We sudied, with echocardiography as a main tool, the natural processes of 211 patients with uncomplicated ventricular septal defect (VSD) (incidence, 5.33 per 1,000 live births); 146 (69.2%) had a perimenbranous VSD and 32 (15.2%) had a subarterial, 25 (11.8%) had a muscular type of VSD. Cumulative rate of spontaneous closure was 26.1%. In the closure processes, about three-fourth of perimembranous VSD showed a partial closure or tunnel formation by changes of septal leaflet of the tricuspid valve, remaining one-fourth showed a "functional" complete closure. Four of 58 neonates had a partially closed-perimembranous VSD. Rates of infundibular stenosis and Eisenmenger syndrome were 6.6% and 1.4% respectively. Aortic prolapse with insufficiency was detected in 6 patients who were over 6 years of age. Surgical closure was required in 27.5% of all studied patients and in 12% of infants (14 of 177). No natural deaths were observed during the study-periods of recent 3 years. But, 3 of 58 (5.2%) were dead postoperativel (two were early, one late). Doppler color flow mapping is a valuble aid in the diagnosis of VSD and may be on reason for the observed increase in the incidence of VSDs.
Constriction, Pathologic ; Diagnosis ; Echocardiography* ; Eisenmenger Complex ; Heart Septal Defects, Ventricular* ; Humans ; Incidence ; Infant ; Infant, Newborn ; Prolapse ; Tricuspid Valve

Mitral regurgitation (MR) was analyzed by Doppler echocardiography, preoperatively and postoperatively, in 59 patients with patent ductus arteriosus (PDA). The ratio of left atrial dimension and aortic root dimension (LAD/AOD) and the maximal velocity of the mitral valve (MVmax) were compared in pre, postop group. The degree of the regurgitation was given to the MR group. In preop MR group (13 of 59,22%), we compared the LAD/AOD by echo and the Qp/Qs by catheterization with non-MR group. The following results were obtained: 1) In preop MR group, about half of them had a grade 1 regurgitation, where as one fourth showed grade 2, remaining one fourth showed grade 3. The later were all changed to grade 2, postoperatively. The whiffle or mild MR (grade 1 or 2) shown preoperatively were slightly reduced in their degrees of regurgitation, but most were not disappeared and persisted to 7th postop day. 2) LAD/AOD and MVmax were significantly reduced at postop state of PDA. 3) In preop MR group (n=13), LAD/AOD was significantly increased. Qp/Qs was higher in MR grade 2 group (n=6). In conclusion, left atrial dilatation could be a factor causing mitral regurgitation in the PDA. The amount of the pulmonary blood flow also related to that. The size of the PDA itself, Rp/Rs and associated cardiac lesions were not related to the regurgitation.
Catheterization ; Catheters ; Dilatation ; Ductus Arteriosus, Patent ; Echocardiography, Doppler ; Humans ; Mitral Valve ; Mitral Valve Insufficiency*

No abstract available.
Heart Failure* ; Heart* ; Hypertension, Pulmonary* ; Nifedipine*

BACKGROUND: Chlamydia pneumoniae, a new species of the obligate intracellular Chlamydia, has been recognized as a significant pathogen that causes infection of the human respiratory tract and has recently been associated with coronary atherosclerosis. Diagnosis of infections with C. pneumoniae is problematic, because the syndrome usually presents few distinguishing features and culture of the organism is far more difficult than other Chlamydia species. To further improve the cell culture isolation and passage of C. pneumoniae organisms. we have studied several chemical and physical factors that might affect their viability and growth. METHODS: C. pneumoniae strain (TW-183) was obtained from the Centers for Disease Control, Atlanta. Ga. First we compared McCoy HeLa-229, and HEp-2 cells in the search for a more efficient and practical cell culture system. The growth rate of C. pneumoniae was assessed by the effects of diethylaminoethyl-dextrin, by the adequate centrifugation force and time, by the growth promoting effect of cycloheximide, and by the optimal incubation time. All of the results were evaluated by the indirect immunofluorescent stain using the genus-specific monoclonal antibody(HYMo 1-1) to Chlamydia. RESULTS: The HEp-2 cell was the most efficient for culturing C. pneumoniae and the inclusion bodies in monolayer were increased with DEAE-dextran pretreatment at 30microgram/ml. Also application of a centrifugal force of 1.500 xg for at least 15 minute during inoculation enhanced the growth of C. pneumoniae. The best concentration of cycloheximide in the culture medium for host cell cytostasis was 1microgram/ml. The yields of organisms were greater when the cultures were harvested at 48 hours. CONCLUSIONS: We suggest that this system may make it more practical for laboratories to culture for C. pneumoniae.
Cell Culture Techniques ; Centers for Disease Control and Prevention (U.S.) ; Centrifugation ; Chlamydia* ; Chlamydophila pneumoniae* ; Coronary Artery Disease ; Cycloheximide ; DEAE-Dextran ; Diagnosis ; Humans ; Inclusion Bodies ; Pneumonia ; Respiratory System

PURPOSE: We reviewed 5 years worth of experience with peritoneal drainage and dialysis in infants who underwent open heart surgery. The aim of this study was to investigate the effect of peritoneal drainage and peritoneal dialysis on fluid balance and several parameters of intensive care. METHODS: Six(10%) of 60 consecutive infants who underwent open heart surgery required peritoneal dialysis during peritoneal drainage. Simple peritoneal drainage was performed in the remaining 54 infants. The silicone rubber peritoneal dialysis catheter was inserted into the center of abdominal cavity just after operation, and subsequent peritoneal drainage was maintained during intensive care. RESULTS: Mean age of the study group was 0.48+/-0.21 years(M: F=32: 28). Early postoperative mortality amang the infants with congenital heart disease was 1.6%. Total amount of output was 7.0+/-2.28mL/kg/hr, urine output 5.14+/-2.9lmL/kg/hr, pleural fluid 0.80+/-0.5lmL/kg/hr, and peritoneal fluid 1.20+/-0.90mL/kg/hr. The ratio of output to intake(O/I) was 1.06. None of the complications required early termination of peritoneal drainage or peritoneal dialysis. Hemodynamics and pulmonary function were maintained steadily during postoperative intensive care. CONCLUSION: The early institution of peritoneal drainage and peritoneal dialysis in infants with congenital heart disease after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.
Abdominal Cavity ; Ascitic Fluid ; Catheters ; Dialysis ; Drainage* ; Heart Defects, Congenital* ; Heart* ; Hemodynamics ; Humans ; Infant* ; Critical Care ; Mortality ; Peritoneal Dialysis ; Silicone Elastomers ; Thoracic Surgery ; Water-Electrolyte Balance

Total anomalous pulmonary venous return(connection) is a congenital heart disease. Especially, the reports of the patients with double connections of all pulmonary veins were rare. An infant who underwent operation for total anomalous pulmonary venous return had double drainge of all pulmonary veins to both left vertical vein and anomalous descending vein. This second lesion was not diagnosed preoperatively, but in operative field. Operative treatments were performed by ligation of left vertical vein and central pulmonary vein-to-left atrium anastomosis without ligation of the descending anomalous vein. For these less common variants fo total anomalous pulmonary venous return,a more detailed and precise understanding of morphology can facilitate accurate surgical repair. And also, early detection of the disease is an another issue for a good prognosis.
Heart Defects, Congenital ; Humans ; Infant ; Ligation ; Prognosis ; Pulmonary Veins ; Scimitar Syndrome* ; Veins

The authors analysed 261 cases of mycoplasmal pneumonia in children who were admitted to the pediatric department of Seoul Adventist Hospital between July 1986 and June 1991. The result obtained were as follows; 1) Yearly distribution of the cases showed high in 1987 and 1991, but no significant difference was noted in seasonally or monthly distribution. 2) The peak incidence of age was between 2 and 6 years of age, and the sex ratio of boy to girl was 1.1:1. 3) pulmonary manifestations were asthma in 21 cases (8.0%), atelectasis in 5 cases (1.9%), emphysema in 3 cases (1.2%), pleural effusion in 16 cases (6.1%), otitis media in 4 cases (1.2%) and sinusitis in 9 cases (3.4%). 4) Extrapulmonary complication were hepatitis in 53 cases (20.3%), skin rash in 9 cases (2.4%), proteinuria in 6 cases (2.3%), and hematuria in 4 cases (1.5%). 5) On the chest X-ray examination, the most common type of pneumonia was interstitial pneumonia (94 cases, 39.8%), and unilateral involvement was common (85.6%), and the most common involvement was right lower lobe (83 cases, 41.4%). 6) The relationship between the type of pneumonia and cold agglutinini titer, and between the type of pneumonia and Mycoplasma antibody titer were not found (P>0.05). 7) In the 16 cases of pleural effusion, The type of pneumonia was lobar, lobular (9 cases), bronchopneumonia (7 cases), and interstitial type was not present. The site of pneumonia was left (6 cases), right (9 cases), and 1 case showed bilatrality. The extent of pleural effusion was mild (10 cases), moderate (3 cases), and severe (3 cases). The result of pleural fluid exam in severe cases was all exudate. 8) The mean duration of admission was most common from 6 to 10 days. the mean duration of admission by the type of pneumonia was lobar, lobar (10.71+/-3.40), interstitial (8.78+/-2.14), and bronchopneumonia (8.83+/-2.47). 9) Both mycoplasma antibody test and cold agglutinin test were carried out in 185 cases and sensitivity of mycoplasma antibody test was 55.1%.
Asthma ; Bronchopneumonia ; Child* ; Emphysema ; Exanthema ; Exudates and Transudates ; Female ; Hematuria ; Hepatitis ; Humans ; Incidence ; Lung Diseases, Interstitial ; Male ; Mycoplasma* ; Otitis Media ; Pleural Effusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Proteinuria ; Pulmonary Atelectasis ; Seasons ; Seoul ; Sex Ratio ; Sinusitis ; Thorax

BACKGROUND: A number of studies have demonstrated that an accurate measurement of the peak tricuspid regurgitation velocity with contimuous wave Doppler, which may predict the right ventricular systolic pressure using the simplified Bernoulli equation. However, the peak velocities are often of low intensity on the spectral Doppler display if the tricuspid regurgitation(TR) is not severe. The aim of this study was to evaluate the usefulness of measuring the time interval from pulmonary closure to the end of tricuspid regurgitation, in predicting peak tricuspid regurgitant velocity and hence derive peak right ventricular systolic and pulmonary artery pressure(PAP). METHODS: We studied 19 patients with normal PAP(group A), and 7 with pulmonary hypertension(group B), 27 with postop state of the open cardiac surgery(group C), who underwent echocardiographic and Doppler assessment. Pulmonary closure(PC) was taken as the closure artifact on the Doppler recording in the main pulmonary artery. Regurgitant flow was identified and recorded in continuous wave mode from the apex. The time interval from end of the TR to PC(TR end PC) was measured, and corrected by 100/min of heart rate. RESULTS: The time interval of corrected “TR and-PC” was 12.95±48.69 msec in group A, 16.8±43.15 msec in group C, where as 72.43±37.71 msec in group B(p < 0.01, comparing with group A). the correlation between TR end-PC and TR gradient was low in group A and C(r=0.12, 0.41 respectively), but high in group B(r=0.73)(TR gradient=0.55×TR end-PC+29.1). CONCLUSIONS: The time interval of TR end-PC in the patients with pulmonary hypertension was higher than normal subjects. And also, we found a good correlation between TR end-PC and TR gradient in patients with pulmonary hypertension. However, in postop state of the open cardiac surgery, there was no significant correlation. The precise explanations of this are by no means clear, but abnormal function of the right ventricle may affect the dynamics of regurgitant flow.
Artifacts ; Blood Pressure ; Echocardiography ; Heart Rate ; Heart Ventricles ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery ; Thoracic Surgery ; Tricuspid Valve Insufficiency

Purpose: This study aimed to investigate the mediating effects of health promotion behavior (HPB) in the relationship between anxiety and quality of life (QoL) in young adults living in the post-pandemic era. Methods: A cross-sectionaldescriptiveonlinesurveydesign was utilized. Data on anxiety, QoL, HPB, and demographic characteristics were collected from 213 adults aged 19–35 years in Korea via an online survey in January 2024. The collected data were analyzed using SPSS 27.0 and PROCESS MACRO 4.2 software. Results: Strong correlations were observed among anxiety, QoL, and post-pandemic HPB (PP-HPB) in young adults, andanxiety and PP-HPB were identified as significant predictors of QoL. The total effect of anxiety on QoL was significant (B = −1.40, bootstrapped SE = 0.10), with both the direct effect (B = −0.70, bootstrapped SE = 0.09) and the indirect effect (B = −0.70, bootstrapped SE = 0.11) being significant. This suggests that PP-HPB partially mediated the relationship between anxiety and QoL. Conclusion This study highlights the importance of strengthening HPB with consideration of life changes since the coronavirus disease 2019 pandemic to improve QoL among young adults with anxiety.

PURPOSE: To investigate the postoperative patterns of weight-gain in early infants with ventricular septal defects (VSDs), we analyze 48 patients who received primary surgical closure of the symptomatic VSDs during 6 months of age in the period of 1993 through 1995. METHODS: Forty-sixt infants met criteria for inclusion in the study. The mean follow up period was 14 months (3 to 36 months). Weight percentile was extrapolarated from data of the Korean boys and girls measured in 1985. The data was compared by one-group paired student t-test. RESULTS: The overall mortality rate of this study was 4% (2/48). No surviving patients required a second ventricular septal defect operation, and the majority no longer received anticongestive therapies. The mean percentile of the preoperative weight was 3.53. In postoperative follow up period, they grew steadily. But, the mean weight percentile was only 5.46 in age under 6 months. Mean 12 percentile was achieved in age of 6 to 8 months, hence 25.4 percentile in 9 to 12 months, 33.5 percentile over 12 months, 64.8 percentile over 24 months of age. The weighing pattern of the patients with smaller defect was similar in 24 patients (52%) with large VSD, which size were same or larger than diameter of the aortic root. CONCLUSIONS: This study indicated that the patients under 6 months who have undergone primary surgical closure of the symptomatic large ventricular septal defects could gain the weight normally in postoperative period. Although the weight-gain was not sufficient when the age was under 12 months, It became normal pattern of weighing in age over 12 months.
Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Infant* ; Mortality ; Postoperative Period