Digitized QT dispersion by the Valsalva Maneuver in Hypertensive Patients

BACKGROUND: Hypertension is an important risk factor for sudden cardiac death, of which the incidence increases with increases in blood pressure. Prolonged QT dispersion has been identified to indicate increased risk of life-threatening ventricular arrhythmia and sudden cardiac death. In this study, QT dispersion was investigated in hypertensive patients during the strain phase of the Valsalva maneuver. METHODS: The study population included 75 subjects: 25 with normal blood pressure (Control), 25 with stage I hypertension (Group A), and 25 with stage II hypertension (Group B). Electrocardiography for QT dispersion was recorded at 25 mm/sec paper speeds before and during the Valsalva maneuver. RESULTS: The patients in Group B were significantly older than the controls (p< 0.05). Differences in sex, smoking, diabetes, angina, and hyperlipidemia were not statistically significant between the three groups. The basal QT dispersion was 25.3 +/- 18.3 ms in the controls, 39.0 +/- 17.8 ms in Group A, and 36.8 +/- 18.8 ms in Group B. The QT dispersion was significantly higher in group A patients than the controls (p< 0.05). In Group B only, a significant increase in QT dispersion was observed during the Valsalva maneuver, compared to conditions prior to the Valsalva maneuver (p< 0.05). CONCLUSION: The conditions that increase intrathoracic pressure may increase QT dispersion and severe hypertensive patients should avoid these conditions.

Bilateral Sequential Lung Transplantation for a case with Respiratory Failure due to Lymphagioleiomyomatosis / 대한흉부외과학회지

Pulmonary lymphangioleiomyomatosis is a chronic destruct8ive disease of the lung affecting women of childbearing ages which eventually leads to respiratory failure. Lung transplantation is the only conclusive therapeutic measure because this disease responds poorly to other therapies, To date only a few reports in the literature describes the clinical experience of the bilateral sequential lung transplantation of this rare condition. We performed a bilateral sequential lung transplantation on a 32-year-old woman suffering from lymphangioleiomyo-matosisw. The heart-lung block was harvested from a 51-year-old donor. We transplanted the left lung first through the clam-shell incision. As the hemodynamics deteriorated suddenly during the dissection of the right lung the right lung was transplanted under the cardio-pulmonary bypass. Although the patient's lung function was initially satisfactory the patient died of sepsis and subsequent cardiogenic shock at the postoperative 18th day. Autopsy findings showed infection of Candida albicans on the pericardium and the left lung which had been initiated possibly from the left bronchial anastomosis site,. Through detailed review of the clinical course we concluded that lung transplantation could have been performed safely on this disease provided that early diagnosis and proper management or the opportunistic infection have been carried out.

A Case Report of Myocardial Infarction in Myxoma Patient with Normal Coronary Arteries

Left atrial myxoma is a common primary tumor which frequently presents systemic embolizations. Embolization in various systemic organs is often the first and sometimes the only symptom in patient with cardiac myxoma. However, coronary embolization from the left atrial myxoma is very rare clinical presentation. We experienced 57-year-old woman with a left atrial myxoma combined with inferior myocardial infarction who had no stenotic lesion in coronary angiography. The ergonovine spasm test was negative. In the interleukin-6 immunohistochemical staining, the extracellular matrix of myxoma stained abundantly with pink color. It can be considered as inferior myocardial infarction due to embolization from the myxoma, which is associated with interleukin-6. So, we report this case with review of literature for the first time in Korea.

Predictors of Thromboembolism in Severe Mitral Stenosis

OBJECTIVE: Systemic emboli related to atrial thrombi in severe mitral stenosis are a well known complication of percutaneous ballooon dilatation of the mitral valve(PMV). The purpose of this study was to identify factors that predicted left atrial thrombi and systemic embolism in patients with severe mitral stenosis. METHODS: Retrospective study of 79 patients with severe mitral stenosis by analysis of videotape having the record for transthoracic(TTE) and transesophageal echocardiography(TEE) was done over a 24 month period. RESULTS: The twenty eight patients(35%) had left atrial thrombus, and fifteen patients(19%) had experience of systemic embolization. Both appeared most commonly in the ages of 50 years. In thrombus group, the incidence of atrial fibrillation was more frequent(p=0.001), left atrial size larger(p=0.0014), and mitral valve area(p=0.0353) and ejection fraction of left atrial appendage(p=0.037) were lesser than non-thrombi group. In left atrial appendage(LAA) thrombus group, the left atrial dimension(p=0.0282) and the ejection fraction of LAA(p=0.008) were lesser than those in the left atrial thrombus group. In embolism group, the age was older(p=0.0212) and the incidence of atrial fibrillation tended to be more frequent(p=0.05470 than non-embolism group. CONCLUSION: In severe mitral stenosis, the formation of left atrial thrombus was related to presence of atrial fibrillation, size of left atrial dimension and area of mitral valve. And the thrombus of LAA was related to low ejection fraction of left atrium. The predictors of embolism in severe mitral stenosis were age and the presence of atrial fibrillation. The TEE was the useful diagnostic tool in detecting the thrombus of left atrium and LAA before PMV and the patients with predictors of thromboembolism should be treated more actively in severe mitral stenosis.

Kasabach-Merritt syndrome in an adult with consumption coagulopathy: report of a case / 대한혈액학회지

No abstract available.

Laparoscopic segmental resection and intracorporea anastomosis of the colon: report of a case

No abstract available.

Diminutive Colonic Polyps (Less than 5 mm in diameter) : Endoscopic and Histologic Study / 대한소화기내시경학회지

A series of 241 polyps from 127 patients endoscopically removed during the period from march 1991 through July 1992 at our department were analysed. The following items were studied. 1) Incidence, age, and sex distrlbution of the patients 2) Number of the calonic polyps 3) Histologic classification and polyp size 4) Anatomic distribution and polyp size 5) Gross types and polyp size 6) Hietopathologic types and polyp size In conclusion, colonic diminutive polyps should not be ignored or overlooked clinically. The majority were neoplastic polyps. It is suggested that diminutive polyps should be removed endoscopically if possible

A Study on P50 in Mongrel Dogs / 대한마취과학회지

For obtaining P50 in mongrel dogs at normal body temperature (37degrees C), pH(7.4) and PaCO2 (40 mmHg), we performed arterial blood gas analysis in 14 mongrel dogs by using ABL 30 blood gas analyzer ( Radiometer, Copenhagen, Denmark) after inhalation of various concentration of oxygen. The oxyhemoglobin dissociation curve was made by plotting of arterial O2 saturation against each PaO2, and P50 was obtained by using linear regression equation. The result shows that P50 in mongrel dogs is 28.5+/-0.8 mmHg (mean+/-DS).

A Study on P50 in Mongrel Dogs / 대한마취과학회지

For obtaining P50 in mongrel dogs at normal body temperature (37degrees C), pH(7.4) and PaCO2 (40 mmHg), we performed arterial blood gas analysis in 14 mongrel dogs by using ABL 30 blood gas analyzer ( Radiometer, Copenhagen, Denmark) after inhalation of various concentration of oxygen. The oxyhemoglobin dissociation curve was made by plotting of arterial O2 saturation against each PaO2, and P50 was obtained by using linear regression equation. The result shows that P50 in mongrel dogs is 28.5+/-0.8 mmHg (mean+/-DS).

A Clinical Survey on Pediatric Respiratory Intensive Cares - The third report / 대한마취과학회지

The clinical analysis was performed on 730 critically ill patients under 15 years old who had been admitted in respiratory intensive care unit(RICU) from January, 1983 to December 1984. 1) The mortality rates in 1983 and 1984 were 8.7% and 5.9% and the number of patients was increased but the mortality rate was decreased than before 1983. 2) the mortality was significantly high in neonates and infants but gradually decreased with age. 3) Of 730 patients, 30 of 437 male and 24 of 393 female patients were dead. 4) Of 730 patients, 667 were the patients of chest surgery and 56 were the patients of pediatric surgery but 7 were the patients in the departments other than in chest surgery or pediatric surgery. The Mortalities in chest surgery, pediatric surgery and other surgical departments were 5.4%(36 patients) 26.8%(15 patients) and 37.5%(3 patients). 5) Of 667 patients in department of chest surgery, 640 were the patients with the congenital heart disease and the mortality was 5.2%(33 patients) but 12 were the patients with acquired heart disease and the mortality was 16.7%(2 patients). Of 667 patients, 15 were the patients with noncardiac disease and mortality was 0.1%(1 patients). 6) The duration of the mechanical ventilation in RIDU patients, was 54.5 hours on the average and in the patients of mechanical ventilation more than 72 hours, the mortality was significantly increased compared with the patients of mechanical ventilation less than 72 hours. 7) The major causes of the death in RICU patients under 15 yearts old were LCOS(low cardiac output syndrome) and sepsis.