No abstract available.
Child ; Coronary Vessels* ; Echocardiography ; Humans

Clinical study was performed on 42 patients diagnosed as TARVR at the Departmet of pediatrics, Seoul National University Hospital, from January, 1966 to June, 1982. The results are as follows, 1) Of the 25 cases with isolated TAPVR, age distribution was from 10 days to 10 years. Seventeen cases were male and eight cases were female. Of the 24 cases with complicated TAPVR, age distribution was from 2 days to 22 years. Eighteen cases were male and six cases were female. 2) The type of TAPVR was supracardiac in 29 cases (59.1%), cardiac in 10 cases (24.4%), infradiaphragmatic in 3 cases (6.1%) and mixed in 5 cases (10.2%). 3) Birth weights of patients were within normal limits except 1 case. 4) The most freuent complaints at diagnosis were tachypnea and cyanosis. 5) PDA was the most frequently associated intracariac anomaly (54.1%) which was followed by pulmonary stenosis (16.6%), single atrium (16.6%) and single ventricle (16.6%). 6) Of the 25 cases with isolated TAPVR, chest roentgenographic findings were cardiomegaly in 22 cases (88%) and increased pulmonary vascularity in 23 cases (92%). 7) Of the 25 cases with isolated TAPVR, the ECG showed right axis deviation in 22 cases (88%), right atrial enlargement in 13 cases(52%), right ventricular hypertrophy in 24 cases (96%) and combined ventricular hypertrophy in 1 cases (4%). 8) Of the 23 cases with isolated TAPVR, echocardiographic finding showed increased dimension of the right ventricle in all cases. Of the 39 cases with TAPVR, the common venous chamber was visualized posterior to the left atrium in 14 cases(35.8%). 9) Cardiac catheterization was performed in 24 cases with isolated TAPVR. Pulmonary hypertension was observed in 19 cases (79.1%). 10) Fourteen patients with isolated TAPVR were operated. Three patients died.
Age Distribution ; Axis, Cervical Vertebra ; Birth Weight ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Cyanosis ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Heart Atria ; Heart Ventricles ; Humans ; Hypertension, Pulmonary ; Hypertrophy ; Hypertrophy, Right Ventricular ; Male ; Pediatrics ; Pulmonary Valve Stenosis ; Scimitar Syndrome* ; Seoul ; Tachypnea ; Thorax

Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.
Brain Edema ; Brain Infarction* ; Brain* ; Caudate Nucleus ; Child ; Dehydration ; Diabetic Ketoacidosis* ; Female ; Fever ; Hemorrhage* ; Humans ; Infant* ; Lateral Ventricles ; Rabeprazole

Blunt chest trauma can cause various types of cardiac injuries such as myocardial contusion,cardiac ruptrue, valvular or papillary muscle injuries, and pericardial or coronary artery injuries. Complete rupture of both papillary muscles accompanied by left ventricular(LV) rupture following blunt chest trauma to our knowledge has not been previously reported. A 40-year-old female was referred because of severe dyspnea and anterior chest pain which occured immedicately after blunt chest trauma. Echocardiography demonstrated a moderate pericardial effusion as well as rupture of both papillary muscle with severe mitral regurgitation. Hemopericardium and a complets tear of the anterolateral papillary muscle at the mid portion were observed. The posteromedial papillary muscle was totally transected at the attachment site of LV wall and accompanied by external rupture of left ventricle at that site. Mitral valve replacement and primary repair of LV ruptrue was performed successfully. In the case we report, complete rupture of both papillary muscles developed after blunt chest trauma and LV rupture occurred as the papillary muscle was torn from the LV wall.
Adult ; Chest Pain ; Coronary Vessels ; Dyspnea ; Echocardiography ; Female ; Heart Ventricles ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles* ; Pericardial Effusion ; Rupture* ; Thorax*

Metastasis to the skin occurs rarely in gynecologic cancer. Although carcinoma of the cervix is the fifth most common malignancy in Korean women, cutaneous involvement originating from cervical cancer is unusual. Common pattern of occurrence is multiple nodule in abdomen, vulva, lower extremities. We report a case of metastasis from squamous cell carcinoma of cervix to vulva. The patient was diagnosed with cervical cancer IIA. The extensive skin lesion on the vulva occurred 3 months after neoadjuvant chemotherapy, radical hysterectomy and concurrent chemoradiation. We have experienced such a case and report the case with brief review of literatures.
Abdomen ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Hysterectomy ; Lower Extremity ; Neoplasm Metastasis ; Skin ; Uterine Cervical Neoplasms ; Vulva

Disseminated intravascular coagulation (DIC) is the result of a severe underlying disorder that initiates massive activation of the coagulation system. We report an unusual case of 79-year-old man who developed DIC after tooth extraction in abdominal aortic aneurysm. He was referred to our hospital because of persistent bleeding after tooth extraction. Physical examination indicated a pulsating mass in abdomen. Abdominal computerized tomography (CT) scan revealed 70 mm diameter aneurysm of the abdominal aorta, extending from the renal infrahilar level to the common iliac artery, and his coagulation profile showed the features of DIC by revealing thrombocytopenia, hypofibrinogenemia, and increased level of fibrinogen degradation product (FDP). After he had received blood component therapy including fresh frozen plasma and continuous intravenous heparin infusion (4,800 U/day), the bleeding diathesis and coagulopathy improved. He refused to have definitive surgery for the aneurysm.
Abdomen ; Aged ; Aneurysm ; Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Dacarbazine ; Disease Susceptibility ; Disseminated Intravascular Coagulation* ; Fibrinogen ; Hemorrhage ; Heparin ; Humans ; Iliac Artery ; Physical Examination ; Plasma ; Thrombocytopenia ; Tooth Extraction* ; Tooth*

PURPOSE: Infective endocarditis (IE) is a serious complication in children with structural heart disease. We reviewed 35 cases of IE to identify the recent changes in the pattern of preexisting heart diseases, the spectrum of causative organisms and prognosis. METHODS: The clinical records of children diagnosed as IE at the Seoul National University Children's Hospital from January 1987 through December 1997, were reviewed retrospectively. Duke criteria was used for diagnosis. Cases were categorized into primary group(PG) IE in an unoperated heart and post operative group(POG), and the latter further into early POG(within 2 months after operation) and late POG. RESULTS: There were 35 cases of IE developed in 34 patients; 18 cases in the PG, 6 cases in the early POG, and 11 cases in the late POG. Male to female ratio was 16 : 19. Mean age of POG, especially early POG was less than that of PG (early POG : late POG : PG=1.65 years : 6.5 years : 8.34 years, P=0.0267). Preexisting heart diseases were identified in 30 cases; rheumatic heart disease 1 case and congenital heart disease (CHD) 29 cases. Causative organisms were identified in 80%; viridans streptococci, 10 cases (33.3%); pneumococci, 2 cases; Group-D streptococci, 3 cases; staphylococci, 8 cases; Gram (-) organisms, 5 cases and Candida albicans, 2 cases. Vegetation was detected in 88.9% of PG and 64.7% of POG. The most common indication for surgery was uncontrolled infection, which were required in 9 cases. The overall mortality rate was 12.1%. Mortality in POG was higher than that of PG (23.5% versus 0%, P=0.033). CONCLUSION: The discrepancy of mean age among patient groups and the high proportion of patients belonging to POG, were consistent with the increase in the number of newly risky population that survived after cardiac surgery. A more aggressive consideration for operative management may improve the treatment results.
Candida albicans ; Child* ; Diagnosis ; Endocarditis* ; Female ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Male ; Mortality ; Prognosis ; Retrospective Studies ; Rheumatic Heart Disease ; Seoul ; Thoracic Surgery ; Viridans Streptococci

Brunner's gland adenoma is a rare benign tumor that is usually asymptomatic and it the result of a benign proliferation of the Brunner's glands of the duodenum. In symptomatic patients, the common clinical presentation is gastrointestinal bleeding and obstructive symptoms. A 48-year-old man presented with abdominal discomfort and vomiting. The endoscopic examination revealed a large pedunculated polypoid mass arising in the bulb and it was prolapsing through the pylorus into the antrum, and this all resulted in a ball-valve obstruction. After endoclips were applied at the peduncle of the mass, this polyp was simply and successfully cut with using an IT-knife without bleeding or perforation. We report here on a case of Brunner's gland adenoma that caused a ball-valve obstruction, and the tumor was removed by a simple and easy method with using endoclips and an IT-knife.
Adenoma ; Brunner Glands ; Duodenum ; Hemorrhage ; Humans ; Middle Aged ; Polyps ; Pylorus ; Vomiting

OBJECTIVE: To translate, adapt, and test the reliability, validity, and responsiveness of the Korean version of the Shoulder Disability Questionnaire (SDQ) and the Shoulder Rating Questionnaire (SRQ). METHODS: The international guideline for the adaptation of questionnaires was referenced for the translation and adaptation of the original SDQ and SRQ. Correlations of the SDQ-K and SRQ-K with the Shoulder Pain and Disability Index (SPADI) and the Numeric Rating Scale (NRS) were assessed to determine the reliability and validity of the questionnaires. To evaluate reliability, surveys were performed at baseline and a mean of 6 days later in 29 subjects who did not undergo any treatment for shoulder problems. To evaluate responsiveness, assessments were performed at baseline with 4-week intervals in 23 subjects with adhesive capsulitis who were administered triamcinolone injection into the glenohumeral joint. RESULTS: Fifty-two subjects with shoulder-related problems were surveyed. Cronbach alpha for internal consistency was 0.82 for the summary SDQ-K and 0.75 for the summary SRQ-K. The test-retest reliability of the SDQ-K, SRQ-K, and domains of the SRQ-K ranged from 0.84 to 0.95. The SDQ-K and SRQ-K summary scores correlated well with the SPADI and NRS summary scores. Generally, the effect sizes and standardized response means of the summary scores of the SDQ-K, SRQ-K, and domains of the SRQ-K were large, reflecting their responsiveness to clinical changes after treatment. CONCLUSION: The reliability, validity, and responsiveness of the SDQ-K and SRQ-K were excellent. The SDQ-K and SRQ-K are feasible for Korean patients with shoulder pain or disability.
Bursitis ; Disability Evaluation ; Humans ; Reproducibility of Results ; Shoulder Joint ; Shoulder Pain ; Shoulder* ; Translations ; Triamcinolone