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

No abstract available.

No abstract available.

BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal involvement may influence on its course and prognosis. To verify prevention with early administration of steroid, we studied the efficacy of corticosteroid treatment. MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein purpura according to their age, sex, and seasonal incidence. Forty children showed typical skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and group B did not. We carried out their physical examination and urinalysis monthly for a year. RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %), joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms, abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting (44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2% of them within 4 months. Mild elevation of IgA was more frequently observed in renal involvement group than non-involved group (p< 0.01). There were no significant differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase and severity of cutaneous symptoms between two growps. None of steroid treated growp showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein purpura influences its course and prognosis.
Abdominal Pain ; Ankle ; Arthralgia ; Child ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Joints ; Nausea ; Physical Examination ; Prognosis ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Seasons ; Skin ; Urinalysis ; Vomiting

No abstract available.
Cryotherapy* ; Leishmaniasis, Cutaneous* ; Metronidazole*

No abstract available.
Myiasis*

Bony defect is one of the most common problems in craniomaxillofacial surgery. Although aurogenous bone graft is the best choice for the treatment of bone defect, it provides many problems such as donor site morbidity, irregular absorption, and limited amount of harvest. To overcome the shortcomings of autogenous bone graft many bone substitutes have been introduced. The ideal bone substitution is to have characteristics such as cheap, easy to obtain, rapid fusion to recipient bone, hard structure, long maintenance of shape and volume, low infection rate, and low exposure rate. Among those bone substitutes which have been widely used we chose lyophilized cartilage allograft because of low antigenecity, low resorption rate, easiness of carving and ling term preservation. From August 1993 to August 1997, 66 patients had been performed craniomaxillofacial reconstruction with lyophilized cartilage allograft. Orbital wall reconstruction and correction of enophthalmos were 24, correction of cleft lip and nose deformity were 19, temporal augmentations were 7, and others 16. Complications such as infection, exposure were not common. And partially removed cartilage was proved some calcification. Radiologic follow-up presented well positioned lyophilized cartilage allograft. Two radiologic works revealed haziness of bone density at the site of cartilage allograft. This suggests the ossification of lyophilized cartilage allograft. Together with liw infection rate, low exposure rate, and good framework for osteoconduction, lyophilized cartilage allograft are regarded as one of the good bone substitutes.
Absorption ; Allografts* ; Bone Density ; Bone Regeneration ; Bone Substitutes ; Cartilage* ; Cleft Lip ; Congenital Abnormalities ; Enophthalmos ; Follow-Up Studies ; Humans ; Nose ; Orbit ; Tissue Donors ; Transplants

PURPOSE: To assess the combined effectiveness of angioinfarction and immunotherapy for improving survival in patients with stage IV renal cell carcinoma. MATERIALS AND METHODS:During the past 3 years, 13 patients of stage IV renal cell carcinoma were treated with angioinfarction and immunotherapy. Angioinfarction was performed on these 13 patients using absolute ethanol and occlusive baloon catheter. After angioinfarction, Interferon alpha was used for immunotherapy. For our analysis, 12 control patients of stage IV renal cell carcinoma without treatment were included in the study. Survival has been calculated according to the Kaplan and Meier method. RESULTS: The 1 year survival rate and median survival time in patients treated with angioinfarction and immunotherapy, were 46% and 13 months and in patients without treatment, 16% and 4 months, respectively. CONCLUSION:The combined treatment of angioinfarction and immunotherapy is of considerable value for improving survival in patients with stage IV renal cell carcinoma
Carcinoma, Renal Cell* ; Catheters ; Ethanol ; Humans ; Immunotherapy* ; Interferon-alpha ; Survival Rate

PURPOSE: To analyze the dynamic MR imaging of breast fibroadenoma according to the histologic type for differentiation from breast carcinoma. MATERIALS AND METHODS: Dynamic MR images of 26 lesions from 22 breasts in 19 patients showing atypical clinical features or film mammogram and ultrasound manifestations were performed. We analyzed the speed and the maximal amount of contrast enhancement and the patterns, such as shape, border, and internal signal intensity, among the histologic types during five minutes after contrast injection. RESULTS: The speed and maximal amount of contrast enhancement of fibroadenoma were in descending order of myxoid, sclerotic, glandular, and calcified types. Among these, the value of maximal amount of contrast enhancement of myxoid and sclerotic type were more than 700 NU, but only myxoid type was enhanced more than 700NU within the first 1 minute after contrast injection, similar to the findings of carcinoma. In general, fibroadenoma showed the tendency of smooth surface(69%), well-defined border(88%) with safety rim, and internal homogeneous signal intensity(65%). However, sclerotic type of fibroadenoma had relatively high incidence of heterogeneous internal signal intensity(78%) after Gd-DTPA injection. CONCLUSION: Dynamic MR imaging of atypical breast fibroadenoma mimicking breast malignancy was very useful in differentiation it from carcinoma and had the benefit of classifying fibroadenoma according to its histologic types.
Breast Neoplasms ; Breast* ; Fibroadenoma* ; Gadolinium DTPA ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Ultrasonography

This study aimed 1) at determining the seasonal pattern of the first onset and 2) at examining different demographic and clinical factors by the seasonality of first onset, for shizophrenia, mood disorder and subtypes of each diagnosis. Finally, the 52 subjects with paranoid schizophrenia were selected from all patients who fulfilled DSM-IV criteria far schizophrenia who had been admitted to the National Seoul Mental Hospital from March 1994 to February 1995. And the 44 subjects with bipolar I disorder were selected from all patients who fulfilled DSM-IV criteria for mood disorder who had been admitted to the hospital from March 1994 to February 1996. This study was done by reviewing the hospital records about season of the first outset, demographic factors(sex, age, occupation, educated period, religion, marital status, residence and socioeconomic status) and clinical factors(age at the first onset, duration of illness, family history, length of admission, frequency of admission and treatment result). The seasonal pattern of the first onset and the different demographic and clinical factors by the season of the first onset in paranoid shizophrenia and I disorder were analyzed. The results were as follows: 1) There was no significant seasonal variation of the first onset for paranoid schizophrenia. 2) There was a significant seasonal variation of the first onset with a maximum in spring for bipolar I disorder. 3) There was no significant seasonal variation of the first onset in case of bipolar I disorder that began with the manic episode. 4) There was nonsignificant seasonal tendency to peak in spring/summer in the case of the first manic episode for bipolar I disorder. 5) There were no significant differences in demographic and clinical factors by the season of the first onset for paranoid schizophrenia and bipolar I disorder.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Hospital Records ; Hospitals, Psychiatric ; Humans ; Marital Status ; Mood Disorders* ; Occupations ; Schizophrenia* ; Schizophrenia, Paranoid* ; Seasons ; Seoul