Clinical characteristics and coronary angiographic findings were analyzed in 24 patients with angiographically documented coronary artery spasm, which developed spontaneously in 11 cases and was provoked by intravenous ergonovine meleate in 13 cases. The commonest clinical presentation was chest pain at rest in 21 out of 24 cases, and nine patients with resting angina had also exertional chest pain. Ten patients complained of chest pain which developed especially at night and in the early morning. Cumulative doses of ergonovine meleate whoch were required to provoked spasm were 0.05mg in 3, 0.15mg in 8 and 0.35mg in 2 cases. Transient hypertension occured in one case as a complication of ergonovine provocation test. In 20 cases coronary artery spasm developed at the portion of normal or insignificantly narrowed coronary arteries, at the severely stenotic portion in 3 cases and at the normal portion different fropm severe tight lesion in one case. Electrocardiographic findings at the time of coronary spasm were ST segment elevation in 11 among 18 cases, ST segment depression in 2 cases and no change in 3 cases. Twenty two patients complained of chest pain of the same characteristics which they had previously experienced, but there was no chest pain in 2 patients. Right coronary artery was the most prevalent site of coronary artery spasm, and percutaneous transluminal coronary angioplasties were performes successfully in 4 cases with significantly tight lesions. In conclusion coronary artery spasm is thought to play a significant role in the conversion of stable to unstable angina and the development of silent myocardial ischemia as well as variant angina.
Angina, Unstable ; Angioplasty ; Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Depression ; Electrocardiography ; Ergonovine ; Humans ; Hypertension ; Myocardial Ischemia ; Spasm*

No abstract available.
Colitis, Ischemic* ; Colon*

Serum levels of HDL-cholesterol, triglyceride and total cholesterol were measured in 107 normal Koreans and in 327 patients; 66 patients with hypertension, 34 patients with coronary heart disease, 45 patients with cerebral thrombosis, 18 patients with nephrotic syndrome, and 164 patients with diabetes mellitus. Patterns of serum lipoprotein fractions were also investigated by agarose gel electrophoresis in 41 normal Koreans and in 72 patients; 14 patients with hypertension, 10 patients with coronary heart disease, 19 patients with cerebral thrombosis, 7 patients with nephrotic syndrome, and 22 patients with diaebetes mellitus. The results are summarized as follows; 1. Mean values of serum HDL-cholesterol, triglyceride and cholesterol in normal Koreans were 52.2+/-12.4mg/100ml, 110.6+/-31.6mg/100ml and 175.3+/-21.4mg/100ml respectively. No significant difference in mean value of serum HDL-cholesterol was observed between Korean males and females. 2. In Korean females serum, HDL-cholesterol level showed peak values in the fifth decade, but no significant difference with aging was observed in Korean males. 3. Serum HDL-cholesterol levels were significantly decreased in patients with hypertension, coronary heart disease, cerebral thrombosis, and in male diabetic patients with complication. 4. Serum triglyceride levels were significantly increased in all the disease groups, and serum cholesterol levels were significantly increased in all the disease groups except cerebral thrombosis. 5. Mean values of alpha-lipoprotein, pre-beta-lipoprotein and beta-lipoprotein fraction ratios in normal Koreans were 28.9+/-7.5%, 14.9+/-4.9% and 56.2+/-8.1% respectively. 6. Seum alpha-lipoprotein fraction ratio was significantly decreased in relatively advanced hypertensive patients. Pre-beta-lipoprotein fraction ratio tends to be increased in patients with hypertension, cerebral thrombosis, nephrotic syndrome and in diabetic patients with complications, and beta-lipoprotein fraction ratio tends to be increased in patients with hypertension, coronary heart disease and nephrotic syndrome, but those were not statistically significant.
Aging ; Cardiovascular Diseases* ; Cholesterol ; Coronary Disease ; Diabetes Mellitus ; Electrophoresis, Agar Gel ; Female ; Humans ; Hypertension ; Intracranial Thrombosis ; Lipoproteins ; Male ; Nephrotic Syndrome ; Triglycerides

No abstract available.
Animals ; Iproniazid* ; Monoamine Oxidase* ; Rats* ; Tyramine*

Apocrine carcinoma is a rare type of mammary cancer, which shows partial or total apocrine differentiation in either ductal or lobular carcinoma. The malignant transformation of apocrine epithelium of the breast was first described by Krompecher in 1916. It is well known that their relationship to true apocrine glands of the skin is only a morphological similarity, and this histological difference does not affect the prognosis. The authors experienced two cases of apocrine carcinoma of the breast which involved infiltrating ductal carcinoma of a 64-year old woman and intraductal carcinoma of a 69-year old woman respectively. Electron microscopic examination and brief review of literature was done.
Female ; Humans

Echocardiographic right ventricular systolic time invervals were measured in 69 cases of congenital and acquired valvular heart disease, who have neither arrhythmia nor conduction disturbances. The results were as follows: 1) Right ventricular preejection periord(RVPEP) relates with main pulmonary arterial systolic pressure (MPA(s)), main pulmonary arterial diastolic pressure (MPA(d)), main pulmonary arterial mean pressure (MPA(m)), pulmonary vascular resistance (Rp), and the ratio of pulmonary systemic vascular resistance (Rp/Rs) (r=0.746, 0.738, 0.755, 0.721, 0.687). 2) Rifht ventricular ejection time relates with MPA (s), MPA (d), MPA (m), Rp, and Rp/Rs (r=-0.580, -0.541, -0.544, -0.577, -0.420). 3) The ratio of right ventricular preejection period-right ventricular ejection time (RVPEP/RVET) relates with MPA (s), MPA (d), MPA (m), Rp and Rp/Rs (r=0.789, 0.784, 0.781, 0.778, 0.695). 4) Pulmonary hypertension and increased pulmonary vascular resistance can be predicted, when RVPEP/RVET is over 0.3. 5) By serial preoperative and postoperative measurements, pulmonary hypertension and increased pulmonary vascular resistance were relieved in the cases of mitral stenosis. But in the cases of congenital heart diseas there were no significant change in RVPEP/RVET ratio.
Adult* ; Arrhythmias, Cardiac ; Blood Pressure ; Echocardiography* ; Heart ; Heart Valve Diseases ; Humans ; Hypertension, Pulmonary ; Mitral Valve Stenosis ; Systole* ; Vascular Resistance

A clinical review was done on 343 infants and children diagnosed and operated at the Department of Pediatric Surgery in Keimyung University, Dong San Medical Center for congenital gastrointestinal anomalies from January, 1988 to December, 1991. The results are summarized as follows; The most prevalent age group of congenital gastrointestinal anomaly was within first week after birth, and infants within 3months occupied 70% of total, and male to female ratio was 2:1. 2) The moat common lesion of congenital gastrointestinal anomalies was stomach with 87cases (25.4%), followed by anus with 80 cases (23.3%), colon with 63 cases (18.4%) and biliary tract with 38 cases(11.1%). 3) The most common congenital anomaly was congenital hypertophic pyloric stenosis with 87 cases (25.4%), followed by imperforate anus with 70 cases (20.4%), congenital megacolon with 63 cases (18.4%), and prevalent age was 2 week-3month, first week after birth, 1month-3year. 4) The incidence of common congenital gastrointestinal anomalies were mostly higher in male than in female but choledochal cyst was higher in female than in male. 5) Associated anomalies were observed in 14 cases (4%) of total cases, duodenal atresia was seen the highest rate of the associated anomalies and the most common associated anomaly was annular pancreas, followed by Down syndrome, congenital diaphragmatic hernia.
Anal Canal ; Anus, Imperforate ; Biliary Tract ; Child ; Choledochal Cyst ; Colon ; Down Syndrome ; Female ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant ; Male ; Pancreas ; Parturition ; Pyloric Stenosis ; Stomach

Endoscopic retrograde cholangiopancreatography(ERCP) is a new diagnostic method for pancreatic and biliarydiseases which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCPwell serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions ofthe pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic RetrogradeParechymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed atthe Kwangju Christian Hospital between Jan. and Dec. 1980, and compared them with the final diagnosis. The resultswere as follows; 1. Out of 117 cases, successful visualization of the duct of concern was achieved in 105 cases.Of these, 25 cases were ERPP. 2. The ratio of males to female was 1.44:1. Most patients were in the 4th to 6thdecade. 3. The commmonest clinical manifestations were upper abdominal pain (77cases), jaundice(23 cases),indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreaticdiseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These werediagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, localdilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction orstenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with orwtihout) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymalfilling defect. 5. Out of 71 cases of suspected biliary tract diseases, the biliary tract was visualized in 57cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 cases of ascariasis, 1case of clonorchiasis with cholangitis, 1 case of clonorchiasis with stone, 2 cases of C.B.D. ca. 2 cases of G.B.ca, 3 cases of intrahepatic disease, 1 case of stones in the biliary tree with ampullary ca. 6. Complications ofERCP and ERPP were extremely raare. Transient abdominal distention, abdominal discomfort and elevated serumamylase were noted, but were not clinically significant.
Abdominal Pain ; Ascariasis ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Clonorchiasis ; Diagnosis ; Dilatation ; Duodenoscopy ; Female ; Gwangju ; Humans ; Male ; Methods ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis, Chronic ; Vomiting

Three cases who were successfully treated for cardiac injuries by open thoracotomy were reported. The range of the ages of the patients was 3rd decade. Two of the 3 were males with blunt injuries by motor vehicle accident and one was male with stab wound by knife. In the case of blunt injuries, the right atrium was involved in one case and the right and left atrium were involved in the other. The site of stab wound was the right atrium. There were two cases with the pre-operative diagnosis of cardiac injuries and they were blunt injuries. The case of stab wound was not diagnosed pre-operatively. All cases were treated with open thoracotomy-one posterolateral thoracotomy, one median sternotomy and one Clam shell incision. All of them had an uneventfull post-operative course.
Bivalvia ; Diagnosis ; Heart Atria ; Humans ; Male ; Motor Vehicles ; Sternotomy ; Thoracotomy ; Wounds, Nonpenetrating ; Wounds, Stab

Diltiazem(Herben(R)) was orally administered in a daily dose of 180mg over 8 weeks to 15 patients with angina pectoris requiring minimum 5 tablets of nitroglycerin per week. The symptom of angina pectoris was scored according to frequency and character of anginal attacks and the number of nitroglycerin tablets used was recorded during the Diltiazem therapy. We noted significant decrease of the score of anginal attack and the number of nitroglycerin tablets used during the course of Diltiazem therapy. No significant change in blood pressure, heart rate and the product of systolic blood pressure and heart rate was noted during the course of Diltiazem therapy. It is possibel that Diltiazem improved ischemic heart disease by slightly decreasing myocardial oxygen demand and increasing blood flow to the ischemic areas by dilatation of coronary arteries and collateral vessels. There was no abnormal change in laboratory findings during the Diltiazem treatment. These findings suggest that Diltiazem(Herben(R)) is a favorable and safe antianginal agent useful for longterm treatment of anginal pectoris.
Angina Pectoris* ; Blood Pressure ; Coronary Vessels ; Dilatation ; Diltiazem ; Heart Rate ; Humans ; Myocardial Ischemia ; Nitroglycerin ; Oxygen ; Tablets