We evaluated the accuracy of a noninvasive method for estimating right ventricular systolic pressures in patients with atrial septal defect and tricuspid regurgitation defected by two-dimensional and Doppler ultrasound. Of 54 patients with atrial septal defect, 24(44%) had jets of tricuspid regurgitation. By use of the maximum velocity(V) of the regurgitatant jet recorded by continuous wave Doppler ultrasound and the Bernoulli equation, we predicted right ventricular systolic pressure(RVP) calculated by the equation of RVP=4V2+10 proposed by Tei et al.The values correlated well with catheterization values(r=0.851, standerd error of estimate=4mmHg). In addition the relation between the Lt to Rt shunt amount and the severity of tricuspid regurgitation was assessed. The severity of tricuspid regurgitation graded on a four-pointscali by pulsed Doppler and two-dimensional echocardiography correlated with Qp/Qs ratio calculated by the Fick's method(p<0.05).
Catheterization ; Catheters ; Echocardiography ; Heart Septal Defects, Atrial* ; Humans ; Tricuspid Valve Insufficiency* ; Ultrasonography

Infection in primary total hip arthroplasty may cause catastrophic results and is the major reason for implant failure. The purpose of this study was to evaluate the utility of the hip joint fluid culture as a method of predicting the possibility of a hip joint infection by calculating the sensitivity, specificity and accuracy. We performed 628 primary total hip arthroplasty and aerobic and anaerobic bacterial cultures for hip joint fluid between January 1989 and June 1996. The hip joint fluid culture was routinely performed to evaluate the utility of the femoral head for bone banking. Thirty-two cases out of the 628 hips showed positive intraoperative culture and 596 cases showed negative intraoperative culture. The isolated organisms from 32 positive cultures were 11 for Staphylococcus aureus, eight for Staphylococcus coagulase negative, seven for Enterococcus, three for E.coli and one each for Enterobacter, Acinetobacter and Pseudomonas. Anaerobic culture was negative in all cases. In the positive intraoperative culture cases, none had delayed infection during the follow-up period. But in the negative intraoperative culture cases, one case had acute infection and two cases had delayed infection. In the case with acute infection, Staphylococcus aureus was isolated and on two cases with delayed infection, Enterococcus and Staphylococcus coagulase negative were isolated, respectively. All 32 positive culture cases were fa~lse positive and 595 negative culture cases were true negative and one negative culture case was fa~lse negative. The sensitivity of the hip joint culture was 0%, the specificity was 94.9% and the accuracy was 0%. The specificity of hip joint fluid culture in primary total hip arthroplasty was high, hut the sensitivity score was zero. Therefore, the hip joint fluid culture should not be used for a routine check of infection status in primary total hip arthroplasty. We recommend the hip joint fluid culture in revision arthroplasty or hips in which infection is clinically suspected.
Acinetobacter ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Banks ; Coagulase ; Enterobacter ; Enterococcus ; Follow-Up Studies ; Head ; Hip Joint* ; Hip* ; Pseudomonas ; Sensitivity and Specificity ; Staphylococcus ; Staphylococcus aureus

Angiofollicular lymph node hyperplasia(AFLNH) was first described in 1956 by Castleman et al. It was initially reported as a solitary mediastinal mass but multicentric and extranodal disease is now well known. Histologically two distinct variants, e.g. the hyaline vascular type and the plasma cell type, of AFLNH are recognized. And the plasma cell type is typically associated with clinical syndrome consisting of fever, anemia, elevated erythrocyte sedimentation rate and polyclonal hypergammaglobulinemia. Recently, we experineced three cases of AFLNH. Histologically, two cases were hyaline vascular type, that were presented as a right supraclavicular mass of 49-year-old female, and as an anterior mediastinal mass of 53-year-old female. The remaining one case was plasma cell type that was presented as a left axillary mass of 63-year-old male. The former two cases showed typical features of hyaline vascular type but in case 1, exuberant proliferation of hyalinized vessels of capillary size was characteristic feature. The latter case of plasma cell type characteristically showed clinical syndrome consisting of fever, hypoalbuminemia, polyclonal hypergammaglobulinemia. All cases were presented as a single mass and they were well after surgical excision.
Female ; Humans

Degenerative lumbar spondylolisthesis requires fusion of the involved segments and decompression laminectomy because it is mechanically unstahle and usually associated with stenosis of the spinal canal. Transabdominal retroperitoneal approach through small longitudinal pararectal skin incision provides easy and safe access to L3-4 and L4-5 disc spaces with less bleeding. We thought that anterior interbody fusion enable us to restore the disc space and to reduce partially the listhesis with less hleeding and less harvest of graft hone compared to posterolateral fusion, and also without the risk of neural or dural damage which could he occurred in posterior lumbar interbody fusion 4.15.16.17). Thus, authors performed the same-day anterior and posterior spinal surgery (APSS) in 28 patients (30 disc spaces) from 1992 to 1996 and analyzed the clinical and radiological results. The most common site of involvement was L4-5 level (82.1%). The mean follow-up period was 2 years and 2 months (from l2 months to 4 years). Fusion was ohtained at 29 disc spaces (96.7%) within 24 weeks (average, I 6 weeks). The anterior displacement was corrected up to the average of 65.4% (5.8mm) postoperatively and the average of 60.7% (5.2mm) correction remained at last follow-up. The intervertebral disc space was restored up to the average of 96.9% (7.5mm) postoperatively and the average of 86.0% (6.2mm) restoration remained at last follow-up. Twenty-five out of 28 patients (89.2%) showed excellent or good clinical results hy the criteria of Kim, et al6). In conclusion, the same-day procedure of successive anterior interbody fusion, decompression laminectomy and posterior pedicular instrumentation for the degenerative lumbar spondylolisthesis associated with spinal stenosis was thought to be a good method of treatment.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Hemorrhage ; Humans ; Intervertebral Disc ; Laminectomy ; Skin ; Spinal Canal ; Spinal Stenosis ; Spondylolisthesis* ; Transplants

No abstract available.
Antibody Formation* ; Child* ; Diploidy* ; Humans* ; Immunization* ; Measles ; Measles-Mumps-Rubella Vaccine* ; Mumps ; Rubella ; Vaccination

Sinuolinea capsularis Davis, 1917 is myxosporean that infect the urinary system of the host fish. Insufficient morphological and molecular data of S. capsularis exits, and it is therefore difficult to make an accurate identification of the parasite. We tried a series of morphological and molecular analysis to identify an myxosporean isolated from urinary bladder of cultured olive flounder, Paralichthys olivaceus, from Jeju island in the Republic of Korea. Some of them were observed under a light microscope and SEM, and remain samples were used molecular and phylogenetic analysis. Mature spores were subspherical, measuring 13.9±0.6 μm in length and 13.8±0.8 μm in width. Two spherical polar capsules on opposite sides in the middle of the spore had a diameter range of 4.3±0.4 μm. Scanning electron microscopy revealed that spores a severely twisted the suture line. By the morphological comparison and analysis, it was identified as S. capsularis. In addition, we obtained the partial 18S rDNA of S. capsularis and first registered it in NCBI. Phylogenetic analysis showed that S. capsularis clustered with Zschokkella subclade infecting the urinary system of marine fish, and it supported the infection site tropism effect on phylogeny of marine myxosporeans as well as the origin of Sinuolinea is not monophyly.
Capsules ; DNA, Ribosomal ; Flounder ; Microscopy, Electron, Scanning ; Olea ; Parasites ; Phylogeny ; Polymerase Chain Reaction ; Republic of Korea ; Spores ; Sutures ; Tropism ; Urinary Bladder

Since Kudoa septempuntata was identified as a causative agent of food poisoning associated with raw olive flounder Paralichthys olivaceus, interest and concern regarding the parasite have increased. However, there have been no investigations or reports of other Kudoa species infecting the fish (except for K. paralichthys, which infects the brain) in Korea. We found cysts filled with myxospores of Kudoa species in muscles of cultured olive flounder specimens and identified these to the species level. Mature spores were quadrate, measuring 8.7±0.5 μm in length, 9.2±0.4 μm in thickness, and 12.9±0.6 μm in width. The spores containing 4 polar capsules had a length of 2.1±0.2 μm and a width of 1.8±0.3 μm. The partial 18S and 28S rDNA of isolates showed 99–100% similarities with K. ogawai. Using these morphological and molecular analyses, the species was identified as K. ogawai. This study is the first report of K. ogawai infection in cultured olive flounder in Korea.
Capsules ; DNA, Ribosomal ; Flounder ; Foodborne Diseases ; Korea ; Muscles ; Olea ; Parasites ; Spores

Two forms of priapism are known. The more common type, low-flow priapism, presents as a prolonged painful erection and is characterized by ischemia and a disordered veno-occlusive mechanism. The less common form, high-flow priapism, is characterized by absence of pain and ischemia and unregulated blood inflow from the artery to the cavernosal sinuses. Prompt relief of priapism is essential to prevent ischemia and fibrosis of the corpora with resultant impotence. According to the type of priapism, the therapeutic approach is different. We report a case of idiopathic priapism that was initially identified as low-flow priapism. However, during treatment, it was confirmed as high-flow priapism by the finding of an arteriocavernosal fistula on arteriography, and the abnormal erection subsided after arterial embolization. On arteriography, there was an aberrant artery from the right common penile artery, and we were able to seen an arterial blush from the aberrent artery to the right cavernosal base.
Angiography ; Arteries ; Erectile Dysfunction ; Fibrosis ; Fistula ; Ischemia ; Male ; Priapism*

Fetus-in-fetu (FIF) is a rare congenital condition in which a fetiform mass is detected in the host abdomen and also in other sites such as the intracranium, thorax, head, and neck. This condition has been rarely reported in the literature. Herein, we report the case of a fetus presenting with abdominal cystic mass and ascites and prenatally diagnosed as meconium pseudocyst. Explorative laparotomy revealed an irregular fetiform mass in the retroperitoneum within a fluid-filled cyst. The mass contained intestinal tract, liver, pancreas, and finger. Fetal abdominal cystic mass has been identified in a broad spectrum of diseases. However, as in our case, FIF is often overlooked during differential diagnosis. FIF should also be differentiated from other conditions associated with fetal abdominal masses.
Abdomen ; Ascites ; Diagnosis, Differential ; Diagnostic Errors ; Fetus ; Fingers ; Head ; Laparotomy ; Liver ; Meconium ; Neck ; Pancreas ; Peritonitis ; Thorax

OBJECTIVE: The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods.METHODS: Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated.RESULTS: Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate.CONCLUSION: For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.
Breast ; Comorbidity ; Decompression ; Hand ; Humans ; Insurance, Health ; Liver ; Lung ; Methods ; Neoplasm Metastasis ; Prognosis ; Prostate ; Spine ; Survival Rate ; Vertebroplasty