VSD is the most common congenital carciac malformation and the natural history depends not only on the age ofpatients and the size of defect but the subtype of VSD as well, important factor in clinical management or thosepatients. In 110 patients, with surgically repaired VSD in Yonsei Medical Center in 1984, the subtype of VSDs evaluated by surgical observation were correlated with LV angiogram findings to verify the incidence of subtype inKorean and the diagnostic accuracy to predict the subtype by angiogram. 1. 110 patients included 64 boys and 46 girls, the age ranged from 3 months to 14 years(average 4.6 years old) 2. Angiographic findings were interpretedas follows; a. Perimembranous defects were profiled in LAO 60 degrees LV angiogram and located below the aorticvalve. In inlet excavation the shunted blood opacified the recess between septal leaflet of tricuspid valve and interventricular septum in early phase, in infundibular excavation opacified the recess between anterior leafletof TV and anterior free wall of RV and in travecular excavation the shunted blood traversed anterior portion of TVring, opacified trabecular portion of RV cavity. b. Subarterial type were profilled in RAO 30degrees LV angiogram,just below aortic valve as well as pulmonic valve. Total infundibular defects were profilled in RAO 30degrees andLAO 60 degrees LV angiogram subaortic in location in both views. c. In muscular VSD the profilled angle was variedaccording to the subtype but the defects were separated from the aortic valve as muscular septum interposedbetween the aortic valve and the defect. 3. The incedence of subtype of VSDs evaluated by surgical observationwere as follows. Subaterial type 32 cases(29.1%) Total infundibular defect 5 cases( 4.5%) Perimembranous type 73cases(66.3%) Infundibular excavation 32 cases(29.1%) Trabecular excavation 28 cases(25.5%) Inlet excavation 10cases(9.1%) Mixed 3 cases(2.7%) Muscular type 1 cases(0.9%) Total 63.6% of VSD, were the varieties of theinfundibular septum type. 4. The prediction of VSD subtype accoridng to the angiographic findings described above,were compared to the surgical observation. Diagnostic rate was 100% in perimembranous type, 75% in subarterialtype, 0% in total infundibular type, so 88% of cases were in accordance with the surgical findings.
Aortic Valve ; Bays ; Female ; Humans ; Incidence ; Natural History ; Tricuspid Valve

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

To evaluate the diagnostic accuracy of two-dimensional echocardiogrphy(2-D echo) in ventricular septal defect, location and size of the defects, estimated right ventricular systolic pressure and associated cardiac anomaly were compared to the operative findings in 139 children operated for correction of ventricular septal defect at Severance Hospital from Jan. 1983 to June 1987. In addition, postoperative complications and mortality cases were anlysed. The following results were obtained; 1) Perimembranous defects were 82 cases(66.1%), subarterial infundibular defects 33 cases(26.6%), and muscular defect was found in only 1 case(0.8%). The accuracy of 2-D echo in localizing the defects was 84.2%. 2) In 79.2% of the patients, the defects were moderate to large in size, and actual size measured at operation was larger than that obtained by echocardography in general. 3) The estimated right ventricular systolic pressure was correlated(r=0.650) with that measured at the operating field. 4) Combined cardiac anomalies were patent ductus arteriosus(22 cases), atrial septal defect(3 cases), valvular pulmonic stenosis(2 cases) and interventricular septal aneurysm(2 cases). The sensitivity of 2-D echo in detecting these anomalies was 65.5% and the specificity was 96.4%. 5) Among 32 patients who had postoperative complications, in two thirds, there were pulmonary complication including lung atelectasis(16 cases), pleural effusion(5 cases)and pneumonia(5 cases). 6) Operative mortality was 2.9%(4 cases). The causes of death were low cardiac output state due to left ventricular myocardial failure in 3 patients and respiratory failure from asphyxia in one case. In conclusion, with close cooperation with cardiac surgeons, there will be few problems in diagnosing and operating patients with ventricular septal defect on the basis of two-dimensional echocardiographic findings without invasive procedures, such as cardiac catheterization, even with pulmonary hypertension, unless Eisenmenger syndrome is complicated.
Asphyxia ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output, Low ; Catheterization* ; Catheters* ; Cause of Death ; Child* ; Echocardiography* ; Eisenmenger Complex ; Heart Failure ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Lung ; Mortality ; Postoperative Complications ; Respiratory Insufficiency ; Sensitivity and Specificity

The author carried out a study on the effectiveness of the boric acid as a stomach poison for German cockroach control from July to September 1971. The test was performed by the feeding method under conditions of 20 C and 80 per cent relative humidity. The baits were composed of one control group and five different combination groups with boric acid and sugar as follows. 10 g sugar only(control group), 1 g powedered boric acid to 9 g sugar(1:9 poison baits), 2 g powdered boric acid to 8 g sugar(2:8 poison baits), 4 g powdered boric acid to 6 g sugar(4:6 poison baits), 5 g powdered boric acid to 5g sugar(5:5 poison baits), 10 g powdered boric acid only (10:0 poison baits). The insects were composed of 360 female adult German cockroaches collected by traps at the kitchens of restaurants and house holds in Seoul City. The results were as follows: The total mortality by poison baits in 72 hours after treatment were: 44.3 per cent by 1:9 poison baits , 79.4 per cent by 2: poison baits , 96.7 per cent by 4:6 poison baits(the most effective poison baits), 88.3 per cent by 5:5 poison baits, 91.1 per cent by 10:0 poison baits. The peak mortality by the treatment hours were: Up to 21 hours: 23.3 per cent by 5:5 poison baits, 20.0 per cent by 10:10 poison baits, From 24 to 48 hours: 71.1 per cent by 4:6 poison baits, 55.6 per cent by 10:0 poison baits, From 48 to 72 hours: 21.9 per cent by 2:8 poison baits, 19.6 per cent by 1:9 poison baits. The most effective treatment hours was from 24 to 48 hours.
parasitology-arthropoda-cockcroach ; Blattella germanica ; chemotherapy ; boric acid

No abstract available.
Catheters* ; Heart Defects, Congenital*

Background: Bone tumors can cause severe pain and poor quality of life due to recurrence and non-achievement of complete remission after surgery, chemotherapy, or radiotherapy. Radiofrequency ablation (RFA) can be considered for minimally invasive treatment of bone tumors that are difficult to radically excise. In this study, RFA was performed for bone tumors that were difficult to radically excise and did not respond to surgery, chemotherapy, or radiotherapy due to their large sizes and/or locations. The purpose of this study was to retrospectively analyze the clinical characteristics and survival rates of bone tumors after RFA and provide one more treatment option for the future. Methods: There were 43 patients with bone tumors who underwent percutaneous RFA at our hospital from April 2007 to October 2017. The median age of the patients was 59 years (range, 31–75 years), and the median follow-up duration was 67.2 months (range, 10.2–130.5 months). Of the 43 patients, 26 were male and 17 were female. Thirty-four cases were metastatic bone tumors, 5 were chordomas, 3 were osteosarcomas, and 1 was a giant cell tumor. Pain and functional ability of the patients were evaluated using a visual analog scale (VAS) and the Musculoskeletal Tumor Society (MSTS) functional scoring system, respectively. Scores were recorded preoperatively, 1 week postoperatively, and 4 weeks postoperatively. The 1-year, 2-year, and 5-year survival rates were evaluated using the Kaplan-Meier method. Results: The mean VAS score was 8.21 preoperatively. The mean VAS score at 1 week, 4 weeks, 12 weeks, and 24 weeks postoperatively were 3.91, 3.67, 3.31, and 3.12, respectively. The mean preoperative MSTS score was 64.0% (range, 32%–87%). The mean postoperative MSTS score was 71.0% (range, 40%–90%). The 1-year, 2-year, and 5-year survival rates were 95.3%, 69.8%, and 30.2%, respectively. Conclusions As per our study findings, RFA was effective in reducing pain and improving functional ability of patients with bone tumors that were difficult to radically excise.

Background: Bone tumors can cause severe pain and poor quality of life due to recurrence and non-achievement of complete remission after surgery, chemotherapy, or radiotherapy. Radiofrequency ablation (RFA) can be considered for minimally invasive treatment of bone tumors that are difficult to radically excise. In this study, RFA was performed for bone tumors that were difficult to radically excise and did not respond to surgery, chemotherapy, or radiotherapy due to their large sizes and/or locations. The purpose of this study was to retrospectively analyze the clinical characteristics and survival rates of bone tumors after RFA and provide one more treatment option for the future. Methods: There were 43 patients with bone tumors who underwent percutaneous RFA at our hospital from April 2007 to October 2017. The median age of the patients was 59 years (range, 31–75 years), and the median follow-up duration was 67.2 months (range, 10.2–130.5 months). Of the 43 patients, 26 were male and 17 were female. Thirty-four cases were metastatic bone tumors, 5 were chordomas, 3 were osteosarcomas, and 1 was a giant cell tumor. Pain and functional ability of the patients were evaluated using a visual analog scale (VAS) and the Musculoskeletal Tumor Society (MSTS) functional scoring system, respectively. Scores were recorded preoperatively, 1 week postoperatively, and 4 weeks postoperatively. The 1-year, 2-year, and 5-year survival rates were evaluated using the Kaplan-Meier method. Results: The mean VAS score was 8.21 preoperatively. The mean VAS score at 1 week, 4 weeks, 12 weeks, and 24 weeks postoperatively were 3.91, 3.67, 3.31, and 3.12, respectively. The mean preoperative MSTS score was 64.0% (range, 32%–87%). The mean postoperative MSTS score was 71.0% (range, 40%–90%). The 1-year, 2-year, and 5-year survival rates were 95.3%, 69.8%, and 30.2%, respectively. Conclusions As per our study findings, RFA was effective in reducing pain and improving functional ability of patients with bone tumors that were difficult to radically excise.

No abstract available.
Child* ; Humans ; Leprosy*

BACKGROUND AND OBJECTIVES: The kinds of offending allergens in our environment have changed in accordance with the changes wrought in the living environment. Thus, the study of offending allergens in allergic rhinitis is important. This study attempted to find out annual and seasonal distribution of offending allergens in patients of allergic rhinitis and to investigate the common offending allergens. MATERIALS AND METHODS: A series of allergic skin tests were performed for 3,159 allergic rhinitis patients from Jan. 1981 to Jun. 1990 at the allergic clinic, St.Benedict Hospital, Pusan, Korea, and the results were reviewed. The allergic study included 1) an allergic skin test, 2) a nasal smear for eosinophil. RESULTS: The following summary shows the results of this study: 1) The ratio between male and female of allergic rhinitis patients was 1.15:1 with the peak age being the teens and the twenties (60.6%). 2) The peak season of allergic rhinitis was winter (29.6%), followed by autumn, spring and summer. 3) The common offending allergens were dust and mites (35.9%), pollens (31.2%), epithelials (24.8%). 4) The most common offending allergen was D. farinae (52.5%), followed by D. pteronyssinus, cat fur, Alder pollens and Hazel pollens. 5) 29.6% of patients reacted positive to the skin tests for perennial types of allergens only and 5.2% of patients demonstrated pure pollinosis. CONCLUSION: The most common offending allergen was found to be the dust mite, and the most common pollen was from Alder trees. Perennial types of allergic rhinitis exceeded seasonal types in their occurence.
Adolescent ; Allergens* ; Alnus ; Animals ; Busan ; Cats ; Dust ; Eosinophils ; Female ; Humans ; Korea ; Male ; Mites ; Pollen ; Rhinitis* ; Rhinitis, Allergic, Seasonal ; Seasons ; Skin Tests ; Trees

Hyperreflexic bladder is a disease manifested in patients with spinal cord lesions above the sacral segment. The treatments for hyperreflexic bladder are medical therapy, interruption of innervation, argumentation cystoplasty, etc. We treated four hyperreflexic bladder patients with 12% a phenol injection into the subarachnoid space for sacral nerve block. Before treatment the average bladder capacity was about 100 ml, and there was one case of autonomic dysreflexia. After the subarachnoid block the average bladder capacity increased above 300 ml and maximal intravesical pressure decreased below 30cmH2O, autonomic dysreflexia disappeared in one patient. The decreased bladder compliance after nerve block was managed by repetitive bladder overdistention. We suggest that subarachnoid block is easier and more effective than sacral nerve block individually, and is a treatment for hyperreflexic bladder refractory to medical therapy.
Autonomic Dysreflexia ; Compliance ; Humans ; Nerve Block ; Phenol ; Spinal Cord ; Subarachnoid Space ; Urinary Bladder*