BACKGROUND: Patients with sinus rhythm, the left atrial appendage(LAA) appeared as a vigorously contracting structure and the blood flow patterns of LAA showed biphasic configuration. However, patients with AF rhythm the blood flow showed irregular or no configuration in doppler echocardiographic study. The purpose of this study is to evaluate relationship between the blood flow patterns of LAA with the presence of spontaneous contrast(SC) and thrombi in LAA. METHODS: We performed TEE and TTE simultaneously to 58 consecutive patients who had native mitral valve disease or mitral prosthesis. Spontaneous contrast(SC) and the presence and location of LAA thrombi were evaluated during TEE and left atrial dimension(LAD) & ejection fraction(EF) were evaluated during TTE. We divided the whole subjects into three groups according to the blood flow patterns ; regular pattern(Group 1), irregular pattern(Group 2), no flow pattern(Group 3). RESULTS: 1) Blood flow within the left atrial appendage is divided with three groups among of them, atrial fibrillation have two blood flow patterns. 2) Peak prositive & negative flow velocity within LAA in AF rhythm groups were slower than normal sinus rhythm group.(p<0.01) 3) Left atrial dimension in group 3 is significantly larger than others groups.(p<0.01) 4) Spontaneous contrast(SC) with LAA could be detected in 2(6.8%) of the 29 patients of group 1, 6(31.5%) of the 19 patients of group 2, 10(100%) of the 10 patients of group 3. Incidence of SC within LAA in group 3 is significantly higher than others groups. 5) LAA thrombi could be detected in 1(3.4%) of the 29 patients of group 1, 1(5.2%) of the 19 patients of group 2, 3(30%) of the 10 patients of group 3. Incidence of LAA thrombi is significangly higher than other groups. CONCLUSIONS: We can suggest that blood flow within LAA is divided into three groups according to the blood flow patterns, and spontaneous contrast and thrombi in LAA were closely related with the blood flow pattern.
Atrial Appendage ; Atrial Fibrillation ; Echocardiography ; Humans ; Incidence ; Mitral Valve ; Prostheses and Implants

BACKGROUND: Antihypertensive effect and safety of the newer, long acting, nonsulfhydryl angiotensin converting enzyme inhibitor, lisinopril, were studied. METHODS: Twenty eight patients of mild to moderate essential hypertension were administered 10-20mg of lisinopril once daily for ten weeks. Patients were evaluated every two weeks concerning the changes of blood pressure and pulse rate in the sitting position and also any untoward sumptoms and signs attributable to the side effect. Chest X-rey, ECG and laboratory examination were performed in principle two times before and after the completion of medication. RESULTS: The blood pressure declined from 165.4/107.6mmHg to 141.3/92.4mmHg at the end of ten weeks of medication, thus the reduction of 24.1mmHg of systolic pressure and 15.2mmHg of diastolic pressure were observed and the overall effective rate was 85.7%. The pulse rate and laboratory findings were not sigificantly changed before and after the administration of lisinopril. The side effects were observed in 2 cases(7.1%) of mild dry cough and in 2 cases(7.1%) of transitory mild headache and in 1 case(3.6%) of dizziness but no one discontinued medication due to adverse effects. CONCLUSION: Lisinopril proved effective and safe in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Cough ; Dizziness ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension* ; Lisinopril* ; Peptidyl-Dipeptidase A ; Thorax

BACKGROUND: The prompt and accurate diagnosis of acute aortic dissection is decisive for the prognosis of the patient, since an effective surgical and medical therapy can improve the high rate of mortality due to this pathology. Among the various diagnostic methods, transesophageal echocardiography can provide a rapid and accurate method of diagnosing and evaluating dissecting aortic aneurysm and permits prompt initiation of appropriate treatment. Thus we performed transesophageal echocardiography in patients supected to dissecting aortic aneurysm, as a preliminary examination, and now we reported the result. METHODS: We have studied 4 case of dissecting aortic aneurysms among the patient received examination of cardiovascular system by transesophageal echocardiography, since January 1991 at Keimyung University hospital. In these 4 cases, 3 cases had CT scan, 2 cases had MRI scan, and all cases had transthoracic echocardiography simultaneously as a adjuvant diagnostic method. RESULTS: All 4 cases could be promptly and accuratoly diagnosed and typed by transesophageal echocardiography. As a consequence, patients could receive the early medical treatment and good clinical results. CONCLUSION: Transesophageal echocardiography is fast, inexpensive and accurate method in diagnosis of dissecting aortic aneurysm. So we recommend transesophageal echocardiography, as a preliminary examination in case of suspecting dissecting aortic aneurysm.
Aortic Aneurysm* ; Cardiovascular System ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Magnetic Resonance Imaging ; Mortality ; Pathology ; Prognosis ; Tomography, X-Ray Computed

BACKGROUND: In vitro study, normal cardiac prosthetic valve has functional regurgitation due to structural characteristics of prosthetic valve. To evaluate functional regurgitant characteristics of prosthetic valves, we examined patients who had clinically normal mitral prosthesis. METHODS: Transesophageal two-dimensional and color doppler echocardiography were performed to 25 patients who had the clinically normal mitral prosthesis. RESULTS: Seven patients had the mitral bioprosthesis and 18 patients had the mitral mechanical prosthesis. Regurgitation was found in 4 patients(57%) with bioprosthetic valve, and the pattern of regurgitation was central in three patients and unilateral in one patient. But regurgitation was detected in 17 patients(94%) with mechanical prosthesis, and the pattern of regurgitation was bilateral in twelve patients, unilateral in four patients and central in one patient(p=0.0035). The length of regurgitant jets were 22.00+/-6.73(mm) in bioprosthetic valve and 28.65+/-7.33(mm) in mechanical valve. The regurgitant jets were detected in systolic period in most of patients. But in 4 patients who had tachycardia during TEE, regurgitation was detected in systolic and early diastolic period. CONCLUSION: Regurgitation was found in clinically normal cardiac prosthetic valves by TEE. These findings may be useful to differentiate between normal and abnormal cardiac prosthesis.
Bioprosthesis ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal* ; Humans ; Prostheses and Implants* ; Tachycardia

The effects of Equiseti Herba Water-heating extract on the kidey & liver of rats were studied in 25 male Sprague-Dawley rats evenly divided into five groups, i.e., 5 rats each. The group I, which served as control and the group II, III, IV, were fed 300 mg/kg, 1000 mg/kg of Eqiseti Herba water-heating extract daily for one week, respectively. The group V was fed 1000 mg/kg of Equiseti Herba extract daily for two weeks. The effect of Equiseti Herba on the kidney and liver were determined by the measurements of the serum levels of BUN, creatinine, calcium, phosporus, sodium and potassium, total protein, albumin, transaminase (GOT & GPT) and cholesterol and 24hrs urine volume and GFR(ml/min), as well as by light microscopic and ultrastructural examinations of kidney and light microscopic examinations of liver in rats. The results were as follows; The groups II, III, IV were slightly higher than the control group on serum creatinine and potassium levels, but the group V was declined on serum creatinine and potassium levels, and 24hrs urine volume in spite of increased GFR. Histologically there was no remarkable changes in groups compared with the group I, except mild vacuolization of proximal convoluted tubule in group IV and V. These results suggested that equiseti Herba water-heating extract in rats induced reversible tubular changes on the kidney of rats. But the groups administrated by Equiseti Herba water-heating extract were not significantly higher than the control group on liver function test. Histologically there was no remarkable changes in groups II, III, IV & V compared with the group I.
Animals ; Calcium ; Cholesterol ; Creatinine ; Humans ; Kidney* ; Liver Function Tests ; Liver* ; Male ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Sodium

BACKGROUND: The prevalence of cognitive impairment in the elderly has been increasing in recent years with the growing of the aged population. Clinical assessment of cognitive function and mood is very important because cognitive impairment and depression commonly coexist in the elderly. The elderly interacts with the other family members, so cognitive impairment of the elderly influence family function. The objectives of this study were to delineate the factors correlated with cognitive function and to explore the relationship of depression and family function with cognitive function. METHODS: This study was done during 20 day period from July to August, 1996. The subjects were home residents aged 60 years or more living in a subcounty of Kyungpook Province, Korea. The final analysis included 195 subjects(male 95, female 100). The questionnaire included sociodemographic data, MMSE-K(Korean version of Mini Mental State Examination) for evaluation of cognitive function, BDI for evaluation of depression and family APGAR score for evaluation of family function. The results were analyzed by descriptive, comparative and correlative analysis. RESULTS: Mean MMSE-K score was 25.3+/-4.3 with female subjects(23.9+/-4.8) having significantly higher cognitive impairment when compaired to male subjects(26.6+/-3.2)(P<0.001). MMSE-K score was associated with gender, age, year of education(P<0.001), BDI and APGAR score(P<0.05). Religion, smoking and alcohol use were not associated with MMSE-K score. The prevalence of dementia by MMSE-K was 9.7% in definite dementia (MMSE-K<_19) and 23.1% with questionable dementia(20<_MMSE-K<_23). In male, the prevalence was 1.1% and 20.0% respectively. In female, the prevalence was 18.0% and 26% respectively, indicating difference between male and female subjects(P<0.001). CONCLUSIONS: In the elderly, female gender, older age and lower educational level were associated with cognitive function impairment. There was a positive correlation between cognitive function and family function. The group with impaired cognitive function had more depression than the normal group.
Aged* ; Apgar Score ; Dementia ; Depression* ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Male ; Prevalence ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: This study was undertaken to review the clinical and hematologic findings of the preterm infants delivered from pregnancy induced hypertension(PIH) mothers. METHODS: The data were collected by reviewing the medical records on the current prognosis of preterm birth and sending questionnaires on the status of NICU. We reviewed the medical records from two university hospitals and two resident training hospitals in Gwangju-Chonnam to evaluate the neonatal prognosis of preterm birth from Jan. 1, 1995 to Dec. 31, 1997. RESULTS: The average survival rate of total preterm babies was 79.6%. According to birth weights, survival rate from less than 1,000 gm was 10%, 1,000-1,499 gm was 55.3%, 1,500-1,999 gm was 82.2%. Maternal risk factors were pretmature rupture of membrane(42.2%), preterm labor (21.3%), PIH(10.7%), multiple pregnancy(8.2%) and incompetent internal os of cervix(4.2%). The average gestational age and birth weight were 34.2+/-2.3 weeks and 1,940+/-620 gm in the preterm infants born to mothers with PIH. The death rate was 12.9% in the preterm infants born to mothers with PIH. There were no significant differences in the incidence of RDS, use of assisted ventilation and surfactant, and frequency of the blood transfusion between the preterm infants born to normotensive mothers and those to mothers with PIH. There were significant differences in the total WBC count, platelet count and the concentration of the Mg, Ca and P between the preterm infants born to normotensive mothers and those to mothers with PIH. CONCLUSION: Our results may be helpful to predict the perinatal complications and manage the preterm infants by considering the clinical and hematologic findings of preterm infants born to mothers with PIH.
Birth Weight ; Blood Transfusion ; Female ; Gestational Age ; Hospitals, University ; Humans ; Hypertension, Pregnancy-Induced* ; Incidence ; Infant, Newborn ; Infant, Premature* ; Medical Records ; Mortality ; Mothers* ; Obstetric Labor, Premature ; Platelet Count ; Pregnancy ; Premature Birth ; Prognosis ; Surveys and Questionnaires ; Risk Factors ; Rupture ; Survival Rate ; Ventilation

We describe here a case of intraductal tubular carcinoma of the main pancreatic duct. Gadolinium-enhanced pancreas magnetic resonance (MR) imaging showed an enhancing mass that was confined in the dilated main pancreatic duct of the pancreatic body, along with dilatation of the upstream main pancreatic duct and chronic pancreatitis that was due to obstruction. MR cholangiopancreatography and an endoscopic retrograde pancreatogram showed a filling defect that was due to an intraductal mass of the pancreatic body, along with dilatation of the upstream main pancreatic duct and no dilatation of the downstream main pancreatic duct. The pathological findings demonstrated an intraductal nodular appearance without papillary projection or mucin hypersecretion.
Adenocarcinoma/*diagnosis/pathology ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms/*diagnosis/pathology ; Tomography, X-Ray Computed

OBJECTIVES: Endoscopic Ultrasonography (EUS) is widely used to diagnose upper gastrointestinal tract disease. In recent, it is reported that EUS is also goood diagnostic method to assess depth of invasion through rectal wall and lymph node involvement of rectal cancer. We performed EUS in preoperative rectal cancer patients and compared to post operative histologic findings to evaluate EUS diagnostic accuracy for rectal cancer staging system METHODS: 51 patients with rectal cancer were performed with EUS. They were diagnosed by endoscopic biopsy from August 1994 to June 1996 at Kangbuk Samsung Hospital. Their ages were 28 to 78 (mean: 55 years) and the male to female ratio was 2 : 1 (34/17). Olympus GF-UM3, EU-M3 EUS and 7.5/12 MHz transducer were utilized. EUS was performed by the deaerated water filling method. We have analyzed between preoperative EUS findings and postoperative biopsy findings in order to evaluate the accuracy of EUS. The accuracy of EUS was signified by percentage. RESULTS: 1) Endoscopic ultrasonographic accuracy for assessment of wall invasion of rectal cancer was as follows ; The accuracy of mucosal cancer was 50% (patient numbers of EUS diagnosis/patient numbers of histologic diagnosis: 2/4). Submucosal cancer was 100% (1/1). Muscularis propria cancer was 44% (4/9). The accuracy with penetration to subserosa (or perirectal fat tissue) was 97% (33/34). The accuracy with invasion to adjacent organ was 33% (1/3). The overall accuracy rate was 80% (41/51). 2) EUS accuracy of lymph node metastasis in rectal cancer was ; The sensitivity was 90% (patient numbers of EUS diagnosis/patient numbers of histologic diagnosis: 28/31). The specificity was 60% (12/20). 3) EUS diagnosis of modified Duke classification was ; The accuracy of A stage was 80% (patient numbers of EUS diagnosis/patient numbers of histologic dagnosis: 4/5). B1 stage was 60% (4/8). B2 stage was 33% (1/3). C1 stage was 0% (0/3). C2 stage was 86%(25/28). D stage was 33% (1/3). The overall accuracy rate was 69% (35/51). CONCLUSION: EUS is useful method to assess rectal cancer invasion through rectal wall and lymph node involvement. However, further refinements in instruments and the techniques is required for more improving diagnostic accuracy.
Biopsy ; Classification ; Diagnosis* ; Endosonography* ; Female ; Humans ; Lymph Nodes* ; Male ; Neoplasm Metastasis* ; Rectal Neoplasms* ; Sensitivity and Specificity ; Transducers ; Upper Gastrointestinal Tract ; Water

Norovirus is a leading cause of epidemic and sporadic acute gastroenteritis worldwide. Rapid and accurate detection of norovirus is essential for the prevention and control of norovirus outbreaks. The purpose of this study was to propose and develop a process for establishing appropriate standardized guidelines for the approval and evaluation of in vitro diagnostic medical devices (IVDD) for norovirus detection in Korea based on the related laws, regulations, and guidelines of USA, Europe, and Korea. We expect that this study could be used for diagnostic test standardization and the approval and evaluation of domestic norovirus diagnostic devices. We also expect the results will contribute to industrial expansion and public health promotion.
Diagnostic Tests, Routine* ; Disease Outbreaks ; Europe ; Gastroenteritis ; Jurisprudence ; Korea* ; Norovirus* ; Public Health ; Reagent Kits, Diagnostic ; Social Control, Formal