PURPOSE: The purposes of this study were to evaluate the plain radiologic findings of the childhood intussusception and to evaluate the role of plain abdominal films in predicting the success of air or barium reduction. SUBJECTS AND METHODS: We retrospectively reviewed 140 cases with the diagnosis of intussusception in children. The radiological signs that included soft tissue mass, dilatation of small bowel suggesting obstruction, crescent sign, and target sign were evaluated in terms of frequency. The relationship between radiological findings and outcome of reduction was analyzed. The site of soft tissue mass or crescent sign seen on plain radiographs was correlated with the position of the apex of the intussusceptum seen at the beginning of barium enema. The degree of dilated small bowel was evaluated by calculating the proportion of air-filled small bowel occupying peritoneal cavity and measuring the maximal diameter of dilated bowel lumen. The radiological finding for small bowel obstruction is determined by observation of the degree of small bowel dilatation and/or air-fulid levels. RESULTS: Ninety-two cases out of 140 showed one or more radiographic signs. Two most common signs were soft tissue mass and small bowel obstruction. The success rate of air or barium reduction was significantly lower in patients with most severe degree of dilatation of small bowel and/or more than 7 air-fulid levels on erect view. The suspected location of intussusception on plain radiographs correlated well with the true location of intussusception seen in the first few seconds of barium reduction. CONCLUSION: Plain abdominal radiography is useful in the diagnosis of intussusception and provides helpful informations for the reduction procedure as well as for the exclusion of the contraindications such as bowel perforation.
Barium ; Child ; Diagnosis ; Dilatation ; Enema ; Humans ; Intussusception* ; Peritoneal Cavity ; Radiography, Abdominal ; Retrospective Studies

Here, we investigated the role of zerumbone, a natural cyclic sesquiterpene of Zingiber zerumbet Smith, on angiogenesis using human umbilical vein endothelial cells (HUVECs). Zerumbone inhibited HUVECs proliferation, migration and tubule formation, as well as angiogenic activity by rat aorta explants. In particular, zerumbone inhibited phosphorylation of vascular endothelial growth factor receptor-2 and fibroblast growth factor receptor-1, which are key regulators of endothelial cell function and angiogenesis. In vivo matrigel plug assay in mice demonstrated significant decrease in vascularization and hemoglobin content in the plugs from zerumbone-treated mice, compared with control mice. Overall, these results suggest that zerumbone inhibits various attributes of angiogenesis, which might contribute to its reported antitumor effects.
Animals ; Aorta ; Endothelial Cells ; Fibroblast Growth Factors ; Ginger* ; Human Umbilical Vein Endothelial Cells ; Mice ; Phosphorylation ; Rats ; Receptors, Vascular Endothelial Growth Factor ; Vascular Endothelial Growth Factor Receptor-2

Marfan syndrome may be associated with various cardiovascular complications, but expanding abdominal aneurysm is a relatively rare complication. A 32 year old male patient was admitted to S.N.U.H. because of pulsating abdominal mass and back pain. The patient was diagnosed as a case of expanding abdominal aortic aneurysm and annuloectasia of aorta due to Marfan syndrome. Abdominal aneurysm was located from 3 cm below the origin of left renal artery to left common iliac artery. Abdominal aneurysm was operated successfuly. The size of abdominal aneurysm was about 2815cm. The pathological findings of surgically removed abdominal aortic wall showed loss of elastic fibers and fragmentation of fibers in media. A case of expanding abdominal aortic aneurysm due to Marfan's syndrome was reported with a review of literatures.
Adult ; Aneurysm* ; Aorta ; Aortic Aneurysm, Abdominal ; Back Pain ; Elastic Tissue ; Humans ; Iliac Artery ; Male ; Marfan Syndrome* ; Renal Artery

BACKGROUND: In dental intravenous sedation, continuous intravenous infusion of a low-dose drug requires an infusion pump such as a syringe pump. To develop a new syringe pump for clinical use, the functions of the pump must meet certain international standards. Various safety and efficacy tests must be performed on the syringe pump, as stipulated by these standards, and an approval must be received from the approving agency based on such test results. METHODS: The authors of the present study developed a novel syringe pump and performed efficacy evaluation by testing its infusion speed at 1 and 25 ml/h, and infusion performance testing at 2 and 24 h. Moreover, performance evaluation was conducted by comparing the novel pump to an existing pump with the infusion speed varied from 1 to 5 ml/h. RESULTS: In the efficacy testing on the newly developed syringe pump, infusion with the infusion speed initially set to 1 ml/h resulted in infusion speeds of 1.00 and 0.99 ml/h in the 2- and 24-h assessment, respectively. Changing the infusion speed setting to 25 ml/h resulted in an infusion speed of 25.09 and 23.92 ml/h in the 2- and 24-h assessment, respectively. These results show no significant differences when compared with other commercially available pumps. CONCLUSIONS: The efficacy testing of the newly developed syringe pump showed the accuracy to be within tolerance. Based on these findings, we believe that the newly developed syringe pump is suitable for clinical use.
Data Accuracy ; Infusion Pumps ; Infusions, Intravenous ; Syringes*

BACKGROUND: Dipyridamole-stressed myocardial scan is a useful diagnostic tool of coronary artery disease, however clinical significance of dipyridamole-induced chest pain is not well documented. METHOD: To investigate clinical significance of chest pain after intravenous dipyridamole infusion, reversibility score was calculated in 320 patients using reconstructed polar map of dipyridamole (99m)Tc-MIBI myocardial perfusion scan. In 81 patients who undertook both coronary angiogram and (99m)Tc-MIBI myocardial scan within 5 weeks, jeopardy score and myocardial ischemic score were calculated using coronary angiogram. RESULT: Group 1 consisted of the patients with typical chest pain, group 2 consisted of the patients with atypical chest pain, and group 3 consisted of the patients without chest pain. Mean reversibility score of group 1(90.0+58.4) was significantly higher(p<0.05) than that of group 3(64.7+/-44.5). Mean myocardial ischemic score of group 1(632.5+/-272.3) was significantly(p<0.05) higher than that of group 2(356.9+/-244.6) or group 3(287.5+/-257.7). Proportion of normal coronary angiogram in group 1(2/27, 7.4%) was significantly lower than that in group 3(11/34, 32.4%). CONCLUSION: These findings suggest that typical chest pain after intravenous dipyridamole infusion might represent myocardial ischemia and suggest more severe coronary artery disease.
Chest Pain* ; Coronary Artery Disease ; Dipyridamole* ; Humans ; Myocardial Ischemia ; Perfusion ; Thorax*

BACKGROUND AND OBJECTIVES: Congestive heart failure is one of the most frequent problems in cardiovascular patients. However, very little data concerning this syndrome in Korea was available. The objectives of this study were to evaluate the demographic and clinical characteristics of hospitalized Korean patients with congestive heart failure. SUBJECTS AND METHODS: Six university hospitals that fulfilled the protocol for clinical information of the patients with heart failure, were prospectively engaged in this study. Six hundred and ninety patients, admitted between Jan. 1. 1998 and Dec. 31. 1999, were enrolled. RESULTS: Ischemic heart disease was the most frequent underlying disease (33.2%), with the other causes of heart failure being cardiomyopathy (23%), hypertensive heart disease (22%) and valvular heart disease (12.7%). Compared with ischemic cardiomyopathy, the patients with idiopathic dilated cardiomyopathy were younger (61.1+/-16.6 vs. 66.9+/-10.3, p<0.05), had less incidence of diabetes (16.8% vs. 32.2%) and smoked less (13.5+/-21.5 vs. 20.4+/-26.0 pack-year). The common aggravating factors were arrhythmia (22%), myocardial ischemia (21.7%) and infection (18.7%). Thirty nine (5.7%) patients died during the one year follow up period. Ischemic heart disease was the main underlying disease in the fatal cases (46.2%). CONCLUSION: Ischemic heart disease was the major cause of heart failure, and the leading cause of death in Korean patients with congestive heart failure.
Arrhythmias, Cardiac ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cause of Death ; Coronary Disease ; Epidemiology ; Estrogens, Conjugated (USP)* ; Follow-Up Studies ; Heart Diseases ; Heart Failure* ; Heart Valve Diseases ; Hospitals, University ; Humans ; Incidence ; Korea* ; Myocardial Ischemia ; Prospective Studies ; Smoke

BACKGROUND: Vasodilators including angiotensin converting enzyme inhibitor(ACEI) have been suggested to reduce left ventricular volume and to improve left ventricular performance in patients with moderate to severe regurgitant valvular heart diseases. However, long-term effects of angiotensin converting enzyme inhibitor upon left ventricular size and function in asymptomatic or minimally symptomatic patients with chronic mitral regurgitation remain to be elucidated. MATERIALS AND METHOD: Forty five patients with moderate to severe chromic mitral regurgitation on echocardiography and mild or no symptoms were studied. Serial changes of left ventricular dimension and ejection fraction were analyzed retrospectively using M-mode echocardiography in patients treated with ACEI(ACEI group, n=21) and in patients treated with other medications except ACEI or with no medication(non-ACEI group, n=24). RESULTS: The mean duration of follow-up was 30+/-15 months. ACEI group showed trends of decreasing left ventricular end-systolic dimension(LVESD) and left ventricular end-diastolic dimension(LVEDD) and a trend of increasing ejection fraction(EF), though statistically insignificant when compared to those of before-treatment or non-ACEI group. In patients with larger initial LVESD(>35mm), LVEDD was reduced(the percent changes of LVEDD 2 and 3 years after ACEI treatment were -4.2# and -4.4%) that was significantly different from those of non-ACEI group(+3.4% and +3.4% each)(p<0.05). In patients with larger initial LVEDD(>60mm), the percent changes of LVEDD 2 and 3 years after ACEI treatment were -4.9% and -5.8%, and in patients with initial EF less than 60%, the percent change of LVEDD 2 years after ACEI treatment was -0.57%. Those changes were also statistically significant compared to those of non-ACEI group(p<0.05 each). CONCLUSION: In mildly symptomatic chronic mitral regurgitation patients, especially whose left ventricular dimension is increase, long-term ACEI therapy seems to be effective in preventing left ventricular dilatation or in reducing left ventricular volume and such therapy may have a beneficial effect on the natural history of such patients.
Angiotensins* ; Dilatation ; Echocardiography ; Follow-Up Studies ; Heart Valve Diseases ; Humans ; Mitral Valve Insufficiency* ; Natural History ; Peptidyl-Dipeptidase A* ; Retrospective Studies ; Vasodilator Agents

BACKGROUND/AIMS: Despite of increasing numbers of reports on intraductal papillary mucinous tumor (IPMT), there is still difficulty in its' diagnosis, treatment and prediction of prognosis. The purpose of this multicenter study was to evaluate the clinico-pathological features of IPMT in Korea and suggest the prediction criteria of malignancy in IPMT. METHODS: We retrospectively reviewed the clinico-pathological data of 208 patients who underwent operations with IPMT between 1993 and 2002 at 28 institutes in Korea. RESULTS: Of the 208 patients with a mean age of 60.5+/-9.7 years, 147 were men and 61 were women. 124 patients underwent pancreatoduodenectomy, 42 distal pancreatectomy, 17 total pancreatectomy, 25 limited pancreas resection. Benign cases were 128 (adenoma (n=62), borderline (n=66)) and malignant cases were 80 (non-invasive (n=29), invasive (n=51)). A significant difference in 5-year survival was observed between benign and malignant group (92.6% vs. 65.3%; p=0.006). Of the 6 factors (age, location, duct dilatation, tumor appearance, main duct type, and tumor size) that showed the statistical difference in univariate analysis between benign and malignant group, we found three significant factors (tumor appearance (p=0.009), tumor size (p=0.023), and dilated duct size (p=0.010)) by multivariate analysis. CONCLUSION: Although overall prognosis of IPMT is superior to ordinary pancreatic cancer, more curative surgery is recommended in malignant IPMT. Tumor appearance (papillary), tumor size (> or =30 mm) and dilated duct size (> or = 12 mm) can be used as preoperative indicators of malig-nancy in IPMT.
Academies and Institutes ; Diagnosis ; Dilatation ; Female ; Humans ; Korea* ; Male ; Mucins* ; Multivariate Analysis ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies