Four hundred and fifty patients of cerebrovascular accident who underwent computerized tomographic scanning during the 45 months, from January 1978 to October 1981, at department of internal medicine, Kyung Hee University Hospital, were studied and following results were obtained. 1. In Korea, intracerebral hematoma(48.2%) is more common than cerebral infarction(27.6%). 2. 87.3% of intracerebral hemorrhage were comfirmed while 61.5% of cerebral infarction were identified by brain CT. 3. Cerebrovascular accidents are definitely developing in 6th decade(40.6%) and male is more often affected. 4. hypertension is the most common underlying disease(72.3%) of cerebral hemorrhage, 52.4% of cerebral infarction. 5. hematoma occurs most frequently in basal ganglia(40.6%) and cerebral infarction occurs most frequently in global area(48.4%). 6. Changes of consciousness level were observed in 54.2% of the cases of mild degree hematoma. Mortality was 6.2% in mild degree hematoma and 88.2% in severe degree hematoma. 7. In 26.2% of cerebral hematoma, inital CSF findings were normal in spite of the evidence of cerebral hematoma confirmed by CT scanning.
Brain* ; Cerebral Hemorrhage ; Cerebral Infarction ; Classification* ; Consciousness ; Hematoma ; Humans ; Hypertension ; Internal Medicine ; Korea ; Male ; Mortality ; Stroke* ; Tomography, X-Ray Computed

To study left ventricular diastolic filling in patient with hypertension in different form of left ventricular hypertrophy(LVH), 105 patients with hypertension and 30 normal persons underwent M-mode echocardiography and pulsed Doppler measurement of the left ventricular inflow. From the M-mode echocardiographic measurement of left ventricular dimension, hypertensive patients were subdivided into three grouops : group I(n=27) ; no LVH, group II(n=36) ; concentric LVH, grooup III(n=42) asymmetric septal hypertrophy. From the digitized trace of the pulsed Doppler at the mitral valve level, Doppler diastolic time intervals, peak velocities at rapid filling (E velocity) and atrial contraction(A velocity) and the triangle area under the A velocity(A area) and triagle area under the E velocity(E area) were measured. The peak A velocity(normal subjects ; 0.51+/-0.08m/sec, group I ; 0.73+/-0.14m/sec, group II ; 0.78+/-0.15m/sec, group III ; 0.8+/-0.23 m/sec) and the A area(noral subjects ; 4.71+/-1.64, group I; 6.24+/-1.78, group II ; 7.75+/-2.93, group III ; 8.05+/-3.11) and the peak A/E velocity ratio and the A/E area ratio were significantly different from the normal controls(P<0.01). The peak E velocity(normal subjects ; 0.76+/-0.13, group I ; 0.7+/-0.12, group II ; 0.63+/-0.12, group III ; 0.59+/-0.15m/sec) and E area (normal subjects ; 9.61+/-2.8, group I ; 8.11+/-2.13, group II ; 7.82+/-2.73, group III ; 7.34+/-3.07) were significantly different between hypertensive groups with LVH and normal controls. Doppler time intervals, total area were not different between groups. This study shows that abnormal pattern of left ventricular diastolic filling occur in patients with hypertension and the peak A velocity and the peak A/E velocity ratio and the peak A/E area ratio are the earliest findings that can detectable by Doppler echocardiography.
Cardiomyopathy, Hypertrophic ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension* ; Mitral Valve

To study factors related to release of atrial natriuretic polypeptide(ANP) in human subjects, instracardiac pressure and plasma ANP concentration in peripheral and central circulation were measured in patients with various heart disease (18 valvular heart disease, 4 congenital heart disease, 2 cardiomyopathy). 1) The concentration in peripheral venous plasma were increased in 14 patients with New York Heart Associaion (NYHA) functional class III-IV (87+/-38 pg/ml) as compared with that in 10 patients with NYHA functional class I-II (39+/-21 pg/ml, P<0.005)and 15 normal subjects (51+/-21 pg/ml, P<0.01). 2)The concentration of plasma ANP in inferior vena cava, right ventricle, pulonary artery, left ventricle and aorta were markedly increased in patient with NYHA functional class III-IV, elevated mean right atrial pressure (MRAP> or =8 mmHg) elevated mean pulmonary capllary wedge pressure (MPCWP> or =15 mmHg) and/or elevated pulminary artery systolic pressure (PASP> or =35 mmHg), as compared with those in patients with NYHA functional class I-II and/or lower intracardiac pressure (MRAP<8 mmHg, MPCWP<15 mmHg, and/or PASP<35 mmHg). 3) A step up in ANP concentration between inferior vena cava and right atrium was seen in patients with elevated MRAP (81+/-28pg/ml, 137+/-60pg/ml, P<0.05), MPCWP (74+/-37pg/ml,112+/-62pg/ml, P<0.05) and/or PASP (75+/-29 pg/ml,119+/-64 pg/ml, P<0.05). But there were no differences among intracardiac ANP concentrations from right atrium though aorta. 4) Plasma concentrations in right atrium, pulmonary artery, left ventricle and aorta correlated with MRAP (r=0.82, 0.63, 0.56, p<0.005 and r=0.52, P<0.01, respectively), MPCWP (r=0.86, 0.75, 0.73 and 0.72 respectively, P<0.005 in all) and PASP (r=0.73, 0.57, 0.68 and 0.59 respectively P<0.005 in all). 5) Left atrial diameter correlated with plasma ANP concentration in peripheral plasma (r=0.55, P<0.01), inferior vena cava (r=0.51, P<0.025), right atrium (r=0.45, P<0.05), right ventricle (r=0.55, P<0.01), pulmonary artery (r=0.52, P<0.01), left ventricle (r=0.55, P<0.01) and aorta (r=0.56, P<0.005). These results suggest that the heart secrets atrial natriuretic polypeptide into right atrium in response to increased mean right atrial pressure, mean pulmonary capillary wedge pressure, pulmonary artery systolic pressure and/or left atrial distention.
Aorta ; Arteries ; Atrial Natriuretic Factor ; Atrial Pressure ; Blood Pressure ; Heart ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases* ; Heart Valve Diseases ; Heart Ventricles ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Vena Cava, Inferior

Regional left ventricular wall motion was evaluated by two-dimensional echocardiographic technique with floating-axis (internal frame of reference) system in three groups of subject; normal subject (n=12), patients with acute anterior myocardial infraction(n=16), and patients with acute inferior myocardial infraction(n=10). Significant hypokinetic wall motion were detected in apical portion (Mean Percent Shortening; 0.27-5.84% in anterior infraction group and 9.64-13.17% in controls) and apicoanterior portion (MPS; 2.86% in anterior infraction group and 14.13% in controls) in patients with acute anterior myocardial infraction (P<0.01), and inferior portion (MPS; 3.56-6.93% in inferior infraction group and 18.26-19.8% in controls) and apical portion (MPS; 4.04% in inferior infraction group and 9.64% in controls) in patients with acute inferior myocardial infraction (P<0.01) in apical long-axis views. We conclude that echocardiographic wall motion analysis by floating axis system is an accurate non-invasive method for detecting abnormal wall motion in patients with acute anterior and in ferior myocardial infraction.
Axis, Cervical Vertebra ; Echocardiography* ; Humans ; Myocardial Infarction*

Squamous cell carcinoma is a rare complication of chronic osteomyelitis. Squamous cell carcinoma of extremity campromises approximately 1 to 2% of all squamous cell carcinoma and of these 2.5 to 4.5% are secondary to chronic osteomyelitis. Biopsy of squamous cell carcinoma, which arises in the proliferating edge of the cutaneous ulcer and invades the bone, should include tissues from all portion of sites of ulcer including bone marrow spaces. But histological diagnosis may be difficult becasue of preexisiting and coexisisting metaplasia and pseudo-epitheliomatous hyperplasia. With prompt and aggressive surgical treatment, the prognosis for patient with squamous cell carcinoma secodary to chronic osteomyelitis is good. Routine regional lymphadenectomy at site of amputation seems unnecessary. This case report represets an unusual bone marrow involvement of squamous cell carcinoma which was complicated by femur fracture.
Amputation ; Biopsy ; Bone Marrow ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelial Cells ; Extremities ; Femur ; Humans ; Hyperplasia ; Lymph Node Excision ; Metaplasia ; Osteomyelitis ; Prognosis ; Ulcer

No abstract available.
Adult* ; Humans ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

A total of 6043 surgical cases were performed at S.D.A. Hospital from 1973 to 1979. These were analyzed statistically according to yearly numbers and emergency states, age, sex, anesthetic methods, anesthetic technique, duration of anesthesia, anesthetic agents and mortality. These were all inpatients operated under general anesthesia, and the results are as follows. Results. 1) Yearly numbers and emergency numbers were steadily increasing. 2) Sex ratio was 65%: 35% 2887 male cases(47.7%) and 5156 female cases(52.23%). 3) More than half of the age group was adult(21 to 60 years) 4) Halothane, nitrous oxide and neuromuscular blocker were used with increasing tendency. 5) The anesthetic technique was, in more than 90% of cases, was circle absorption system. 6) General surgery cases were 40% of the total of all departments. 7) In 66.95% of anesthesias the duration was 1 to 3 hours. 8) General anesthesia group was 98.63%. 9) Deathe occurred in 6 cases our of a total of 6043 cases.
Absorption ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Emergencies ; Female ; Halothane ; Humans ; Inpatients ; Male ; Mortality ; Neuromuscular Blockade ; Nitrous Oxide ; Sex Ratio

A 24 hour ECG monitoring was performed before hospital discharge in 19 patients who survived the hospital phase of acute myocardial infarction and follow-up 6 hour daytime ambulatory ECG monitoring was performed in 11 out of 19 patients 6 months after discharge. In predischarge ambulatory ECG monitoring, VPBs were detected in 78.9% with 26% of complex VPB s(bigeminy, multiform, salvos and R on T) and these rates were some-what decreased in follow-up study(63.6% and 19%). The mean number of VPBs was decreased in follow-up study(18.6+/-7.6/hour) than that of predischarge ECG monitoring(27.9+/-1/hour), but the premature index was similar in both studies. In patients with complex VPBs, the mean number of VPBs(93+/-17.1/hour) was greater than that of low grade VPBs(6.5+/-1.8/hour)(P<0.01) and the EPSS measured by echocardiography was greater in patient with VPBs than inpatients without VPBs(P<0.05). Inspite of using antiarrhythmic drugs such as beta-blocker and calcium channel blocker, only half of the patients improved and one-third of patients were aggravated. Sudden cardiac death was datected in one patient at 13th month after discharge who had multiple-site infarction and ventricular tachycardia.
Anti-Arrhythmia Agents ; Calcium Channels ; Cardiac Complexes, Premature* ; Death, Sudden, Cardiac ; Echocardiography ; Electrocardiography* ; Follow-Up Studies ; Humans ; Infarction ; Inpatients ; Myocardial Infarction* ; Tachycardia, Ventricular

No abstract available.
Vascular System Injuries

Primary adenocarcinoma of the jejunum which accounts for only approximately 3% of all gastrointestinal tract malignancies, is distinctly unusual. The rarity and the non-specific symptoms of this cancer, which are the major factors contributing to its poor prognosis, make the diagnosis difficult. As the prognosis of primary adenocarcinoma of the jejunum, once metastasized, is poor, a greater awareness of the possibility of a jejunal cancer must accompany aggressive diagnostic and surgical procedure. We report our experience of a child with primary adenocarcinoma of the jejunum with a brief review of the literature.
Adenocarcinoma* ; Child* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Jejunal Neoplasms ; Jejunum ; Prognosis