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

A 6-month old girl who had pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals underwent one-stage complete repair with unifocalization through a bilateral thoracosternotomy(clamshell incision). There were no serious postoperative compli cations, and the postoperative echocardio-graphy showed no residual ventricular septal defect or significant pulmonary artery stenosis. In this condition, great surgical variability exists regarding the sources of pulmonary blood flow. Recent clinical work has focused on a one-stage complete repair. The potential advantages of the clamshell incision are apparent in terms of mediastinal approach, postoperative results, and safety.
Cations ; Constriction, Pathologic ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Infant ; Pulmonary Artery ; Pulmonary Atresia*

PURPOSE: The purpose of this study is to present points of improvement data in developing a public educational approach for the correct understanding and use of contact lenses with a focus on the actual condition of wearing contact lenses, side effects and problem of circulation. METHODS: The questionnaires were distributed to contact lens wearers of 175 local clinics, 75 universities and general hospitals and 202 opticians were interviewed. RESULTS: This survey showed that many respondents had incorrect knowledge about contact lenses (purchase, prescription, complication, method of contact lens use), including persons who are not optometrists handling contact lenses. CONCLUSIONS: Nationwide pre-education is necessary for the correct understanding and purchase, prescription, and side effects of contact lenses, as well as to prohibit opticians from illegally prescribing the lenses; ophthalmologists should prescribe all contact lenses for proper vision correction.
Contact Lenses* ; Surveys and Questionnaires ; Hospitals, General ; Humans ; Korea* ; Prescriptions

OBJECTIVES: The purpose of this study was to investigate the relationship between restricted activity due to oral diseases and oral health behaviors among adolescents. METHODS: A cross-sectional study design was used. The subjects were 238 middle school students and 231 high school students; a total of 469 students from 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. The adolescents who participated in the survey were chosen by convenience sampling. The association between restricted activities due to oral diseases and oral health behaviors was analyzed using multiple logistic regression analysis. RESULTS: The annual experience rate of oral diseases stood at 1.4 percent, while the number of days absent and early departures from school was 0.15 days per student. The rate of middle school students who were disturbed by oral disease with respect to sleep, eating, speaking, and/or schoolwork was 33.1 percent. In high school students, it was 40.6 percent. Dental pain and gingival bleeding were identified as major factors to the restriction of activities, and being disturbed while eating was related to cariogenic beverages. CONCLUSIONS: It would be of great social interest to support and promote oral health programs among adolescents. Therefore, a national survey of the status of activity restrictions due to oral diseases in adolescents should be implemented in order to make specific future plans.
Adolescent ; Cross-Sectional Studies ; Eating ; Hemorrhage ; Humans ; Logistic Models ; Oral Health

PURPOSE: In the pediatric patients who have medically intractable epilepsy the callosotomy is useful to prevent the propagation of seizure from one hemisphere to the other. The indications of callosotomy are drop attack, life threatening primarily or secondarily generalized seizure, medically refractory mixed seizure types such as Lennox-Gastaut syndrome. In addition, the retarded children are not contraindicated. The anterior callosotomy is used to perform to control medically intractable epilepsy which is believed to have some advantages to total callosotomy. But, we propose that the anterior callosotomy does not seem to be superior to total callosotomy for the prevention of the propagation of seizure or complication. We describe a series of 21 patients with medically intractable epilepsy who underwent total callosotomy in one stage. METHODS: The diagnoses in these patients included Lennox-Gastaut syndrome, atonic seizure, infantile hemiplegia, and no obvious solitary seizure focus on chronic video/EEG monitoring to characterize seizures, electrographic activity, and postictal behaviors. Preoperatively 16 patients suffered from disabling drop attacks or intense head drop seizures which caused frequent physical injuries. Other types of seizures are 12 generalized tonic-clonic seizures, 7 complex partial seizures, 1 absence seizure, and 7 myoclonic seizures. Male:Female=14:7, Age: 2-22 years (Mean: 9.4 years). The follow-up period ranged from 0.8 to 3.8 years (median 2.4 years). Seizure outcome, parental assessment of daily function, and parental satisfaction with outcome were assessed postoperatively. RESULTS: Drop attacks disappeared completely during the entire follow-up period in 13 patients and decreased to less than 10% of baseline in five. The corpus callosum of the one patient were not completely sectioned in Diffusion Tensor Image, tractography. Other types of seizures resolved completely in 14 patients and decreased in 7. 2 patients experienced a transient disconnection syndrome, but completely resolved within four weeks. Overall daily function improved and parents were satisfied with the surgical outcome in all patients except three who experienced recurrent of drop attacks after operation. There was no sign of significant and persistent neurological deficits in any case. CONCLUSION: Results of total callosotomy in patients with medically intractable epilepsy with diffuse epileptic foci were favorable in most cases. The procedure was particularly effective against drop attacks causing physical injuries and impaired quality of life in these patients.
Child ; Corpus Callosum ; Diagnosis ; Diffusion ; Epilepsy* ; Epilepsy, Absence ; Follow-Up Studies ; Head ; Hemiplegia ; Humans ; Parents ; Quality of Life ; Seizures ; Syncope

BACKGROUND: In postmenopausal women, progestogen should be added to protect the endometrium from hyperplasia or carcinoma induced by the unopposed estrogen. However, the effects of progestogen on bone mineral densities and serum lipodproteins have not been precisely evaluated in Korean postmenopausal women. METHODS: To evaluate the effects of progestogen on bane mineral densities and serum lipoprotein in estrogen rephcement therapy, we canducted a 2-year trial of long conjugated equine estrogen(conjugated estrogen 0.625mg/day) with or without cyclic progestogen(MPA 5mg/day for 12 days) in 120 postmenopausal women. In all subjects, bone mineral density was measured in lumbar vertebra(L2-L4) and femur neck using dual energy X-ray absorptiometry(DEXA) and serum lipoprotein was measured from the beginning of the treatment, 12 manths, and 24 manths later, respectively. RESULTS: BMD of femur neck in both groups increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly in both groups. Both groups showed a significant decrease in the levels LDL cholesterol, but there was no statistical significance in serum triglycerids. Conjugated estrogen plus MPA group in constrast to conjugated estrogen only group showed a significant decrease in total cholesterol levels. CONCLUSIONS: These results suggest that the addition of MPA of the daily of 5mg for 12 days cyclically in estrogen replacement treatment appear to be effective in postmenopausal women with protection on bone mineral density and maintenance of long-term favorable effects on serum lipoprotein.
Bone Density* ; Cholesterol ; Cholesterol, LDL ; Endometrium ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Femur Neck ; Humans ; Hyperplasia ; Lipid Metabolism* ; Lipoproteins ; Postmenopause ; Spine

OBJECTIVES: The purpose of this study was to identify the status of dental care utilization among mothers and children from multicultural families and analyzing the related factors. METHODS: The subjects in this study were 131 mothers from multicultural families and 175 mothers from Korean (control) families who were selected by convenience sampling from the city of Nonsan. The dental care utilization among mothers and children from multicultural families and mothers and children from Korean families were compared. A questionnaire survey was conducted using the self-administration method for mothers from Korean families and by a face-to-face interviewing method for mothers from multicultural families. RESULTS: The proportion of subjects who visited the dentist's office in the past year was not different between the two groups of mothers. However, this proportion was lower in children from multicultural families than those from Korean families. The factors that influenced the visit to dental clinics were age and spouse's age among multicultural mothers and age, spouse's age, personal perceptions about oral health, and oral health concerns among Korean mothers. The factors that influenced dental clinic visits were mother's career, household income, education level of the mother, children's age, mother's dental clinic visits, mother's perception of children's oral health among multicultural children and father's age, marriage duration of parents, children's age, mother's dental clinical visit, and the mother's concerns about children's oral health among Korean children. CONCLUSIONS: Multicultural children visit the dental clinic a lot less than Korean children. Social economic factors such as household income, education level affect the use of dental clinic services by multicultural families.
Child* ; Chungcheongnam-do ; Dental Care* ; Dental Clinics ; Education ; Family Characteristics ; Humans ; Marriage ; Mothers* ; Oral Health ; Parents ; Surveys and Questionnaires

OBJECTIVES: This study investigated the busyness of dentists and analyzed factors related to busyness in these professionals. METHODS: The subjects were 243 practicing dentists. Surveys were carried out via mail. Busyness was measured by using the Mumma scale. The data were analyzed using the Kruskal-Wallis test. RESULTS: The dentists' busyness index was 1.91. Of the participants, 40% of practicing dentists wanted more patients, 30.8% did not overwork but did not want more patients, and 27.1% overworked and did not want more patients. The busyness index was significantly related to the number of dental hygienists and dentists. However, it did not differ with respect to the number of assistant nurses. CONCLUSIONS: The busyness index should be considered when developing relevant human resource plans.
Dental Hygienists ; Dentists* ; Humans ; Postal Service

Chylothorax is a rare but serious postoperative condition with a high rate of morbidity that may lead to death of children with congenital heart disease. Here we reviewed nine consecutive cases with chylothorax in infants and children following cardiac surgery from March 2002 to February 2003. Somatostatin was added to conservative treatment proctocol to increase effectiveness of therapy in all cases. The duration of somatostatin therapy varied from 7 to 32 days. All cases of chylothorax were successfully treated with intravenous infusion of somatostatin as an adjunctive treatment. Even though two cases showed rebound phenomena, we avoided any surgical procedure in the nine patients who treated with conservative management combined with somatostatin. No significant side effects of somatostatin were observed. It seems that somatostatin is effective, noninvasive and safe therapeutic modality. It can be used as an adjunctive treatment to conservative management to control postoperative chylothorax in children with congenital heart disease.
Child, Preschool ; Chylothorax/*drug therapy/*etiology ; Female ; Heart Defects, Congenital/complications/*surgery ; Humans ; Infant ; Infant, Newborn ; Infusions, Intravenous ; Male ; Postoperative Complications/*drug therapy/*etiology ; Somatostatin/administration and dosage/*therapeutic use

PURPOSE: Dialysis and renal transplantation, the current therapies for end-stage renal disease (ESRD), have limitations including severe complications, donor organ shortage, and graft failure. The present study investigated the possibility of using a tissue engineering technique for renal tissue reconstruction as a new method to replace the current treatments for ESRD. We restored renal structure in vivo by transplanting isolated renal cells in renal failure animal models. METHODS: Renal failure was surgically induced by 5/6 nephrectomy using silk tie method in Sprague-Dawley (SD) rats. Renal failure was confirmed by measuring the concentrations of blood urea nitrogen (BUN) and creatinine from blood samples. Renal cells were freshly isolated from newborn SD rat kidneys and implanted into renal failure- induced kidneys with fibrin gel matrix for 4 weeks. Retrieved specimens were examined by histological analyses. RESULTS: Renal failure-induced rats exhibited higher concentrations of BUN and creatinine compared to those of normal rats. Four weeks after cell transplantation, histological examination showed the reconstitution of vascular tufts of glomerular structures. CONCLUSION: Renal failure rat models were successfully created by 5/6 nephrectomy. This study showed a possibility of restoring the renal structures by transplanting renal cells with fibrin gel matrix in renal failure rat models. Further studies, such as investigation on renal function recovery by cell transplantation, are necessary to determine the clinical utility of this method for partial or full replacement of renal structure and function in the treatment of ESRD.
Animals ; Blood Urea Nitrogen ; Cell Transplantation* ; Creatinine ; Dialysis ; Fibrin ; Humans ; Infant, Newborn ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Models, Animal* ; Nephrectomy ; Rats* ; Rats, Sprague-Dawley ; Recovery of Function ; Regeneration* ; Renal Insufficiency* ; Silk ; Tissue Donors ; Tissue Engineering ; Transplants*