1.Associated Ventilation with Mechanical Aids in Newborn Infants.
Eue Cho YANG ; Chong Ku YUN ; Jung Hwan CHOI
Journal of the Korean Pediatric Society 1985;28(5):435-447
No abstract available.
Humans
;
Infant, Newborn*
;
Ventilation*
2.Early MRI Finding of Femoral Head in Traumatic Hip Dislocation.
Hyung Ku YOON ; Kwang Pyo JEON ; Dae Eun JUNG ; Hoe Seung JEON ; Ji Ung YANG
The Journal of the Korean Orthopaedic Association 1997;32(3):565-572
Traumatic dislocation of the hip presents serious problems that may lead to avascular necrosis, nerve palsy, post-traumatic arthritis even when reduction is promptly and adequately carried out. Among them avascular necrosis is the most important prognostic factor, so the early detection of this complication has critical significance for final result. Bone scan has been considered one of early diagnostic test, but recently MRI replaced its role for imaging in the detection of early AVN, treatment monitoring and prediction of prognosis. Authors prospectively studied the early finding of MRI to detect avascular necrosis of the femoral head and to predict prognosis in traumatic hip dislocation and fracture-dislocation. From December 1990 to November 1994, 12 case of dislocation and fracture-dislocation of the hip were studied . In follow up period ranging from 19 months to 65 months, 10 case had excellent or good result. All cases had abnormal MRI finding such as paraarticular edema, capsular bulging, joint effusion, femoral head fracture, but findings such as femoral head signal changes were dectected in only 3 cases. Among the 3 cases, 1 case had developed AVN and 2 cases were uneventful. Other complications were 3 cases of posttraumatic arthritis, 2 cases of incomplete sciatic nerve palsy, and 1 case of heterotrophic ossification. Although early MRI finding at posttrauma 2weeks gave less specific information, it could give good information for risk group and follow up control with more cases. Although it is expensive, MRI can be one of the most reliable reference in early diagnosis of AVN and prediction of prognosis in traumatic dislocation and fracture- dislocation of the hip with non-invasive method.
Arthritis
;
Diagnostic Tests, Routine
;
Dislocations
;
Early Diagnosis
;
Edema
;
Follow-Up Studies
;
Head*
;
Hip Dislocation*
;
Hip Joint
;
Hip*
;
Joints
;
Magnetic Resonance Imaging*
;
Necrosis
;
Paralysis
;
Prognosis
;
Prospective Studies
;
Sciatic Neuropathy
3.Comparison of Outcome between Double and Inoue Balloon Techniques for Percutaneous Mitral Valvuloplasty in Mitral Stenosis: A Randomized Prospective Study.
Won Heum SHIM ; Jung Han YOON ; Yang Soo JANG ; Seung Yun CHO ; Seong Soon KIM ; Woong Ku LEE
Korean Circulation Journal 1992;22(5):747-753
BACKGROUND: Since the nonsurgical treatment of mitral stenosis using a single balloon has been introduced by Inoue et al. in 1984. percutaneous mitral valvuloplasty has became an accepted therapeutic modality for selected patients with mitral stenosis. Zeibag et al. demonstrated the double balloon technique showed a better outcome than the single balloon in obtainning the optimal mitral valve area. On the other hand, there are several reports that single balloon technique was comparable with the double balloon technique. Therefore, there are still controversies in efficacy, benefit and complications between balloon techniques. METHOD: To compare the efficacy and complications of percutaneous mitral valvuloplasty with the double balloon or the Inoue balloon technique, 40 patients were studied consecutively by random method in selecting the balloon technique. RESULTS: In all cases, percutaneous mitral valvulopasty was performed successfully. Optimal outcome defined as mitral valve area larger than 1.5cm2 was obtained in 12 cases out of 16(75%) in double balloon group and 15 out of 24(63%) in Inoue balloon group(p=NS). Mitral valve area was significantly increased after valvulopasty in both technique but there was no different between both groups(Mean+/-SD ; 0.9+/-0.3 to 1.7+/-0.2 vs 0.9+/-0.2 to 1.9+/-0.2cm2). There were also hemodynamic improvement significantly in mean mitral gradient(MG). pulmonary artery pressure (PAP) and left atrial pressure(LAP) after PMV but there were no difference between groups (18+/-8 to 7+/-2 vs 21+/-13 to 9+/-4 mmHg for MG. 29+/-12 to 22+/-9 vs 28+/-9 to 18+/-5mmHg for PAP and 22+/-8 to 11+/-5 vs 21+/-6 to 11+/-4 for LAP respectively). Mitral requrgitation greater than grade 2 occurred in 2 cases of the double balloon group and one case of the Inoue balloon group(p=NS). New development of atrial shunt was found in 3 cases in both groups. CONCLUSIONS: The double and Inoue balloon techniques were quite comparable in immediate outcome and complications.
Hand
;
Hemodynamics
;
Humans
;
Mitral Valve
;
Mitral Valve Stenosis*
;
Prospective Studies*
;
Pulmonary Artery
4.Relationship of Ultrasonographic Findings and Neurologic Outcomes in Infants with Birth Weight of Less than 2,000gm.
Seong Won YANG ; Jung Hwan CHOI ; Chong Ku YUN
Journal of the Korean Pediatric Society 1997;40(1):21-28
PURPOSE: In premature, neurologic sequelae is most important long-term complication. So we investigated the relationship between brain ultrasonographic findings and neurologic outcome. METHODS: Infants weighting less than 2,000gm who were discharged from the Neonatal Intensive Care Unit of Seoul National University Children's Hospital from Jan 1, 1989 to Dec. 31 1992, were investigated. All ultrasound images were examined for evidence ICH/IVH, periventricular echogenicity, and cystic PVL. Infants were assessed neurodevelopmentally in the neonatal period and at least until 12 months corrected for gestation age. RESULTS: 1) Total 291 infants were discharged, but expired, against medical advice discharged, and lost follow-up infants were exculded, 187 infants were investigated for the realtionship between brain ultrasonographic findings and neurologic outcomes. 2) The proportion of infants with neurologic sequelae (cerebral palsy) according to birth weight was as follow: 4 cases (50%) of less than 1,000gm; 13 cases (24.5%) of between 1,001gm and 1,500gm; 11 cases (5.6%) of between 1,501gm and 2,000gm, 3) The proportion of infants with neurologic sequelae according to intraventricular hemorhage (IVH) was as follows : no IVH, 1 cases (1.4%) of 69 case; IVH gradeI, 9 cases (16.1%) of 56 cases; IVH grade II, 9 cases (17%) of 53 cases; grade III, 5 cases (55.6%) of 9 cases. 4) The proportion of infants with neurologic sequelae according to the degree of periventricular echogenisity (PVE) was as follows : normal PVE, none of 53 cases; transient increased PVE, 1 case (2.5%) of 40 cases; persistent increased PVE, 6 cases (8.3%) of 72 cases; cystic periventricular leukomalacia (PVL), 17 cases (77%) of 22 cases. 5) Mantel-Haenszel chi-square analysis for the relationship between IVH and PVE showed significant correlation (p<0.05). 6) Linear logistic regression analysis for risk factors of neurologic sequelae showed that low birth weight and PVE were significant factors (p<0.05), but IVH was not significant factor (p>0.05). 7) The severity and nature of neurologic sequelae correlated with the locations and the severity of cystic PVL. CONCLUSIONS: These data suggest that low birth weight and PVL are risk factors of neurologic sequelae, and location and extent of PVL correlate with severity and type of neurologic sequelae. So early detection and follow-up examination of PVL by brain ultrasonography are needed for early detection of neurologic sequelae and minimization of handicaps.
Birth Weight*
;
Brain
;
Follow-Up Studies
;
Humans
;
Infant*
;
Infant, Low Birth Weight
;
Infant, Newborn
;
Intensive Care, Neonatal
;
Leukomalacia, Periventricular
;
Logistic Models
;
Parturition*
;
Pregnancy
;
Risk Factors
;
Seoul
;
Ultrasonography
5.Relationship of Ultrasonographic Findings and Neurologic Outcomes in Infants with Birth Weight of Less than 2,000gm.
Seong Won YANG ; Jung Hwan CHOI ; Chong Ku YUN
Journal of the Korean Pediatric Society 1997;40(1):21-28
PURPOSE: In premature, neurologic sequelae is most important long-term complication. So we investigated the relationship between brain ultrasonographic findings and neurologic outcome. METHODS: Infants weighting less than 2,000gm who were discharged from the Neonatal Intensive Care Unit of Seoul National University Children's Hospital from Jan 1, 1989 to Dec. 31 1992, were investigated. All ultrasound images were examined for evidence ICH/IVH, periventricular echogenicity, and cystic PVL. Infants were assessed neurodevelopmentally in the neonatal period and at least until 12 months corrected for gestation age. RESULTS: 1) Total 291 infants were discharged, but expired, against medical advice discharged, and lost follow-up infants were exculded, 187 infants were investigated for the realtionship between brain ultrasonographic findings and neurologic outcomes. 2) The proportion of infants with neurologic sequelae (cerebral palsy) according to birth weight was as follow: 4 cases (50%) of less than 1,000gm; 13 cases (24.5%) of between 1,001gm and 1,500gm; 11 cases (5.6%) of between 1,501gm and 2,000gm, 3) The proportion of infants with neurologic sequelae according to intraventricular hemorhage (IVH) was as follows : no IVH, 1 cases (1.4%) of 69 case; IVH gradeI, 9 cases (16.1%) of 56 cases; IVH grade II, 9 cases (17%) of 53 cases; grade III, 5 cases (55.6%) of 9 cases. 4) The proportion of infants with neurologic sequelae according to the degree of periventricular echogenisity (PVE) was as follows : normal PVE, none of 53 cases; transient increased PVE, 1 case (2.5%) of 40 cases; persistent increased PVE, 6 cases (8.3%) of 72 cases; cystic periventricular leukomalacia (PVL), 17 cases (77%) of 22 cases. 5) Mantel-Haenszel chi-square analysis for the relationship between IVH and PVE showed significant correlation (p<0.05). 6) Linear logistic regression analysis for risk factors of neurologic sequelae showed that low birth weight and PVE were significant factors (p<0.05), but IVH was not significant factor (p>0.05). 7) The severity and nature of neurologic sequelae correlated with the locations and the severity of cystic PVL. CONCLUSIONS: These data suggest that low birth weight and PVL are risk factors of neurologic sequelae, and location and extent of PVL correlate with severity and type of neurologic sequelae. So early detection and follow-up examination of PVL by brain ultrasonography are needed for early detection of neurologic sequelae and minimization of handicaps.
Birth Weight*
;
Brain
;
Follow-Up Studies
;
Humans
;
Infant*
;
Infant, Low Birth Weight
;
Infant, Newborn
;
Intensive Care, Neonatal
;
Leukomalacia, Periventricular
;
Logistic Models
;
Parturition*
;
Pregnancy
;
Risk Factors
;
Seoul
;
Ultrasonography
6.Segmental Analysis of Thallium-201 Stress Myocardial Perfusion Scanning in Coronary Artery Disease.
Namsik CHUNG ; Won Heum SHIM ; Seung Yun CHO ; Kum Soo PARK ; Seung Jung PARK ; Yang Soo CHANG ; Woong Ku LEE
Korean Circulation Journal 1986;16(4):521-530
This study was done to determine the value of thallium-201 stress myocardial perfusion scanning for identifying disease in the individual coronary arteries. Segement analysis of rest and stress myocardial perfusion scanning was performed in 65 subjects who underwent coronary arteriography. Anterolateral wall detects had a sensitivity of 70%, a spectivity of 92%, and a predicitive accuracy of 93.3% for identifying left anterior descending(LAD) coronary artery disease(CAD). Anteroseptal wall defects had a sensitivy of 62.5%, a specificity of 80%, and a predictive accuracy of 83.3% for identifying LAD CAD. Septal wall defects had a sensitivity of 67.5%, a specificity of 92%, and a predictive accuracy of 94.4% for identifying LAD CAD. Inferior wall defects had a sensitivity of 65.4%, a specificity of 89.7%, and a predictive accuracy of 80.9% for identifying right CAD. Posterolateral wall defects had a identifying left circumflex CAD. Thus, although senmental analysis of stress myocardial perfusin scanning can identify LAD CAD with high sensitivity and specificity, only moderate sensitivity and specificity are achieved in identifying right CAD or left circumflex CAD. But stress myocardial perfusion scanning has tendency to identify the most severely ischemic area, use of segmental analysis may be of benefit in the evaluation of patients with ischemic heart disease before or after coronary artery bypass graft and percutaneous transluminal coronary angioplasty.
Angiography
;
Angioplasty, Balloon, Coronary
;
Coronary Artery Bypass
;
Coronary Artery Disease*
;
Coronary Vessels*
;
Humans
;
Myocardial Ischemia
;
Perfusion*
;
Sensitivity and Specificity
;
Transplants
7.Effect of position change on oxygen saturation(SpO2)by pulse oximetry in the newborn infants.
Yun Sil CHANG ; Yang Sung WON ; Mi Jung KIM ; Dong Woo SON ; Beyong Il KIM ; Jung Hwan CHOI ; Chong Ku YUN
Korean Journal of Perinatology 1993;4(3):295-304
No abstract available.
Humans
;
Infant, Newborn*
;
Oximetry*
;
Oxygen*
8.Usefulness of Dynamic Magnetic Resonance Imaging in Brain Tumors.
Jung Sik KIM ; Sung Moon LEE ; Yang Gu JOO ; Hong KIM ; Sung Ku WOO ; Hee Jung LEE ; Soo Jhi SUH ; Seok Kil ZEON ; Mutsumasa TAKAHASHI
Journal of the Korean Radiological Society 1994;30(4):605-611
PURPOSE: To investigate the usefulness of dynamic MR imaging in the differential diagnosis of brain tumors. MATERIALS AND METHODS: Dynamic MR imaging was performed in 43 patients with histopathologically proved brain tumrs. Serial images were sequentially obtained every 30 seconds for 3--5 minutes with use of spin-echo technique(TR 200msec/TE 15msec) after rapid injection of Gd-DTPA in a dose of 0.1mmol/kg body weight. Dynamics of contrast enhancement of the brain tumors were analyzed visually and by the sequential contrast enhancement ratio(CER). RESULTS: On the dynamic MR imaging, contrast enhancement pattern of the gliomas showed gradual increase in signal intensity(SI) till 180 seconds and usually had a longer time to peak of the CER. The SI of metastatic brain tumors increased steeply till 30 seconds and then rapidly or gradually decreased and the tumors had a shorter time to peak of the CER. Meningiomas showed a rapid ascent in SI till 30 to 60 seconds and then made a plateau or slight descent of the CER. Lymphomas and germinomas showed relatively rapid increase of Sl till 30 seconds and usually had a longer time peak of the CER. CONCLUSION: Dynamic MR imaging with Gd-DTPA may lead to further information about the brain tumors as the sequential contrast enhancement pattern and CER parameters seem to be helpful in discriminating among the brain tumors.
Body Weight
;
Brain Neoplasms*
;
Brain*
;
Diagnosis, Differential
;
Gadolinium DTPA
;
Germinoma
;
Glioma
;
Humans
;
Lymphoma
;
Magnetic Resonance Imaging*
;
Meningioma
9.Three Cases of Cerebellar Hemangioblastoma in a von Hippel-Lindau Family: Case Report.
Jung Hoon HAN ; Chul Ku JUNG ; Ji Ho YANG ; Chang Myung CHOI ; Il Woo LEE ; Joon Ki KANG
Journal of Korean Neurosurgical Society 1997;26(4):563-570
Hemangioblastoma is one of the benign tumors in the central nervous system. It is often associated with von Hippel-Lindau disease(VHL disease), a well known autosomal dominant hereditary tumor syndrome. We have experienced three cases of hemangioblastoma associated with von Hippel-Lindau disease in a same family, mother(case 1, 58 years old), son(case 2,19 years old, dead) and daughter(case 3, 17 years old). All of them had cerebellar hemangioblastomas. Renal cyst was associated in the case of mother, but not in the son or daughter. Hemangioblastoma associated with von Hippel-Lindau disease frequently occurres in multiple regions such as cerebellum, spinal cord, medulla oblongata. Also it is frequently presented with renal cell carcinoma, pheochromocytoma, cyst in pancreas, kidney and liver, and epididymal cystadenoma. The age of onset of von Hippel-Lindau disease in the second generation was younger than that of the first generation in this family.
Age of Onset
;
Carcinoma, Renal Cell
;
Central Nervous System
;
Cerebellum
;
Cystadenoma
;
Hemangioblastoma*
;
Humans
;
Kidney
;
Liver
;
Medulla Oblongata
;
Mothers
;
Nuclear Family
;
Pancreas
;
Pheochromocytoma
;
Spinal Cord
;
von Hippel-Lindau Disease
10.Follow-up of Patients Undergoing Percutaneous Mitral Balloon Valvuloplasty(PMV): Analysis of Factors Predicting Restenosis at 1 Year Follow-up.
Won Heum SHIM ; Yang Soo JANG ; Jung Han YOON ; Joo Young YANG ; Nam Sik CHUNG ; Seung Yun CHO ; Woong Ku LEE
Korean Circulation Journal 1991;21(4):727-736
To determine the long-term results after PMV, the incidence of restenosis and analysis the factors predicting restenosis, 108 patients were studied at pre-, post-PMV, after 3 months and 1 year (13+/-4 months) with echocardiography. 1) Restenosis was demonstrated in 25 of 108 patients(23%) at 1 year follow-up. 2) Descriminant analysis showed echocardiographic score and mitral valve area before PMV as predictors of restenosis. 3) There were significant decreament of mitral valve area from 1.8+/-0.4cm2 (after PMV) to 1.5+/-0.3 cm2 at 3 months follow-up and further stenosis (1.2+/-0.3 cm2) at long-term follow-up in group with restenosis. In contrast, in group without restenosis, mitral valve area after PMV was 1.8+/-0.3cm2, aat 3 months follow-up was 1.8+/-0.3cm2 and at long term follow-up was 1.8+/-0.4cm2. 4) There was higher restenosis rate in group with Inoue balloon (47%) than group with double balloon (18%) despite of large EBDA/BSA.
Constriction, Pathologic
;
Echocardiography
;
Follow-Up Studies*
;
Humans
;
Incidence
;
Mitral Valve