PURPOSE: We reviewed 5 years worth of experience with peritoneal drainage and dialysis in infants who underwent open heart surgery. The aim of this study was to investigate the effect of peritoneal drainage and peritoneal dialysis on fluid balance and several parameters of intensive care. METHODS: Six(10%) of 60 consecutive infants who underwent open heart surgery required peritoneal dialysis during peritoneal drainage. Simple peritoneal drainage was performed in the remaining 54 infants. The silicone rubber peritoneal dialysis catheter was inserted into the center of abdominal cavity just after operation, and subsequent peritoneal drainage was maintained during intensive care. RESULTS: Mean age of the study group was 0.48+/-0.21 years(M: F=32: 28). Early postoperative mortality amang the infants with congenital heart disease was 1.6%. Total amount of output was 7.0+/-2.28mL/kg/hr, urine output 5.14+/-2.9lmL/kg/hr, pleural fluid 0.80+/-0.5lmL/kg/hr, and peritoneal fluid 1.20+/-0.90mL/kg/hr. The ratio of output to intake(O/I) was 1.06. None of the complications required early termination of peritoneal drainage or peritoneal dialysis. Hemodynamics and pulmonary function were maintained steadily during postoperative intensive care. CONCLUSION: The early institution of peritoneal drainage and peritoneal dialysis in infants with congenital heart disease after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.
Abdominal Cavity ; Ascitic Fluid ; Catheters ; Dialysis ; Drainage* ; Heart Defects, Congenital* ; Heart* ; Hemodynamics ; Humans ; Infant* ; Critical Care ; Mortality ; Peritoneal Dialysis ; Silicone Elastomers ; Thoracic Surgery ; Water-Electrolyte Balance

Pagets disease is a chronic skeletal disease of middle and later life, beginning insidiously and characterized by progressive structural changes and typical deformities occuring in the long bones, pelvis, and cranium. The occurence of Pagets disease is extremely rare in Korea. We have experienced a case of Pagets disease of bone in 67 year-old female affecting mainly the ilium and skull, and we report the case with brief review of the literatures.
Congenital Abnormalities ; Female ; Humans ; Ilium ; Korea ; Pelvis ; Skull

No abstract available.
Cardiomyopathies* ; Peripartum Period*

One of the purposes of this experiment is to observe the structure of crystalline lens with cataract, which is formed artificially, using the light microscope and electron microscope. The other is to observe the differences of structural variations in the cataract developed inside body. Twelve eyes of six pigs were used for this experiment. Two of them are normal crystalline lens, five are cystalline lens in distilled water, and the rest are in balanced salt solution through intact or ruptured capsule. We examined the time of cataract formation and compared the ultrastructural changes. Ruptured capsule and high osmotic pressure difference induced more rapid opacity. In case of distilled water, the capsule is maintained but it is very difficult to distinguish between epithelium and lens fibers. Also, there is a severe crack in the lens fibers. In electron microscopic, as the cataract progresses, the osmotic swelling becomes more prominent. One of the striking changes was a marked intercellular cyst formation. Lens cells became irregular in size and density and were extensively vacuolated. The swelling of the lens cells continuously induced large intracellular vacuoles and liquefied the cytoplasmic protein. In conclusion, the structural change of cataract, which was seen by an electron microscope, resulted from change in osmolarity from previously announced in vivo experiment and structural change resulted from this experiment are similar.
Cataract* ; Crystallins* ; Cytoplasm ; Epithelium ; Lens, Crystalline* ; Microscopy, Electron ; Osmolar Concentration ; Osmotic Pressure ; Strikes, Employee ; Swine ; Vacuoles ; Water

PURPOSE: We report the results of a policy of primary surgical closure of large ventricular septal defects(VSDs) applied over the past 3 years to all symptomatic infants regardless of patient weight, location or number of VSDs. To analyze the early postoperative mortality and other surgical complications in young infants, comparison of preoperative and outcome variables were made between infants weighing 6 kg or less and those weighing mort than 6 kg at the time of operation. METHODS: Forty-eight infants met criteria for inclusion in the study, and were divided into two groups based on body weight: group 1 infants weighed 6 kg or less(n=24), and group 2 infants weighed more then 6 kg(n=24). Both groups had similar variation in ventricular septal defect location and the ratio of the flow. resistance. RESULTS: The major associated cardiac defects were more in group 1. The overall mortality rate of this study was 4%(2/48): Two early deaths occurred in only group 1(8%). Both infants had a doubly committed subarterial defect and mild degree of coarctation of aorta (one was a preductal type). One received a coatctation-repari. There was o only one patch dehiscence(in group 1). No surviving patients required a second ventricular septal defect opetation, and the majority no longer received anticongestive therapies. CONCLUSIONS: These results indicate that primary surgical closure of large ventricular septal defects can be performed in small infants with no difference in mortality or serious complication rates compared with larger infants. Protracted medical efforts to achieve larger size before primary repair and palliative pulmonary artery banding are not necessary.
Aortic Coarctation ; Body Weight ; Heart Septal Defects, Ventricular* ; Humans ; Infant* ; Mortality ; Pulmonary Artery

OBJECTIVE: To translate the English Qualiveen questionnaire which was developed to measure the specific impact of urinary problems on the quality of life of patients with neurogenic bladder into Korean and validate it. METHOD: First, we made the Korean version Qualiveen questionnaire through translation and cross-cultural adaptation followed by the international guideline. This process consisted of 6 steps including translation, reconciliation, back translation into English and debriefing. And then to assess the reliability and construct validity of the questionnaire, 32 patients with neurogenic bladder conducted the Korean Qualiveen questionnaire twice at an interval between three and four weeks. RESULTS: We translated and arbitrated a total of 151 questions. In step of the backward translation, we went through discussion and corrected 12 questions. We found out that 7 questions delivered inaccurate meanings or were unhandy items such as method of writing age or date in debriefing process. A reliability study revealed strong internal consistency (Cronbach's alpha coefficients above 0.7 for all domains) and test-retest reliability (Pearson's coefficient range from 0.524 to 0.837). The sub-domain strongly correlated with each other (Pearson's coefficient range from 0.625 to 0.936) in the construct validity study. CONCLUSION: The Korean version of the Qualiveen Questionnaire was successfully translated and validated.
Humans ; Linguistics ; Quality of Life ; Surveys and Questionnaires ; Urinary Bladder, Neurogenic ; Writing

PURPOSE: Clinical and radiologic results of operative versus nonoperative treatment were compared in patients 70 years or older who had an unstable distal radius fracture. MATERIALS AND METHODS: From March 2007 to April 2009, 49 patients who had an unstable distal radius fracture treated nonoperatively (22 patients) or operatively (27 patients) were investigated. The radiologic results between the two patient groups were compared based on bone union, dorsal tilt, radial inclination and radial shortening. The clinical results were compared based on disabilities of arm, shoulder & hand (DASH) score, the patient-rated wrist evaluation (PRWE) score, the grip strength and the motion range of the wrist joint. RESULTS: At the last follow-up examination, DASH score, PRWE score, the flexion, supination and radial deviation of wrist joint and the grip strength did not showed significant difference. Among the patients who received non-operative treatments, 18 of 22 showed radiologically recognizable deformation; average dorsal tilt of 11.9degrees, the average radial inclination of 18.9degrees, and average radial shortening of 3.8 mm. The patients who received operative treatments showed average volar tilt of 3.3degrees, radial inclination of 18.8degrees+/-3.7degrees, and radial shortening of 1.5 mm. Three patients showed radiologically recognizable deformation. CONCLUSION: Our results suggest that nonoperative treatment is initially recommended in patients with the age of 70 years or older who have an unstable distal radius fracture in terms of functional results.
Arm ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Radius ; Radius Fractures ; Shoulder ; Supination ; Wrist ; Wrist Joint

Cor triatriatum is a rare cardiac malformation in which the left atrium is subdivided into two chambers by a fibromuscular septum, one locates posterosuperiorly, which is connects with the pulmonary veins, and the other locates anteroinferiorly connecting with the mitral valves and left ventricie. It is often lethal in children with cor triatriatum due to congestive heart faliure which develops abruptly and rapidly. So, the most important thing is early detection of the disease. We experienced a case of cor triatriatum in 20 month-old female. She had severe symptoms related to congestive heart faliure, and the conditions showed dangerous. Echocardiography was used for correct diagnosis. The patients was improved dramatically after proper surgery. So, We reported this case and review literatures briefly.
Child ; Cor Triatriatum* ; Diagnosis ; Echocardiography ; Estrogens, Conjugated (USP) ; Female ; Heart ; Heart Atria ; Heart Septal Defects, Atrial* ; Humans ; Infant ; Mitral Valve ; Pulmonary Veins

No abstract available.
Embryonic Structures* ; Fluorescence* ; Humans* ; In Situ Hybridization* ; Preimplantation Diagnosis*

BACKGROUND: In Korea, cerebrovascular accident (CVA) is the most significant cause of death among older people, and the incidence of cerebral hemorrhage is much higher than that of developed countries. There have been many investigations about the risk factors for CVA in both Korea as well as developed countries. A few papers reported various risk factors for cerebral hemorrhage in developed countries:however, well-designed studies of risk factors for the various causes of CVA were rare in Korea. Therefore, the purpose of this study was to compare the risk factors for the various causes of CVA and to evaluate the risk factors compared with age- and sex-matched control groups. In addition, duplex sonographic findings of the carotid artery were evaluated in patients with cerebral infarction. METHODS: One hundred and sixty-four patients admitted to the hospital in 1996 were enrolled. The four groups were divided based on the following states: cerebral infarction (n-63), cerebral hemorrhage (n-64), cerebral infarction with atrial fibrillation (n-19), and lacunar infarction (n-18). Major risk factors were compared with age- and sex-matched control groups and among CVA groups. Duplex sonography of the carotid artery was done in 14 patients with cerebral infarction. RESULTS: In multiple logistic regression analysis, patients with cerebral infarction had higher prevalence of diabetes mellitus and lower high density lipoprotein-cholesterol level than the control group, and hypertension showed borderline significance. Patients with cerebral hemorrhage had higher prevalence of hypertension, higher high density lipoprotein-cholesterol level, and more frequent prevalence of smoking compared with the control group. Patients with cerebral infarction showed lower high density lipoprotein-cholesterol, higher low density lipoprotein-cholesterol levels, more frequent diabetes mellitus, lower prevalence of hypertension and older age than patients with cerebral hemorrhage. Patients with cerebral infarction and atrial fibrillation showed only older age than patients with cerebral infarction only. There were no differences in risk factors between patients with cerebral infarction and lacuna infarction. Atheromatous plaque was found in 71% of patients with cerebral infarction. CONCLUSION: Metabolic abnormalities played more important role in the development of cerebral infarction and hemodynamic abnormalities in cerebral infarction. Sonographic examination of the carotid artery may be useful for predicting the occurrence of cerebrovascular accident in high risk patients.
Atrial Fibrillation ; Carotid Arteries* ; Cause of Death ; Cerebral Hemorrhage ; Cerebral Infarction* ; Developed Countries ; Diabetes Mellitus ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Infarction ; Korea ; Logistic Models ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar ; Ultrasonography*