No abstract available.
Diabetic Nephropathies*

For the non-invasive evaluation of cardiac performance in hyperthyroidism, fractional systolic and diastolic time intervals were determined in 96 female patients with hyperthyroidism from the mechanocardiograms which included apexcardiograms together with electrocardiograms, phonocardiograms and carotid arterial pulse tracings. The observed values of the time intervals inversely related to heart rate, i.e., ejection period, mechanical systole, isovolumic relaxation time and active ventricular filling period, were significantly shortened in proportion to the severity of the disease in general, as determined by the rate of the radioactive iodine uptake of the thyroid glands. However, these values were not significantly different from those of the predicted for heart rate, except for one of mechanical systoles which is a time interval from the onset of the systolic upstroke in the apexcardiogram to the second aortic sound. This suggests that the shortening of these observed values is promarily due to tachycardia associated with hyperthyroidism. One the other hand, the observed values of the time intervals unrelated to heart rate, i.e., electromechanical delay, isovolumic contraction time together with one of its components, namely ventricular pressure elevation time, and rapid ventricular filling period, were significantly shorter than those in the controls, although the degree of the shortening was not related to the degree of the radioactive iodine uptake of the thyroid gland. It appears that the shortening of these time intervals is related to the altered cardiac function caused by hyperthyroidism and, in particular, that of the isovolumic contraction time and ventricular pressure elevation time reflects enhancemet by the thyrotoxic myocardial contractility.
Electrocardiography ; Female ; Hand ; Heart Rate ; Humans ; Hyperthyroidism* ; Iodine ; Relaxation ; Systole ; Tachycardia ; Thyroid Gland ; Ventricular Pressure

BACKGROUND: Studies of human coronary plaque specimens have shown that T lymphocytes and macrophages are present in all types of lesions, from fatty streaks to advanced plaques. There is growing evidence for a pathogenic role for immune response in progression of atherosclerosis. This study was designed to investigate cytokine production by mononuclear leukocytes from patients with myocardial infarction. METHOD: We measured the kinetics of secretion of tumor necrosis factor-alpha (TNF-alpha) and interferon-r (IFN-r) by mononuclear leukocytes from 8 control subjects and 12 patients with acute myocardial infarction. Mononuclear leukocytes were isolated and incubated with plant lectin mitogen concanavalin-A for 24 and 48 hours. TNF-alpha and IFN-r secretions were measured by ELISA. RESULTS:There were no significant differences between TNF-alpha and IFN-r secretions by mononuclear leukocytes at and before 24 hours of incubation from both patients and control subjects, but TNF-alpha and IFN-r secretions at 48 hours of incubation were higher (p<0.005, p<0.05) in patients when compared with control subjects. TNF-alpha and IFN-r secretions by mononuclear leukocytes after incubation correlated with the peak level of creatine phosphokinase (CK) and CK-MB. CONCLUSION: Increased cytokine secretory capacity of mononuclear leukocytes may be due to the acute inflammatory response of myocardial infarction. Further trials may be needed to determined the effects of increase in secretory capacity of mononuclear leukocytes before myocardial infarction.
Atherosclerosis ; Creatine Kinase ; Enzyme-Linked Immunosorbent Assay ; Humans ; Kinetics ; Leukocytes, Mononuclear* ; Macrophages ; Myocardial Infarction* ; Plants ; T-Lymphocytes ; Tumor Necrosis Factor-alpha*

We report unusual 3 cases of adult coronary arteriovenous fistula(CAVF) diagnosed by coronary arteriography in Soonchunhyang University Hospital. In one patient with mitral stenoinsufficiency, multiple CAVFs originated from left anterior descending and left circumflex coronary areries. In another patient with significant stenosis(90%) in distal right coronary artery, new CAVF was seen in mid right coronary artery during consecutive coronary arteriography. In the remaining one, it was arose from contus branch of right coronary artery. Surgical correction was performed in two cases.
Adult* ; Angiography ; Arteriovenous Fistula* ; Coronary Vessels ; Humans

The bone formation of periarticular connective tissue after head injury and total hip arthroplasty is included in the category of heterotopic ossification. Induction of a new bone formation in the soft tissue is related to various materials such as bone morphogenic protein. The alkaline phosphatase and acid phosphatase act as important factors in the formation and absorption of the bone. The acid phospatase has the important function of acting as the control with specific activity of phosphatase in vivo. Cholecalciferol induces absorption of the calcium in the alimentary tract and bone resorption and increment of bone calcification, whereas disodium etidronate inhibits the deposition and dissolution of calcium salt and formation of heterotopic bone. This paper reports on the relationship of alkaline phosphatase and various phosphoaminoacid phosphatase which affect the cellular differentiation and remodelling in the heterotopic ossification, with the effect of cholecalciferol and disodium etidronate on the heterotopic bone induction in rats. The following results were obtained: 1. The contents of the calcium in the implanted bone matrix increased markedly from two to five weeks. There was no changes in the calcium content by cholecalciferol or in the administration of small doses of disodium etidronate (5mg/kg). However, in the administration of large dose of disodium etidronate (25mg/kg), calcium mobilization was totally suppressed for the whole period of the experiment. 2. The protein content in the implanted bone matrix did not much change for the whole period of the experiment and the administratinn of cholecalciferol or disodium etidronate also had no effect on the protein content. 3. The activities of alkaline phosphatase in the implanted bone matrix peaked at two weeks in control or cholecalciferol group, whereas disodium etidronate admninstration caused the highest activity in the third week. 4. The activity of acid phosphatase in the implanted bone matrix increased in first and third weeks by cholecalciferol treatment. Disoidum etidronate inhibited the activity of the acid phosphatase in the first, fourth & sixth weeks of implantation. 5. The activity of phosphoserine phosphatase increased due to cholecalciferol treatment, but was significantly inhibited by disodium etidronate (25mg/kg) treatment. 6. The activity of phosphothreonine phosphatase in the implanted bone matrix slightly increased due to cholecalciferol treatment, whereas the activity decreased significantly for the whole period of the experiment by disodium etidronate (25mg/kg) treatment. 7. The activity of phosphotyrosine phosphatase in the implanted bone matrix was not change much for the whole period of the experiment and the administration of cholecalciferol or disodium etidronate had no effect on the activity of phosphotyrosine phosphatase. In conclusion, the disodium etidronate (25mg/kg) almost completely inhibited the molilization of calcium and the activities of acid phosphatase, phosphoserine and phosphothreonine phosphatases. Therefore, it can be suggested that the above phosphatases are closely related to the action mechanism of disodium etidronate.
Absorption ; Acid Phosphatase ; Alkaline Phosphatase ; Animals ; Arthroplasty, Replacement, Hip ; Bone Matrix ; Bone Resorption ; Calcium ; Cholecalciferol ; Connective Tissue ; Craniocerebral Trauma ; Etidronic Acid ; Ossification, Heterotopic ; Osteogenesis ; Phosphoric Monoester Hydrolases ; Phosphoserine ; Phosphothreonine ; Protein Tyrosine Phosphatases ; Rats

We studied 105 patients with trasmural myocardial infarction who were admitted to Soonchunhyang university hospital from 1984-1988, and evaluated the clinical and coronary angiographic findings accordin to the age. The following results were obtained: 1) Among 105 patients with myocardial infarction, the prevalent age were sixth and seventh decade(27.6%) and the ration of male to female was 2:1, But the raion of male to female was 5.3:1 under the 50 years of age. 2) In frequency of risk factor of coronarhy heart disease, cigarrette smoking was present in 66.7%, hypertensio in 44.8% and hypercholesterolemia in 28.6%. The mean number of risk factor was 1.3 under the 50 years of age and was 1.7 over the 50 years of age. 3) Anterior myocardial infarction was most common under 50 years of age whereas anterior and inferior myocardial infarction occur similarly over the 50 years of age. 4) By coronary angiography, one vessel disease of stenosis of left anterior descending coronary artery was common findings under 50 years of age, but multivessel disease was common findings over the 50 years of age.
Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Female ; Heart Diseases ; Humans ; Hypercholesterolemia ; Inferior Wall Myocardial Infarction ; Male ; Myocardial Infarction* ; Risk Factors ; Smoke ; Smoking

The authors analyzed data from 15 patients with idiopathic dilated cardiomyopathy to evaluate the hemodynamic changes and left ventricular cineangiogram as compared with normal control. Mean right atrial pressure, right ventricular systolic pressure, mean pulmonary artery pressure and mean pulmonary wedge pressure were signigicantly elevated in patients with dilated cardiomyopathy. Left ventricular enddiastolic volume was increased in idiopathic dilated cardiomyopathy(139.9+/-58.73 ml/m2). Cardiac index, left ventricular ejection fraction and circumferential fiber shortening were significantly reduced in patients with dilated cardiomyopathy as compared with normal control(p<0.001). Hypokinetic, diffuse wall motion abnormalities of left ventricle were common in idiopathic dilated cardiomyopathy. A few cases of akinetic or dyskinetic segmental wall motion abnormalities were present. Left ventricular configurations in patients with idiopathic dilated cardiomyopathy were globe shape(53.4%) as compared with pear core shape(90%) of normal control. Associated mitral regurgitations in patients with idiopathic dilated cardiomyopathy confirmed by left ventricular cineangiogram were 53.3 percent. Mild to moderate mitral regurgitations were often present(46.6%).
Atrial Pressure ; Blood Pressure ; Cardiomyopathy, Dilated* ; Heart Ventricles ; Hemodynamics* ; Humans ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Pyrus ; Stroke Volume

We experienced a case of pedunculated left atrial primary fibrosarcoma, which obstructed the mitral orifice and produced symptoms and manifestations of mitral stenosis clinically. There was no evidence of metastasis to adjacent tissue or distant organs. It was treated by open heart surgery.
Fibrosarcoma* ; Heart Atria* ; Mitral Valve Stenosis ; Neoplasm Metastasis ; Thoracic Surgery

BACKGROUND: Hemodynamic derangements of cardiac tamponade are generally believed to result from compression of the cardiac chambers, which limits diastolic filling. The character and magnitude of the alternation are determined by the compliance characteristics of the pericardium and the total pericardial fluid volume. During serial pericardial fluid withdrawal, improvement of hemodynamic alternations is expected in patients with pericardial effusion. Method : Hemodynamic study was performed before and during serial fluid drainage in 11 patients with chronic moderate to severe pericardial effusion. RESULTS: 1) Intrapericardial pressure was elevated and equal to mean right atrial ventricular diastolic, and pulmonary capillary wedge pressure. Pulmonary arterial and right ventricular systolic pressure were also midly elevated equal to one another. 2) Pericardial fluid was gradually removed in 50ml aliquots in all patients. The most significant hemodynamic improvement occured during intial 50mL withdrawal. Futher drainage of intrapericardial fluid was accompanied by slight hemodynamic improvement. 3) There were significant correlations between total pericardial fluid volume and intrapericardial and right atrial pressure (r=0.75 (p<0.005), r=0.71(p<0.01)). Correlations between intrapericardial pressure and right atrial, right ventricular diastolic and pulmonary capillary wedge pressure were also significant. 4) Two groups of patient could be distinguished based upon intrapericardial pressure as 7mmHg. More significant hemodynamic changes were in 6 patients with higher intrapericardial pressure after withdrawal of 200mL fluid. CONCLUSION: In chronic moderate to severe pericardial effusion, the most significant hemodynamic improvement occurred during initial fluid drainage. Early pericardiocentesis is important in management of pericardial effusion with high intrapericardial pressure.
Atrial Pressure ; Blood Pressure ; Cardiac Tamponade ; Compliance ; Drainage* ; Hemodynamics* ; Humans ; Pericardial Effusion* ; Pericardiocentesis ; Pericardium ; Pulmonary Wedge Pressure

We observed the motion of left ventricular posterior wall aortic root posterior wall in 20 normal persons and 20 patients with left ventricular hypertrophy during the period from March 1985 to Agust 1985. The results were as followings; 1) The percentage of rapid filling time to one cycle of heart beat obtained from the ventriculat posterior wall motion was significantly prolonged in patients with left ventricular hypertrophy(24.1+/-5.44%) than in normal persons(13.5+/-3.69%)(p<0.05) and that of slow filling time was significantly shortend in patients with left ventricular hypertrophy(27.4+/-6.10%) than in normal persons(38.7+/-9.06%)(P<0.005). 2) The rapid filling slop obtained from left ventricular postrior wall motion was significantly reduced in patients with left ventricular hypertrophy(44.0+/-12.45mm/sec)than in normal persons(91.7+/-53.16mm/sec)(P>0.005) but the slow were not signigficantly different between the two groups. 3) The left artial emptying index calculated from the aortic root posterior wall motion was significantly lower in patients with left ventricular hypertrophy(0.6+/-0.18) than in normal persons(1.1+/-0.26)(P<0.005).
Echocardiography* ; Heart ; Humans ; Hypertrophy, Left Ventricular*