Echocardiographic Findings in Systemic Lupus Erythematosus

BACKGROUND: Systemic lupus erythematosus(SLE) frequently has cardiovascular complications. Pericardial inflammation and effusion. ventricular dysfunction, valvular disease and coronary atherosclerosis may result in morbidity. While the pathologic findings in SLE have been well described, the antemortem documentation of the cardiac complications has been less frequent than the postmortem findings would support, we therefore sought to study how echocariography may improve the clinical assessment of cardiac involvement in 40 consecutive patients with SLE. SUBJECTS AND METHODS: This study began in 1990 with a prospective design. An appointment was scheduled with all patients whose SLE was diagnosed at the outpatient clinic and during the admission of the internal medicine service at the Kang Nam St Mary's hospital These were 40 female patients, with a mean age of 32+/-11 years(+/-SD). The average duration of disease was 37+/-32months, the average dosage of prednisolone per day was 20+/-17mg. M-mode and 2-D echocardiogram were carried out to the 40 SLE patients. RESULT: Seventeen(43%) of the SLE patients had pericardial effusion. Reduced left ventricular contractility was evident in 8 patients(20%). Abnormality of diastolic dysfunction to be checked by A/E ratio was in 3 patients(8%). No patients had echocardiographic evidence of pulmonary arterial hypertension. Clinical findings of myocardial dysfunction in these patients included dyspnea(30%), jugular venous distension(20%), rales(10%) and S3 gallop(8%). Valvular abnormality of SLE patients included mitral regurgitation in five patients(13%) and aortic regurgitation in two patients(5%). Electrocardiogram showed myocardial ischemia, atrial fibrillation and sick sinus syndrome in 3, 1 and 1 patients respectively. CONCLUSION: In this study, pericardial effusion were the most common echocardiopraphic abnormalities in Patients with SLE. The incidence of valvular and myocardial disease were relatively common.

A Case of Long Term Survived Advanced Gastric Cancer with Only Conservative Treatment : Clinical and Endoscopic Floow-up for 6.5 Years / 대한소화기내시경학회지

Gastric cancer is the most common malignancy in Korea. Although five years survival rate of gestric cancer has been gradually improved due to advances in the diagnostic technique and therapeutic modalities, the advanced gastric cancer remains a disease with poor pragnosis. At the time of diagnosis, the disease, is usually advanced and longterm survivor is uncommon without a proper surgical treatment or chemotherapy. We experienced a case of advanced gastric cancer who lived for more than 6 years after making a diagnosis, without curative surgical therapy or chemotherapy. The patient at age of 76 year-old, was seen in St. Mary's hospital due to gastroinestinal bleeding in January of l985. A large ulcerating cancer in the diameter of 2.0 cm was found at the posterior wall of body with endoscopy and confirmed the diagnosis of stomach cancer by the endoscopic biopsy. He was recommended the surgical intervention of gastric cancer but he denied the operation due to his age, He had been treated symptomatically with H2 receptor antagonist and antacid with relief of symptoms. Thereafter he had been followed-up clinically at every 2-4 weeks, and the lesion was examined 3-4 times in a year endoscopically, In May l990, an endoscopic esophageal dilation was done due to esophageal stricture with tumor invasion at the lower esophageal sphincter. He was expired in July, 1991 in this hospital. Here we report a case of long term survived advanced gastric cancer who had been followed-up for 6 and half years clinically and endoscopically with review of literatures.