Congenital pulmonary lymphangiectasis is a rare cause of severe respiratory distress in the newborn period and most of these patient die, usually within the first 24 hours of life. The light microscopic characteristics of the lungs are a network of partly tubular, partly cystically enlarged lymph vessels within large areas of connective tissue and they have thin wall lined by endothelium. Also congenital pulmonary lymphangiectasis is closely associated with cardiovascular malformation, and most frequently occurs in the clinical setting of congenital heart disease with or without pulmonary venous obstruction(total anomalous venous return, atresia of large pulmonary veins) The authors describe three typical cases of congenital pulmonary lymphangiectasis.
Connective Tissue ; Endothelium ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Lung ; Lymphangiectasis* ; Lymphangioleiomyomatosis

A series of 250 patients with filariasis due to periodic type of Brugia malayi was selected for the mass treatment with diethylcarbamazine from two areas in Cheju-Do. Two types of dosage schedules have been employed: the one was the conventional dosage schedule (uninterrupted dose of 6 mg/kg once daily 6 times repeated with an interval of one or two month totaling 72 mg/kg), and the other was the low dosage schedule (uninterrupted dose of 0.5, 1, 2, 4, 6 mg/kg body weight given once a day with an additional 6 mg/kg once daily totaling the maximum 37.5 mg/kg). The relative effectiveness of those two schedules was evaluated under the basis of the effects on microfilaria counts and the results of analysis of side-reactions observed. The results obtained in this experiment are summarized as it follows. In the conventional dosage treatment, 118 out of 141 microfilaria positives treated (83.7%) became negative and microfilaria reduction rate was about 99%. However, in the low dosage treatment, 35 out of 43 positives treated (85.4%) became negative and reduction rate of microfilaria, 99.5% in average. Total dose and duration of treatment were 72 mg/kg and about 60 days in the former schedule but it were maximum 37.5 mg/kg and 10 days in the latter. The recurrence of filariasis after treatment in both conventional and low dosage was negligible. Comparative analyses regarding the resulting side-reactions between the two schedules were made on their frequency, severity, onset and duration and relationship with microfilaria density. The febrile reaction was most frequently observed in 80.5% in the conventional, 43.9% in the low dosage schedule. The main side-reactions usually appeared within 6 to 10 hours and lasted 48 to 72 hours in the former threament, however they occurred in 7 to 8 hours and lasted 24 to 43 hours in the latter dosage schedule. It is assumed that the side-reactions are not directly related with the microfilaria count. However, the febrile reaction seems to be correlated with microfilaria density if it is above a certain limit. The presence of adult worm in a lymphnode involved with local reaction was ascertained from the biopsy specimens performed and local reactions such as lymphangitis and lymphadenitis after drug administrations were assessed from clinical and pathological point of view. It was conclusively indicated that the chemotherapeutic response to low dosage schedule within shorter length of treatment was equal to that of larger doses in long term medication from the point of the reduction in microfilaria, and particularly the resulting side-reactions were also reduced in the low dosage schedule.
parasitology-helminth-nematoda-Bruigia malayi ; chemotherapy-diethylcarbamazine ; microfilaria ; diethylcarbamazine

Echocardiographic examination was performed before, immediately after, 4-6 months after and 10-12 months after mitral valve replacement(MVR) surgery in 46 patients with mitral valve disease(8 patients with mitral regurgitation, 24 patients with mitral stenosis and 14 patients with mitral stenosufficiency) to evaluate the effects of mitral valve replacement on dimension of left atrium and left ventricle, volume of left ventricle, ejection fraction(EF) and fractional shortening(FS) of left ventricle. The results are as follows : 1) The endsystolic dimension(ESD), enddiastolic dimension(EDD), endsystolic volume(ESV) and enddiastolic volume(EDV) decreased significantly after operation in patients with mitral stenoinsufficiency(MSR), the ESD, EDD, ESV and EDV increased significantly after the operation, but returned to preoperative value 10-12 months after the operation. 2) The EF and FS of left ventrcle after MVR were significantly lower than preoperative value throughout the postoperative period in patients with MR. However in patients with MS or MSR, there were no significant postoperative changes in EF and FS, except transient depression in the patients with MS at the immediate postoperative period. 3) In all patients with mitral valve disease, the left atrial dimension and the ratio of domension of left atrium to the dimension of aorta decreased significantly after MVR. From above results, it is suggested that surgery should be considered seriously for the patients with MR before the ESD, EDD and ESV increase maekedly, even if the EF anf FS are in normal range and the symptoms are not severe, to prevent irreversible depression of myocardial function. It seems that serial echocardiographic examination is very helpful in this respect.
Aorta ; Atrial Natriuretic Factor ; Depression ; Echocardiography* ; Heart Atria ; Heart Ventricles ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Postoperative Period ; Reference Values

Ligamentous injury of the knee which could be easily occur in sports or traffic accidents resulted in more and severe disability than that of other joints. Rupture of the anterior cruciate ligament which restrain hyperextension, excessive rotation and anterior motion of tibia on femur is the most frequent and significant injury of the knee. Its treatment and clinical significance is one of the most controversial issue and its incidence tends to increase. From 1983 to 1985, modified Scott operation were performed on 10 patients at the department of orthopedic surgery, Chung Ang university hospital. Following results are obtained. 1. No limitation of range of motion of the knee was developed. 2. Intra-articular fixation by use of pull-out wire was done and special consideration was done for the site of fixation on tibia plateau and method of dilatation of posterior capsule. 3. Of the ten patients, nine had negative anterior drawer test, postoperatively.
Accidents, Traffic ; Anterior Cruciate Ligament ; Dilatation ; Femur ; Humans ; Incidence ; Joints ; Knee ; Ligaments ; Methods ; Orthopedics ; Range of Motion, Articular ; Rupture ; Sports ; Tibia

The antiarrhythmic effect of Mexiletine was evaluated in five patients with recurrent ventricular tachycardia and in twelve patients with frequent premature ventricular contractions. Electrophysiologic study was performed on the the patients with recurrent ventricular tachycardia before and after the administration of Mexiletin(600-800mg/day). The antiarrhythmic effects of Mexiletine in the patients with frequent premature ventricular contraction was assessed by ambulatory electrocardiography. The results were as follows: 1) In all of the five patients with recurrent ventricular tachycardia, sustained ventricular tachycardia was induced by programmed ventricular stimulation. However, on repeated electrophysiologic study performed while receiving Mexiletine, ventricular tachycardia was not induced in four patients and non-sustained ventricular tachycardia was induced in one patients. 2) The number of premature ventricular contraction was decreased markedly in seven patients(58.3%) with frequent premature ventricular contractions. 3) Minimal side effects, mild indigestion and tremor, were recorded in 3 cases(23%) while receiving Mexiletine 600 mg/day. The higher dose was associated with more frequent and severe side effects.
Dyspepsia ; Electrocardiography, Ambulatory ; Humans ; Mexiletine* ; Tachycardia, Ventricular ; Tremor ; Ventricular Premature Complexes

No abstract available.
Abscess* ; Multivariate Analysis* ; Recurrence*

A clincal study was made on 383 adult patients with congenital heart disease who visited the Seoul National university Hospital during the period of March, 1961-July, 1979. 1. The incidence of congenital heart disease for the consecutive years was increasing in 1970s, especially in recent two years. 2. The sex incidence of congental heart disease was female 47.0%, male 53.0%, with male preponderance in tetralogy of Fallot, ventricular septal defect, coarctation of aorta, aortopulmonary window and female preponderance in atrial septal defect, patent ductus arteriosus. 3. Age distribution of congenital heart disease showed that 79.1% of all were below 30 years of age but atrial septal defect showed wide distribution below and above 30 years of age. 4. The incidences of each congenital heart disease were atrial septal defect 20.9%, tetralogy of Fallot 20.6%, ventricular septal defect 19.%, patent ductus arteriosus 12.0%, pulmonary stenosis 7.6%, trilogy of Fallot 1.8%, Ebstein's anomaly 1.8%, ventricular septal defect with pulmonary stenosis 1.3%, coarctation of aorta 1.3%, ventricular septal defect with aortic insufficiency 1.0%, transposition of great vessels 1.0%, in order and rare and various combined anomalies. 5. Average duration of illness in congenital heart disease was less than 15 years in majority, but duration from 11 years to 20 years was most common in tetralogy of Fallot. 6. Functional class of congenital heart disease is class II and I in majority, but class III was most common in tetralogy of Fallot. 7. Comparision of precatheterization diagnosis with postcatheterization diagnosis showed concordence in 92.2% and comparison of postcatheterization diagnosis with postoperative diagnosis showed concordence in 95.5% of cases. 8. Electrocardiographic findings in 5 major congenital heart disease were observed as follows; right ventricular hypertrophy 86.3%, right atrial enlargement 16.4% in tetralogy of Fallot, right ventricular hypertrophy 30.9%, incomplete right bundle branch block 27.9% in atrial septal defect, left ventricular hypertrophy 28.8%, right ventricular hypertrophy 10.6%, biventricular hypertrophy 10.6% in ventricular septal defect, left ventricular hypertrophy 63.2% in patent ductus arteriosus and right ventricular hypertrophy 70% in pulmonary stenosis. 9. Postoperative changes in electrocardiographic findings were observed in 36.1% of operated patients, of whom teteralogy of Fallot 61.7%, ventricular septal defect 48.0% were most common. Pstoperative electrocardiographic changes were complete right bundle branch block 58.3%, incomplete right bundle branch block 11.7%, myocardial ischemia 10%, nonspecific ST-T changes 10%, etc. in order.
Adult* ; Age Distribution ; Aortic Coarctation ; Bundle-Branch Block ; Diagnosis ; Ductus Arteriosus, Patent ; Ebstein Anomaly ; Electrocardiography ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Seoul ; Tetralogy of Fallot ; Transposition of Great Vessels ; Trilogy of Fallot

A clincal study was made on 383 adult patients with congenital heart disease who visited the Seoul National university Hospital during the period of March, 1961-July, 1979. 1. The incidence of congenital heart disease for the consecutive years was increasing in 1970s, especially in recent two years. 2. The sex incidence of congental heart disease was female 47.0%, male 53.0%, with male preponderance in tetralogy of Fallot, ventricular septal defect, coarctation of aorta, aortopulmonary window and female preponderance in atrial septal defect, patent ductus arteriosus. 3. Age distribution of congenital heart disease showed that 79.1% of all were below 30 years of age but atrial septal defect showed wide distribution below and above 30 years of age. 4. The incidences of each congenital heart disease were atrial septal defect 20.9%, tetralogy of Fallot 20.6%, ventricular septal defect 19.%, patent ductus arteriosus 12.0%, pulmonary stenosis 7.6%, trilogy of Fallot 1.8%, Ebstein's anomaly 1.8%, ventricular septal defect with pulmonary stenosis 1.3%, coarctation of aorta 1.3%, ventricular septal defect with aortic insufficiency 1.0%, transposition of great vessels 1.0%, in order and rare and various combined anomalies. 5. Average duration of illness in congenital heart disease was less than 15 years in majority, but duration from 11 years to 20 years was most common in tetralogy of Fallot. 6. Functional class of congenital heart disease is class II and I in majority, but class III was most common in tetralogy of Fallot. 7. Comparision of precatheterization diagnosis with postcatheterization diagnosis showed concordence in 92.2% and comparison of postcatheterization diagnosis with postoperative diagnosis showed concordence in 95.5% of cases. 8. Electrocardiographic findings in 5 major congenital heart disease were observed as follows; right ventricular hypertrophy 86.3%, right atrial enlargement 16.4% in tetralogy of Fallot, right ventricular hypertrophy 30.9%, incomplete right bundle branch block 27.9% in atrial septal defect, left ventricular hypertrophy 28.8%, right ventricular hypertrophy 10.6%, biventricular hypertrophy 10.6% in ventricular septal defect, left ventricular hypertrophy 63.2% in patent ductus arteriosus and right ventricular hypertrophy 70% in pulmonary stenosis. 9. Postoperative changes in electrocardiographic findings were observed in 36.1% of operated patients, of whom teteralogy of Fallot 61.7%, ventricular septal defect 48.0% were most common. Pstoperative electrocardiographic changes were complete right bundle branch block 58.3%, incomplete right bundle branch block 11.7%, myocardial ischemia 10%, nonspecific ST-T changes 10%, etc. in order.
Adult* ; Age Distribution ; Aortic Coarctation ; Bundle-Branch Block ; Diagnosis ; Ductus Arteriosus, Patent ; Ebstein Anomaly ; Electrocardiography ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Seoul ; Tetralogy of Fallot ; Transposition of Great Vessels ; Trilogy of Fallot

BACKGROUND: Angiotensin convertiong enzyme inhibitors have been shown to exert favorable effects on the left ventricular remodeling process associated with ventricular dilation after coronary occlusion. However, the effects of such therapy on global and regional left ventricular remodeling after coronart artery reperfusion have not been characterized, nor have such effects been assessed after exercise training. METHODS AND RESULTS: Female Sprague-Dawley rats(n=80) were randodmized into 4 groups at 5 days after 45 minutes of left coronary artery occlusion followed by reperfusion. Animals completion the experiment included : Untreated Sedentary group(n=20), Untreated with Swimming Exercise group(n=21), Captopril Treated Sedentary group(n=18) and Captoril Treated with Exercise group(n=21). At 3 weeks after randomization, global and regional morphologic changes of the left ventricle(LV) were examined from mid-ventricular transverse slices which were perfusion-fixed at a constant aortic pressure of 60mmHg and a left ventricular cavity pressure of 10mmHG. At rest and during exercise, compared to untreated rats, the captopril treated animals showed significantly decreased LV weight/tibial length ratio(LV/TL)(p<0.01),increased LV cavity area and dimension(both p<0.01), decreased total myocardial area and noninfarcted area(both p<30.001) and reduced wall thicknesses in the noninfarcted and infarcted regions(both p<0.001). Compared to treated and untreated dsedentary rats, exercise significantly increased LV/TL(p<0.05) and epicardial and endocardial areas in the infarcted zone(both p<0.05) and decreased transmurality(p<0.01). Exercise decreased LV cavity area in the captopril treated groups(42.3+/-10.4 vs. 40.4+/-6.0mm2),whereas exercise increased LV cavity area in the untreated groups(33.5+/-8.9 vs. 39.1+/-6.2mm2)(p<0.05). CONCLUSION: These findings provide evidence in rats for evidence in rats for exaggerated left ventricular dilation and supperssion of compensatory myocardial hypertrophy globally and in the infarct zone with 3 weeks of captopril treatment following coronary artery reperfusion with acute nontransmural myocardial infarction. In addition, the effects of captopril on LV dilation and suppression of global and regional hypertrophic response were partially reversible by swimming exercise.
Angiotensins ; Animals ; Arterial Pressure ; Arteries ; Captopril ; Coronary Occlusion ; Coronary Vessels* ; Enzyme Inhibitors ; Female ; Humans ; Hypertrophy ; Myocardial Infarction ; Myocardial Reperfusion ; Random Allocation ; Rats* ; Rats, Sprague-Dawley ; Reperfusion* ; Swimming ; Ventricular Remodeling*

Nine patients with ipsilateral tibial shaft fractures and knee ligament injuries were retrospectively reviewed to determine the methods of the diagnosis and the results of the treatment. The incidence of this combined injuries was 5% in one hundred and eighty two tibial shaft fractures. The injuries of posterior cruciate ligament were combined most freqently. Five of nine patients were open fractures. Bone union was obtained in all cases and the mean duration of bone union was 22.5 weeks. Athroscopy and stress X-ray for the cruciate ligament were helpful to diagnose this combined injures. The ligament injuries were surgically managed in eight and conservatively in one. Better results were obtained when this combined injuries were operated early, but four of nine patients were disabled. The results suggest that the examination of the knee is necessary to document ligamentous injuries that occur with tibial shaft fractures.
Diagnosis ; Fractures, Open ; Humans ; Incidence ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Retrospective Studies