It is well known that pulmonary arterial hypertension in congenital heart disease is an important prognostic factor, as is pulmonary vascular resistance. So it is tempting to get certain radiologic index that could predict the presence and the degree of pulmonary arterial hypertension. A total of 152 cases of left to right shunt with pulmonary arterial hypertension and 50 cases of left to right shunt without pulmonary arterial hypertension is presented, in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between March 1981 and Feb. 1983. Statistical analysis of plain radiographic findingswith the emphasis on the correlation of radiologic index with the hemodynamic data. The results are as follows; 1. The incidence of pulmonary arterial hypertension is much less in atrial septal defect than other two disease groups of left to right shunt. 2. PA/T ratio correlates well with pulmonary arterial pressure(r= 0.674),especially in mild pulmonary hypertension group. No correlation in moderated pulmonary hypertension group insignificant level. 3. PA/T ratio is below 38 in total cases of normal control group and in 32 cases (21.0%) among 152 cases of pulmonary arterial hypertension group. 4. The average PA/T ratio in normal presuure group of left toright shunt is 35.3, which has no significant difference from that of normal control group. 5. The average CTratio of pulmonary arterial hypertension group is 59.0, which is larger than 49.1 of normal control group. The CTratio shows no correlation with the pulmonary arterial pressure in statistically significant level. 6. The higher the pulmonary arterial pressure, the larger the R./Rs value. The Rp/Rs in atrial septal defect is 0.1393 in average, the lowest value in comparison with other two disease groups. 6. The higher th pulmonrya arterial presure, the larger the Rp/Rs value. The Rp/Rs in atrial septal defect is 0.1393 in average, the lowest value in comparison with other two disease groups.
Angiocardiography ; Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Hemodynamics ; Hypertension ; Hypertension, Pulmonary ; Incidence ; Seoul ; Vascular Resistance

BACKGROUND: Rupture of thoracic aortic aneurysm and dissection into the chest space results in the death of the patient from uncontrolled hemorrhage. The purpose of our study is to evaluate chest radiographic findings that may assist in the rapid detection of nontraumatic disorder in mediastinum and thoracic aorta. MATERIAL AND METHOD: Thirteen consecutive chest radiographs obtained at emergency room of patients with hemorrhage from ruptured thoracic aortic aneurysms or aortic dissections were randomized with radiographs of 8 subjects with nonruptured thoracic aortic aneurysms, 11 subjects with nonruptured aortic dissections, and 20 control subjects. Diagnoses were confirmed by computed tomography(CT) and transesophageal echocardiography(TEE). A retrospective study was performed by assessment of 14 parameters on each of these 52 radiographs to screen the mediastinum and thoracic aortic disorder. RESULTS: Significant difference between patients with mediastinum and thoracic aortic disorder(aneurysm and dissection) and normal subjects occurred in mediastinal/chest ratio>0.25, aortic knob width>4cm, tracheal shift to right loss of paratracheal stripe & azygos vein, and left pleural & extrapleural fluid of chest radiographs(p<0.05). The most useful predictors of mediastinum and thoracic disorder were aortic knob widening above 4cm and combining signs of mediastinum/chest ratio above 0.25 and abnormal aortic arch. These plain radiographic signs had a sensitivity of 9.1~96.9% and a specificity of 40~100% for mediastinum and thoracic aortic disorder. CONCLUSION: The chest radiograph obtained at emergency room remains the best available screening test for mediastinum and thoracic aortic disorder and can be used effectively, though not perfectively, to eliminate unnecessary CT or TEE.
Aorta, Thoracic* ; Aortic Aneurysm, Thoracic ; Azygos Vein ; Diagnosis ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Mass Screening ; Mediastinum* ; Radiography, Thoracic ; Retrospective Studies ; Rupture ; Sensitivity and Specificity ; Thorax*

Experimental hydronephrosis was induced in rabbit by ureteral ligation, then deligation followed after certain experimental period as designed. Histopathological changes of the kidney and restoration of hydronephrosis were studied and the following results were obtained: 1. Ligation of the ureter for 3 days produced mild to moderate degrees of tubular dilatation. irregular proliferation and dilatation of small arterioles. Deligation initiates regeneration of the tubules at 1 week and almost normal histology returns by 3 weeks. 2. Ligation of the ureter for 5,7 and 14 days causes marked tubular dilatation, atrophy of the .cortex, and partial obliteration of the glomerulus. By 3 weeks after deligation, the tubules seem to partially regenerate but no significant histological changes were observed. 3. Ligation of the ureter for 21 to 60 days causes formation of scar, marked obliteration of the glomerulus and compensatory hypertrophy of the remaining glomerulus. No morphological restoration was observed by 3 weeks after deligation. 4. It seems that histological restoration starts at periglomerular tubules located closer to the cortex toward the medulla.
Arterioles ; Atrophy ; Cicatrix ; Dilatation ; Hydronephrosis* ; Hypertrophy ; Kidney* ; Ligation* ; Regeneration ; Ureter*

The mechanism of forward blood flow during closed chest cardiac massage remains controversial. Two theories have been suggested: the cardiac pump theory and the thoracic pump theory. Case report is presented to illustrate the use of transesophageal echocardiography during cardiopulmonary resuscitation. The findings included right and left ventricular compression, closure of the mitral valve during compression, opening of the mitral valve during the release phase, and atrioventricular regurgitation during compression, indicating a positive ventricular-to-atrial pressure gradient. These findings suggest that direct cardiac compression was the predominant mechanism of forward blood flow during cardiopulmonary resuscitation in this patient. Transesophageal echocardiography offers a new approach for study of the flows and cardiac morphologic features during chest compressions in humans. An understanding of the actual mechanisms involved is necessary if improved cardiopulmonary resuscitative techniques are to be rationally developed for enhancing the outcome of resuscitation.
Cardiopulmonary Resuscitation ; Echocardiography* ; Echocardiography, Transesophageal ; Heart Massage* ; Humans ; Mitral Valve ; Resuscitation ; Thorax*

PURPOSE: To diagnose the coronary artery disease, it is necessary to have a thorough knowledge on coronary anatomy and normal variations. We performed a morphological study on normal variations of coronary artery in Korean adults. MATERIALS AND METHODS: 1012 cases of coronary angiography were analyzed with particular emphasis on the normal variation of three coronary arteries and their major branches, including origin of conus artery, sinus node artery and atrioventricular node artery and the variation in posterior descending artery and ramus medianus. RESULTS: We found right dominance in 895 cases(88.4%), left domainance in 44 cases(4.3%), and balanced dominance in 73 cases(7.2%). Conus artery branched from right coronary artery in 468 cases(47.6%) and originated in right coronary sinus close to the os of right coronary artery in 515 cases(52.4%). Sinus node artery originated from left circumflex artery in 551 cases(54.4%), from right coronary artery in 442 cases(43.7%), and from both coronary arteries in 19 cases(1.9%). Atrioventricular node artery originated from right coronary artery in 943 cases(93.4%), from left circumflex artery in 59 cases(5.8%), and two atriovenricular node arteries from both arteries in 8 cases(0.8%). Posterior descending artery had the normal pattern in 505 cases(58.6%) and some variation in 357 cases(41.4%). We found short left main coronary artery, less than 2--3 mm, making it hard to cannulate in 172 cases(17.0%). Ramus medianus was found in 165 cases(16.5%) with marginal distribution in 84 cases(8.4%), diagonal distribution in 80 cases(8.0%) and coursing interventricular sulcus as double left anterior descending artery in 1 case(0.1%). Left main coronary artery gave off 4 branches in 8 cases(0.8%). Myocardial bridging was found in only 3 cases(0.3%). CONCLUSION: This study could provide basic morphological data on anatomy and normal variations of coronary arteries in Korean adults.
Adult ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Sinus ; Coronary Vessels* ; Humans ; Myocardial Bridging

The corrected transposition of the great arteries is an usual congenital cardiac malformation, which consisitsof transposition of great arteries and ventricular inversion, and which is caused by abnormal developement ofconotruncus and ventricular looping. High frequency of associated cardiac malformations makes it difficult to getaccurate morphologic diagnosis. A total of 18 cases of corrected transposition of the great arteries is presented,in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul NationalUniversity Hospital between Sep. 1976 and June 1981. The clinical, radiogrpahic ,and operative findings with theemphasis on the angiocardiographic findings were analized. The resuls are as follows; 1. Among 18 cases, 13 caseshave normal cardiac position, 2 cases have dextrocardia with situs solitus, 2 cases have dextrocardia with situsinversus and 1 case has levocardia with situs inversus. 2. Segmental sets are {S.L.L.} in 15 cases, and {I.D.D} in3 cases and there is no exception to loop rule. 3. Side by side interrelationships of both ventricles and bothsemilunar valves are noticed in 10 and 12 cases respectively. 4. Subaortic type conus is noted in all 18 cases. 5.Associated cardiac malformations are VSD in 14 cases, PS in 11, PDA in 3, PFO in 3, ASD in 2, right aortic arch in2, tricuspid insufficiency, mitral prolapse, persistent left SVC and persistent right SVC in 1 case respectively.6. For accurate diagnosis of corrected TGA, selective biventriculography using biplane cineradiography is anessential procedure.
Angiocardiography ; Aorta, Thoracic ; Arteries ; Cardiac Catheterization ; Cardiac Catheters ; Cineradiography ; Conus Snail ; Dextrocardia ; Diagnosis ; Levocardia ; Mitral Valve Insufficiency ; Prolapse ; Seoul ; Situs Inversus ; Transposition of Great Vessels

Thirteen patients with visceroatrial situs abnormalities were evaluated by magnetic resonance(MR) imaging. Eleven patients were confirmed surgically. Two patitnts were diagnosed by MRI and cardiac catheterization. Right isomerism was found in seven patients, left isomerism in two, and situs inversus in four. For the determination of situs, we evaluated the morphology of atrial appendages and main bronchi, the relationship between abdominal aorta and inferior vena cava(IVC), and the status of upper abdominal viscera. The bilateral atrial morphology was differentiated in 8 of 12 patients. The bronchial situs was determined in 11 of 12 patients. Juxtaposition of abdominal aorta and IVC was found in 6 of 7 with right isomerism. IVC interruption with azygos continuation was found in all two with left isomerism. Incidentally three cases of short pancreas were found. MR imaging showed all structures relevant for the assessment of situs, thus obvrating the need for performing additional diagnostic procedures. MR imaging, therefore, is a valuable tool in the clinical management of patients who are suspected of having a situs abnormality.
Aorta, Abdominal ; Atrial Appendage ; Bronchi ; Cardiac Catheterization ; Cardiac Catheters ; Humans ; Isomerism ; Magnetic Resonance Imaging ; Pancreas ; Situs Inversus ; Viscera

Chronic prostatitis is very common urologic disease, but its symptomatology is varied and nondiagnostic. We have performed transrectal ultrasonography in 66 cases of patients who were impressed as chronic prostatitis based upon their symptoms and physical findings for the purpose of evaluating the role of transrectal ultrasonography in the diagnosis of chronic prostatitis.The results were summarized as follows;1. In microscopic findings of prostatic secretion, 20 cases(Group I ) showed W.B.C. less than 10/H.P.F and 16 cases(Group II ) showed W.B.C. more than 10/H.P.F. 2. The abnormal findings of transrectal sonography in chronic prostatitis were as follows; 1) Echolucent zones; 22 cases(39%) 2) Calcification; 37 cases( 56%). 3) Heterogeneous echo; 40 cases( 61%). 4) Capsular irregularity or thickening; 35 cases( 50%) 5) Periurethral zone irregularity, 28 cases(42%). 6) Echolucent 'halo' sign; 33 cases( 50%). 7) Seminal vesicle or ejaculatory duct abnormality; 18 cases(27%). 3. Among above findings, l), 2), 3), 4), 5) findings were more frequently detected in Group II than in Group I (p<0.05). 4. The combined detection rate of l), 2), 3), 4), 5) findings were statistically higher in Group II than in Group I (p<0.05). 5. High grade l), 2), 3), 4), 5) findings were more frequently detected in Group II than in Group I (p<0.05). Our results suggest that although transrectal ultrasonography is not diagnostic for chronic prostatitis, it may be an useful adjuvant diagnostic modality to laboratory studies in the evaluation of chronic prostatitis.
Diagnosis ; Ejaculatory Ducts ; Humans ; Male ; Prostatitis* ; Seminal Vesicles ; Ultrasonography* ; Urologic Diseases

It is well known that the cell type and histopathological grading of gliomas correlate well with clinicalcourse and prognosis. Therefore, it is tempting to set certain criteria that could predict the histopathologiccharacteristics of the gliomas before the surgical intervention. With a total of 56 cases of gliomas which wereverified histopathologically in Seoul National University Hospital between July 1978 and May 1983, a statisticalanalysis of the computed tomographic findings was done with the particular emphasis on the correlation withhistopatholoigcal features. The results are as follows; 1. The calcification is observed in 27 cases (48.2%) intotal: in 20 cases (62.5%) among low grade group, in 6 cases (46.1%) among high grade group and in 1 case (9.1%)among glioblastoma multiformed group respectively. 2. The mass effect, especially surrounding low densitycorrelates well with the grade of malignancy. 3. The contrast enhancement is observed in 43 cases (76.8%). Thepattern of enhancement provides clues for the assessment of cell type and grade with fair degree of reliability.Among low grade group, 10 cases (31.3%) show no enhancement and 10 cases show solid enhancement. Among high gradegroup, 6 cases (46.8%) show solid enhancement and nodular or ring enhancement are not observed. Among glioblastomamlultiform group, 8 cases (72.7%) show characteristic thick irregular ring enhancement. 4. Plain CT densities arenot useful in differentiating each group in statistically significant level. 5. Neither the margin of the mass northe degree of contrast enhancement contributes for the differentiation of each group. 6. Summarizing the abovementioned findings it is concluded that CT is very helpful in differentiating the gliomas with regard tohistopathological cell type and the grade of malignancy as well.
Glioblastoma ; Glioma ; Prognosis ; Seoul

Sex hormones were administered to adult male rats (Sprague-Dawley inbred line) with in tact gonads and with castration to study their influences on the morghological changes and acid phosphatase activities of the prostate. 1. Testosterone administered to normal and castrated rats caused marked increase in the wel gets of the prostates, while both estrogen administration and castration brought marked de cline of the prostatic weight. 2. Testosterone administration caused marked proliferation of the prostate, such as cystic hyperplasia and epithelial flattening of the acini, while estradiol, atrophy of the prostate. Such atrophy was also observed in castrated rats, but with the administration of testosterone the prostate resumed normal histologic picture. 3. The activities of acid phosphatase were highly pronounced histochemically in the ventral lobe of the prostate. These activities were dependent on sex hormones: decrease by estrogen and increase by testosterone. In castrated animals, the activities of the enzyme were almost negligeble, but with treatment of testosterone those activities resumed normal levels. 4. Estrogen administered to normal rats caused marked atrophy of the testis; decrease in the weight of the gland, atrophy of the germinal epithelium and decreased spermatogenesis.
Acid Phosphatase* ; Adult ; Animals ; Atrophy ; Castration ; Epithelium ; Estradiol ; Estrogens ; Gonadal Steroid Hormones* ; Gonads ; Humans ; Hyperplasia ; Male ; Prostate* ; Rats* ; Spermatogenesis ; Testis ; Testosterone