To assess the efficacy of 2 different mitral balloon valvotomy (PMV) techniques, PMV was performed using Inoue balloon (I) in 35 pts and double balloon (D) in 33 pts with mitral stenosis (male 27, female 41, mean age 42+/-12 years). The success rate of PMV was 89%(31/35 pts) in I group and 97%(33/33 pts) in D group. Mitral valve area after dilation increased equally effectively in both groups (I and D) from 0.9+/-0.2 and 0.8+/-0.2 to 1.9+/-0.2 and 1.9+/-0.3cm2 respectively (p<0.0001). There were no differences in degree of improvement of cardiac output, mitral gradient, left atrial pressure, pulmonary artery pressure and various doppler echocardiographic findings in both groups, but EF slope was more improved from 13+/-7 to 48+/-16 mm/sec in D group than those (from 15+/-6 to 39+/-15mm/sec) of I group. Increments of long and short diameters of mitral valve orifice by 2D-echocardiogram were 1.1+/-0.6 and 0.3+/-0.3cm in D group and 0.9+/-0.5, 0.4+/-0.3cm in I group. The ratio of long and short diameter increase was significantly larger in D than that of I group (long/short 2.8+/-0.7 vs 2.4+/-0.7, p<0.05) and short diameter of orifice after dilation was more improved in I than that of D group (1.1+/-0.2 vs 1.0+/-0.2cm p<0.05). Complications included deflation failure of Inoue balloon in 2, and cerebral embolic episode in 1 (D). Incidence of increased mitral regurgitation was 50% in D and 45% in I, development of ASD (Qp/Qs>1.2) was 20% in D, 13% in I group respectively and mean amount of left to right shunt (Qp/Qs) was 1.7+/-0.3 in D and 1.5+/-0.1 in I group. Total procedure and fluoroscopic time were 84+/-24 and 25+/-11 min. in D and 56+/-20 and 16+/-6 min. In I, which had statistically significant differences (p<0.002). Thus we concluded PMV using Inoue or double balloons was equally effective in selected patients. Total procedure and fluoroscopic time of Inoue balloon technique were significantly shorter than those of double balloons. Double balloon technique had more tendency of longitudinal splitting of the commissures.
Atrial Pressure ; Balloon Valvuloplasty* ; Cardiac Output ; Echocardiography ; Female ; Follow-Up Studies* ; Humans ; Incidence ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Pulmonary Artery

No abstract available.
Audiometry*

No abstract available.

No abstract available.
Histamine* ; Pruritus*

BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

No abstract available.
Empyema*

BACKGROUND: The functional dyspepsia gives rise to such a symptom similar to peptic ulcer without showing a noticeable lesion(e.g, gastric or duodenal ulcer) by endoscopy or upper GI serises, and it has been known that this is about twice as many as the peptic ulcer. However, there is no exact theory about its pathophysiology and it is suggested that multiple factors including genetic, physiologic, psychologic, environmental factors are engaged. Especially, in respect to the occurrence of functional dyspepsia and psychological factors, there have been many clinical studies over the world. But, we still need more studies in this country, therefore, this study has been initiated to give help patients of functional dyspepsia, invest.igating their characteristic traits through MMPI. METHODS: From March to September in 1996, the patients who visited the family medicine out-patients department of St. Marys hospital of Catholic Medical College were sampled in this study. There were 46 patients having a similar symptoms to peptic ulcer without showing pathologic lesions by endoscopy. Through an interview and some basic tests, the 41 controls who had no dyspeptic symptoms and were not affected to a noticeable physical or physiological disorders were selected for the normal reference group. The standardized MMPI of our country was applied to the whole object groups to get a result. Then each average value of the measure(mean T-score) was calculated, and the differences of the average value were analyzed by the t-test and chi-square test. And the psychological pattern analysis was done. RESULTS: In demographic aspects, there were no significant differences between the two groups. The mean T score for each measure of the two groups falls within the normal ranges with their values being of between 30 to 70. And the average of L, F, and K measure, known as the validity measure, did not give a significant differences between the two groups. The measure of Hs, D, and Hy have appeared significantly high in the patients group(p<0.01) and the Pd measure, too(p<0.05). While Mf, Pa, and Ma measure have not shown a significant differences, Pt, Sc, and Si measure have very significant differences(p<0.01). CONCLUSIONS: In the patient group with the functional dyspepsia, the measures of Hs, D, and Hy where they indicate a neurotic pattern have shown a very significantly high point as well as those of Pd, Pt, Sc, and Si where they indicate a psychotic pattern. This reveals that in the group of the functional dyspepsia neurotic or psychotic trends to attribute. However, it is very hard to define the characteristics of a group with just one test, so further study with more variable test will be necessary.
Dyspepsia* ; Endoscopy ; Humans ; MMPI* ; Outpatients ; Peptic Ulcer ; Psychology ; Reference Values

The anterior cruciate ligament(ACL) is one of the major stabilizers of knee motion. The ACL does not heal once torn, unlike many other biological tissues. Its absence can lead to severe joint instability which can lead to disruptions of secondary restraints around the knee and then progress to degenerative joint disease. Thus many authors advocate surgical intervention for a torn ACL in order to restore stability to the joint. Yet, there is still controversy as to best treatment for the ACL injuries. It is desirable to be considered for the patients age, the severity of the injury, and the future activity level of the patient to decide treatment. We analyzed thirty ACL acute injuries of twenty seven patients who had an ACL injury and treated surgically between Apr. 1986 and Dec. 1991 at St. Pauls Hospital. The results were as follows: 1. There were twenty five males and two females. The mean age was 33.4 years ranged, 15 to 52 years. 2. The anterior cruciate ligaments were torn at proximal portion in twenty two cases, at midportion and distal portion in four, respectively. 3. Two knees had isolated ACL injuries and twenty eight had combined injuries. 4. Twenty one out of twenty six cases treated with primary repair, and three out of four cases treated with reconstruction had good-excellent results.
Anterior Cruciate Ligament ; Female ; Humans ; Joint Diseases ; Joint Instability ; Joints ; Knee ; Male

Forry-two symptomatic hands of 29 patients with carpal tunnel syndrome operated during the period from Marth 1986 to December 1993 were analized in clinical aspect. Among 29 patients, 3(10.3%) were male and 26(89.7%)were female. The syndrome occured on the right side in 10(34.5%) patients, on the left in 6(20.7%) patients, and on both in 13(44.8%) patients. The causes of the syndrome were idiopathic(90.5%), trauma(7.1%), mass(2.4%). Paresthesia(57.1%) was the most common chief complanit, followed by numbness(35.7%), pain(21.4%), weakness(9.5%). Thenar muscie atrophy occured in 84.8%, positive Tinel sign in 83.3% and positive Phalen sign in 90.0%. Delay of motor conduction velocity of median nerve was noted in all cases and delay of sensory nerve conduction velocity in all cases. Denervation finding such as fibrillation or sharp waves were seen in all cases. The carpal tunnel release was performed in all cases, and 31 cases were treated by carpal tunnel tunnel release with internal neurolysis. 35 cases(83.3%) were excellent or good results. The cases were long duration were poorer results. No significant difference was found between the results in cases treated by carpal tunnel release alone and those in cases treated by carpal tunnel release with internal neurolysis of median nerve.
Atrophy ; Bryophyta ; Carpal Tunnel Syndrome ; Denervation ; Female ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction

Because of the frequent misdiagnosis of the carpal injury, the orthopedic surgeon must know the mechanism of injury and exact radiological interpretation. We had encountered 114 cases of carpal injury, in which carpal fracture, carpal dislocation and instability were analysed by radiological examination. The following results were obtained: 1. In 75 carpal bone fractures, the most common fracture was scaphoid fracture (64 cases), the next com- mon one was triangular fracture (4 cases). 2. Among the 64 scaphoid fractures, the waist portion was the most frequent site (45 cases) and the least was tubercle fracture (2 cases). 3. Of the carpal bone fractures, the fresh fracture was 48 cases (64%) and old one was 27 cases (36%), these showed sclerosis, cystic change, and degenerative change in radiological examination. 4. In 14 carpal dislocations, perilunar dislocation was 2.5 times move common than lunate dislocation, and the trans-scaphoid perilunar dislocation was the most common dislocation. 5. Carpal instability was 25 cases. These were dorsiflexion instability, navicular rotary subluxation, and pal- mar-flexion instability. The most common instability was dorsiflexion instability.
Carpal Bones ; Classification ; Diagnostic Errors ; Dislocations ; Incidence ; Orthopedics ; Sclerosis ; Wrist