BACKGROUND: Recently, Doppler echocardiography has been widely used to evaluate left ventricular(LV) diastolic filling. However, There are only limited date about the influence of LV systolic function on the pattern of left ventricular diastolic filling. METHODS: To evaluate the changes of Doppler echocardiographic parameters of left ventricular filling induced by variations in left ventricular systolic function in dilated cardiomyopathy(DC) with heart failure(HF), 25 patients(M : F=14 : 11) with DC and HF, and 21 age-matched normal subjects(M : F=13 : 8) were examined by ECG, phonocardiography and echocardiography. From the Doppler recording, A2D(time from second heart sound to the onset of early diastolic mitral flow), peak velocity at early diastole(E) and late diastole(A), ratio of E to A velocity(E/A) and flow velocity integral(FVI) were measured. RESULTS: In 22 patients with DC and HF without mitral regurgitation(MR), A2D was significantly prolonged(119.5+/-12.7 vs 92.4+/-14.1msec, p<0.01), and early diastolic peak velocity and E/A velocity ratio were decreased as compared with the normal subjects(E=0.39+/-0.08 vs 0.57+/-0.12m/sec, p<0.01, E/A : 0.87+/-0.19 vs 1.33+/-0.19 vs 1.33+/-0.18, p<0.05). There were significant correlations between A2D and FVI(r=+0.73, p<0.01), and between E/A velocity ratio and FVI(r=-0.78, p<0.01). However, in 3 patients with MR, A2D(88.7+/-12.1msec), E(0.56+/-0.05m/sec), and E/A(1.32+/-0.12) were similar to those in normal subjects, despite of decreased FVI(12.0+/-0.9cm). CONCLUSIONS: These data show that a change of left ventricular systolic function in patients without MR may influence a diastolic filling pattern of left ventricle but not in patient with MR, and suggest that MR masks left ventricular distolic filling abnormalities.
Cardiomyopathy, Dilated* ; Echocardiography ; Echocardiography, Doppler* ; Electrocardiography ; Heart ; Heart Sounds ; Heart Ventricles ; Humans ; Masks ; Phonocardiography ; Ventricular Function, Left*

No abstract available.

OBJECTIVES: This study was intended to compare psychiatric symptoms, neurocognitive function and quality of life between normal finding group and abnormal finding group on Brain-MRI. We investigated which variables were related to quality of life (QOL) in traumatic brain injury (TBI) patients. METHODS: Among thirty nine patients who had mild to moderate TBI, twenty two patients (57%) showed abnormal brain MRI findings correlated with their injury and 17 patients (43%) showed normal or nonspecific brain MRI findings. All patients completed Symptom check list-90-revised (SCL-90-R), Beck depression inventory (BDI), State-trait anxiety inventory (STAI), Korean version of the Smith Kline Beecham Quality of Life scale (KvSBQOL) and Marlowe-Crown Social Desirability Scale (MCSDS). Two psychiatrists assessed the patients using Hamilton rating scale for depression (HAMD), Hamilton anxiety scale (HAMA) and Functional assessment scale (FAS). In addition, Korean Wechsler Adult intelligence Scale (K-WAIS), Rey-Kim Memory Test (R-KMT) and Kims frontal-executive neuropsychological test (KF-ENT) were assessed. RESULTS: On FAS, the mean score was significantly lower in the abnormal finding on B-MRI group than the normal finding group (p=0.014). In the patients with abnormal MRI findings, the QOL scores significantly correlated with several subscales of SCL-90-R (obsessive-compulsive, depression, anxiety, global severity index and positive symptom total), FAS and memory quotient after controlling for MCSDS. However, in the patients with normal MRI findings, QOL scores significantly correlated with BDI and all subscales of SCL-90-R. When all pertinent variables were entered in stepwise regression analysis, depression (p<0.05) and interpersonal sensitivity (p<0.05) subscales of SCL-90-R explained 38.5% and 17.7% of the variance of the QOL score in patients with abnormal MRI findings. As for the patients with normal MRI findings, depression (p<0.05) subscale of SCL-90-R accounted for 54.2% of the variance of the QOL score. CONCLUSION: TBI patients who have persisting abnormal brain findings suffered from impaired daily functioning. Depression and interpersonal sensitivity explained 55% of the variance of the QOL together. In the patients with normal brain MRI findings, objective depression or anxiety did not correlate with QOL whereas subjective depressive symptom accounted for 54.2% of the variance of the QOL. This study suggests that subjective psychiatric symptoms including depression significantly correlated with the subjective QOL of TBI patients regardless of their brain MRI finding.
Adult ; Anxiety ; Brain ; Brain Injuries* ; Depression ; Humans ; Intelligence ; Magnetic Resonance Imaging ; Memory ; Neuropsychological Tests ; Psychiatry ; Quality of Life* ; Social Desirability

OBJECTIVES: The pharmacologic treatment of obsessive-compulsive disorder(OCD) with serotonergic antidepressant agents is well established in clinical psychiatry on the basis of serotonin hypothesis. Studies on predictive factors of treatment response to OCD are relatively scarce. The author compared the demographic factors, age of onset, length of illness, family history of mental illness, previous drug history for OCD, severity and type of symptoms between the drug responders and non-responders to find out the predicitive factors that may be related to treatment response. METHODS: The subjects were 31, both inpatients and outpatients who met the diagnostic criteria for OCD by DSM-IV and scored 20 or higher on the Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) completed 12-week trial of sertraline. Y-BOCS, National Institute of Mental Health Obsessive-Compulsive Scale(NIMHOCS), Clinical Global Impression Scale(CGI) were scored to measure the changes of obsessive-compulsive symptoms, and Hamilton Anxiety Scale(HAM-A) was measured at each visit. RESULTS: 1) The responders, defined as achieving at least a 40% decrease in the Y-BOCS total score and more than a 2 point decrease in CGI score, were 17(54.8%), and non-responders were 14(45.2%). Responders tended to show later onset(p<0.1), and shorter duration of illness(p<0.05), and less previous drug therapy for OCD(p<0.05) than non-responders. There were no significant differences in family history of mental illness between the two groups. 2) The baseline Y-BOCS compulsive score was significantly lower in responders(p<0.05), although there was no significant difference in the baseline severity of other measures. 3) The obsession of contamination and washing behaviors were more frequent, but compulsive counting was not shown, in responders(p<0.05). The pathological doubt tended to be more common in nonresponders(p<0.1). CONCLUSIONS: In summary, the patients with shorter duration of illness, less prior drug therapy for OCD, and less severe compulsive behaviors, and the obsession of contamination and washing behaviors are expected to be better outcome with sertraline, whereas compulsive counting are the predictor of poor response.
Age of Onset ; Anxiety ; Compulsive Behavior ; Demography ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy ; Humans ; Inpatients ; National Institute of Mental Health (U.S.) ; Obsessive Behavior ; Obsessive-Compulsive Disorder* ; Outpatients ; Serotonin ; Sertraline*

OBJECTIVES: Schizophrenia, one of the major mental illnesses, shows abnormal developmental patterns such as delayed developmental milestones, impaired language and motor function, and poor premorbid social adjustment long before the onset of clinical symptoms of illness. In this study, we tried to find out developmental patterns and premorbid adjustment during childhood and adolescence in Schizophrenic patients. METHODS: The subjects were 56 inpatients (26 male patients and 30 female patients) who met the diagnostic criteria for schizophrenia by DSM-IV and 52 healthy control subjects (25 male patients and 26 female patients). Interview with subjects and their families and the review of medical records were done to assess sociodemographic factors, timing of developmental milestones, language and motor function of childhood, and timing of sexual maturational events. Obstetrical Complication Scale of Lewis was used to get information on the subjects' prenatal and perinatal history, and Premorbid Social Adjustment Scale (PSAS) to assess premorbid adjustment. RESULTS: 1) There were no significant differences in the rates of obstetrical complications. The deveolpmental milestones during infancy such as sitting, walking, age of first sentence were significantly delayed in the Schizophrenics than in the controls (p<0.05). 2) Disturbances of speech and language development were significantly more common in the schizophrenics than in the controls (p<0.05), but there were no significant differences in the rates of disturbance in motor development. Mean ages of reading and writing were significantly delayed in schizophrenics than in the controls (p<0.05). No significant differences were found between males and females for either language disturbance or motor disturbance in the Schizophrenics. 3) During adolescence, premorbid adjustment was poorer in Schizophrenic patients (p<0.05). The Schizophrenic patients scored significantly worse than the controls on both sociability and schooling domains (p<0.05). There was a trend for correlation between poor premorbid functioning and early age of onset, but it failed to achieve statistical significance (Spearman's coeff =-0.27, p=.07). 4) Male Schizophrenic subjects showed poorer premorbid functioning on schooling domain than female Schizophrenic subjects (p<0.05). No significant difference was recogni ed in timing of sexual maturational events between Schizophrenics and controls. CONCLUSION: In summary, the Schizophrenics were significantly delayed in infantile developmental milestones, impaired in development of language, delayed mean age of reading and writing, and showed poorer premorbid social adjustment than the controls.
Adolescent* ; Age of Onset ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Inpatients ; Language Development ; Male ; Medical Records ; Schizophrenia ; Social Adjustment* ; Walking ; Writing

Strumal carcinoid of ovary is an unusual form of monodermal ovarian teratoma with thyroid-like follicles admixed with typical carcinoid tumor pattern. Most of them arise in dermoid cyst or in mature solid teratoma. Recently we experienced a case of strumal carcinoid postoperatively and report this case with a brief review of the concerned literatures.
Carcinoid Tumor* ; Dermoid Cyst ; Female ; Ovarian Neoplasms ; Ovary* ; Teratoma

OBJECTIVE: This study was to evaluate the association of the G1691A mutation of factor V gene with preeclamptic patients in Korea. METHODS: Factor V genotype were determined in 113 preeclamptic patients and 100 normotensive pregnant women. A 267 base-pair DNA fragment of the factor V gene that includes nucleotide 1691 was amplified by PCR. PCR product was digested with MnlI restriction enzyme and the fragments were analysed by electrophoresis using 2% agarose gel. RESULTS: The difference of genetic and allelic frequencies between two groups could not be mentioned because all women were G1691G homozygotes. There was no individuals with mutant allele among preeclamptic patients and control women. CONCLUSION: There was no evidence of association between preeclampsia and factor V gene polymor- phism in Korean population.
Alleles ; DNA ; Electrophoresis ; Factor V* ; Female ; Genotype ; Homozygote ; Humans ; Korea* ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnant Women ; Sepharose

E.S.T. is performed not only for the treatment but also for the diagnosis of biliary tract diseases. E.S.T. serves as a diagnostic aid for some of biliary tract diseases which require such procedures as a peroral cholangioscopy or biopsy of the biliary duct for precise diagnosis and further differential diagnosis. The diseases of our patients were diagnosed by clinical findings and such diagnostic maneuvers as abdominal ultrasonography, intravenous cholangiography, percutaneous transhepatic chorangiography(P.T.C.), endoscopic retrograde chorangiopancreatography(E.R.C.P.), In all the two cases, abdominal ultrasonography revealed dilated extrahepatic duct, but biliary trees were not visualized at E.R.C.P. In one of the two cases, P.T.C. revealed a filling defect with dilated common bile ducts(CBD) but we could not make a differential diagnosis of CBD stone from CBD cancer. In another of the two cases, on which intravenous cholangiography was done, we could not see CBD. For the purpuse of precise diagnosis and further differential diagnosis, we performed EST and then ERCP thraugh widened papillae. With those procedures, CBD stones were shown.
Bile ; Biliary Tract Diseases ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diagnosis, Differential ; Humans ; Ultrasonography

No abstract available.
Humans ; Nephritis, Interstitial* ; Nephrotic Syndrome*

PURPOSE: To correlate signal intensities of hepatocellular carcinomas on MR images with applied field strength, tumor vascularity, history of transarterial chemoembolization, and their histopathologic findings. MATERIALS & METHODS: Twenty-two tumors in 18 patients with histologically proved hepatocellular carciomas were examined by MRI at 0.5T(14), 1.5T(5), or 2.0T(3). Tumor size ranged from 1 cm to 10 cm. We analyzed the signal intensities, presence of pseudocapsule and mosaic pattern of hepatocellular carcinomas on TI-, T2- and heavily T2-weighted images, and correlated them with histologic type and grade, as well as tumor vascularity on hepatic arteriography. RESULTS: Signal intensities of the tumors were hyperintense(6), isointense(11), or hypointense(5) on Tl-weighted images, hyperintense(21) or isointense(1) on T2-weighted images, and hyperintense(15) or isointense(3) on heavily T2-weighted images. There were hypointense tumors(3/13) on Tl-weighted MR images at 0.5 T, whereas they were absent at 2.0 T(0/4). Only one tumor was avascular which was hyperintense on Tl-weighted images. Capsules were present in 13 cases and Tl-weighted images depicted them in 10 cases, while T2-weighted images depicted them in 8 cases. Mosaic patterns with inhomogeneous signal intensity were present in 15 cases, and were seen in 7 cases on Tl-weighted images whereas 11 cases on T2-weighted images. Mixed trabecular and pseudoglandular patterns of histologic growth were seen in 5 tumors. On MR images, trabecular portion was seen as hypointense area on Tl-weighted images and hyperintense on T2-weighted images. Pseudoglandular portion was seen as isointense or hyperintense area on Tl-weighted images and as marked hyperintense and on T2-weighted images. Mixed cytologic feature of classic and clear cell was found in 4 tumors and three of these 4 cases were hyperintense on Tl-weighted images. Four of the six tumors with grades I-II were hyperintense on Tl-weighted images. Tumors with grades II-Ill, Ill-IV were 14 cases, and only two of these cases showed hyperintensity on Tl-weighted images. Peliotic change was present in one case, and was seen as hyperintense foci on T2, & heavily T2-weighted images. CONCLUSION: Pathologic correlation suggest that hyperintensity on Tl-weighted images might be due to pseudoglandular pattern, low grade of malignancy or clear cell portion of hepatocellular carcinoma. Marked hyperintensity on T2-weighted images may be due to pseudoglandular pattern or peliotic change.
Angiography ; Capsules ; Carcinoma, Hepatocellular* ; Humans ; Magnetic Resonance Imaging*