BACKGROUND: For the evaluation of pulmonary nrtery branches after operation of right ventricular outflow obstructive disease, we reviewed the usefulness of both simple X-ray and lung perfusion scan with 99mTc-macroaggregated albumin compared with cardiac angiography. METHODS: From March, 1986 to July, 1993, at Seoul National University Children;s Hospital, we chose 23 cases who underwent both simple X-ray and cardiac angiography among the patients who had distinct difference between right and left pulmonary blood flow in lung perfusion scan after operation of right ventricular outflow obstructive disease. So we calculated the ratio of right and left pulmonary blood flow and Spearman correlation coefficient. RESULTS: Of the 23 cases, 17 cases were tetralogy of Fallot, 4 cases pulmonary atresia, 1 case double outlet right ventricle, and 1 case truncus arteriosus. The mean age at poeration was 27 months, and the mean postoperative follow-up period was for 68 months. The correlation coefficient between cardiac angiography and simple X-ray was 0.86(p<0.01), and that beteen cardiac angiography and lung perfusion scan was 0.80(p<0.01). CONCLUSION: The cardiac angiography has been known as the best diagnostic tool for the evaluation of pulmonary artery branches after operation of right ventricular outflow obstructive ddisease, but we proposed that the lung perfusion scan should be widely used because its results were similar with those of cardiac angiography.
Angiography ; Double Outlet Right Ventricle ; Follow-Up Studies ; Humans ; Lung* ; Perfusion* ; Pulmonary Artery* ; Pulmonary Atresia ; Seoul ; Tetralogy of Fallot ; Truncus Arteriosus

No abstract available.

No abstract available.
Ductus Arteriosus, Patent*

PURPOSE: We performed this study to define the characteristic mammographic and ultrasonographic findings in lower risk lesions of fibrocystic change and also tried to evaluate the role of both modalities in planning the treatment of these lesions. MATERIALS AND METHODS: We retrospectively reviewed 38 cases of mammography and 46 cases of ultrasonography in biopsy proven 55 cases of fibrocystic change, histologically showing the nonproliferative pattern or proliferative pattern without atypia. We analyzed the mammographic and ultrasonographic findings, final assessments, and compared the effectiveness of each modality. RESULTS: On mammography, there were no abnormalities in 20 cases(53%), nodules or masses in 9 cases(24%), microcalcifications in 6 cases(16%) and asymmetric density in 5 cases(14%). On ultrasonography, there were 40 cases(87%) of focalsonographic abnormality and no abnormality in 6 cases(13%). Most focal sonographic abnormalities were smooth(40cases, 93%), well-defined(21 cases, 49%) or ill-defined(22 cases, 51%) round or oval(36 cases, 84%) shaped, homogeneous(31 cases, 67%), hypoechoic(30 cases, 65%) lesions. Final assessment revealed that only 7 cases(18%) of mammography and 8 cases(18%) of ultrasound examinations were included into the category of indeterminate and malignancy groups which were recomended biopsy. Mammography was excellent to demonstrate the microcalcifications and ultrasonography was effective in depiction of the focal lesions. CONCLUSION: The mammography and ultrasonography findings were not specific in diagnosing lower risk group of fibrocystic change. But complementary study of both modalities in conjunction with clinical findings will be helpful in making decinion amary biopsy, fine needle aspiration, and simple close follow up of the lesions.
Biopsy ; Breast* ; Mammography ; Needles ; Retrospective Studies ; Ultrasonography

NO abstract available.
Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Lymphocytes* ; RNA, Messenger* ; Transforming Growth Factor beta

PURPOSE: This study was performed to identify the characteristic findings of miliary pulmonary tuberculosis on HRCT and to evaluate the usefulness of HRCT by compareson with chest radiographs. MATERIAL AND METHODS: High resolution CT, chest radiographs and medical records were retrospectively reviewed in 10 patients with miliary pulmonary tuberculosis. We analysed the size, distribution and margin of nodules, reticular or ground-glass density, parenchymal lesion, mediastinal lymphadenopathy and pleural effusion on HRCT which were compared with chest radiographic findings. RESULTS: On HRCT, characteristic 1--2mm sized sharp or ill-defined nodular densities were randomly distributed throughout both lungs in all cases. In seven cases, the nodules were evenly scattered, but slightly more in upper lung zone in two cases, and in lower in one case. Only three cases revealed somewhat large and abundant nodules in posterior lung zone. There were findings of ill-defined margin of nodules in three cases, reticular densities in three cases and ground-glass opacity in two cases, all of which were observed within 4 weeks after onset of symptom. In one case, HRCT scan revealed a micronodular pattern in the lung parenchyma, even though chest radiographs of 2 days before were not obviously abnormal. HRCT was better to evaluate the margin of nodule and distribution than chest radiographs in four cases. Focal parenchymal lesion (n=5), pleural effusion(n=4), mediastinal lymphadenopathy(n=6) and ARDS(n=I) were also associated. CONCLUSION: HRCT could suggest a more specific diagnosis of miliary pulmonary tuberculosis with the above characteristic findings in appropriate clinical setting and normal or interstitial pattern of chest radiographs.
Diagnosis ; Humans ; Lung ; Lymphatic Diseases ; Medical Records ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Tuberculosis, Pulmonary*

No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*

We reviewed 26 cases of cardiac rhabdomyoma in children which were diagnosed between 1986 and 1991 in Seoul National University Children's Hospital. Twenty-two cases were associated with tuberous sclerosis. Total tumor count was 58 and mean tumor count per patient was "daehakgyo".23. Their cardiac rhabdomyomas were diagnosed from fetal period through 12 years after birth. Median age was 9."uiwon" months. Fifteen patients were males and rest 11 patients were females. Cardiac symtoms and signs at initial diagnosis were present in 12 cases. They consisted of cardiac murmur in "hakgyo", arrhythmia in 8 and congestive heart failure in "daehakgyo" cases (one with murmur and the other with arrhythmia). Cardiomegaly was seen in 9 cases on chest X-ray and other "byeongwon" case showed abnormal left cardiac border. Electrocardiography and 24 hour Holter monitorings showed arrhythmia in 15 cases. Clinically significant arrhythmias were found in 7 cases on 24 hour Holter monitorings. They consisted of 1with frequent premature ventricular contractions, "daehakgyo uigwadaehak" with frequent premature atrial contractions, "daehakgyo" with atrial tachycardia and "daehakgyo uigwadaehak" with atrio-ventricular block ("daehakgyo" cases of atrio-ventricular block had other arrhythmias also). The locations of tumors were left ventricle in 21, interventricular septum in 21, right ventricle in 13 and atrium in "daehakgyo uigwadaehak" tumors. Mean tumor count per patient in fetal period and infancy was "daehakgyo".86 and it was statistically much more than that after infancy which was "byeongwon".5. Mean tumor area which was calculated on two dimensional echocardiography was larger in fetal period and infancy(128.9 +/- 38.2mm2)than that after infancy(47.8 +/- 11.2mm2). Mean relative tumor area to aortic root dimension was also significantly larger in fetal period and infancy than that after infancy ("daehakgyo".07vs 0.30). In tuberous sclerosis, mean mass area and mean relartive tumor area to aortic root dimension in fetal period and infancy was significantly larger than those in patients after infancy. Of 26 cases, tumorectomy was done in "daehakgyo uigwadaehak" cases due to hemodynamic obstruction and arrhythmia. One case died immediately after operation and the other "daehakgyo" cases are still alive with the follow up period of 30 and 44 months each. Of the 7 patients with significant arrhythmia on 24 hour Holter monitorings, pacemaker insertion was done in "byeongwon" case who received tumorectomy and other 1 case was treated with anti-arrhythmic drugs. All the other patients did not need anti-arrhythmic drugs or other management.
Arrhythmias, Cardiac ; Atrial Premature Complexes ; Cardiomegaly ; Child* ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Failure ; Heart Murmurs ; Heart Ventricles ; Hemodynamics ; Humans ; Male ; Parturition ; Rhabdomyoma* ; Seoul ; Tachycardia ; Thorax ; Tuberous Sclerosis ; Ventricular Premature Complexes

No abstract available.
Animals ; Cricetinae* ; Macrophage Activation* ; Macrophages* ; Macrophages, Peritoneal* ; Mice* ; Nitric Oxide ; Phagocytosis

BACKGROUND: In congenital heart disease, the lung perfusion through stenosed pulmonary artery is usually decreased. And this decrement of lung perfusion also occurs with diaphragmatic palsy after the operation of congenital heart disease. It is difficult to delineate the amount of lung perfusion in case of combination of pulmonary artery stenosis and diaphragmatic palsy. We examined the change of lung perfusion after the induction of diaphragmatic palsy in rabbits. METHODS: We dissected left phrenic nerves in 20 rabbits to induce left diaphragmatic palsy. The lung perfusion scan was performed with 99mTc-MAA and the movement of diaphragm was examined with fluoroscopy. They were performed as baseline data and on 3rd and 10th day postoperatively. The amount of left lung pefusion before and after diaphragmatic palsy was compared and analysed in 12 rabbits which definitely had diaphragmatic palsy. RESULTS: Weight of the rabbits was 1.65+/-0.26 kg. Left lung perfusion percent was 45.93+/-6.42% before operation and these were 32.48+/-6.09% and 37.62+/-3.39% on the 3rd and 10th postoperative day, respectively. Left lung perfusion was significantly decreased just after diaphragmatic palsy but it was not changed thereafter. The decrement of lung perfusion was not affected by the body weight. The decreased amount of left lung perfusion was reciprocally correlated with the body weight of the rabbits on the postoperative 3rd day but not 10th day. CONCLUSION: Left lung perfusion percent of the rabbits was decreased 7% with the induction of diaphragmatic palsy and the decreased amount was reciprocally correlated with the body weight just after the diaphragmatic palsy was induced.
Body Weight ; Constriction, Pathologic ; Diaphragm ; Fluoroscopy ; Heart Defects, Congenital ; Lung* ; Paralysis* ; Perfusion* ; Phrenic Nerve ; Pulmonary Artery ; Rabbits