BACKGROUND: Noninvasive estimation of pulmonary artery pressure is an important component of echocardiographic studies. A number of methods are available for estimation of pulmenary pressure, each with varying degrees of reported accuracy. To assess accuracy and difficulties, noninvasive pulmonary artery pressure estimates were performed in infants and children with congenital heart diseases. METHODS: Noninvasive estimates from 8 methods were compared with catheterization measurements. Systolic pressure was estimated by the Burstin method and from perak tricuspid regurgitation velocity, and also from systolic pressure gradients through the VSD(ventricular septal defect) and PDA(patent ductus arteriosus). Mean pressure was estimated by acceleration time divided by ejection time measured from Koppler spectrum obtained at the right ventricular out flow tract. Diastolic pressure was estimated from pulmonary regurgitation velocity spentrum at end-diastolic, and also from diastolic pressure gradient through the patent ductus arteriosus. RESULTS: IN systolic pressure, Burstin and tricuspid regurgitation velocities estimates correlated significantly(r=0.92, 0.90 respectively), whereas VSD and PDA estimates correlated less well with catheterization estimates(r=0.83, 0.65 respectively). The mean pressure, measured from RVOT(right ventricular outflow tract) Doppler spectrum corresponded well with catheterization pressure(r=0.89), whereas those obtained from the main pulmonary artery correlated less well(r=0.74). The diastolic pressure estimates from pulmonary regurgitation velocity spectrum, revealed good correlation(r=0.79), but those from diastolic Doppler spectrum at PDA correlated less well with catheterization estimates(r=0.63). CONCLUSION: All of eight Doppler echocardiographic methods seemed to be easily performable for estimation of pulmonary artery pressure. But, the degree of accuracy was variable. Because a pressure estimante from only a single method may be in error, care should be taken in combining use of other(one or two) methods.
Acceleration ; Blood Pressure ; Catheterization ; Catheters ; Child ; Ductus Arteriosus, Patent ; Echocardiography* ; Echocardiography, Doppler ; Heart Diseases ; Humans ; Infant ; Pulmonary Artery* ; Pulmonary Valve Insufficiency ; Tricuspid Valve Insufficiency

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

No abstract available in English.
Acromioclavicular Joint ; Dislocations ; Methods

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

No Abstract Available.
Pterygium*

OBJECTIVE: We evaluate the rates and outcomes of major procedure-related complications during coiling. MATERIALS AND METHODS: Between 2007 and 2015, 436 intracranial saccular aneurysms were treated. Complications are categorized as three types: intraprocedural aneurysm rupture (IAR), thromboembolism (TE), and post-procedural early rebleeding (PER). And we evaluated the risk factors of procedure related complications by multivariate analysis. RESULTS: Complications occurred in 61 aneurysms (14%). The overall incidence of complications in subarachnoid hemorrhage (SAH) was significantly higher than in unruptured intracranial aneurysm (UIA) (20% vs. 6%). The incidence of IAR and TE were higher in SAH than in UIA (IAR 12% vs. 4%, TE 7% vs. 3%, p < 0.05). Five PER occurred only in SAH. In 34 UIA which were treated with balloon-assisted coiling (BAC), all these patients had good recovery despite 3 patients had the IAR. The incidence of IAR and TE were not different between BAC and non-BAC groups (p > 0.05). All 7 patients who had IAR during BAC had good recovery. In multiple logistic regression analysis, female gender, SAH, and intraventricular hemorrhage were associated with procedure related complication (p < 0.05). CONCLUSION: Endovascular coil embolization is a minimally invasive procedure, but incidence of its complication is not low, especially in SAH. BAC can be a good tool to avoid poor outcome from unexpected IAR during coiling. While IA tirofiban injection is a useful therapy in TE during coiling, sometimes we are aware of the risk of the early rebleeding in SAH patients.
Aneurysm* ; Embolization, Therapeutic ; Female ; Hemorrhage ; Humans ; Incidence ; Intracranial Aneurysm ; Logistic Models ; Multivariate Analysis ; Risk Factors ; Rupture ; Subarachnoid Hemorrhage ; Thromboembolism

OBJECTIVE: The pathophysiology of chronic subdural hematoma (CSH) is not yet clear. Trauma alone is not sufficient to result in CSH in young individuals, while a trivial injury can result in CSH in older adults. Although the causality and apportionment of trauma are important issues in CSH, especially in terms of insurance, it is too obscure to solve all struggles. METHODS: There are three key factors for producing CSH. First, CSH necessitates a potential subdural reservoir. Other important precipitating factors are trauma and coagulopathy. However, these factors are not sufficient to cause CSH development. The trauma apportionment score (TAS) can be used to compare the relative importance of these three factors. Here, we applied the TAS to 239 consecutive cases of CSH. We retrospectively obtained the patients' history and laboratory results from their medical records. RESULTS: The TAS ranged from −5 to 5. The most common score was 0. If we defined the cause of CSH as being combined when the TAS was 0, then the cause was combined in 30 cases (12.6%). If we extended the criteria for a combined cause from 0 to −1 to 1, the cause was combined in 107 cases (44.8%). Regardless of the criteria used, traumatic CSHs were more common than were spontaneous CSHs. Spontaneous CSHs were more common in older than in younger patients (p < 0.01, Fisher's exact test). CONCLUSION: The TAS is a useful tool for differentiating the causality of CSH.
Adult ; Aging ; Craniocerebral Trauma ; Hematoma, Subdural, Chronic* ; Humans ; Insurance ; Intracranial Pressure ; Medical Records ; Precipitating Factors ; Retrospective Studies

To evaluate the relationship between spontancous diuresis and improvement of pulmonary function in respiratory distress syndrome, 15 premature neonates requiring mechanical ventilation for RDS, who admitted in NICU of Wonkwang University Hospital from January 1990 to June 1992, were studied. The results were as follows (results are mean+/-SEM) 1) Mean birth weight of study infants was 1.82+/-0.08Kg, and mean gestational age was 32.80+/-0.54 weeks. 2) The onset of diuresis occured at a mean age of 29.1+/-2.48 hours with maximum diuresis at a mean age of 41.9+/-1.8 hours 3) Mean urine output increased from 2.25+/-0.43ml/Kg/hr at the stage of pre 12 hours-onset of diuresis (p<0.001), then decreased 3.5+/-0.2ml/Kg/hr at the stage of after maximum diuresis (p<0.05). 4) After maximum diuresis, inspired oxygen gradient, peak inflating pressure, peak end expiratory pressure, mean airway pressure, and respiratory rate were decreased significantly (p<0.05), and alveolar-arterial oxygen gradient was decreased more significantly (p<0,01). So, We conclude that the pulmonary function was rapidly improving after maximum diuresis and these changes reflect the general principle used in ventilatory management of infants with RDS.
Birth Weight ; Diuresis* ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Oxygen ; Respiration, Artificial ; Respiratory Rate

No abstract available.
Female ; Ovary*