No abstract available.
Amylases* ; Child* ; Encephalitis, Arbovirus* ; Humans

Deveolopmental coax vara represents coax vara not present at birth but rather developing in early childhood, showing a progressive deterioration in the proximal femoral neck-shaft angle during growth. In order to determine the factors that could affect the results of corrective osteotomy, we evaluated the results of 15 developmental coax vara in 12 patients who had been treated with the femoral osteotomy at the Department of Pediatric Orthopedic Surgery, Seoul National University Children's Hospital, from February 1983 to March 1993. Of the 12 patients, there were 6 boys and 6 girls. Three patients had bilateral operations, 5 patients on the right, and the remaining 4 patients on the left. Average at the onset of symptoms was 4 years plus 5 months(range; from 1 year to 7 years plus 2 months), and average age at the tome of operation was 6 years plus 3 months(range; from 2 years plus 4 months to 10 years). We could obtain the following results: 1. Average post-operative loss of neck-shaft angle was 5% in the cases in which post-operative neck-shaft angle was converted more than 130 degrees, and was 8% in the cases in which post-operative neck-shaft angle was converted less than 130 degrees. 2. Loss of neck-shaft angle was higher during the first post-operative period, and was higher in cases in which the triangular osseous defect was persistent post-operatively. There was no correlation between the post-operative neck-shaft angle and disappearance of triangular osseous defect. 3. The femoral anteversion was converted 8.7 degrees to 27.2 postoperatively. 4. The premature arrest of the capital femoral physis was higher in cases in which the neck-shaft angle was less than 130 degrees postoperatively. 5. Leg length discrepancy, which was 2.1 cm preoperatively, did not change in cases in which the neck-shaft angle was more than 130 degrees postoperatively. However, it was converted to 3.3 cm in cases in which the neck-shaft angle was less than 130 postoperatively. 6. we could observe the femoral head deformity in 6 out of 7 cases in which the operation was performed after 7 years of age. We could draw the following conclusion based on our results: 1. We must correct the neck-shaft angle more than 130 degrees. 2. We could not equalize the leg length discrepancy by corrective osteotomy alone. 3. It may be reasonable to perform the corrective osteotomy before 7 years of age.
Congenital Abnormalities ; Coxa Vara ; Female ; Head ; Humans ; Leg ; Orthopedics ; Osteotomy ; Parturition ; Seoul

PURPOSE: Conventional contrast dacryocystography(C-DCG) has been used mainly for anatomical assessment of the lacrimal drainage apparatus, due to its limited information on the dynamics of the lacrimal system, and thus correlation role in epiphora. The purpose of study was to improve the diagnostic value in epiphora by utilizing RI dacryocystography(RI-DCG) with quantitative criteria. MATERIALS AND METHODS: The patient for RI dacryocystography set erect with the head fixed in front of gamma camera fitted with a standard 6 mm pinhole collimater. Both eyes of 85 patients(170 eyes) were scanned with 99rnTc-pertechnetate followed by conventional dacryocystography. The data from gamma camera were recorded simultaneously on a computer system for subsequent quantitative analysis. RESULTS: In 94 of 96 eyes without epiphora, RI-DCG was correlated with normal C-DCG and % of emptying was at least over 50%. In 58 of 74 eyes with epiphora, RI-DCG was correlated with abnormal C-DCG and % of emptying was at most below 50%. In 16 eyes with functional block, quantitative RI-DCG showed abnormal % of emptying. CONCLUSION: Nuclear DCG with quantitation had higher diagnostic yield in functional block and correlated higher with epiphora. Thus nuclear DCG with quantitation would be a valuable functional test after postprocedures such as dacryocystoplasty.
Computer Systems ; Drainage ; Gamma Cameras ; Head ; Humans ; Lacrimal Apparatus Diseases* ; Radionuclide Imaging*

BACKGROUND AND OBJECTIVES: We assessed the ability of portable echocardiography (with contrasts) to clearly delineate the cardiac structure, and evaluated the impact of its use on the diagnosis and management of critically ill patients in Korea. SUBJECTS AND METHODS: We prospectively enrolled 123 patients (mean age 66+/-16 years), who underwent portable transthoracic echocardiography (with contrast) for image enhancement at 12 medical centers. The quality of the global left ventricular (LV) images, the number of the regional LV segments visualized, the ability to visualize the LV apex and the right ventricle (RV), and any changes in the diagnostic procedure and treatment strategy were compared before and after the contrast. RESULTS: Of the 123 patients, 52 (42%) were using mechanical ventilators. The amount of poor or uninterpretable images decreased from 48% to 5% (p<0.001), after the contrast. Before the contrast, 15.6+/-1.1 of 16 LV segments were seen, which improved to 15.9+/-0.6 segments (p=0.001) after the contrast. The ability to visualize the LV apex increased from 47% to 94% (p<0.001), while the inability to clearly visualize the RV decreased from 46% to 19% (p<0.001). Changes in the diagnostic procedure (for example, not requiring other types of imaging studies) were observed in 18% of the patients, and the treatment plan (medication) was altered in 26% of patients after the contrast echocardiography. CONCLUSION: The use of a contrast agent during the portable echocardiography, in intensive care settings, can improve the image quality and impact the diagnostic procedures and treatment for Korean patients.
Critical Illness ; Diagnosis ; Echocardiography* ; Heart Ventricles ; Humans ; Image Enhancement ; Critical Care* ; Korea ; Prospective Studies ; Ventilators, Mechanical

BACKGROUND: Increasing numbers of resistant and multidrug resistant (MDR) isolates of Pseudomonas aeruginosa have become a worldwide problem. This report provides the trend of antimicrobial resistance, the proportions of MDR and metallo-beta-lactamase-producing isolates among clinical isolates of P. aeruginosa in Korea. MATERIALS AND METHODS: Clinical isolates of P. aeruginosa were collected from two representative reference laboratories during 2002-2004. Clinical information regarding specimens and type of hospital for isolates was investigated. Antimicrobial susceptibility against 11 antibiotics was tested by disk diffusion according to NCCLS criteria. MDR was assessed as resistance to > or =3 of the core drugs (ceftazidime, ciprofloxacin, gentamicin, imipenem and piperacillin). PCR assays and sequencing for detection of blaVIM-2 and blaIMP-1 gene were carried out. RESULTS: Of 1,748 P. aeruginosa isolates, 179 isolates were collected from primary care hospitals and 1,569 isolates were recovered from outpatients and inpatients in secondary care hospitals. From 2002 to 2004, rates of resistance to ceftazidime and imipenem increased from 10% to 12.3% and from 14.8% to 15.9%, respectively. Rates of resistance to amikacin (from 26.2% to 31.0%) and ciprofloxacin (from 35.6% to 46.2%) increased annually. In the period 2002-2004, decreasing of susceptibility to meropenem (from 83.4% to 76.8%) was observed, but meropenem was the most potent agent against P. aeruginosa isolates studied. During the 3-year period, MDR P. aeruginosa accounted for 26.4-33.5% of clinical isolates and the most common MDR phenotype was concurrent resistance to piperacillin, gentamicin and ciprofloxacin. The prevalence of VIM-2-producing isolates obviously increased from 1.7% in 2002 to 6.3% in 2004. CONCLUSIONS: These results suggested that MDR P. aeruginosa was already prevalent in one third of clinical isolates and VIM-2-producing P. aeruginosa isolates disseminated in non-tertiary care hospitals in Korea.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime ; Ciprofloxacin ; Diffusion ; Drug Resistance, Multiple ; Gentamicins ; Humans ; Imipenem ; Inpatients ; Korea* ; Outpatients ; Phenotype ; Piperacillin ; Polymerase Chain Reaction ; Prevalence ; Primary Health Care ; Pseudomonas aeruginosa* ; Pseudomonas* ; Secondary Care

BACKGROUND: Increasing numbers of resistant and multidrug resistant (MDR) isolates of Pseudomonas aeruginosa have become a worldwide problem. This report provides the trend of antimicrobial resistance, the proportions of MDR and metallo-beta-lactamase-producing isolates among clinical isolates of P. aeruginosa in Korea. MATERIALS AND METHODS: Clinical isolates of P. aeruginosa were collected from two representative reference laboratories during 2002-2004. Clinical information regarding specimens and type of hospital for isolates was investigated. Antimicrobial susceptibility against 11 antibiotics was tested by disk diffusion according to NCCLS criteria. MDR was assessed as resistance to > or =3 of the core drugs (ceftazidime, ciprofloxacin, gentamicin, imipenem and piperacillin). PCR assays and sequencing for detection of blaVIM-2 and blaIMP-1 gene were carried out. RESULTS: Of 1,748 P. aeruginosa isolates, 179 isolates were collected from primary care hospitals and 1,569 isolates were recovered from outpatients and inpatients in secondary care hospitals. From 2002 to 2004, rates of resistance to ceftazidime and imipenem increased from 10% to 12.3% and from 14.8% to 15.9%, respectively. Rates of resistance to amikacin (from 26.2% to 31.0%) and ciprofloxacin (from 35.6% to 46.2%) increased annually. In the period 2002-2004, decreasing of susceptibility to meropenem (from 83.4% to 76.8%) was observed, but meropenem was the most potent agent against P. aeruginosa isolates studied. During the 3-year period, MDR P. aeruginosa accounted for 26.4-33.5% of clinical isolates and the most common MDR phenotype was concurrent resistance to piperacillin, gentamicin and ciprofloxacin. The prevalence of VIM-2-producing isolates obviously increased from 1.7% in 2002 to 6.3% in 2004. CONCLUSIONS: These results suggested that MDR P. aeruginosa was already prevalent in one third of clinical isolates and VIM-2-producing P. aeruginosa isolates disseminated in non-tertiary care hospitals in Korea.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime ; Ciprofloxacin ; Diffusion ; Drug Resistance, Multiple ; Gentamicins ; Humans ; Imipenem ; Inpatients ; Korea* ; Outpatients ; Phenotype ; Piperacillin ; Polymerase Chain Reaction ; Prevalence ; Primary Health Care ; Pseudomonas aeruginosa* ; Pseudomonas* ; Secondary Care

BACKGROUND: Because conventional echocardiographic parameters have several limitations, strain echocardiography has often been introduced in clinical practice. However, there are also obstacles in using it in clinical practice. Therefore, we wanted to find the current status of awareness on using strain echocardiography in Korea. METHODS: We conducted a nationwide survey to evaluate current use and awareness of strain echocardiography from the members of the Korean Society of Echocardiography. RESULTS: We gathered total 321 questionnaires from 25 cardiology centers in Korea. All participants were able to perform or interpret echocardiographic examinations. All participating institutions performed strain echocardiography. Most of our study participants (97%) were aware of speckle tracking echocardiography and 185 (58%) performed it for clinical and research purposes. Two-dimensional strain echocardiography was the most commonly used modality and left ventricle (LV) was the most commonly used cardiac chamber (99%) for clinical purposes. Most of the participants (89%) did not think LV strain can replace LV ejection fraction (LVEF) in their clinical practice. The common reasons for not performing routine use of strain echocardiography was diversity of strain measurements and lack of normal reference value. Many participants had a favorable view of the future of strain echocardiography. CONCLUSION: Most of our study participants were aware of strain echocardiography, and all institutions performed strain echocardiography for clinical and research purposes. However, they did not think the LV strain values could replace LVEF. The diversity of strain measurements and lack of normal reference values were common reasons for not using strain echocardiography in clinical practice.
Cardiology ; Echocardiography* ; Heart Ventricles ; Korea* ; Reference Values