Cardiac relaxation is impaired in many cardiac disorders and is the subject of extensive investigation. Though measurement of isovolumic relaxation time ought to prove a simple means of quantifying such abnormalities in clinical practice, the problem of defining the timing of mitral valve opening at the onset of ventricular filling has been a difficulty. previous studies have used the 'O' point of the apexcardiogram, but more recently it has been shown that this may be open to considerable error. It was the purpose of the present study to determine the duration of true isovolumic relaxation and the factors influencing its duration, and to evaluate its use as a simple noninvasive measurement of cardiac dynamics in terms of the present approach. True isovolumic relaxation time (IRT) was measured noninvasively from the onset of the aortic component of the second heart sound to the onset of rapid opening of the mitral leaflets from simultaneous recording of echocardiogram, phonocardiogram, electrocardiogram and carotid tracing in 60 normal subjects, 30 male and 30 female and in 50 with hypertension, 28 male and 22 female ranging in age from 20 to 45 years. 1. The duration of IRT was 53.6+/-9.9 msec in normal subjects with no relation to sex. 2. IRT was related to heart rate, systemic blood pressure, and systolic and diastolic time intervals. 1) IRT tended to decrease with increasing heart rate and a regression equation for predicting it in relation to heart rate was 'IRT(msec)=88.97-0.466xH.R.(beats/min)' (P<0.01). 2) IRT tended to increase with increasing systemic blood pressure and a regression equation for predicting it in relation to aortic closing pressure was 'IRT(msec)=5.09+0.459xaortic closing pressure(mmHg)' (P<0.01). IRT was prolonged in patient with hypertension. 3) IRT was in close relation to left ventricular contraction indices such as preejection period(PEP), isovolumic contraction time and preejection period/left ventricular ejection time ratio. 4) There was no relation between IRT and left ventricular pump performance indices such as stroke volume, ejection fraction, fractional shortening and left ventricular dimension. 5) There was strong association between IRT and diastolic time intervals. Authors were impressed through this study that IRT is a useful measurement of left ventricular dynamics in early diastole.
Blood Pressure ; Diastole ; Electrocardiography ; Female ; Heart Rate ; Heart Sounds ; Humans ; Hypertension ; Male ; Mitral Valve ; Relaxation* ; Stroke Volume

No abstract available.
Phospholipases* ; Protein Kinase C* ; Protein Kinases* ; Psychotropic Drugs* ; Type C Phospholipases*

We evaluate the effects of diltiazem in 19 patients with ischemic heart disease (15 patients) of classical anginal pectoris & 4 patients of variant angina) by means of clinical status & electrocardiographic changes and obtain the results as follows: 1. The pulse rate & blood pressure were decreased by diltiazem slightly but these decreases were not significant in statistical meaning. 2. Diltiazem administration of 4 weeks duration normalized EKG completely in 4 patients & partially in 3 patients among the 13 patients who showed abnormal resting EKG initially. 3. All 19 patients who received diltiazem showed clinical improvement; 9 patients had excellent responses, 7 patients good responses & 3 patients fair responses. 4. Diltiazem had side effects in 3 patients, drowsiness, mild euphoria & possibly tolerance respectively in each patients.
Angina Pectoris* ; Blood Pressure ; Diltiazem ; Electrocardiography ; Euphoria ; Heart Rate ; Humans ; Myocardial Ischemia ; Sleep Stages

The fractures of the ankle in children are differ from those of adults in terms of the fracture pattern and the possibilities of influence to growth. The injuries of the ankle in children occur mostly at the bony structure rather than ligamentous structure, and some injuries of the growth plate may result in the arrest of entire growth plate or parts of growth plate and these may lead to leg length discrepancy or deformity. Many authors agree that the prognosis of injuries of the growth plate is dependent on the fracture type, the age of the patient at the onset of injuries, the degree of displacement of the fracture fragments, whether the injuries open or closed, and the efficacy of reduction. But the authors can not postulate one uniformed method of classification and treatment of the children's ankle fracture because of the variability of injuries. We have reviewed 35 cases of children's ankle fracture treated at our clinics from Dec. 1979 to Feb. 1984. The results obtained are as follows: l. Over half of the patients were between the ages of 13 and 16 years (54.3%). 2. The incidence of each type as Salter-Harris classification was that of type II(48.6%), type I(20.0%),type III(14.3%),type IV (8.6%). 3. The traffic accidents were the main causes of injury (68.5%). 4. The type I fractures occured mostly under 10 years of age and the type II fractures in adolescents. 5. All the type I fractures were treated conservatively without any complication, and the type II fractures were treated conservatively in 13 cases (76.5%) and operatively in 4 cases (23.5%) with variable results. 6. Overall incidence of complication was 20.0%, consisted with two cases of conservatively treated but not accurately reduced type II fractures, a conservatively treated type III fracture, a triplane fracture, and the others.
Accidents, Traffic ; Adolescent ; Adult ; Ankle Fractures ; Ankle ; Child ; Classification ; Clinical Study ; Clothing ; Congenital Abnormalities ; Growth Plate ; Humans ; Incidence ; Leg ; Ligaments ; Methods ; Prognosis

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

BACKGROUND: The infection rate of syphilis in married couples has been reported by a few investigators during the 1940s. However, studies on recent trends of that particular aspect of syphilis in married couples have not yet been done. OBJECTIVE: We therefore studied the infectivity of T. pallidum and recent trends of conjugal syphilis by observing the spouses of patients with untreated syphilis. METHODS: Couples married for more than 1 year who visited Yonsei Medical Center from 1983 to 1990 for syphilis were entered into this study. We observed the infection rate among spouses of 224 index patients (defined as, between husband and wife, the one who was the first to be diagnosed to have syphilis) who were not treated for syphilis. Syphilis was diagnosed on the basis of physical examination, history of extramarital sexual contacts, and the results of VDRL, TPHA, FTA-ABS, and 19S(IgM)-FTA tests. RESULTS: Fifty-six wives(48%) of 117 male index patients and 50 husbands (47%) of 107 female index patients had been infected at the time of examination. Among the 224 couples, 106(47%) were both infected and in 118(53%), only either husbands(27%) or wives(26%) were infected. Two spouses(50%) of the 4 first incident patients with primary syphilis, 9(53%) of 17 with secondary syphilis and 23(72%) of 32 with early latent syphilis were infected at the time of examination. CONCLUSION: From our results showing the low infection rates among married couples, even in early syphilis when the infectivity is high, it can be deduced that T. pallidum has only a low infectivity.
Family Characteristics ; Female ; Globus Pallidus ; Humans ; Male ; Physical Examination ; Research Personnel ; Spouses ; Syphilis* ; Syphilis, Latent

Dislocation and subluxation of proximal interphalangeal joint of a finger are relatively common and reduction by closed method is normally easily achieved. However anterior dislocation of a proximal interphalangeal joint is an uncommon injury that produces permanent joint stiffness unlike the more common radial, ulnar, and dorsal dislocations. The case reported here is irreducible due to the displacement of the intact lateral band and interposition of the central slip between the joint.
Dislocations ; Fingers ; Joints ; Methods

The index on myocardial contractility of pure mitral regurgitation(MR) after mitral valve replacement is believed to be useful in determining proper operation time before irreversible myocardial damage by volume overload. Thus the authors examined pre and post-operative echocardiographic results of 20 cases of pure MR patients who had been admitted to Pusan National University hospital and compared the usefulness of each index. Pre and post-operative echocardiographic results were as follows respectively ; 1) Left ventricular internal dimension in diastole(LVIDd) were 6.49+/-0.19cm and 5.51+/-0.17cm. 2) Left ventricular internal dimension in systole(LVIDs) were 4.26+/-0.12 and 3.79+/-0.18cm. 3) Ejection fraction were 71.28+/-1.57% and 59.24+/-3.05%. 4) Fractional shortening(FS) were 34.09+/-1.18% and 27.21+/-1.84%. 5) Mean Vcf were 1.53+/-0.08cm/sec and 1.18+/-0.09cm/sec. 6) Left ventricular end-diastolic volume index(EDVI) were 196.35+/-18.33cc/m2 and 98.46+/-9.96cc/m2. 7) Left ventricular end-systolic volume index(ESVI) were 55.28+/-5.12cc/m2 and 41.88+/-6.07cc/m2. 8) Left ventricular end-systolic wall stress/ESVI(ESS/ESVI) were 2.3+/-0.21 and 3.91+/-0.83. ESS/ESVI showed significantly(p<0.05) elevated postoperative change, LVIDd, LVIDs, EF, FS, EDVI, ESVI revealed significantly(p<0.05) reduced postoperative change whereas Mean Vcf had no postoperative change. After examining correlation between preoperative and postoperative results of each index, it is believed that LVIDd, LVIDs, and ESS/ESVI were useful prognostic indices but were unrelated to postoperative ejection phase indices such as EF, FS, and MEan Vcf. Especially in case of LVIDd>6cm, LVIDs>4cm, and ESS/ESVI<2, the prognosis was poor due to myocardial damage by mitral regurgitation.
Busan ; Echocardiography ; Humans ; Mitral Valve Insufficiency* ; Mitral Valve* ; Prognosis ; Stroke Volume

The incidence of rhabdomyosarcoma of the bladder is extremely rare. Two cases of rhabdomyosarcoma of the bladder were reported here with a review of literature. Case I. Five year old boy complained urinary retention & hematuria for 5 months cystogram revealed filling defect of the bladder. Pathological specimen which was taken after cystectomy showed characteristic cross-striation of rhabdomyosarcoma. Case II. Two year old boy was admitted because of complete urinary retention & hematurie. Biopsy after exploratory laparatomy revealed cross-striation which is characteristic of rhabdomyosarcoma.
Biopsy ; Child* ; Cystectomy ; Hematuria ; Humans ; Incidence ; Male ; Rhabdomyosarcoma* ; Urinary Bladder* ; Urinary Retention

The papillary eccrine adenoma is a rare benign sweat gland neoplasm charscterized by potentislly locally aggressive clinical course. We report herein a case of papillsry eccrine adenoma in a 28-year-old female who presented single intradermal tumor on the right postauricular ares. Histopathological findings showed dilated ducts containing eosinophilic or keratinous materials and intraluminal papillary rowths.
Adenoma* ; Adult ; Eosinophils ; Female ; Humans ; Sweat Gland Neoplasms