BACKGROUND AND OBJECTIVES: The assessment of left ventricular (LV) diastolic function is important in chronic renal failure because abnormal LV diastolic function has been frequently described in patients on maintenance hemodialysis both during the dialysis and in the dialysis-free interval despite the normal LV systolic function. But the echocardiographic indexes of LV diastolic function is known to be affected by several factors such as loading condition, LV compliance and heart rate. The purpose of this study is to investigate the effect of hemodialysis on the echocardiographic indexes of left ventricular diastolic function in chronic renal failure. Materials AND METHODS: We examined transmitral flow velocity, pulmonary venous flow velocity, and mitral annulus velocity in 20 patients (15 men and 5 women, average 50+/-14, range 19-69 years) of chronic renal failure with normal LV systolic function by echocardiography before and after hemodialysis. RESULTS: 1)According to the body weight change (from 59.5+/-8.3 to 57.2+/-8.1 kg, p=0.0001), after hemodialysis, inferior vena cava dimension (from 18+/-4 to 13+/-5 cm, p=0.0001), left ventricular end-diastolic dimension (from 57+/-6 to 53+/-7 cm, p=0.0001), and left ventricular outflow tract (LVOT)-time velocity integral (TVI, from 26+/-5 to 23+/-5 cm, p=0.004), which reflect intravascular blood volume, decreased significantly. 2)The peak velocity of early transmitral flow (E, from 0.79+/-0.14 to 0.64+/-0.11 m/s, p=0.0001), the peak velocity of late transmitral flow (A, from 0.84+/-0.21 to 0.78+/-0.21 m/s, p=0.011), and E/A ratio (from 0.99+/-0.25 to 0.87+/-0.27, p=0.007) decreased significantly, and deceleration time (DT, from 241+/-48 to 267+/-59 ms, p=0.055) showed tendency of prolongation after hemodialysis. 3)Peak systolic velocity of pulmonary venous flow decreased significantly after hemodialysis (from 0.65+/-0.11 to 0.59+/-0.12 m/s, p=0.042). 4)The difference between duration of reversal flow of pulmonary vein and duration of transmitral flow during atrial contraction (ADD) did not change significantly after hemodialysis (from 5+/-31 to 1+/-29 ms, p=0.502), and did not correlate with the change of peak velocity of early transmitral flow during hemodialysis (DMVE, r=0.390, p=0.089). 5)The peak early diastolic velocity (Ean, from 0.07+/-0.02 to 0.06+/-0.02 m/s, p=0.002) and Ean/the peak late diastolic velocity (Aan) ratio (from 0.78+/-0.27 to 0.62+/-0.19, p=0.003) of medial annulus of mitral valve decreased significantly after hemodialysis. CONCLUSION: Hemodialysis, which reduces LV preload by fluid removal, changes the echocardiographic indexes of left ventricular diastolic function in chronic renal failure. Preload condition need to be accounted for when we evaluate the LV diastolic function with echocardiography.
Blood Volume ; Body Weight Changes ; Compliance ; Deceleration ; Dialysis ; Echocardiography* ; Female ; Heart Rate ; Humans ; Kidney Failure, Chronic* ; Male ; Mitral Valve ; Pulmonary Veins ; Renal Dialysis* ; Vena Cava, Inferior

Noabstract available.
Hantaan virus*

PURPOSE: The purpose of this study was to identify the correlation between the feeling of powerlessness, social support and life satisfaction in the elderly. METHODS: The subjects were 158 old people aged over 65 who were attending one of one college and three settlement houses for senior citizens located in B city. RESULTS: The relationship between the feeling of powerlessness and life satisfaction was in a moderate negative correlation with each other (r=-.433, p=.000). The relationship between social support and life satisfaction was in a moderate positive correlation with each other (r=.410, p=.000). It was found that the higher social support was, the higher life satisfaction was. There was remarkable difference in the form of family (F=2.69, p=.023), the form of residence (F=5.29, p=.002), whether to belong to a group (F=2.26, p=.025). CONCLUSION: For the reasons stated above, as the feeling of powerlessness is lower and social support is higher, life satisfaction is higher. The results clearly show that in order to improve life satisfaction of the elderly, we need to ease their feeling of powerlessness and enhance social support to them. Therefore, it is necessary to develop a nursing intervention program to reduce powerlessness and to improve social support for the elderly.
Aged* ; Humans ; Nursing

To evaluate the morphogenesis of the human thyroid, a histologic study was made based on 100 normal thyroids of human embryos and fetuses ranging in age from 4 to 42 weeks of gestation. The embryos were serially sectioned and fetuses were examinated as an individual organ. 1) The first sign of thyroid primordium was the spherical proliferation of median ventral pharyngeal wall at the 4th week of development. 2) At the 6th week of gestation, the thyroid differentiated into two lobes that were connected by an isthmus, and was on the way of migration to the definite position from the foramen cecum. 3) The developing thyroid consisted of two cell cords, solid nests or interconnecting complex pattern until 14th week of gestation, when the entire portion of thyroid was replaced by follicles of variable size. 4) At the 9th week, the first follicle was recognizable at the periphery of the gland. 5) At the 14th week, follicles were partly filled with faintly eosinophilic colloid. 6) After the 18th week of gestation, lobulation of the thyroid parenchyme was a prominent feature. 7) After the 24th week, large follicles with rich colloid content are distributed through both superificial and deep portions. And after the 34th week, maturation reached the general pattern of adult thyroid. 8) The ability of thyroglobulin synthesis which was confirmed by PAP method, was first recognized at the 10th week of gestation.
Adult ; Male ; Female ; Humans

No abstract available.
Constriction, Pathologic* ; Diagnosis*

This report describes the pathologic features of 17 cases of Castleman's disease, examined at the Department of Pathology, Seoul National University Hospital during a period from 1973 to 1989. The lesions in 12 cases were hyaline-vascular type and the remainders plasma cell type. The pathologic features favoring the plasma cell type over the hyaline vascular type included a sufficient number to large-sized follicles. However, a histologic overlapping between two types was present. In the hyaline vascular type the age of the patients ranged from 7 to 76 years and they appeared to be no particular sex predominence. The majority of the lesions occurred in the neck and within the chest. Almost all cases presented with a solitary mass except three cases. Neither conventional symptoms nor systemic manifestations were associated. The plasma cell type was characterized by presentation of constitutional symptoms, involvement of intra abdominal and inguinal lymphnodes, in association with unusual clinicopathologic features including IgA nephropathy, diabetes mellitus, systemic progressive sclerosis, peripheral neuropathy, and anemia. Immunohistochemical study was performed in three cases of the plasma cell type. Two cases revealed poly-clonal plasma cell infiltration. In a patient with IgA nephropathy, however, serum IgA was increase and a strong immunoreactivity to IgA heavy chain was found. Another case, associated with systemic progressive sclerosis and neuropathy, revealed monoclonal plasma cell infiltration (IgG and lambda light chain). The above results support a possibility that in some of the plasma cell type an altered immune mechanism is involved in its pathogenesis.

BACKGROUND: Determination of left ventricular(LV) myocardial mass with echocardioraphy is feasible and validated. American society of echocardiography(ASE) issued recommendations for the quantitation of the left ventricle by M-mode and 2-dimensional echocardiography in 1978 and 1989, respectively. Although some controversies exist regarding the relative accuracy of M-mode and 2-dimensional techniques, many workers now agree that 2-dimensional methods are more accurate and can be applied to a higher percentage of patients. But sometimes the validated methods are not optimal when parasternal short axis view is difficult to obtain, when the ventricle is distorted, or when scar tissue constitutes a portion of the myocardial volume. METHODS: We measured left ventricular mass in 72 normal subjects using three different methods-ASE cube method with correction in M-mode(method A), area-length method from parasternal short axis view and apical four chamber view(method B), and the method using Simpson's rule from apical four chamber view(method C). RESULTS: 1) LV mass(index) was 161.8+/-30.3g(98.7+/-15.6g/m2) by method A, 166.2+/-32.8g(101.2+/-16.5g/m2) by method B, and 161.2+/-31.8g(98.2+/-15.5g/m2) by method C. 2) LV mass or index by method B was significantly different from that by method A(p<0.001) and from that by method C(p<0.001). However there was no significant difference in LV mass or index between by method A and C(p>0.05). 3) There was a strong correlation between LV mass or index by the method A and B(r=0.873, p<0.001), by the method B and C(r=0.923, p<0.001), and by the A and C(r=0.945, p<0.001). CONCLUSIONS: It is suggested that the method using Simpson's rule can reliably assess LV mass, although it results in smaller value that that by area-length method.
Axis, Cervical Vertebra ; Cicatrix ; Echocardiography* ; Heart Ventricles ; Humans

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) reduces the intracellular Ca2+ concentration ([Ca2+]i) in smooth muscle cells, whereas the effect of NO on [Ca2+]i in endothelial cells is still controversial. Therefore, the effect of NO on the [Ca2+]i, and its mechanism in mouse aortic endothelial cells (MAEC) and human umbilical vein endothelial cells (HUVEC) were examined. MATERIALS AND METHODS: In primary cultured MAEC and HUVEC, cells were loaded with fura 2-AM and [Ca2+]i and measured using a microfluorometer. RESULTS: The NO donor, sodium nitroprusside (SNP), reduced the [Ca2+]i in 72% of the cells tested (n=100). In the remaining cells, the effect of SNP was biphasic, or the [Ca2+]i was increased. In addition, the membrane-permeable cGMP, 8-bromo cGMP, decreased the [Ca2+]i. The effects of SNP and 8-bromo cGMP were inhibited by the soluble guanylate cyclase inhibitor, 1H-[1,2,4] oxadiazole[4,3-a]quinoxalin-1-one (ODQ), and the cGMP-dependent protein kinase inhibitor, KT5823, respectively. In contrast, in the presence of 8-bromo cGMP or ODQ, SNP increased the [Ca2+]i. CONCLUSION: These results suggest that NO inhibits the [Ca2+]i through a cGMP-dependent mechanism and increases the [Ca2+]i through a cGMP-independent mechanism.
Animals ; Cyclic GMP ; Endothelial Cells* ; Endothelium ; Guanylate Cyclase ; Human Umbilical Vein Endothelial Cells ; Humans ; Mice ; Myocytes, Smooth Muscle ; Nitric Oxide ; Nitroprusside ; Protein Kinases ; Tissue Donors

No abstract available.
Cochlear Implants*

Aplasia cutis congenita is a rare disorder characterized by localized or generalized absence of skin at birth. Group 4 in Friden's classification, which is associated with embryologic malformations including myelomeningocele, encephalomeningocele, omphalocele, gastroschisis. The authors have experienced a case of aplasia cutis congenita of right frontal scalp associated with bony defect, forming encephalocele in a newborn. We reported this case with brief review of literatures.
Classification ; Ectodermal Dysplasia* ; Encephalocele ; Gastroschisis ; Hernia, Umbilical ; Humans ; Infant, Newborn ; Meningomyelocele ; Parturition ; Scalp ; Skin