Myocardial infarction is almost regularly associated with severe and widespread obstructive coronary artery disease. Recently, there have been some reports of myocardial infarction with normal of near normal coronary arteries on cineangiography. The following report concerns 6 cases (4% of a series of 142 consecutively studied patients with myocardial infarction) of myocardial infarction proved on clinical grounds with normal or near normal coronary arteries at coronary angiography obtained several months later. The clinical data was shown in Table 1 and Table 2. All 6 patients were male. Three were in the fifth, two in the sixth, and one in the seventh decade. Multiple risk factors were present in only one patient. Areas of localized dyskinesia or hypokinesia were demonstrated in five on the left ventricular cineangiography. The left ventricular end-diastolic pressure was greater than 12 mmHg in all 6 patients. One patient had hypertrophic cardiomyopathy and the remaining 5 patients had no underlying heart diseases. One patient had moderate congestive heart tailure. It is possible that prolonged, localized coronary artery spasm or platelet thrombi that subsequently resolved are a part of the pathogenic mechanism.
Blood Platelets ; Cardiomyopathy, Hypertrophic ; Cineangiography ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Dyskinesias ; Estrogens, Conjugated (USP) ; Heart ; Heart Diseases ; Humans ; Hypokinesia ; Male ; Myocardial Infarction* ; Risk Factors ; Spasm

No abstract available.
Echocardiography*

No abstract available.
Breast Feeding* ; Breast* ; Statistics as Topic*

No abstract available.
Aorta, Thoracic* ; Rupture*

The writers have conducted the investigation to assess the nutritional status of young rural Korean children aged form 0 to 4 years old in August 1971. The survey areas were Kaejong-myon, Daeya-myon, Okku-gun, Jeonra-bukdo, Korea. These survey areas were typical agriculture plain areas. The total numbers of children examined were 2,706 comprising 1,394 male and 1,312 female. the weight, height, and chest circumference of children were measured and means and standard deviations were calculated for each measurement. In addition, the nutritional status of each child was classified by the four levels of malnutrition and the Gomez classification. The examination of red blood cell count, haematocrit value, and intestinal parasite infection were carried out at the same time. In general, recent work tend to suggest that environment influences, especially nutrition, are of great importance than genetic background or other biological factors for physical growth and development. Certainly the physical dimensions of the body are much influenced by nutrition, particularly in the rapidly growing period of early childhood. Selected body measurements can therefore give valuable information concerning protein-calory malnutrition. Growth can also be affected by bacterial, viral, and parasite infection. For the field workers in a developing country, therefore, nutritional anthropometry appears to be of greatest value in the assessment of growth failure and undernutrition, principally from lack of protein and calories. In order to compare and evaluate the data obtained, the optimal data of growth from the offspring of the true well-fed, medically and socially protected are needed, So-called "Standards" that have been compiled for preschool children in Korea, However, are based on measurement of children from middle or lower socio-economic groups, sho are in fact, usually undernourished from six months of age onwards and continuously exposed to a succession of infective and parasitic diseases. So that, the Harvard Standards which os one of the international reference standards was used as the reference standards in this study. Findings of the survey were as follows: A. Anthropometric data: 1) Comparing the mean values for body weight obtained with the Korean standard weight of the same age, the rural Korean children were slightly haevier than the Korean standard values in both sexes. Comparing with the Japanese children values, the rural Koran children were slightly haevier in male and in the infant period of female but lighter in female of the period of 1 to 4 years old than Japanese children. 2) Comparing the mean values for height obtained with the Korean standard height of the same age, the rural Korean children were taller than the Korean standard values except the second half of infant period in both sexes. Comparing with the Japanese children, the rural Korean children were slightly smaller than Japanese children except the first half of infant period in both sexes. 3)Mean values of chest circumference of rural Korean children obtained were less than the Korean standard values of the same ages in birth sexes. B. Prevalence of Protein-Calory Malnutrition: Children examined were divided into two groups, i. e. , infant (up to the first birthday) and toddler (1 to $ years old). 1) Percentage of four levels of malnutrition: a) when the nutritional status of each child was classified (1) by body weight value, the percentages for male and female of children attained standard value, the percentages for male and female of children attained standard growth were 52.8%(infant 83.3%, toddler 44.4%) and 39.7%(infant 74.5%, toddler 30.5%), the first level of malnutrition were 31.9% (infant 13.7%,toddler 36.9%) and 31.7%(infant 15.3%, toddler 36.0%), the second level of malnutrition were 12.3%(infant 1.7%, toddler 15.3%) and 23.3% (infant 7.7%, toddler 27.5%), the third level of malnutrition were 2.7%(infant 0.7%, toddler 3.2%) and 4.6%(infant 1.8%, toddler 5.3%) the fourth level of malnutrition were 0.3% (infant 0.7%, toddler 0.2%) and 0.7%(0.7% for infant and toddler) respectively. (2)by height value, the percentages for male and female of children attained standard growth were 80.3%(infant 97.3%, toddler 75.6%) and 75.1%(infant 96.4%, toddler 69.5%), the first levels of malnutrition were 17.9%(infant 2.0%, toddler 22.3%) and 23.6%(infant 3.6%, toddler 28.8%), the second level of malnutrition were 1.2%(infant 0.3%, toddler 1.5%) and 1.1%(infant 0%, toddler 1.4%), the third level of malnutrition were 0.4%(infant 0.3%, toddler 0.5%) and 0.2%(infant 0%, toddler 0.3%), the fourth level of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 0% respectively. (3) By body weight in relation to height, the percentages for male and female of children attained standard growth were 87.9%(infant 77.6%, toddler 87.9%) and 78.2%(infant 77.4%, toddler 78.2%), the first level if malnutrition were 12.2%(infant 18.4%, toddler 10.6%) and 18.2%(infant 17.9%, toddler 18.3%), the second level of malnutrition were 1.9%(infant 3.3%, toddler 1.5%) and 3.0%(infant 3.3%, toddler 2.9%), the third level of malnutrition of malnutrition were 0.1%(infant 0.7%, toddler 0%)and 0.3%(infant 1.5%, toddler 0%) respectively. b) When the nutritional status of each child according to the mother's aged mother (31 to 40 years old) and old aged mother (41 years of above) was classified. (1) By body weight, among infants and toddlers, at each year of age, with increasing the mother's age, there was an increase in percentage of subjects underweight. This tendency of increasing percentage f underweight was more significant in the infant period than the toddler period. (2) By height value, no significant differences between each mother's age group were found. c) When the nutritional status of each child according to the birth rank, i. e. , lower birth rank(first to third) an higher birth rank(fourth of above) was classified. (1) By weight value, children of higher birth rank were slightly more often underweight than those of lower birth rank, but not significant. (2) By height value, no differences were found between children of lower and higher birth rank. 2) Gomez Classification: When the nutritional status of each child was classified a) By body weight value, the percentages for male and female of children, attained standard growth were 53.1%(infant 82.6%, toddler 44.9%) and 39.2%(infant 73.4%, toddler 30.1%), the first degree of malnutrition were 39.4%(infant 14.7%, toddler 46.2%) and 47.1%(infant 21.9%, toddler 53.8%), the second degree of malnutrition were 7.3%(infant 2.3%, toddler 8.6%) and 12.9%(infant 4.0%, toddler 15.2%), and the third degree of malnutrition were 0.2%(infant 0.3%, toddler 0.2%) and 0.8%(infant 0.7%, toddler 0.9%) respectively. b)By body weight value, the percentages for male and female of children, attained standard growth were 80.8%(infant 97.0%, toddler 76.3%) and 73.8%(infant 95.6%, toddler 68.0%), the first degree of malnutrition were 18.5%(infant 2.7%, toddler 22.9%) and 24.6%(infant 4.4%, toddler 30.0%), the second degree of malnutrition were 0.6%(infant 0.3%, toddler 0.7%) and 0.5%(infant 0.1%, toddler 0.7%), and the third degree of malnutrition were 0.1%(infant 0%, toddler 0.1%) and 1.1%(infant 0%, toddler 1.3%) respectively. C. Results of clinical laboratory examination: 1) Red blood cells: The range of mean red blood counts for male and female were 3,538,000/m3 to 4,483,000/m3 respectively. The lowest red cell counts were seen at the age of 0-3 months for male and 1-2 months for female. 2) Haematocrit value: The ranges of haematocrit value of male and female were 35.1% to 38.8% and 34.7% to 38.8% respectively. The lowest haematocrit values were seen at the age of 2-3 months for male and 1-2months for female. 3)The prevalence rates of intestinal parasites for male and female children with Ascaris lumbricoides were 34.1%(infant 18.8%, toddler 38.1%) and 36.0%(infant 18.4%, toddler 40.7%), with Trichocephalus trichiuris were 6.8%(infant 2.9%, toddler 7.9%) and 9.0%(infant 3.0%, toddler 10.6%), with Hookworm were 0.3%(infant 0.5%, toddler 0.2%)and 0.3%(infant 0.5%, toddler 0.3%), with Clonorchis sinensis were 0.4%(infant 0%, toddler 0.5%) and 0.1%(infant 0%, toddler 0.1%)respectively.
Agriculture ; Ancylostomatoidea ; Anthropometry ; Ascaris lumbricoides ; Asian Continental Ancestry Group ; Biological Factors ; Body Weight ; Cell Count ; Child* ; Child, Preschool ; Classification ; Clonorchis sinensis ; Developing Countries ; Erythrocyte Count ; Erythrocytes ; Female ; Growth and Development ; Health Personnel ; Humans ; Infant ; Korea* ; Male ; Malnutrition ; Mothers ; Nutritional Status* ; Parasites ; Parasitic Diseases ; Parturition ; Prevalence ; Thinness ; Thorax ; Trichuris

OBJECTIVE: The changes of the production of nitric oxide in preeclampsia are still controversial. To determine the changes of nitric oxide production in preeclamptic pregnancies, NOS activity and eNOS and iNOS expression in preeclamptic placentae were compared with those in normal placentae, and to determine the changes of nitirc oxide production according to the sites of placenta, NOS activity and eNOS expression in preeclamptic placentae were also compared with those in normal placentae. METHODS: Human placentae were obtained from 15 normal and 15 preeclamptic pregnant women at the time of cesarean section. NOS activity was assessed by measuring the conversion of [3H]-arginine into [3H]-citrulline. The eNOS and iNOS expression were assessed by using western blot analysis. Data were analyzed by Student t-test and paired t-test where appropriate. RESULTS: The NOS activity(judged by measurement of [3H]-citrulline production) was significantly increased in preeclamptic placentae compared to normal(P<0.05). In normal and preeclamptic pregnant placentae, the NOS activity in main stem villi was increased compared to that in terminal villi. However, the difference of NOS activity between main stem villi and terminal villi was not significant(P>0.05). Quantification of the autoradiographic images demonstrated that the integrated optical density of the immunoreactive bands of eNOS were significantly lower in preeclamptic placentae compared to normal(p<0.05). Conversely, the integrated optical densities of the bands of iNOS were significantly higher in preeclamptic placentae compared to normal(p<0.05). CONCLUSIONS: Although the eNOS expression in preeclamptic placentae was lower than that in normal placentae, the NOS activity was significantly higher in preeclamptic placentae than that in normal in this study. These are result from increased production of iNOS in the compensatory mechanisms for the decreased nitric oxide production in pre-eclamptic placentae.
Blotting, Western ; Cesarean Section ; Female ; Humans* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Placenta* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

Coronary arterivenous fistula(CAVF) is an uncommon congenital coronary anomaly-Bilateral CAVFs that originate from both coronary arteries are very rare. Coronary arteriography performed in recent years has clarified the incidence and various features of this lesion. Baim et al.1) reported that only 5% of the coronary artery fistulas arose from bilateral coronary arteries. In this report, we present a case of bilateral coronary artery pulmonary artery fistulas associated with atypical chest pain.
Angiography ; Arteries* ; Chest Pain ; Coronary Vessels ; Fistula* ; Incidence ; Pulmonary Artery

BACKGROUND: This study was designed to examine the interactions between mivacurium and vecuronium when administered during a standardized technique. METHODS: Eighty patients (ASA physical status I or II) were randomly assigned to one of four groups (n=20). Their neuromuscular function was measured in response to ulnar nerve supramaximal square-wave TOF stimulation at 10-sec intervals. After the attainment of a stable baseline neuromuscular response, the patients were randomly assigned to receive a rapid iv bolus of either: (1) 3M group (n=20): mivacurium 0.21 mg/kg. Alone, or (2) 2M1V group (n=20): mivacurium 0.14 mg/kg plus vecuronium 0.05 mg/kg, or (3) 1M2V group (n=20): mivacurium 0.07 mg/kg plus vecuronium 0.10 mg/kg, or (4) 3V group (n=20): vecuronium 0.15 mg/kg alone. The onset time of the neuromuscular block, time of recovery of T1 to 25% and reblock time (the time from the reinjection of vecuronium at the time of recovery of T1 to 25% to the time of recovery of T1 to 25%: T25-25) were measured. The intubating condition was evaluated clinically with a scoring system. RESULTS: The onset of block in the 3M group was 33% slower than in the 3V group. The time durations until 25% recovery in the 2M1V, 1M2V and 3V groups were longer than in the 3M group, and the durations in the 1M2V and 3V groups were longer than in the 2M1V group. The T25-25 reblock times of the 2M1V, 1M2V and 3V groups were prolonged in comparison to that of the 3M group. There was no difference in intubating conditions between any of the groups. CONCLUSIONS: A combination of mivacurium with vecuronium provides rates of onset and duration of block which are more effective than an equivalent dose of mivacuriun alone as an additive reaction.
Anesthesia, General* ; Humans ; Neuromuscular Blockade* ; Ulnar Nerve ; Vecuronium Bromide*

A 3-year-old boy with Wilms' tumor had unusual severe hypertension, polydipsia, polyuria, and hypokalemia. Physical examination on admission was unremarkable except for the presence of a smooth, firm mass in the right abdomen. Computerized tomography showed a tumor occupying upper two thirds of the right kidney. Plasma renin activity and aldosterone concentration were markedly elevated, 37.7 mg/ml/hour (normal supine 0.15-2.33 mg/ml/hour) and 120.1 ng/dl (normal supine 1 to 16 ng/dl), respectively. His hypertension, varied from 150/90 mmHg as high as 240/180 mmHg, was not effectively controlled by antihyperensive drugs. Because of concern for the complications of hypertension, a right nephrectomy was performed on the sixth hospital day. At laparotomy, there was no evidence of mechanical compression of the renal artery by the tumor. The tumor, about 8 cm in diameter, was confined within the renal capsule without involvement of the renal blood vessels at the hilum. Histopathologically, it was characteristic Wilms' tumor of favorable histology. On electron microscopy, the tumor cells contained many electron dense secreting granules in the cytoplasm, suggesting that the tumor itself was the source of the renin and cause the clinical manifestations. Shortly after nephrectomy, signs and symptoms were relieved dramatically, and plasma renin activity and aldosterone concentration were also decreased to normal.
Abdomen ; Aldosterone ; Blood Vessels ; Child* ; Child, Preschool ; Cytoplasm ; Humans ; Hypertension* ; Hypokalemia* ; Kidney ; Laparotomy ; Male ; Microscopy, Electron ; Nephrectomy ; Physical Examination ; Plasma ; Polydipsia* ; Polyuria* ; Renal Artery ; Renin ; Wilms Tumor*

Renal thromboembolism almost always occurs in the setting of cardiac disease. Acute renal infarction may occur rarely in middle-aged patients without apparent risk factors for cardiac thromboembolism. We report a 40-year-old man who developed bilateral renal infarction and had no cardiovascular risk factors, except smoking. In middle-aged healthy patients with renal colic without lithiasis, the diagnosis of idiopathic renal infarction should be considered, especially if lactate dehydrogenase is elevated.
Adult ; Heart Diseases ; Humans ; Infarction ; Kidney ; L-Lactate Dehydrogenase ; Lithiasis ; Renal Colic ; Risk Factors ; Smoke ; Smoking ; Thromboembolism