Comparative assessment of left ventricular volume curves using echocardiography, gated radionuclide angiography, and contrast left ventriculography was done in 11 cases of valvular heart disease. The parameters obtained from the left ventricular volume curves are enddiastolic volume (EDV), endsystolic volume(ESV), stroke volume(SV), and ejection fraction(EF). The parameters obtained from derivative curves of the left ventricular volume curves are peak ejection rate(PER), peak filling rate(PFR), time to peak ejection rate(TTPER), and time to peak filling rate(TTPFR). All the parameters(EDV, ESV, SV, and EF) obtained from left ventricular volume curves using three methods relate significantly each to each. The shapes of the left ventricular volume curves obtained from three methods were similar to each other. Without significant differences, noninvasive methods can be applied for serial and repetitive left ventricular volume curve analysis.
Echocardiography* ; Gated Blood-Pool Imaging* ; Heart Valve Diseases ; Stroke

Echocardiographic right ventricular systolic time invervals were measured in 69 cases of congenital and acquired valvular heart disease, who have neither arrhythmia nor conduction disturbances. The results were as follows: 1) Right ventricular preejection periord(RVPEP) relates with main pulmonary arterial systolic pressure (MPA(s)), main pulmonary arterial diastolic pressure (MPA(d)), main pulmonary arterial mean pressure (MPA(m)), pulmonary vascular resistance (Rp), and the ratio of pulmonary systemic vascular resistance (Rp/Rs) (r=0.746, 0.738, 0.755, 0.721, 0.687). 2) Rifht ventricular ejection time relates with MPA (s), MPA (d), MPA (m), Rp, and Rp/Rs (r=-0.580, -0.541, -0.544, -0.577, -0.420). 3) The ratio of right ventricular preejection period-right ventricular ejection time (RVPEP/RVET) relates with MPA (s), MPA (d), MPA (m), Rp and Rp/Rs (r=0.789, 0.784, 0.781, 0.778, 0.695). 4) Pulmonary hypertension and increased pulmonary vascular resistance can be predicted, when RVPEP/RVET is over 0.3. 5) By serial preoperative and postoperative measurements, pulmonary hypertension and increased pulmonary vascular resistance were relieved in the cases of mitral stenosis. But in the cases of congenital heart diseas there were no significant change in RVPEP/RVET ratio.
Adult* ; Arrhythmias, Cardiac ; Blood Pressure ; Echocardiography* ; Heart ; Heart Valve Diseases ; Humans ; Hypertension, Pulmonary ; Mitral Valve Stenosis ; Systole* ; Vascular Resistance

A clinical study was made on 434 patients of valvular heart disease admitted to the Seoul National University Hospital during the period of November 1971-February 1978. The results were obtained as follows: 1) The number of valvular heart disease was 434 patients, which accounts for 2.6% of the total hospitalized patients during the same period. The sex incidence of valvular heart disease were female 48.6%, male 51.4%. The incidences of each valvular heart disease were mitral stenoinsufficiency 31.8%, mitral stenosis 24.2%, mitral insufficiency 21.0%, combined valvular heart disease 12.2%, aortic insufficiency 7.1%, aortic stenoinsufficiency 1.6%, pulmonic stenosis 1.4%, and aortic stenosis 0.7%, in order. 61.5% of all were in third to fifth decade in age distribution. 2) The following were found as etiological factors: rheumatic fever 36.4%, atherosclerosis 1.6%, syphilis 0.9%, and unknown and others 61.3%. 3) The main subjective symptoms were dyspnea, palpitation, cough, orthopnea, sputum, chest pain, fatigue, blood tinged sputum, dizziness, and headache. And the main objective finding were hepatomegaly, venous engorgement, edema, pulmonary congestion, thrill, ascites, splenomegaly, malar flush, and finger clubbing. 5) The disturbance of liver function were found in about 30% of valvular heart disease. 6) The abnormalities of electrocardiographic findings were observed as follows: atrial fibrillation 55.1%, ventricular premature beat 15.2%, first degree atrioventricular block 8.5%, incomplete right bundle branch block 4.1%, complete right bundle branch block 1.4%, second degree atrioventricular block 0.9%, and left bundle branch block 0.9%, in rhythm and conduction disturbance, and left ventricular hypertrophy 44%, right ventricular hypertrophy 18.2%, biventricular hypertrophy 4.6%, left atrial enlargement 19.8%, and right atrial enlargement 3.2%, in chamber enlargement.
Age Distribution ; Aortic Valve Stenosis ; Ascites ; Atherosclerosis ; Atrial Fibrillation ; Atrioventricular Block ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Chest Pain ; Cough ; Dizziness ; Dyspnea ; Electrocardiography ; Estrogens, Conjugated (USP) ; Fatigue ; Female ; Fingers ; Headache ; Heart Valve Diseases* ; Hepatomegaly ; Humans ; Hyperemia ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Liver ; Male ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Pulmonary Edema ; Pulmonary Valve Stenosis ; Rheumatic Fever ; Seoul ; Splenomegaly ; Sputum ; Syphilis ; Tolnaftate

BACKGROUND: Spontaneous echo contrast(SEC) is known to predict the increased incidence of thromboembolism in a variety of heart diseases. Transesophageal echocardiography can be useful for the detection of SEC due to proximity of the probe to the left atrium. We performed this study (1) to evaluate the incidence of SEC in mitral stenosis and its relation to the past history of thromboembolism and (2) to characterize the echocardiographic and hemodynamic indices in patients with SEC compared with those without SEC. METHODS: Transesophageal and thransthoracic echocardiographies were done in 89 patients with mitral stenosis. Biplane probe was used in transesophageal echocardiography. In 47patients cardiac catheterization and angiography were performed. RESULTS: (1) SEC was found in 56 out of 89 patients(63%), and left atrial thrombus was found in 32 patients. (2) Left atrial dimension was larger in patients with SEC than in patients without SEC(57.3%+/-8.4mm vs 49.3+/-6.8mm, p<0.05) and mitrial valve area was smaller in patients with SEC than in patients without SEC(0.85+/-0.27cm2 vs 0.97+/-0.24cm2) (3) Association of SEC to thrombi or previous history of arterial embolism showed a high sensitivity and negative predictive value. CONCLUSION: SEC was an useful finding to predict the increased risk of thromboembolism in patients with mitral stenosis. Patients with SEC had severe mitral stenosis than patients without SEC.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Atria ; Heart Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Stenosis ; Thromboembolism ; Thrombosis

No abstract available.
Eustachian Tube*

No abstract available.
Meniere Disease*

Poland's syndrome is congenital anomaly which was described first by Alfred Poland in 1841. The clinical features are variable but always include congenital aplasia of fingers and syndactyly. We have experienced a case of Poland's syndrome. This case was male children and revealed thoracic anomaly of right side (absence of pectoral muscles and anterior axillary fold), atrophy of forearm muscles, ipsilateral syndactyly with aplasia of thumb and middle phalanges of 2, 3, 4, 5,th fingers, and ipsilateral congenital radio-ulnar synostosis.
Atrophy ; Child ; Fingers ; Forearm ; Humans ; Male ; Muscles ; Poland ; Syndactyly ; Synostosis ; Thumb

The antihypertensive effects of diltiazem was observed in 30 cases of essential hypertension, and following results were obtained. 1) Mean decrease in systolic and diastolic blood pressure by oral diltiazem was 42.0+/-2.5mmHg and 17.8+/-1.7mmHg. The results of antihypertensive therapy revealed good control in 50% fair control in 30% poor in 17% and failure in 3% of the cases. In 80% of the cases, good or fair control of Hypertension which means drop of diastolic pressure to the level of less than 100mmhg was observed. 2) Mean drop in heart rate was 21+/-2 beats/min. 3) Daily dose was 90-180mg. 4) The side effect of oral Diltiazem was mild headache and dizziness, respectively one case.
Blood Pressure ; Diltiazem* ; Dizziness ; Headache ; Heart Rate ; Hypertension

Clinical EPS was performed in 16 normal adults without evidence of conduction disease on the surface standard 12 lead electrocardiogram in order to provide normal electrophysiological values of the sinus node function and AV conduction. EPS was also performed in 15 patients with sick sinus syndrome and 10 patients with AV conduction disturbance to evaluate the clinical usefulness of EPS in detecting sinus node dysfunction and AV conduction disturbance. The results were as follows. 1) The results of sinus node function test in the normal group were m-SNRT 853+/-198msec(range 800-1,560msec), c-SNRT 230+/-66msec(range 120-370msec), and %m -SNRT/SCL 127+/-11%(range 114-149%). 2) In 15 patients with SSS, the M-SNRT were ranged from 1,270 to 12,330msec and 10 patients(66%) had significantly increased m-SNRT exceeding 1,560msec. The c-SNRT were ranged from 230 to 10,730msec and 13 patients(83%) had significantly increased c-SNRT exceeding 370msec. The % m-SNRT/SCL were ranged from 136 to 770% and 12 patients(80%) had significantly increased % m-SNRT/SCL exceeding 150%. 3) The SACT in normal group were 84+/-14msec(range 70-105msec) measured by continuous atrial pacing method and 80+/-19 msec(range 60-115msec) measured by atrial extrastimulation method. 4) In SSS, the SACT measured by continuous atrial pacing method was ranged from 80 to 1,050msec and 11/12 patients(92%) had significantly increased SACT exceeding 112 msec. The SACT measured by atrial extrastimulation method was ranged from 90 to 310msec and 7/8 patients(88%) had significantly increased SACT exceeding 118 msec. 5) C-SNRT, % m-SNRT/SCL, and SACT were more useful in detecting sinus node dysfunction than m-SNRT. 6) The AV conduction intervals in normal group were PA interval 17+/-6(range 5-25msec), AH interval 96+/-18 msec(range 70-135msec), and HV interval 46+/-7msec(range 35-55msec). 7) Rapid atrial pacing induced Wenckebach type second degree AV block proximal to H at pacing rate of 90 to 190/min in 14/16 normal adults. 2 patients maintained intact AV conduction upto maximum pacing rate of 200/min. 8) His bundle electrogram showed the site of AV block in 9 of 10 patients with AV conduction disturbances. The sites of AV block were AV nodal area 1 case, intraHis bundle 4 cases, and infraHis bundle 4 cases. 9) EPS provided a good supportive information that was useful in selecting pacemaker therapy in a patient with chronic bifascicular block who revealed prolonged HV interval and infraHis bundle block at a pacing rate of 70min. 10) The refractory periods of AV conduction system in normal group were AERP 274+/-54msec (range 170-410msec), AVN-FRp 467+/-74msec(range 285-600msec), AVN-ERP 341+76msec(range 190-460), and V-ERP 280+/-25msec(range 240-320msec).
Adult ; Atrioventricular Block ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Humans ; Sick Sinus Syndrome ; Sinoatrial Node*

No abstract available.
Osteoporosis* ; Spondylolisthesis*