A clinical study was done on 16 cases of cerebellar hemorrhage and 3 cases of cerebellar infarction which were diagnosed with brain CT scan at Keimyung university Dongsan hospital from July 1981 to June 1985 and conclusions obtained are as follows. 1. The incidence of cerebellar hemorrhage and infarction was 3.5% and 0.6% of all spontaneous intracranial parenchymal hemorrhage and infarction, respectively. 2. The most prevalent age group was 7th decade and sex ratio was higher in male in cerebellar stroke. 3. Major single percipitating factor of cerebellar stroke was hypertension. 4. Most of cerebellar stroke showed catastrophic or sudden onset type. 5. The most common initial symptoms of cerebellar stroke were nausea and vomiting, followed by headache and dizziness or vertigo, in order of frequency. 6. The most common neurologic signs on admission were impaired consciousness, constricted pupil with preserved light reflex and cerebellar signs. 7. The common site of cerebellar hemorrhage was right hemisphere, followed by vermis and left hemisphere, in order of frequency, and that of cerebellar infarction was right posterior hemisphere. 8. The better the consciousness on admission, the better the outcome of cerebellar stroke. 9. The following parameters indicated good prognosis with medical therapy, so called benign cerebellar hemorrhage: clear consciousness on admission, gradual onset type, less than 20cc of hematoma, no or mild hydrocephalus, no ventricular hematoma, no vermis involvement on CT scan.
Brain ; Consciousness ; Dizziness ; Headache ; Hematoma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Infarction ; Male ; Miosis ; Nausea ; Neurologic Manifestations ; Prognosis ; Reflex ; Sex Ratio ; Stroke ; Tomography, X-Ray Computed ; Vertigo ; Vomiting

No abstract available.
Hair Removal*

Clincal studies were made on 166 cases of spontaneous subarachnoid hemorrhage (SAH), were admitted to the keimyung university Dongsan hospital from January 1981 to March 1984. The age and sex distribution, causes of SAH, clinical symptoms and signs, computed tomographic (CT) findings, aneurysmal site, number and size, comparison between the highest density on CT findings and site of aneurysm confirmed by angiography,relationship between CT class and clinical grade, complication, and relationship between hospital course and clinical grade on admission were analysed. The results summarized as follow. 1. The most prevalent age group was between 41-60 years of age, and above 61 years, 31-40 years and below 30 years of age in the order of frequency. Male to female ratio was 43.4 : 56.6. 2. The most common causes of 100 cases of SAH confirmed by cerebral angiography was cerebral aneurysm (75 cases), and the other causes were unknown cause (16 cases), arteriovenous malformation (6 cases), moyamoya disease (3 cases) in the order of frequency. 3. The clinical symptoms on admission in the order of frequency were headache, nausea and vomiting, brief loss of consciousness, dizziness, seizure, and urinary incontinence. The neurological findings showed stiffneck, hemiparesis, cranial nerve palsies, papilledema and/or hemorrhage on the fundus, and Babinski sign in that order. 4. CT findings (158 cases) revealed typical high densities consistent with SAH in 125 cases (79.1%), associated with the low density (13 cases), and visible cerebral aneurysm (5 cases), while negative findings were 33 cases (20.9%). 5. The most common site of aneurysm among the 75 cases of SAH confirmed by the cerebral angiography was the region of the anterior communicating artery (AcomeA) which accounted for 30 cases (35.3%), and posterior communicating artery (PcomeA) and middle cerebral artery (MCA) 23 cases (27%), respectively, the internal carotid artery 5 cases (5.9%), the anterior ecrebral artery (ACA) 2 cases (2.4%), the posterior inferior cerebellar artery and basilar artery 1 cases (1.2%), respectively in the order of frequency. Among the 75 cases of cerebral aneurysms, single aneurysms were 67 cases (89.3%) and multiple aneurysms were 8 cases (10.7%). The most common size of the aneurysms was 6-10 mm (47 cases), and below 5 mm (30 cases), and above 10 mm (8 cases) in the order of frequency. 6. Sixteen out of 27 cases of AcomA aneurysms present the highest density on CT scan in the anterior hemispheric fissure, 9 out of 22 cases of PcomA aneurysms in syulvian fissure and 6 cases in suprasellar cistern, and all cases of MCA aneurysm (21 cases) in the ipsilateral aneurysmal site. 7. Comparison between CT grade by Davis (1980) and clinical grade by Hunt-Hesse (1968) revealed that the 93 of 94 patients (pts) with CT class 1 or 2 belong to under clinical grade 3, the 17 of 64 pts with CT class 3 or 4 belong to clinical grade IV or V, and the 17 of 18 pts with clinical grade IV or V belong to CT class 3 or 4. 8. The most common complication was the hydrocephalus (30.1%), and cerebral arterial spasm (24.1%), SIADH (8.4%), and rebleeding confirmed by lumbar puncture and/or CT (4.2%), in the order of frequency. 9. One hundred and four pts (62.7%) out of total 166 patient with SAH were improved, whereas 39 pts (23.5%) were not improved or signed out without clinical improvement, and 23 pts (13.8%) were died. The 81 (77.9%) of 104 pts who were improved belong to clinical grade I or II on admission, the 18 (78.3%) of 23 pts who were expired belong to clinical grade III or IV, and the 19 (48.7%) of 39 pts who were signed out without improvement belong to clinical grade III to V.
Aneurysm ; Arteries ; Arteriovenous Malformations ; Basilar Artery ; Carotid Artery, Internal ; Cerebral Angiography ; Cranial Nerve Diseases ; Dizziness ; Female ; Headache ; Hemorrhage ; Humans ; Hydrocephalus ; Inappropriate ADH Syndrome ; Intracranial Aneurysm ; Male ; Middle Cerebral Artery ; Moyamoya Disease ; Nausea ; Papilledema ; Paresis ; Reflex, Babinski ; Seizures ; Sex Distribution ; Spasm ; Spinal Puncture ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed ; Unconsciousness ; Urinary Incontinence ; Vomiting

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure

No abstract available.
Abscess* ; Animals ; Immunoglobulin G* ; Mice*

Although it has been suggested that the calcium antagonist verapamil has beneficial effects on ischemic myocardium, its effect during coronary reperfusion has not been studied in detail. The purpose of this study was to investigate the inhibitory effect of verapamil on myocardial damage quantitatively using 111 In-anticardiac myosin antibody (ACM Ab) and qualitatively using electronmicroscopic method. Anesthetized open-chest dogs were subjected to 1 hour of occlusion of the left anterior descending coronary artery (LAD) followed by 90 minutes of reperfusion. Regional myocardial blood flow was determined by injecting 85Sr-microsphere prior to LAD reperfusion, and regional myocardial damage was measured by injecting 111In-ACm Ab at 30 minutes after LAD reperfusion. Six dogs were randomly selected as saline control and verapamil-treated (0.6 mg/kg. hr) groups each. Saline or verapamil was infused at 40 minutes after LAD occlusion and continued through the experiment. 1) Verapamil produced significant (P<0.05 by Wilcoxon rank sum test) decrease in heart rate, mean arterial blood pressure and double product. There was no significant change in pulmonary hemodynamics or cardiac output. 2) Stroke volume was reduced significantly (P<0.05 by Wilcoxon rank sum test) after 30 minutes of LAD reperfusion in the control group, but it was preserved in the verapamil-treated group. 3) There was an inverse exponential relationship between 111In-ACm Ab localization and regional blood flow in both control (r=-0.86) and verapamil treated (r=-0.71) groups. Significant difference between the two groups was found in exponential curve (p[t]<0.05). 4) A lesser uptake of 111in-ACM Ab was observed in the verapamil treated group compared with that in the control group in the region where the regional blood flow was lower than 30+/- of normal. 5) In the control group, the myocardium showed swelling, contraction bands, and electron dense granules in the mitochondria which were proven to be calcium aggregates. In the verapamiltreated grooup, the myocardium showed fewer electro dense granules and mild degree of contraction bands. This study supports the concept that verapamil reduces the myocardial damage following coronary reperfusion in myocardial infarction and may reduce contraction band necrosis.
Animals ; Arterial Pressure ; Calcium* ; Cardiac Output ; Coronary Vessels ; Dogs ; Heart Rate ; Hemodynamics ; Mitochondria ; Myocardial Infarction* ; Myocardial Reperfusion* ; Myocardium* ; Myosins ; Necrosis ; Regional Blood Flow ; Reperfusion ; Stroke Volume ; Verapamil

After the performance of 100 coronary cineangiographies in 100 paitents who were adminitted to Soonchunhyang University Hospital under the diagnosis of ischemic heart disease from July 1986 to October 1987, we observed the coronary collateral circulation and measured the ejection fraction, circumferential fiber shortening, left ventricular end-diastolic pressure and pulmonary artery wedge pressure in 52 paitents who had 50% or more stenosis in one or more coroanry arteries. The results were as follow : 1) The collaterall circulation was observed in 16 patients(30.8%) of the 52 patients and it was developed mainly(87.5) in patients with 90% or more coronary artery stenosis. In patients with stenosis of less than 90%, however, collateral circulation was observed rarely(12.5%). 2) The left ventricular wall motion abnormality was severe in the group without collateral circulation. 3) The collteral circulation was most frequently developed in patients with severe right coronary artery stenosis and most of the routes were supplied from contralateral coronary arteries. 4) There was no significant difference in ejection fraction, circumferential fiber shortening, left ventricular end-diastoic pressure and pulmonary artery wedge pressure between the 2 groups with and without coronary artery collateral circulation.
Arteries ; Cineangiography ; Collateral Circulation* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Diagnosis ; Humans ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Ventricular Function, Left*

Cardiovascular diseases have been the most serious threat to life and health. The socioeconomic ramifications of heart disease have long been a source of vexing legal as well as medical problems with no easy resolution as yet in hand. Heart weight, one of the important factors for the diagnosis of cardiomegaly and various heart diseases, shows extreme variability according to the height, weight, age, sex, nutritional status of individuals as well as other various factors. The purpose of this investigation was to find a practical method for calculating expected normal range of heart weight in a given individual. The study was performed on 259 autopsy cases of normal Korean men and women, consisting of 123 men and 136 women in age from newborn to 77 years old. Height, body weight, and heart weight were measured and the body surface area was calculated by height (cm)0.725 x weight (kg)0.425 x 71.84 and height (cm)0.7763 x weight (kg)0.4081 x 71.84 in men and women, respectively. The results showed that the mean heart weight of men and women older than 20 years old were 316.20 +/- 51.15 g (n=96) and 275.87 +/- 44.69 g (n=108), respectively. Heart weight was gradually increased according to the age. The body weight (men: r=0.81, women: r=0.84) and body surface area (men: r=0.83, women: r=0.83) were better univariate predictors of normal heart weight than body height (men: r=0.78, women: r=0.75) and age (men: r=0.42, women: r=0.57). No significant difference was found in predictive precision between body weight and body surface area. Since the body surface area was calculated from body weight and height, measuring the body weight was essential for calculating expected normal range of heart weight in a given individual, and calculation of expected normal range of heart weight using body weight was simpler method than using body surface area.
Aged ; Autopsy ; Body Height ; Body Surface Area* ; Body Weight* ; Cardiomegaly ; Cardiovascular Diseases ; Diagnosis ; Female ; Hand ; Heart Diseases ; Heart* ; Humans ; Infant, Newborn ; Male ; Nutritional Status ; Reference Values ; Young Adult

BACKGROUND: A number of studies in western countries have shown that coronary artery disease(CAD) and younger patients with acute myocardial infarction(AMI) is less extensive but more. closely related to cigarette smoking. However, there are some similarities between the characteristics of the CAD and the risk factors analyzed by age subsets in patients with AMI in Korea. METHODS: Pre-discharge coronary angiograms and risk factors in 194 patients with first AMI(male/female : 154/40,79.4%/20.6%) were analyzed. A comparison was made between the lesion characteristics of the infarct related artery(IRA) and the CAD risk factors. Those under 49 years old (Group I, n=54, male/female : 50/4 : 92.6%/7.4%) and those over 50 years old ( Group II, n=140, male/female : 104/36 : 74.3%/25.7%). RESULTS: There are 54 and 140 patients in groups I and II respectively. 92% of group I and 74.1% of group II were male (p<0.01). At the time of study, more group I patients were smoking cigarettes and drinking alcohol(over 3 times per week 22.6% vs 11.5%, p<0.01) and insignificant stenosis was more common in group I than in group II. In both groups, the most common IRA was the left anterior descending artery and concurrently the anterior wall was the most common morphological type of coronary stenosis of IRA was concentric irregular in group I(27.7%) and eccentric smooth in groupII(31.5%). Although group I had the larger minimal cross sectional area of coronary stenosis(0.97+/-1.16mm2 and 0.54+/-0.80mm2, respectively, p<0.05, reference diameters 2.71+/-0.60mm and 2.66+/-0.67mm, respectively),the coronary lesion was shorter in group I patients(3.39+/-4.06cm and 5.49+/-6.13cm respecitively, p=0.03). CONCLUSION: These findings reveal that coronary atherosclerotic lesions of IRA in patients with AMI in the younger age group are less severe. However, they are more closely related to cigarette smoking and alcohol intake, than cases in the older age group.
Arteries ; Constriction, Pathologic ; Coronary Stenosis ; Coronary Vessels ; Drinking ; Humans ; Korea ; Male ; Middle Aged ; Myocardial Infarction* ; Risk Factors* ; Smoke ; Smoking ; Tobacco Products

BACKGROUND: A number of studies in western countries have shown that coronary artery disease(CAD) and younger patients with acute myocardial infarction(AMI) is less extensive but more. closely related to cigarette smoking. However, there are some similarities between the characteristics of the CAD and the risk factors analyzed by age subsets in patients with AMI in Korea. METHODS: Pre-discharge coronary angiograms and risk factors in 194 patients with first AMI(male/female : 154/40,79.4%/20.6%) were analyzed. A comparison was made between the lesion characteristics of the infarct related artery(IRA) and the CAD risk factors. Those under 49 years old (Group I, n=54, male/female : 50/4 : 92.6%/7.4%) and those over 50 years old ( Group II, n=140, male/female : 104/36 : 74.3%/25.7%). RESULTS: There are 54 and 140 patients in groups I and II respectively. 92% of group I and 74.1% of group II were male (p<0.01). At the time of study, more group I patients were smoking cigarettes and drinking alcohol(over 3 times per week 22.6% vs 11.5%, p<0.01) and insignificant stenosis was more common in group I than in group II. In both groups, the most common IRA was the left anterior descending artery and concurrently the anterior wall was the most common morphological type of coronary stenosis of IRA was concentric irregular in group I(27.7%) and eccentric smooth in groupII(31.5%). Although group I had the larger minimal cross sectional area of coronary stenosis(0.97+/-1.16mm2 and 0.54+/-0.80mm2, respectively, p<0.05, reference diameters 2.71+/-0.60mm and 2.66+/-0.67mm, respectively),the coronary lesion was shorter in group I patients(3.39+/-4.06cm and 5.49+/-6.13cm respecitively, p=0.03). CONCLUSION: These findings reveal that coronary atherosclerotic lesions of IRA in patients with AMI in the younger age group are less severe. However, they are more closely related to cigarette smoking and alcohol intake, than cases in the older age group.
Arteries ; Constriction, Pathologic ; Coronary Stenosis ; Coronary Vessels ; Drinking ; Humans ; Korea ; Male ; Middle Aged ; Myocardial Infarction* ; Risk Factors* ; Smoke ; Smoking ; Tobacco Products