In order to define the relation between echocardiographically determined left atrial size and atrial fibrillation(AF) in rheumatic mitral valvular heart disease, 44 patients with mitral valvular heart disease with AF, 29 patients with mitral valvular heart disease without AF, 24 patients with idiopathic AF and 24 normal controls were studied. In mitral valvular heart disease with AF group, AF was more common when the absolute left atrial internal diameter(LAID) was above 50 mm(86.4%) than in mitral valvular heart disease without AF group(41.4%). In addition, although the values of LAID, LA(left atrium)/Aortic Root ratio and LA/BSA(body surface area) are higher in mitral valvular heart disease with AF group than in mitral valvular heart disease without AF group(p<0.05), there was no correlation between LAID and BSA(r=0.06). These findings suggest that an absolute value of LAID is a more important factor in the development of AF in mitral valvular heart disease than LAID considered in conjunction with BSA and that an absolute LAID of 50 mm may be used as a reliable guide to therapeutic and prophylactic intervention in AF associated with mitral valular heart disease.
Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans

No abstract available.
Animals ; Brain* ; Rats* ; Serotonergic Neurons*

Septic arthritis of the children's hip causes acute or chronic inflammatory change in structure about the joint, and results in serious destruction. Due to recent advance of the diagnostic technique and of the antibiotics, the incidence of it's sequelae is decreased. The management of acute stage with antibiotics and early surgical drainage has been well established in the literature, but the management of residual anatomic deformity is less documented, and little comprehensive classification or treatment program has been outlined. We experienced two patients who had sequelae induced by delayed diagnosis and improper treatment. One had a complete loss of femoral neck with femoral head remaining in the acetabulum. Femoral neck reconstruction was performed using proximal femur : i.e., Open reduction of femoral head to femur shaft with distal transfer of greater trochanter (1st stage) followed by varus osteotomy(2nd stage) and follow-up period was 3.5 years. Another had loss of femoral head and neck, dislocation of the hip, and Larsen's trochanteric arthroplasty was performed with 6 Years follow-up. Satisfactory results were obtained in both patients who had reconstructive surgery, so we report these cases with related literatures.
Acetabulum ; Anti-Bacterial Agents ; Arthritis, Infectious ; Arthroplasty ; Child ; Classification ; Congenital Abnormalities ; Delayed Diagnosis ; Dislocations ; Drainage ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Joints ; Neck

The results of alpha-acetyldigoxin(Dioxanin(R)) administration in 21 patients with congestive heart failure were as follows. Alpha-acetyldigoxin is a new oral preparation of cardiac glycoside derived from lanatosid C. 1. For rapid digitalization in 2-3 days, the initial dose was 1.2 to 2.6mg (average 1.96mg). For medium-fast digitalization in 4 days, the loading dose was 2.0 to 3.2mg (average 2.7mg). For slow digitalization 0.1 to 0.4mg was required for 5 to 6 days without loading dose. The maintenance dose was 0.1 to 0.4mg (average 0.33mg) daily. 2. The therapeutic effect of acetyldigoxin was excellent in 15 cases (71%), good in 4 cases (20%) and stationary in 2 cases (9%). 3. Side effects were observed in 2 cases with usual dosage regimen. One accidental case who took single dose of 4mg(20 tablests) developed supraventricular tachycardia with varying degree of atrioventricular block, ventricular bigeminy and premature beat but recovered completely after 6 days.
Acetyldigoxins* ; Atrioventricular Block ; Cardiac Complexes, Premature ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Tachycardia, Supraventricular

Tibric acid is a new oral hypolipidemic agent with the chemical name of 2-chloro-5(3,5-dimethyl piperidinosulfonyl) benzoic acid. The results of tibric acid administration in 22 patients with primary hyperlipidemia were as follows. 1) Serum triglyceride level was significantly decreased in 84.6% of 22 cases with an average 43.9% decrease in serum triglyceride. 2) Serum cholesterol level was decreased in 59.1% of 22 cases with an average 15.8% decrease in serum cholesterol. The decrease in serum cholesterol level was not significant. 3) It seemed that there were significant falls in the serum triglyceride of the hyperlipoproteinemia type IV and IIb patietns and in the serum cholesterol of type IIa patients 4) The side effects of tibric acid were indigestion, loose stool and anorexia. There was no side effects in 63.6% of cases.
Anorexia ; Benzoic Acid ; Cholesterol ; Dyspepsia ; Humans ; Hyperlipidemias* ; Hyperlipoproteinemia Type IV ; Triglycerides

The accuracy of fine needle aspiration cytology (FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases (43.6%) were diagnosed as tuberculosis, 4 (10.3%) as granulomatous lymphadenitis, 3 (7.7%) as necrotizing lymphadenitis, and 15 (38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

An exercise stress test using the bicycle ergometer was carried out in Korea University Hospital in 121 untrained apparently healthy male Koreans with the ages ranging from 20 to 69 years. The graded exercise test consisted of 12 minutes' work on the bicycle ergometer, 4 minutes with each work load, such as 50 W, 100W and 150W, and an additional time with the maximal load to the point of voluntary exhaustion or until other symptoms of exercise intolerance appeared. During the graded exercise a bipolar electrocardiogram from the forehead to the V 5 position(lead CH5) was monitored with an oscilloscope with the sweep speed of 50mm per second and recorded for the analysis. The results obtained were summarized as follows. 1. Heart rates were measured before and during the graded exercise at 50W, 100W, 150W and maximal work loads, and those of the 98 cases with no significant ST segment depression in the exercise ECG are presented. Mean heart rates per minute on 150W load by age group were: 171.0 in the 20-29 year-old group, 170.8 in the 30~39 year-old group, 168.0 in the 40-49year-old group, 162.9 in the 50-59 year-old group and 153.6 in the 60-69 year-old group. Mean heart rates per minute on maximal work load by age group were: 186.0 in the 20-29 year-old group, 178.8 in the 30-39 year-old group, 174.7 in the 40-49 year-old group, 166.0 in the 50-59 year-old group and 161.8 in the 60-69 year-old group. 2. The maximal working capacities by age group were: 266.3W in the 29-29 year-old group, 186.1W in the 30-39 year-old group, 182.2W in the 40-49 year-old group, 160.0W in the 50-59 year-old group and 161.8W in the 60-69 year-old group. 3. More than 1mm ST segment depression 0.08 second after the J point was seen in 10.7% and that 0.06 second after the J point in 19.1%. 4. Electrocardiographic QX/QT ratios ranging from 50 to 59% were seen in 21.5% and more than 60% in 0.8% of the cases. 5. Arrhythmias observed during the exercise test included premature ventricular contraction (2.5%), atrial premature contraction(1.7%) and nodal premature contraction(0.8%). 6. Distressing symtoms experienced during the graded exercise test were dizziness(6.6%) and leg pain(5.8%). Excessive sweating(3.3%), hypotension(1.7%) and nausea and vomiting (0.8%) were noticed immediately after the maximal exercise was finished.
Arrhythmias, Cardiac ; Depression ; Electrocardiography ; Exercise Test* ; Forehead ; Heart Rate ; Humans ; Korea ; Leg ; Male* ; Nausea ; Ventricular Premature Complexes ; Vomiting

We report a case of hepatoma with duodenal metastasis in a 53 year-old male patient. Hepatoma was confirmed by fine needle aspiration cytology technique, and duodenal metastasis by gastrofiberscopic biopsy. Duodenal metastasis of hepatoma is rare. We briefly review the role of fine needle aspiration cytology technique in diagnosis of hepatoma.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Diagnosis ; Endodermal Sinus Tumor ; Humans ; Male ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Proteinuria* ; Specific Gravity*

Two cases of acute digitalis poisoning were presented. The first patient was 20-year-old male with asymptomatic ventricular septal defect (maladie de Roger) who attempted suicide by ingestion of degitalis leaf about 6.0 g (60 tablets). He developed severe epigastric pain and vomiting one hour after ingestion. Syncopal attack was developed once for a few minutes and recovered. Electrocardiogram revealed 2:1 A-V block. By conservative management he was recovered. The second patient was 2-year-old, healthy baby who ingested digoxin about 2.5 mg(10 tablets) by accident. He developed severe vomiting and electrocardiogram revealed 1degrees, 2degreesand 3degrees A-V block in series. He was recovered by conservative management without sequele.
Child, Preschool ; Digitalis* ; Digoxin ; Eating ; Electrocardiography ; Heart Septal Defects, Ventricular ; Humans ; Male ; Poisoning* ; Suicide, Attempted ; Vomiting ; Young Adult

PURPOSE: The main purpose of this study was to evaluate effects of non-nutritive sucking (NNS) on the oxygen saturation level and behavioral state of preterm infants during tube feeding. METHODS: This study was performed prospectively in the NICU, Chonbuk National University Hopspital from November, 2004 through April, 2005. Preterm infants of gestational age 28 to 37 weeks, who had neither major congenital defects interfering feeding nor respiratory difficulty needing ventilatory support, were included. A total of 64 subjects were divided randomly into the control group (n=32), and the non-nutritive sucking (NNS) group (n=32). The patients in each group were tested for changes in oxygen saturation and behavioral state at 3 different times; 2 minutes before, during, and 2 minutes after feeding. RESULTS: The oxygen saturation of the NNS group increased during feeding and gradually decreased after feeding while the control group decreased during feeding and increased slightly after feeding (P<0.001). During feeding, the "quiet awake" state was observed more frequently in the NNS group and the "crying" state was observed more frequently in the control group. During the post-feeding assessment, the "sleep" state was more frequent in the NNS group and the "crying" state was more frequent in the control group. CONCLUSION: The infants in the NNS group showed significantly higher oxygen saturation level and they were less fussy during tube feeding and slept better after feeding.
Congenital Abnormalities ; Enteral Nutrition* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Jeollabuk-do ; Oxygen* ; Prospective Studies