The pulse transmission times measured from polygraphic recordings of cardiac events were studied in 52 cases of female hyperthyroidism and 60 cases of normal females. The pulse transmission times measured in this study were M1-S, R-S and C-S intervals, i.e., the time intervals from the mitral first sound, the R wave of an electrocardiogram and the onset of the upstroke of the ventricular contraction in an apexcariogram to the finger tip, respectively, and the A2-C interval, and interval from the aortic second sound to the finer tip. The M1-S, R-S and C-S intervals, which were measured during systole, were significantly shortened in proportion to the severity of the disease, whereas the A2-C interval, which was a measurement during diastole, was well within normal limits. By correcting these observed values for the heart rate, the A2-C interval became significantly longer than in the control, apparently in proportion ot the severity of the disease. The M1-S, R-S and C-S intervals, however, were normalized by the correction. In the analysis of the correlation of these observed values to the age and the various hemodynamic parameters, it was noted that the A2-C interval was negatively correlated to the diastolic and mean blood pressure, which tended to be low in this condition, and was positively correlated to the age, but had no correlation to the heart rate or the systolic blood pressure. The A2-C interval also showed positive and negative correlation to left ventricular ejection time/isovolumic contraction time ratio and preejection period/left ventricular ejection time ratio, respectively. On the contrary, there was a tendency for the remaining intervals measured during systolic to be negatively correlated to the systolic blood pressure, which tended to be high, heart rate and age, as well as systolic time intervals. These facts suggested that the shortening of the M1-S, R-S and C-S intervals was caused primarily by the rapid heart rate and also by the systolic hypertension. It was strongly felt that the A2-C interval was of a limited value as an index of the pulse transmission in hyperthyroidism.
Blood Pressure ; Diastole ; Electrocardiography ; Female ; Fingers ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Hyperthyroidism* ; Systole

Statistical analysis of 18,211 cases of electrocardiogram which were recorded in Chung-Ang University Hospital from January 1969 to December 162% of total cases(61% of male and 63% of female) and the incidence of normal electrocardiogram was decrease with aging. 2) Abnormal Q-wave was seen in 0.4% of total cases(0.5% of male and 0.3% of female) and the incidence of abnormal Q-wave was more common over 50 years of age. 3) Left axis deviation was seen in 1.1% of total cases(1.4% of male and 0.9% of female) and the incidence of left axis deviation was more common over 50 years of age. Right axis deviation was seen in 0.3% of total cases(0.3% of male and 0.4% of female) and the incidence of right axis deviation was more common under 30 years of age. 4) Left ventricular hypertrophy was seen in 3.6% of total cases(4.8% of male and 2.5% of female) and the incidence of right ventricular hypertrophy was more common under 30 years of age. 5) ST-segment depression was seen in 2.0% of total cases(2.2% of male and 1.9% of female) and the incidence of ST-segment depression was increased with aging. 6) T-wave inversion was seen in 1.6% of total cases (1.5% of male and 1.7% of female) and the incidence of T-wave inversion was increased with aging. 7) Atrioventricular block was seen in 1.4% of total cases(1.8% of male and 1.0% of female) and the incidence of atrioventricular block was more common over 50 years of age. 8) Incidence of complete left bundle branch block was 0.2% and was more common overs 60 years of age. Incidence of complete right bundle branch block was 1.1% and the incidence was more common over 50 years of age. Incidence of incomplete right bundle branch block was 3.0% and the incidence was more common under 40 years of age. 9) The incidence of premature beat was 2.7% of total cases, atrial fibrillation 1.5%, supraventricular tachycardia 0.2%, sinus tachycardia 7.5%, sinus bradycardia 2.2% and sinus arrhythmia 2.3%. 10) Low voltage was ssen in 3.8% of total cases and the incidence of low voltage was more common over 50 years of age.
Aging ; Arrhythmia, Sinus ; Atrial Fibrillation ; Atrioventricular Block ; Axis, Cervical Vertebra ; Bradycardia ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Depression ; Electrocardiography* ; Humans ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Tachycardia, Sinus ; Tachycardia, Supraventricular

The present study has been undertaken to investigate the values of serum lipids with hypertension and ischemic heart diseases. Serum lipids and lipoproteins were measured from 231 cases of hypertension, 23 cases of angina pectoris, 18 cases of acute myocardial infarction and 67 healthy adults together with normal value as controls. The results obtained were as follows: 1. The mean values of serum lipids in healthy adults were 111.0+/-41.3mg% for triglyceride, 171.2+/-33.5mg% for cholesterol, 175.1+/-36.3mg% for phospholipid, 479.9+/-82.6mg% for total lipid. The values of serum lipoproteins were 219.8+/-46.8mg% for beta-lipoprotein, 93.4+/-53.8mg% for pre beta-lipoprotein and 164.1+/-40.8mg% for alpha-lipoprotein. The values of cholesterol, triglyceride and beta-lipoprotein were gradually increased with aging. 2. The mean values of serum lipids in patients with hypertension were 176.3+/-94.5mg% for triglyceride, 199.7+/-36.9mg% for cholesterol, 207.8+/-38.0mg% for phospholipid, 601.9+/-139.9mg% for total lipid. The values of serum lipoproteins were 266.0+/-73.5mg% for beta-lipoprotein, 147.7+/-89.5mg% for pre-beta-lipoprotein and 187.7+/-56.7mg% for alpha-lipoprotein. The serum lipid values in patients with hypertension were significantly higher than those in healthy controls. 3. The mean values of serum lipids and lipoproteins in patients with angina pectoris were significantly higher than in healthy controls. 4. The serum lipid values in general were higher rather in patients with acute myocardial infarction than healthy controls, but the values of serum phospholipid, pre-beta-lipoprotein and alpha-lipoprotein in them were not significantly higher than those in healthy controls. 5. The values of serum HDL-cholesterol in patients with hypertension, anginal pectoris and acute myocardial infarction were lower than those in healthy controls. The values of serum HDL-cholesterol in all cases were in general higher rather in femal than male.
Adult ; Aging ; Angina Pectoris ; Cholesterol ; Humans ; Hypertension* ; Lipoproteins ; Male ; Myocardial Infarction ; Myocardial Ischemia* ; Reference Values ; Triglycerides

Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Diagnosis ; Epidural Abscess* ; Follow-Up Studies ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Myelitis* ; Neck ; Paresis ; Sensation ; Spinal Cord ; Spine

Sacroiliac joint infection is relatively rare and difficult in differential diagnosis with other spinal disorders. Delay in diagnosis is frequent which causes an increased morbidity. The authors reviewed clinical courses of the patients who were treated for pyogenic sacroiliac joint infection from January 1985 to April 1997. Investigation included physical examination, bone scan, biopsy, ESR, plain radiography, CT scan, and MRI. The diagnosis was made on clinical findings and a positive results of the above investigation. There were 17 pyogenic arthritis. Six patients had all symptoms of triad(fever, unilateral buttock pain, limping gait) and fifteen patients had typical buttock pain. Increased ESR(>20mm/hr) was noticed in fourteen patients. In all seventeen cases, skeletal scintigraphy and Gaenslen test were positive. Also CT scan and MRI study were helpful in diagnosis of the sacroiliac joint infection. Pus culture could be done in twelve cases and staphylococcus aureus was found in seven cases. Conservative treatment was performed in eleven cases, and operation in six cases. Fifteen cases were recovered and two cases relieved.
Arthritis ; Biopsy ; Buttocks ; Diagnosis ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Physical Examination ; Radiography ; Radionuclide Imaging ; Sacroiliac Joint* ; Staphylococcus aureus ; Suppuration ; Tomography, X-Ray Computed

No abstract available.

INTRODUCTION: The fixation strength of transpedicular screw system in the vertebral hody relied on bone quality and anatomical characteristics of vertebral pedicle, designs of screw and types of connection(rod or plate) with screw. The purpose of this study is to verify the biomechanical nature of the transpedicular fixation in spine under various conditions with porcine vertebrae. MATERIAL AND METHOD: Fresh porcine vertebrae and the custom-made screws were used in this experiment. To reduce the errors caused by vertebral bodies of different size and quality, vertebral bodies having regular range of pedicular width(10.0 to 11.5mm) and hone density(more than 1.0 gm/cm2) were used. The pedicle screws were inserted in the same procedure and axial pull out test was performed with using the Material Testing System(lntron8511, Canton, USA). The experiments were performed in four types to assess the difference of strength accroding to designs of the screw hy using two group of screws. The first group of screw was designed according to the outer and inner diameter and the second group was designed according to the shape, pitch, and thread profile of screw. Experiment I was perfomed to evaluate the effect of screw diameters on the biomechanical pull-out strength hy using the first group of custom-made pedicle screw which fixed all other factors except the diameter of screw. Experiment I was to verify the effect of screw shape, experiment III to verify the effect of pitch and experiment IV to verify the effect of thread profile. RESULTS: The results of experiments were summarized as follows: Experiment I showed that the screw of larger outer diameter had greater holding strength. Experiment II showed that the holding strength of cylindrical shaped screw is superior to that of conical shaped screw. Experiment III showed that there is no statistical significance between different modes of pitch. Experiment IV showed that the holding strength of buttress shape of thread profile is superior to that of V-shape. CONCLUSION: It seemed that the fixation strength of the screw was more powerful with 1 mm increment of outer diameter in 4-7mm of outer diameter, 3mm of pitch and buttress shape of thread of the screw with the same operation technique.
Spine

BACKGROUND: Exercise testing is an importnat diagnostic and prognostic procedure in the assessment of patients with ischemic heart disease. But standard ST-segment depression criteria was not high enough to estimate coronary srtery disease. Recently, the heart rate adjustment of ST segment depression, ST segment/heart rate slope and index, have been proposed as a more accurate criteria for diagnosing significant coronary artery disease. The objective of this study was to compare the discriminating power of proposed ST segment/heart rate slope and index with that of a standard method of assessing exercise-induced ST segment depression for estimating coronary artery disease. METHODS: Sixty nine patients with ischemic heart disease were studied with exercise treadmill testing and coronary angiography. Computer-measured ST-segment amplitudes were obtained and analysis of the heart rate-adjusted ST segment depression(ST/HR slope and big up tri, Delta ST/HR index) was done. The sensitivity, specificity, and extent of coronary artery disease on each criteria were compared. RESULTS: 1) The sensitivity of big up tri, Delta ST/HR index partition of 1.6uV/beats/min was slightly higher(83%) and the specificity of ST/HR slope partition of 2.4uV/beats/min was higher(87%) than the standard exercise electrocardiographic criteria. 2) Early onset of ischemic ST-segment depression, profound ST-segment depression(> or =2mm), and downsloping ST-segment were associated with more extensive coronary artery disease. 3) On ST/HR slope, no CAD was 1.7+/-0.26uV/beats/min, one vessel disease was 2.6+/-0.34 uV/beats/min, two vessel disease was 2.7+/-1.36uV/beats/min, one vessel disease was 2.8+/-0.35uV/beats/min, and on big up tri, Delta ST/HR index, no CAD was 1.8+/-0.38uV/beats/min, one vessel disease was 2.8+/-1.36uV/beats/min, two vessel disease 3.4+/-1.44uV/beats/min, and three vessel disease was 3.7+/-2.95uV/beats/min. The increment of ST/HR slope and big up tri, Delta ST/HR index were associated with the coronary artery disease and its severity, but the correlations were not high enough. CONCLUSION: The heart rate adjustment of ST segment depression was not high enough for improved detection of coronary artery disease, compared with standard ST-segment depression criteria. But these indexes can be improved the clinical usefulness of the treadmill exercise test for coronary aretry disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Depression* ; Electrocardiography ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Myocardial Ischemia* ; Sensitivity and Specificity

Clinical observation was done on 302 cases of cerebrovascular accidents admitted at Sung-Sim hospital, Chung-Ang University from January, 1968 to August, 1976. 1) Of 302 cases of cerebrovascular accidents, the incidence of cerebral hemorrhage was 28.8, cerebral thrombosis 47,7 Subarachnoid hemorrhage 20.2% and cerebral embolism 3.3%. 2) The peak age incidence was in the fifth decade in cerebral hemorrhage, subarachnoid hemorrhage, whereas in cerebral thrombosis, it was in the sixth decade. 3) The most frequent predisposing factor in cerebral hemorrhage and subarachnoid hemorrhage were physical activity and emotional stress, whereas in thrombosis and embolism, it was rest. 4) Among disease preceding the onset of cerebrovascular accidents, hypertension were presented 65.4% in cerebral hemorrhage, 63.6% in cerebral thrombosis, 56.6% in subarachnoid hemorrhage and valvular heart disease was presented 40.0% in cerebral embolism. 5) Serum cholesterol level over 200mg% was seen in 33.0% of cerebrovascular accidents. 6) Leukocytosis was seen 58.6% of cerebrovascular accidents which was predominantly found in the hemorrhagic group. 7) The pressure of cerebrospinal fluid was elevated in 61.7% of cerebrovascular accidents, predominantliny the hemorrhagic group. 8) The peak duration of admission was present in 51.7% of cerebrovascular accidents within 7 days and mortality rate during hospitalization was 38.0% in cerebral hemorrhage, 10.4% in cerebral thrombosis and 27.8% in subarachnoid hemorrhage. 9)The mortality rate during hospitalization was 35.3% in all cerebrlavascular accidents within 24 hours.
Causality ; Cerebral Hemorrhage ; Cerebrospinal Fluid ; Cholesterol ; Embolism and Thrombosis ; Heart Valve Diseases ; Hospitalization ; Hypertension ; Incidence ; Intracranial Embolism ; Intracranial Thrombosis ; Leukocytosis ; Mortality ; Motor Activity ; Stress, Psychological ; Stroke ; Subarachnoid Hemorrhage

We evaluated MR imaging of spondylolytic spondylolisthesis degenerative spondylolisthesis and retrolisthesis in 14, 9 and 20 patients respectively. Sagittal and axial spin echo and gradient echo images were obtained with 25-30cm FOV and 5mm/0.5mm thickness/gap by using spine surface coil. Sagittal images showed defects of pars interarticularis just inside of the pedicles of spines in all the cases of spondylolytic spondylolisthesis with relatively variable signal intensity. Displaced vertebrae were commonly observed at L5 (8/14) in spondylolytic spondylolisthesis, at L4 (5/9) in degenerative spondylolisthesis and at variable locations in retrolisthesis. The mean length of displacement of vertebrae in spondylolytic spondylolisthesis was about 7mm and less displacement was onserved in degenerative spondylolisthesis and retrolisthesis. Seven, four and six cases of pseudobulging of disk at displaced level were observed in cases of spondylolytic spondylolisthesis, degenerative spondylolisthesis and retrolisthesis respectively. Seven, five and 14 cases of true disk lesions were onserved in cases of spondylolytic spondylolisthesis, degenertive spondylolisthesis and retrolisthesis respectively. Grade II neural foraminal stenoses (obliteration of one half epidural fat of neural foramen) were commonly (8/14) seen in spondylolytic spondylolisthesis, however the other two types showed less severe neural foraminal stenosis. In conclusion, MR imaging is a highly accurate method for the diagnosis and evaluation of spondylolisthesis and associated lesions of spine and disks.
Constriction, Pathologic ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Methods ; Spine ; Spondylolisthesis*