Ventricular premature beats(VPB) are the most common cardiac arrhythmia and frequently found in apparently normal healthy persons as well as in various heart diseases. Postectopic potentiation of ventricular contraction has widely reported by electrocardiography. In this study, the authors performed comparative assessment of the left ventricular function at the preextrasystolic, extrasystolic and postextrasystolic beats by M-mode echocardiography and electrocardiography. The results obtained were as followings; 1) Among 22 patients of isolated, unifocal ventricular premature beats with fully compensatory pause, male were 6 and female 16, mean age being 47.2 years. 2) Hypertensive heart disease was the most common underlying disease of ventricular premature beats(5 patients) and the others were valvular heart diaeases(3), ischemic heart diseases(3), cardiomyopathy(2), intracerebral hemorrhagy(1), atrial septal defect of secundumtype(1), cor pulmonale(1), pericarditis(1), 1degree A-V block(1) and enteric fever(1). In 3 patients the causes were not clarified. 3) R wave amplitude was higher in the postextrasystolic beat(2.02+/-0.79cm) than preestrasystolic beat(1.86+/-0.66cm) 4) PEP/LVET ratio showed more decrease(18%) in postextrasystolic beat than that of preextrasystole. 5) Diastolic filling time of mitral valve was more reduced in the extrasystole than preextrasystole, but that of postextrasystole exceeded the preextrastystole. 6) Aortic cusps separation was more decreased in the extrasystole than preextrasystole and slightly more increased in the postextrasystole than preextrasystole. 7) LVID, LSa, ENa, DeltaEN/Deltat, LVEDV, SV and LV mass showed more decrease in extrasystole compared with those in pre-and postextrasystole, which was higher than preextrasystole. But LVESV was slightly lower in extrasystole than preextrasystole. 8) In extrasystolic beat, LVEDV, LVESV, stroke volume, and ejection fraction of ventri cular premature beat were 15.77%, 0.18%, 24.05% and 12.21% lower, respectively, than those of preextrasystole. And in the postextrasystole, LVEDV, LVESV, stroke volume and ejection fraction were 23.35%, 2.42%, 28.51% and 10.4% higher, respectively, than these of preextrasystole.
Arrhythmias, Cardiac ; Cardiac Complexes, Premature* ; Echocardiography* ; Electrocardiography ; Female ; Heart ; Heart Diseases ; Heart Septal Defects, Atrial ; Humans ; Male ; Mitral Valve ; Stroke Volume ; Ventricular Function, Left*

PURPOSE: This study was performed to find out the role of routine lumbar puncture in children presented with their first seizure with Fever. METHODS: This study included 220 children, over a 5 year period, from April 1999 to March 2003, who visited or were admitted at Dae Dong Hospital with their first febrile convulsion. Lumbar puncture was performed in all children. We analyzed their age, family history, type of seizure, duration of seizure, cause of fever, and the results of lumbar puncture. RESULTS: In the sex distribution, males(58.6%) outnumbered females(41.4%) and the ratio was 1.2:1. 81.7% of the patients had febrile convulsion from 6 months- to 3 years of age(P<0.05). 30.5% also had family history of febrile convulsion. The types of seizure were generalized tonic-clonic(72.7%), generalized tonic(17.7%), and generalized clonic(6.4 %). For the duration of seizure, 90.4% of the patients were estimated less than 15 minutes(P<0.05). The causes of fever were pharyngotonsilitis(40.5%), gastroenteritis(19.1 %), pneumonia or bronchitis(13.2%), meningitis(11%), otitis media, urinary tract infection, and exanthem subitum. However, 9.1% of the patients were diagnosed meningitis, with 18 of 20 patients under 3 years of age. CONCLUSION: In the first seizure with fever, lumbar puncture is a useful method for meningitis, especially under 3 years of age.
Child* ; Exanthema ; Fever* ; Humans ; Meningitis ; Otitis Media ; Pneumonia ; Seizures* ; Seizures, Febrile ; Sex Distribution ; Spinal Puncture* ; Urinary Tract Infections

Doxorubicin(Adriamycin(R)) is effective in the treatment of various solid tumors and hematologic malignancies. Because of dose-related cardiotoxicity, however, early inappropriate discontinuation of doxorubicin therapy may minimize its therapeutic efficacy in many patients. Consequently, clinically sensitive tests are needed to select patients in whom treatment must be stopped early. Various techniques have been used for early detection of subclinical doxorubicin-induced cardiotoxicity, including electrocardiography, systolic time intervals, echocardiography, radionuclide angiography and endomyocardial biopsies. Most studies of doxorubicin cardiotoxicity have dealt with systolic function of the left ventricle and effects on diastolic function have not been reported. In order to determine whether impaired diastolic function may be an early sign of doxorubicin cardiotoxicity, a retrospective study was performed in 12 patients who had undergone serial radioangiography and were found to have left ventricular ejection fractions(LVEF)> or =55% prior to doxorubicin treatment and during follow-up. Average rapid filling velocity(RFV) and slow filling velocity(SFV) were both significantly reduced after doxorubicin treatment. RFV fell from 5.17+/-1.52 units/second to 4.18+/-0.96(P<0.01) and SFV fell from 2.20+/-1.32 units/second to 1.42+/-0.62(P<0.05). There were no significant changes in filling volume ratio, total diastolic time and diastolic time ratio. Since a change in left ventricular diastolic function can occur before ejection fraction falls to subnormal levels, diastolic function as well as systolic function should be examined in the early detection of doxorubicin cardiotoxicity.
Biopsy ; Doxorubicin* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Hematologic Neoplasms ; Humans ; Radionuclide Angiography ; Retrospective Studies ; Systole

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal* ; Pregnancy, Twin* ; Salpingectomy* ; Twins*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal* ; Pregnancy, Twin* ; Salpingectomy* ; Twins*

PURPOSE: This study was intended to evaluate the positional relationship between the hyoid bone and the mandible in patients with mandibular protrusion after mandibular set-back surgery by means of 3D-CT. MATERIALS AND METHODS: Preoperative(3 weeks before) and postoperative (6 weeks after) 3D-CT and cephalogram were taken on 32 patients(12 male, 20 female, mean age of 23.2) treated by bilateral sagittal split osteotomy with rigid fixation. The angular measurement on 3D-CT basilar view were deviation of Me and H, long axis angle of left and right cornu majus. The lineal measurement on 3D-CT basilar view were composed of intercondylar line and coordinates(x,y) of Me and H. The angular and lineal measurement of lateral cephalogram were composed of mandibular plane angle, SNA, SNB, ANB, FH-NA and FH-NB, and coordinates(x,y) of B, Pog, Me and H, PAS, Lpw, MPH and IAS. On the frontal cephalogram, deviation of Me were evaluated. RESULTS: The mean mandibular set-back was 8.0mm horizontally and mandibular plane angle was slightly increased. The hyoid bone was displaced postero-inferiorly, the distance between MP(mandibular plane) and H(hyoid bone) was increased and the posterior airway space values (PAS, Lpw, IAS) were decreased. The coordinates Me(x,y), H(x,y) and deviation angle Me' and H'were revealed the strong positive correlation. CONCLUSION: The results revealed that the horizontal, vertical and transverse relationship of the mandibular and the hyoid bone movements were significantly correlated in patients performed mandibular set-back surgery.
Axis, Cervical Vertebra ; Female ; Humans ; Hyoid Bone* ; Male ; Mandible* ; Orthognathic Surgery* ; Osteotomy

A 43-year-old woman presented with numerous cutaneous neurofibromas, limited to the left anterior chest(T2-3) and the right lower back(L1-2). These had been present for 10 years. Neither cafe-au-lait spot, intertriginous freckle, nor Lisch nodule was found. The family history was negative for neurofibromatosis. Biopsy specimens showed circumscribed, nonencapsulated neurofibromas. The present case was a rare form of bilateral segmental neurofibromatosis in that while most of the reported cases involved the same dermatome bilaterally, she had bilaterally different dermatomal neurofibromas.
Adult ; Biopsy ; Cafe-au-Lait Spots ; Female ; Humans ; Melanosis ; Neurofibroma ; Neurofibromatoses*

Plasma col1 leukemia with motility-related morphological behavior is rarely studied. The plasma cells have variable degrees of cytoplasmic morphologies as dairy Projections, long extensions and pseudopods. These morphological evidences show the papa bility of wide spread and dissemination of disease itself. We present a case of a 38 year old woman who had back pain for 4 months and was diagnosed as a solitary plasmacytoma of the third lumbar vertebra. In spite of resection of the tumor and chemotherapy, the plasmacytoma was disseminated into both breasts and ovaries within less than a year. On her blood examination, we counted 34% of plasma cells in peripheral blood and 91.6% of plasma cells in bone marrow aspiration. Most of them resealed hairy projections and pseudopods of the cytoplasm.
Adult ; Back Pain ; Bone Marrow ; Breast ; Cytoplasm ; Drug Therapy ; Female ; Humans ; Leukemia ; Leukemia, Plasma Cell* ; Ovary ; Plasma Cells* ; Plasma* ; Plasmacytoma ; Spine

Ullrich's disease is a congenital muscular dystrophy clinically characterized by generalized muscle weakness, multiple contractures of the proximal joints, and hyperextensibility of the distal joints. All the patients develop rigidity of spine, often assoicated with scoliosis, failure to thrive, and early and severe respiratory involvement, irrespective of their levels of motor function. Intellectual development is normal. The biopsied muscles show dystrophies including remarkable variation in the fiber size, notably proliferated endomysial connective tissues, and a lot of degenerated and regenerated fibers. The expression of merosin and dytrophin is normal. Recent studies have demonstrated that collagen VI is deficient in the muscles of the patients with Ullrich's disease, and some result from recessive mutations of the collagen VIalpha 2 gene(COL6A2). And a marked reduction of fibronectin receptors in the extracellular matrix of skin and cultured fibroblasts of these patients is also reported. These results suggest that collagen VI deficiency may lead to the reduction of fibronectin receptors and that any abnormalities of cell adhesion may be involved in the pathogenesis of the disease. A case of Ullrich's disease has not been reported yet in Korea. So, we describe a male patient with Ullrich's disease with a brief review of the literature.
Cell Adhesion ; Collagen ; Connective Tissue ; Contracture ; Extracellular Matrix ; Failure to Thrive ; Fibroblasts ; Humans ; Integrin alpha5beta1 ; Joints ; Korea ; Laminin ; Male ; Muscle Weakness ; Muscles ; Muscular Dystrophies ; Receptors, Fibronectin ; Scoliosis ; Skin ; Spine

BACKGROUND: The addition of bupivacaine to lipid soluble opioids have improved analgesia and can reduce opioid related side effects in the epidural analgesia. The use of the combination of bupivacaine and lipid soluble opioid fentanyl is gaining in popularity after surgery. But recent work has produced conflicting results, and the ideal combination of local anesthetics and opioid for Patient Controlled Epidural Analgesia (PCEA) is unknown. We have compared the efficacy and the safety of 0.1% bupivacaine and 0.2% bupivacaine combined with fentanyl 5 microgram/ml for PCEA. METHODS: Forty women undergoing lower abdominal gynecological surgery under general anesthesia were assigned to receive an epidural initial bolus of 0.1% (0.1% group) or 0.2% bupivacaine (0.2% group) combined with 5 microgram/ml fentanyl mixture 10 ml, followed by a PCEA with 2 ml/hr continuous background infusion and demand-dose of 2 ml in prospective, random, double blind fashion. Resting and coughing visual analogue scale (VAS) for pain, infusion rates of the mixture, and side effects were recorded at 4, 8, 24, 48 hr postoperatively, and satisfaction were noted after 48 hr. RESULTS: No differences in resting and coughing VAS scores, hypotension, nausea, itching sensation, and somnolence were observed between the two groups. The mean infusion rates of mixtures during the first 4 hr were higher in the 0.1% group (3.3 1.3 ml/hr) than the 0.2% group (2.5 0.6 ml/hr) (p<0.05). The incidence and the degree of sensory and motor block were higher in the 0.2% group (p<0.05). CONCLUSIONS: Both groups provided sufficient postoperative analgesia and satisfaction with some side effects. The high incidence and degree of sensory and motor block were resulted in the 0.2% group, which is not optimal for early ambulation. To search for more titrated bupivacaine concentration between 0.1% and 0.2%, loading doses or appropriate epidural puncture level having reduced demand dose and decreased side effects, further studies are expected.
Analgesia ; Analgesia, Epidural* ; Analgesics, Opioid ; Anesthesia, General ; Anesthetics, Local ; Bupivacaine* ; Cough ; Early Ambulation ; Female ; Fentanyl* ; Gynecologic Surgical Procedures ; Humans ; Hypotension ; Incidence ; Nausea ; Prospective Studies ; Pruritus ; Punctures ; Sensation