Vesicoureteral reflux (VUR) is common disease found in up to 70% of children who have urinary tract infection, and the various type of antireflux surgerys were used to correct the problem. Among them, Gil-Vernet antireflux technique is a useful method and it has many advantages such as procedure of simplicity, shorter operative time, and lower complication rate along with maintaining high success rate. We present six cases of vesicoureteral reflux who had been managed with Gil-Vernet antireflux technique, and review the advantages, disadvantages, complications, and usefulness of the procedure.
Child ; Humans ; Operative Time ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

PURPOSE: The purpose of this study is to identify nature of regenerated articular cartilage after microfracture surgery. MATERIALS AND METHODS: From Oct. 1997 to Nov. 1998, 40 knees were treated for osteoarthritis by arthroscopic microfracture technique. In the 18 knees, during the second arthroscopic procedure, biopsy specimens extending to the subchondral bone were taken and immunohistochemical staining was done to identify type of collagen. One patient was man and 17 patients were women. Average age of the patients were 58 years (range, 40-75 years). RESULTS: Type II collagen in articular cartilage appeared to be brown color with this staining. Degree of staining were +3 in 4 knees(22%), +2 in 2 knees(11%), +1 in 7 knees(39%) and trace in 5 knees(28%). CONCLUSION: Microfracture surgery restores the function of the joint by forming predominantly hyaline-like cartilage containing type II collagen. As analyzing amounts of type II collagen with an immunohistochemical staining in regenerated cartilage, we can presume the prognosis of regenerated cartilage tissue after microfracture surgery.
Biopsy ; Cartilage* ; Cartilage, Articular ; Collagen ; Collagen Type II* ; Female ; Humans ; Joints ; Knee ; Osteoarthritis ; Prognosis

PURPOSE: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. METHODS: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. RESULTS: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. CONCLUSION: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.
Bile ; Bile Ducts, Intrahepatic ; Biliary Atresia* ; Biliary Tract ; Cholestasis ; Chungcheongnam-do ; Diagnosis* ; Early Intervention (Education) ; Hepatitis ; Humans ; Infant, Newborn ; Parenteral Nutrition, Total ; Radioactivity ; Radionuclide Imaging* ; Sensitivity and Specificity

No abstract available.
Catheters* ; Stents*

BACKGROUND AND OBJECTIVES: Several randomized studies have shown that the implantable cardioverter-defibrillator (ICD) is a very effective treatment modality for the primary and secondary preventions of sudden cardiac death. The purpose of this study was to analyze our initial experience of ICD implantation in patients who had experienced syncope or sudden cardiac death between 1997 and 2004. SUBJECTS AND METHODS: Between Aug. 1997 and Feb. 2004, 28 patients who had undergone an ICD implantation at the Yonsei Cardiovascular Center were retrospectively analyzed. RESULTS: There were 28 patients (24 men, 4 female), with a mean age of 48+/-13.1 (21-74) years. ICD implantation was performed in 2 and 26 patients for the primary and secondary preventions of sudden cardiac death. Eight patients (28.6%) had neither a structural heart disease nor an electrical disease, but 8 (28.6%) had Brugada Syndrome. Twelve patients (42.8%) presented with structural heart disease. The most frequent documented clinical arrhythmia was ventricular fibrillation, which occurred in 11 patients (39.3%). During the mean follow-up of 29.3 months, the were 60 events of tachyarrhythmia triggered shock; 25 of these were from inappropriate shock due to atrial fibrillation (1 6), sinus tachycardia (6) and farfield T wave sensing (3). Two patients died: one of stomach cancer and the other died suddenly without DC shock. An autopsy revealed a moderate amount of bloody pericardial effusion, but unknown hemodynamic significance. CONCLUSION: The implant of an ICD is an effective measure for the secondary prevention of sudden cardiac death. Dual-chamber ICD is desirable for the prevention of inappropriate ICD shock for supraventricular tachyarrhythmias.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Autopsy ; Brugada Syndrome ; Death, Sudden, Cardiac ; Defibrillators, Implantable* ; Follow-Up Studies* ; Heart Diseases ; Hemodynamics ; Humans ; Male ; Pericardial Effusion ; Retrospective Studies ; Secondary Prevention ; Shock ; Stomach Neoplasms ; Syncope ; Tachycardia ; Tachycardia, Sinus ; Ventricular Fibrillation

Coronary aneurysm is a rare disorder, defined as a abnormal dilatation that exceeds 1.5 times the diameter of the adjacent segment of artery. Percutaneous transluminal coronary angioplasty is often associated with a coronary aneurysm and mechanical injury of vessel wall during the procedure is suspected as the cause. The reported incidence of coronary aneurysms in Caucasians was 4.9%, but the incidence in Asian population was 0.25%. Morphologically, aneurysms can be divided into true versus pseudo aneurysms. These differentiation by intravascular (interventional) ultrasound is important to predict prognosis of the coronary aneurysm. We experienced a case of coronary artery true aneurysm, that developed after coronary balloon angioplasty and stent implantation. So we report the case.
Aneurysm* ; Angioplasty, Balloon, Coronary ; Arteries ; Asian Continental Ancestry Group ; Coronary Aneurysm ; Coronary Vessels* ; Dilatation ; Humans ; Incidence ; Prognosis ; Stents* ; Ultrasonography ; Ultrasonography, Interventional

Double coronary artery with coronary arteriovenous fistula is a very unusual anomaly and has not been reported in Korea. Coronary arteriovenous fistula consists of communication between one of the coronary arteries and a cardiac chamber or vein. It generally drains into the right ventricle, right atrium, coronary sinus, or pulmonary artery. It is being diagnosed with increasing frequency with combined use of coronary angiography and contrast echocardiography. In the present case, coronary angiography showed double right coronary artery with separated ostia. We confirmed that one of them drained into right ventricular chamber by contrast echocardiography performed after intraaortic contrast injection.
Arteriovenous Fistula ; Coronary Angiography ; Coronary Sinus ; Coronary Vessels* ; Echocardiography ; Heart Atria ; Heart Ventricles ; Korea ; Pulmonary Artery ; Veins

BACKGROUND: Continuous metabolic syndrome (MS) severity scores that can track metabolic risk in individuals over time have been developed for Western populations. The present study aimed to develop gender- and age-specific equations for MS severity scores in Korean adults. METHODS: Using data from the Korea National Health and Nutrition Examination Surveys (KNHANES) IV (2010–2012) and VI (2013–2015), we performed a confirmatory factor analysis of single MS factor that allowed for differential loadings across groups to generate gender- and age-specific, continuous MS severity scores. Then, we validated this equation in a different dataset of Korean adults. RESULTS: In confirmatory analysis, waist circumference had the highest factor loading, indicating that waist circumference had the strongest correlation with MS among Korean adults. Lower factor loadings (< 0.4) among Korean adults aged 40–59 years were noted for systolic blood pressure and fasting glucose. MS severity score values were significantly correlated with metabolic parameters, including high-sensitivity C-reactive-protein, glycated hemoglobin, and homeostasis model assessment of insulin resistance. Furthermore, MS severity scores well predicted traditional MS according to receiver operating characteristic analysis in a validation dataset (KNHANES VII). In a longitudinal cohort dataset, participants diagnosed with Adult Treatment Program III (ATP-III) MS after an initial assessment had progressively higher baseline MS severity scores in relationship to their time until ATP-III MS diagnosis. CONCLUSION: The new MS severity score equations for Korean adults proposed in this study provide a clinically-accessible continuous measure of MS for potential use in identifying adults at higher risk for MS-related diseases and following changes within individuals over time.
Adult ; Blood Pressure ; Cohort Studies ; Dataset ; Diagnosis ; Epidemiology ; Fasting ; Glucose ; Hemoglobin A, Glycosylated ; Homeostasis ; Humans ; Insulin Resistance ; Korea ; Nutrition Surveys ; Obesity ; ROC Curve ; Waist Circumference

Background: Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population. Methods: From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve. Results: Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III. Conclusion The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.

Background: Recently, a metabolic syndrome severity score (MS score) using a dataset of the Korea National Health and Nutrition Examination Surveys has been developed. We aimed to determine whether the newly developed score is a significant predictor of cardiovascular (CV) events among the Korean population. Methods: From the Korean National Health Insurance System, 2,541,364 (aged 40 to 59 years) subjects with no history of CV events (ischemic stroke or myocardial infarction [MI]), who underwent health examinations from 2009 to 2011 and were followed up until 2014 to 2017, were identified. Cox proportional hazard model was employed to investigate the association between MS score and CV events. Model performance of MS score for predicting CV events was compared to that of conventional metabolic syndrome diagnostic criteria (Adult Treatment Program III [ATP-III]) using the Akaike information criterion and the area under the receiver operating characteristic curve. Results: Over a median follow-up of 6 years, 15,762 cases of CV events were reported. MS score at baseline showed a linear association with incident CV events. In the multivariable-adjusted model, the hazard ratios (95% confidence intervals) comparing the highest versus lowest quartiles of MS score were 1.48 (1.36 to 1.60) for MI and 1.89 (1.74 to 2.05) for stroke. Model fitness and performance of the MS score in predicting CV events were superior to those of ATP-III. Conclusion The newly developed age- and sex-specific continuous MS score for the Korean population is an independent predictor of ischemic stroke and MI in Korean middle-aged adults even after adjusting for confounding factors.