Two cases of abnormalities of the left ventricular wall(left ventricular aneurysm or diverticulum) are presented. A saccular deformity of the left ventricle may be and aneurysm or a diverticulum. In one case, the defect seems to be subcalvular aneurysm(or fibrous diverticulum) or aneurysm of the membranous ventricular septum; this lesion seems to be a natural consequence of spontaneous closure of a defect of the membranous septum. The other case, it seems that the defect is ventricular aneurysm with syndrome of myocardial infarction and normal coronary arteries, or double or accessory chambered left ventricle. The thromboembolic phenomenon was noted on a left frontoparietal lobe of brain. Both cases have the diagnosis supported by cardiac catheterization and angiography. The clinical, angiographic and pathologic characteristic of diverticulum and aneurysm of the heart are reviewed, and an attempt is made to clarify the concept of aneurysm and diverticulum of the heart.
Aneurysm* ; Angiography ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Diverticulum* ; Heart ; Heart Ventricles* ; Myocardial Infarction ; Ventricular Septum

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor*

The Clinical analysis of 130 spontaneous intracebral & cerebellar hematoma confirmed by brain CT & admitted to this neurosurgical clinic past years & 5 months were made with literature review. 1) The age incidence showed increase over fourth decade and male to female ratio was 56.1:43.9. 2) 50.4% of total patients showed hypertension but 40.3% did not checked their B.P. & 9.3% had normal B.P. before cerebral hemorrhage. Among 50.4% of hypertension cases, 72% received antihypertensive treatment intermittently, 2.9% regularly and the rest 24.3% did not. 3) 69.7% of hematoma located in basal ganglia & thalamus. In nonoperated patients, the morbidity & mortality showed no marked difference in their location except pontine & cerebellar hematomas. In operated patients the morbidity & mortality was prominent in putaminal hemorrhage than in thalamus and cerebellum. Most of putaminal hematoma had semicomatose or comatose mental state and ventricular hemorrhage in 87.5%. 4) The morbidity & mortality increased in proportion to size of hematomas, grade of unconsciousness in admisson and state of intraventricular hemorrhage. 5) About time interval from ictus to operation, the patients within first 24 hours are 29 cases(51.1%) and the next 24 hours are 13 cases(26.5%). The mortality rate of two groups were 55.1% & 53.8% respectively but no death in the patients with operation performed after 48 hours. 6) The morbidity & mortality rate were as follows. In the non operated patients (90 patients), no or mild neurological deficits:22.2% moderate:21.1% severe:20% and moribund or death:36.6%. In the operated patients no or mild neurological deficits:16.3% moderate:18.4% severe:18.4% and moribund or death:46.9%. The results of total patients showed no or mild neurological deficits:20.1%, moderate:20.1%, severe:19.4% and moribund or death:40.2%.
Basal Ganglia ; Brain ; Cerebellum ; Cerebral Hemorrhage ; Coma ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Putaminal Hemorrhage ; Thalamus ; Unconsciousness

In spite of general agreement that pain relief after upper abdominal surgery is important for the reduction of postoperative morbidity, the most widely used method remains intramuscular injection of narcotics or non-opioid analgesics with their well known disadvantages of respiratory depression, nausea, vomiting and epidural anesthesia and intercostal nerve block are invasive, so do not achieve much popularity. This double-blind prospective study, 30 patients with subcostal incision performed for cholecystectomy, reeeived 20 ml of either physiologic saline or 0.5% bupivacaine by wound infiltration at the time of closure of the incision. After operation, pain score and analgesic requirements were compared at emergence and postoperative 24 hour in each group. The results were as following: 1) Mean age of control and bupivacaine group were 45.3+/-14.9 and 53.6+/-10.3 yr respectively and mean duration of anesthesia 175+/-63 and 145+/-54 minutes respectively. 2) At emergence, mean pain score was 7.7+/-1.7 in control and 2.7+/-2.6 in bupivacaine group (p < 0.01), and at postoperative 24 hour, mean value of pain score was 6.8+/-2.1 in control and 2.31.9 in bupivacaine group(p<0.01). 3) At emergence, there were 11 patients(73%) of none to mild pain, 3(20%) of moderate pain and 1(7%) of severe pain in bupivacaine group, while 0(0%), 6(40%) and 9(60%) respectively in control group. But at postoperative 24 hour, the number of patients with none to mild, moderate and severe pain were 13(87%), 2(13%) and 0(0%) in bupivacaine group and 4(27%), 3(20%) and 8(53%) in control group respectively. 4) In experimental group, patients less than 14% needed additive analgesic, and there were no side reactions in the bupivacaine group. With above results, we suggest that pouring of 0.5% bupivacaine into incisional wound, especially in cholecystectomy patients, would be a method for postoperative pain relief.
Analgesics ; Anesthesia ; Anesthesia, Epidural ; Bupivacaine* ; Cholecystectomy* ; Humans ; Injections, Intramuscular ; Intercostal Nerves ; Narcotics ; Nausea ; Pain, Postoperative* ; Prospective Studies ; Respiratory Insufficiency ; Vomiting ; Wounds and Injuries

BACKGROUND: Left ventricular hypertrophy is common in chronic renal failure patients and may contribute increased risk of cardiovascular morbidity and mortality. We evaluated the left ventricular morphology and function in renal transplant recipients to find the relationship between hemodynamic changes and morphologic and functional improvement after transplantation. METHODS: Serial echocardiographic evaluations were performed in 27 adults(20 men and 7 women) at the time of transplantaion and posttransplantation 1 month and 4 months. The average duration of hemodialysis was 16+/-24 months(mean+/-S.D.). RESULTS: At the time of transplantation, the hematocrit level was 21+/-6% and posttransplantation 1 month and 4 months, that was increased to 39+/-5% and 42+/-7%, respectively(p<0.001). Left ventricular mass index by echocardiography was decreased significantly from 246+/-87g/m2(pre-KT) to 169+/-38g/m2(post-KT 1 month) and 153+/-40g/m2(post-KT 4 months), respectively (p<0.001). Interventricular septal thickness and left ventricular posterior wall thickness were decreased significantly after 4 months of transplantation. Left ventricular systolic and diastolic dimensions were also decreased significantly after 1 month and 4 months of transplantation. Left ventricular volumes and cardiac output were also decreased significantly. But A/E ratio, ejection fraction and fractional shortening did not change significantly. CONCLUSION: These findings showed that pretransplant high output state was resolved radipidly(within 1 month) but the diastolic function did not improved after transplantation 1 month and 4 months.
Cardiac Output ; Echocardiography* ; Hematocrit ; Hemodynamics ; Humans ; Hypertrophy, Left Ventricular ; Kidney Failure, Chronic ; Kidney Transplantation ; Male ; Mortality ; Renal Dialysis ; Transplantation*

Herpes zoster is an uncommon disease in children, especially in healthy children. The clinical studies and observations of herpes zoster has been focused to children with hemato-oncologic diseases or immuno-compromised conditions. Recently the association of herpes zoster after varicella vaccine (Oka strain) immunization has been concerned and some cases of normal children after varicella vaccination have been reported. We experienced two cases of herpes zoster in healthy children after varicella vaccination.
Chickenpox Vaccine ; Chickenpox* ; Child* ; Herpes Zoster* ; Humans ; Immunization ; Vaccination*

Eclampsia is characterized by hypertension. Proteinuria, edema. And seizures or mental changes after the 20th week of gestation. The incidence of abnormal CT findings in eclamptic patients are reported in 29%-21% previously, according to authors. In many previous reports, abnormal CT findings in eclamptic patients were usually bilateral. Symmetrical and non-enhancing hypodensities with mass effect at posterio; parts of cerebral hemispheres. We anal!zed the abnormal CT findings and clinical findings of 16 eclamptic Korean women and the following results were obtained. 1. There were three patterns of abnormal CT findings: low density pattern(13 cases). High density hemorrhagic pattern(3 cases). And a pattern of generalized cerebral edema(one case). 2. Low density lesions. Which could be found within 24 hours after development of neurologic symptoms or signs were usually bilateral (9/13) and symmetrical (6/9). 3. The usual location of low density lesions was around basal ganglia rather than posterior parts of cerebral hemispheres. The major clinical symptom of basal ganglia lesions was mental change rather than visual symptoms of lesions of posterior parts of cerebral hemispheres. 4. Within 2 weeks. The characteristic low density lesions on CT scans were markedly diminished or disappeared, which run parallel with neurological symptoms. 5. The cases with definite neurological deficits revealed the corresponding CT abnormalities, but the patient with sezure showed variable CT abnormalities.
Basal Ganglia ; Cerebrum ; Eclampsia* ; Edema ; Female ; Humans ; Hypertension ; Incidence ; Neurologic Manifestations ; Pregnancy ; Proteinuria ; Seizures ; Tomography, X-Ray Computed

BACKGROUNDS: Rheumatoid factor (RF) is common serological marker for the diagnosis of rheumatoid arthritis (RA), but its sensitivity and specificity are not satisfactory for the diagnosis of RA. Therefore, we investigated the diagnostic performance of a new antifilaggrin antibody test by enzyme linked immunosorbent assay (ELISA) in RA. METHODS: Recombinant human filaggrin was deiminated in vitro by peptidylarginine deiminase and used as the coating antigen for ELISA. We performed the RF and the antifilaggrin antibody for 324 RA patients, 251 non-RA patients (rheumatic diseases other than RA), and 286 normal individuals and evaluated the sensitivities and specificities of RF and antifilaggrin antibody. Optimal cut off values were calculated as mean+2SD in 95% confidence interval except 3SD for 286 normal individuals. Optimal cut off values of antifilaggrin antibody and RF were 9.6 U/ml and 12 U/ml, respectively. RESULTS: The sensitivities and specificities of antifilaggrin antibody were 44.8% and 89.2% at optimal cut off values. The sensitivity and specificity of RF were 75.0% and 83.3%. Combination of "antifilaggrin antibody and RF" showed significantly high specificity of 95.2% and that of "antifilaggrin antibody or RF" showed slightly high sensitivity of 79.3% at optimal cut off values. Antifilaggrin antibody was positive in 17.3% among 81 sero-negative RA patients. CONCLUSION: We considered that antifilaggrin antibody could be used a supplementary test of RF for the diagnosis of RA, because "antifilaggrin antibody and RF" had higher diagnostic specificity than RF alone and antifilaggrin antibody test was easy, convenient ELISA method in performance.
Arthritis, Rheumatoid* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Rheumatoid Factor ; Sensitivity and Specificity

To determine the early diagnostic parameters of the left ventricular diastolic filling defect in the uncontrolled adult onset diabetes mellitus, 86 diabetics were evaluated from the left ventricular inflow velocity pattern using pulsed Doppler echocardiography compared with normal 21 subjects. The diabetics were divided into 3 groups according to the presence or absence of background diabetic retinopathy(RE or coexisting cardiovascular diseases(group I : 34 cases without RE, group II : 24 cases with RE, group III : 28 cases with CVD). RE was thought to be having microangiopathy, but the cases with persistant massive proteinuria were excluded in this study. The left ventricular inflow velocity patterns were recorded from the apical approach. Peak velocity of the rapid filling phase(PFVE), that in the atrial systole(PFVA), E/A ratio, acceleration time(AT), deceleration time(DT), acceleration rate(ATR) and deceleration rate(DTR) were measured in the left ventricular inflow patterns. The results were ; 1) PFVE, AT and ATR in group I(56.26+/-12.21mm/sec, 70.91+/-14.98msec, 858.5+/-247mm/sec2), group II(51.91+/-14.35mm/sec, 64.84+/-14.98msec, 855.7+/-248.5mm/sec2) and group III(50.07+/-12.45mm/sec, 67.59+/-17.46msec, 817.5+/-266.8mm/sec2) were not significantly changed(p>0.05) compared to the controls(50.24+/-8.24mm/sec, 66.19+/-10.98msec, 784.5+/-221mm/sec2). 2) PFVA and DT in group I(51.21+/-14.86mm/sec, 156.2+/-23.42msec) and group II(64.26+/-13.93mm/sec, 64.84+/-14.13msec) were significantly increased(p<0.05, p<0.0001) compared to the controls(43.43+/-9.1mm/sec, 140.05+/-25.22msec). But those were not significantly different between group II and group III(p>0.05). 3) E/A ratio was significantly decreased in group II(0.82+/-0.21) and III(0.75+/-0.23) compared to the controls(1.19+/-0.25, p<0.0001) or group I(1.16+/-0.41, p<0.0001). But not significantly different between group II and group III(p>0.05) was noted. 4) DTR was also decreased in group II(311.9+/-95mm/sec2, p<0.05) and group III(297.7+/-125.8mm/sec2, p<0.05) compared to the controls(370.2+/-88mm/sec2) and group I(379.8+/-126mm/sec2). In conclusion, left ventricular diastolic filling defect in adult onset diabetics could be determined by using a various parameters of the pulsed Doppler echocardiography, which were closely related with diabetic retinopathy(RE). And DT and PFVA could be used as good parameters for early determination of the left ventricular diastolic filling defect in diabetics even without microangiopathy.
Acceleration ; Adult* ; Deceleration ; Diabetes Mellitus* ; Diabetic Angiopathies ; Echocardiography* ; Echocardiography, Doppler, Pulsed ; Humans ; Proteinuria

BACKGROUND: Conventional treatment of molluscum contagiosum(MC) has been surgical curettage. This treatment is painful and not feasible in widespread lesions, particularly in infants and children. OBJECTIVE: We evaluated 30 children with MC for the clinical effectiveness and advantage of treatment with topical tretinoin therapy. METHODS: Thirty children with MC visited our clinic were asked to apply the tretinoin cream to each individual lesion, and followed up for 8 to 12 weeks. During these periods the assessment of therapeutic response was performed on a biweekly basis. RESULTS: Fifteen(50%) of 30 patients achieved complete clearance after a mean treatment period of 4.7 weeks. Partial clearance were observed in 5(16.7%) and no response in 1 children(3.3%). No patient dropped out because of the adverse effects. Twenty one children(66.7%) reported a mild itching and/or erythema, stinging, and temporary hyperpigmentation. CONCLUSION: Therapy with treatinoin cream was found to be effective, safe, and painless in the treatment of MC in children.
Bites and Stings ; Child ; Curettage ; Erythema ; Humans ; Hyperpigmentation ; Infant ; Molluscum Contagiosum* ; Pruritus ; Tretinoin*