Seven patients with aortic valve vegetation were examined by M-mode and two dimensional echocardiography. Underlying cardiac abnormalities were found in 6 patients, four had rheumatic heart disease, one had congenital bicuspid aortic valve, one had coexistence of asymmetrical septal hypertrophy and aortic regurgitation. Aortic regurgitation were found in all patients. One of seven patients had cerebral embolization and all patients had overt congestive heart failure. Of 5 patients medically treated, three became moribund, one died and one improved clinically. One patient underwent cardiac surgery, the aortic cusps were congenital bicuspid with vegetation, aortic valve replacement was successful. Echocardiogram of 7 patients with aortic valve vegetation showed characteristic shaggy, irregular mass of echoes produced by vegetation in the aortic valve during systole and diastole. Two of seven patients had abnormal mass of echoes in the left ventricular outflow tract. During systole, two had vegetation on the right coronary cusp and one had vegetation on the noncoronary cusp by M-mode echocardiography. In other patients we could not localize invoving aortic cusps by M-mode echocardiogram. All patients had left ventricular volume overload. For of seven patients had fluttering of anterior mitral valve. Two had fluttering of interventricular seputm. Five had premature mitral valve closure before QRS complex.
Aortic Valve Insufficiency ; Aortic Valve* ; Bicuspid ; Diastole ; Echocardiography* ; Heart Failure ; Humans ; Hypertrophy ; Mitral Valve ; Rheumatic Heart Disease ; Systole ; Thoracic Surgery

PURPOSE: Leptin, a product of the ob gene, is a 16-KDa protein that is mainly expressed in the adipose tissue and involved in the regulation of body weight. Elevated levels of serum leptin is noted in pregnant woman and the placenta is the site of nonadipose tissue production of leptin. In this study, we investigated the effect of serum leptin concentrations on fetal growth to estimate the effect of leptin on fetal growth. METHOD: Leptin concentrations were measured in venous and arterial cord blood and maternal serum at birth using a specific radioimmunoassay employing human recombinant leptin(Human Leptin RIA kit; Linco research, St. Louis, Mo). Thirty two full term pregnant women(n=32) had no medical complications and delivered the healthy babies(male=14, female=18). RESULTS: Serum leptin levels were 1.51 - 19,36 ng/ml(mean 7.16, SD 3.76) in arterial cord blood and 1.59 - 16.18(mean 7.47, SD 4.08) in venous cord blood and there was no difference between arterial and venous cord blood. Serum concentrations in arterial and venous cord blood were positively correlated with birth weight(r=0.7181, 0.6970; p<0.0001). There was no correlation in maternal BMI, maternal serum leptin and cord blood leptin concentrations. CONCLUSION: These findings suggest that cord blood leptin independently contributes to fetal body weight regardless of maternal serum leptin and body weight.
Adipose Tissue ; Birth Weight* ; Body Weight ; Female ; Fetal Blood* ; Fetal Development ; Fetal Weight ; Humans ; Hypertension, Pregnancy-Induced* ; Leptin* ; Parturition* ; Placenta ; Pregnancy* ; Pregnant Women ; Radioimmunoassay

OBJECTIVE: To determne whether abnormal results of doble saeening tests for Down syndrome with MSAFP and free B-hCG are associated with adverse pregnancy outcome. METHODS: Between October 1994 and September 1997, 205 among 1731 who were screened had increased risk for Down screening program of CIS biointernational, Fetuses with Chromosomal abnormality or congenital anomalies and less than 35 years of maternal age were excluded from this study. Down syndrome screening test was performed between 14-22 weeks of gestation. RESULTS: Of 1731 women, 205 (13.4%) had increased Down syndrome risk. The pregnancy outcome of women with increased Down syndrome risk were compared with those of women without such risk There were no significant difference in the incidence of preterm labor (6[2.9%] vs 112[7.3%)), premature rupture of the membranes (2[0.9%] vs 56[3.6%]), pregnancy induced hypertension (2[0.9%] vs 36[2.3%]), abruptio placentae (0[0%] vs 2[0.1%]), low birth weight (2[0.9%] vs 21[1.3%]), oligohydramnios (4[1.9%] vs 10[0.6%]), intrauterine fetal death (0[0%] vs 2[0.1%]). CONCLUSION: False positive results of Down syndrome screening test in the 2nd trimester do not appear to be associated with adverse pregnancy outcome. But there are statistically significant increases of adverse pregnancy outcome in wemen with elevation of MSAFP or elevation of free B-hCG.
Abruptio Placentae ; Chromosome Aberrations ; Down Syndrome ; Female ; Fetal Death ; Fetus ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Mass Screening* ; Maternal Age ; Membranes ; Obstetric Labor, Premature ; Oligohydramnios ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Rupture

Gastritis cystica superficialis (GCS) is a rare lesion which is characterized by glandular hyperplasia with regeneration and degeneration in the mucosa and muscularis mucosa. Recently, GCS is revealed as precancerous lesion, but most report has been associated with those found at the site of a gastroenterostomy. So, we report two cases with GCS who had not previous gastric surgery. A 45-year-old woman visited for epigastric discomfort and another 4Q-year-old woman for epigastric pain. They had not undergone any gastric surgery. The gastroscopy discovered one polyp on anterior wall of greater curvature, upper body and another polyp in the center of the fold of greater curvature, lower body. We removed it by snare polypectomy and the histologic finding showed the character of GCS.
Female ; Gastritis* ; Gastroenterostomy ; Gastroscopy ; Humans ; Hyperplasia ; Middle Aged ; Mucous Membrane ; Polyps ; Regeneration ; SNARE Proteins

No abstract available.
Keratosis, Seborrheic* ; Poroma* ; Scalp*

It is well known that the bona pellucidae of mouse oocytes become 'hardened' when they are allowed to mature in vitro in the absence of serum components. To see if oocytes already undergone meiotic resumption in vivo exhibit similar zona hardening, hardening of ZP of cumulus-enclosed oocytes(CEOs) was examined after culture in vitro since their release from follicles various hours after hCG injection. When CEOs matured in vivo for 3h or longer were subjected to culture in vitro for 14h with BSA alone, zona hardening was significantly reduced compared to those cultured in vitro from the begining of maturation. However, when CEOs matured in vivo for 5h were freed from cumulus cells and then cultured in vitro with BSA alone, little reduction of zona hardening was observed. Preincubation of CEOs for 5h with fetuin, one of the well known inhibitor of in vitro zone hardening, did not prevent bona hardening during its subsequent culture of CEOs for 14h without fetuin. However, when CEOs precultured with both fetuin and PMSG for 5h and then further cultured with BSA alone for 14h, zona hardening was dramatically reduced. Under these conditions, the expansion of cumulus cell was observed. In addition, CEOs cultured with both BSA and dbcAMP to prevent their meiotic resumption showed a significant increase of zona hardening. Whether the observed zona hardening was correlated with the conversion of ZP2 to ZP2f was examined. Zona pellucida, isolated from CEOs matured for 5h in vivo and then further cultured with BSA alone was subjected to SDS-PAGE. Most of ZP2 molecules from these CEOs did not undergo conversion from ZP2 to ZP2f. From these results, it is concluded that CEOs undergone meiotic resumption in vivo do not exhibit bona hardening when they were subsequently cultured in vitro without serum components. It appears that cumulus cells play an important role in this phenomenon.
Animals ; Bucladesine ; Cumulus Cells ; Electrophoresis, Polyacrylamide Gel ; Fetuins ; Herpes Zoster* ; Mice* ; Oocytes* ; Zona Pellucida

OBJECTIVE: The objective of this study is to compare the effectiveness and safety in the labor induction between the high dose oxytocin method and the new low dose oxytocin method. STUDY DESIGN: Firstly, we selected 125 pregnant women hospitalized, having the indication of labor induction from March, 1995 to August, 1996. Of them, we selected 61 pregnant women tothem the high dose oxytocin method was used, as the control group, and in- creased the quantity of 2.5 mU/min every 20 minutes with the start dose of 2.5 mU/min to them. On the other hand, with the start dose of 1.25 mU/min, we increased the quantity of 1.25 mU/min every 20 minutes to the study group of low dose oxytocin method, 64 pregnant women. RESULTS: No statistical significance was found in the time from the effective uterine contraction to the delivery in the study group, in contrast to that of the control group to them the labor induction was conducted by using the high dose oxytocin. Maximum amount used to the high dose oxytocin was significantly more than that of the low dose oxytacin, but in the total given dose, there was no significant difference between two groups. Maxi- mum uterine contraction of the control group did not show any significant. difference from that of the study group, and there was also no significant difference in the frequency of generating the complications such as fetal distress. CONCLUSION: There was no difference in the labor.induction -to delivery time, and the complications of fetus, between the existing high dose oxytocin method and the new low dose oxytocin method. Therefore it is thought the low dose oxytocin method may reduce the possibility of a complieation compared with the high dose oxytocin method. However, it is considered this matter must be investigated further in the futrre.
Female ; Fetal Distress ; Fetus ; Hand ; Humans ; Oxytocin* ; Pregnant Women ; Uterine Contraction

Interrupted aortic arch may be defined as a discontinuity of the aortic arch. This uncommon anomaly was first described by Steidele in 1778 and was later classified into 3 types by Celoria and Patton. We experienced the case of a 25-year-old male with an interrupted aortic arch(Type B) which was well supplied by collateral circulations. Ligation of collateral supplies and a Y-graft replacement from ascending aorta to descending thoracic aorta and left subclavian artery was done. Postoperative aortogram revealed no collateral circulations and good continuity of the aorta without narrowing of the anatomic site. During the period of 2-month follow up, the patient was able to lead a relatively active life.
Adult ; Aorta ; Aorta, Thoracic ; Collateral Circulation ; Equipment and Supplies ; Follow-Up Studies ; Humans ; Ligation ; Male ; Subclavian Artery

PURPOSE: The aim of study is to investigate the clinical manifestations and the etiology of markedly-elevated serum alkaline phosphatase(ALP) levels in children without accompanying liver or bone disease. METHODS: The serum ALP and other biochemical laboratory data of 4,989 patients attending the pediatric department of Ewha Womans University Mokdong Hospital between January 2002 to December 2002 were studied. The subjects' ages ranged from 4 months to 14 years. Among them, serum ALP levels were markedly elevated over 1,000 IU/L in 114 children. Among those 114 children, 97 children without liver or bone disease were reviewed retrospectively. RESULTS: Of the 114 children with serum ALP activity of over 1,000 IU/L, 97(85.8 percent) children had neither liver or bone disease. The average ALP activity level was 1,539+/-948 IU/L. The male:female ratio was 1:0.7. Forty-four children(45.3 percent) were between 4 months to 1-year-old, 19 children(19.3 percent) were between 1- to 2-year-old. We observed a seasonal clustering of cases in during October with 10 cases(10.2 percent) and in during December with 11 cases(11.3 percent). The most common clinical presentation was respiratory tract infection in 25 cases(26.9 percent), and acute gastroenteritis in 17 cases(17.5 percent). Forty-four cases had follow-up ALP activity level, 1 month later and the activity decreased under 1,000 IU/L in 37 cases(84percent). CONCLUSION: Hyperphosphatasemia is a benign and transient phenomenon. If there are no clinical and laboratory abnormalities of liver and bone, we suggest monitoring monitor the high serum ALP level 1 month later. If decreased, it seems that it is not necessary for specific examinations to exclude other diseases of malignant condition.
Alkaline Phosphatase ; Bone Diseases ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Liver ; Respiratory Tract Infections ; Retrospective Studies ; Seasons

BACKGROUND: Myocardial dysfunction after cardiopulmonary bypass (CPB) is a significant cause of morbidity and mortality after congenital cardiac surgery. The aim of this study was to evaluate myocardial function on sevoflurane anesthesia after CPB during ventricular septal defect repair. METHODS: Forty patients were randomly allocated into two groups: sevoflurane-fentanyl was used in group S, midazolam-fentanyl in group M. Myocardial performance index (MPI) and ejection fraction (EF) were measured by transesophageal echocardiography before incision and after operation. Serum cardiac Troponin-I (cTnI) levels were measured before incision, and at 0, 12, and 24 h after operation. RESULTS: MPI increased after operation in both groups (S: 0.35 +/- 0.06 vs. 0.43 +/- 0.05, M: 0.36 +/- 0.07 vs. 0.46 +/- 0.06 [P < 0.05]), but there was no significant difference between groups. EF decreased after operation in both groups (S: 65.1 +/- 5.5% vs. 62.7 +/- 3.9%, M: 64.9 +/- 5.3% vs. 61.4 +/- 4.4% ([P < 0.05]), but there was no significant difference between groups. cTnI was markedly elevated after operation, and decreased thereafter. There was no significant difference between groups. CONCLUSIONS: Both groups showed decreased myocardial function after CPB, but there were no difference between groups. Sevoflurane did not adversely affect intraoperative myocardial function compared to midazolam.
Anesthesia ; Cardiopulmonary Bypass ; Child* ; Echocardiography, Transesophageal ; Heart Septal Defects, Ventricular* ; Humans ; Midazolam ; Mortality ; Thoracic Surgery ; Troponin I