No abstract available.

No abstract available.
Diagnosis* ; Heart Failure* ; Heart Septal Defects, Ventricular ; Heart*

We performed this study to analyse the morbidity and mortality of stoma formation in infants and children over a 17-year period. Thirty-seven stoma formations were performed in 37 patients: 21 for anorectal malformation, 9 for Hirschsprung's disease, 3 for necrotizing enterocolitis, 2 for multiple ileal atresia, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. There were 26 boys and 11 girls with a mean age of 0.4 years. Complications after stoma formation were encountered in 12 patients(32.4%) and included stomal prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. Four patients(10.8%) required stomal revision. The incidence of complications was neither related to the age nor to the primary indication for the stoma formation, but sigmoid colostomy was associated with a lower complication rate compared to transverse colostomy(22.1% versus 42.1%, P<0.05). Five patients died, but only one(2.7%) was dead, which was directly related to stoma formation. Eighteen of these children subsequently underwent stoma closure which was associated with complications in six patients(33.3%). The most common complication after stoma closure was wound sepsis in 4 children. In conclusion, because the significant morbidity of stoma formation still exists the refinements in surgical technique may help in reducing the incidence of complications and a sigmoid loop colostomy should be used whenever possible.
Child* ; Colon ; Colon, Sigmoid ; Colostomy ; Constriction, Pathologic ; Enterocolitis, Necrotizing ; Female ; Hernia ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant* ; Intestinal Volvulus ; Mortality ; Prolapse ; Sepsis ; Skin ; Wounds and Injuries

Recently, five cases of osteogenesis imperfecta have been observed at Severance Hospital, Yonsei University. Two newborn females, two female children (one year and eight months, five years and a male child (five years and four months) were typical examples with multiple bone fractures, blue sclerae, and deformity of extremities. The mother of case 3 has also had blue sclera but no history of bone fracture. In case 1, a chromosome study was done because the infant had a short neck, low set ears and a high arched palate besides typical signs of steogenesis imperfecta of which result was found as normal karyotype. In case 3, the patient also presented the rachitic changes of the long bones and ribs and exhibited congenital agenesis of the right kidney. In case 4, the blue sclera was questionable. Three cases on1y have been reported prior to this study in Korea. We are presenting another five cases of osteogenesis imperfecta congenita, its pathology and a brief review of the literature.
Child, Preschool ; Female ; Human ; Infant, Newborn ; Karyotyping ; Male ; Osteogenesis Imperfecta/congenital* ; Osteogenesis Imperfecta/genetics ; Osteogenesis Imperfecta/radiography

No abstract available.
Animals ; Lordosis*

The surgical management of patients whose pulmonary arteries are discontinuous from the ventricular mass depends in part on adequate visualization and quantification of the pulmonary arteries. Pulmonary vein wedge angiography has proven effective technique in demonstrating the true mediastinal(intrapericardial) pulmonary arteries(when present) when standard anterograde injections do not suffice. Pulmonary vein wedge angiography was performed in 11 patients during cardiac catheterization at Serverance Hospital Yonsei University College of Medicine between June, 1984 and December, 1985. In all the patients, venous angiography gave a more complete, clear picture of the pulmonary arteries. We feel that pulmonary venous wedge angiography often is superior to and at least complements standard angiographic methods of opacifying the pulmonary artries in patients with pulmonary atresia or occluded pulmonary arteries. We recommend it as a routine part of the evaluation of these patients.
Angiography* ; Cardiac Catheterization ; Cardiac Catheters ; Complement System Proteins ; Humans ; Pulmonary Artery* ; Pulmonary Atresia* ; Pulmonary Veins*

Nine patients of mean age 47.8 years, with suspected sinus node dysfunction, underwent extensive electrophysiological studies. Sinus bradycardia(6the electrophysiological study, AH and HV intervals were prolonged in 2/9 and 1/9 patients, respectively. Maximal sinus node recovery times were prolonged in 7/9 patients, ranging from 1,330 msec to 12,330msec. Sinoatrial conduction times measured by atrial premature stimulation technique were prolonged in 5/7 patients, ranging from 137msec to 310 msec. And sinoatrial conduction time measured by continuous pacing technique also revealed prolonged value in 4/6 patients ranging from 140 msec to 195 msec. The effective refractory periods, of atrium were prolonged in 6/8 patients (320 msec to 470 msec). The effective and functional refractory periods of AV node were prolonged in 3/8 patients (440 csec to 490 msec) and 4/8 patients (530 msec to 560 msec), respectively. Retrograde VA conduction could be observed in 3/7 patients and ventricular effective refractory periods were normal in 7/7 patients. Atrial flutter was induced in 1/9 patients by electric stimulation during electrophysiological study. Above data suggest that the electrophysiological study is very useful in assessing the sinus node function and other electrophysiological properties in sick sinus syndrome patients and also suggest that the data could be utilized in choosing the proper mode of artificial pacemaker for each patient.
Atrial Flutter ; Atrioventricular Node ; Electric Stimulation ; Humans ; Pacemaker, Artificial ; Sick Sinus Syndrome* ; Sinoatrial Node

The purpose of this study was to investigate the effects of fluvastatin on the pharmacokinetics of repaglinide in rats. The effect of fluvastatin on P-glycoprotein and CYP3A4 activity was evaluated. The pharmacokinetic parameters and blood glucose concentrations were also determined after oral and intravenous administration of repaglinide to rats in the presence and absence of fluvastatin. Fluvastatin inhibited CYP3A4 activity in a concentration-dependent manner with a 50% inhibition concentration(IC50) of 4.1 microM and P-gp activity. Compared to the oral control group, fluvastatin significantly increased the AUC and the peak plasma level of repaglinide by 45.9% and 22.7%, respectively. Fluvastatin significantly decreased the total body clearance (TBC) of repaglinide compared to the control. Fluvastatin also significantly increased the absolute bioavailability (BA) of repaglinide by 46.1% compared to the control group. Moreover, the relative BA of repaglinide was 1.14- to 1.46-fold greater than that of the control. Compared to the i.v. control, fluvastatin significantly increased the AUC0-infinity of i.v. administered repaglinide. The blood glucose concentrations showed significant differences compared to the oral controls. Fluvastatin enhanced the oral BA of repaglinide, which may be mainly attributable to the inhibition of the CYP3A4-mediated metabolism of repaglinide in the small intestine and/or liver, to the inhibition of the P-gp efflux transporter in the small intestine and/or to the reduction of TBC of repaglinide by fluvastatin. The study has raised the awareness of potential interactions during concomitant use of repaglinide with fluvastatin. Therefore, the concurrent use of repaglinide and fluvastatin may require close monitoring for potential drug interactions.
Administration, Intravenous ; Animals ; Area Under Curve ; Biological Availability ; Blood Glucose ; Carbamates ; Drug Interactions ; Fatty Acids, Monounsaturated ; Indoles ; Intestine, Small ; Liver ; P-Glycoprotein ; Piperidines ; Plasma ; Rats

Primary adenocarcinoma of appendix is a rare clinical entity that is virtually neverdiagnosed preoperatively.The first description was that of Berger in 1882 and this carcinoma was alwayssymptomatic causing a variant of acute appedicitis and palpable right lower quadrant mass. Thefrequency range between 0.08% to 0.5% and these tumors behave aggressively. The possibleroute of metastasize is mainly by peritoneal implantation and right-sided hemicolectomyis the best treatment.We experienced a case of mucinous adenocarcinoma of appendix metastasis to ovaryand we present this case with the brief review of literature.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Appendix* ; Female ; Mucins* ; Neoplasm Metastasis* ; Ovary*

BACKGROUND AND OBJECTIVE: Vocal cord palsy is a complex disorder which may result from numerous causes. Laryngeal electromyography is a valuable adjunct in the study of vocal cord dysfunction. It yields objective and reproducible data, and may establish the pathophysiology and prognosis of laryngeal nerve pathology. We investigated the clinical usefullness of laryngeal electromyography for patients with vocal cord palsy. MATERIAL & METHOD: Laryngeal EMG was performed for 35 patients diagnosed as vocal cord palsy. RESULTS: We defined complete denervation when electrical silence, fibrillation potential or positive sharp waves were seen. We defined partial denervation when motor unit potential with low amplitude and low frequency was seen. We planned treatment modality according to the laryngeal EMG findings. In case of complete denervation, phonosurgery was recommended, whereas voice therapy and observation were recommended when partial denervation was noted. CONCLUSION: Laryngeal EMG is clinically valuable for the evaluation of vocal cord palsy and can serve as a guideline for determining the treatment plan. It is also useful in anticipating the prognosis of laryngeal nerve palsy.
Denervation ; Electromyography* ; Humans ; Laryngeal Nerves ; Paralysis ; Pathology ; Prognosis ; Vocal Cord Dysfunction ; Vocal Cord Paralysis* ; Vocal Cords* ; Voice