BACKGROUND: It was recently shown that human atherosclerotic plaque contains large numbers of T lymphocytes : this indicates that immune and inflammatory mechanism may be important factors in the pathogenesis of atherosclerosis. By measuring the soluble interleukin 2 receptor(sIL-2R) level we can evaluate the activation of T lymphocyte. The purpose of this study is to evaluate relationship between T cell activation and ischemic heart disease by measuring the soluble interleukin 2 receptor (sIL-2R) level in patient with ischemic heart disease. METHOD: Seventy-two patients(40 males and 32 female, mean age : 56.5+/-9.9 years) who were taken coronary angiography were included in this study. Among them, 49 patients showed abnormal coronary angiographic findings and 23 patients showed normal coronary angiographic findings. Ten mililiters of arterial blood was drawn at the time of coronary angiography. The blood was allowed to coagulate and then the serum was removed and tested in duplicate for soluble interleukin 2 receptor (sIL-2R) level by ELISA. RESULTS: 1) The soluble interleukin 2 receptor (sIL-2R) level was significantly different between abnormal coronary angiographic findings and normal coronary angiographic findings (P < 0.001). 2) According to clinical severity of ischemic heart disease (i.e. stable angina, unstable angina, acute myocardial infarction.), soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05), but showed increasing tendency with clinical severity. 3) According to numbers of involved coronary vessels, soluble interleukin 2 receptor (sIL-2R) level was not significantly different between single vessel disease group and multivessels disease groups (p > 0.05). CONCLUSION: T lymphocyte activation, as reflected in elevated soluble interlekin 2 receptor (sIL-2R) level, is frequent in patient with ischemic heart disease. In the further we will investigate relationship between clinical diagnosis of ischemic heart disease of the numbers of involved coronary vessels and T cell activation.
Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Coronary Angiography ; Coronary Vessels ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interleukin-2 ; Lymphocyte Activation ; Lymphocytes ; Male ; Myocardial Ischemia* ; Plaque, Atherosclerotic ; Receptors, Interleukin-2 ; T-Lymphocytes

A single coronary artery is a rare congenital anomaly. The right coronary artery, originating from distal left circumflex, is an extremely rare variety of a single coronary artery. Our report is accompanied by a brief review of the literature.
Coronary Vessel Anomalies ; Coronary Vessels*

A coronary pseudostenosis is a characteristic angiographic image, which may appear as coronary winkles, or intussusceptions, due to a stiff guidewire during coronary interventions. Intravascular ultrasound (IVUS) plays a role in ruling out severe coronary stenosis, coronary dissections, thrombus or coronary spasm. We report a case of coronary pseudostenosis, which occurred during coronary interventions, diagnosed by intravascular ultrasound.
Coronary Stenosis ; Intussusception ; Spasm ; Thrombosis ; Ultrasonography*

No abstract available.

A clinical analysis was carrried out on 306 pts c Gastric ulcer who have visited the Depart on Internal Medicine. Daegue Catholic Hospital during the period from August 1980 to June l982. The result were as follows: of the total 306 cases, 249(81%) cases were male and 57(19%) cases were female, Male to female ratio was 4. 3: 1. Thirsty two percent of the cases blonged to the 6 tb decade, 25.5% to 5 th and 19% to 7 th decade. (continue...)
Daegu ; Female ; Humans ; Internal Medicine ; Male ; Stomach Ulcer*

Coronary arteriovenous fistula is relatively rare disease and originates more commonly in the right than in the left cononary artery. We report one case of cononary arteriovrnous fistula which we have experienced recently in 22 years old female, who has complained of dyspnea on exertion and intermittent anterior chest pain radiating to the left shoulder for several years. It was detected by transthoracic and transesophageal echocardiography and confirmed by cardiac catheterization and coronary angiography. In this case, the fistula was originated from the right coronary artery and drained into the posterior wall of the right ventricle, the coronary artery was dilated(diameter=1.5cm) and tortuous and significant shunt was measured(Qp/Qs=2.31). The opening of the fistula draining into right ventricle was obliterated with sutures.
Arteries ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dyspnea ; Echocardiography* ; Echocardiography, Transesophageal ; Female ; Fistula ; Heart Ventricles ; Humans ; Rare Diseases ; Shoulder ; Sutures ; Young Adult

BACKGROUND: In aerometabolic process, the human heart mainly utilizes free acid as fuel. During anaerobic process, lactate production by the myocardium is increased and accumulates in the myocardium. Thus it decreases the contractility of myocadium. Therefore in patients with ischemic heart disease, lactate prodution must be increased by the myocardium during myocardial ischemia. During paroxysmal supraventricular tachycardia, patients frequently experience chest pain and ST segment depression suggesting acute myocardial ischemia. However it occurs on a physiologic basis independent of ischemia. The purpose of this study was to assess whether tachycardia induced by artial pacing produces myocardial ischemia in patients without evidence of ischemic heart disease. METHODS: Between May 28, 1996 and August 13, 1996, at the University of Keimyung, Dong-San Medical center, 15 patients(male 9, female 6, mean age of 38 years) with palpititation underwent electrophysiologic testing and had radiofrequency cather ablation. There were no evidence of ischemic heart disease. Right artrial pacing was done with lengths of 500msec, 400msec and 350msec in each 5 patients. A 12 lead electrdcardiogram, left ventricular enddiastolic pressure, blood from femoral artery and coronary sinus for lactate determinations and blood gas analysis were dbtained simultaneously. They were obtained at baseline, at 1, 5, 10 and 15 minute of atrial pacing and at 1, 5, 10 minute after cessation of pacing. RESULT: Significant changes were not observed in , , concentration of , pH and saturation. In all patients, mean percent lactate extraction was above 10% and not significantly changed during atrial pacing. However ST segment depression was significantly progressive during atrial pacing and according to decrease the cycle length(p<0.05), also left ventricular end-diastolic pressure was significantly decreased during atrial pacing(p<0.05). Conclusion: Therefore tachycardia induced by atrial pacing for 15 minutes did not produce myocardial ischemia in patients without evidence of ischemic heart disease. Depression of STsegment during supraventricular tachycardia or atrial pacing, in patient without underlying heart disease is necessary to inveestigate what makes this phenomenon.
Blood Gas Analysis ; Blood Pressure ; Chest Pain ; Coronary Sinus ; Depression ; Female ; Femoral Artery ; Heart ; Heart Diseases ; Humans ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Metabolism* ; Myocardial Ischemia ; Myocardium ; Tachycardia ; Tachycardia, Supraventricular

BACKGROUND: Left ventricular diastolic dysfunction may precede systolic dysfunction and play a major role in producing the signs and symptoms of congestive heart failure. Ischemic heart disease can cause impairment of left ventricular filling without any alteration in systolic function so it is very important to evaluate relationship of left ventricular diastolic dysfunction and ischemic heart disease. The purpose of this study is to investigate left ventricular diastolic dysfunction during transient myocardial ischemia caused by balloon occlusion. METHODS: We prospectively studied 20 patients(11 males and 9 females, mean age : 58.5+/-5.9 years) who had been undergone coronary angiography and confirmed significant luminal stenosis(> or =75%)in proximal or middle portion of left anterior descending artery. After coronary angiography, percutaneous transluminal coronary angioplasty were performed all patients. We measured early propagation slope of left ventricular inflow, time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip and normalized TD(nTD) which dividing TD by the distance of mitral opening to apical region using color M-mode Doppler echocardiography, peak earaly diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave using pulsed wave Doppler echocardiography, left ventricular end diastolic pressure using left heart catheterization. A color M-mode Doppler echocardiography, pulsed wave Doppler echocardiography and left ventricular end diastolic pressure were recorded before, during 30sec, 60sec & 90sec and after 60sec & 180sec balloon occlusion. RESULTS: Early propagation slope of left ventricular inflow was significantly decreased during 30sec & 60sec balloon occlusion and significantly increased after 60sec & 180sec balloon occlusion, respectively (64.45+/-28.23cm/sec, 39.37+/-11.77cm/sec, 32.78+/-11.77cm/sec, 51.86+/-19.78cm/sec, 65.05+/-29.99cm/sec, p<0.05). Time difference(TD) between occurrence of peak velocity in the apical region and at the mitral tip was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(60+/-20msec, 90+/-30msec, 110+/-30msec, 80+/-20msec, 60+/-20msec, p<0.05). Normalized time difference(nTD) was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(11.24+/-3.87msec/cm, 17.76+/-6.67msec/cm, 21.51+/-6.67msec/cm, 15.22+/-4.00msec/cm, 12.63+/-3.59msec/cm, p<0.05). Left ventricular end diastolic pressure was significantly increased during 30sec & 60sec balloon occlusion and significantly decreased after 60sec & 180sec balloon occlusion, respectively(9.70+/-3.88mmHg, 14.15+/-6.49mmHg, 17.00+/-7.14mmHg, 10.20+/-3.68mmHg, 8.75+/-3.16mmHg, p<0.05). Peak early diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), E to A ratio, acceleration time of E wave and deceleration time of E wave were not significantly different(p>0.05). CONCLUSIONS: These data suggest that transient myocardial ischemia can cause left ventricular diastolic dysfunction and color M-mode Doppler echocardiography is very sensitive diagnostic method to detect early diastolic dysfunction compare to other echocardiographic diastolic indices.
Acceleration ; Angioplasty, Balloon, Coronary ; Arteries ; Balloon Occlusion ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Angiography ; Deceleration ; Echocardiography ; Echocardiography, Doppler* ; Echocardiography, Doppler, Pulsed ; Female ; Heart Failure ; Heart Ventricles* ; Humans ; Male ; Myocardial Ischemia* ; Phenobarbital ; Prospective Studies

BACKGROUND: Coronary sinus catheterization is important in electrophysiological studies. However the mor-phologic feature of the coronary sinus and its significance in patients with supraventricular tachycardia (SVT) have not been determined. During diagnostic electrophysiological studies, coronary sinus catheterization was easier in patients with atrioventricular nodal reentry tachycardia (AVNRT) than in patients with atrioventricular reentry tachycardia (AVRT). Therefore, we studied coronary sinus morphology in patients with SVT and compared AVNRT and AVRT patients. METHODS: The size and shape of the coronary sinus were measured in 13 patients who underwent retrograde coronary sinus venogram during electrophysiologic study between May and June 1996. The diagnosis was 7 cases of AVNRT, 2 of Wolff-Parkinson-White syndrome and 4 of concealed bypass tracts (mean age, 40 years : male vs female, 1 : 1.2). RESULTS: The mean coronary sinus ostial diameter was 10.4+/-2.0 mm:for AVNRT, it was 11.4+/-2.2 mm, and for AVRT it was 9.3+/-1.0 mm in left anterior oblique projection (p=0.031). The mean coronary sinus-to-spine angle was 82.6+/-17.4degrees : AVNRT 95.4+/-24.4degrees and AVRT 67.7+/-15.2degrees in anterior posterior projection (p=0.035). CONCLUSION: The coronary sinus ostial diameter of AVNRT patients was significantly larger than that of AVRT patients. This finding may have important implications for arrythmia pathogenesis in such patients.
Arrhythmias, Cardiac ; Catheterization ; Catheters ; Coronary Sinus* ; Diagnosis ; Female ; Humans ; Male ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Supraventricular* ; Wolff-Parkinson-White Syndrome

BACKGROUND: Measurement of echocardiographic mitral valve area (MVA) is an useful noninvasive method of estimating the stenotic mitral valve area. This study was undertaken to evaluate the accuracy of echocardiographic MVA measurement by comparing MVAs measured by the planimetric and pressure half-time method versus direct MVA measurement by using a cone shaped device specifically made for direct measurement of MVA. METHODS AND RESULTS: The study population consisted of 22 consecutive patients from August 1993 to February 1996. All the patients underwent 2D planimetry and Doppler echocardiographic MVA measurement before and after valve replacement surgery ; direct measurement also was performed after surgery. Five patients (22.7%) had normal sinus rhythm, and the rest of the patients had atrial fibrillation. Two-dimensional echocardiographic examinations were attempted in 22 patients, and adequate measurements were obtained in 21 of the patients studied. Mean mitral valve area were 0.99+/-0.32cm (2) ranged from 0.42 to 1.68cm (2) on 2D planimetry method, 0.93+/-0.32cm (2) ranged from 0.42 to 1.68cm (2) on Doppler pressure half-time method, 1.17+/-0.20cm (2) ranged from 0.93 to1.68cm (2) on direct measurement of mitral valve area after surgery. 2D planimetry method (r=0.621, p=0.003, SE=0.165), pressure half-time method (r=0.454, p=0.003, SE=0.187), and transmitral peak velocity (r=-0.480, p=0.026, SE=0.189) was relatively well correlate with operative mitral valve area. There was relatively good agreement between direct and 2D planimetric measurement and between direct and Dopler pressure-half time method. CONCLUSION: 2D planimetry and Doppler pressure half-time method on echocardiography are useful, noninvasive measurement method in patients with mitral stenosis.
Atrial Fibrillation ; Echocardiography* ; Humans ; Mitral Valve Stenosis* ; Mitral Valve*