No abstract available.
Chorion* ; Chorionic Villi*

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

BACKGROUND: In a health examination program, advice from physician for change of health-related behavior and distribution of health educational pamphlets is routine. This study was done prospectively to analyze factors such as personal general characteristics, results of health examination, health examination satisfaction that relate to change of health promotion attitudes and compliance towards overweight, smoking, heavy drinking, elevated blood pressure, dyslipidemia, chronic diseases such as diabetes, hypertension. METHODS: The subject population was 689 cases from May 1997 to June 1997 in a general hospital health examination center. After health examination, 60.2%(415 cases) showed personal satisfaction by questionnaire. Three to four months later 78.4%(540 cases) responded to the telephone survey on change of health beliefs, health-related attitudes and compliance. RESULTS: In the telephone survey, 239 cases(46.0%) comprised high compliance group that had positive attitudes toward abnormal health examination results, 145 cases(27.9%) were mid compliance group, and 135cases(26.0%) were low compliance group. In males there was higher frequency of high compliance group than females(p<0.05). According to age, the older, the higher frequencies of high compliance group(p<0.05). In educational level group, the higher the educational level, the lower the frequencies of high compliance group(p<0.01). There was no difference in frequency of each compliance group between symptom motive and non-symptom motive group with each satisfaction group(p>0.05). In positive responders to the correspond advice of physician or health educational pamphlets, the frequencies for quit smoking, reduction of drinking amount, regular exercise, Compliance with taking antihypertensives, blood sugar control, diet control for dyslipidemia, taking antihyperlipidemics were higher(p<0.01). CONCLUSIONS: Health examination service includirg advice of physician and education changed health belief and influenced positively to health promotion attitudes. Health examination is not only important for early detection of disease but also to promote positive change of health-related behavior. Further studies are needed to understand the changing process of management of health and disease.
Antihypertensive Agents ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Compliance ; Diet ; Drinking ; Dyslipidemias ; Early Diagnosis ; Education ; Health Education ; Health Promotion ; Hospitals, General ; Humans ; Hypertension ; Hypolipidemic Agents ; Male ; Overweight ; Pamphlets ; Personal Satisfaction ; Prospective Studies ; Smoke ; Smoking ; Telephone ; Surveys and Questionnaires

In effort to determine whether aircraft noise can have health effects such as hearing loss, hypertension and psychological stress, a total of 111 male professors and administrative officers working a college near a military airport in Korea(exposed group) and a total of 168 males and 112 females matched by age groups(control groups) were analyzed. Personal noise exposure and indoor and outdoor sound level of jet aircraft noise were measured at the exposed area. And pure tone, air conduction test and measurement of blood pressure were given to the exposed(males) and matched control groups(males and females). BEPSI(Brief Encounter Psychological Instrument) and psychological response to aircraft noise were examined for the exposed group. The noise dosimetry results revealed time-weighted averages(TWAs) that ranged from 61 to 68 dBA. However the levels encountered during taking off jet airplanes reached 126 dBA for two half minutes time period. The audiometric test showed that mean values of HTL(hearing threshold level) in exposed group at every frequency(500, 1,000, 2,000, 4,000, and 8,000 Hz were much lower than them of male and female control groups. And in old age groups, interaction of age and noise was observed at 8,000 Hz in both ears(p< 0.05). Conclusively, aircraft noise does not appear to induce hearing loss directly, but may decreased hearing threshold level by interaction of aging process and noise exposure. However, difference of mean values of exposed and control groups on blood pressure was not significantly. In psychological test, annoyance was the most severe psychological response to noise in exposed group, but mean value of BEPSI was not correlated with job duration in exposed group
Aging ; Aircraft* ; Airports ; Blood Pressure* ; Female ; Hearing Loss* ; Hearing* ; Humans ; Hypertension ; Male ; Military Personnel ; Noise* ; Presbycusis ; Psychological Tests ; Stress, Psychological*

Neurofibromatosis 1(NF-1, Von Recklinghausen disease) and Neurofibromatosis 2(NF-2, bilateral acoustic neurinoma) have been established as distinct disorders by the National Institutes of Health(NIH) Consensus Development Conference in 1988. We recently have encountered a patient of NF-2 who develop multiple intracranial and spinal tumors 12 years after the surgical treatment of Schwannoma of lumbar nerve roots. The tumors were right acoustic neurinoma, left cerebellopontine angle(CPA) meningioma, multiple intracranial meningiomas, intraorbital glioma, multiple ependymomas of the brain stem and cervical spinal cord, and meningiomas of cervical nerve roots. We present this case with a review of reported cases of neurofibromatosis.
Academies and Institutes ; Acoustics ; Brain Stem ; Ependymoma ; Glioma ; Humans ; Meningioma ; Neurilemmoma ; Neurofibromatoses* ; Neurofibromatosis 2* ; Neuroma, Acoustic ; Spinal Cord

BACKGROUND AND OBJECTIVE: There has been little clinical data on the treatment outcome of patients with acute asthma attack in Korea. We designed a management protocol of acute asthma, and analyzed clinical p arameters obtained from this protocol. METHOD: A total of 32 cases with acute asthma were treated with oxygen, beta2 agonist, and methylprednisolone. Ipratropium was added in cases of severe attack. After 90 minutes, intravenous aminophylline was given to the patients with poor response. RESULT: Beta2 agonist and methylprednisolone were sufficient for symptom control in 17 cases. Ipratropium and aminophylline were added in 6 and 9 cases, respectively. There was no difference in improvement of PEF, heart rate, respiratory rate, PaO2, PaCO2, and SaO2 at 90 minutes and 8 hours between beta2 agonist inhalation and subcutaneous group. Serum potassium concentration levels significantly decreased in patients treated with ipratropium of aminophylline(n=15, 4.17+/-0.45 vs. 3.99+/-0.35mM/L, p<0.05), compared with patients using only beta2 agonist and methylprednisolone(n=17, 3.89+/-0.30 vs. 4.14+/-0.45mM/L, p>0.05). CONCLUSION: Subcutaneous beta2 agonist may be an alternative to inhalant beta2 agonist for the emergency treatment of acute asthma, and we think a consensus regarding use of aminophylline in the emergency room should be made.
Aminophylline ; Asthma* ; Consensus ; Emergency Service, Hospital ; Emergency Treatment ; Heart Rate ; Humans ; Inhalation ; Ipratropium ; Korea ; Methylprednisolone ; Oxygen ; Potassium ; Respiratory Rate ; Treatment Outcome*

OBJECTIVES: To assess the clinical efficacy and safety of Hyruan(sodium hyaluronate) in patients with osteoarthritis of the knee. METHODS: A 12-week open study of Hyruan was conducted in 48 patients with osteoarthritis(OA) of the knee. Hyruan was injected into knee joints weekly for 5 weeks. Clinical evaluations were performed using visual analog scale(VAS) for pain, Lequesne's index, tenderness and swollen joint counts weekly for the first 5 weeks and then monthly up to 3 months post-injection. RESULTS: Significant improvements in VAS, Lequesne's index, tenderness and swollen joint counts were noted from the first week and maintained until the end of 3 month follow-up period. At 3 months post-injection, 68.8% of patients had >20mm reduction in the VAS. The patients with Kellgren stage lIl showed significant response in VAS and Lequesne's index as patients with Kellgren stage I and II. The clinical improvement after treatment was slower in patients(n=16) with late(>5 years) OA than in patients(n=32) with early(<5 years) OA, but it was statistically significant in either groups, compared to baseline. There were no severe adverse reactions to Hyruan therapy and laboratory examinations revealed no evidence of toxicity. CONCLUSION: Hyruan has been shown to be effective and safe in the treatment of patients with osteoarthritis of the knee.
Follow-Up Studies ; Humans ; Hyaluronic Acid ; Joints ; Knee Joint ; Knee* ; Osteoarthritis*

Leiomyomas of the vagina are rare benign solid tumors. A leiomyoma arises frommuscle in the round ligament and appears as a firm movable tumor deep in the substanceof the labium majus, but minority of these tumors occur in vaginal wall. A case of a 39year old woman with leiomyoma of the vaginal orifice was reported with a brief review ofliterature.
Female ; Humans ; Leiomyoma* ; Round Ligament of Uterus ; Vagina

PURPOSE: To evaluate the factors influencing clinical outcome after removal of intraocular silicone oil and the relationship of the factors to the postoperative visual prognosis. METHODS: The authors retrospectively analyzed clinical outcomes related to 76 patients (79 eyes) who underwent silicone oil tamponade. Prognostic factors were as follows: age, underlying pathologies, systemic diseases, range and type of retinal detachment (RD), type of RD, number of retinal tears, macular and lens status, and types of operation. The influence of these factors on visual acuity and anatomical success rates were studied. RESULTS: The 79 eyes that underwent silicone oil removal had preoperative diagnoses as follows: proliferative diabetic retinopathy in 32 eyes, primary rhegmatogenous RD in 12 eyes, RD with an intraocular foreign body in nine eyes, traumatic RD in eight eyes, RD with a macular hole in six eyes, RD development after other surgeries in six eyes, RD with endophthalmitis in three eyes, and RD with high myopia in three eyes. Anatomical success was achieved in 59 eyes (74.7%) after silicone oil removal. Thirty-two eyes (40.5%) had an increase in visual acuity, 28 eyes (35.4%) showed no changes and 19 eyes (24.1%) showed deteriorated conditions after silicone oil removal. The number of surgeries was an important factor related to anatomical and functional success rate. Postoperative visual improvement was observed when the number of surgeries was greater than two and in groups with no macular holes or degenerations. CONCLUSIONS: When considering prognostic factors for silicone oil removal, reducing complications and retinal redetachment after silicone oil removal may be helpful.
Diabetic Retinopathy ; Endophthalmitis ; Eye ; Foreign Bodies ; Humans ; Myopia ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Silicone Oils ; Visual Acuity ; Vitrectomy