To analyse the clinical characteristics of children with atrial flutter(AF1), we reviewed(the medical records of the children who had been admitted and diagnosed as AF1 or 12 leads surface ECG during the period between February, 1986 and Octobe, 1990. The onset age of 25 children was evenly distributed between gestational period and upto 14 years of age. The sex ratio between boys and girls was 11:14. The cardiac abnormalities were detected in 21 children(dilated cardiomyopathy in 3, congenital heart defect in 18). In 4 children, AF1 occured in apparently normal heart. In 9 children, AF1 developed without relation to cardiac surgery(4 in normal heart, 3 in dilated cardiomyopathy, 2 in preoperative CHD). AF1 developed in 9 children within 30 days postoperatively(group A) and in 7, after 30 days postoperatively(group B). In group A, various types of operation were done. In 2 of them, AF1 persisted beyond the immediate postoperative period and 1 died of cardiac decompensation 3 months postoperatively. In group B, operative procedures before AF1 were Senning operation in 2, Fontan operation in 2, operation for tetralogy of Fallot, ventricular septal defect with severe tricuspid regurgitation, endocardial cushion defect in 1 each. Five children in group B( except 1 Senning operation and 1 Fontan operation) had significant residual atrioventricular regurgitation. The associated rhythm disturbance besides AF1 could be determined in 23 children. The sinus node dysfunction was associated in 8 ; the supraventricular dysrhythmia in 10; the ventricular dysrhythmia in 6; the atrioventricular conduction disturbance in 3, and no other associated rhythm disturbance in 6. The efficacy of various methods in conversion of AF1 to sinus rhythm were 57.1%(4/7) with DC cardioversion, 38.5%(5/13) with digoxin and other antiarrhythmic drug(amiodarone, beta blocker, quinidine, verapamil, flecainide), 25%(5/20) with pacing in esophagus or endocardium. The follow-up evaluation was possible in 24 children. Eight children were dead : 5 due to chronic decompensation, 2 due to sudden cardiac arrest, and 1 due to sepsis. Of the 16 alive children, 14 had recovered the normal sinus rhythm and the other 2 had persistent AF1. Twelve children without AF1 and 1 with persistent AF1 were on medication, Although there were none cardiac death in children without persistent AF1, 7 out of 9 children with persistent AF1 were dead. Of the 7 children with significant atrioventricular regurgitation, corrective procedures were done in 4. There were no death in these 4 children, despite of 2 cardiac death out of 3 children on whom corrective procedure were not done. In conclusion, the atrioventricular regurgitation was a significant factor in relation to the occurrence and persistence of AF1 and the prognosis was bad in children with persistent AF1. It is recommended to trat the children with AF1 associated with atrioventricular regurgitation promptly and more aggressively.
Age of Onset ; Atrial Flutter* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Child* ; Death ; Death, Sudden, Cardiac ; Digoxin ; Electric Countershock ; Electrocardiography ; Endocardial Cushion Defects ; Endocardium ; Esophagus ; Female ; Follow-Up Studies ; Fontan Procedure ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Humans ; Medical Records ; Postoperative Period ; Prognosis ; Quinidine ; Sepsis ; Sex Ratio ; Sick Sinus Syndrome ; Surgical Procedures, Operative ; Tetralogy of Fallot ; Tricuspid Valve Insufficiency ; Verapamil

With a rapid development of neuroscience, the theories related to the pathophysiology of schizophrenia have been changed a lot from a simple hyperdopaminergic one to the various complicated ones. Among these, the theories regarding prefrontal cortex(PFC) pathology as a cause of schizophrenia are gaining more recognition as the results of neuroimaging and neuropsychological tests in schizophrenia consistently report abnormalities in PFC. Therefore, we first reviewed the unique characteristics of PFC in anatomy, neurochemistry and neurophysiology to enhance an understanding of those ones. Secondly, various neurotransmitter, neurodevelopmental and neural network theories of schizophrenia introduced recently were reviewed in terms of PFC pathology.
Dopamine ; Neurochemistry ; Neuroimaging ; Neurophysiology ; Neuropsychological Tests ; Neurosciences ; Neurotransmitter Agents ; Pathology ; Prefrontal Cortex* ; Schizophrenia*

To identify whether acromial shape, osteophyte, and acromio-humeral interval have effects on impingement syndrome or rotator cuff tear, we reviewed 40 cases of normal group (F:M=22:18), and 30 cases of impingement syndrome(F:M=16:14). Forty cases of normal group aged from 40 to 69 who had no pain, no abrasion sign, no limitation of motion, and normal function of shoulder joint were selected. Thirty cases of impingement syndrome were managed by acromioplasty of direct repair from October, 1993 to May, 1994. Twenty-five cases of 30 were identified rotator cuff tear(RCT), and the others were turned out subacromial abrasion. We reviewed the acromial thickness, the acromial shape, the anterior protuberance, the presence of osteophyte, and the acromio-humeral interval to compare the difference between two groups. Forty-seven point five per cent of normal group had a flat, type I acromion, 47.5% had a curved, type II acromion and 5% were identified by a hooked, type III acromion. However, in subjects with impingement syndrome and RCT, 37% had type I, 20% had type II, and 43% displayed type III. Type III was considerably noticed in the massive tear. In regarding to acromial thickness, normal group had type A(less than 8mm)-37.5%, type B(8-12mm)-62.5%, and the impingement syndrome or RCT group had type A-53%, type B-47%. We couldn’t find any significant difference with each group in type III(more than 8mm)-15% in normal, and type I-17%, type II-33%, type III-50% in the impingement syndrome or RCT. It was suggested that the anterior protuberance was related with the evidence of RCT. A-H interval was 10.25mm±1.46mm in normal, and 9.44mm±1.70mm in the impingement syndrome or RCT. There was on significance in A-H interval except rotator cuff arthropathy. Thirty three percent of normal group had osteophytes and 40% of impingement syndrome or RCT had osteophytes on the undersurface of acromion.
Acromion ; Osteophyte ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears

The study was undertaken to assess the CT density of the antibiotics solution. CT scan of six antibioticssolution-streptomycin, chloramphenicol, Na-penicillin, ampicillin, kanamycin and cefamezine-in concentration ofabout 33% (approximatly single dose of intramuscular injection) was performed, using plastic syringes. Variousconcentrations of striptomycin, chloramphenicol and Na-panicillin were also examined for evaluation of relationbetween concentration and the CT density of the antibiotics. In addition, relationship between CT number andmathematically calculated effective atomic number and electron density of the antibiotics was evaluated. Theresults are as follows; 1. The CT densities of all antibiotics reveal high density (CT number 80–150) inconcentration of single intramuscular injection dose. 2. CT number of striptomycin, chloramphenicol andNa-penicillin gradually increased with increase of concentration of the antibiotics, producing linear proportionto concentration, effective atomic number and electron density of the antibiotics. 3. Therefore, density ofantibiotics should be included in differential diagnosis when high density on CT scan is observed.
Ampicillin ; Anti-Bacterial Agents ; Chloramphenicol ; Diagnosis, Differential ; Injections, Intramuscular ; Kanamycin ; Plastics ; Syringes ; Tomography, X-Ray Computed

We measured fasting Serum Angiotensin-Converting Enzyme (SACE) in 100 healthy controls and 75 coal worker's pneumoconiosis (CWP) patients by a commercial kits (ACEcolor®, Fujirio Inc., Japan) and evaluated this manual method. The linear range extends to an activity of 80U/L. Precision on a commercial control serum (ACE control-N®, Sigma Co.) with a mean value of 9.47U/L yielded a within-run and between-run CVs are 5.6% (N=15) and 6.9% (N=14) respectively. Save in 75 CWP was 20.3±5.7U/L (mean±s.d.); higher than in healthy controls (13.4±3.9U/L, P<0.01). No correlation was found between SACE, sex, and age. The results suggest that the measurement for SACE and follow-up SACE in coal workers may be a useful diagnostic tools for CWP.
Anthracosis* ; Coal* ; Fasting ; Follow-Up Studies ; Humans ; Methods

No abstract available.
Hepatitis B Surface Antigens* ; Humans ; Prevalence*

Acardic twining is a rare congenital anomaly, usually in monozygotic twins. This condition is characterized by the absence or rudimentary development of fetal hear, and associated with various anomaly(especially with anecephalus). The acardiac malformations are uniformly fatal in the affected twin, and mortality in the co-twin is as high as 55%. We recently experienced a case of acardius acephalus associated with a normal term male infant, so present with a brief review of the literature.
Humans ; Infant ; Male ; Mortality ; Twins* ; Twins, Monozygotic

No abstract available.
Bilirubin* ; Humans ; Infant, Newborn* ; Kernicterus*

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

No abstract available.
Aorta, Thoracic* ; Blood Flow Velocity* ; Pregnancy*