Authors analysed systolic pressure-volume-stress relations by combined echo-pressure-cineangiographic measurement in 10 normal subjects(Group I) and 37 patients with chronic valvular heart diseases. Patients with chronic valvular heart diseases were divided into 3 groups : Group II ; mitral stenosis(n=9), Group III ; mitral stenosis with aortic regurgitation(n=19). The aims of this study are to find useful left ventricular(LV) contractility indices and evaluate left ventricular contractility at various volume loading states. Studied LV contractility indices were maximal elastance of isovolumic contraction(Eiso), endsystolic pressure-volume ratio(Ees) and slope of regression line in late systolic stress-volume loop(A). Eiso was estimated using an isovolumic contraction model of Sunagawa and A was analysed in a single ejecting beat. Endsystolic volume index(ESVI), end diastolic volume index(EDVI), stress at peak pressure(Speak), cardiac index, Vmax, mean Vcf and ejection fraction were determined also. The obtained results were as follows. 1) Significant correlations were found in whole group(n=47) between Eiso and Ees(r=0.88, P<0.005), Elso and cardiac index(r=0.83, P<0.005), Ees and CI(r=<0.76, p<0.005). Further, these correlation coefficiencies were not different between any two groups of Group I, Group II, Group III, Grouop IV and whole group (p<0.05); that is Eiso or Ees had a constant significance at various loading state. 2) Significant correlation between A and cardiac index was noted in Group I+II+III(n=28, r=0.48, p<0.01), but this correlation coefficiency was significantly different from that of Group IV(n=19, r=0.08); p<0.05. 3) In Group II(patients with mitral stenosis), cardiac index* and EDVI* and stress at peak pressure** were decreased significantly(*:p<0.05, **:p<0.005). But Eiso, Ees, A and all the other idices were not decreased. These findings suggested that left ventricular contractility is not reduced in mitral stenosis. 4) In Group IV(patients with amitral regurgitation with or without aortic regurgitation), **EDVI and ESVI** were increased while Eiso**, Ees, Vmax*, mean Vcf* and cardiac index** were decreased significantly. But ejection fraction and A were not decrease. These findings suggested that ejection fraction and A may not be decreased at volume overload, despite of impaired left ventricular contractility. In summary; Eiso or Ees was evaluated as an useful contractility index which appeared not to be influenced by various volume loading state, while eiection fraction and A to be influenced. Patients with mitral stenosis as a group have reduced cardiac performance which is not due to impairment of left ventricular contractility(muscle function) but to reduced preload.
Constriction, Pathologic ; Heart Valve Diseases* ; Humans ; Mitral Valve Stenosis

Lupus nephropathy shows a variable clinical course including remission, relapse and progression to renal failure. To examine the clinical or morphological parameters which might be related to the progression of lupus nephropathy, we have analyzed renal biopsies of 19 patients (M : F=5 : 14), who underwent repeated renal biopsies by morphology and morphometry. The average age of the patients was 22.8+/-9.0 years. The mean interval between two biopsies was 34.5+/-13.3 months. The first renal biopsies of these patients were diagnosed with WHO class IV (74%), class II (11%), class I (5%), class III (5%), and class V (5%). According to the clinical data the patients were divided into 3 groups, static, relapsing and progressive. At the time of the first biopsies, the amount of proteinuria in both the static and relapsing groups was significantly higher than that in the progressive group (P<0.05). The volume density of the renal cortical interstitium of the first biopsies in the progressive group was significantly greater than that in the static and relapsing groups (0.14+/-0.07 micrometer3/micrometer3 vs. 0.05+/-0.02 micrometer3/micrometer3, P<0.05; 0.14+/-0.07 micrometer3/micrometer3 vs. 0.05+/-0.04 micrometer3/micrometer3, P<0.05). The activity index of the second biopsies in the relapsing group was significantly higher than that in the static group (2.7+/-0.6 vs 1.2+/-1.0, P<0.05). In the progressive group, the percentage of glomeruli with global sclerosis and the volume density of the renal cortical interstitium in the second biopsies was elevated over the first biopsies (P<0.05). Half of the patients in the static and relapsing groups underwent a morphologic transformation on the second biopsy. However, of the 7 patients in the progressive group, only one showed a transformation from WHO class IV to class III, suggesting that the transformation is not related to the progression of lupus nephropathy. These results suggest that interstitial expansion and heavy proteinuria at the time of the first renal biopsy may bode for poor prognosis in lupus nephropathy. Furthermore, they suggest that an increased histologic activity index could be related to the relapse of the disease.
Biopsy* ; Humans ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Sclerosis

Early diastolic left ventricular relaxation was determined in 20 patients by combined echopressure measurement. 7 normal control cases and 13 cases with valvular regurgitation were studied with reference to incremental delta elastance. The hemodynamic and echocardiographic data were analysed during the phase of decreasing left ventricular elastance (that is, when pressure is decreasing while volume is increasing). Starting from a fixed level of wall stress (40 kdyne/cm2), we determined Incremental Delta Elastance(ratio big up tri, Delta p/big up tri, Delta V) by a constant increase in LV volume(eg. 10 ml/M2 or 20 ml/M2). We named Incremental Delta Elastance at 10 ml/M2 and 20 ml/M2 of LV volume increase as d-E 10 and d-E 20 respectively. In valvular regurgitation, incremental delta elastances were statistically different from those of normal subjects(p<0.01). d-E10 was -1.67+/-0.69(versus -3.38+/-1.75 in normal subjects) mmHgm2/ml and d-E20 was -0.98+/-0.39(versus -1.69+/-0.84 in normal subjects) mmHgm2/ml. d-E 10 and d-E20 were compared with ejection phase indices(ejection fraction, meanVcf) in whole group(n=20). There was significant correlation between d-E and ejection fraction(d-E10 : r=-0.47, d-E20:r=-0.50) p<0.05. There was significant correlation between d-E and meanVcf(d-E10: r=0.53, d-E20: r=-0.57) p<0.05. d-E10 and d-E20 were compared with volume indices(end-diastolic volume index and end-systolic volume index) but no significant correlation was found. Because we evaluated that inotropic state or afterload would influence incremental delta elastance, further study, especially with reference to endsystolic volume index may be needed. The absolute values between d-E10 and d-E20 were different but they were simliar in property. We concluded that incremental delta elastance(d-E10 or d-E20) could be used as a useful index of early diastolic relaxation in chronic valvular regurgitation.
Echocardiography ; Hemodynamics ; Humans ; Relaxation*

No abstract available.
Child* ; Humans ; Proteinuria*

This paper is studied for statistical anaIysis of 1181 cascs of positive V.D.R.L test among 24414 cases who were visited for annual Physical examination and in or outpatients in the Han Gang Sung Shim Hospital during 5 years and 7 months from January 1972 to July 1977. Clinical survey was carried out with 182 syphilitic patients in the Department of Dermatology, Han Gang Sung Shim Hospital during 19 months from January l976 to July 1977. The results were as follows; 1. Positive rate for V.D.R.L test was 4.8%, and there were statistically significant differences in annual incidence(P<0.01). Biologic false positive rate for V.D.R.L test was 26. 7%, and there were statistically aignificant differences in annual incidence(P<0.01). 2. Departmental analysis such as Dermatology, Urology, Physical Examination and others including Obstetrics and Gynecology, Internal Medicine, Pediatrics etc. were carried out, the results showed that there were statistically significant departmental differences in V.D.R.L positive rate, but no in biologic false positive rate. 3. Biologic false positive rate was high inversely proportional to dilution titer, and that was a statistically significant difference(P<0.01). 4. 182 had syphilis, of whom 106(58. 2%) were latent syphilis and 74(40. 7%) were primary and secondary syphilis. 5. 119(65. 4%) among 182 syphilitic patients were male, most of patients(87.8%) occured in age from 21 to 40 years in the both sex. But there no statistically significant differences in age distribution between males and females. 6. The most predilection site of chancre was coronary sulcus(54.5%). 7. The lesions of secondary syphilis were composed of 18 cases(25%) of condyloma latum, 17 cases(23. 6%) of roseolar syphilid, 17 cases of papulo-squamous syphilid, 13 cases of alopecia syphilitica, 1 case of pustular syphilid, and 6 cases of others. 8. Married patients were nearly two times than single. In women, married. patients were much more(80. 3%) than single, and there were statistically significatnt differences(P<0.01). 9. There were no significant differences in S.T.S positive rate of spouse between infectious and latent syphilis. 10. Occupation distribution of male sexual partners were composed of 35 cases(29. 4%) of waitress, 28 cases(23. 5%) of call-girl, 20 cases(16. 8%) of office-girl, 17 cases of housewife, 12 cases of out of work, 7 cases of student. 1I. For patients with primary, secondary, and latent syphilis, treatment consiste of benzathine penicillin 2. 4 million units intramuscularly on the first visit and repeated three penicillin preparations at 7 days intervals in most of patients.
Age Distribution ; Alopecia ; Chancre ; Dermatology ; Female ; Gynecology ; Humans ; Internal Medicine ; Male ; Obstetrics ; Occupations ; Outpatients ; Pediatrics ; Penicillin G Benzathine ; Penicillins ; Physical Examination ; Serologic Tests* ; Sexual Partners ; Spouses ; Syphilis* ; Syphilis, Cutaneous ; Syphilis, Latent ; Urology

Volkmanns ischemic contracture, despite a relatively small incidence, is one of the most devastating complications following a limb injury. The orthopedic surgeon must be equipped to recognize and effectively treat this complication. Recently the authors have managed 3 cases with V.I.C. with the following results. 1) The etiology showed CO poisoning, arterial injury, wringer injury around the elbow in each case. 2) The method of surgical treatment depended upon deformities and functional loss of individual patient. 3) The end results seemed to be proportionate to the previous deformities and functional less. 4) Early postoperative passive exercises of the digits seemed to be helpful in restoring further range of motion.
Congenital Abnormalities ; Elbow ; Exercise ; Extremities ; Humans ; Incidence ; Ischemic Contracture ; Methods ; Orthopedics ; Poisoning ; Range of Motion, Articular ; Upper Extremity

We observed clinical and microscopic features in 34 patients with dermatofibroma. Of these features, peculiar epidermal changes were observed in six (17.6%) cases. These were keratoacanthosis(1 case), acanthosis nigricans-like(2 cases), pseudoepitheliomatous hyperplasia.(1 case), hair follicle-like basal cell proliferation(1 case) and early basalioma-like(1 case) changes.
Hair ; Histiocytoma, Benign Fibrous* ; Humans

A case of dermatitis herpetiformis resembling atopic dermatitis is reported. The patient is 45 year-o1d male, who 6 months ago developed the pruritic erythematous vesicular eruptions on the left side of back and it gradually spread to the margin. He was treated with steroid but the lession had undergone exacerbation and remissions. Biopsy was performed on the vesicular lesion and revealed non-acantholytic subepidermal bulla with mild inflammatory cells infiltration and then he was treated with DDS for 2 months with good response.
Biopsy ; Dermatitis Herpetiformis* ; Dermatitis* ; Dermatitis, Atopic* ; Humans ; Male

No abstract available.
Bender-Gestalt Test* ; Hallucinations*

Two cases of Weber-Christian disease are reported. This very rare disease, we had two another reports of case sincc last ten years in The Korean Journal of Dermatology. In our cases both patients are seventeen years old girls and have the histories of remissions and exacerbations for two to three years. The skin lesions of subcutaneous nodules are scattered on the trunk, extremities and even to the hand dorsurns, with the atrophic depressions. Histologic features are typical with faormy histiocytes in the subcutaneous fat tissue. On tne treatments these patients are given oral corticosteroid, antihistaminics and salicylate with some improvments.
Depression ; Dermatology ; Extremities ; Female ; Hand ; Histiocytes ; Humans ; Panniculitis, Nodular Nonsuppurative* ; Rare Diseases ; Skin ; Subcutaneous Fat