One hundred seven consecutive patients aged 3 years to 34 years with simple ventricular septal defect were prospectively investigated with 2-dimensional Doppler echocardiography to assess the echocardiographic criteriae in defining the anatomic site of the VSD. The anatomy was confirmed in all patients at operation. Two-dimensional Doppler echocardiography correctly categorized the site and extension of VSDs in 104 of 107(97%). All doubly committed subarterial VSDs were correctly diagnosed as an area of discontinuity beneath the pulmonary valve in the parasternal short-axis plane taken at the aortic root level. Forty eight of 49 perimembranous VSDs with infundibular extension showed an area of discontinuity beneath the right aortic cusp in the parasternal long axis plane of the left ventricle. Of 17 perimembranous VSDs with trabecular extension, 16 had an area of discontinuity around the medial papillary muscle in the short axis plane taken at the level of high left ventricular outflow tract(LVOT). All 5 perimembranous VSDs with inlet extension showed an area of discontinuity adjacent to the septal leaflet attachment in the short axis plane taken at the level of high LVOT. One muscular trabecular VSD was categorized correctly by the short axis view and the apical 4-chamber view. Thus, these 2-dimensional Doppler echocardiographic criteriae are a simple and reliable in identifying the anatomic site of VSDs.
Axis, Cervical Vertebra ; Bays ; Classification* ; Echocardiography ; Echocardiography, Doppler* ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans ; Papillary Muscles ; Prospective Studies ; Pulmonary Valve

No abstract available.

Weber-Christian disease is a relapsing, febrile, nodular, nonsuppurative inflammation of the subcutaneous fat tissue. Many authors reported these cases which illustrate the great variability of the clinical manifestation, such as acute or chronic, fulminating or transient, febrile or non febrile, systemic or cutaneous. Two of our cases have had recurrent painful subeutaneous nodules without fever for several years. Biopsy showed a nonspecific inflammatory panniculitis with lymphocytes chiefly, and small amount of histiocytes and foamy cells. It should be suggested Weber-Christian disease when subcutaneous nodules appear recurrently same areas of the whole body surface except anterior aspects of tibia even if no fever as systemic manifestation. Treatment with steroid and chloroquine diphosphete produced good improvement.
Biopsy ; Chloroquine ; Fever ; Histiocytes ; Inflammation ; Lymphocytes ; Panniculitis ; Panniculitis, Nodular Nonsuppurative* ; Subcutaneous Fat ; Tibia

Erythema multiforme(EM) is an acute, self-limited eruption of the skin and mucous membrane, characterized by distinctive target lesions. Although a wide range of factors have been implicated as precipitating EM, the pathogenesis is unknown. Recently, several studies on EM have been reportecl, showing the presence of immune complexes in patient with EM, and these authors suggested that such complexes may be cf immunopathogenic significance. The atudy was undertaken to irivestigate the pathogenesis of EM. In ten patients with EM, we performed serological study and direct immunofluorescence study. The reaults obtained were as follows. 1) There was no signifir.ant abnormality in CBC, urinalysis, chest PA, stool, and serology including ASO, CH, Ig quantitation, VDRL, HBsAg, ANA, RF, and cryoglobul in. 2 In direct immunofluorescence study, 4 biopsies showed IgM deposits in the su!erficial blood vessels, 4 demonstrated C, 2 showed IgG deposition and 2 biopsies showed fibrin deposition. All biopsies were negative for lgA. Additionally 1 biopsy demonstrated IgM depnsition along the dermoepidermal junction, and 1 showed both IgG and fihrin deposition. This study supports the view that deposition of immune complexes may play a role in the pathogenesis of EM.
Biopsy

Actinomycosis is an indolent, suppurative infection caused by an anaerobic gram-positive organism (usually actinomyces israelii) which usually causes infection in the face, mediastitum, lung, and abdomen. Primary esophageal actinomycosis which is not related with pulmonary or mediastinal actinomycosis, is very rare, especially in immunocompetent host. A 58-year-old woman has been suffered from dysphagia, odynophagia, and chest pain after insertion of esophageal stent in esophageal acid stricture. She underwent a esophagectomy with esophagogastrostomy for above mentioned symptoms. Pathologic diagnosis was a esophageal actinomycosis.
Abdomen ; Actinomyces ; Actinomycosis* ; Chest Pain ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Esophagectomy ; Female ; Humans ; Lung ; Middle Aged ; Stents*

Only a few cases of cyst related to cruciate ligament were reported in the literatrure. It is not only because of rarity but also difficulty of diagnosis by conventional method. Recentely, the precise intraarticular structure of the knee joint became to be seen by introduction of MRI and arthroscope and cycts would bave been found incidentally during the workup of the internal derangement of knee. We have experienced three cases of ganglion around the cruciate ligament in the patients whose symptom was mimic of intemal derangement of knee. We excised the ganglion with good clinical results.
Arthroscopes ; Diagnosis ; Ganglion Cysts ; Humans ; Knee Joint ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Methods

For prevention of limitation of range of motion due to arthrofibrosis of the knee joint after anterior cruciate ligament reconstruction, it is accepted in general that the operation should be delayed for about three weeks after injury. We studied the duration form operation to time of full range of motion, and analized the results in forty-eight patients who had undergone arthroscopic anterior cruciate ligament recostruction using the autologous bone-patella tendon-bone graft and early CPM, range of motion exercise during Feb. 1991 and June 1994. The results were as follows: 1. The average interval from injury to operation were 1.3 weeks in acute injury group, 6 weeks in subacute injury group and 20.7 months in chronic group. The average interval from operation to full range of motion were 7.1 weeks in acute injury group, 5.7 weeks in subacute injury group and 3.0 weeks in chronic group. 2. In acute injury group, 14(93.3%) of 15 cases showed full extesion and only 1 case(6.7%) showed the limitation of extension less than 5 degrees. In subacute injury group, 6(85.7%) of 7 cases showed full extension but1 case(14.3%) showed the limitation of extension less than 5 degrees. On the other hand in the chronic injury group, all the 26 cases(100%) of the patients showed full extension. 3. In acute injury group, 14(93.3%) of 15 cases showed full flexion and only 1 cases(6.7%) showed the limitatin of flexion less than 5 degrees. In subacute injury group, 6(85.7%) of 7 cases showed full flexion but 1 case(14.3%) showed the limitation of flexion less than 5 degrees. On the other hand in the chronic injury group, 23(88.5%) of 26 cases could flex to full range of flexion, and 3 cases(11.5%) revealed limitation of flexion less than 5 degrees. 4. The limitation of ROM mainly due to arthrofibrosis can be prevented by early range of motion execise and active rehabilitation in the acute or chronic anterior cruciate ligament reconstruction using the autograft bone-patella-bone graft. Although in acute patients the interval from operation to full ROM can be prolonged, the full ROM can be achieved after all.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; Hand ; Humans ; Knee Joint ; Patella ; Patellar Ligament ; Range of Motion, Articular ; Rehabilitation ; Transplants

No abstract available.

Mitral valvular orifice area is important for the evaluation of prognosis and treatment of patients with mitral valvular stenosis. Until recently, Gorlin's formula using cardiac catheterization has been utilized in the measurement of mitral valve area, but it is invasive and impractical to examine repeatedly. Recently 2-Dimensional echocardiography appeared to be a practical and useful substitute in measurement of valve area and also it is economical and has no risk to patients. In 31 patients with mitral valvular stenosis examined at the echocardiography room of Busan national University Hospital from March 1982 to March 1983, we measured the mitral valve area with 2-Dimensional echocardiography and evaluated its relationship with the left ventricular functions measured on M-mode echocardiogram. Among many parameters on M-mode measurements EF slope, excursion amplitude and the ratio of left atrial dimension to aortic root dimension were rather helpful for the assessment of severity of mitral valvular stenosis than other parameters. And each relationship with the valve area showed correlation coefficient of 0.60, 0.05 and -0.58, respectively.
Busan ; Cardiac Catheterization ; Cardiac Catheters ; Constriction, Pathologic* ; Echocardiography* ; Humans ; Mitral Valve* ; Prognosis ; Ventricular Function, Left

We evaluate the effects of diltiazem in 19 patients with ischemic heart disease (15 patients) of classical anginal pectoris & 4 patients of variant angina) by means of clinical status & electrocardiographic changes and obtain the results as follows: 1. The pulse rate & blood pressure were decreased by diltiazem slightly but these decreases were not significant in statistical meaning. 2. Diltiazem administration of 4 weeks duration normalized EKG completely in 4 patients & partially in 3 patients among the 13 patients who showed abnormal resting EKG initially. 3. All 19 patients who received diltiazem showed clinical improvement; 9 patients had excellent responses, 7 patients good responses & 3 patients fair responses. 4. Diltiazem had side effects in 3 patients, drowsiness, mild euphoria & possibly tolerance respectively in each patients.
Angina Pectoris* ; Blood Pressure ; Diltiazem ; Electrocardiography ; Euphoria ; Heart Rate ; Humans ; Myocardial Ischemia ; Sleep Stages