PURPOSE: The morphogenic mechanism of tetralogy of Fallot is known to be an antero-superior deviation and hypertrophy of the subpulmonary infundibulum. We performed this study to measure the subpulmonary infundibulum in patients with tetralogy of Fallot and compare those with normal control. METHODS: Echocardiographic data and medical reports of 12 patients, with classical tetralogy of Fa11ot who were diagnosed echocardiographically from Dec. 1996 to Jan. 1999 in Kyungpook National University Hospital, were retrospectively reviewed. A control group consisted of 11 children who underwent a complete echocardiographic examination for a heart murmur and were found to be structually norrnal. Measurements of the subpulmonary infundibulum were performed in systolic still frames with the subxiphoid short axis view. RESULTS: Compared with the normal control children, the following indexed infundibular dimensions in patients with tetralogy of Fallot were significantly smaller' volume, length, cross-sectional area, diameters of pulmonary valve annulus, main, left and right pulmonary arteries, PA index and McGoon ratio. The following measurements were increased in tetralogy patients ' the angle between infundibular septum and ventricular septum, and infundibular free wall thickness. CONCLUSION: We confirmed both antero-superior deviation of infundibular septum and infundibular hypoplasia as morphologic abnormalities in tetralogy of Fallot. We also revealed relatively equal contributions of shortening of infundibular length, and increased infundibular septal and free wall thickness to infundibular hypoplasia.
Axis, Cervical Vertebra ; Child ; Echocardiography ; Gyeongsangbuk-do ; Heart Murmurs ; Humans ; Hypertrophy ; Pulmonary Artery ; Pulmonary Valve ; Retrospective Studies ; Tetralogy of Fallot* ; Ventricular Septum

The effects of epidural anesthesia for normal vaginal delivery on maternal cardiovascular system and boood gas analysis, and newborn umbilical arterial blood gas analysis and Apgar scores were studied in 24 paturients. The paturients were divided into two groups by random sampling, and one group underwent epidurial anesthesia and the other did not. Maternal systolie pressure, heart rate and cardiac output were measured at the time of 4 cm of cervical dilation (preanesthetic), 8 cm of cervical dilation, and immediate postpartum. PH, Pco, Po and bicarbonate levels of maternal atrerial blood were measured at the time of 4 cm and 8 cm of cervical dilation. PH, Pco, Po, and bicarbonate levels of newborn umbilical arterial blood were measured immediately after delivery. One minute and 5 minute Apgar scores of newborn were measured. Systolic blood presssures did not change in both groups. In non-epidural group diastolic and mean blood pressures decreased after delivery. In epidural group its slightly increased at the time of 8 cm of cervical dilation and returned to preanesthetic level after delivery. Heart rate and cardiac output also slightly increased at the time of 8 cm of cervical dilatior. and returned to preanesthetic level after delivery. Maternal pH slightly decreased at the time of 8 cm of cervical dilation in epidural group. Pco2 decreased in both groups, but the rate of decrease was smaller in epidural group. Po increased at the time of 8 cm of cervical dilation in epidural group. Bicarbonate ion level did not changed in both groups. Newborn umbilical arterial blood gas analysis and l minute and 5 minute Apgar scores were not different in both group.
Anesthesia ; Anesthesia, Epidural* ; Bicarbonates ; Blood Gas Analysis ; Cardiac Output ; Cardiovascular System ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mothers* ; Postpartum Period

No abstract available.
Humans ; Referral and Consultation*

BACKGROUND: In 2026, the elderly population (age> or =65 years) in Korea is projected to be 20.8% of the total population. Along with this rise will be the rise in need for medical care in geriatric hospitals. Geriatric inpatients are vulnerable to infections because of functional disabilities and comorbidities. We investigated the clinical features of pneumonia in the elderly at these facilities. METHODS: We performed a retrospective study based on medical records looking at pneumonia, which was identified in 63 inpatients >65 years admitted to a geriatric hospital from October 2013 to December 2014. RESULTS: In-hospital mortality was 31.7%(20/63) and the 30-day mortality was 17.5%(11/63) of the total number of patients. Median age was 83 years (range, 67-94 years). Univariate analysis showed that the following factors were significantly different between survivors and nonsurvivors, number of comorbidities, history of antibiotics therapy in preceding 90 days, clinical improvement in 72 hours, alteration of mentality, respiration rate, serum albumin level, and peripheral blood leukocyte count. Multivariate analysis showed that the independent factors for predicting increased mortality were number of comorbidities > or =4 (odds ratio [OR], 9.803; p=0.030), failure to improve clinically in 72 hours (OR, 6.150; p=0.046), respiration rate> or =30/min (OR, 9.370; p=0.021), and serum albumin level< or =3.0 g/dL (OR, 32.022; p=0.010). CONCLUSION: When elderly inpatients with pneumonia have factors such as comorbidities greater than 4, failure to improvement clincally in 72 hours, tachypnea (> or =30/min), and hypoalbuminemia (< or =3.0 g/dL), escalation of empiric antibiotics or transfer to an acute care setting is necessary to reduce mortality.
Aged ; Anti-Bacterial Agents ; Comorbidity ; Geriatrics ; Hospital Mortality ; Humans ; Hypoalbuminemia ; Inpatients ; Korea ; Leukocyte Count ; Medical Records ; Mortality ; Multivariate Analysis ; Pneumonia* ; Respiration ; Respiratory Rate ; Retrospective Studies ; Serum Albumin ; Survivors ; Tachypnea

No abstract available.
Humans ; Intracranial Aneurysm* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Among 5 subfamilies of dopamine receptors (DAR), D3 and D5 DAR are expressed on peripheral blood mononuclear cells (PBMC). Recently, those DARs have been reported to change in Parkinson's disease (PD). METHODS: We measured the DAR mRNA expression in PBMC from 15 PD patients who had never taken antiparkinson medication, and 16 age-matched healthy people by reverse transcription and quantitative competitive polymerase chain reaction. The beta-actin mRNA expression was also measured to evaluate the relative expression of DAR mRNA. RESULTS: The D3 and D5 DAR mRNA expression was not different between patients and controls. In patients, no significant cor-relation was found between DAR mRNA expression in PBMC and clinical variables such as severity and duration of symptoms, and patients' age. CONCLUSIONS: We confirmed the presence of D3 and D5 DAR in PBMC. However, their mRNA expressions were not influenced by the disease process of PD.
Actins ; Dopamine* ; Humans ; Parkinson Disease* ; Polymerase Chain Reaction ; Receptors, Dopamine* ; Reverse Transcription ; RNA, Messenger*

PURPOSE: To compare the efficacy of breathhold and non-breathhold sequences in the detection of hepatocellular carcinoma (HCC) in cirrhotic patients using superparamagnetic iron oxide (SPIO)-enhanced MR imaging, and to determine the optimal sequence combination. MATERIALS AND METHODS: By means of unenhanced and iron-oxide-enhanced MRI, 29 patients with 49 nodular HCCs were evaluated for the presence of HCC nodules. Twenty-one were male and eight were female, and their ages ranged from 38 to 71 (mean, 56) years. Eight different MR sequences were used, including four non-breath-hold sequences and four breath-hold, and images were obtained before and after the administration of S-PIO particles. Non-breath-hold sequences included T2-, proton density-weighted SE, and TSE imaging, while breath-hold sequences comprised T1-weighted fast low-angle shot (T1wFLASH), half-Fourier acquisition single shot turbo spine echo (HASTE), T2-weighted fast imaging with steady-state free precession (T2*wFISP) and T2-weighted breath-hold TSE (T2wBHTSE). Image analysis involved both quantitative and qualitative analysis. The quantitative parameters calculated were signal-to-noise (S/N) ratios for livers and tumors, contrast to noise (C/N) ratios for tumors seen on precontrast and postcontrast images, and percentage of signal intensity loss (P-SIL) after SPIO injection. Images were analysed qualitatively in terms of image artifacts and lesion conspicuity, and prior to calculating sensitivity, the numbers of lesions detected using various pulse sequences were counted. RESULTS: SPIO had a marked effect on liver S/N ratio but a minimal effect on tumor S/N ratio. PSIL was best in T2*wFISP images, while T2wSE images showed the second-best results (p< 0.05). Tumor-to-liver C/N values were also highest with T2*wFISP, while T2wTSE and HASTE images were next. Qualitative study showed that non-breath hold images and FISP were better than breath hold images in terms of lesion conspicuity. The latter, however, were much better than non-breath-hold images with regard to image artifacts (p <0 . 0 5 ) . Sensitivity after the injection of contrast material increased in every image sequence except T1wFLASH, and,in particular, postcontrast FISP and T2wTSE showed the best results (p> 0.05). CONCLUSION: SPIO-enhanced MR imaging effectively detected hepatocellular carcinoma in cirrhotic livers. In terms of lesion detection and improvement of the lesion to liver C/N ratio, the FISP sequence was at least as good as non-breath-hold sequences, but if the T2 suppression effect of SPIO is to be obtained, other breath-hold sequences are not appropriate. To help lesion characterization, we suggest that T1w-FLASH and non-breath- hold T2w-TSE imaging are added to the optimal SPIO-enhanced MR imaging sequence.
Artifacts ; Carcinoma, Hepatocellular ; Female ; Humans ; Iron ; Liver ; Magnetic Resonance Imaging* ; Male ; Noise ; Protons ; Spine

PURPOSE: We wanted to evaluate the efficacy and safety of using ultrasound guided percutaneous radiofrequency ablation for the benign nodules of the thyroid gland. MATERIALS AND METHODS: We studied 148 patients with benign thyroid nodules (200 total nodules) that were confirmed histopathologically, and we performed ultrasound guided radiofrequency ablation. The radiofrequency ablation was done 1 to 5 times per one nodule, and follow-up ultrasonography was performed one to nineteen months after the ablation procedures. The physical changes and the decrease of volume of the nodules were evaluated, and the complications related to radiofrequency ablation were observed. RESULTS: The mean initial nodule volume was 0.01-95.61 ml (mean; 6.83+/-SD of 10.63 ml) and the nodule volume after radiofrequency ablation was decreased to 0.00-46.56 ml (mean; 1.83+/-SD of 4.69 ml). The mean volume reduction rate was 73.2%. Reduction of more than 50% was noted in 90% of all cases. For 180 nodules (90%), the decrease was 50% or more, in 20 nodules (10%), the decrease was 49% or less. On gray-scale ultrasonogram obtained after ablation, the echogenicity of the nodules changed to darker, and on the doppler-sonogram, the vascular flow within the nodules disappeared in all cases. Most patients complained pain during or right after the procedure, but the pain was transient and subsided after medication. Two patients developed hoarseness that was improved in 1 week and 2 months, respectively. CONCLUSION: Sonoguided percutaneous radiofrequency ablation can be one of the treatments for benign nodules of the thyroid gland.
Catheter Ablation* ; Follow-Up Studies ; Hoarseness ; Humans ; Thyroid Gland* ; Thyroid Nodule ; Ultrasonography

Primary aldosteronism is present in approximately 1% of unselectd hypertensive patients. Adrenal adenoma is a known as one of the surgically curable form of the hypertension. Hypertension is one of the contributing factors for the development of aortic dissection. Cincurrence of aortic dissection in patient with primary aldosteronism is extemely rare. Only one case wasconfirmed by autopsy and reported in the world literature. We report a case of DeBakey type 3 anortic aneursm in a 49-year old hypertensive female patient with primary aldosteronism due to left adrenal adenoma. She underwent left adrenalectomy uneventfully after stabilization of her blood pressure with maximal medical management including nitroprusside, aldactone, enalapril and inderal.
Adenoma ; Adrenalectomy ; Autopsy ; Blood Pressure ; Enalapril ; Female ; Humans ; Hyperaldosteronism ; Hypertension ; Middle Aged ; Nitroprusside ; Propranolol ; Spironolactone

Schwannoma, also known as a neurilemmoma, neurinoma, and perineural fibroblastoma, can be either a benign or malignant tumor, arising from the associated nerve sheath. A retroperitoneal malignant schwannoma is a rare tumor. Immunohistochemical staining for S-100, leucine-7 and the myelin basic protein is useful for diagnosis. Here we report a case of retroperitoneal malignant schwannoma with a brief review of the literatures.
Diagnosis ; Myelin Basic Protein ; Neurilemmoma*