No abstract available.
Anemia* ; Echocardiography* ; Ventricular Function, Left*

No abstract available.
Balloon Valvuloplasty* ; Pulmonary Valve Stenosis* ; Pulmonary Valve*

BACKGROUND: Idiopathic left ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation that is sensitive to verapamil is electrophysiologically distinct arrhythmia entity but descriptions in pediatric ages are infrequent. This study attempted to describe the clinical presentation and dignostic clues from the surface ECG in children with idiopathic left venteicular tachycardia. METHODS: We retrospectively reviewed the medical records, electrocardiograms, Holter recordings, echocardiographic reports of 10 children with idiopathic left ventricular tachycardia who have been managed at Sejong General Hospital and Asan Medical Center, Seoul, Korea from January 1991 to July 1996. Follow-up periods are 2 months to 5 years(mean=26 months). RESULTS: 1) Age of tachycardia onset was 8 months to 14 years(median=4.3 years). In 3 children tachycardia began from infancy. The main complaint in older children was palpitation and chest discomfort but young childen complained abdominal pain during tachycardia attack. Tachycardia was paroxysmal and sustained. Tachycardia responded to intravenous use of verapamil in 9 patients and was controlled by chronic verapamil medication in 6 patients. 2 patients were well without medication. Radiofrequency catheter ablation was done in an adolescent patient successfully. 2) In sinus rhythm, surface ECG showed normal QRS axis and normal QRS morphologies in all patients. During ventricular tachycardia, the heart rate was 183 to 270 beats/min. The taxhycardia of RBBB morphology was observed in all patients. The mean QRS duration was 109+-12ms and the QRS axis was -50* to -90*. Themean RS interval was 60+-12ms. AVdissociation was found on surface RCG in all patients and confirmed in 4 patients by transesophageal ECG. We tried rapid transesophageal atrial pacing in 3 patients and could induce and terminate the ventricular tachycardia. CONCLUSIONS: Idiopathic left ventricular tachycaedia is rare in childhood and is seen from infancy. Idiopathic left ventricular tachycardia is generally benign but occasionally causesmyocardial dysfunction. Idiopathic ventricular tachycardia with a QRS pattern of right bundle branch block amd left axis deviation that is sensitive to verapamil in children should not be confused with supraventricular tachycardia with aberrancy and most helpful diagnostic clue is AV dissociation in surface ECG.
Abdominal Pain ; Adolescent ; Arrhythmias, Cardiac ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Child ; Chungcheongnam-do ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Hospitals, General ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Seoul ; Tachycardia ; Tachycardia, Supraventricular ; Tachycardia, Ventricular* ; Thorax ; Verapamil

OBJECTIVE: Recently, microdissection of tissue sections has been used increasingly for the isolation of morphologically identified homogeneous cell populations, thus overcoming the obstacle of tissue complexity for the analysis cell-specific expression of macromolecules. The aim of the present study was to establish the minimal conditions required for the RNA extraction and amplification from the cells captured by the laser captured microdissection. METHODS: Mouse ovaries were fixed and cut into serial sections (7 micrometer thickness). Oocytes were captured by laser captured microdissection (LCM) method by using PixCell IITM system. The frozen sections were fixed in 70% ethanol and stained with hematoxylin and eosin, while the paraffin sections were stained with Multiple stain. Sections were dehydrated in graded alcohols followed by xylene and air-dried for 20 min prior to LCM. All reactions were performed in ribonuclease free solutions to prevent RNA degradation. After LCM, total RNA extraction from the captured oocytes was performed using the guanidinium isothiocyanate (GITC) solution, and subsequently evaluated by reverse transcriptase -polymerase chain reaction (RT-PCR) for glyceraldehyde-3-phosphate-dehydrogenase (GAPDH). RESULTS: With the frozen sections, detection of the GAPDH mRNA expression in the number of captured 25 oocytes were not repeatable, but the expression was always detectable from 50 oocytes. With 25 oocytes, at least 27 PCR cycles were required, whereas with 50 oocytes, 21 cycles were enough to detect GAPDH expression. Amount of the primary cDNA required for RT-PCR was reduced down to at least 0.25 microl with 50 oocytes, thus the resting 19.75 microl cDNA can be used for the testing other interested gene expression. Tissue-to-slide, tissue-to-tissue forces were very high in the paraffin sections, thus the greater number of cell procurement was required than the frozen sections. CONCLUSION: We have described a method for analyzing gene expression at the RNA level with the homogeneously microdissected cells from the small amount of tissues with complexity. We found that LCM coupled with RT-PCR could detect housekeeping gene expression in 50 oocytes captured. This technique can be easily applied for the study of gene expression with the small amount of tissues.
Alcohols ; Animals ; DNA, Complementary ; Eosine Yellowish-(YS) ; Ethanol ; Female ; Frozen Sections ; Gene Expression* ; Genes, Essential ; Guanidine ; Hematoxylin ; Mice ; Microdissection* ; Oocytes* ; Ovary ; Paraffin ; Polymerase Chain Reaction ; Ribonucleases ; RNA Stability ; RNA* ; RNA, Messenger ; RNA-Directed DNA Polymerase ; Xylenes

From January to December 1984, 191 patients with associated ventricular septal defect(VSD) were studied in the cardiac cathetherization laboratory. Among theses 191 cases, 58 cases(30.4%) of subpulmonic VSD were identified by angiocardiography. Among the 59 cases of subpulmonic VSD, 12 cases(20.6%) were complicated with aortic infficiency(AI). The relative frequency of subpulmonic VSD increased with the increase of age and the frequency of complication of AI with the subpulmonic VSD also increased with the increase of age. The amount of left to right shunt in the patients with subpulmonic VSD and AI was small and Qp/Qs ratio was less than 2.0 in all of the 12 cases. Among the 12 patients 4 cases had a pressure gradient greater than 20 mmHg across the infundibular region of the right ventricle.
Angiocardiography ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans

Digora(R)-an intraoral digital radiography system utilizing image plate(IP) - has a dynamic range of expo sure time which allows it to decrease the patient's exposure time and to increase diagnostic ability through imge proces sing, transmission and storage. The purpose of this study was to evaluate the Digora(R) system by assessing the effects of various exposure times on the detectability on the tip of the endodontic file. Examining the root canals of 45 extracted sound premolars, K-files No. 10, 15, and 20 were placed at slightly varying distances from the apex. The teeth were glued onto resin-pla ster blocks. Five exposure times varying between 0.01 seconds and 0.25 seconds were used. Four observers were asked to m easure the distance between the tip of the file and a reduction of crown portion, and obtained mean errors (subtracting true file length from the measured file length), comparing Digora(R) monitors with E-plus films, which were bot h obtained under the same geometrical positions. The results were as follows : 1. Comparing E-plus film with Digora(R) at 0.01 seconds, the mean errors in E-plus film showed -4.453mm, -4.49 7mm, and -3.857mm, while the mean errors in Digora(R) showed 0.065mm, 0.607mm, and 0.719mm according to the fil e groups. Therefore there was a significant difference between E-plus film and Digora(R)(P<0.05). 2. By comparison of mean errors according to the various exposure times in the Digora(R) system, the mean error at standard deviation was the highest at 0.01 seconds was significantly lower than that at 0.12 and 0.25 seconds in No . 10 and 20 file group(P<0.05). and the standard deviation was the highest at 0.01 seconds. 3. Comparing E-plus film at 0.25 seconds with the Digora(R) system, the mean errors showed a significant diffe rence between E-plus at 0.25 seconds and the Digora(R) system at 0.25 seconds in No. 10 and 20 file groups (P <0.05). 4. Comparing E-plus film at 0.25 seconds with other exposure times, the mean errors showed a significant difference between E-plus film at 0.25 seconds and E-plus film at 0.01 and 0.03 seconds in 10 file group(p<0.05). In the NO. 15 and 20 file groups, there was a significant difference between E-plus film at 0.25 seconds and E-plus film at 0.01 seconds(p<0.05). In conclusion, Digora(R) was better than E-plus film in detectability on the tip of the file at the exposure time of 0.01 seconds in all file groups. And we concluded that Digora(R) can shorten exposure times up to 4% of 0.25 seconds (0.01 sec), which is adequate exposure time for premolar in E-plus film using No. 15 and 20 files.
Bicuspid ; Crowns ; Dental Pulp Cavity ; Radiographic Image Enhancement ; Tooth

This study was conducted to investigate the validity of using a cameraphone for a dietary intake survey method. The subjects were 28 female college students. After eating a standard lunch meal which consisted of plain rice, seaweed soup, bulgogi, cucumber salad, roasted anchovy and kimchi, the quantity of dietary intake, calorie intake & nutrients intake were analyzed by weighed method, diet record method and cameraphone method by dietitian with & without cameraphone analysis training. There were no significant differences in the quantity of 6 foods intake between weighted method and cameraphone method by dietitians with camera phone analysis training. However, the quantity of seaweed soup, bulgogi & cucumber salad intake analyzed by diet record method was significantly lower than the weighed method. And the quantity of seaweed soup, bulgogi, cucumber salad, roasted anchovy and kimchi intake analyzed by the cameraphone method by dietitians without cameraphone analysis training was significantly lower than the weighed method. There were no significant differences in the calorie intake and nutrients intake between the weighted method and camera phone method by dietitians with camera-phone analysis training. However, protein, calcium, iron, phosphorous, Vitamin A, Vitamin B2, Vitamin E and cholesterol intake analyzed by diet record method was significantly lower than the weighed method. And fat and Vitamin B2 intake analyzed by the camera phone method by dietitians without cameraphone analysis training was significantly lower than the weighed method. Therefore, this study suggests that the use of the camerephone may be a valid and convenient method for evaluating a dietary intake survey. However, systematic and standard education is necessary about the size and volume of dishes and angle of photo for more accurate results.
Calcium ; Cholesterol ; Surveys and Questionnaires* ; Diet Records ; Eating ; Education ; Female ; Humans ; Iron ; Lunch ; Meals ; Nutritionists ; Riboflavin ; Seaweed ; Vitamin A ; Vitamin E ; Vitamins

BACKGROUND: Chaotic atrial rhythm (CAR) is characterized by the presence of three or more P-wave morphologic features on the surface electrogram, absence of a dominant atrial pacemaker, and variable P-P, R-R, and P-R intervals with an atrial rate of over 100 beats/min. CAR is infrequently seen in pediatric ages and its clinical course, management and underlying mechanism are uncertain. We report our recent experience with 11 infants with CAR and describe their clinical characteristics and reponse to treatment. METHODS: We retrospectively reveiwed the medical records, electrocardiograms, Holter recordings, echocrdiographic reports of 11 cases of CAR managed at Sejong general hospital and Asan medical center from January 1991 to June 1995. RESULTS: 1) All patients were < or =6 months old and 5 of 11 patients had symptoms at neonatal period. The duration of follow-up was 3-42 months(mean : 18 months). 2 patients had structural heart disease and 3 patients showed signs of ventricular dysfunction. In 10 of 11 patients tachycardia was sustained or recurrent. 1 patient died of severe congestive heart failure due to incessant rapid tachycardia. 2) 3 of 10 patients took digoxin only and others took more than 2 medications. Full control within 1 month after medication was in 2 patients, with digoxin only in one and digoxin and amiodarone in another patient. At discharge, state of arrhythmia control in 8 patients with medications were full control in 2, good control in 3, and partial control in 3. At last follow-up, full control in 5, good control in 1 were confirmed through Holter recordings and the other 4 patients showed sinus rhythm in surface electrocardiograms. The total duration of medications were < or =1 year except 1 patient. 3) In 3 patients with ventricular dysfunction, ventricular function was normalized after restoration of sinus rhythm. CONCLUSION: CAR in children usually occurs in the first month of life and genenally takes benign course, but sometimes it causes severe congestive heart failure or ventricular dysfunction. Frequently, the patients remain asymptomatic despite persistence of the tachycardia for weeks or months. CAR is difficult to convert to sinus rhythm with medications but tends to resolve spontaneously within 1 year. We think treatment is necessary only in the symptomatic patients with rapid ventricular response and it is enough to control the ventricular rate with antiarrhythmic agents.
Amiodarone ; Arrhythmias, Cardiac ; Child ; Chungcheongnam-do ; Digoxin ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Hospitals, General ; Humans ; Infant ; Medical Records ; Retrospective Studies ; Tachycardia ; Ventricular Dysfunction ; Ventricular Function

Human Adjuvant Disease(HAD) is a connective tissue disease occuring after cosmetic surgery with a foreign substance. It was first reported by Miyoshi in 1964. There have been specific connective disorders such as systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis and mixed connective tissue disease. Scleroderma is the single most commonly reported disease. A 55-year-old woman was seen for evaluation of dypnea. Four years previously, she underwent cosmetic surgery with silicone injected directly into eyelid, forehead, both hand and monspubis. The patient presented the classic feature of systemic sclerosis and pericardial effusion. Following pericardiocentesis, she felt somewhat better and became less dyspneic. Seventeen days later, however, she progressively deteriorated and died in spite of intensive medical therapy and supportive care.
Arthritis, Rheumatoid ; Connective Tissue Diseases ; Eyelids ; Female ; Forehead ; Hand ; Humans ; Lupus Erythematosus, Systemic ; Middle Aged ; Mixed Connective Tissue Disease ; Pericardial Effusion ; Pericardiocentesis ; Scleroderma, Diffuse ; Scleroderma, Systemic ; Sclerosis* ; Silicone Gels* ; Surgery, Plastic*

BACKGROUND: Diagnosis of aortic arch obstruction can be made with two-dimensional and Doppler echocardiography in most cases.However,not infrequently,clear imaging of the aortic arch can not be obtained,particularly in sick neonates and young infants from a number of reasons and heart catheterization and angiography carries significant risk in sick babies.Therefore it is the purpose of this study to assess the feasibility and safety of counter-current aortography through a peripheral artery in young infants and neotates with suspected aortic arch obstruction. METHOD: We studied 56 patients with suspected aortic arch anomaly at Asian Medical Center from Feburary 1990 to April 1997.First choice for the peripheral artery was radial artery on the same side as the aortic arch,followed by brachial artery and axillary artery.Small 24 gauge plastic cannula was inserted and special attention was given to ensure that the peripheral artery,plastic cannula,and a syringe containing contrast material are all in the same plane.1ml/kg of contrast material was injected by rapid hand injection and biplane cineangiograms were taken at 60 frame/second. RESULTS: Fifty six patients underwent 58 angiograms.Age ranged from 5-255 days(median 30 days) and body weight nanged from 2.1-5.4kg(mean3.4kg).There were 27 males and 29 females.Arteries used were:Radial artery in 37,brachal artery in 19,and axillary artery in 2 cases.Peripheral arteries were ipsilateral side as the aortic arch in 54,contralateral side in 2 and bilateral in 2 cases.In 8 patients heart catheterization was done because of inadequate visualization of aortic arch anatomy and/or need for evaluating other defects.In 48 patients who had periperal angiography only,fluoroscopic time ranged from 0.6 to 3.5 minutes and total procedure time ranged from 10 to 15 minutes.Among these 48 patients,only 11 patients(23%) were given intraveous sedation and 37 patients(77%) did not recieve any sedation.Diagnosis of aortic arch anomaly was aortic coarctation in 38,aortic interruption in 10 and nomal aortic arch in 8 patients.Aortic arch anatomy was well demonstrated in all cases where injected artery was on the same side as the aortic arch.In patients who had angiograms through peripheral arteries contralateral to the side of the aortic arch did not haveadequate visualization of the arch.Compression of the carotid artery did not enhance the imaging of the arch.Simultanous bilateral angiography did not improve the imaging quality as compared to ipsilateral artery angiography.Transient complication,related to cannulation,e.g.,prolonged bleeding was seen in only one patient with aortic interruption.Circulation on the upper extremities was normal after angiography in all patients. CONCLUSION: Counter-current aortography using 24 gauge plastic cannular through peripheral artery is feasible,rapid,safe,economic and relatevely non-invasive procedure and provides adquate imaging of aortic arch obstruction in infants and neonates without risk of heart catheterization and angiography.We,therefore,recommend this procedure in selected patients in whom echocardiographic imaging alone is not conclusive for planning corrective sursery.
Angiography ; Aorta, Thoracic* ; Aortic Coarctation ; Aortography* ; Arteries* ; Asian Continental Ancestry Group ; Axillary Artery ; Body Weight ; Brachial Artery ; Cardiac Catheterization ; Cardiac Catheters ; Carotid Arteries ; Catheters ; Diagnosis ; Echocardiography ; Echocardiography, Doppler ; Hand ; Heart Defects, Congenital ; Hemorrhage ; Humans ; Infant* ; Infant, Newborn* ; Male ; Plastics ; Radial Artery ; Syringes ; Upper Extremity