2015;53(4):341-342
No abstract available.
Acupuncture*
;
Tattooing*
5.Inflammatory Pseudotumor of the Liver.
Sang Hyun KIM ; Hyun Kyung LEE ; Won Choong CHOI ; Kwan Yub KIM ; Kyung Mi PARK
The Korean Journal of Hepatology 1998;4(1):69-76
Inflammatory pseudotumor of the liver is a rare benign tumor with microscopic finding of fibrous stroma and chronic inflammatory cell infiltration. Predominance of plasma cells, histiocytes, lymphocytes, some eosinophils and whorled pattern of fibrosis is often characteristic. Due to similar radiologic appearance of hepatocellular carcinoma, inflammatory pseudotumor of the liver was often misdiagnosed and hepatic resection is often performed before preoperative tissue diagnosis. We report a case of inflammatory pseudotumor, which was a 47-year-old woman with fever, upper aMominal pain and weight loss, diagnosed by sonoguided liver biopsy and treated with antibiotic therapy only without surgery. After two weeks of treatment, the radiologic image of the mass was almost disappeared with improvement of previous symptoms. This opportunity and the possible effectiveness of antibiotic treatment should keep in mind in the differential diagnosis of the hepatic mass with similar radiologic appearance of hepatocellular carcinoma.
Biopsy
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Carcinoma, Hepatocellular
;
Diagnosis
;
Diagnosis, Differential
;
Eosinophils
;
Female
;
Fever
;
Fibrosis
;
Granuloma, Plasma Cell*
;
Histiocytes
;
Humans
;
Liver*
;
Lymphocytes
;
Middle Aged
;
Plasma Cells
;
Weight Loss
6.Spontaneous Rectus Sheath Hematoma with Hypovolemic Shock.
Sang Hyun PARK ; Dong Rul OH ; Hyung Kook KIM ; Se Kyung KIM ; Seung Hyun PARK
Journal of the Korean Society of Emergency Medicine 2000;11(4):586-591
Rectus sheath hematoma of the abdominal wall is a well-recognized, but uncommon condition, caused by a tear in an epigastric vessel and characterized by sudden onset of severe abdominal pain and palpable mass. In most cases, a precipitating cause can be demonstrated. Causes include external trauma, strenuous activities, coughing, lifting, sneezing, vomiting, straining while urinating or defecating, golfing, pregnancy and the puerperium, anticoagulation therapy, infection, chronic diesase, arteriosclerosis, hypertension, prior paracentesis or laparotomy, inadequate hemostasis or excessive retraction in surgery, and idiopathy. Unfortunately, the correct diagnosis often is missed, and the hematoma is found only during an exploratory laparotomy. Treatment should be conservative in most instances. Although the mortality rate for patients with rectus sheath hematoma is low, the condition may be fatal if the volume of the hemorrhage is large and if treatment is delayed. Hence, it should be included in the differential diagnosis of any patient who presents to the emergency department with acute onset of abdominal pain. Our purpose is to familiarlize emergency physicians with the pathophysiology, the diagnosis, and the treatment of rectus sheath hematoma. We describe a patient with fatal rectus sheath hematoma presenting to the emergency department and give a review of the literature.
Abdominal Pain
;
Abdominal Wall
;
Arteriosclerosis
;
Cough
;
Diagnosis
;
Diagnosis, Differential
;
Emergencies
;
Emergency Service, Hospital
;
Golf
;
Hematoma*
;
Hemorrhage
;
Hemostasis
;
Humans
;
Hypertension
;
Hypovolemia*
;
Laparotomy
;
Lifting
;
Mortality
;
Paracentesis
;
Postpartum Period
;
Pregnancy
;
Shock*
;
Sneezing
;
Vomiting
7.A STUDY ON THE FACTORS AFFECTING TO TOOTH WEAR.
Hyun Bae PARK ; Tai Ho JIN ; Kyung Soo HAN
The Journal of Korean Academy of Prosthodontics 1999;37(3):328-342
This study was performed to investigate the factors related to tooth wear. For this study, 78 patients with temporomandibular disorders and 76 dental students without any signs and symptoms of temporomandibular disorders were selected as the patients group and as the normal group, respectively. Preferred chewing side, Angle's classification, lateral guidance pattern, head and shoulder posture wee observed clinically. Electromyographic activity of anterior temporalis and masseter muscle were recorded with BioEMG and occlusal status were recorded with T-Scan . Wear facet area of each tooth was measured from working model of upper arch corresponding to the occlusal status from T-Scan, Wear facet area were measured with planimeter in mm2. Total area were divided into incisal, canine, posterior tooth area. Anterior wearfacet area was incisor area plus canine area, and unilateral area was anterior area plus posterior area. The data collected were analyzed by SAS statistical program and the results of this study were as follows: 1. There was no significant difference between the two groups in total werafacet area, and male subjects showed tendency to have larger area in the normal group but female subjects showed tendency vice versa. 2. There was no significant difference related to preferred chewing side and Angle's classification, however, some difference was observed by lateral guidance pattern. Anterior wear facet area in subjects of canine guidance was the largest in the three subgroups. 3. Subjects with head tilting to right side had larger posterior and total area, and subjects with higher shoulder in right side had larger canine and anterior area than any other subgrous. 4. Electromyographic activity of masseter muscle was more correlated with wear facet area than anterior temporalis muscle, and tooth contact number and force were significantly correlated with wear facet area, but the most important factor affecting tooth attrition was age.
Dental Occlusion
;
Female
;
Head
;
Humans
;
Incisor
;
Male
;
Malocclusion
;
Masseter Muscle
;
Mastication
;
Posture
;
Shoulder
;
Students, Dental
;
Temporomandibular Joint Disorders
;
Tooth Attrition
;
Tooth Wear*
;
Tooth*
8.Mouse embryo culture as quality control for human in vitro fertilization.
Young Kyung LIM ; Hyun Jeong PARK ; Yu Il LEE
Korean Journal of Fertility and Sterility 1991;18(1):49-53
No abstract available.
Animals
;
Embryonic Structures*
;
Fertilization in Vitro*
;
Humans*
;
Mice*
;
Quality Control*
9.Association of Macrovascular Disease with Serum Lipoprotein(a) Levels in the Elderly .
Ie Byung PARK ; Kyung Hwan CHO ; Sei Hyun BAIK
Journal of the Korean Geriatrics Society 1998;2(2):68-75
BACKGROUND : Lipoprotein(a)[Lp(a)] may be an independent risk factor for macrovascular disease in middle aged populations, but in elderly populations, Lp(a) levels to predict macrovascular risk is controversial. The purpose of this study is to evaluate the association of macrovascular disease with Lp(a) levels and lipid change in the elderly. METHODS : We have examined Lp(a) levels, lipid change and clinical, biochemical profile in 114 patients with macrovascular disease and 55 control subjects. Macrovascular disease was defined as ishemic heart disease and/or peripheral vascular disease, peripheral vascular disease was defined as arteriosclerosis obliterans, diabetic foot and/or cerebrovascular disease. RESULTS : Hypertension, diabetes were more prevalent and median Lp(a) levels, fasting blood glucose and HDL-cholesterol were significant higher in patients with macrovascular disease than control subjects, but there were no significant differences in age, body mass index, total cholesterol and triglycerides levels. Lp(a) levels were positively weak correlated with fibrinogen levels, but not correlated with age, body mass index, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides levels. In logistic regression analysis, there was no independent risk factor for ischemic heart disease, whereas diabetes, hypertension and low HDL-cholesterol levels were independent risk factors for peripheral vascular disease. CONCLUSION : Serum Lp(a) levels was not independent risk factor for macrovascular disease, but diabetes, hypertension and low HDL-cholesterol levels were independent risk factors for peripheral vascular disease. Therefore, the relationship between Lp(a) and lipid change and macrovascular disease in the elderly were different from middle aged subjects.
Aged*
;
Arteriosclerosis Obliterans
;
Blood Glucose
;
Body Mass Index
;
Cholesterol
;
Diabetic Foot
;
Fasting
;
Fibrinogen
;
Heart Diseases
;
Humans
;
Hypertension
;
Lipoprotein(a)*
;
Logistic Models
;
Middle Aged
;
Myocardial Ischemia
;
Peripheral Vascular Diseases
;
Risk Factors
;
Triglycerides
10.Cloning and Expression of the Gene Encoding the 32-kDa Protein of Rickettsia typhi.
Kyung Hee PARK ; Myong Joon HAHN ; Jong Hyun KIM
Journal of the Korean Society for Microbiology 1997;32(4):399-404
The crystalline surface layer protein (SLP) and a 28-32 kDa antigen of Rickettsia typhi were known as strong immunogens. We previously reported a cloning and sequence analysis of the SLP gene of R. typhi (slpT) and showed that the open reading frame of this gene encodes both the SLP and a 32-kDa protein. Our study also showed that a 48-kDa protein reacted strongly with polyclonal antiserum of a patient with murine typhus. In this study, we produced three recombinant proteins (SLP, 32-kDa, and 48-kDa protein) in E. coli as fusion proteins with maltose binding proteins. The reactivity of these proteins with patients' sera was investigated.
Clone Cells*
;
Cloning, Organism*
;
Crystallins
;
Humans
;
Maltose-Binding Proteins
;
Open Reading Frames
;
Recombinant Proteins
;
Rickettsia typhi*
;
Rickettsia*
;
Sequence Analysis
;
Typhus, Endemic Flea-Borne