No abstract available.

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

No abstract available.

Osteoma is a slow-growing benign tumor composed of mature bone. Osteoma of the nose and paranasal sinuses is usually asymptomatic and most commonly occurs in the frontal sinus, followed by the ethmoidal and maxillary sinus. The occurrence in the sphenoidal sinus and nasal cavity is very rare. We present a case report of a patient with an isolated osteoma in the right nasal cavity presenting with nasal obstruction.
Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity* ; Nasal Obstruction ; Nose ; Osteoma* ; Paranasal Sinuses

Acoustic stimulation test(AST), is currently being used as an alternative tool of nonstress test (NST). However, there are no standard guideline for analysis of AST. Computerized numerical analysis of AST would be helpful for development of diagnostic criteria of AST. Fifty-one normal pre-term pregnancies entered to this study after conventional 20-minutes NST and 10-minutes AST. Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. The loss of signal was increased about 2 fold(122.61%). The baseline FHR was increased from 144.57bpm to 156.81bpm(8.5%) after acoustic stimulation. Number of fetal movements was increased about 2 fold(from 2.1 to 4.12/10 minutes). FHR variability was also increased from 17.81 bpm to 26.37 bpm. After AST, number of FHR accelaration was increased 55.47%(10sec 10bpm) and 68.42%(15sec 15bpm), respectively. In this study, we acrumulated elemental FHR data using computerized system after AST. These data would be helpful in the accurate analysis of AST and also enable us to develop the objective interpretation system for AST.
Acceleration ; Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

No abstract available.
Free Tissue Flaps*

Thirty-seven patient who had forearm bone fracture were treated by four different methods at the Department of Orthopedic Surgery, Soonchunhyang University Hospital from Jan. 1979 to March 1982. The obtained results are as follow; 1. Nineteen cases out of 37 cases of the forearm bone fracture were both forearm bones, 10 cases were ulna and 8 were radius fracture. 2. Twenty-three cases out of 37 were closed and 13 cases were open fracture, respectably. 3. The applied treatment were manual reduction with cast immobilization, intramedullary naliing, plate and screw fixation and combined. 4. Mean duration of primary bone union of the forerm bone fracture which were treated by plate and screw was 12. 4 weeks, combined fixation was 12.8 weeks, intramedullary nailing was 15.3 weeks and that of manual reduction and cast was 16 weeks in order. 5. Functional result was classified according to the rating system of Smith and Sage. The best method was plate and screw and the worst was manual reduction and cast immobilization. 6. D.C.P. fixation seems to be one of the best method in this series. Combined method, in a way of D.C.P. for radius and I–M nailing for ulna, is a method when shortening of operation time is inevitable.
Adult ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Immobilization ; Methods ; Orthopedics ; Radius ; Radius Fractures ; Ulna

Surgical resection is the best treatment for operable metastatic liver cancer. Large metastatic cancer usually has low operability, so a debulking modality of mass is needed to increase operability. Chemotherapy and radiotherapy were commonly used as neoadjuvant treatments. Cyberknife stereotactic radiosurgery systems were only considered as one of the palliative treatment modalities for inoperable or surgically complex tumors. But, in this case, we applied Cyberknife as the preoperative debulking modality for large hepatic metastasis of adrenocortical carcinoma. After Cyberknife treatment 3 cyclex2,700 cGY, tumor size decreased (metastatic liver mass decreased to 15x9 cm from 19x12.5 cm, adrenal mass decreased to 5x3 cm from 7.4x4.5 cm). We could then resect the tumor completely by extended right hemihepatectomy & right adrenalectomy. A preoperative multidisciplinary approach, including chemotherapy and radiation therapy can be considered to increase operability. So, cyberknife can be considered an additional modality as a neoadjuvant radiotherapy.
Adrenalectomy ; Adrenocortical Carcinoma ; Liver ; Liver Neoplasms ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Palliative Care ; Radiosurgery

BACKGROUND: To evaluate the efficacy of transesophageal echocardiography(TEE) to detect left atrial thrombi(LAT) and to investigate the clinical and echocardiography parameters which related with LAT. METHOD: We performed TEE and TTE simultaneously to 98 consecutive patients who had native mital valve disease or mital prosthesis as usual method. We examined the presence and location of LAT and spontaneous contrast(SC) in TEE and measured left atrial dimension(LAD), ejection fraction(EF), mital valve area(MVA) in TTE. Cardiac rhythm, history of anticoagulation and systemic embolization were also reviewed. We compared such parameters in LAT positive/negative groups and SC positive/negative groups. RESULTS: 1) In TEE, we detected 26 cases of LAT, among them seventeen cases : left atrial appendage(LAA) thrombi, 3 cases : combined LA and LAA thrombi, 6 cases : LA thrombi. In TTE, six cases showed LAT but we couldn't detect LAA thrombi. The difference between two methods was statistically significant(p<0.05). 2) LAT positive group showed larger LAD, lower EF, and higher prevalence of AF, systemic embolization, and LAT than negative groups(p<0.01). 3) SC positive group showed larger LAD, lower EF, higher prevalence of AF, systemic embolization LAT than SC negative groups(p<0.05). 4) In multiple discriminant analysis, the history of systemic embolization was most important factor which can suspect LAT(Wilk's Lambda:0.77152. p<0.0001). SC, EF, presence of AF, LAD, anticoagulation therapy. MVR were also statistically valuable factors in order. The hit ratio of this analysis was 86.84%. CONCLUSION: We can suggest that TEE is very useful method to detect LAT than TTE, and the spontaneous contrast was very important factor which can suggest LAT and systemic embolization in mitral valve disease.
Echocardiography ; Echocardiography, Transesophageal* ; Humans ; Mitral Valve ; Prevalence ; Prostheses and Implants

Cystic parathyroid adenoma is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. This type of adenoma tends to cause increased serum level of parathyroid hormone and alkaline phosphatase, similar serum calcium level when compared to those of solid adenoma. Thanks to current radioimmunoassay and easy accessibility to serum autoanalyzer, serum calcium level and parathyroid hormone level are more easily measured, which in turn lead to more easier diagnosis of hyperparathyroidism. Also improvement in imaging and nuclear diagnostic method of parathyroid lesion are suggested to enable easy diagnosis of cystic parathyroid adenoma. A 35-year-old male presented with easy fatigability for 12 months. The serum calcium, phosphate, alkaline phosphotase were 11.5mg/dL, 1.4mg/dL, 194IU/L respectively and his parathyroid hormone level in serum was 126.42pg/mL. Neck CT showed enlargement of right lobe of thyroid gland with well defined inhomogenously enhanced density inside the right thyroid gland. The patient was diagnosed of hyperparathyroidim due to parathyroid adenoma and was surgically removed. The surgical biopsy showed cystic parathyroid adenoma. After operation his general condition was improved and serum calcium, phosphate, parathyroid hormone level were normalizd. We report a case of hyperparathyroidism caused by cystic parathyroid adenoma with brief review of literature.
Adenoma ; Adult ; Alkaline Phosphatase ; Biopsy ; Calcium ; Diagnosis ; Humans ; Hyperparathyroidism* ; Male ; Mediastinum ; Neck ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Radioimmunoassay ; Thyroid Gland