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

A case of mucous gland adenoma arising from the main bronchus of the middle lobe of the right lung is reported, with review of related literatures. The patient, a 12 year-old Korean male, was admitted to Pusan National University Hospital with complaints of progressive coughing and dyspnea. Roentgenographic studies revealed a well defined mass involving the right middle lobe of the lung. With the impression of benign tumor, right middle lobectomy was performed. The gross specimen revealed a polypoid mass involving the main bronchus, measuring 4.5x 3.7 x 2.5cm. The cut surface of the mass revealed yellow-gray myxoid tissue. Histologically, the mass consisted of glandular structures filled with mucus, which proved to be acid one on histochemical study. The glandular lining was made up of a single layer of berign mucous cells, many of them being flattened.
Adenoma

Leg ; Osteogenesis, Distraction

No abstract available.
Asphyxia* ; Brain Stem* ; Humans ; Infant, Newborn* ; Parturition*

AIM: To evaluate fundus findings in patients with intracranial aneurysm (ICA) to determine the relation between ICA and distinguishable retinal features.METHODS: We analyzed the medical records and ocular images of 46 patients with previously diagnosed ICA referred from the Neurosurgical Department.All patients underwent ophthalmologic evaluation including fluorescein angiography (FAG).Furthermore, the presence of drusen, macular degeneration, cotton wool spot, hard exudates, retinal hemorrhage, arteriolar attenuation, A-V crossing signs, arm-to-retina time, and A-V transit time were evaluated.The results of ICA patients (Group 1) were compared with those of 22 idiopathic epiretinal membrane patients with unaffected eyes (Group 2).RESULTS: Mean ages were 60.02y (Group 1) and 60.68y (Group 2) respectively (P=0.70).The prevalence of hypertension was similar in both groups.No case with retinal macroaneurysm was found in either group.The presence of drusen, macular degeneration, cotton wool spot, hard exudates, retinal hemorrhage, arteriolar attenuation, and A-V crossing sign was not significantly different between the two groups.Mean arm-to-retina time was not significantly different in two groups, either.CONCLUSION: We cannot find any evidence that the patients with ICA shows specific changes in the FAG and fundus.

No abstract available.
Acetabulum* ; Osteotomy*

No abstract available.
Adenocarcinoma* ; Appendix*

No abstract available.
Bone Conduction* ; Ear, Middle* ; Otitis Media* ; Otitis* ; Pathology* ; Temporal Bone*

This study was made to identify compliance in self-medication, and factors influencing the self-medication of pulmonary TB patients. Self-medication of pulmonary TB patients is a very important factor for the cure of the patients. In this study, variables were used from three theories of health behavior. These were the Health Belief Model, Health Locus of Control, Theory of Planned Behavior. These were included to examine their effect on self-medication. Data were collected during the period from July 1 to August 20, 1994 using a structured questionnaire. And they were analyzed by mean, standard deviation, ANOVA, Pearson Correlation Coefficient, and Multiple Regression analysis using the SAS program. The result were as follows : 1. The mean on the self-medication scores ranging from 6.0 to 12.0 was 10.93. The mean for the self-evaluation scores of the self-medication ranging from 50.0 to 100.0 was 86.51. 2. There were significant associations between the scores on self-medication and age(F=2.34, p=0.033), and method of treatment(F=4.65, P=0.018). And there were significant associations between the self-evaluation scores of self-medication and age (F=3.79, P=0.000), and presence of TB patients among family(F=4.92, P=0.000). 3. (a) The relationship between the scores on self-medication and perceived barrier in health belief revealed a significant correlation(r=-.2046, p=0.0082). (b) The relationship between the scores on self-medication and other-dependency in LOC revealed a significant correlation(r=0.2322, p=0.0018). (c) The relationship between the self-evaluation score of self-medication and other-dependency in LOC revealed a significant correlation(r=0.1946, p=0.0122). (d) The relationship between the attitude in self-medication of the subjects and the self-evaluation score of self-medication revealed a significant correlation(r=0.2102, p=0.0066). 4. (a) 14.8% of the score of compliance in self-medication of the subjects was explained by five variables : Behavioral Intention, Duration of Treatment, Age, Perceived Sensitivity and Perceived Sensitivity and Perceived Barrier. (b) 8.7% of the score of self-evaluation of self-medication was explained by three variables : Perceived Control, Perceived Sensitivity, and Age. In conclusion : This study provides insights and information which may be valuable for motivation and instruction to improve compliance in self-medication among pulmonary TB patients.
Compliance* ; Diagnostic Self Evaluation ; Health Behavior ; Humans ; Intention ; Internal-External Control ; Motivation ; Tuberculosis, Pulmonary* ; Surveys and Questionnaires

No abstract available.
Granuloma, Lethal Midline*