We reviewed the clinical and hemodynamic studies in 10 patients with the isolated congenital mitral insufficiency. The patients ranged in age from 6 months to 16 years at the time of diagnosis and the incidence was 0.26% among the total congenital heart disease proven by cardiac catheterization and angiography. In two cases anterior mitral cleft was demonstrated by 2-D echocardiography and/or operation. In two cases left coronary artery was originated from pulmonary artery. Eight cases out of ten presented symptoms indicating varying degrees of left ventricular failure. Apical systolic murmur was heard in all except one, who had only triple rhythm. The electrocardiograms revealed left ventricular hypertrophy in 8 cases and biventricular hypertrophy in 2 cases. Roentgenographically left atrial enlargement was observed in 4 cases. Left arterial and ventricular dimension were increased in 7 cases by echocardiography. In 5 cases of them, pulmonary artery wedge pressure or left atrial pressure was increased. One patient died in congestive heart failure at the age of 10 months and one patient died postoperatively. Other 4 patients have been managed with medication without difficulty.
Angiography ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Electrocardiography ; Heart Defects, Congenital ; Heart Failure ; Hemodynamics ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Incidence ; Mitral Valve Insufficiency* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Systolic Murmurs

No abstract available.
Evoked Potentials* ; Intercostal Nerves* ; Neural Conduction*

BACKGROUND: In congenital heart disease, the lung perfusion through stenosed pulmonary artery is usually decreased. And this decrement of lung perfusion also occurs with diaphragmatic palsy after the operation of congenital heart disease. It is difficult to delineate the amount of lung perfusion in case of combination of pulmonary artery stenosis and diaphragmatic palsy. We examined the change of lung perfusion after the induction of diaphragmatic palsy in rabbits. METHODS: We dissected left phrenic nerves in 20 rabbits to induce left diaphragmatic palsy. The lung perfusion scan was performed with 99mTc-MAA and the movement of diaphragm was examined with fluoroscopy. They were performed as baseline data and on 3rd and 10th day postoperatively. The amount of left lung pefusion before and after diaphragmatic palsy was compared and analysed in 12 rabbits which definitely had diaphragmatic palsy. RESULTS: Weight of the rabbits was 1.65+/-0.26 kg. Left lung perfusion percent was 45.93+/-6.42% before operation and these were 32.48+/-6.09% and 37.62+/-3.39% on the 3rd and 10th postoperative day, respectively. Left lung perfusion was significantly decreased just after diaphragmatic palsy but it was not changed thereafter. The decrement of lung perfusion was not affected by the body weight. The decreased amount of left lung perfusion was reciprocally correlated with the body weight of the rabbits on the postoperative 3rd day but not 10th day. CONCLUSION: Left lung perfusion percent of the rabbits was decreased 7% with the induction of diaphragmatic palsy and the decreased amount was reciprocally correlated with the body weight just after the diaphragmatic palsy was induced.
Body Weight ; Constriction, Pathologic ; Diaphragm ; Fluoroscopy ; Heart Defects, Congenital ; Lung* ; Paralysis* ; Perfusion* ; Phrenic Nerve ; Pulmonary Artery ; Rabbits

OBJECTIVE: To determine the relationship of the Mini-Mental State Examination (MMSE) scores to the functional improvement of the brain-injured patients with a traumatic brain injury or cerebrovascular accident. METHOD: Thirty patients who were admitted to a rehabilitation hospital for their initial brain injury were retrospectively studied. Subjects were administerd a MMSE as cognitive assessment and a Functional Independence Measure (FIM) and Modified Barthel Index (MBI) as functional assessment upon referral for the rehabilitation and at discharge. RESULTS: MMSE scores, FIM scores and MBI scores at discharge increased significantly compared to the scores at the start of rehabilitation. The changes of MMSE scores significantly correlated with the changes of FIM scores and MBI scores in 30 brain injured patients (p<0.001). Among the subitems of FIM, the social cognition, communication, self care, and sphincter control were strongly correlated with the MMSE scores. CONCLUSION: We conclude that the MMSE can be a relevant predicting factor for the changes of functional status of brain-injured patients from a inpatient stroke rehabilitation and post brain- injury rehabilitation.
Brain Injuries ; Brain* ; Cognition ; Humans ; Inpatients ; Referral and Consultation ; Rehabilitation ; Retrospective Studies ; Self Care ; Stroke

PURPOSE: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. METHODS: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. RESULTS: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. CONCLUSION: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.
Blood Pressure ; Case Management* ; Chronic Disease ; Delivery of Health Care ; Health Care Costs ; Humans ; Hypertension* ; National Health Programs ; Self Care

In this case, we describe a case of a 76-year-old male with extensive aortoiliac aneurysms treated by endovascular aneurysm repair using the sandwich technique in order to preserve left internal iliac artery perfusion. The sandwich technique refers to the deployment of multiple paralleled stent grafts into main distal and side branches in overlapping with a single proximal stent graft. The procedure was successfully performed without complications. Post-procedural CT angiography demonstrated patent stent grafts without any endoleak. The strengths and limitations of the sandwich technique need to be investigated in large-scale, long-term clinical trials.
Aged ; Aneurysm ; Angiography ; Aortic Aneurysm ; Endoleak ; Endovascular Procedures ; Humans ; Iliac Artery ; Male ; Perfusion ; Stents ; Transplants

No abstract available.

PURPOSE: The aim of this study was to evaluate the effect of inhaled nitric oxide(iNO) on gas exchange, hemodynamics and pulmonary inflammation in newborn piglets with E. coli induced septic lung. METHODS: Twenty three instrumented and ventilated piglets were randomized into three groups: CON(n=6), PCON(n=9), and PNO(n=8). In the piglets of the PCON and PNO groups, E. coli septic lung was induced by endotracheal instillation of E. coli. Ten ppm iNO was given continuously in the PNO group after endotracheal instillation of E. coli. All animals were mechanically ventilated for six hour with a peak inspiratory pressure of 30 cmH2O, frequency of 25 breaths/min, FiO2 1.0 and a positive end-expiratory pressure of 4 cmH2O. All measurements were made at one hour intervals during the experiment. At the end of the experiment, lung tissue was harvested for the analysis of myeloperoxidase activity, indicative of lung inflammation. RESULTS: All piglets with pulmonary instillation of E. coli developed E. coli sepsis. Piglets in the PCON group developed progresseve pulmonry hypertension, hypoxemia and hypercarbia compared to the CON group due to increased pulmonary vascular resistance, intrapulmonary shunt fraction and physiologic dead space fraction. iNO did not reverse pulmonary hypertension in the PNO group. However iNO significantly improved oxygenation, which was attributed to marked improvement of venous admixture and partial attenuation of increase in dead space fraction. Increased myeloperoxidase activity in PCON compared to CON was significantly attenuated in PNO. CONCLUSION: iNO improves oxygenation and lung inflammation in newborn piglets with E. coli induced septic lung.
Animals ; Anoxia ; Escherichia coli* ; Escherichia* ; Hemodynamics* ; Humans ; Hypertension ; Hypertension, Pulmonary ; Infant, Newborn* ; Lung* ; Nitric Oxide* ; Oxygen ; Peroxidase ; Pneumonia* ; Positive-Pressure Respiration ; Sepsis ; Vascular Resistance

Malignant transformation in phyllodes tumor (PT) is uncommon and almost always confined to the stromal component. Epithelial changes like hyperplasia, metaplasia, and varying degrees of atypia are not uncommon in PT, whereas carcinomatous change is extremely rare. We report a 37-year-old woman with carcinoma in situ (CIS) arising in a benign PT. Grossly, it was a well circumscribed, 4.5 cm-sized mass. The CIS component was confined to the PT and showed overlapping ductal and lobular features with coexpression of E-cadherin and high molecular weight cytokeratin (HMW-CK). The present case emphasizes that careful investigation of multiple microscopic sections is mandatory to find a small carcinomatous lesion within PT. Expression of E-cadherin and HWM-CK in this hybrid CIS suggests that intraepithelial neoplasia of the breast arising in PT may be derived from a common progenitor of the terminal duct-lobular unit.
Female ; Humans

According to the reports, the prevalence of anti-HCV is about 1%. In past, the results of the prevalence of HBs Ag & HBs Ab in the patients of Hansen's disease were reported. But we don't know about that of anti-HCV. So we study about the prevalence of serum anti-HCV of 60 patients & PALS of Hansen's disease. And we test about Alk. Phosp., ALT, AST, Gtlc HBs Ag & HBs Ab. 1. The prevalence of anti-HCV is 8.33%. It is higher than past reports(about 1-2%). 2. The prevalence of HBs Ag is 3.4% & that of HBs Ab is 36.3%. 3. Because of the high prevalence of anti-HCV in the patients of Hansen's disease & PALS, we think that more studies are need about it.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Humans ; Leprosy ; Prevalence