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

BACKGROUND: Intermittent rhythmic delta activity (IRDA) is classified as a nonspecific abnormal EEG pattern. IRDA is clinically associated with alteration of consciousness, hydrocephalus, cerebral edema, deep midline lesions, subcortical lesions, and tumors of the posterior fossa and the third ventricle. Frontal IRDA(FIRDA) is usually seen in patients over age 15 years, whereas occipital IRDA(OIRDA) occurs mainly in children. We have investigated the clinical feature and significance of IRDA in children. SUBJECTS AND METHODS: We retrospectively reviewed the medical records of 36 children with IRDA of EEG concerning diagnosis, neurologic examination, classification of epilepsy, and CT & MRI findings. RESULTS: 1) The location of the IRDA was frontal(FIRDA) in 11 of 36(30.5%), occipital(OIRDA) in 20 of 36(55.6%) and mixed in 5 of 36(13.9%) patients. 2) Thirty of 36(83.3%) have epilepsy (including 1 each with MELAS and tuberous sclerosis), 4 of 36(11.1%) have migraine and 2 of 36(11.1%) patients have meningitis. 3) Sixteen of 30(53.3%) have partial or partial with secondary generalized seizure, 10 of 30(33.3%) have generalized seizure and 4 of 30(13.3%) patients with epilepsy have absence seizure. 4) Neuroimaging studies (CT or MRI scan) were performed in 27 cases. Among 27 cases of studies, 6 cases(22.2%) were abnormal including; two cases of infections, and each case of infarction, venous angioma, arachnoid cyst, cortical atrophy, and tuberous sclerosis, respectively. CONCLUSIONS: IRDA may be considered an epileptiform pattern in childhood and FIRDA is frequently seen in children than previous reports.
Arachnoid ; Atrophy ; Brain Edema ; Child* ; Classification ; Consciousness ; Diagnosis ; Electroencephalography ; Epilepsy ; Epilepsy, Absence ; Hemangioma ; Humans ; Hydrocephalus ; Infarction ; Magnetic Resonance Imaging ; Medical Records ; MELAS Syndrome ; Meningitis ; Migraine Disorders ; Neuroimaging ; Neurologic Examination ; Retrospective Studies ; Seizures ; Third Ventricle ; Tuberous Sclerosis

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures

Corticosteroids has been used in treatment of wide varieties of disease, but there was no report which related to the effects on cardic function with the long term corticosteroids therapy in children. We had been evaluated 18 patients with nephrotic syndrome who were admitted to department of pediatrics, Kyung Hee University Hospital until March 1987. Also we examined interventricular septal thickness, left ventricular posterior wall thickness and all parts of internal dimension of heart, and cardiac output and STI(Systolic Time Interval) by M-mode and Doppler echocardiography, and compared with body surface matched control group. Result are as follows;age and sex distribution were 4 4/12 to 14 6/12(9.11+/-3.55 years) and 15 males and 3 females. The duration of follow up was from 6 to 132 months(39.28+/-36.12 months). The interventricular septal thickness and left ventricular posterior wall thickness were more thickened in corticosteroids group than those of control. Systolic time interval, the index of left ventricular function, was more increased in corticosteroids group than in control group, but there was no differences in cardiac output between two groups. lthough longterm follow up studies are needed to confirm the cardiac effects of long term corticosteroids therapy, we conclude that long term corticosteroids therapy cause significant hypertrophy of cardiac muscle and periodic evaluation of cardiac function such as noninvasive Doppler echocardiographic studies are mandatory in patients with long term corticosteroids therapy.
Adrenal Cortex Hormones* ; Cardiac Output ; Child ; Echocardiography ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertrophy ; Male ; Myocardium ; Nephrotic Syndrome* ; Pediatrics ; Sex Distribution ; Systole ; Ventricular Function, Left

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

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

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

No abstract available.
Ultrasonography, Doppler, Color*

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

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