This study was performed to compare the amount of blood flow from left and right side heart using Doppler echocardiography and Fick method. The pulmonary blood flow (Qp), aortic blood flow (Qs) and Qp/Qs ratio were noninvasively evaluated by two dimensional Doppler echocardiography in 10 patients with ventricular septal defect in children, aged 2 years to 15 years (mean+/-SD=7.1+/-4.9 years). Cardiac catheterization was performed within 2 days after examination of Doppler echocardiography in all patients. Systemic and pulmonary blood flow was calculated by using Fick principle, based on measured oxygen consumption and measured blood oxygen saturation. The Doppler frequency shift was analyzed by computer system combined with Meridian Echocardiography System. Comparison of Qp, Qs and Qp/Qs ratio obtained by invasive methods and by two-dimensional pulsed wave Doppler echocardiography showed a correlation of 0.679 in Qp, 0.710 in Qs and 0.639 in Qp/Qs ratio (p<0.05).
Cardiac Catheterization* ; Cardiac Catheters* ; Child* ; Computer Systems ; Echocardiography ; Echocardiography, Doppler* ; Heart ; Heart Septal Defects, Ventricular* ; Humans ; Oxygen ; Oxygen Consumption

Among total 108 cases of biopsy-proven fibroadenomas of the breast, which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-leading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) in 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proliferative breast lesions with atypia(26.1%). None were subject to the category of carcinoma. Cytologic features leading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pleomorphism without nuclear enlargement, and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.
Neoplasm Metastasis

No abstract available.
Ultrasonography, Doppler, Color*

OBJECTIVE: To evaluate the accuracy of combined transvaginal ultrasound and beta-hCG discriminatory zone for diagnosing intrauterine pregnancy, abortion, and ectopic pregnancy in early abnormal pregnancy. METHODS: Initial ultrasound findings and beta-hCG level were compared with final pregnancy outcome in 164 early pregnant women who visit our hospital with vaginal bleeding or abdominal pain. The sensitivity, specificity, and predictive value by the combination of two diagnostic tools were calculated. Statistic analysis of collected data used x2 of SPSS(9.0). RESULTS: Of 90 women with normal outcome, 64(71.1%) had a gestational sac 5mm, and in 47 cases, the hCG level was above 1,800 mIU/ml. Transvaginal ultrasound was non-diagnostic in 47(28.6%) of 164 women, and especially, 43(53.1%) of 81 cases with beta-hCG levels below 1,800 mIU/ml. The portion of accurate ultrasound diagnosis was significantly higher in women above 1,800 mIU/ml (85.5%, 71 of 83 cases) compard with levels below 1,800 mIU/ml (37.0%, 30 of 81 cases) : P < 0.001; Relative Risk(RR) 2.31; CI 95%. Sensitivity of transvaginal ultrasound diagnosis of intrauterine pregnancy, abortion, and ectopic pregnancy was 90.2%, 79.3%, and 66.7% in women who presented with beta-hCG levels above 1,800 mIU/ml, and 41.0%, 23.5%, and 75% below 1,800 mIU/ml, respectively. And, negative predictive value was 83.9%, 89.7%, and 98.8% in each of intrauterine pregnancy, abortion, and ectopic pregnancy above 1,800 mIU/ml, and 64.6%, 60%, and 97.3% below 1,800 mIU/ml, respectively. CONCLUSIONS: The sensitivity, specificity, and predictive value of transvaginal ultrasound for diagnosing abnormal early pregnancy were poor except cases of ectopic pregnancy when beta-hCG levels were low than discriminatory zone. Ultrasound impressions were well related with beta-hCG levels.
Abdominal Pain ; Diagnosis ; Female ; Gestational Sac ; Humans ; Pregnancy Outcome ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Sensitivity and Specificity ; Ultrasonography* ; Uterine Hemorrhage

No abstract available.
Diabetes Insipidus, Nephrogenic* ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

We report a rare case of primary glomerular disease with both features of IgA nephropathy and membranous glomerulonephritis in a 27 year-old woman with nephrotic syndrome. Histologically, glomeruli showed slight mesangial expansion, proliferation of mesangial cells, and short subepithelial spikes on capillary wall. Direct immunofluorescence demonstrated granular IgG and C3 deposits along the capillary walls, and IgA with C3 deposits in mesangium. Granular subepithelial and rnesangial deposits were observed by electron microscopy. The patient showed complete remission after 6 months therapy with steroid and ACE inhibitor.
Adult ; Capillaries ; Female ; Fluorescent Antibody Technique, Direct ; Glomerulonephritis, IGA* ; Glomerulonephritis, Membranous* ; Humans ; Immunoglobulin A* ; Immunoglobulin G ; Mesangial Cells ; Microscopy, Electron ; Nephrotic Syndrome

No abstract available.
Animals ; Doxorubicin* ; Mononuclear Phagocyte System* ; Rats* ; Vincristine*

Inflammatory linear verrucose epidermal nevus(ILVEN) is characterized by an early age of onset, predominance in females, pruritus, unresponsiveness to treatment, and a distinctive inflammatory and psoriasiform histologic appearance. We present two cases of typical ILVEN. One of them was a 16-year-old male, who had had a mild pruritic linear verrucose patch involving the right arm which grew slowly for about 8 years. The other case was a 14-year-old girl whose lesion appeared at the age of 13. This lesion was localized on the right posterior thigh and showed linear distribution and verrucose appearance. Histopathological findings of two cases showed hyperkeratosis with foci of parakeratosis, moderate to marked acanthosis, elongation of the rete ridges, and occasional slight spongiosis, and chronic inflammatory infiltration in the dermis.
Adolescent ; Age of Onset ; Arm ; Dermis ; Female ; Humans ; Male ; Nevus, Sebaceous of Jadassohn* ; Parakeratosis ; Pruritus ; Thigh

In the past, irritant or radiation therapy have been used to treat discoid lupus erythematosus, therefore malignant and proriferative change in the lesion of discoid lupus erythematosus were not uncommon. In recent year, however, because the preferred treatment of discoid lups erythematosus consisted of steroids and antimalarials, the association with squamous cell carcinoma has been extremely rare. We present a case of giant squamous cell carcinoma arising in the discoid lupus erythematosus in 39 year-old women. She had had a 20 year history of facial discoid lupus erythematoseus. In September of 1976, a thumb tip-sized tumor mass found on the right cheek and the maas grew into the adult palm size rapidly. The tumor show ulceration, serosanguinous discharge, easy bleeding, and foul oder. Histopathologically, the specimen obtained from plaques of the left cheek showed hyperkeratosis with plugging, atrophy of the stratum malpighii, a patchy, chiefly lymphoid cell infiltrate with a tendency to arrangement about the cutaneous appendages, hydropic degeneration of the basal cells, edema and vasodilatation in the dermis. The specimen obtained from tumor mass of the right cheek showed many nests consisted of well differentiated squamous cells, keratin pearls.
Adult ; Antimalarials ; Atrophy ; Carcinoma, Squamous Cell* ; Cheek ; Dermis ; Edema ; Female ; Hemorrhage ; Humans ; Lupus Erythematosus, Discoid* ; Lymphocytes ; Steroids ; Thumb ; Ulcer ; Vasodilation

No abstract available.
Child* ; Humans ; Rheumatic Heart Disease*