Objective: Depending on the direction and degree of the septal deviation, the patient with malalignment-type VSD present with a variety of clinical syndrome. It is the purpose of this study to examine clinical characteristics of malalignment-type VSD, and to emphasize the clinical significance of septal malalignment in VSD and thus to increase the awareness for it. Methods: We analyzed echocardiographic or cardic catheterization and angiographic findings of 85 patients who were diagnosed as malalignment-type VSD at the department of pediatrics, Chonnam University Hospital between July 1990 and September 1992 Results: 1) Among 85 patients with malalignment-type VSD, there were 52 Cases (61. 2%) of Fallot-type VSD. 14 cases (16.5%) of Eisenmenger-type VSD, 19 cases (22.3%) of coarctation-type VSD. 2) All the 85 cases with malalignment-type VSD had the infundibular defects, and perimembranous infundibular VSD was most frequently associated with septal malalignment. 3) There was no prolapsing valve in all the cases with malalignment-type VSD. 4) Pulmonary hypertension was observed in all the cases with Eisenmenger-type and coarctation-type VSD. 5) Among the 19 cases with coarctation-type VSD, 8 cses (42.1%) were associated with coarctation of the aorth, and 3 cases (15.8%) with interrupted aortic arch. Conclusion: We conclude that septal malalignment in VSD has considerable clinical significance. Therefore, the authors believe that we should always consider the presence or absence of septal malalignment, in addition to the size and location of defect at the time of diagnostic evaluation of VSD, especially in the Koreans showing high incidence of infundibular VSD.
Aorta, Thoracic ; Catheterization ; Catheters ; Echocardiography ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Incidence ; Jeollanam-do ; Pediatrics

No abstract available.
Blood Cell Count* ; Blood Cells* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prognosis* ; Remission Induction*

No abstract available.

No abstract available.
Glomus Tumor*

PURPOSE: The purpose of this study was to resolve, in an efficient manner, the mechanoreceptor problems of the part far from the paretic upper extremity in stroke patients, as well as to provide clinical basic data of an intervention program for efficient neurodynamic in stroke patients, by developing a rhythmic neurodynamic exercise program and verifying functional changes depending on the increase in the upper extremity nerve conduction velocity. METHODS: Samples were extracted from 18 patients with hemiplegia, caused by stroke, and were randomly assigned to either the experimental group I for the general upper extremity neurodynamic (n=9) and the experimental group II for rhythmic upper extremity neurodynamic (n=9). An intervention program was applied ten times per set (three sets one time) and four times a week for two weeks (once a day). As a pre-test, changes in the upper extremity nerve conduction velocity and functions were assessed, and two weeks later, a posttest was conducted to re-measure them in the same manner. RESULTS: The wrist and palm sections of the radial nerve and the wrist and elbow sections of the median nerve, as well as the wrist, lower elbow, upper elbow, and axilla sections of the ulnar nerve had significant differences with respect to the upper extremity nerve conduction velocity between the two groups (p<0.05)(p<0.01), and significant differences were also found in the upper extremity functions (p<0.05). CONCLUSION: Rhythmic neurodynamic accelerated the nerve conduction velocity more in broader neural sections than the general neurodynamic. In conclusion, rhythmic neurodynamic was proven to be effective for improving the functions of upper extremity.
Axilla ; Elbow ; Hemiplegia ; Humans ; Mechanoreceptors ; Median Nerve ; Neural Conduction* ; Radial Nerve ; Stroke* ; Ulnar Nerve ; Upper Extremity* ; Wrist

PURPOSE: To see the stability and error in the diffusion-weighted magnetic resonance (MR) imaging technique in the experimental models and to observe the signal intensities in the early cerebral lesions of the animal models. MATERIALS AND METHODS: Diffusion coefficients of acetone and distilled water were measured by diffusion-weighted MR image and were compared with actual values. Differentiation of diffusion from perfusion were done at the resin flow phantom. The signal intensities caused by early parenchymal changes were measured in normal, hypovolemic, and embolic, and dead animal models by using diffusion-weighted image and compared with pathoIogic finding and vital staining. RESULTS: Diffusion coefficients of acetone and distilled water were 4.48 x 10-3 and 2.72 x 10-3 which were very close to the actual values. Diffusion-weighted MR image obtained at flow phantom was not affected by flow (perfusion) at the 100-400 of b-factor range. Animal study done at that b-factor range revealed a significant signal difference between the left and right sides only at the embolic model induced by polyvinyl alchol particles (p<0.05). These changes were not detected in microscopic finding but could be identified in vital staining. CONCLUSION: Diffusion-weighted MR image can be used to detect early parenchymal change when the appropriate b-factor range was applied.
Acetone ; Animals ; Diffusion* ; Hypovolemia ; Models, Animal ; Models, Theoretical* ; Perfusion ; Polyvinyls ; Water

Sedation is an essential component for gastrointestinal endoscopy. It allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. For the safety during endoscopic sedation, patient monitoring is crucial. Minimal monitoring requirements during endoscopic sedation are periodic assessment of blood pressure and application of continuous pulse oximetry. Continuous electrocardiography is recommended in selected patients with high risk for sedation or have cardiopulmonary diseases. Continuous supplemental oxygen is also recommended for endoscopic sedation. This study describes detailed monitoring and associated devices based on the current guidelines and recommendations from gastrointestinal society of America, Europe, and Korea.
Americas ; Anxiety ; Blood Pressure ; Conscious Sedation ; Electrocardiography ; Endoscopy ; Endoscopy, Gastrointestinal ; Europe ; Humans ; Korea ; Monitoring, Physiologic* ; Oximetry ; Oxygen

BACKGROUND: The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. METHOD AND MATERIALS: The basic design o f the DIC and DRRS was to build an digital image database of radiation therapy patient records for a more efficient and timely flow of critical image in formation throughout the department. This system is a subunit of comprehensive radiation oncology managemert system (C-ROMS) and composed of a picture archiving and communication system (PACS), radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology image... Gross lesion photos, and radiotherapy planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). RESULTS: From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in; paperless environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. CONCLUSION: The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the paperless and filmless practice of radiation oncology with this system.
Breast Neoplasms ; Dacarbazine ; Hospital Information Systems ; Humans ; Income ; Patient Care ; Radiation Oncology* ; Radiotherapy*

No abstract available.
Carcinoma, Hepatocellular*

BACKGROUND: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. METHOD: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and EGG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Gontrol, n=25). RESULTS: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (Al), apnea-hypopnea index (AHI), arterial oxygen saturation nadir (SaO2 nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with Al, AHI, SaO2 nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n=14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (deltaHR) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (deltaSaO2) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control. In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. CONCLUSION: These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.
Anoxia ; Apnea ; Arousal ; Arrhythmias, Cardiac ; Blood Pressure* ; Catecholamines* ; Epinephrine ; Heart Rate ; Humans ; Hypertension ; Incidence ; Mortality ; Norepinephrine ; Ovum ; Oxygen ; Polysomnography ; Sleep Apnea, Obstructive* ; Sympathetic Nervous System ; United Nations