The ventricular septal defect with aortic insufficiency is a relatively uncommon congenital heart disease. Once the prolapse of aortic cusp complicates the ventricular septal defect, the prolapse of the aortic cusp is a progressive, rather than static lesion. With the curent possibility of surgical correction in cases of ventricular septal defect and other abnormalities, the differential diagnosis assumes marked importance. vTwo cases of ventricular septal defect with aortic insufficiency are presented with a review of pertinent literature. These young female patients had long standing palpitation and dyspnea on exertion since childhood. The physical examination showed with pulse pressure, bounding carotid pulsation and a systolic ejection-type murmur and a decrescendo diastolic murmur at the upper left sternal border, which simulated "machinery" type murmur of patent ductus arteriosus. The ventricular septal defect with aortic insufficiency was demonstrated by cardiac catheterization and cineangiocardiography.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis, Differential ; Ductus Arteriosus, Patent ; Dyspnea ; Female ; Heart Defects, Congenital ; Heart Murmurs ; Heart Septal Defects, Ventricular* ; Humans ; Physical Examination ; Prolapse

No abstract available.
Carcinoma, Squamous Cell ; Esophageal Neoplasms ; Neoplasm Metastasis

No abstract available.

No abstract available.

Isolated pulmonary stenosis, a relatively common congenital anomaly that accounts for about 10 percent of all congenital heart disease, is characterized by stenosis of pulmonary valve itself, infundibulum or both of them. Since cardiac catherterization was applied to man by Cournand and Ranges, pulmonary stenosis had been easily diagnosed and many clinical studies had been investigated. It has a wide clinical spectrum depending on the degree of stenosis. The electrocardiogram, phonocardiogram and chest X-ray have proved useful in estimating the severity of hemodynamic facotrs in individual cases. This series comprises 47 cases in whom the clinical diagnosis of isolated pulmonary stenosis was confirmed by right heart catheterization with cardiac cineangiography at Severance Hospital, Yonsei University. An attempt was made to correlate the electrocardiographic, phonocardiographic, chest X-ray findings, and types of stenosis with the hemodynamic data in these cases. 1. Of 47 patients, 33 were male and 14 female. Their ages ranged from 2 to 42 years: the mean age was 19.1 years. 2. The incidence was 5.9 percent of all 797 catheterized congenital heart disease cases. The pulmonary valvular stenosis was 30 (68.3%), infundibular 7 (14.6%) and combined 10 (21.6%) cases. 3. The correlation between electrocardiogram and hemodynamic data were as follows. i) The regression equation between right ventricular sysytolic pressure (RVSP) and height of R wave in V1 lead (RV1) was RVSP=3.32 RV1+48.2: its correlation coefficient was 0.818 and it was very significant (p=0.000). ii) The higher the RVSP, the more the frontal axis of QRS complex shifted to the right side (r=0.55. p=0.001). iii) The RVSP of the groups with positive ECG findings such as p-pulmonale, right ventricular hypertrophy or right ventricular strain were much higher than the RVSP of the groups without such findings (p=0.032.0.000, 0.000). iv) The group with RV1 higher than 20 mm showed much more elevated mean of RVSP than the group with lower RV1 (p=0.000). v) The groups with the above mentioned positive ECG findings showed good correlation with the severity of RVSP which was arbitrarily classified as 49 or less, 50~100, and 100 mmHg or more (chi-square=8.96, 26.69, 19.06; p=0.011, 0.000, 0.000). 4. The group with late occurrence of the maximum intensity of the ejection systolic murmur showed higher mean of RVSP than the group with early peak of the murmur (p=0.014). 5. The means of RVSP of the groups with chest X-ray findings such as decreased pulmonary vascularity, were much higher than the means of RVSP of the groups without such findings (p=0.000, 0.005, 0.015). The groups with above mentioned positive chest X-ray findings showed good corelations with the severity of RVSP which was classified as above limits (chi-square=7.55, 10.94, 13.36; p=0.022, 0.004, 0.001). 6. Combined pulmonary valvular and infundibular stenosis showed more severe systolic pressure gradient and higher mean of RVSP than the isolated types (p=0.000).
Axis, Cervical Vertebra ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Electrocardiography ; Female ; Heart Defects, Congenital ; Hemodynamics* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax

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

Drusen are small, yellowish deposits that form under the retinal pigment epithe lium with senescence or under certain pathological conditions. The present study examined these structures under the scanning electron microscope. Tissue came from the eyes of four donors, who were 22, 56, 60 and 61 years of age and who demonstrated widespread drusen of the posterior fundus. which was noted on postmortem examination. Specimens were prepared by detaching the retinal pig ment epithelium from Bruch's membrane and freeze fracturing the tissue. Drusen appeared as follows: 1. Distinct spherical masse, 10 X 9 um and 9 X 7 um in size, were situated between basement membrane of the retinal pigment epithelium and Bruch's membrane. The surface of the spherical masses were smooth. 2. Indistinct globular dome-like masses, with a harsh surface, were situated bet ween basement membrane of the retinal pigment epithelium and Bruch's membrane. These masses varied greatly in size. 3. Localized of dispersed small granular deposits of the inner collagen layer of Bruch's membrane were noted.
Aging ; Autopsy ; Basement Membrane ; Bruch Membrane ; Collagen ; Epithelium ; Freeze Fracturing ; Humans* ; Microscopy, Electron, Scanning* ; Retinal Pigment Epithelium ; Retinaldehyde ; Tissue Donors

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

To evaluate the antihypertensive effects of serotonin antagonist, ketanserin, a daily dosage of 10~40mg (18.9+/-6.8 mean+/-SE) was administered to 22 patients with essential hypertension and aged 55??1 years (64+/-7.7 mean+/-SE) for 12 weeks. After 12 weeks of ketanserin treatment mean blood pressure decreased from 177.9+/-11.9 to 15.7+/-15.3mmHg in systole and from 104.2+/-7.4 to 88.4+/-7.9mmHg in diastole (P<0.001). There was no significant change in heart rates with ketanserin treatment. The antihypertensive treatment with ketanserin was effective in 18 patients(81.8%) and ineffective in 4 patients (18.2%). Adverse reactions such as drowsiness (8.7%), edama (4.3%) and weakness (4.3%) were noted, but all were mild and transient. This results suggest that ketanserin is an effective and safe antihypersive agent in the treatment of essential hyperension.
Aging* ; Blood Pressure ; Diastole ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Serotonin ; Sleep Stages ; Systole

In previous report, the posterior vitreous detachment was found to be an important factor in progression of idiopathic macular cyst to macular hole. Our study provides the possibility of supporting role of the posterior vitreous detachment in formation and progression of traumatic macular cyst, and the vitrectomy was found to be a valuable procedure to prevent the progression of traumatic macular cyst, combined with posterior vitreous detachment. After posterior vitrectomy in 2 eyes of traumatic macular cyst with posterior vitreous detachment, traumatic macular cyst did not progress to macular hole, and visual acuity of 2 eyes was improved from finger count/30cm to 20/200 and 20/100 to 20/50(follow up period: 6-7 months).
Fingers ; Retinal Perforations ; Visual Acuity ; Vitrectomy* ; Vitreous Detachment