We measure left ventricular mass, mitral peak flow velocity and isovolumic relaxation time(IVRT) with M-mode and Doppler echocardiography to evaluate daistolic function of the heart in hypertensive patients, who are seperated into group A(18 patients) with normal electrocardiogram and group B(24 patients) with abnormal electrocardiogram. There is no difference in fractional shortening, which reflects systolic function of the heart,between normal subjects and both groups of patients(36.5+/-6.7% in group B).The left ventricular mass index in group A is higher than in normal subjects(139.8+/-33.6g/m2, 100.2+/-28.8g/m2, respectively, p<0.005). But, that is lower than group B(200.7+/-40.6g/m2, p<0.005). The sensitivity and specificity of electrocardiograohy to detect left ventricular hypertrophy in patient whose left ventricualr mass index is above 160.8g/m2, are 80% and 91%, respectively. The peak flow velocities in early diastolic(PFVE) are 0.67+/-0.15m/sec in normal subjects and 0.60+0.14m/sec in group A (p=not siginificant). In group B, that is lower than normal subjects(0.54+/-0.15m/sec, p<0.005). In both groups, the peak flow velocities in late diastole(PFVA) are higher than normal subjects(0.48+/-0.11m/sec in normal, 0.69+/-0.18m/sec in groups A, 0.71+/-0.16m/sec in group B, p<0.005). The PFVE/PFVA ratio is lower in both groups of patients(1.40+/-0.23 in normal subjects, 0.90+/-0.25 in group A, 0.77+/-0.23 in group B, p<0.005). The IVRT is also prolonged in both groups(85+/-10m/sec in normal, 112+/-16msec in group A, 123+/-23msec in group B, p<0.005). The PFVE/PFVA ratio decreases in relation with the increament of index of IVRT(r=0.60, p<0.01). The IVRT increases in relation to the left ventricular mass index in hypertensive patients(r=0.34, p<0.05), but, the PFVE/PFVA ratio reveals no relation to those. In cocclusion, the impairment of diastolic function develops before the systolic function or electrocardiogram show abnormalities in htpertensive patients.Therefore, it is importment to detect early any abnormalities in the indices of the diastolic function, such as mitral peak flow velocity and isovolumic relaxation time, in the prevention and treatment of hypertensive geart disease.
Echocardiography, Doppler ; Electrocardiography ; Heart ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular ; Relaxation ; Sensitivity and Specificity

No abstract available.
Hemorrhage*

Ninty-seven patients underwent prosthetic mitral valve replacement at Seoul National University hospital during the eight year period, from January 1, 1971, through September 20, 1978. Included in this group were patients who had concomitant aortic valve replacement (10 patients), tricuspid annuloplasty and valve replacement (12 patients), closure of atrial or ventricular septal defect (3 patients), and aortic valve replacement and tricuspid annuloplasty (1 patient). The ages of the patients at the time of operation ranged from 11 to 54 years, the mean being 32.0 years. Forty-eight patients were female and 49 male. Mitral valve replacement was carried out on 18 patients (18.6%) under 20 years of age. The operative findings of the mitral valve indicated rheumatic valvulitis in 94 patients, while in the remaining three the etiology was undetermined. Twenty-seven patients had predominant mitral stenosis, 29 predominant mitral regurgitation, and 27 mixed mitral lesions. Four patierts belonged to functional class II (NYHA), 45 to class III, and 34 to class IV. On physical and angiographic examinations, 13 patients had associated tricuspid regurgitation, 11 patients had aortic valvular disease, and 3 patients had atrial septal defect or ventricular septal defect. Forty-three patients had atrial fibrillation, 24 had normal sinus rhythm, and the remaining four had other supraventricular arrhythmia. Sixty-four patients were studied before operation by right heart catheterization. Severe pulmonary hypertension, indicated by a pulmonary arterial systolic pressure of 61 mmHg or greater, was present in 19 patients. In only one patients was the pulmonary arterial pressure normal. The average value for the systolic pressure in the 64 patients was 52 mmHg. One-hundred-five cardiac prosthetic valves were placed in 97 patients in the past 8 years. This series included 97 mitral, 11 aortic, and 7 tricuspid valve replacements. There were 18 perioperative deaths, an over-all mortality of 18.6 per cent. High perioperative mortality was seen in patients with associated aortic valvular diseases. Patients who were in class IV preoperatively had a higher motality (50 per cent) than those in class III (22 per cent). A dramatic decrease in the operative mortality from 100 per cent in 1971 to 5.7 per cent in this year was noted.
Aortic Valve ; Arrhythmias, Cardiac ; Arterial Pressure ; Atrial Fibrillation ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Female ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypertension, Pulmonary ; Male ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Mortality ; Seoul ; Tricuspid Valve ; Tricuspid Valve Insufficiency

No abstract available.
Animals ; Embryonic Development* ; Embryonic Structures* ; Female ; Mice* ; Pregnancy

Traumatic dislocation of the knee joint occurs very infrequently, but is one of the true emergencies in the orthopedic field. It is a serious injury, associated with extensive soft tissue demage and the danger of neurological and vascular involvement. There is a lot of theories about the mechanism of injury, the treatment and the incidence of complications. Generally they accept that in irreducible cases operative reduction is essential, but there is no uniformity of opinion on the treatment of the uncomplicated cases. This paper is based on 7 traumatic knee dislocations treated at Kang Nam Sacred Heart Hospital, Hallym College during the period from January 1980 till December 1984. The results of the study are as follows: 1. The patients are mostly injured due to the traffic accident and show even age distribution from twenties to fifties. 2. 5 cases out of 7, reduced at our hospital, were all anteriorly dislocated. 3. The posterior capsule and the posterior cruciate ligament were injured in all cases. 4. There were no significant differences between primary repair of soft tissues and the late reconstruction.
Accidents, Traffic ; Age Distribution ; Clinical Study ; Clothing ; Dislocations ; Emergencies ; Heart ; Humans ; Incidence ; Knee Dislocation ; Knee Joint ; Knee ; Orthopedics ; Posterior Cruciate Ligament

No abstract available.
Urachus*

Poor R-Wave Progression(PRWP) of precordial leads is frequently encountered electrocardiographic findings of uncertain significance and has simply been deemed as suggestion of anterior myocardial infarction without concrete ground. 217 cases with poor R-Wave Progression have been analyzed on clinical records and results are as follows. 1) PRWP was most frequently found in fifties and sixities, comprising 63.9% of the subjects. 2) Co-existent disease entities with PRWP were classified into three categories, cardiovascular diseases, chronic lung diseases and normal variants. 3) The cardiovascular diseases related with PRWP were mainly hypertensive diseases, comprising 59.8% of cardiovascular diseases, followed by ischemic heart disease, valvular heart disease and cardiomyopathies. 4) PRWP may be an early sign of acute myocardial infarction in a certain part of cases, which was endorsed by typical clinical symptoms and enzyme studies. 5) As the criterion of PRWP, V3R equal to or less than 3 mm was thought more adequate for higher specificity rather than 4 mm.
Cardiomyopathies ; Cardiovascular Diseases ; Electrocardiography ; Heart Valve Diseases ; Lung Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Sensitivity and Specificity

No abstract available.
Pregnancy*

No abstract available.
Brachial Artery* ; Female* ; Humans

Amiodarone, an antiarrhythmic drug, may exert pulmonary toxicity in some patients but the pathogenesis is not clear. This study was carried out to investigate the pathogenetic mechanism of pulmonary injury induced by amiodarone at dose of 100 mg/kg/day given to rats by intraperitoneal injection for 3 weeks. And the preventive effects of concomitantly injected steroid (10 mg/kg/day) on amiodarone induced pulmonary injury was also studied using bronchoalveolar lavage, light microscopy and transmission electron microscopy. The results obtained were summarized as follows: Mild lymphocytosis of bronchoalveolar lavage fluid was found in all experimental groups. Intracytoplasmic lamellar body formation was found in all types of pulmonary cells and type II pneumocytes revealed the earliest abnormal lamellar body formation. The capillary endothelial cells showed cellular swelling and detachment from underlying basement membrane at early phase of experiment and the edema of alveolar wall and interstitium were noted. Interstitial fibrosis and proliferation of type II pneumocytes were noted at late phase. The lungs of steroid injected groups revealed accumulation of lamellar bodies in all types of pulmonary cells but interstitial fibrosis was not occurred. These findings support the concept that amiodarone is responsible for a drug-induced phospholipidosis and directly toxic to pulmonary endothelial and epithelial cells. And steroid may regress the progression of amiodarone induced pulmonary injury.
Rats ; Animals