OBJECTIVE: Although cor pulmonale due to chronic lung disease was not uncommon, there was uncertainty in its diagnosis due to the difficulty in measuring functional and anatomical changes of right heart and pulmonary vascular system. Among various non-invasive diagnostic methods presented so far, no ideal standard diagnostic criterion has been established. The authors attempted to know positive diagnostic ratio of cor pulmonale and to study the presence of the relationship between these diagnostic criteria when electrocardiographic and echocardiographic diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease. And we investigated the usefulness of echocardiogaphic diagnostic criteria for the diagnosis. METHODS: One electrocardiographic and two echocardiographic diagnostic criteria were applied to 38 patients with chronic lung disease(21 pulmonary emphysema and 17 chronic advanced pulmonary tuberculosis) for the diagnosis of cor pulmonale. Comparison was also made in their relationship. Then pulmonary artery diameter, measurement of pulmonary function test and echocardiographic examination and radio-nuclear right ventricular ejection faction were compared between the groups to ensure each criterion was satisfied. RESULTS: 1) When the three diagnostic criteria for confirming the cor pulmonale, electrocardiographic rriterion(right ventricular hypertrophy), right ventricular dimension criterion(right ventricular end-diastolic dimension>25mm, RVDd>25mm), and right ventricular wall thickness criterion (right ventricular wall thickness>6mm, RVWT>6mm) were applied to the patients, the positive rate were 32%(12/37), 30%(10/33) and 17%(6/36) respectively. A statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion was found to exist. 2) Various parameters of pulmonary function test and echocardiographic examination were compared in the patient groups with and without cor pulmonale when each non-invasive diagnostic criterion was applied to all patients. Followings are the results. (1) In the positive group on electrocardiographic criteria, vital capacity, forced vital capacity, and arterial oxygen tension were significantly smaller than in the negative group on electrocardiographic criterion(p<0.05), and the echocardiographic parameters of right ventricle, ie. end-diastolic area, end-systolic area, end-diastolic dimension, end-systolic dimension, mid-ventricular short axis and maximal short axis in positive group were significantly larger than in the negative group. (2) In the positive group on right ventricular diastolic dimension criterion(RVDd>25mm), percentage forced expiratory volume in 1 second and forced expiratory flow 25-75% were significantly smaller than in the negative group on right ventricular diastolic dimension criterion. (3) In the positive group on right ventricular wall thickness criterion(RVWT>6mm), vital capacity, forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow 25-75% and arterial oxygen tension were significantly smaller than in the negative group on right ventricular wall thickness criterion. CONCLUSION: When several non-invasive diagnostic criteria for cor pulmonale were applied to the patients with chronic lung disease, there were some differences in its positive diagnostic ratio depending on the applied diagnostic criteria. There was also a statistically significant correlation between electrocardiographic criterion and right ventricular wall thickness criterion. When each diagnostic criterion was applied to the patients, significant differences were found in several parameters resulted from pulmonary function test and echocardiographic examination based on presence or nonpresence of cor pulmonale. But no difference in the ejection fraction measured by radio-nuclear method was shown between cor pulmonale group and non cor pulmonale group. Consequently it was suggested that applying echocardiographic criteria in addition to electrocardiographic criterion for the diagnosis of cor pulmonale in the patients with chronic lung disease is clinically useful.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Electrocardiography ; Forced Expiratory Volume ; Heart ; Heart Ventricles ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Artery ; Pulmonary Emphysema ; Pulmonary Heart Disease* ; Respiratory Function Tests ; Uncertainty ; Vital Capacity

The structures forming the shoulder joint are very complex and the biomechanical effects of them on the joint are not clearly lunderstood. Frequently the long head of the biceps brachii muscle is dislocated naturally and it has been said that the supratubercular ridge, the depth, and angle of medial wall of the intertubercular groove are important. And the angles between the long axis of the humerus and the axis of head and neck are important clinically. So the authors studied them in the 105 specimens of the Korean adults humerus. The results are as follows: 1. The complete type of the supratubercular ridge was present in 22.9% and the partial type was in 53.3% 2. If the ridge was present, the spur of the lesser tubercle was present in 67.5% and if not present, the spur was in 8%. 3. The angle of medial wall of the intertubercular groove was variable, and the angle less than 45 was 13.41°. 4. The angles between the long axis of the humerus and the axis of head and neck were much greater in male than female (P<0.05). 5. The average diameter of the head of the humerus was 4.42±0.4cm in male and 4.4±0.4cm in female (P < 0.05).
Adult ; Female ; Head ; Humans ; Humerus ; Joints ; Male ; Neck ; Shoulder Joint

No abstract available.
Blood Donors* ; Humans

A 70 years old female patient with thyroid cancer received palliative radiation therapy for neck swelling and hemoptysis. She had a cardiac pacemaker under her chest due to complete AV block since 8 years ago. We present clinical detail and review previously reported articles.
Aged ; Atrioventricular Block ; Female ; Hemoptysis ; Humans ; Neck ; Radiotherapy* ; Thorax ; Thyroid Neoplasms

BACKGROUND: Decreased heart rate variability(HRV) has been shown to be an independent predictor of poor outcome after acute myocardial infarction, Spectral analysis of HRV has recently been shown to be a reliable noninvasive test for quantiative assessment of cardiovascular autonomic regulatory response. We estimated the reproducibility and circadian rhythm of HRV parameters in patients with acute myocardial infarction. METHODS: Three consecutive 24-hour ambulatory electrocardiographic recordings were made in 24 patients with acute myocardial infarction, with 10~14 days after the acute attack, and analyzed for HRV parameters of both frequency and time domains. Parameters of frequency domain include low frequency(LF) and high frequency(HF) components. Parameters of time domain include sdRR, SDANN, SD, pNN50, rMSSD, HRV index. RESULTS: Mean total, low frequency and high frequency amplitude spectral densities were 33msec, 19msec and 11msec, respectively. Mean values of sdRR, SDANN, SD, rMSSD, pNN50 and HRV index were 103msec, 90msec, 47msec, 28msec, 7% and 32, respectively. Coefficients of variation(CV) of total amplitude spectral density, and low and high frequency components were 7%, 9% and 12%, respectively. CV of most HRV parameters of time domain were also around 10% except rMSSD and pNN50. Heart rate increased in the morning to be sustained during the day time and decreased in the night. Heart rate variability of high frequency component decreased in the early morning to be sustained during day time with increase in the night. CONCLUSIONS: We conclude that in the predischarge period of acute myocardial infarction, HRV parameters of frequency and time domains are reproducible and there are some morning fall of cardiac vagal activity.
Circadian Rhythm ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Myocardial Infarction*

In brachytherapy of uterine cervical cancer using the high dose rate remote afterloading system, it is of prime importance to determine the position of the radiation sources and to estimate the irradiation time. However, calculation with manual method is so time consuming and laborious, that authors designed a software as an aid to intracavitary radiotherapy planning using the personal computer to obtain the precision of treatment without being too complicated for routine use. Optimal source arrangement in combination with dose rate at each specific points and irradiation time can be easily determined using this software in several minutes.
Brachytherapy* ; Microcomputers ; Radiotherapy ; Uterine Cervical Neoplasms*

In electron therapy, lead cutout or low-melting alloy block is used for shaping the field. Material for shaping electron field affects the output factor as well as the collimation system. The authors measured the output factors of electron beams for shaped fields from Clinac-18 using ionization chamber of Farmer type on polystyrene phantom. They analyzed the incident energy, collimation system and size of shaped field. For shaped field the variation of output factor for the field (A/P) has appearance of a smooth curve for all energy and all applicator collimator combination. The output factors for open field deviate from the curves for shaped fields. An output factor for a given field can be calculated by equivalent field method such as A/P method, if a combination of applicator and collimator is fixed.
Alloys ; Polystyrenes

Whole brain irradiation is one mode in the treatment of brain cancer and brain metastasis, but it might cause brain injury such as brain necrosis. It has been studied whether the dose distribution could be a cause of brain injury. The dose distribution in whole brain irradiated by Co-0 beam has been measured by means of calibrated TLD chips inserted in the brain of Humanoid phantom. The following results were obtained. 1. Dose distribution on each transverse section of the brain was uniform. 2. On the midsagital plane of the brain, the dose was highest in upper portion and lowest in lower portion, varying 8 from 104% to 90%. 3. When the radiation field includes free space of 2cm or more width out of the head, the dose distribution in the whole brain is almost independent of the field width. 4. It is important to determine adequate shielding area and to set shielding block exactly in repetition of treatment.
Brain Injuries ; Brain Neoplasms ; Brain* ; Head ; Necrosis ; Neoplasm Metastasis ; Radiotherapy*

Several combinations of measuring devices and phantoms were studied to measure electron beams. Silicon PN junction diode was used to find the dependence of depth dose profile on field size on axis of electron beam Depths of 50, 80 and 90% doses increased with the field size for small fields. For some larger fields, they were nearly constant. The smallest of field sizes over which the parameters were constant was enlarged with increase of the energy of electron beams. Depth dose distributions on axis of electron beam of 10 x 10 cm2 field were studied with several combinations of measuring devices and phantoms. Cylindrical ion chamber could not be used for measurement of surface dose, and was not convenient for measurement of near surface region of 6 MeV electron. With some exceptions, parameters agreed well with those studied by different devices and phantoms. Surface dose in some energies showed 4% difference between maximum and minimum. For 18 MeV, depths of 80 and 90% doses were considerably shallower by film than by others. Parallel-plate ion chamber with polystyrene phamtom and silicon PN junction would be recommended for measurement of central axis depth dose of electron beams with considerably large field size. It is desirable not to use cylindrical ion chamber for the purpose of measurement of surface dose or near surface region for lower energy electron beam. It is questionable that film would be recommended for measurement of dose distribution of electron with high energy like as 18 MeV.
Axis, Cervical Vertebra ; Polystyrenes ; Silicones

The clincal investigation have been performed on the effect of vistamycin in the field dof pediatric infection and the following results were obtained. 1. As for the effect of vistamycin, excellent in 3 cases, good in 13 cases, fair in 4 cases, no response in 5 cases. The effectiveness rate was 80%. 2. No noticeable side effects were observed concerning allergic reaction, neurotoxicity, hepatorenal toxicity, and blood toxicity.
Hypersensitivity ; Pediatrics*