Isolated pulmonary stenosis, a relatively common congenital anomaly that accounts for about 10 percent of all congenital heart disease, is characterized by stenosis of pulmonary valve itself, infundibulum or both of them. Since cardiac catherterization was applied to man by Cournand and Ranges, pulmonary stenosis had been easily diagnosed and many clinical studies had been investigated. It has a wide clinical spectrum depending on the degree of stenosis. The electrocardiogram, phonocardiogram and chest X-ray have proved useful in estimating the severity of hemodynamic facotrs in individual cases. This series comprises 47 cases in whom the clinical diagnosis of isolated pulmonary stenosis was confirmed by right heart catheterization with cardiac cineangiography at Severance Hospital, Yonsei University. An attempt was made to correlate the electrocardiographic, phonocardiographic, chest X-ray findings, and types of stenosis with the hemodynamic data in these cases. 1. Of 47 patients, 33 were male and 14 female. Their ages ranged from 2 to 42 years: the mean age was 19.1 years. 2. The incidence was 5.9 percent of all 797 catheterized congenital heart disease cases. The pulmonary valvular stenosis was 30 (68.3%), infundibular 7 (14.6%) and combined 10 (21.6%) cases. 3. The correlation between electrocardiogram and hemodynamic data were as follows. i) The regression equation between right ventricular sysytolic pressure (RVSP) and height of R wave in V1 lead (RV1) was RVSP=3.32 RV1+48.2: its correlation coefficient was 0.818 and it was very significant (p=0.000). ii) The higher the RVSP, the more the frontal axis of QRS complex shifted to the right side (r=0.55. p=0.001). iii) The RVSP of the groups with positive ECG findings such as p-pulmonale, right ventricular hypertrophy or right ventricular strain were much higher than the RVSP of the groups without such findings (p=0.032.0.000, 0.000). iv) The group with RV1 higher than 20 mm showed much more elevated mean of RVSP than the group with lower RV1 (p=0.000). v) The groups with the above mentioned positive ECG findings showed good correlation with the severity of RVSP which was arbitrarily classified as 49 or less, 50~100, and 100 mmHg or more (chi-square=8.96, 26.69, 19.06; p=0.011, 0.000, 0.000). 4. The group with late occurrence of the maximum intensity of the ejection systolic murmur showed higher mean of RVSP than the group with early peak of the murmur (p=0.014). 5. The means of RVSP of the groups with chest X-ray findings such as decreased pulmonary vascularity, were much higher than the means of RVSP of the groups without such findings (p=0.000, 0.005, 0.015). The groups with above mentioned positive chest X-ray findings showed good corelations with the severity of RVSP which was classified as above limits (chi-square=7.55, 10.94, 13.36; p=0.022, 0.004, 0.001). 6. Combined pulmonary valvular and infundibular stenosis showed more severe systolic pressure gradient and higher mean of RVSP than the isolated types (p=0.000).
Axis, Cervical Vertebra ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Catheters ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Electrocardiography ; Female ; Heart Defects, Congenital ; Hemodynamics* ; Humans ; Hypertrophy, Right Ventricular ; Incidence ; Male ; Pulmonary Valve ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Thorax

No abstract available.
Retinopathy of Prematurity* ; Risk Factors*

To delineate the coronary anatomy and the left ventricular function during early myocardial infarction, coronary arteriography and left ventriculography were performed prospectively in 28(34%) of 83 patients who were admitted to the coronary care unit at Severance Hospital from November 1983 to August 1984 within 30 days(median : 14 days;range : 4 hours to 30 days) after the onset of symptoms. The frequency of total occlusion of the infarct related artery was evaluated in the time course of infarction. To prove spontaneous recanalization, 3 patients who had total coronary occlusion underwent serial study within 11-20 days after the first study. We categorized the patients into two comparable groups according to the infarction site, coronary angiographic findings, and age. Comparison of clinical and angiographic findings between each group was made. The following results were obained. 1) There were 23 patients with transmural myocardial infarction(82.1%) and 5 with nontransmural infarction(17.9%). Among 23 patients with transmural infarction, 14 had anterior infarction(60.9%) and 9(39.1%) inferior infarction. 2) The mean age was 51.3 years(range : 31-79 years). The ratio of male to female was 3.7:1. 3) Fifteen patients(53.6%) had one-vessel disease, 10(35.7%) two-vessel disease and 2(7.1%) three-vessel disease, One patient(3.6%) had insignificant disease(less than 50% reduction in luminal diameter). Nontransmural infarction had a tendency to be associated with higher prevalence of multivessel disease than transmural infarction(80% vs 34.8%). 4) In 23 patients with transmural infarction, 12(52.2%) had complete occlusion and 11(47.8%) incomplete occlusion of the infarct related artery. Three patients(13.0%) had subtotal occlusion(90-99%) and 4(17.4%) had lesions of 70-89% luminal diameter narrowing. Three patients(13.0%) had 50-69% lesions and the remaining 1(4.4%) had insignificant obstructive lesions. 5) Of the 23 patients with transmural infarction, 12 were studied within 14 days and 11 in 15-30 days after the onset of symptoms. The frequency of total coronary occlusion was significantly higher in the patients studied within 14 days of symptom onset vs those studied in the 15-30 days period(83.3% vs 18.2%;p<0.001). Serial studies of 3 patients with total coronary occlusion at the initial study demonstrated occurrance of spontaneous recanalization in 2 patients. 6) The left ventricular-ejection fraction was higher in the patients with nontransmural infarction, inferior infarction, and incomplete coronary occlusion(65+/-14%, 58+/-16% and 57+/-17%) than that of the patients with transmural infarction, anterior infarction, and complete coronary occlusion(51+/-15%, 47+/-14% and 46+/-13, p<0.05). But there was no significant difference in left ventricular ejection fraction between the young(<45 year) and the old(> or =45 year) age groups. And also 0-1 vessel disease and 2-3 vessel disease groups did not show significant difference in ejection fraction. The degree of congestive heart failure was more severe in the patients with anterior infarction than in those with inferior infaction. multi-vessel disease group was significantly older than 0-1 vessel disease group(55+/-8 yrs vs 46+/-12 yrs, p<0.05), and the young age group had a tendency to be associated with higher prevalence of single vessel disease. 7) As for the complications of angiocardiography in this study, there was ventricular finbrillation in 2 patients(7.1%) without mortality. It is concluded that coronary arteriography can be safely performed within one month after acute myocardial infarction;high prevalence of one-vessel disease in acute myocardial infarction in the Korean adult patients admitted to a general hospital;lower incidence of total coronary occlusion in the late time course of infarction due to spontaneous recanalization;better left ventricular function in the patient groups with nontransmural infarction, inferior infarction and incomplete coronary occlusion.
Adult* ; Angiocardiography ; Angiography ; Arteries ; Coronary Care Units ; Coronary Occlusion ; Female ; Heart Failure ; Humans ; Incidence ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Phenobarbital ; Prevalence ; Prospective Studies ; Stroke Volume ; Ventricular Function, Left

The organ transplantation process requires the interdisciplinary team approach, including the transplantation-surgery doctor, the nurse, the coordinator, the medical social worker, etc. Because the legislation of the organ transplantation and "brain death" remains under consideration, we have still some arguments on legal, social, and ethical issues of organ transplantation, especially in Korea. In this study, we analyse the 29 cases of validity evaluation of donation, and 28 donors who voluntarily registered for organ donation. Also we review the role of medical social worker in the organ transplantation team and the social work process in the live organ donation and cadaveric donation. To prevent anticipating problems with social, legal and ethical issue, as a member of the organ transplantation team, the medical social worker verifies the validity of unrelated donation, gets the informed consent from the family of the brain death patient and tries to exclude the commercialism of transplantation. In addition, the medical social worker can extend the mood of altruistic donation and encourage the people to do the valid donation for the helpless chronic patients.
Brain Death ; Cadaver ; Ethics ; Humans ; Informed Consent ; Korea ; Organ Transplantation ; Social Workers* ; Tissue and Organ Procurement* ; Tissue Donors ; Transplants

The organ transplantation process requires the interdisciplinary team approach, including the transplantation-surgery doctor, the nurse, the coordinator, the medical social worker, etc. Because the legislation of the organ transplantation and "brain death" remains under consideration, we have still some arguments on legal, social, and ethical issues of organ transplantation, especially in Korea. In this study, we analyse the 29 cases of validity evaluation of donation, and 28 donors who voluntarily registered for organ donation. Also we review the role of medical social worker in the organ transplantation team and the social work process in the live organ donation and cadaveric donation. To prevent anticipating problems with social, legal and ethical issue, as a member of the organ transplantation team, the medical social worker verifies the validity of unrelated donation, gets the informed consent from the family of the brain death patient and tries to exclude the commercialism of transplantation. In addition, the medical social worker can extend the mood of altruistic donation and encourage the people to do the valid donation for the helpless chronic patients.
Brain Death ; Cadaver ; Ethics ; Humans ; Informed Consent ; Korea ; Organ Transplantation ; Social Workers* ; Tissue and Organ Procurement* ; Tissue Donors ; Transplants

With the recent increase of coronary artery disease in Korea, coronary arteriography israpidly gaining importance as a diagnostic procedure in the management of ischemic heart disease in this country. In order to delineate normal angiographic anatomy of the coronary arteries in Korean adults, the author reviewed 63 normal or near normal coronary angiograms out of 113 consecutive cases done at the cardiac laboratory of Yonsei University Severance Hospital from February, 1976 through September, 1982 and obtained the following results. 1) The diameter of the main stems of the left and the right coronary arteries measured 2.7-6.3mm(mean, 4.0mm) and 2.1-6.0mm(mean, 3.6mm) respectively, and the length of the left main stem measured 0-23mm(mean, 9.3mm). 2) The conus branch was visualized to originate from the proximal right coronary artery in 50 cases(79.4%), and in the other 13(20.6%) in whom the conus branch was not visualized, it was assumed to have a separate ostium directly from the aortic root. 3) The sinus node artery originated from the right coronary artery in 35 cases(55.5%) and from the left circumflex 20(31.7%). The remaining 8 cases(12.7%) appeared to have dual blood supply. 4) The artery to the A-V node arose from the proximal part of the posterior descending artery as a branch of the right coronary artery in 59 cases(93.7%) and of the left circumflex in only 4(6.3%), and the pattern of the A-V node blood supply coincided with the dominancy(crossing the crux of the heart and giving rise to the posterior descending artery) of the right or the left circumflex arteries. 5) In 33 cases(52.4%), both of the arteries to the SA and the AV nodes arose from the right coronary, and in 19(30.2%), the SA node artery came from the right, whereas the AV node artery originated from the left circumflex. 6) The number of ramifications(furcation) of the main left coronary artery was two in 53 cases(83.1%), three in 9(14.3%), and four in 1(1.6%). 7) The number of diagnoal branches of the left anterior descending artery was one in 34 cases(54%), two in 28(44.4%) and 3 in 1(1.6%).
Adult* ; Angiography ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Korea ; Myocardial Ischemia

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.
Benzodiazepines ; Cues ; Diazepam ; Humans ; Lorazepam* ; Memory ; Memory, Episodic ; Prospective Studies ; Stress Disorders, Post-Traumatic ; Videotape Recording

OBJECTIVE: Personality is defined as the trait-like qualities of a person. However, it has been recently suggested that the state effect of a situation leads to changes in scores on personality assessments. We predicted that traumatic experiences would induce changes not only in personality scores but also in the factor structures of personality assessments. METHODS: MethodsaaWe conducted a cross-sectional, case-controlled study using two data sets: a traumatized adolescent sample (n=71) and a non-traumatized adolescent sample (n=296). Personality factor structures were compared between the two samples using exploratory factor analyses for 25 lower-ordered subscales of the Temperament and Character Inventory (TCI). In the non-traumatized sample, evaluation of the scree plot suggested a five-factor solution supporting TCI's original seven-factor model. RESULTS: The traumatized sample showed a three-factor structure representing a biological factor, a social factor and an existential factor. This decrease in number of personality factors was caused by strengthened correlations among personality subscales related to coping with traumatic situations. Cloninger's psychobiological model of personality (i.e., temperament-character) was adequate in capturing personality traits of non-traumatized adolescents, but the tripartite view of existential psychology (i.e., body-mind-spirit) clearly corresponded to the factor structure of the traumatized adolescents. CONCLUSION: The three-factor solution of the present traumatized group is consistent with the tripartite model of personality (i.e., body-mind-spirit), while the five-factor solution of the non-traumatized group corresponds to Cloninger's seven-factor model. This is the first study to describe the state effects of traumatic experiences on personality structure.
Adolescent ; Biological Factors ; Case-Control Studies ; Existentialism ; Humans ; Personality Assessment ; Temperament

Congenital neonatal neuroblastoma is not uncommon but bilateral adrenal neuroblastoma is rare, accounting for about ten percent of neuroblastomas in children. We report the US and MR findings of a stage IV-S congenital bilateral neuroblastoma occurring in a one-day-old neonate.
Child ; Humans ; Infant, Newborn ; Neuroblastoma*

Nimodipine the potent, centrally active, clacium channel blocker, is known to increase cerebral and spinal blood flow. In the present study, the authors investigated the effect on Nimodipine on injured spinal cord. The experiment was a randomized blind study in which four groups of five cats received Nimodipine(0.05mg/kg) intravenously, and control groups of five cats received only Diluent. As a step in the investigation of the possible effect of spinal cord trauma on biochemical and ultrastructural changes in the injured cord, activities of lipid peroxidation were measured in the frozened-dried sample of the spinal cord and fine structure of the mylinated nerve fiber in the white matter were observed. An increase of lipid peroxidation level was found as early as 1 hour after the injury and the highest concentration was reached at 5 hours after the injury(P<0.01). Fine structures of the myelinated nerve fibers were changed progressively with the lapse of time after the injury. The effect of Nimodipine on lipid peroxidation and fine ultrastructural changes of myelinated nerve fibers were studied, and the result of this study revealed that Nimodipine groups showed a lower level of lipid peroxidation with statistical significance(P<0.05) and preservation of ultrastructural myelinated nerve fiber was prominent.
Animals ; Cats ; Lipid Peroxidation ; Nerve Fibers ; Nerve Fibers, Myelinated ; Nimodipine* ; Spinal Cord Injuries* ; Spinal Cord*