Echocardiographic examination was performed before, immediately after, 4-6 months after and 10-12 months after mitral valve replacement(MVR) surgery in 46 patients with mitral valve disease(8 patients with mitral regurgitation, 24 patients with mitral stenosis and 14 patients with mitral stenosufficiency) to evaluate the effects of mitral valve replacement on dimension of left atrium and left ventricle, volume of left ventricle, ejection fraction(EF) and fractional shortening(FS) of left ventricle. The results are as follows : 1) The endsystolic dimension(ESD), enddiastolic dimension(EDD), endsystolic volume(ESV) and enddiastolic volume(EDV) decreased significantly after operation in patients with mitral stenoinsufficiency(MSR), the ESD, EDD, ESV and EDV increased significantly after the operation, but returned to preoperative value 10-12 months after the operation. 2) The EF and FS of left ventrcle after MVR were significantly lower than preoperative value throughout the postoperative period in patients with MR. However in patients with MS or MSR, there were no significant postoperative changes in EF and FS, except transient depression in the patients with MS at the immediate postoperative period. 3) In all patients with mitral valve disease, the left atrial dimension and the ratio of domension of left atrium to the dimension of aorta decreased significantly after MVR. From above results, it is suggested that surgery should be considered seriously for the patients with MR before the ESD, EDD and ESV increase maekedly, even if the EF anf FS are in normal range and the symptoms are not severe, to prevent irreversible depression of myocardial function. It seems that serial echocardiographic examination is very helpful in this respect.
Aorta ; Atrial Natriuretic Factor ; Depression ; Echocardiography* ; Heart Atria ; Heart Ventricles ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Postoperative Period ; Reference Values

No abstract available.
Toes*

No abstract available.
Humans ; Interferon-alpha* ; Interferons* ; Melanoma* ; Ulcer*

Diastematomyelia is an uncommon congenital malformation of the vertebral axis characterized by a localized longitudinal separation of the spinal cord with an interposed septum. It may be found in association with congenital scoliosis. The Authors experienced a case of congenital scoliosis with diastematomyelia. Diastematomyelia was surgicallv resected and scoliosis was corrected by Dwyer operation 5 months later. The results of both operations were satisfactory in 10 months follow up.
Follow-Up Studies ; Neural Tube Defects ; Scoliosis ; Spinal Cord

No abstract available.
Carcinoma, Basal Cell* ; Diagnostic Errors*

No abstract available.
Breast* ; Child* ; Humans

The antiarrhythmic effect of Mexiletine was evaluated in five patients with recurrent ventricular tachycardia and in twelve patients with frequent premature ventricular contractions. Electrophysiologic study was performed on the the patients with recurrent ventricular tachycardia before and after the administration of Mexiletin(600-800mg/day). The antiarrhythmic effects of Mexiletine in the patients with frequent premature ventricular contraction was assessed by ambulatory electrocardiography. The results were as follows: 1) In all of the five patients with recurrent ventricular tachycardia, sustained ventricular tachycardia was induced by programmed ventricular stimulation. However, on repeated electrophysiologic study performed while receiving Mexiletine, ventricular tachycardia was not induced in four patients and non-sustained ventricular tachycardia was induced in one patients. 2) The number of premature ventricular contraction was decreased markedly in seven patients(58.3%) with frequent premature ventricular contractions. 3) Minimal side effects, mild indigestion and tremor, were recorded in 3 cases(23%) while receiving Mexiletine 600 mg/day. The higher dose was associated with more frequent and severe side effects.
Dyspepsia ; Electrocardiography, Ambulatory ; Humans ; Mexiletine* ; Tachycardia, Ventricular ; Tremor ; Ventricular Premature Complexes

A clincal study was made on 383 adult patients with congenital heart disease who visited the Seoul National university Hospital during the period of March, 1961-July, 1979. 1. The incidence of congenital heart disease for the consecutive years was increasing in 1970s, especially in recent two years. 2. The sex incidence of congental heart disease was female 47.0%, male 53.0%, with male preponderance in tetralogy of Fallot, ventricular septal defect, coarctation of aorta, aortopulmonary window and female preponderance in atrial septal defect, patent ductus arteriosus. 3. Age distribution of congenital heart disease showed that 79.1% of all were below 30 years of age but atrial septal defect showed wide distribution below and above 30 years of age. 4. The incidences of each congenital heart disease were atrial septal defect 20.9%, tetralogy of Fallot 20.6%, ventricular septal defect 19.%, patent ductus arteriosus 12.0%, pulmonary stenosis 7.6%, trilogy of Fallot 1.8%, Ebstein's anomaly 1.8%, ventricular septal defect with pulmonary stenosis 1.3%, coarctation of aorta 1.3%, ventricular septal defect with aortic insufficiency 1.0%, transposition of great vessels 1.0%, in order and rare and various combined anomalies. 5. Average duration of illness in congenital heart disease was less than 15 years in majority, but duration from 11 years to 20 years was most common in tetralogy of Fallot. 6. Functional class of congenital heart disease is class II and I in majority, but class III was most common in tetralogy of Fallot. 7. Comparision of precatheterization diagnosis with postcatheterization diagnosis showed concordence in 92.2% and comparison of postcatheterization diagnosis with postoperative diagnosis showed concordence in 95.5% of cases. 8. Electrocardiographic findings in 5 major congenital heart disease were observed as follows; right ventricular hypertrophy 86.3%, right atrial enlargement 16.4% in tetralogy of Fallot, right ventricular hypertrophy 30.9%, incomplete right bundle branch block 27.9% in atrial septal defect, left ventricular hypertrophy 28.8%, right ventricular hypertrophy 10.6%, biventricular hypertrophy 10.6% in ventricular septal defect, left ventricular hypertrophy 63.2% in patent ductus arteriosus and right ventricular hypertrophy 70% in pulmonary stenosis. 9. Postoperative changes in electrocardiographic findings were observed in 36.1% of operated patients, of whom teteralogy of Fallot 61.7%, ventricular septal defect 48.0% were most common. Pstoperative electrocardiographic changes were complete right bundle branch block 58.3%, incomplete right bundle branch block 11.7%, myocardial ischemia 10%, nonspecific ST-T changes 10%, etc. in order.
Adult* ; Age Distribution ; Aortic Coarctation ; Bundle-Branch Block ; Diagnosis ; Ductus Arteriosus, Patent ; Ebstein Anomaly ; Electrocardiography ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Seoul ; Tetralogy of Fallot ; Transposition of Great Vessels ; Trilogy of Fallot

A clincal study was made on 383 adult patients with congenital heart disease who visited the Seoul National university Hospital during the period of March, 1961-July, 1979. 1. The incidence of congenital heart disease for the consecutive years was increasing in 1970s, especially in recent two years. 2. The sex incidence of congental heart disease was female 47.0%, male 53.0%, with male preponderance in tetralogy of Fallot, ventricular septal defect, coarctation of aorta, aortopulmonary window and female preponderance in atrial septal defect, patent ductus arteriosus. 3. Age distribution of congenital heart disease showed that 79.1% of all were below 30 years of age but atrial septal defect showed wide distribution below and above 30 years of age. 4. The incidences of each congenital heart disease were atrial septal defect 20.9%, tetralogy of Fallot 20.6%, ventricular septal defect 19.%, patent ductus arteriosus 12.0%, pulmonary stenosis 7.6%, trilogy of Fallot 1.8%, Ebstein's anomaly 1.8%, ventricular septal defect with pulmonary stenosis 1.3%, coarctation of aorta 1.3%, ventricular septal defect with aortic insufficiency 1.0%, transposition of great vessels 1.0%, in order and rare and various combined anomalies. 5. Average duration of illness in congenital heart disease was less than 15 years in majority, but duration from 11 years to 20 years was most common in tetralogy of Fallot. 6. Functional class of congenital heart disease is class II and I in majority, but class III was most common in tetralogy of Fallot. 7. Comparision of precatheterization diagnosis with postcatheterization diagnosis showed concordence in 92.2% and comparison of postcatheterization diagnosis with postoperative diagnosis showed concordence in 95.5% of cases. 8. Electrocardiographic findings in 5 major congenital heart disease were observed as follows; right ventricular hypertrophy 86.3%, right atrial enlargement 16.4% in tetralogy of Fallot, right ventricular hypertrophy 30.9%, incomplete right bundle branch block 27.9% in atrial septal defect, left ventricular hypertrophy 28.8%, right ventricular hypertrophy 10.6%, biventricular hypertrophy 10.6% in ventricular septal defect, left ventricular hypertrophy 63.2% in patent ductus arteriosus and right ventricular hypertrophy 70% in pulmonary stenosis. 9. Postoperative changes in electrocardiographic findings were observed in 36.1% of operated patients, of whom teteralogy of Fallot 61.7%, ventricular septal defect 48.0% were most common. Pstoperative electrocardiographic changes were complete right bundle branch block 58.3%, incomplete right bundle branch block 11.7%, myocardial ischemia 10%, nonspecific ST-T changes 10%, etc. in order.
Adult* ; Age Distribution ; Aortic Coarctation ; Bundle-Branch Block ; Diagnosis ; Ductus Arteriosus, Patent ; Ebstein Anomaly ; Electrocardiography ; Female ; Heart Defects, Congenital ; Heart Diseases* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Myocardial Ischemia ; Pulmonary Valve Stenosis ; Seoul ; Tetralogy of Fallot ; Transposition of Great Vessels ; Trilogy of Fallot

BACKGROUND: Angiotensin convertiong enzyme inhibitors have been shown to exert favorable effects on the left ventricular remodeling process associated with ventricular dilation after coronary occlusion. However, the effects of such therapy on global and regional left ventricular remodeling after coronart artery reperfusion have not been characterized, nor have such effects been assessed after exercise training. METHODS AND RESULTS: Female Sprague-Dawley rats(n=80) were randodmized into 4 groups at 5 days after 45 minutes of left coronary artery occlusion followed by reperfusion. Animals completion the experiment included : Untreated Sedentary group(n=20), Untreated with Swimming Exercise group(n=21), Captopril Treated Sedentary group(n=18) and Captoril Treated with Exercise group(n=21). At 3 weeks after randomization, global and regional morphologic changes of the left ventricle(LV) were examined from mid-ventricular transverse slices which were perfusion-fixed at a constant aortic pressure of 60mmHg and a left ventricular cavity pressure of 10mmHG. At rest and during exercise, compared to untreated rats, the captopril treated animals showed significantly decreased LV weight/tibial length ratio(LV/TL)(p<0.01),increased LV cavity area and dimension(both p<0.01), decreased total myocardial area and noninfarcted area(both p<30.001) and reduced wall thicknesses in the noninfarcted and infarcted regions(both p<0.001). Compared to treated and untreated dsedentary rats, exercise significantly increased LV/TL(p<0.05) and epicardial and endocardial areas in the infarcted zone(both p<0.05) and decreased transmurality(p<0.01). Exercise decreased LV cavity area in the captopril treated groups(42.3+/-10.4 vs. 40.4+/-6.0mm2),whereas exercise increased LV cavity area in the untreated groups(33.5+/-8.9 vs. 39.1+/-6.2mm2)(p<0.05). CONCLUSION: These findings provide evidence in rats for evidence in rats for exaggerated left ventricular dilation and supperssion of compensatory myocardial hypertrophy globally and in the infarct zone with 3 weeks of captopril treatment following coronary artery reperfusion with acute nontransmural myocardial infarction. In addition, the effects of captopril on LV dilation and suppression of global and regional hypertrophic response were partially reversible by swimming exercise.
Angiotensins ; Animals ; Arterial Pressure ; Arteries ; Captopril ; Coronary Occlusion ; Coronary Vessels* ; Enzyme Inhibitors ; Female ; Humans ; Hypertrophy ; Myocardial Infarction ; Myocardial Reperfusion ; Random Allocation ; Rats* ; Rats, Sprague-Dawley ; Reperfusion* ; Swimming ; Ventricular Remodeling*