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In order to observe the aspects of prosthetic cardiac valve failure, we analyzed 26 cases of Redo operation among 1081 cases of valve replacemant performed from Jan. 1961. to July 1986. The results are as follows; 1) Crude Redo operation rate was 2.4%. 2) The most common cause or prosthetic cardiac valve failure was the primary tissue failure (73%) 8r the PVE was the 2nd (15.4%). 3) Mean valve implantation time was 47.7 months. Implantation time in the child group was shorter than in adult by 6.8 months, In the primary tissue failure group (19 cases) implantation time in the child was 42.8 months 8z in adult, 66.8 months. (P$lt;0.05) In conclusion, the durability of tissue valves was significantly decreased in the child age group because of increased propensity for calcification, so the preference of tissue valves especially in this age group should be reconsidered.
Type-C retrovirus, human T-cell leukemia virus type-l(HTLV-1), has been shown to be associated etiologically with adult T-cell leukemia, which is an endemic disease in southwestern parts of Japan. We examined the seroepidemiological characteristics of antibody to adult T-cell leukemia virus associated antigen (anti-ATLA-antibody) by the indirect immunofluorescent assay and ELISA from the healthy individuals and various diseased patients in the Republic of Korea, a country adjacent to Japan in which HTLV-1 is endemic. The results were as follows. 24 out of 9,603 individuals(0.25%) were seropiositive. The positve rate was 0.17% in males and 0.36% in females, the sex difference was female predominent relatively. HTLV-1 carriers were found 16 individuals in Seoul, 5 in Kyonggi area, 1 in Chungnam and Jonbuk, respectively, but found only 1 individual in Busan city and Jaejoo area close to southwestern parts of Japan. Positive rate to anti-ATLA-antibody seemed to be high in older age, especially at the 50s(0. 4Yo). In conclusion the prevalence rate of anti-ATLA- antibody seemed to be very low in the Republic of Korea adjacent to Japan in which HTLV-1 is endemic and no patient with adult T-cell leukemia has been found as yet. Also we noted that the Republic of Korea is not an endemic area to HTLV-1.
We evaluated the diagnostic usefulness of latexagglutination test for elevated serum myoglobin as a screening test in the early phase of acute myocardial infarction and 21 patients with chest pain mimicking acute myocardial infarction were included in this study. Result was compared with serum myoglobin level measured by radioimmunoassay (RIA) in every case. The Following results were obtained: 1) When serum myoglobin levels measured by RIA below 85ng/㎖ were regarded as normal, this test showed sensitivity of 82%, specificity of 95%. 2) In latex-agglutionation test for elevated serum myoglobin, test results were interpreted as negative, weakly positive and positive. If we regard weakly positive tests as positive, sensitivity was 93% and specificity was 62%. In contrast, if we regard weakly positive tests as negative specificity rose to 100% while sensitivity reduced to 75%. 3) Agreement rate of both test was k=0.59. It is suggested that latex-agglutination test for elevated serum myoglobin is helpful in ruling out acute myocardial infarction when test result is negative, and that it can be used as a screening test in the early phase of acute myocardial infarction because of its rapidity and simplicity in performing the procedure.
Background: Type 2 diabetes is a heterogeneous disease. As to its complications, microangiopathy predominantly develop in some patients while macroangiopathy is more predominant in others. Therefore, this study was performed to identify the factors associated with such dissociation. Methods: Type 2 diabetic patients were classified into the macro and microangiopathy groups by carotid intima-medial thickness (IMT) and the presence of severe diabetic retinopathy. Patients with IMT ≤ 0.83 mm and severe NPDR or PDR were assigned to microangiopathy group; those with IMT 0.84 mm and no diabetic retinopathy were assigned to macroangiopathy group. Of 95 patients studied, 14 were classified as microangiopathy group and 20 as macroangiopathy group. Results: When the microangiopathy and macroangiopathy groups were compared, the microangiopathy group were significantly younger at the time of examination and at the onset of diabetes, and had longer duration of diabetes. Percentage of patients receiving insulin treatment was significantly higher and plasma C-peptide significantly lower in the microangiopathy group. However, HDL-cholesterol levels were significantly lower in the macroangiopathy group. Furthermore, the multiple logistic regression analyses revealed that younger onset of type 2 diabetes was an independent factor that was associated with the acceleration of microangiopathy. Conclusion: This study suggests that the age at onset of diabetes is an important independent risk factor that is associated with predominant development of microangiopathy in type 2 diabetic patients.
Diastolic LA and LV pressure gradient was determined with doppler echocardiography in 35 patients with mitral valvular heart disease and was compared with that determined with cardiac catheterization. In 23 patients who underwent mitral valvular replacement, pre and postoperative pressure gradients were observed, Correlation between pressure gradient and pressure half time was investigated with Doppler echocardiography. The results were as follows; 1) 1n total 35 patients with MVHD, mean ΔP in Doppler and cath were 15.8±6.3 (mean±S.D.) mmHg and 17.0±6.7mmHg, respectively, and the correlation coefficient was 0.91. 2) In 15 patients with pure MS, mean ΔP in Doppler and cath, were 15.5±6.1mmHg and 16.1±5.6mmHg, respectively, and the correlation coefficient was 0.90. 3) In 23 patients who underwent MVR, preop ΔP and postop Δ4P were 17.0±6.2mmHg and 2.2±0.9mmHg, respectively, and the difference was significant. 4) In 13 patients with Ionescu Shiley valve, ΔP and T were 2.1mmHgSl.lmmHg, and 110±50msec respectively. In 9 patients with St. Jude valve, ΔP and T1/2 were 2.3±0.7mmHg and 65±22msec, respectively, 5) The correlation coefficient between ΔP and T1/2 was 0.48 in total 35 MVHD and 0.57 in 15 pure MS. The correlation coefficient between ΔP divided by cardiac index and T1/2 f, was 0.63 in 15 pure MS. Therefore, Doppler echocardiography is a useful noninvasive diagnostic tool for measurement of the pressure gradient between LA and LV in MVHD, and can be used to assess the severity of preop, MVHD and postop. result and to follow up patients after operation.
The etiology of this disease is unknown but Chronic inflammation and ulceration have been reported as the etiologic mechanism in many cases. This lesion has appeared in orbital area, skin, salivary glands, mediastinum, abdomen, lymphnode, lung, rectum, breast, soft tissue and thyroid. The most common location has especially appeared in the stomach. We have found experiences of chronic symptoms of nausea, anorexia, hemtemesis, melena and especially epigastric pain in our case. U.G.I. series and gastrofiberscopy with biopsy are not very effective in diagnosis. An histologic examination of a resected stomach is the only sure way for a diagnosis. Histologic finding of gastric pseudolymphoma is showed small sized tumor, infiltration of small round mature lymphocytes, plasma cell, eosinophil and lymphoid germinal center. The appropriate clinical management is not well known. Gastric resection is recommended with extensive histologic examination of a resected stomach because potssible malignant patential has been reported. We reported that gastric pseudolymphoma with gastric bleeding was histologically confirmed after a subtotal gastrectomy.
This study was aimed to take the available informations about the acute poisoning, its prevention and therapy. This survey was accomplished with acute intoxicated patients in the ER(emergency room) of Chonnam National University Hospital during 42 months from Jan.1986 to June 1989. The intoxicated patients occupied 5.8% of total ER patients (47007 cases). The average of intoxicated patients per day in ER was 2.13. On sex analysis, males occupied 49.3% and females 50.7%. On the motive of poisoning, intoxication by accident occupied 42.1%, by suicide attempt 39.4%, and by the others 18.5%. Poisoning substances included CO poisoning(23.9%), agricultural agents (22.8%), drugs(15.4%), chemicals(14.6), bites, rodenticides and food poisoning. The mortality of intoxicated patients was 8% (216 cases) and the major death-inducing substance was paraquat(39.8%). To decrease and prevent these acute poisonings, we suggest, first, that agricultural agents and psychotropic drugs must be carefully controlled by authorities, second, the informations on the acute poisoning continuously collected, third, poison control center established as soon as possible.
This survey reports on the extensive examination of the quality of 14 jogging and tennis shoes separately, availavable in the domestic market. Both jogging and tennis shoes were catagorised in two groups, namely the general goods (less expensive ones) and the exclusive goods (expensive models). The detailed classification are shown below; (도표) The domestic products meet the general purpose just as that of the foreign products. Due to the adhesion technology, the domestic tennis shoes consist of rubber sole with natural leather upper; In fact, the desirable combination, as foreign products, must be polyurethane/natural leather. The expensive models were heavier than the less expensive ones. The greater weight difference of right and left shoes are shown in the expensive models than that of the less expensive ones. The moisture absorption ratio of the expensive model is far superior in comparison with the less expensive model. The reason is identified by the material supplyed to produce the expensive model consisted of the natural leather and proper parts. The abrasion resistance of the expensive models were excellent that of the less expensive ones, because the rubber soles were showed the properties better than polyurethane sole which was used in the less expensive model.
Tensile and fracture behaviors of double-forged and aged Ti-6Al-4V alloys, with and without solution heat treatment and/or rapid cooling, were examined in the present study. Depending on the forging temperature and heat treatment condition, the microstructures of Ti-6Al-4V alloys varied greatly, including equiaxed α+transformed β. elongated α+equiaxed α, α' or acicular α in the prior β grain, and significantly affected the tensile and fracture properties at 25 and 316℃. Tensile and fracture failure modes of Ti-6Al-4V alloys with different microstructures were discussed based on the detailed fractographic examinations.
This study was accomplished to take the available informations about drug allergy, its prevention and therapy. Drug allergy was surveyed with the inpatients in Chonnam National University Hospital during 14 days from Oct, 5 to Oct. 18, 1989. The medical doctors of the ward of the clinical department wrote the drug allergy survey card and our team members reviewed the chart profiles to perform exactly. The drug allergic patients occupied 3.2% of total 657 inpatients. The longer the hospitalization period, the higher the ratio of the occurrence of drug allergy. On the allergy-induced drug, cephalosporins occupied 10 cases, penicillins 7 cases, NSAIDS 3 cases and the miscellaneous drugs 8 cases. On the route of drug administration in the case of drug allergy, parenteral route occupied 16 cases and oral route 5 cases. The symptom of drug allergy included skin eruption(16 cases), palpitaion(6 cases), drug fever(4 cases), itching sense(3 cases), flushing face(1 case) and syncope(1 case). The major test of drug allergy was skin test. On the onset time of drug allergy after starting drug therapy, 3 cases occurred immediately, 4 cases after 1 day-2 days, 5 cases during 2 days-1 week and 5 cases after 2 weeks.