A2 D time, a time interval from aortic second heart sound to the D point of mitral valve echogram, was reported as a valuable index of the left ventricular relaxation in its early diastole. It was suggested, however, that A2D time is influenced by variable factors rather than single factor. This study was performed to evaluate the influences of several on the A2D time and to extend our understandings in A2D time. For this purpose, A2D time was measured in 4 groups whose hemodynamic states were different, i.e.31 normal subjects (group A), 32 patients with essential hypertension without decompensation (group B), 10 normotensive patients with clinically full blown congestive heart failure (group C), and 11 patients with hypertensive heart failure (group D), and the mean values of each group were compared between the groups. Concordantly systolic hemodynamic parameters were observed and the relationship of A2D time and each of these parameters were observed. A2D time was consistently influenced by the level of left ventricle impedance and it is well correlated with parameters representing left ventricular systolic performances. In hypertensive subiects, A2D time was increased before the deterioration of the left ventricular systolic function but shortened after clinical heart failure. These findings suggest that A2D time may be of value in longitudinal follow-up of the left ventricular function in the hypertensive patients even before the development of clinical heart failure.
Diastole ; Electric Impedance ; Heart Failure ; Heart Sounds ; Heart Ventricles* ; Hemodynamics ; Humans ; Hypertension ; Mitral Valve ; Relaxation ; Ventricular Function, Left

Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting

No abstract available.
Neural Conduction*

No abstract available.

To analyze the improvement of shouder function after arthroscpic subacrominal decompression and open repair for complete rotator cuff tear, we performed a prospective study in 14 patients using self evaluation form from the American Shouder and Elbow Society(ASES). All patients were treated with arthrscopic biplanar subacromial decompression and open repair by use of bony trough and followed for more than 1 year from November 1994 to June 1996 in Dankook university hospital. All patients were assessed preoperatively and at final follow-up using the standardised method of research committee of American shoulder & elbow surgeons. Tears of the rotator cuff were divided into medium(8 shoulders), large(3 shoulders) and massive(3 shoulders). Most of the patients were heavy laborers. Average age was 56.2 years (51-73 years). There were 9 male and 5 female patients. The dominant arm was affected in 8 shoulders. Postoperative abduction brace was used in all cases and passive range of mortion exercise was started from postoperative third day. At average follow-up of 17 months, average pain scores decreased to 0.8+/-1.1 from 6.9+/-2.3. Scores of ASES evaluation form increased to 87.3+/-12.2 from 35.8+/-16.3(p<0.05). As to the range of mortion, only internal rotation improved from T12 to T8(p<0.05). Thirteen patients achieved excellent or good result. Twelve patients returned to initial occupations. Arthroscopy is helpful to define the tear size which may affect the surgical approach and open repair by use of bony trough and tunnel is useful to recovery of shoulder function.
Arm ; Arthroscopy ; Braces ; Decompression* ; Diagnostic Self Evaluation ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Occupations ; Prospective Studies ; Rotator Cuff* ; Shoulder

Dermatomyositis is a severe, idiopathic systemic disorder with predominant involvement of skin and skeletal muscle. The association of adult dermatomyositis and malignancy in particular has generated much attention. The reported prevalence of cancers in this disease varies from 6.7% to 52.2%. We experienced a concurrent case of transverse colon cancer and dermatomyositis on 67 year old female patient and report with review of literatures.
Adult ; Aged ; Colon* ; Colon, Transverse ; Colonic Neoplasms* ; Dermatomyositis* ; Female ; Humans ; Muscle, Skeletal ; Prevalence ; Skin

Castleman's disease, or giant Iymph node hyperplasia, is a Iymphoproliferative disorder which is characterized by Iymphoid hyperplasia with capillary proliferation, and divide histologically into two 0varieties, hyaline vascular and plasmal cell form. Some system manifestations are occasionally accompanied with the diseases, but peripheral neuropathy is a rarely reported manifestatlon of them and not in Korea. The present report describes a 40 year old female patient who had been admitted to Yonsei university medicai center because of progressive quadriparesis. On examination, she revealed various other manifestations such as hyperpigmentation, Iymphadenopathy, pitting edema, and bilateral papilledema. The electrophysiologic studies and sural nerve biopsy showed severe sensori-motor peripheral neuropathy showing features of mixed demyelinatlon and axonal degeneration. The Iymph node biopsy showed features compatible with Castleman's disease of hyaline vascular type. The recovery was poor over four month period despite of treatment with corticosterold.
Adult ; Axons ; Biopsy ; Capillaries ; Edema ; Female ; Giant Lymph Node Hyperplasia ; Humans ; Hyalin ; Hyperpigmentation ; Hyperplasia ; Korea ; Papilledema ; Peripheral Nervous System Diseases* ; Quadriplegia ; Sural Nerve

Guillain-Barre syndrome (GBS) is an autoimmune disease with an acute evolution of inflammatory demyelinating polyradiculoneuropathy. Although the precise immune mechanisms and involved antigens are uncertain, both humoral and cellular immune mechanisms are thought to be involved. Interactions between the various compartments of the immune system are governed by cytokines. Laboratory investigations have shown that immune activation can be quantified by measurement of cytokines and soluble immune activation products in serum. Interleukin-2(IL-2) is probably the best characterized among the many cytokines and soluble interleukin-2 receptor (sIL-2R) and neopterin are major immune activation products. In order to observe activities of cellular immunity of GBS, we measured serum concentrations of IL-2, sIL-2R and neopterin in 28 patients with GBS and in 22 healthy controls. Serial serum samples were drawn 2 to 25 days after motor onset of the disease, 2 to 3 days after treatment with plasmapheresis and 43-300days of follow-up. The occurences of IL-2 positive serum samples were 41.7%, 23.8% and 18.2% in each time in GBS but none in healthy controls. Initial serum sIL-2R and neopterin level were elevated in 21% and 17% of patients with GBS compared with healthy controls. After plasmapheresis, both serum sIL-2R and neopterin level were significantly elevated in GBS compared with initial serum samples and healthy controls. Thus, T-cell and macrophage activation may play a role in the pathogenesis of GBS. However, further study is needed to evaluate the effect of plasmapheresis and clinical severity on the serum concentration of IL-2, sIL-2R and neopterin in GBS.
Autoimmune Diseases ; Cytokines ; Follow-Up Studies ; Guillain-Barre Syndrome* ; Humans ; Immune System ; Immunity, Cellular ; Interleukin-2* ; Macrophage Activation ; Neopterin* ; Plasmapheresis ; Polyradiculoneuropathy ; Receptors, Interleukin-2* ; T-Lymphocytes

Thanatophoric dysplasia is the most common lethal congenital chondrodysplasia with characteristic features of narrow thorax, short rib, severe platyspondyly, short bowed limbs and skull deformity, etc. It is not a hereditary disorder and there is usually no family history of dysplasia. We experienced a case of thanatophoric dysplasia at 38 weeks of gestation with antenatal sonographic and abdominal radiographic findings of small thorax, short bowed extremities with surrounding thickened soft tissues and marked platyspondyly. Soon atter delivery, the baby died and post-mortem radiographs showed the characteristic findings of thanatophoric dysplasia.
Congenital Abnormalities ; Extremities ; Humans ; Pregnancy ; Ribs ; Skull ; Thanatophoric Dysplasia* ; Thorax ; Ultrasonography

No abstract available.
MELAS Syndrome*