The term dilated(congestive) cardiomyopathy refers to a variety of cardiac disorders that have in common ventricular dilation and reduced myocardial contractility, and is derived from the common late clinical manifestation of congestive heart failure. Since echocardiography can evaluate several aspects of anatomical structures and cardiac function, it has provide a valuable contribution to the understanding of ventricular function and diagnosis of dilated cardiomyopathy. The purpose of this study is to perform the echocardiographic evaluation of left ventricular function in 44 patients with dilated cardiomyopathy and to compare the patients with normal individuals. The patients, 24 males and 20 females, had a mean age of 53.0 and body surface area of 1.61m2. Normal individuals as a control group, 10 males and 10 females, had a mean age of 47.2 and body surface area of 1.67m2. Among 44 patients with dilated cardiomyopathy, 22 cases had a history of heart failure and in 15 cases systolic murmur was heard at the apex. The cardiothoracic ratio was 0.7+/-0.1 on chest X-ray which showed significant difference when compared to normal control group, being 0.4+/-0.1(p<0.01) One case showed left ventricular thrombus and in 8 cases small mounts of pericardial effusion were noted. Among the 44 patients two had uremia, one had a history of myocarditis, one patient was young female whose illness began during the peripartum period and one had a diabetes mellitus. Results obtained were as follows; 1) Mitral valve echocardiogram (1) DE amplitude and EF slope of mitral valve(16.5+/-3.3mm and 83.5+/-3.65mm/sec respectively) showed significant decrease when compared to normal control group (20.1+/-3.0 mm and 102.4+/-28.9 mm/sec respectively) (p<0.01 and p<0.05). (2) EPSS (25.5+/-7.6mm) and the distance between posterior cusp of mitral valve and left ventricular posterior wall (9.1+/-2.1mm) showed significant increase (p<0.01) when compared to normal control group (7.1+/-2.1mm and 5.9+/-1.2mm). The ratio of the separation of two mitral leaflets to the left ventrticular diastolic dimension (0.4+/-0.1) showed significant showed significant decrease in patients when compared to normal control group (p<0.01) (3) Among 44 patients with dilated cardiomyopathy, 12 cases showed B-notch in mitral valve. 2) Echocardiographic findings of aortic valve. Left atrial size was markedly increased (37.7+/-7.5mm) when compared to nomal control group (29.1+/-4.9) (p<0.01). The ratio of left atrial size to aortic dimension was 1.3+/-0.3, showing significant increase when compared to normal control group (0.99+/-0.3) (<0.01). And 4 cases showed systolic notch in aortic valves. 3) Echocardiographic findings of left ventrcle and ventricular septum. (1) Left ventricular diastolic and systolic dimensions (41.8+/-7.8mm/m2 and 36.7+/-7.2mm/m2) were markedly increased in patient with dilated cardiomyopathy, when compared to normal control group (30.4+/-2.6mm/m2 and 11.4+/-3.2mm/m2) (p<0.1, both). Left ventricular diastolic and systolic volume (181.5+/-91.0ml/m2 and 136.6+/-69.7ml/m2) were also significantly higher in patients with dilated cardiomyopathy when compared to normal control group (79.1+/-23.8mm/m2 and 19.4+/-2.5ml/m2) (p<0.01, both). (2) Ejection fraction (0.32+/-0.10) percent fractional shortening (12.3+/-4.6) and mVcf (0.5+/-0.2 cric/sec) showed significant decrease in patients when compared to normal control group (0.74+/-0.05, 34.6+/-6.7 and 1.4+/-0.2) (p<0.01, all). Thus, We could find the reduced myocardial contractility in dilated cardiomyopathy. (3) Systolic amplitudes of venticular septum (LSa) and ventricular posterior wall (Ena) were markedly decreased (p<0.01). The sum of both values (LSa+ENa) also showed significant decrease (12.0+/-4.2mm) when compared to normal control group (p<0.01) (4) Thickness of ventricular septum and ventricular posterior wall showed slight increase in patients, but there was no significant changes when compared to normal group. 4) Systolic time interval Echocardiograms showed significant increase in ratio of preejection period to ejection time, when compared to normal group (p<0.01). Thus, the author observed that in dilated cardiomyopathy the contractility of left ventricle was significantly reduced and the left ventricular diameter and diastolic volume of left ventricle showed marked increase. And also the decreased motions of ventricular septum and posterior wall of left ventricle were noted.
Aortic Valve ; Body Surface Area ; Cardiomyopathies ; Cardiomyopathy, Dilated* ; Diabetes Mellitus ; Diagnosis ; Echocardiography* ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Male ; Mitral Valve ; Myocarditis ; Pericardial Effusion ; Peripartum Period ; Systole ; Systolic Murmurs ; Thorax ; Thrombosis ; Uremia ; Ventricular Function ; Ventricular Function, Left* ; Ventricular Septum

OBJECTIVE: To identify prenatal fetal sex and chromosomal aneuploidies by FISH using isolation of fetal nucleated RBCs. METHODS: peripheral blood samples was collected from 37 women between 11 and 24 weeks of gestation. we tried to enrich nucleated RBCs morphologically by Kleihaur-Betke staining after double gradient centrifugation and magnetic activating cell sorting (MACS) from maternal blood. Fluorescence in situ hybridization (FISH) analyses with CEP X and CEP Y probes for K-B positive nucleated RBCs were performed to detect whether fetal cells were existed among nucleated RBCs by observation of sex chromosomes. RESULTS: The average number of K-B positive nucleated RBCs separated from 10ml of maternal blood was 17.3 (+/-17.2) and the maximum number of nucleated RBCs was 54. We observed FISH signals in nucleated RBCs separated from 18 pregnant women, and Y probe signals were observed in 67.3% of nucleated RBCs separated from 10 pregnant women. CONCLUSION: We confirmed that separated nucleated fetal RBCs can be used to identify fetal sex and chromosomal aneuploidies by FISH. Since nucleated RBCs from maternal origin were not excluded, further studies are needed to overcome this limitation.
Aneuploidy ; Centrifugation ; Female ; Fluorescence ; Humans ; In Situ Hybridization ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis* ; Sex Chromosomes

OBJECTIVES: Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. MATERIALS AND METHODS: Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2007 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, were retrospectively investigated. The objective tests and subjective evaluations were performed to evaluate the degree of damage and duration of sensory disturbance recovery. Tests were performed on the day of the first visit and every two months afterward. Patient's initial symptoms, proximity of the implant to the IAN, time interval between implant surgery and the first visit to our clinic, and treatment after implant surgery were analyzed to determine whether these factors affected the final outcomes. RESULTS: Among the 64 patients, 23 had a chief complaint of sensory disturbance and others with dysesthesia. The mean time until first visit to our hospital after the injury was 10.9 months.One year after nerve injury, the sensation was improved in 9 patients, whereas not improved in 38 patients, even 4 patients experienced deterioration. Better prognosis was observed in the group of patients with early visits and with implants placed or managed not too close to the IAN. CONCLUSION: Nearly 70% of patients with IAN injury during implant placement showed no improvement in sensation or dysesthesia with the conservative management. Earlier decision for active treatment needs to be considered because of possibility of deterioration of symptoms and unsatisfactory recovery.
Dental Implants ; Humans ; Mandibular Nerve ; Paresthesia ; Prognosis ; Retrospective Studies ; Sensation ; Surgery, Oral ; Trigeminal Nerve

Objective: The role of surgery in spontaneous intracerebral hemorrhage (sICH) is still controversial. We aimed to investigate the effectiveness of minimally invasive surgery (MIS) compared to conventional surgery (CS) for supratentorial sICH. Methods: The medical data of 70 patients with surgically treated supratentorial sICH were retrospectively reviewed. MIS was performed in 35 patients, and CS was performed in 35 patients. The surgical technique was selected based on the neurological status and radiological findings, such as hematoma volume, neurological status and spot signs on computed tomographic angiography. Treatment outcomes, prognostic factors and the usefulness of the spot sign were analyzed. Results: Clinical states in both groups were statistically similar, preoperatively, and in 1 and 3 months after surgery. Both groups showed significant progressive improvement till 3 months after surgery. Better preoperative neurological status, more hematoma removal and intensive care unit (ICU) stay ≤7 days were the significant prognostic factors for favorable 3-month clinical outcomes (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.10-0.96, p=0.04; OR 1.04, 95% CI 1.01-1.08, p=0.02; OR 26.31, 95% CI 2.46-280.95, p=0.01, respectively). Initial hematoma volume and MIS were significant prognostic factors for a short ICU stay (≤7 days; OR 0.95; 95% CI 0.91-0.99; p=0.01; OR 3.91, 95% CI 1.03-14.82, p=0.045, respectively). No patients in the MIS group experienced hematoma expansion before surgery or postoperative rebleeding. Conclusions MIS was not inferior to CS in terms of clinical outcomes. The spot sign seems to be an effective radiological marker for predicting hematoma expansion and determining the surgical technique.

Adult ; Animals ; Bone Regeneration ; Calcium Phosphates ; Female ; Fibrin ; Fibroins ; Foreign-Body Reaction ; Humans ; Inflammation ; Membranes ; Rats ; Silk ; Skull ; Tissue Engineering ; Transplants

Blood Platelets ; Centrifugation ; Intercellular Signaling Peptides and Proteins ; Mandible ; Osteoblasts ; Osteogenesis ; Platelet Count ; Platelet-Rich Plasma ; Transplants