BACKGROUND: It is known that left ventricular(LV) wall motion is not uniform even in normal heart, and the restoring forces make phase differences between LV wall motion and mitral flow velocity during rapid filling period. METHOD: To investigate the regional nonuniformity and restoring forces in 46 patients with hypertension(HT)(group:normal wall thickiness.n=12,II:LVH with fractional shortening(FS)>25%. n=22. III:FS<25%.n=12). We measured the time intervals from A2 to peak thinning rate point of LV posterior wall(A2-(-)dpw/dt).to mitral flow starting point (IRT).and to peak mitral flow velocity(A2-E) by M-mode and Doppler echocardiography. RESULTS: The noniformity((-)dpW/dt-dL/dt)and phase differance((-)dpw/dt-E) were increased in HT(control:HT.22+/-7.8 vs. 49+/-5.2msec, 63+/-4.5 vs, 86+/-6.2msec, p<0.05 respectively).In group comparison, nonuniformity increased in group II and III(group I: group II, III, 35+/-5.1 vs. 50+/-7.1,70+/-14msec, p<0.05 respectively). but phase difference increased only in group II(groupII: group I, III, 93+/-6.0 vs. 75+/-5.2, 80+/-20msec, p<0.05, respectively). CONCLUSION: We interpreted these data that in HT with hypertrophy or not, the nonuniformity of LV wall motion working on the restoring forces which can be expressed as phase difference between LV wall motion and mitral flow. But in HT with hypertensive heart failure group, no significant changes of phase difference and it's suggest that other mechanism could be also working on early diastolic filling.
Echocardiography* ; Echocardiography, Doppler ; Heart ; Heart Failure ; Humans ; Hypertension* ; Hypertrophy

BACKGROUND: A regional wall motion nonuniformity and a phase difference between LV posterior wall motion and transmitral flow are present during normal rapid filling period and are thought to be an evidence for involvement of ventricular restoring forces. To assess the role of nonuniformity on diastolic funtional impairment of asymmetric septal hypertrophy(ASH), the time relations between left ventricular regional wall motions and filling velocity were studied. METHOD: We measured the time intervals from A2 to peak rate of LV posterior wall(short axis) thinning(A2-(-)dpw/dt), peak rate of medial mitral annulus (long axis dimension) lengthening(A2-dL/dt) and peak mitral flow(A2-E) by M-mode and Doppler echocardiography. Result: In ASH patients, A2-(-)dpw/dt(106+/-6msec, mean SE) and the regional wall motion nonuniformity((-)dpw/dt-dL/dt, 89+/-11msec, mean SE) were increased significantly when compared with normal control values(88+/-4, 28+/-5msec, mean SE, p<0.01,respectively).In normal controls, peak mitral flow velocity lagged peak rate of regional wall motion, so the phase differences were present((-)dpw/dt-E :71+/-8msec, dL/dt-E:44+/-6msec). In ASH patients, (-)dpw/dt-E was present(90+/-16msec) but dL/dt-E was not present or reversed(-21+/-18 msec). So these chacteristic phase differences were disturbed. CONCLUSION: These data suggested that the relaxation nonuniformity of regional wall motion in ASH may act as an energy dissipating factor of restoring forces during rapid filling period.
Axis, Cervical Vertebra ; Cardiomyopathy, Hypertrophic* ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Relaxation

PURPOSE: To evaluate CT findings of internal hernia. MATERIALS AND METHODS: Three patients with internal hernia had abdominal CT scans and two of them had small bowel follow through examinations. The CT features of two patients with retroanastomotic and one patient with left paraduodenal hernia were evaluated and correlated with small bowel follow through examinations, and surgical findings. Two patients with retroanastomotic hernia had a history of subtotal gastrectomy with antecolic gastrojejunostomy. The diagnosis of internal hernia was made on the basis of surgical find ings in two patients of retroanastomotic hernia, and characteristic barium study findings in one patient of left paraduodenal hernia. RESULTS: The small bowel follow through examination showed small bowel loops gathered in a circumscribed mass in the left mid abdomen, and delay in passage through these loops. In case of left paraduodenal hernia, abrupt narrowing of the distal duodenum could be identified. The characteristic CT findings of all three patients were whorling of the mesentery and mesenteric vessels in the left mid-abdomen. In the patient with left paraduodenal hernia, after resolution of the gastrointestinal symptoms, a follow-up CT scan showed spontaneous disappearance of whorling of the mesentery and mesenteric vessels suggesting spontaneous resolution of the hernia. In the other two cases, upon exploration of the abdomen, dilatation of afferent duodenum caused by adhesion between ligament of Treitz and adjacent bowel walls, and retro- anastomotic herniation of the efferent loops were found. CONCLUSION: The usual diagnosis of internal hernia is based on the appearance of the small bowel follow through examination. However, we consider that the whorling appearance(we call it whorling sign) of the mesentery and mesenteric vessels on CT scan is also suggestive of internal hernia in patients under clinical suspicion.
Abdomen ; Barium ; Diagnosis ; Dilatation ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Hernia ; Humans ; Ligaments ; Mesentery* ; Tomography, X-Ray Computed

PURPOSE: To evaluate the radiologic findings of alimentary anthrax. MATERIALS AND METHODS: 19 patients with alimentary anthrax, which was caused by ingestion of contaminated beef, were included in this study. The diagnosis was made .b.y demonstration of Bacillus anthracis in smear and culture of the contaminated meat. We evaluated the clinical manifestations and the findings of thoracic, abdominal radiographs, cervical, abdominal ultrasonograms and abdominal CT scans. RESULTS: Out of the 19 patients with the alimentary infection, 9 had oropharyngeal form, 18 had abdominal form and 8 had combination of oropharyngeal and abdominal form. The patients had general symptoms and signs such as fever, chill, myalgia. Clinical symptoms and signs were sore throat, throat injection, throat ulcer and patch in oropharyngeal form, and nausea, vomiting, abdominal pain, diarrhea, and gross GI bleeding in abdominal form. Radiologic findings included enlarged cervical lymph nodes(36%) in oropharyngeal form, and paralytic ileus(26%), ascites(26%), hepatomegaly(21%), enlarged mesenteric lymph nodes(26%), small bowel wall thickening(5%) in abdominal form. In two patients, late complications occurred as intestinal obstruction due to ileal stricture with perforation, and inflammatory changes of pelvic cavity due to ileovesical fistula. CONCLUSION: Radiologic findings of alimentary anthrax are difficult in differentiation from those of other inflammatory bowel disease, but those radiologic findings with clinical manifestations may be helpful in diagnosis and evaluation of disease process in patients with alimentary anthrax.
Abdominal Pain ; Anthrax* ; Bacillus anthracis ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Eating ; Fever ; Fistula ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intestinal Obstruction ; Meat ; Myalgia ; Nausea ; Pharyngitis ; Pharynx ; Tomography, X-Ray Computed ; Ulcer ; Ultrasonography ; Vomiting

Time intervals and indices of left ventricular diastolic filling were studied by M-mode and pulsed Doppler Echocardiography in 18 dilated cardiomyopathy patients. After one two hours captopril(capril(R)) 25mg medication. 1)Systolic blood pressure, Diastolic blood pressure, Heart rate were significantly decreased. 2) Dimensions of LVSD, LVDD, LA, Aorta and EF were not changed measured by M-mode echocardiography. 3) IRT measured by M-mode and Pulsed Doppler echocardiography were significantly increased(45+/-33msec VS 74+/-35msec. 84+/-32msec VS 100+/-22msec P<0.05). 4) A2-E measured by M-mode and Pulsed Doppler echocardiography were significantly increased(114+/-45msec VS 134+/-46msec, 156+/-46msec VS 194+/-48msec, P<0.05). 5) Deceleration time was significantly increased(137+/-36msec VS 205+/-40msec P<0.05). 6) Transmitral peak flow velocities were not changed significantly. In summary captopril influences early diastolic time intervals with dilated cardiomyopathy patients and we interpreted these effects be beneficial on diastolic filling pattern.
Aorta ; Blood Pressure ; Captopril ; Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans

The antihypertensive effect of Doxazocin were evaluated in 20 patients with essential hypertension. Two to eight mg of Doxazocin per day were administered continuously for two or eight weeks. The results were as follows : 1) Doxazocin were effective in 18 out of 20 patients(90%) at the end of 8 weeks treatment. 2) The systolic blood pressure was signigicantly decreased(173+/-20mmHg VS 144+/-33mmHg, P+/-0.001), and the diastolic blood pressure was also decreased(110+/-10mmHg VS 93+/-19mmHg, P<0.01) after treatment. 3) Triglyceride showed a decreasing tendency but statistically significance was not observed. Total cholesteral, HDL-cholesterol, BUN, creatinine, and uric acid did not change significantly before and after treatment with Doxazocin. 4) The side effects were headache in one case and dizziness in to cases. These results suggest that Doxazocin is an effective antihypertensive agent and concerning lipid profile, further long term observation is needed.
Blood Pressure ; Creatinine ; Dizziness ; Headache ; Humans ; Hypertension* ; Triglycerides ; Uric Acid

BACKGROUND: To evaluate the safety and the efficacy of amlodipine, a dihydropyridine calcium antagonist, monotherapy in the treatment of moderate essential hypertension. METHOD: Amlodipine 5mg once a day was administered as a starting dose in 30 patients with essential hypertension in the morning and a one step upward titration was performed (amlodipine 10 mg once a day) was done at the end of 4weeks treatment. Final evaluation was done at 12weeks with laboratory test and echocardiogram. RESULT: Within 4weeks treatment with dose of 5mg amlodipine once a day, the systolic blood pressure (SBP) was decreased(184.5+/-23.3/150.5+/-16.0mmHg,p<0.000), and the diastolic blood pressure(DBP) was also decreased significantly (109.9+/-04.6/92.3+/-11.5mmHg, P<0.001). After 12 weeks of treatment with a mean dosage of 6.6mg once a day, SBP and DBP was maintained comparing with basal level (147.0+/-15.8/88.1+/-0.9mmHg, respectively). The efficacy of amlodipine treatment was noted an excellent in 16 patients(53.3%), good in 4 patient(13.3%), fair in 4 patients(13.3%), and failed in 2 patients(6.7%). There was no significant change in heart rate before and after amlodipine treatment. (80.0+/-2.3/80.9+/-10.4 beats/minute n.s). Amlodipine had not significant effects on laboratory findings such as serum creatinine, BUN, ALT/AST, hemoglobin, leukocyte count,platelet and lipid profiles. There was facial flushing 2 patients, but no need to discontinue administration of amlodipine and all patients completed for 12weeks therapy. CONCLUSION: It is concluded that amlodipine is an effective antihypertensive agent, as monotherapy once a day in patients with moderate essential hypertension.
Amlodipine ; Blood Pressure ; Calcium ; Creatinine ; Flushing ; Heart Rate ; Humans ; Hypertension* ; Leukocytes

No abstract available.
Cyclosporine ; Necrobiosis Lipoidica ; Necrobiotic Disorders

PURPOSE: Many techniques have been described for achieving vertical augmentation of the maxillary sinus. The aim of this study is to evaluate the effect of low-intensity pulsed ultrasound (LIPUS) to enhance bone regeneration after sinus floor elevation. METHODS: The sinus lifting technique was performed through a lateral approach on 8 different sites of 5 patients (3 males and 2 females) and their mean age was 45.7 years old. The sites were randomly assigned to the control or test groups. The control group had 4 sites that received lateral sinus lifting procedure only, while the test group had 4 sites that received LIPUS application after the lateral sinus lifting procedure. 24-32 weeks (an average of 29 weeks) postoperatively, new bone formation in the augmented sinus sites was evaluated through histologic and histomorphometric analyses of the biopsy specimens obtained during implant placement. RESULTS: In the test group, the mean percentage of newly formed bone was 19.0+/-2.8%. In the control group, the mean percentage of newly formed bone was 15.2+/-3.1%. The percentage of newly formed bone was approximately 4% higher in those cases where the sinus was treated by LIPUS than the percentage in those cases where it was not used. The difference was statistically significant. CONCLUSIONS: Within the scope of this study, low-intensity pulsed ultrasound application after sinus lifting appeared to have a significant effect on the development of new bone formation.
Biopsy ; Bone Regeneration ; Floors and Floorcoverings ; Humans ; Lifting ; Male ; Maxillary Sinus ; Osteogenesis ; Transverse Sinuses

Bart's syndrome was initially described as a genodermatosis characterized by congenital localized absence of the skin with blistering and nail deformities 1-3. However, it is considered as any type of epidermolysis bullosa(EB) with localized congenital absence of the skin on the extremities. A 33-day-old fbmale baby was presented with congenital absence of the skin over the left shin and dorsa of both feet which were covered with the thin, translucent, and brown-red glistening membranes. Blistering of the right calf and left great toe nail deformity were also noted. She was diagnosed as a recessive dystrophic EB by the histopathological, ultra- structural and immunomapping studies.
Blister ; Congenital Abnormalities ; Extremities ; Foot ; Membranes ; Skin ; Toes