To evaluate the difference of left ventricular diastolic function between pathological hypertrophy(hypertrophic cardiomyopathy) and physiological hypertrophy(hypertensive heart). Doppler echocardiography was used to study mitral flow velocity in 17 hypertrophic cardiomyopathy without obstruction, 32 hypertensive patients with left ventricular hypertrophy and 15 normal persons. From the M-mode echocardopgraphic measurement, hypertensive patients were diviede into two groups;group I;asymmetrical septal hypertrophy, group II;symmetrical septal hypertrophy. Early and late diastolic peak velocity, the ratio of late to early diastolic peak flow velocity and deceleration of early diastolic flow were measured from Doppler mitral flow velocity recordings. The results were as follows; 1) There were significant difference in E velocity between hypertrophic cardiomyopathy and hypertensive patients. 2) There were no significant difference in A velocity between hypertrophy cardiomyopathy and hypertensive patients. 3) E/A ratio was significantly decreased in hypertrophic cardiomyopathy and group II hypertensive patients compared to group I hypertensive patients. 4) There were no significant difference in deceleration of early diastolic flow between groups. The study shows that the diastolic dysfunction of hypertrophic cardiomyopathy is more severe than hypertensive patients with left ventricular hypertrophy. The reason is probably due to the more extentive myopathic process in free wall of hypertrophic cardiomypathy than physiological ventricular hypertrophy.
Cardiomyopathies ; Cardiomyopathy, Hypertrophic* ; Deceleration ; Echocardiography, Doppler ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular*

Pathogenetic mechanisms of progressive glomerulosclerosis are not clear. We studied the long-term(10 weeks) effects of puromycin aminonucleoside(PAN) in Sprague-Dawley rats with or without uninephrectomy(UN). Compared to rats with PAN injections only, rats with uninephrectomy and PAN injections showed significantly higher serum levels of urea nitrogen(153 +/- 155 mg/dl vs. 16 +/- 4 mg/dl, p<0.01), ceatinine(2.96 +/- 1.21 mg/dl vs. 0.92 +/- 0.36 mg/dl, p<0.01), cholesterol(466 +/- 125 mg/dl vs. 94 +/- 27 mg/dl, p<0.01), and triglyceride(337 +/- 237 mg/dl vs. 111 +/- 36 mg/dl, p<0.05) as well as increased amounts of proteinuria(428 +/- 90 mg/day vs. 136 +/- 130 mg/day, p<0.01). Lesions of focal segmental glomerulosclerosis(FSGS) were more frequently observed in rats with UN and PAN injections than rats with PAN infections only(39.5 +/- 17.2% vs. 4.3 +/- 4.7%, p<0.01). Ultrastructural examination of the glomeruli from rats with UN and PAN injections revealed severe epithelial cell changes including foot process effacement, vaculoar change or pseudocyst formation and focal detachment of epithelial cells from the underlying basement membrane. The results suggest that chronic nephrosis induced by PAN showed functional and morphologic features similar to those of human FSGS. Cytotoxic effect of PAN on the glomerular epithelial cells may be an initiating factor for the development of FSGS. which may be aggravated by some hemodynamic changes induced by uninephrectomy.
Humans ; Rats ; Animals

The status of left ventricular (LV) intrinsic contractile function in pure rheumatic mitral stenosis is an unsettled issue. Although the overall LV ejection performance is reduced in a number of patients with MS, it is the product of the interaction of four variables; intrinsic myocardial contractile state, end-diastolic myocardial length(preload), afterload and LV myocardial mass. Although LV intrinsic contractility in MS has been found to be normal in previous studies, we found it to be decreased on the basis of newer techniques for assessing cardiac mechanics. Reliable load-independent indexes of intrinsic contractility using M-mode echocardiography are end-systolic pressure or end-systolic meridian wall stress to end-systolic volume or dimension ratio and fractional fiber shortening to end-systolic stress relations. We assessed LV intrinsic myocardial contractile state as measured by the aforementioned methods in patients with pure rheumatic MS. The results were as follows; 1) The clinical characteristics are no statistical significance of differences between the 2 groups. 2) Preload (LV end-diastolic volume index) was increased in patients with MS(77+/-23 VS 67+/-21 ml/m2, p<0.05). Fractional fiber shortening and LV ejection fraction were significantly lower in patients with MS(31+/-7 VS 40+/-7%, 66+/-9 VS 77+/-8%, p<0.001). 3) End-systolic stress was significantly elevated in the patient population compared with the control subjects (70.1+/-18 VS 50.5+/-10 dynes-cm2x103, p<0.001) The increased in end-systolic stress in the presence of reduced systolic blood pressure(106+/-8 VS 116+/-7mmHg, p<0.001) was due to a higher end-systolic volume index(26+/-12 VS 15+/-6ml/m2 p<0.005) and reduced systolic wall thickening (1.13+/-0.2 VS 1.54+/-0.2cm, p<0.001). 4) The end-systolic stress to volume index ratio and systolic pressure to end-systoli volume ratio were significantly lower in patients with MS(p<0.001). Relation between LV end-systolic wall stress and fractional shortening in patients with MS superimposed on 95% confidence limits of values in 105 normal control subjects derived from a previous study(r=-0.58, p<0.005). Thirty-six(75%) patients were below the 95% confidence limits of normal values.
Blood Pressure ; Echocardiography ; Humans ; Mechanics ; Mitral Valve Stenosis* ; Reference Values

There have been a few reports suggesting that the imune response to pulmonary tuberculosis provides the appropriate setting for the development of IgA nephropathy (IgAN). To define better the relation between pulmonary tuberculosis and IgAN, we evaluated the prevalence of pulmonary tuberculosis among 386 Korean patients with IgAN. Seventeen cases (4.4%) showed abnormal chest X-ray findings suggestive of pulmonary tuberculosis. Ten patients were male and seven were female. Only one case was a child. Urinary abnormalities were detected during the course of antituberculous medication in 11 patients, and after completion of chemotherapy in 2. Chest abnormalities were noted in the remaining 4 patient after IgAN had been diagnosed. Clinical diagnosis of tuberculosis was made mainly based on the chest X-ray findings, but sputum Acid-Fast Bacilli were detected in one patient and pulmonary granulomo was noted in 2. The patients presented various clinical manifestations such as gross hematuris (5 cases), nephrotic syndrome (5 cases), asymptomatic urinary abnormalities (4 cases) and pyuris (1 case) at time of biopsy. Histologic grading of the glomerular lesions was made with modified Meadow classification (1972): one had grade I lesion, 8 grade II, 5 GRADE III and 3 showed grade IV. Follow-up studies were made in 7 patients. Six showed resolution of urinary abnormalities after completion f antituberculous medication, while one pursued chronic renal failure 20 days after the onset. The above clinical and morphologic features suggest that pulmonary tuberculosis may be partly related to the occurrence of IgAN in some Korean patients.
Child ; Male ; Female ; Humans ; Follow-Up Studies

OBJECTIVE: A cytogenetic survey of the mentally retarded children in Seoul City Welfare Center for the Mentally Retarded and St Peter school has been undertaken. METHODS: The chromosome analysis was carried out in 92 males and in 66 females as a total of 158 cases. RESULTS: Abnormal karyotypes were observed in 22.2% of the total cases (35/158). Autosome and sex chromosome anomaly were observed in 20.3%(32/158) and 1.9%(3/158) respectively. Of 35 cases of anomaly, 91.4%(32/35) was autosome anomaly and 8.6%(3/35), sex chromosome anomaly. CONCLUSION: Down syndrome karyotype was the most frequent anomaly among autosome anomalies which was 62.5%(20/32) and other autosome anomalies were observed in 37.5%(12/32).
Abnormal Karyotype ; Child* ; Cytogenetics* ; Down Syndrome ; Female ; Humans ; Karyotype ; Male ; Mentally Disabled Persons* ; Seoul ; Sex Chromosomes

BACKGROUND: Our purpose was to assess the utility of prenatal triple-marker (alpha- fetoprotein (AFP), beta-human chorionic gonadotropin (hCG) and unconjugated estriol (uE3) testing for chromosomal abnormalities in women with Down syndrome screen-positive results. METHODS: Total 1,082 women between 15 and 21 weeks' gestation received second trimester Down syndrome risk evaluation by triple marker testing. AFP, beta-hCG and uE3 were measured by Coat-A-Count(R) IRMA (Diagnostic Products Corporation, LA, USA), The risk for Down syndrome was calculated using a commercially available software program (AFP Expert; Benetech Medical System, Toronto, Canada) by use of a Down syndrome risk cutoff value(1:270 at midtrimester). Karyotypes were reviewed for 32 (54.2%) of these patients who received prenatal chromosome analysis. RESULTS: Fifty nine (5.5%) patients of the 1,082 women screened were identified as positive. Two chromosome abnormalities (47,XYY and 46,XX, int (9) ) were found in the 32 patients who underwent prenatal chromosome analysis (6.3%). Any cases on the abnormal serum tests torn out not to be associated with trisomy 21. CONCLUSIONS: Although triple marker screen appears to be an effective method detecting chromosome abnormalities there is a high false positive rate. Therefore, new screening test that reduce false positive rate is need to be introduced.
Chorionic Gonadotropin ; Chromosome Aberrations ; Down Syndrome ; Estriol ; Female ; Fetal Proteins ; Humans ; Karyotype ; Mass Screening ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis*

No abstract available.
Arthroplasty* ; Knee*

No abstract available.
Congenital Abnormalities* ; Osteotomy* ; Recurrence*

Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone.seeking radiopharmaceuricals in the skeleton can depend on a number of facto rs, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April ′80 to May ′84. The results were as follows: 1. In 16 cases of proven avscular necrosis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head.
Femoral Neck Fractures ; Femur Head Necrosis ; Femur Neck ; Head ; Methods ; Necrosis ; Radiography ; Radionuclide Imaging ; Skeleton ; Technetium Tc 99m Medronate

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Jaundice* ; Phototherapy*