No abstract available.
Polydactyly*

No abstract available.
Animals ; Aorta, Thoracic* ; Rats*

BACKGROUND: In previous study, hypertensive patients with left ventricular diastolic dysfunction showed delayed relaxation time intervals and increased relaxation nonuniformity of regional wall motion. In this point of view, the effects of amlodipine on the regional wall motion and mitral flow patterns were evaluated. METHODS: Before and 32weeks after the antihypertensive medication of amlodipine, M-mode & Doppler echocardiogram were performed in 14 patients with moderate hypertension. We measured A2 to the peak thinning rate point of left ventricular(LV)posterior wall [A2-(-)dpw/dt] and the peak lengthening rate point of mitral annulus [A2-dL/dt] on M-mode echocardiogram and we defined nonuniformity as the time interval, (-)dpw/dt-dL/dt. RESULTS: 1) Mitral flow velocity E/A ratio was increased (0.95+/-0.4 vs 1.42+/-0.6, p<0.05) after amlodipine medication. 2) Heart rate and LV posterior wall thickness was decreased (79+/-9.3 vs 72+/-10.8 beats/min, 10.7+/-1.5 vs 9.4+/-2.0mm, p<0.05 respectively). 3) Long axis relaxation was improved (A2-dL/dt ; 165+/-44 vs 140+/-23msec, p<0.05) and nonuniformity index was decreased ((-)dpw/dt-dL/dt ; 63+/-49 vs 41+/-30msec p=0.07). CONCLUSION: Amlodipine improved E/A ratio of mitral flow (E/A ratio) in hypertensive patients with diastolic dysfunction, which could be attributed to the decreased heart rate, the decrease in wall thickness and the improvement in relaxation movement of LV long axis.
Amlodipine* ; Axis, Cervical Vertebra ; Heart Rate ; Humans ; Hypertension* ; Relaxation

PURPOSE: To compare clinical characteristics of ganglions in hand & Foot. MATERIALS AND METHODS: Seventeen cases of ganglions located in foot and fifty-five cases in hand. Excised from Mar.1988 to Apr.2003, were included in the study. The clinical characteristics and recurrence ratio were evaluated RESULTS: The mean size of 2.2 cm in hand and 2.5 cm in foot. The most common area of ganglions are dorsum of foot and wrist. The cosmetic problem of palpable mass is the primary chief complaint of ganglions on hand and the pain is that of foot. The recurrence was found in 5 cases in hand and 4 cases in foot. The recurrence was related to incomplete excision of ganglion in foot and the large size of ganglion and incomplete excision of ganglion in hand. CONCLUSION: recurrence ratio in the cases of foot is higher than that of hand. The ganglions in foot and hand need to treated by meticulous surgical excision to prevent the recurrence.
Foot* ; Ganglion Cysts* ; Hand* ; Recurrence ; Wrist

BACKGROUND: The effective ventricular function during ejection and filling is likely to depend on the coordinated action of the longitudinally and circumferentially orientated myocardial fibers and the function of these longitudinal fibers has not been extensively studied. METHODS: The role of longitudinally and circumferentially orientated fibers in left ventricular wall motion was evaluated by M-mode echocardiograms of the mitral ring(whose motion reflect long axis change) and the standard minor axis(left ventricular posterior wall), simultaneous recordings of phonocardiograms and electrocardiograms on the paper (speed 100mm/sec), in 24 healty individuals, 17 patients with mitral stenosis, 11 patients with open mitral commissurotomy and 17 mitral valve replaced patients. RESULTS: In the controls long axis shortening significantly preceded minor axis shortening (phase difference between two axes : 20+/-3 msec, mean+/-SEM) during early systole, indicating left ventricle become more spherical. This phase difference was also observed in the patients with mitral stenosis and in those with open mitral commissurotomy. In patients with mitral valve replacement(MVR) whose papillary muscles had been sectioned, the onset of long axis shortening was more delayed during early systole than that of short axis(-33+/-6msec) and the end of shortening was also prolonged to early diastole more than that of normal controls (54+/-3 msec vs 90+/-8 msec, mean+/-SEM, p<0.01 by t-test). CONCLUSION: We observed the time relations between long and short axis motion in normal controls. It can be concluded that the reversed time relation in patients with MVR is one of the important factors which may effect negatively on ventricular function and long-term prognosis, thus the surgical procedures to preserve papillary annular continuity should be considered in patients with mitral valvular disease. And the controlled, prospective, clinical trials with homogenous groups of patients are needed to evaluate the potential benefits of papillary annular continuity in preserving atrio-ventricular interaction in patients undergoing mitral valvular surgery.
Axis, Cervical Vertebra* ; Diastole ; Echocardiography ; Electrocardiography ; Heart Valve Diseases* ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Papillary Muscles ; Prognosis ; Systole ; Ventricular Function

BACKGROUND: This study was designed to evaluate the safety and the efficacy of fosinopril(Monopril(R)) in the treatment of mild to moderate essential hypertension. METHOD: Fosinopril(10mg) once a day was administrated as a starting dose in 20 patients with essential hypertension in the morning and a one step upward titration was performed(fosinopril 20mg once a day, after 4 weeks treatment). RESULT: After 2 weeks treatment with dose of 10mg, the systolic blood pressure(SBP) was decreased(183.8+/-28.5 vs, 161.5+/-25.9mmHg, p<0.05) and the diastolic blood pressure(DBP) was also decreased significantly(108.3+/-9.3 vs, 96.6+/-10.3mmHg, p<0.05). The effect of fosinopril were maintained. The SBP an DBP were decreased in 14 out of 20 patients till 8 weeks. There was no significant change in heart rate before and after fosinopril treatment(74.3+/-10 vs, 76.4+/-7.9beats/min). Fosinopril had no significant effects on laboratory findings such as serum creatinin, BUN, AST/ALT, WBC, Platelet and lipid profiles. Mild dry coughing was noticed only in 5 patients and it did not disturb continuing medication. CONCLUSION: Fosinopril is an effective antihypertensive agent, as monotherapy once a day in patients with mild to moderate hypertension.
Blood Platelets ; Cough ; Fosinopril* ; Heart Rate ; Humans ; Hypertension*

BACKGROUND: Viral myocarditis is considered as a cause of dilated cardiomyopathy. At present, two pathogenic mechanisms may be involved in the pathogenesis of viral myocarditis and subsequent cardiomyopathy. First, the virus infection of myocyte may directly lead to either cell death or persistent metabolic dysfunction. Second, virus-induced immune or autoimmune mechanism may play a role. METHODS: To test the therapeutic efficacy of immunosuppression with cyclophophamide(CYP) on coxsackievirus B3(CB3) myocarditis, 10-14 week-old Balb/c mice were inoculated with 4000 plaque-forming units of CB3. In experiment 1, CYP (100mg/kg/day subcutaneous injection, s.c) was administrated daily on days 1-7(group 2, n=16). In experiment 2, CYP 30mg/kg/day s.c(group 3, n=32) or CYP 100mg/kg/day s.c(group 4, n=32) were administrated on days 8-14. The animals of infected controls(group 1, n=26) and group 2, 3, 4 were dissected at days 4, 7, 15, 22 and spleen, heart, thymus and body weights were measured. RESULTS: In experiment 1. survival rate in group 2 on day 7, 15 were low compared with group 1(85%, 0% vs 100%, p<0.05). and myocardial virus titers in group 2 on day 4 was 50 times, and on day 7, 1000 times higher compared with group 1, Histologically, on day 7, focal cellular infiltrations were prominent findings in group 1, but diffuse myocardial necrosis without cellular infiltration were observed in group 2. In experiment 2, survival rate, cardiac histopathology myocardial virus titer and serum neutralizing antibody titers did not differ among groups 1, 3 and 4. In experiment 1 and 2, the spleen-to-body-weight and thymus-to-body-weight ratios were significantly lower in CYP treated groups than those in controls and marked cellular depletions in spleens and thymus were observed in CYP treated groups. CONCLUSIONS: As the results of above, it can be concluded that the immunosuppression during viremic phase of murine viral myocarditis aggravated the myocardial necrosis, and during aviremic phase, the administration of CYP didnot affect the process of viral myocarditis. Thus, direct viral mechanisms in the production of cardiomyocyte injury in CB3-infected mice appear to bo more important than cell mediated immune mechanism. To understand relevant pathogenic mechanisms of clinical myocarditis and dilated cardiomyopathy resulting from viral infection, the experimental study expanding into nonmurine animals and into various models using other infectious agents may be required.
Animals ; Antibodies, Neutralizing ; Body Weight ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cell Death ; Cyclophosphamide* ; Heart ; Immunosuppression ; Injections, Subcutaneous ; Mice ; Muscle Cells ; Myocarditis* ; Myocytes, Cardiac ; Necrosis ; Spleen ; Survival Rate ; Thymus Gland ; Viral Load

No abstract available.
Echocardiography* ; Electrocardiography*

PURPOSE: This study evaluated the effect of tissue plasminogen activator (TPA) on adhesion between the internal limiting membrane and the vitreous cortex in patients with diabetic macular edema. METHODS: This retrospective study included 14 eyes of 14 patients with diabetic macular edema without posterior vitreous detachment. The fourteen eyes were divided into two groups. In the first group, vitrectomy and internal limiting membrane (ILM) removal were performed after intravitreal TPA 0.1 cc (50 ug) injection the day before vitrectomy and in the second group, vitrectomy and ILM removal were performed without previous injection of TPA. We observed the ILM using electron microscopy and verified the effects of the TPA. RESULTS: Spontaneous posterior vitreous detachment occurred in 3 of 7 eyes in the first group. Internal limiting membranes removed by vitrectomy showed a smooth surface in 4 of 7 eyes in the first group and in 1 of 7 eyes in the second group. Seven eyes of the first group and 6 eyes of the second group revealed decreased foveal thickness and increased visual acuity 90 days postoperatively. CONCLUSIONS: Preoperative intravitreal TPA injection was helpful for achieving posterior vitreous detachment and for decreasing possible postoperative complications involving in remnant vitreous cortex in patients with diabetic macular edema.
Eye ; Humans ; Macular Edema ; Membranes ; Microscopy, Electron ; Postoperative Complications ; Retrospective Studies ; Tissue Plasminogen Activator ; Visual Acuity ; Vitrectomy ; Vitreous Detachment

BACKGROUND: Multi-vessel off-pump coronary bypass surgery (OPCAB) imposes cumulative myocardial ischemia/reperfusion injury, which may be attenuated by continuous infusion of nitrate. However, nitrate infusion and consequent decrease in preload may be hazardous during heart displacement which causes restrictive filling of the ventricles. Therefore, we evaluated the effect of nitrate infusion on myocardial protection and hemodynamics in patients undergoing OPCAB, in a prospective, randomized and controlled trial. METHODS: Fifty patients with stable angina and left ventricular ejection fraction >40% undergoing elective, isolated, multivessel OPCAB were enrolled. Patients were randomized equally to either continuous infusion of isosorbide dinitrate 0.5microg/kg/min or same amount of normal saline during the surgery. Operative data including hemodynamic variables, intraoperative ST segment changes and postoperative cardiac enzyme release (creatine kinase-MB, troponin T) were compared. RESULTS: Patients characteristic and operative data including ST segment changes and use of vasopressors were similar between the groups except the total amount of infused crystalloid during the surgery which was significantly higher in the nitrate group. Postoperative variables including cardiac enzyme release were also similar between the groups. CONCLUSIONS: Prophylactic continuous infusion of nitrate during OPCAB exerted no additional benefit in terms of myocardial protection. It also, was not associated with accentuated decrease in cardiac output during heart displacement, and the decrease in preload seems to have been nullified by modest increase in fluid therapy.
Angina, Stable ; Cardiac Output ; Displacement (Psychology) ; Fluid Therapy ; Heart ; Hemodynamics ; Humans ; Isosorbide ; Isosorbide Dinitrate ; Isotonic Solutions ; Myocardial Ischemia ; Prospective Studies ; Stroke Volume ; Troponin