Since its initial description in 1930, the preexcitation or Wolff-Parkinson-White(W-P-W) syndrome is characterized by a special electrocardiographic pattern and various paroxysmal tachyarrhythmia, which was found to have reciprocating tachycardia frequently. The W-P-W syndrome develops when some part of a ventricle is activated earlier than normal conduction pathway, and described as one type of ventricular preexcitation syndromes by Durrer (1974). The diagnostic criteria of the W-P-W syndrome are 1) initial slurring (delta wave) of the QRS complex, 2) short P-R interval, 3) widened QRS complex and 4) secondary T wave change. The initial slurring of the QRS complex (delta wave) which is the most important finding of preexcitation syndrome results from a premature activation of a portion of the ventricle through an accessary pathway which bypasses the A-V node and bundle. These accessary conduction fiber includes Kent's bundle, Jame's fibers, Mahaim's fibers and its combination. Recent developments in the field of electrophysiology and surgical therapy became to support the concept of anomalous pathways and the possible determination of the re-entry circuit of paroxysmal tachycardia. Total 12 cases including 9 cases of classical W-P-W syndromes and 3 cases of L-G-L syndromes were followed with special interest of pre-excitation phenomenon and paroxysmal tachyarrhythmia at the National medical Center during the period of Jan. 1975 to Feb. 1979 and found to have paroxysmal tachyarrhythmia in 8 cases out of 12 cases. His bundle electrogram (HBE) and right atrial pacing were recoded in 2 cases of W-P-W type B to support the existance of an anomalous pathway. Treatment was instituted in accordance with recent advanced knowledge for the paroxysmal tachyarrhymia and pre-excitation and references were reviewed.
Atrioventricular Node ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Electrophysiology ; Pre-Excitation Syndromes ; Tachycardia ; Tachycardia, Paroxysmal ; Tachycardia, Reciprocating ; Wolff-Parkinson-White Syndrome*

No abstract available.
Neoplasm Metastasis*

The cardiac performance is regulated by the intergration of preload, afterload, contractility (inotropism), heart rate and synergy of ventricular contraction, which are the major determinants that govern the stroke volume and cardiac output. Valvular heart disease may be considered to impose two different types of stress on the cardiac chamber proximal to the lesion. There are either pressure overload(increased after load) or volume overload(increased preload). The compensatory mechanism of the pressure overload and volume overload offer to hypertrophy and dilatation of the chamber. Hypertrophy, increased muscle mass, calls upon the development of greater systolic force. Dilatation, overfilled chamber volume enables increased strength and extent of shortening by Frank Starling's mechanism. In these view, we shall discuss the hemodynamic parameters; cardiac output, stroke volume, ventricular end-diastolic pressure, and the rate of ventricular pressure rise(peak dp/dt), mitral valve gradient and pulmonary circulation. The authors had an opportunity to study 40 cases of mitral valvular heart disease which were accepted during the left ventricular angiography at the cardiac catheterization room and at the fields of operative findings during the period Jan. 1977, throught Sept. 1980, at the Department of Internal Medicine, National Medical Center. The following conclusions were drawn: 1) Cardiac index was 2.65 L/min/m2in average, among 18 cases with mitral stenosis and 2.54 L/min/m2 in average, among 15 cases with mitral valve area of less than 1.0 cm2. Cardiac index was 2.58 L/min/m2in average, among 19 cases with mitral stenoinsufficiency and 3.43 L/min/m2 in average, among 3 cases with pure mitral insufficiency. 2) The mean right ventricular end-diastolic pressure elevated more than 0-8 mmHg were found in 12 cases with mitral stenosis out of 18 cases and mean miral valve area was 0.8m2. The mean left ventricular end-diastolic pressure was also elevated more than 0-12 mmHg in 6 cases out of 12 cases with mitral stenosis in addition to right ventricular failure. These 12 cases of mitral stenosis had cardiac function more than class III clinically. 3) 15 cases with mitral valve area, less than 1.0cm2 demonstrated left ventricular diastolic filling pressure gradient (MVG) of 17.3mmHg in average, the pulmonary vascular resistance of 568 dyndsecd cm(-5) in average, and the right ventricular peak systolic pressure of 72mmHg in average respectively. In all instances, the right ventricular end-diastolic pressure was 11.2mmHg in average and right ventricular peak dp/dt was 571mmHg in average. 4) Among 22 cases with mitral insufficiency, and/or mitral stenoinsufficiency 16 cases showed mean left ventricular end-diastolic pressure elevated more than 0-12mmHg. 10 cases out of these 16 cases disclosed also right ventricular end-diastolic pressure elevated more than 0-8 mmHg. These 16cases of mitral insufficiency and/or mitral stenoinsufficiency had cardiac function more than class III clinically. 5) 16 cases with mitral insufficiency and/or mitral stenoinsufficiency who had mean left ventricular end-diastolic pressure more than 0-12 mmHg showed pulmonary vascular resistance, 358 dyndsecd cm(-5) in average, systemic vascular resistance, 1621 dyne/sec/cm5 in average and left ventricular peak dp/dt, 768-2102mmHg/sec in range. 6) Pulmonary hypertension elevated more than 50mmHg of pulmonary arterial systolic pressure was found in 14 cases out of 18 case with mitral stenosis and in 10 cases out of 22 cases with mitral stenoinsufficiency and/or mitral insufficiency. Pulmonary vascular resistance, however, was markedly variable.
Angiography ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output ; Dilatation ; Heart Rate ; Heart Valve Diseases ; Hemodynamics* ; Humans ; Hypertension, Pulmonary ; Hypertrophy ; Internal Medicine ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Pulmonary Circulation ; Stroke Volume ; Vascular Resistance ; Ventricular Pressure

The so called MOYAMOYA disease is characterized by idiopathic progressive bilateral occlusions of internal carotid arteries near the supraclinoid portion, with a distinctive picture of abnormal net like vessels in the base of the brain. The term MOYAMOYA is a Japanese expression for "PUFF OF A SMOKE", suggested by Suzuki & Takaku in 1969. We have experienced typical 3 cases of so called MOYAMOYA disease during 1979, which were confirmed by bilateral carotid angiography. All 3 cases were involved bilateral sides of the brain and the exact causes were not detected in spite of various laboratory examinations. All of our cases were compatible with the criteria of Moyamoya disease, suggested by Takeuchi in 1978. In addition to the case report a review of history, etiology & pathogenesis of Moyamoya Disease were discussed.
Angiography ; Asian Continental Ancestry Group ; Brain ; Carotid Artery, Internal ; Humans ; Moyamoya Disease*

BACKGROUND: Recent times, elderly population increased due to development of medical treatment and extension of the average span of a human life. Hereupon, variable studies and measures for elderly population were made an attempt in the world at large. In medical treatment, an aged person related an institutes begin to vivacious activity for reflection of this national concern. So we survey the transition of internal diseases of the aged in Korea for 10 years lo support the policy of medical treatment. METHODS: In order to access this study, we use data of korea medical insurance coorporation and national statistical office republic of Korea. We classified internal diseases into several diseases by age, and sex. RESULTS: 1. The transition of out-Patients Digestive troubles have the most high prevalence in both men and women, and cardiovascular diseases are become increasing. Endocrine diseases are become increasing also. 2. The transition of in-patients 1) 65-69 years old Neoplastic diseases and digestive diseases are high in men, but cardiovascular disease are become increasing. Digestive diseases are high in women but, cardiovascular disease and endocrine diseases are become increasing. 2) 70-74 years old Cardiovascular diseases are decreased in men and especially in women. 3) Over 75 years old Digestive diseases are decreased in both men and women, endocrine diseases and cardiovascular diseases are increased in women. 3. The transition of the cause of death. The cardiovascular diseases are high in both men and women, and showed decreasing tendency gradually, Neoplastic diseases and endocrine diseases are increasing in steady. CONCLUSION: In our data, the cardiovascular diseases are high especially, in women according to age in the transition of internal diseases of an aged man in Korea, recent 10 years and endocrine diseases are increasing in steady. So, in medical treatment, we must consider many-sided methods to access this population
Academies and Institutes ; Aged ; Cardiovascular Diseases ; Cause of Death ; Endocrine System Diseases ; Female ; Humans ; Insurance ; Korea* ; Male ; Outpatients ; Prevalence ; Republic of Korea

PURPOSE: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. METHODS: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. RESULTS: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. CONCLUSION: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.
Bronchitis ; Child ; Cross Infection ; Encephalitis ; Humans ; Influenza, Human ; Medical Records ; Meningitis ; Pandemics ; Pericarditis ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Risk Factors ; Seasons ; Ventilators, Mechanical

BACKGROUND: The major risk factors such as hypercholesterolemia, hypertension, diabetes melitus and cigarrete smoking have not been studied in an attempt to provide a composition of major risk factors in Korea. Also we have met with some patients without major risk factors. METHODS: A Retrospective Study was done on 160 patients of acute myocardial infarction who had been admitted to National Medical Center within 48 hours from onset, from January 1948 to December 1992 and studied on major risk factors of acute myocardial infarction. RESULTS: 1) Among major risk factors, smoking was found in 50%, hypertension in 49%, diabetes in 25% and hypercholesterolemia in 21%. 2) The percentage of patients without major risk factors was 19%. 3) Among major risk factors, hypertension, hypercholesterolemia and diabetes were increasing tendencies, recentely. CONCLUSION: Some patients with acute myocardial infarction don't have any major risk factors. Also hypertension, hypercholesterolemia and diabetes were increasing tendencies. So further study for other risk factors is needed and preventive management should require a commitment to behavior modification and alteration in life-style.
Behavior Therapy ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors* ; Smoke ; Smoking

No abstract available.
Mitral Valve*

BACKGROUND: The interpretation of electrocardiographic change in treadmill exercise test is difficult when the test is performed in patients with abnormal resting electrocardiography. In patients with primary nagative T wave, normalization of primary negative T wave(pseudonormalization)is not uncommon finding during treadmill exercise test. The mechanism of pseudonormalization is uncertain and the interpretation is difficult. Thus this study was performed to evaluate the diagnostic significance of pseudonormalization during treadmill exercise test. METHODS: 200 cases who showed primary negative T wave at rest were included in this study. The results were classified as positive, borderline positive, borderline negative, negative, non-diagnostic and pseudonormalization. RESULTS: Pseudonormalization during treadmill exercise test was oberved in 78(39%) of the 200 cases who had primary negative T wave at rest. Coronary angiography and left ventriculography were performed in 13(mean age 56+/-7 year, male vs. female 1:2.25) of 78 cases who showed pseudonormalization during exercise. They had no history of acute myocardial infarction and no abnormalities such as abnormal Q wave, left ventricular hypertrophy,bundle branch block,right ventricular hypertrophy and QRS widening above 0.1ms in resting electrocardiography. There were significant stenosis in only 3 cases; 2 cases in left anterior descending coronary artery and 1 case in right coronary artery. CONCLUSION: In treadmill exercise tests, pseudonormalization appears as non-specific finding for the diagnosis of ischemic heart disease becuase it is observed in either patients with or without coronary artery stenosis.
Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Exercise Test* ; Female ; Humans ; Hypertrophy ; Male ; Myocardial Infarction ; Myocardial Ischemia*

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration