A reproducible noninvasive technique for measuring right ventricular ejection fraction (RVEF) was developed using first pass quantitative radionuclide angiocardiography. Tests were carried out in the right anterior oblique position with a computerized multicrystal scintillation camera with high count rate capabilities. RVEF was calculated on beat to beat basis from the high frequency components of the background-corrected right ventricular time-activity curve. The following results were obtained; 1) In 10 normal adults, RVEF averaged 50.9+/-8.2. In 20 patients with chronic obstructive lung diseases (COPD), RVEF was 37.9+/-6.1% and significantly lower than that of normal persons(P<0.005). 2) There was meaningful correlation between RVEF and forced expiratory volume (FEVI) in patients with COPD (r=0.51). And there was significant difference of RVEF between 13 patients with FEVI less than IL/min (6 patients with right ventricular failure, 7 patients with patients without that) and 7 patients with FEVI IL/min or more (35.7+/-6.0%, 42.1+/-3.2% respectively. P<0.005). 3) All 6 patients with clinical manifestation of right heart failure had abnormal RVEF and had FEVI less than IL/min, which was significantly lower than that of 14 patients without clinical manifestation of right heart failure (33.6+/-4.8%, 39.8+/-5.6%, respectively. P<0.005). 4) In 14 patients without clinical manifestation of right heart failure, 11 patients among whom 7 patients had FEVI less than IL/min, had abnormal RVEF.
Adult ; Angiocardiography ; Forced Expiratory Volume ; Gamma Cameras ; Heart Failure ; Humans ; Lung Diseases, Obstructive* ; Pulmonary Disease, Chronic Obstructive ; Radionuclide Ventriculography* ; Stroke Volume ; Ventricular Function, Right*

No abstract available.
Humans ; Tuberculosis, Pulmonary*

Clinical findings, electrocardiographic voltage and left ventricular function were evaluated in 104 patients with percardial effusion. Patients were classified into three groups by the amounts of pericardial effusion measured by two-dimensional echocardiography. 49 patients had small pericardial effusion, 31 moderate effusion and 24 large effusion. In 47 patients the effusions were clinically unsuspected prior to echocardiographic examination. Pericardial friction rub was noted in 14 patients, two-thirds of whom had moderate to large effusions. There was no relationship between the size of effusion and the presence of friction rub. Total QRS amplitudes were lower in patients with moderate to large effusions than those in control group. Maximum diastolic endocardial velocity(DEVM) and E-F slope of the anterior mitral leaflet were decreased significantly in patients with moderate to large effusions as compared with those with small effusions. As a result, authors concluded that reduction in the QRS voltages in serial ECGs may suggest the presence and the amount of pericardial effusion and also DEVM and E-F slope of the anterior mitral leaflet can be sensitive measures of left ventricular relaxation in patients with pericardial effusion.
Echocardiography* ; Electrocardiography* ; Friction ; Humans ; Pericardial Effusion* ; Relaxation ; Ventricular Function, Left*

Left ventricular hypertrophy(LVH) is one of common cardiovascular complications in hypertensive patients and it is well known that hypertensive cardiac disease accompained by LVH is still common cause of congestive heart failure in spite of treatment of hypertension. The authors assessed the prevalence of anatomical and functional abnormalities of left ventricle by EKG, chest X-ray and echocardiography in 45 essential hypertensive patients and also in 20 normal controls. Average values of left ventricular posterior wall thickness(LVPWd), interventricular septal thickness(IVSd), left ventricular mass(LVM), and left ventricular mass index(LVM/BSA) by echocardiography in hypertensive groups with LVH by EKG or chest X-ray were significantly higher than those of hypertensive groups without LVH by EKG or chest X-ray(P<0.005). Among 27 hypertensive patients with LVH by EKG and chest X-ray increased LVPWd was found in 24 patients(18%) and increased LVH in 26 patients(19%). Increased LVPWd and LVM were found in 3 patients(23%) among 13 hypertensives without LVH by EKG and chest X-ray. Hypertensive patients with increased LVH showed LVH by EKG and chest X-ray more frequently than those with increased LVPWd. Also, hypertensive patients without increased LVM showed MVH by EKG and chest X-ray less frequently than those without increased LVPWd. Therefore, echocardiography appears to be superior to routine chest X-ray and EKG for defecting LVH in hypertensive patients, especially without LVH by these tests. In conclusion, even though estimation of LVM by echocardiography seems to be a better method than single measurement of LVPWd, it seems thant estimation of LVM together with LVPWd will be more valuable in diagnosis of LVH in hypertensive patients.
Diagnosis ; Echocardiography* ; Electrocardiography ; Heart Diseases ; Heart Failure ; Heart Ventricles ; Humans ; Hypertension* ; Hypertrophy, Left Ventricular* ; Prevalence ; Thorax

Inhalation of buckwheat flour as well as ingestion of buckwheat foods induces bronchial asthma. The buckwheat flour attached to the husks used as bed pillow filling can provoke bronchial asthma in patients sensitized to buckwheat. In Korea one third of the pillows contain buckwheat husk (BH). Recently the authors examined three asthmatics who presented symptoms when exposed to house dust extract and BH-pillow extract. They had no history of asthma attack following ingestion of buckwheat foods. The possibility of mites or mite like substances in the BH-pillow extract was evaluated. There was a good correlation of skin test results between Dermatophagoides farinae (D. farinae) and BH-pillow extract. The concentrated extract of BH-pillow displayed inhibition of D. farinae radioallergosorbent test (RAST) and a dose dependent pattern RAST inhibition. The lyophilized extract of BH-clean did not show any constant feature in D. farinae RAST inhibition test. Furthermore, mites of Dematophagoides species were discovered in the contents of BH-pillows. Ten of 40 cases who tested positive to the skin test for the extract of BH-pillow manifested weakly positive to buckwheat RAST. None of them presented a previous history of buckwheat food allergy. Also we evaluated the possibility of cross-allergenicity between buckwheat and its husk. Using these results the authors concluded that there were some amounts of allergenic substance from house dust mites in the contents of BH-pillows and that the dust from these could provoke or aggravate the symptoms of asthmatics who were sensitive to house dust mites.
Adult ; Allergens/immunology* ; Asthma/etiology ; Bedding and Linens* ; Cross Reactions ; Female ; Flour* ; Human ; Male ; Mite Infestations/complications ; Triticum/immunology

The occurrence of Helicobacter pylori(H.pylori) and its relationship with gastric mucosa were studied by light and electron microscopy and culture of biopsy specimens from gastric mucosa of 160 patients with upper gastrointestinal symptoms. H. pylori were present in 96.6% of patients with active chronic gastritis, 100% of patients with duodenal ulcer and 76.9% of patients with gastric ulcer, while present in only 6.3% of individuals with histologically normal gastric mucosa. The bacteria colonized the antral mucosa more frequently than the body or than the duodenal cap mucosa. The bacteria were rarely seen in the intestinalized epithelium per se, but there was no significant difference in prevalence of H. pylori between gastritis with intestinal metaplasia and gastritis without intestinal metaplasia. H. pylori could be seen in close association with the surface of gastric epithelial cells below the mucus layer without evidence of intracellular parasitism, All of the strains tested were susceptible to penicillin, erythromycin, and most of them susceptible to tinidazole and bismuth salts. It is concluded that H. pylori are highly associated with gastritis and peptic ulcer diseases and its prevalence rates in patients with those diseases is higher than in developed countries. This strong association of H. pylori infection with gastritis and peptic ulcer diseases suggest a possible etiologic role for the bacterium in those diseases.
Adolescent ; Adult ; Aged ; Chronic Disease ; Duodenal Ulcer/*microbiology/pathology ; Female ; Gastric Mucosa/microbiology/pathology/ultrastructure ; Gastritis/*microbiology/pathology ; *Helicobacter Infections ; Helicobacter pylori/*isolation & purification ; Human ; Male ; Middle Aged ; Prospective Studies ; Stomach Ulcer/*microbiology/pathology ; Support, Non-U.S. Gov't

Hyper-activated depressor septi nasi is an important factor caused a nasal tip drooping and many studies have been carried out, however it still remains controversial. This study presents a surgical modality for its intervention, based on the anatomical study. Eleven fixed and six fresh cadavers were used for the study. We found that the depressor septi nasi was consisted of three fascicles. Medial fascicles were inserted into the dermocartilaginous ligament, and deep fibers of the medial fascicles were attached to the anterior nasal spine. After superficial fibers were interdigitated with the orbicularis oris, they were attached to the alveolar bone. Intermedial fascicles were inserted to the footplates of the medial cruses and the caudal septum. After they were interdigitated with the medial fascicle and the orbicularis oris, they were attached to the alveolar bone. From April to August 2008, five patients had surgical intervention for hyper-activated depressor septi nasi. Medial and intermedial fascicles were detached completely from the anterior nasal spine and the septum through intranasal approach. Tip droopings were improved in all cases. Specific complications were not found. We believe that surgical intervention through intranasal approach is a useful method for correction of tip drooping.

The perforator flaps are based on cutaneous vessels which are originated from a main pedicle and penetrate fascia or muscle to reach the skin. The lateral lower leg is one of the most suitable areas for harvesting perforator flaps because a number of perforator vessels exist. The authors applied peroneal perforator flaps in nine patients. Five flaps were reverse island flaps based on peroneal artery and septocutaneous perforator, and four flaps were free flap based on musculocutaneous perforator only. The recipient site was the posterior ankle in three patients, posterior heel in three patients, lateral malleolus, anterolateral ankle, and foot dorsum in one patient each. The flap size ranged from 5 to 12cm long, from 3 to 5cm wide, and the primary closure of the donor site was possible in most cases. All flaps, except for the flap in two patients in the reverse island flap series, survived completely. The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized superficial skin defects. Also, this flap may be considered as an alternative to radial forearm flap or other perforator flaps.
Ankle ; Arteries ; Fascia ; Foot ; Forearm ; Free Tissue Flaps ; Heel ; Humans ; Leg ; Perforator Flap* ; Skin ; Surgical Flaps ; Tissue Donors

Acinetobacter baumannii (AB) is a common pathogen found in patients with hospital-acquired pneumonia all over the world. Community-acquired AB pneumonia, however, is very rare and has seldom been reported in Asia-Pacific countries. Community-acquired AB pneumonia has a fulminant course and is associated with a higher mortality than hospital-acquired AB pneumonia. In Korea, no case of fatal community-acquired AB pneumonia has been reported to date. Here, we describe the first fatal case of fulminant community-acquired AB pneumonia in Korea.
Acinetobacter Infections/diagnosis/*microbiology/therapy ; Acinetobacter baumannii/*isolation & purification ; Community-Acquired Infections/diagnosis/*microbiology/therapy ; Disease Progression ; Fatal Outcome ; Humans ; Male ; Middle Aged ; Republic of Korea ; Time Factors ; Treatment Failure

PURPOSE: It is difficult to reconstruct nasal root defects because of complicated anatomy and function of the nose and eyelids, donor site morbidities, and aesthetic results. So, choosing suitable one of various reconstructive methods is very important and difficult. We report the island composite glabellar flap as an alternative reconstructive method of proximal nasal and medial canthal area. METHODS: From May 2005 to January 2007, we performed 8 cases of the island composite glabellar flap to reconstruct the defects in proximal nasal and medial canthal area after resection of skin cancer. The flap was elevated with the nasal skin, subcutaneous fat tissue, and procerus muscle based on the dorsal nasal branch of the angular artery. The flap donor site was closed in a V-Y fashion. RESULTS: This result was satisfactory in point of color, texture and donor site scar. There was no major complication such as wound disruption, hematoma, and atrophy of flap. But flap bulkiness was observed in one case. CONCLUSIONS: This island composite glabellar flap has several advantages in reconstruction of proximal nasal and medial canthal defects. This flap has reliable vascular pedicle and can be moved to multiple direction and has more mobility than other local flaps. Also, aesthetic outcome of the donor and the recipient site was good. We believe that this flap is a useful technique as a treatment of proximal nasal and medial canthal defects
Arteries ; Atrophy ; Cicatrix ; Eyelids ; Hematoma ; Humans ; Microscopy, Electron ; Nose ; Skin ; Skin Neoplasms ; Subcutaneous Fat ; Tissue Donors ; Wounds and Injuries