The authors analyzed data from 15 patients with idiopathic dilated cardiomyopathy to evaluate the hemodynamic changes and left ventricular cineangiogram as compared with normal control. Mean right atrial pressure, right ventricular systolic pressure, mean pulmonary artery pressure and mean pulmonary wedge pressure were signigicantly elevated in patients with dilated cardiomyopathy. Left ventricular enddiastolic volume was increased in idiopathic dilated cardiomyopathy(139.9+/-58.73 ml/m2). Cardiac index, left ventricular ejection fraction and circumferential fiber shortening were significantly reduced in patients with dilated cardiomyopathy as compared with normal control(p<0.001). Hypokinetic, diffuse wall motion abnormalities of left ventricle were common in idiopathic dilated cardiomyopathy. A few cases of akinetic or dyskinetic segmental wall motion abnormalities were present. Left ventricular configurations in patients with idiopathic dilated cardiomyopathy were globe shape(53.4%) as compared with pear core shape(90%) of normal control. Associated mitral regurgitations in patients with idiopathic dilated cardiomyopathy confirmed by left ventricular cineangiogram were 53.3 percent. Mild to moderate mitral regurgitations were often present(46.6%).
Atrial Pressure ; Blood Pressure ; Cardiomyopathy, Dilated* ; Heart Ventricles ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Pyrus ; Stroke Volume

STUDY OBJECT: To date, the study of critical illness in the emergency department has been limited. The purpose of this study was to determine the length of stay and procedures performed on critical care patient in ED, and to be help to establish Emergency physicians' education program. METHOD: We reviewed patient's medical record, who visited ED, Korea Univ. Hospital from Jan. 1996 to Jun. 1996 and admitted to ICU. We analyzed data to age, sex, clinical diagnosis, length of stay, and critical procedures in ED. RESULTS: The 12,721 patients visited ED during the study period, the 441 of 12,721 (3.50%) patients admitted to ICU. 56 patients were excluded whose medical re cords were incomplete. The study populations consisted of 165 women and 220 men. The mean age were 52 year old (median,58 year old). The mean length of stays were 606.1 (1445.9 minutes (median, 180 minutes)). One hundred sixty one of these patients (41.8 %) received one or more critical procedures. The medical critical patients were 252 cases, and surgical critical patients were 133 cases. The mean length of stay of medical critical patients was 738.8 (1748.9 minutes (median, 177.5 minutes)) in medical department,44.0% of them received critical procedures in ED. The surgical critical patients averaged 354.9 (410.7 minutes (median, 190 minutes)) and 37.6% received critical procedures. CONCLUSION: Critical ill patients stay in the ED with a substantial amount of time, before addition to the ICU. Critical ill patients who have hemodynamiccal unstable conditions, compromised cardiopulmonary functions, and neurologic deficities, were managed in ED frequently. Typical critical care procedures are commonly performed by emergency physicians. Therefore, it is important for emergency physician to prepare to critical ill patients.
Critical Care* ; Critical Illness ; Diagnosis ; Education ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Korea ; Length of Stay ; Male ; Medical Records ; Middle Aged

Endometriosis in the abdominal wall following Cesarean section is one of the very rare condition among the extrapelvic endometriosis. Although benign, endometriosis possesses the unique ability to invade tissue and to disseminate or metastasize by hematogeneous, lymphatic route, or direct implantation. We reported the case with brief review of the literature.
Abdominal Wall* ; Cesarean Section* ; Endometriosis* ; Female ; Pregnancy

BACKGROUND: The development and progression of a tumor can be determined by a complex multistep process involving the activation of oncogenes and the inactivation of tumor suppressor genes. The purpose of this study is to investigate the expression of p53, Rb, bcl-2 protein and Ki-67 labeling index in the intrahepatic cholangiocarcinoma. METHODS: We analyzed 36 cases of intrahepatic cholangiocarcinoma obtained by surgical resection. Expression of p53, Rb, bcl-2 proteins and Ki-67 labeling index were evaluated by immunohistochemical study. RESULTS: Expression of p53 protein was detected in 61.1% (22/36) of cholangiocarcinoma. Rb protein loss and overexpression were observed 27.8% (7/36) and 72.2% (29/36) of cholangiocarcinoma. But bcl-2 protein was not expressed. No significant correlation was found between p53, Rb and bcl-2 protein expression and age, sex, gross type, histologic grade, vascular invasion and lymph node metastases. The Ki-67 labeling index was significantly higher in p53 positive group and Rb overexpression group than in p53 negative group (p<0.01) and Rb loss group (p<0.05). There was a positive correlation between p53 protein and Rb protein expressions, but a negative correlation between Rb protein and bcl-2 protein expressions. CONCLUSIONS: The overexpression of p53 protein and Rb protein may be closely associated with cholangiocarcinogenesis, while bcl-2 has a less crucial role in cholangiocarcinogenesis.
Cholangiocarcinoma* ; Genes, Tumor Suppressor ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Retinoblastoma Protein

BACKGROUND: Circardian variation in the onset of cardiovascular events includig sudden cardiac death, myocardial infarction and ventricular arrhythmias has been discribed. The frequency of ventricular premature complexes has also been reported to demonstrate a pattern consisting of a daytime peak and nightime nadir. We tried to see if the same circardian pattern is found in dilated cardiomyopathy patients. We have also studed how various modifying factors such as left ventricular ejection fration and ACE inhibitor use may affect the circardian pattern. METHOD: 24-hour ambulatory electrocaridiographic monitorings were performed in 50 dilated cardiomyopathy patients and 20 control subjects. Patients were prospectively divided in 2 groups based on LVEF and ACE inhibitor use. RESULTS: In dilated cardiomyopathy patients, the expected morning increase in VPC frequency is absent and show a peak in evening. This pattern is not correlated with heart rate. Evening peak is more prominent in low LVEF group and ACE inhibitor non-user group. CONCLUSION: In dilated cardiomyopathy patients, VPC frequency show a peak in the evening.
Arrhythmias, Cardiac ; Cardiomyopathy, Dilated* ; Death, Sudden, Cardiac ; Heart Rate ; Humans ; Myocardial Infarction ; Prospective Studies ; Ventricular Premature Complexes*

Many methods have been proposed to measure the distensibility of the cornea and sclera, which is ecsential in tonography and tonometry of the eye ball, but little has been reported on the distensibility of the cornea and sclera expressed as Young Modulus, and the changes of the distensibility by beta-irradiation. In the present study, an attempt was made to elucidate the distensibility of the strip of the cornea or sclera, which was placed in the tension-length measuring apparatus immediately after removing from the apparently healthy normal rabbit without anesthesia. Young Modulus of the strip was calculated from the tension-length curve of each sample. Aho strontium 90 beta-irradiation was applied to the cornea and sclera in vitro, and the change of Young Modulus at 1,3,6,12 and 24 hours after beta-irradiation was compared with the normal and control. The results thus obtained are summarized as follows: 1. Young Modulus of the cornea and sclera in the normal rabbit was 2.25 X 10(7) dyne/cm2 and 6.60 X 10(7) dyne/cm2, respectively. 2. When 2,000 Rad of beta-ray was irradiated to the cornea and sclera in vitro, Young Modulus was similar to the control value at one hour, but beta-irraidiaton with 4,000 and 6,000 Rad produced decreased Young Modulus from the control at one hour after the irradiation. The tendency of the decrease was more noticeable in the cornea than in the sclera. 3. Young Modulus of the cornea at 6 hrs after beta-irradiation with 6,000 Rad in vitro did not change from the normal, but the decreased values were observed at 12 and 24 hrs after the irradiation while Young Modulus of the control group showed continuously elevated value from the normal up to 24 post-beta irradiation hour. 4. When 6,000 Rad of beta-ray was irradiated, Young Modulus of the sclera did not change greately from the normal value throughout the entire experiment. In the control group, however, the gradually elevated Young Modulus was observed up to 24 experimental hour.
Anesthesia ; Cornea* ; Elastic Modulus ; Manometry ; Reference Values ; Sclera* ; Strontium*

Many methods have been proposed to measure the distensibility of the cornea and sclera, which is ecsential in tonography and tonometry of the eye ball, but little has been reported on the distensibility of the cornea and sclera expressed as Young Modulus, and the changes of the distensibility by beta-irradiation. In the present study, an attempt was made to elucidate the distensibility of the strip of the cornea or sclera, which was placed in the tension-length measuring apparatus immediately after removing from the apparently healthy normal rabbit without anesthesia. Young Modulus of the strip was calculated from the tension-length curve of each sample. Aho strontium 90 beta-irradiation was applied to the cornea and sclera in vitro, and the change of Young Modulus at 1,3,6,12 and 24 hours after beta-irradiation was compared with the normal and control. The results thus obtained are summarized as follows: 1. Young Modulus of the cornea and sclera in the normal rabbit was 2.25 X 10(7) dyne/cm2 and 6.60 X 10(7) dyne/cm2, respectively. 2. When 2,000 Rad of beta-ray was irradiated to the cornea and sclera in vitro, Young Modulus was similar to the control value at one hour, but beta-irraidiaton with 4,000 and 6,000 Rad produced decreased Young Modulus from the control at one hour after the irradiation. The tendency of the decrease was more noticeable in the cornea than in the sclera. 3. Young Modulus of the cornea at 6 hrs after beta-irradiation with 6,000 Rad in vitro did not change from the normal, but the decreased values were observed at 12 and 24 hrs after the irradiation while Young Modulus of the control group showed continuously elevated value from the normal up to 24 post-beta irradiation hour. 4. When 6,000 Rad of beta-ray was irradiated, Young Modulus of the sclera did not change greately from the normal value throughout the entire experiment. In the control group, however, the gradually elevated Young Modulus was observed up to 24 experimental hour.
Anesthesia ; Cornea* ; Elastic Modulus ; Manometry ; Reference Values ; Sclera* ; Strontium*

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Pregnancy*

The coronary artery cross sectional area (CSA) is proportional to LV mass. We have measured the cross sectional area of the left and right coronary arteries in patients with ischemic heart disease to see whether it is related to the change in the LV mass. The following results were obtained ; 1) There were no significant difference in mean CSA of coronary arteries and LV mass determined by echocardiography and cineangiography between control and ischemic heart disease. 2) There were significantly increased ratio of left ventricular mass by cineangiogram to CSA of left anterior descending coronary artery in patients with myocardial infarction as compared with control group. 3) A linear relation between LV mass by cineangiogram and CSA of left coronary artery was noted in control group (r=0.53, P<0.05) and ischemic heart disease group (r=0.51, P<0.05). 4) A linear relation between LV mass determined by echocardiography and CSA of left coronary artery was noted in control group (r=0.55, P<0.05).
Cineangiography ; Coronary Vessels* ; Echocardiography ; Humans ; Myocardial Infarction ; Myocardial Ischemia