BACKGROUND: Studies of human coronary plaque specimens have shown that T lymphocytes and macrophages are present in all types of lesions, from fatty streaks to advanced plaques. There is growing evidence for a pathogenic role for immune response in progression of atherosclerosis. This study was designed to investigate cytokine production by mononuclear leukocytes from patients with myocardial infarction. METHOD: We measured the kinetics of secretion of tumor necrosis factor-alpha (TNF-alpha) and interferon-r (IFN-r) by mononuclear leukocytes from 8 control subjects and 12 patients with acute myocardial infarction. Mononuclear leukocytes were isolated and incubated with plant lectin mitogen concanavalin-A for 24 and 48 hours. TNF-alpha and IFN-r secretions were measured by ELISA. RESULTS:There were no significant differences between TNF-alpha and IFN-r secretions by mononuclear leukocytes at and before 24 hours of incubation from both patients and control subjects, but TNF-alpha and IFN-r secretions at 48 hours of incubation were higher (p<0.005, p<0.05) in patients when compared with control subjects. TNF-alpha and IFN-r secretions by mononuclear leukocytes after incubation correlated with the peak level of creatine phosphokinase (CK) and CK-MB. CONCLUSION: Increased cytokine secretory capacity of mononuclear leukocytes may be due to the acute inflammatory response of myocardial infarction. Further trials may be needed to determined the effects of increase in secretory capacity of mononuclear leukocytes before myocardial infarction.
Atherosclerosis ; Creatine Kinase ; Enzyme-Linked Immunosorbent Assay ; Humans ; Kinetics ; Leukocytes, Mononuclear* ; Macrophages ; Myocardial Infarction* ; Plants ; T-Lymphocytes ; Tumor Necrosis Factor-alpha*

We report unusual 3 cases of adult coronary arteriovenous fistula(CAVF) diagnosed by coronary arteriography in Soonchunhyang University Hospital. In one patient with mitral stenoinsufficiency, multiple CAVFs originated from left anterior descending and left circumflex coronary areries. In another patient with significant stenosis(90%) in distal right coronary artery, new CAVF was seen in mid right coronary artery during consecutive coronary arteriography. In the remaining one, it was arose from contus branch of right coronary artery. Surgical correction was performed in two cases.
Adult* ; Angiography ; Arteriovenous Fistula* ; Coronary Vessels ; Humans

We studied 105 patients with trasmural myocardial infarction who were admitted to Soonchunhyang university hospital from 1984-1988, and evaluated the clinical and coronary angiographic findings accordin to the age. The following results were obtained: 1) Among 105 patients with myocardial infarction, the prevalent age were sixth and seventh decade(27.6%) and the ration of male to female was 2:1, But the raion of male to female was 5.3:1 under the 50 years of age. 2) In frequency of risk factor of coronarhy heart disease, cigarrette smoking was present in 66.7%, hypertensio in 44.8% and hypercholesterolemia in 28.6%. The mean number of risk factor was 1.3 under the 50 years of age and was 1.7 over the 50 years of age. 3) Anterior myocardial infarction was most common under 50 years of age whereas anterior and inferior myocardial infarction occur similarly over the 50 years of age. 4) By coronary angiography, one vessel disease of stenosis of left anterior descending coronary artery was common findings under 50 years of age, but multivessel disease was common findings over the 50 years of age.
Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Female ; Heart Diseases ; Humans ; Hypercholesterolemia ; Inferior Wall Myocardial Infarction ; Male ; Myocardial Infarction* ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Hemodynamic derangements of cardiac tamponade are generally believed to result from compression of the cardiac chambers, which limits diastolic filling. The character and magnitude of the alternation are determined by the compliance characteristics of the pericardium and the total pericardial fluid volume. During serial pericardial fluid withdrawal, improvement of hemodynamic alternations is expected in patients with pericardial effusion. Method : Hemodynamic study was performed before and during serial fluid drainage in 11 patients with chronic moderate to severe pericardial effusion. RESULTS: 1) Intrapericardial pressure was elevated and equal to mean right atrial ventricular diastolic, and pulmonary capillary wedge pressure. Pulmonary arterial and right ventricular systolic pressure were also midly elevated equal to one another. 2) Pericardial fluid was gradually removed in 50ml aliquots in all patients. The most significant hemodynamic improvement occured during intial 50mL withdrawal. Futher drainage of intrapericardial fluid was accompanied by slight hemodynamic improvement. 3) There were significant correlations between total pericardial fluid volume and intrapericardial and right atrial pressure (r=0.75 (p<0.005), r=0.71(p<0.01)). Correlations between intrapericardial pressure and right atrial, right ventricular diastolic and pulmonary capillary wedge pressure were also significant. 4) Two groups of patient could be distinguished based upon intrapericardial pressure as 7mmHg. More significant hemodynamic changes were in 6 patients with higher intrapericardial pressure after withdrawal of 200mL fluid. CONCLUSION: In chronic moderate to severe pericardial effusion, the most significant hemodynamic improvement occurred during initial fluid drainage. Early pericardiocentesis is important in management of pericardial effusion with high intrapericardial pressure.
Atrial Pressure ; Blood Pressure ; Cardiac Tamponade ; Compliance ; Drainage* ; Hemodynamics* ; Humans ; Pericardial Effusion* ; Pericardiocentesis ; Pericardium ; Pulmonary Wedge Pressure

We experienced a case of pedunculated left atrial primary fibrosarcoma, which obstructed the mitral orifice and produced symptoms and manifestations of mitral stenosis clinically. There was no evidence of metastasis to adjacent tissue or distant organs. It was treated by open heart surgery.
Fibrosarcoma* ; Heart Atria* ; Mitral Valve Stenosis ; Neoplasm Metastasis ; Thoracic Surgery

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

We observed the motion of left ventricular posterior wall aortic root posterior wall in 20 normal persons and 20 patients with left ventricular hypertrophy during the period from March 1985 to Agust 1985. The results were as followings; 1) The percentage of rapid filling time to one cycle of heart beat obtained from the ventriculat posterior wall motion was significantly prolonged in patients with left ventricular hypertrophy(24.1+/-5.44%) than in normal persons(13.5+/-3.69%)(p<0.05) and that of slow filling time was significantly shortend in patients with left ventricular hypertrophy(27.4+/-6.10%) than in normal persons(38.7+/-9.06%)(P<0.005). 2) The rapid filling slop obtained from left ventricular postrior wall motion was significantly reduced in patients with left ventricular hypertrophy(44.0+/-12.45mm/sec)than in normal persons(91.7+/-53.16mm/sec)(P>0.005) but the slow were not signigficantly different between the two groups. 3) The left artial emptying index calculated from the aortic root posterior wall motion was significantly lower in patients with left ventricular hypertrophy(0.6+/-0.18) than in normal persons(1.1+/-0.26)(P<0.005).
Echocardiography* ; Heart ; Humans ; Hypertrophy, Left Ventricular*

No abstract available.
Carcinoma, Squamous Cell* ; Poroma*

We compared the left ventricular ejection fraction by echocardiography with the ejection fraction determined by computerized radionuclide ventriculography in 59 patients who were admitted to the Soon Chun Hyang University Hospotal under the impression of cardiovascular disease from May 1984 to August 1985. The results were as follow : 1) In all patients the ejection fractions by both methods were significantly correlated with each other(r=0.77, P<0.001). 2) In 10 patients with ischemic heart disease the ejection fractions by both methods were not correlated significantly(r=0.42, P>0.10). 3) Except the 10 patients with ischemic heart disease, the ejection fractions by both methods were correlated significantly(r=0.87, P<0.001). 4) In conclusion, though the ejection fraction by the above 2 methods represent the left ventricular function well, the ejection fraction by echocardiography can not represent the left ventricular function precisely in patients in patients with ischemic heart disease because of abnormal left ventricular wall motion and left ventricular function more precisely than that by echocardiography.
Cardiovascular Diseases ; Echocardiography* ; Humans ; Myocardial Ischemia ; Radionuclide Ventriculography* ; Stroke Volume ; Ventricular Function, Left

The goals of treatment of the slipped capital femoral eiphysis(SCFE) are to stabilize the slipped epiphysis, prevent further slipping and induce early closure of the epiphyseal plate. Mutiple pinning was used for the treatment but in recent years, percutaneous in-situ fixation technique with 1 or 2 cannulated screws is preferred due to the advantages of low rate of complication such as pin penetration. We report the results of experimental study and the functional results after percutaneous pinning. The purpose of the experimental study was the investigation for changes of the screw length and the site of screw entry point according to the degree of slipping by bony model. The entry point of the screw was changed toward anterior and proximal portion of femoral neck and the length of inserting screw was changed to be shorter according to the degree of slip. We have treated 10 patients(13 hips) with slipped capital femoral epiphysis(SCFE) at our department since Jan. 1989. Among them, 6 patients(7 hips) could be followed for more than 2 years. There were 5 boys and 1 girl. One case was affected on the both hip. The average age at operation was 11.8 year old. All cases were obese. Degree of slipping was showed 6 cases in mild and 1 case in moderate. The slipping of acute onset was 3 cases, acute-on chronic 3 cases and chronic 1 case. In radiographic results, 6 cases were showing in Grade 0, 1 case was in Grade II. In functional results, 3 cases were excellent, 3 cases in good and 1 case in poor. One poor functional result was a case complicated by chondrolysis.
Epiphyses ; Female ; Femur ; Femur Neck ; Growth Plate ; Hip ; Humans ; Slipped Capital Femoral Epiphyses