Transmitral left ventricular diastolic inflow velocities determined by pulsed Doppler in 47 normotensives, 80 hypertensives and 44 age-matched hypertensives were measured to evaluate the effects of age and left ventricular hypertrophy on left ventricular diastolic fuction in normotensives and hypertensives. The results were as follows: 1) The peak E velocity in normotensives(77.82+/-13.53cm/sec) was significantly different from those of hyeprtensives(58.13+/-11.80cm, p<0.01) and age-matched hypertensives(59.31+/-10.94cm/sec, p<0.01). The peak E/A in normotensives(1.31+/-0.45) was significantly different from those of hypertensives(0.83+/-0.21,p<0.01) and age-matched hypertensives(0.83+/-0.20, p<0.01). 2)In normotensives, simple linear regression analysis revealed strong inverse correlations of peak E with age(r=-0.758, p<0.01), peak E/A with age(r=-0.748, p<0.01), but no significant correlation of peak E and peak E/A with LVMI(p>0.05). Stepwise regression analysis revealed that age was the most important correlate of peak E and peak E/A in normotensives(peak E: R
Heart Diseases ; Hypertrophy, Left Ventricular* ; Linear Models

Most ectopic pregnancies occur in the fallopian tubes. There have been numerous theories to explain the occurrence of ectopic pregnancy in fallopian tubes. The most commonly held view is that the passage of the fertilized ovum through the fallopian tube is delayed or hindered by chronic inflammation and its sequelae. We designed a study to evaluate the details of histopathologic changes and the location of implantation and how they relate to the clinical history. 182 fallopian tube specimens from patients who had undergone total or partial salpingectomy were examined. A high incidence of non-specific inflammation of plicae and wall of tube (31.9%) and salpingitis isthmica nodosa (12.6%) were observed. Other associated findings included acute salpingitis, complex plicae or complex hyperplasia of tubal epithelium, fibrous adhesion with ovary, endometriosis, and calcification. History of previous ectopic tubal pregnancy was found in 8 cases. The cases with serum beta-HCG value above 2,500 I.U./L (group I, n=97) were more frequently noted in those exhibiting myosalpingeal invasion of trophoblast (67 cases) than in those without invasion (30 cases). Of the 182 tubal pregnancies, 117 (64.3%) cases were found in the ampulla and 47 (25.8%) cases in isthmic location. In 117 ampullary pregnancies, the products of conception were found intraluminally in 71 cases (60.7%), and extraluminally in 34 (29.1%) cases, of which the products of conception were found entirely extraluminal. The products of conception, found both within and outside the tubal lumen, were found in 12 cases (10.2%). Of 47 tubes with isthmic pregnancies, 33 cases were intraluminal (70.2%), 12 cases were extraluminal (25.5%), and two cases were mixed (4.3%). In conclusion, significant histopathologic abnormalities accompany a majority of ectopic tubal pregnancy, and myosalpingeal invasion of trophoblast is correlated with high serum beta-HCG. Thus, it is necessary to confirm not only the ectopic placental tissue but also the accompanying details of the other histopathologic findings or the pathologic evaluation of ectopic tubal pregnancy.
Endometriosis ; Epithelium ; Fallopian Tubes ; Female ; Fertilization ; Humans ; Hyperplasia ; Incidence ; Inflammation ; Ovary ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Salpingectomy ; Salpingitis ; Trophoblasts ; Zygote

PURPOSE: ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet been sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-201 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. MATERIALS AND METHODS: Thalliurn-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/kg/min for 6 rnin). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. RESULTS: Although 76.5% of the patients had sorne adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. CONCLUSION: Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.
Adenosine Triphosphate* ; Aminophylline ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Dyspnea ; Flushing ; Follow-Up Studies ; Half-Life ; Headache ; Humans ; Infusions, Intravenous* ; Perfusion Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

Stent entrapment is a very rare complication of percutaneous coronary intervention. The interventional approach could be a treatment strategy. However, if it does not work, surgical treatment should be considered. Here, we report a case of surgical treatment of stent entrapment in the left coronary sinus of a 53-year-old male patient.
Coronary Sinus* ; Humans ; Male ; Middle Aged ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Stents*

We present a series of 10 Patients(Seven men and three women with an average age of 53 years) who underwent decompressive craniectomy for treatment to massive brain swelling following acute cerebral infarction. Clinical signs of cerebral herniation(anisocoria or fixed and dilated pupil, and/or hemiplegia with decerebrate righidity) were present in all patients. Computed tomography and magnetic resonance imaging showed the mass effect by cerebral edema through midline shift. All patients were treated with an extensive craniectomy and duroplasty. Among them, one recovered without neurological deficit, three were moderately disabled but functionally dependent, three remained in a persistent vegetative state and three died within 9 days after surgery(good recovery=1, moderate disability=3, persistent vegetative state=3, death=3). The results suggest that decompressive craniectomy can be an useful lifesaving procedure for massive cerebral edema following widespread hemispheric infarction.
Brain Edema ; Cerebral Infarction* ; Decompressive Craniectomy* ; Female ; Hemiplegia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Male ; Persistent Vegetative State ; Prognosis ; Pupil

BACKGROUND: The aim of this study was to compare the efficacy of ketorolac, paracetamol, and paracetamol plus morphine on pain relief after thyroidectomy. METHODS: Eighty patients were randomly allocated to one of the 4 groups: normal saline (group C), ketorolac 30 mg (group K), paracetamol 1 g (group P), and paracetamol 700 mg plus morphine 3 mg (group PM). Each regimen was administered intravenously (IV) 30 min. before the end of surgery. If pain was not relieved, patients received an IV bolus of pethidine hydrochloride 25 mg. Pain intensity using a visual analogue scale (VAS) was recorded at 0.5, 1, 2, 4, and 6 hr after the end of surgery. RESULTS: VAS at 0.5 and 1 hr after the end of surgery were significantly lower in group K, group P, and group PM than in group C (P < 0.05). The number of patients receiving pethidine hydrochloride at 0.5 and 1 hr after the end of surgery was significantly lower in group K, group P, and group PM than in group C (P < 0.05). There was no significant difference among the groups in the incidences of adverse events associated with study medications and patient satisfaction (P > 0.05). CONCLUSIONS: Paracetamol 1 g IV possesses a similar analgesic efficacy to ketorolac 30 mg IV after thyroidectomy. Paracetamol may represent an alternative to ketorolac for pain prevention after mildly to moderately painful surgery in situations where the use of NSAIDs is unsuitable.
Acetaminophen ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Incidence ; Ketorolac ; Meperidine ; Morphine ; Patient Satisfaction ; Thyroidectomy

This investigation evaluated the fracture toughness (KIC) of eight currently available core materials, and relate the fracture toughness value to fractography analysis and surface characteristics using a atomic force microscope (AFM). Single-edge notched (SEN) test specimens (n=10) and compact tension (CT) test specimens (n=10) were prepared conforming to the ASTM Standard E-399 for a high copper amalgam, three composite core materials (Core-Max II, Core Paste, Bisfil Core), two reinforced composite core materials (Ti-Core, Ti-Core Natural), a resin-modified glass ionomer core material (Vitremer), and a conventional glass ionomer core material (Ketac-Molar). The specimens were tested with an Instron Universal Testing Machine. The maximum loads were measured to calculate the fracture toughness (KIC). Thereafter, fracture surfaces of SEN specimens of each material were investigated for fractography analysis using scanning electron microscope. And, disc-shaped specimens with 1mm thickness were fabricated for each material and were investigated under AFM for surface morphology analysis. The results were as follows : 1. Bisfil Core showed the highest mean fracture toughness regardless of test methods. 2. For the tooth-colored materials, Ti-Core Natural exhibited the highest fracture toughness. 3. Ketac Molar showed a significantly low fracture toughness when compared with the amalgam and the composite resin core materials (p<0.05). 4. The fracture toughness values obtained with the single-edge notched test, except Ketac Molar, were higher than those obtained in the compact tension test. 5. SEM revealed that the fracture surface of high fracture toughness material was rougher than that of low fracture toughness material. 6. AFM revealed that the surface particles of the composite resins were smaller in size, with a lower surface roughness than the glass ionomer core materials.
Composite Resins ; Copper ; Glass ; Molar

PURPOSE: The purpose of this study was to identify effects of an obesity control program including rhythmical dance exercise, on body composition, knowledge about obesity, life habits and self-esteem among obese elementary school children. This program included obesity related health education and counseling based on behavior modification once a week, 1 hour-rhythmical dance class once a week and 40-minute jump rope classes twice a week for 8 weeks. METHOD: There were 29 students with obesity in the experimental and 28 in the control group. Participated was voluntary. The data were collected from April 16 to July 6 2007. chi-square-test, Fisher's exact test, paired t-test and t-test were used to analyze the data. RESULTS: Students in the experimental group showed significantly lower fat mass (t=-2.16, p=.036) and percent body fat (t=-2.93, p=.005) and significantly higher muscle mass (t=2.05, p=.045) and lean body mass (t=2.71, p=.009) than those in the control group. Knowledge of obesity increased significantly and eating habits changed significantly. But difference in exercise habits and self-esteem were not significant. CONCLUSION: This study provides evidence that an 8 week-obesity control program including rhythmical dance exercise is effective in decreasing body fat, increasing muscle mass and increasing knowledge of obesity in children who are obese.
Adipose Tissue ; Behavior Therapy ; Body Composition ; Child ; Counseling ; Eating ; Health Education ; Humans ; Muscles ; Obesity

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

Purpose: The purpose of this study was to understand the process of adapting to daily life after discharge of self-injury adolescents and to develop a substantive theory that can explain their experiences. Methods: Data collection and analysis were conducted through interviews with 9 participants who returned to their daily life after discharge, and data analysis was conducted according to the grounded theory approach. Results: As a result of the analysis, a total of 31 concepts and 9 categories were derived, and were classified into the areas of conditions, actions-interactions, and consequences according to the grounded theory paradigm. As a core category that can explain all these concepts and categories, ‘balance oneself in a precarious daily life’ was derived. Conclusion In this study, a theory in which this process was composed in the order of return stage, crisis stage, and transformative stage, was presented. Finally, the discussions and suggestions of this study based on these results were described.