No abstract available.

Twenty patients with congenital aortic stenosis excluding valvular stenosis were studied beween April 1980 and April 1984 at Seoul National University Hospital. The clinical and radiologic findings with the emphasis on the cineangiographies were analyzed separately according to the type of aortic stenosis as subaortic and supravalvular aortic stenosis. The summaries of the analysis are as follows: 1. Among the 20 cases, 12 cases were subaorticstenosis and 8 cases were supravalvular stenosis. 2. The anatomic types of subaoritc stenosis were the discrete membranous type (8 cases), the fibromuscular type (2 cases) and the tunnel type (2 cases). 3. The obstruction of subaoritic types was usually severe, and the median left ventricular to aortic systolic pressure gradient was 60mmHg, and associated cardiac defects were found in 10 cases (84%), an incidence greater than that reported in mostother large series. 4. The anatomic types of 8 cases of supravalvular aortic stenosis were mainly focal type (7cases ) and 1 case of diffuse hypoplastic type. 5. The median left ventricular to aortic systolic pressure gradient of supravalvular stenosis was 75mmHg, and associated anomalies were seen in 6 cases(75%) with 3 cases of suspected mental retardation and facial abnormalities without definite hypercalcemia. 6. For accurate diagnosis of congenital aortic stenosis, retrograde left ventricular angiograms obtainend in axial pojections are of crucial importance in demonstration of anatomic types of stenosis and associated anomalies. And supravalvular aortic injection is sometimes helpful to outline the anatomy of the valve and to evaluate the degree of aortic regurgitation.
Aortic Stenosis, Supravalvular ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Blood Pressure ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypercalcemia ; Incidence ; Intellectual Disability ; Seoul

PURPOSE: To determine whether the practice of not routinely changing ventilator circuits in patients who require prolonged mechanical ventilation is associated with ventilator-associated pneumonia (VAP). METHODS: Patients were divided into two groups, ventilator circuits were routinely changed every 7 days for the control group (39) and every 14 days for the experimental group (40) over a period of 1 yr (April 1, 2009-March 31, 2010). Pediatric patients (age 17 yr or less) were not included. VAP was diagnosed by the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of VAP and characteristics of infection were evaluated. RESULTS: In the experimental group, 2 episodes of pneumonia were observed in 40 patients and 1,322 ventilator days. The rate of VAP was 1.5 per 1,000 ventilator days. There was 1 episode of pneumonia in 39 patients and 481 ventilator days for the control group. The rate of VAP was 2.1 per 1,000 ventilator days. The difference between both groups was not significant (p=.695). CONCLUSION: Extending ventilator circuit change interval from 7 days to 14 days does not increase the risk for VAP.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Pneumonia, Ventilator-Associated/*epidemiology ; Risk Factors ; Sputum/microbiology ; Time Factors ; Ventilators, Mechanical

PURPOSE: The purpose of this study was to compare the effects of preventing CAUTIs through the practice of using 0.05% chlorhexidine gluconate (CHG) versus normal saline for perineal care in ICU patients. METHODS: A randomized controlled trial was used, and participants were randomly allocated to either the CHG group (n=79) or normal saline group (n=81). CAUTI was diagnosed following the criteria of the Centers of Disease Control and Prevention (CDC). Incidence of CAUTI and characte oftics of infection were evaluated. RESULTS: In the CHG group, 8 epofodes of CAUTI were obsevend in 79 patients and 875 foley catheter e ys. Tnce ate of CAUTI was 9.14 per 1,000 foley catheter e ys. Tncre were 2 epofodes of CAUTI in the 81 patients and 837 foley catheter e ys of the normal saline group. Tnce ate of CAUTI was 2.39 per 1,000 foley catheter e ys. Tnc difference between both groups was not significant (p=.1). CONCLUSION: Using normal saline to provide perineal care to ICU patients with a foley catheter inserted will not increase the risk for CAUTI.
Catheterization ; Catheters ; Chlorhexidine ; Humans ; Incidence ; Infection Control ; Critical Care ; Intensive Care Units ; Urinary Tract ; Urinary Tract Infections

Eccrine nevus is a rare benign cutaneous lesion, frequently present at birth or at an early age. Herein we report on a 1-year-old girl with erythematous papules in a zosteriform arrangement associated with hyperhidrosis on the left side of her trunk.
Female ; Humans ; Hyperhidrosis ; Nevus* ; Parturition

PURPOSE: This study was designed to investigate that men with prostatodynia have petechiae in the bladder and improvement of symptoms after hydrodistension. MATERIALS AND METHODS: A total of 14 men with the diagnosis of prostatodynia underwent cystoscopy and hydrodistension under a general or regional anesthetic. Their charts were retrospectively reviewed. RESULTS: Of the 14 men 5(36%) had moderate to severe petechiae similar in appearance to women with interstitial cystitis after hydrodistension. Men with moderate to severe bladder petechiae had fewer leukocytes in expressed prostatic secretions and smaller bladder capacities than men with more normal appearing bladders after hydrodistension. Symptomatic improvement 2 to 6 weeks after hydrodistension was more common in men with moderate to severe petechiae than in those with fewer petechiae. CONCLUSIONS: We suggest that bladder petechiae after hydrodistension may be a diagnostic finding in men with prostatodynia as well as women with interstitial cystitis. Therefore, the diagnosis of interstitial cystitis should be considered in patients with prostatodynia.
Cystitis, Interstitial ; Cystoscopy ; Diagnosis ; Female ; Humans ; Leukocytes ; Male ; Purpura ; Retrospective Studies ; Urinary Bladder

No abstract available.

Renal cell carcinoma is an uncommon tumor in children and only 3-5 percent of the renal cell carcinoma occur under age of twenty. Interestingly, some of the patients had a history of trauma occurring shortly before the onset of symptom calling attention to the tumor. In histology of renal cell carcinoma, clear cell type is most common and papillary type is 10-15 percent. The papillary type of renal cell carcinoma is characterized by better prognosis than non-papillary types. We report a case of papillary type of renal cell carcinoma which was detected incidentally after trauma in 13-year-old male patient.
Adolescent ; Carcinoma, Renal Cell* ; Child* ; Humans ; Male ; Prognosis

Young adult stroke is not rare disease and have diverse causes. We studied 135 young adults aged 15 - 45 years who had been admitted to Severance Hospital with a diagnosis of cerebral infarction from January 1990 to June 1995. The results are as follows. 1. The diverse causes of earshot infarction in young adults have been found in most patients(88.2%). The major causes of cerebral infarction in young adults were atherosclerosis(32.6%) and cardioembolism(32.6%). The causes were significantly different between younger(15 - 30 years old) and older(31 - 45 years old) patients. 2. The major risk factors of atherosclerotic cerebral infarction were hypertension(29 patients), smoking(14 patients), and hyperlipidemia(11 patients). 3. The major causes of cardioembolism were valvular heart disease(21 patients) and prosthetic valve(I0 patients). The mitral valve prolapse was discovered only in one patient. 4. Fourteen patients had non-atherosclerotic vasculopathies. The moyamoya disease was the most common cause of them. 5. The other causes of cerebral infarction were found in 17 patients and the major causes were alcohol intoxication and postoperative thromboembolism. 6. The cerebral infarction occurred mostly in the carotid artery territory(95 patients) and the distribution of the involved vascular territory was not different between younger and older age groups. 7. The clinical outcomes were good in most patients (86, 7%). From the above results, we demonstrated that young adults with cerebral infarction had various causes and showed favorable clinical outcomes. We also found that the causes of cerebral infarction varied between younger and older groups. Our findings suggest that careful and thorough case-by-ease evaluation may be mandatory to clarify the causes of cerebral infarction in young adults.
Carotid Arteries ; Cerebral Infarction* ; Diagnosis ; Heart ; Humans ; Infarction ; Mitral Valve Prolapse ; Moyamoya Disease ; Rare Diseases ; Risk Factors ; Stroke ; Thromboembolism ; Young Adult*

PURPOSE: To compare the efficacy and safety of ultrasound guided automated gun biopsy with fine needle aspiration biopsy of focal liver lesions. MATERIALS AND METHODS: We performed 32 automated gun(19.5G Autovac Biopsy Needle) biopsies and 27 fine needle aspiration(22G Westcott Style Biopsy Needle) biopsies in 48 patients with malignant focal liver lesion under the guidance of ultrasound. We compared the "positive for malignancy rate" and "pathologic diagnosis rate" of both methods with final diagnosis, and the rate of complications. RESULTS: The "positive for maiignancy rate" of automated gun biopsy and needle aspiration are 84.4%(27/32) and 66.7%(18/27) respectively(p=0.11). The "pathologic diagnosis rate" are 84.4%(27/32) and 55.6%(15/27) with significant statistical difference(p<0.05). And there is no difference of the rates of significant complications. CONCLUSION: When compared with the fine needle aspiration biopsy, ultrasound-guided automated gun biopsy is safe and more effective method for malignant focal liver lesion.
Biopsy* ; Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Liver* ; Needles ; Ultrasonography*