The idiopathic mitral valve prolapse(IMVP) syndrome presents with nonspecific cardiovascular symptoms which need to evaluate those clinical meaning. These symptoms should not necessarily be interpreted as suggesting arrhythmias, conduction abnormalities or myocardial ischemia unless the symptoms and the the electrocardiographic changes documented to occur simultaneously. And it will be that ambulatory electrocardiographic monitoring is a a very sensitive method to detect the transient arrhythmias, conduction abnormalities of ischemic changes in patients with IMVP. Author undertook a study to systemically evaluate the electrocardiographic findings in symptomatic patients with IMVP by means of 24 hour ambulatory Holter electrocardiographic monitoring for the evaluation of the clincal meaning of those symptoms. The following results were obtained; 1) Twenty five subjects, 15 male and 10 female, with IMVP were studied. The subjects ranged in age from 10 to 50 decades. 2) The presenting complaints were palpitation in 20, atypical chest pain in 17, dizziness and syncope in 9, and lyspnea and fatigue in 7 of 25 studied subjects. 3) There were no correlations the presence of complaints with the routine 12 lead electrocardiographic findings, echocardiographic findings, and phonocardiographic findings. 4) The relationship of symptoms recorded in patient diary to Holter monioring electrocardiographic findings is summarized. (1) 20 patients recorded episodes of palpitation. Seven of these patients was associated with sinus tachycardia, 2 with paroxysmal atrial tachycardia, 3 with atrial fibrillation, 2 with atrial premature contractions, 5 with ventricular premature contractions, and 1 with no changes, (2) 17 patients recorded episodes of atypical chest pain. Three of these patients was associated with sinus bradycardia, 2 with sinus tachycardia, 1 with paroxysmal atrial tachycardia, 2 with atrial finbrillation, 2 with ventricular premature contractions, 3 with nonspecific ST segment change, 1 with first degree AV block, and 3 with no changes. (3) 8 patients recorded episodes of dizziness. Three of these patients was associated sinus bradycardia, 2 with paroxysmal atrial tachycardia, 1 with paroxysmal ventricular tachycardia, 1 with ventricular premature contractions, and 1 with no changes. (4) 1 patient recorded episodes of syncope associated with second degree AV block and sinus bradycardia. (5) 3 Patients recorded episodes of dyspnea. One of these patients was associated with sinus bradycardia, 1 with ventricular premature contractions and one with no changes. 5) The prolonged QTc interval revealed in 7 of 25 studied subjects. One of these had frequent ventricular contractions followed by paroxysmal ventricular tachycardia. 6) Ectopic beats associated with bradyarrhythmias tend to decrease in frequency and associated with tachyarrhythmias to increase in frequency in patients with atrial premature contractions during exercise, and with ventricular premature contractions during sleeping, respectively. 7) Bradyarrhythmia accounted for the majority of arrhythmias recorded in 15 of 25 symptomatic IMVP patients. It is concluded that Holter monitoring is of considerable value in assessing the clinical meaning of the nonspecific complaints in patinets with IMVP.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrioventricular Block ; Bradycardia ; Chest Pain ; Dizziness ; Dyspnea ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory* ; Fatigue ; Female ; Humans ; Male ; Mitral Valve Prolapse* ; Mitral Valve* ; Myocardial Ischemia ; Syncope ; Tachycardia ; Tachycardia, Sinus ; Tachycardia, Ventricular

The mechanism of development of pulmonary edema associated with -sympathomimetic agent is still not fully understood. 2-sympathomimetic drugs such as ritodrine, terbutaline, and fenoterol are widely used for the treatment of premature uterine contraction. We describe a case of pulmonary edema that occurred suddenly during Cesarean section in a previously healthy parturient, associated with ritodrine pretreatment for 5 days in an attempt to arrest preterm labor. Pulmonary edema was completely treated with mechanical ventilation and diuretic therapy.
Cesarean Section* ; Female ; Fenoterol ; Humans ; Obstetric Labor, Premature ; Pregnancy ; Pulmonary Edema* ; Respiration, Artificial ; Ritodrine* ; Terbutaline ; Uterine Contraction

The pathogenicity of Demodex folliculorum (DF) is not well established, becausc this cutaneous parasite can be found very often not only from acneic skin lesions but also on healthy human skin, surface, particularly on sebaceous gland-rich and functionaIly active areas of the skin, i.e. on face, and therefore, the mite has been generally considered as normal inhabitant of human skin. However, as is the case with candidiasis, the parasite could also be pathogenic in the state of disturbed host-para-site relationship. To find out the pathogenicity of the mite, the authors studied the incidence of finding DF from different sites of face in several groups of 60 acneic patients (various types of acne vulgaris and rosacea) and 30 normal subjects as control. And the results obtained were as follows: the mite was found in 33 cases out of the acnei patients (55%), in male patients 67% (12 out of l8) were positive and in fernales 50% (21 out of 42). In the control group of 3O (15 each sex), 17 cases (9 males and 8 females) had thc mite, the incidence rate being 57%, The incidence rate of DF in various types of acneic skin lesions were: 85% in rosacea. 80% in pustular acne 71% in cvstic acne and 32% in papular acne. The distribution of the mite in various sites of the face differed markedly in the acneic and normal groups. In the control group 17 (57 %) were positive on nose, 3 (10%) on cheek, 2 (7%) on chin, and none on the forehead. Among 60 acneic patients, however, 18 (30%) were positive on cheek, 17 (28%) on nose, 15 (25%) on chin 12 (20 %) on forehead. In addition, the acuthors observed two cases of demodicidosis in the dogs. These two dogs were siblings and lived together with other dogs of the same lineage, but the other dogs were not affected. In spite of vigorous treatment with 15 % benzyl benzoate aqueous emulsion and 10 % crotamiton ointment applied topically for two to three weeks, the dogs died within one to two months. Slight improvement only was noted in the first week of the treatment, but the dogs were gradually emaciated, leading to death. At the onset of the disease, both dogs were two to three months old. Histopathological studies of the affected skin revealed dense patchy lymphocytic infiltration predominantly in perifollicular area, follicular keratotic plugging and egg-like materials in the Iumen of hair follicle. Histopathology of the affected canine skin appeared similar to that of human demodicidosis except that the mitelike material was observed lodged in the lumen of hair follicle. The morphology of demodex folliculorum canis seemed slightly different from that of the human strain (DF hominis). It is generally smaller in size and has narrower and shorter stunted abdomen than human strain, otherwise it is almost alike. The human demo3icrdosis can be effectively treated with 15% benzyl benzoate aqueous emulsion, 1% gamma benzene hexachlrode cream and 10 % crotamiton ointment, and it seems to be most effective agent being crotamiton ointment among them. It is suggested that demodex folliculorum, which has been hitherto thought to be harmless, can be pathogenic in certain individuals and that some immunologic factors might be implicated in the process of the demodicidosis.
Abdomen ; Acne Vulgaris ; Animals ; Benzene ; Benzoates ; Candidiasis ; Cheek ; Chin ; Dogs ; Dronabinol ; Forehead ; Hair Follicle ; Humans ; Immunologic Factors ; Incidence ; Male ; Mites ; Nose ; Parasites ; Rosacea ; Siblings ; Skin ; Virulence*

Xeroderma pigmentosum is a hereditary disorder characterized by the ear1y development of pigmentary changes, atrophy, keratoses, and carcinoma, predorninantly light exposed area skin. Two cases of xeroderma pigmentosum complicated. by basal cell Ca. were presented. The one was 15 years old male who had been suffered frorn pea to walnut sized multiple tumors and ulcers on the face with scattered brownish macuIes on the sun exposed area since about 9 years old of his age. The other was 22 years old maIe who had been suffered from the same skin lesions as the former on the face, neck and dorsum of hands. In both cases skin lesions aggravated during each summer seasons and there were on history of convulsions and other neurological symptoms Histopathological findings of tumors on both cases revealed typical findings of basal cell Ca.
Adolescent ; Atrophy ; Child ; Hand ; Humans ; Juglans ; Keratosis ; Male ; Neck ; Peas ; Seasons ; Seizures ; Skin ; Solar System ; Ulcer ; Xeroderma Pigmentosum ; Young Adult

No abstract available.
Sternotomy*

Bladder mucosa has been reported as an excellent tissue for construction of a neourethra. We used bladder mucosa in 3 cases when there was inadequate foreskin to create a neourethra. Two cases were penoscrotal hypospadias with chordee which were repaired in one stage operation and one case was scrotal hypospadias with severe chordee which was repaired in two stage operation. The. sizes of harvested bladder mucosa were 4x 1.5cm, 10 x 3.5cm and 15 x 3cm respectively. Two minor and one major complications occurred. The minor complications were urethral stricture in one case which was managed with urethral dilation and penile swelling after self-voiding in one case which required urinary diversion for several days. In one case severe problem with entire neourethra stricture necessitated internal urethrotomy and intermittent urethral dilatation. In all cases sufficient graft tissue could be obtained and there were no urethrocutaneous fistulas. Thus, the use of bladder mucosal graft in hypospadias repair is feasible in cases in which previous repairs have railed or in which sufficient foreskin for neourethral reconstruction is lacking.
Constriction, Pathologic ; Dilatation ; Female ; Fistula ; Foreskin ; Hypospadias* ; Male ; Mucous Membrane ; Transplants* ; Urethral Stricture ; Urinary Bladder* ; Urinary Diversion

No abstract available.
Humans ; Infant, Newborn*

No abstract available.

OBJECTIVES: We aimed to identify the degree of perceived need and use of child mental health services, and to examine the factors associated with the perceived need and use of the child mental health services. METHODS: The sample consisted of 3,477 children aged 8 to 13 years. The parents completed the sociodemographic data, the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of DuPaul's Attention Deficit Hyperactivity Disorder Rating Scale (K-ARS). RESULTS: Overall, 10% of children demonstrated the need for mental health services, and 2.36% utilized the child mental health services. All subcategory scores of K-CBCL and K-ARS were significantly low in the no help needed group. Factors associated with the actual use of child mental health services included social problems and thought problems. CONCLUSION: The demand for child mental health services is high, but only a small number of children are using mental health services. To increase actual use, it is necessary to educate and campaign for various child mental health.
Aged ; Attention Deficit Disorder with Hyperactivity ; Checklist ; Child ; Child Behavior ; Humans ; Mental Health ; Mental Health Services ; Parents ; Social Problems

PURPOSE: Nutritional as well as genetic and hormonal factors play an important role in the bone mineralization during childhood and adolescence. There are several physical and metabolic changes in obese children, and these changes may influence on the mineralization of the skeleton. The studies about bone mineralization of obese children are rare and contradictory. This study was performed to evaluate the influence of childhood obesity on bone mineral density(BMD). METHODS: The BMD of 49 obese and 41 non-obese children were measured at lumbar spines(L2-L4) using dual energy X-ray bone absorptiometry. Then, the results were assessed and compared according to the degree of obesity and pubertal sex maturation. RESULTS: There were no significant differences in BMD between obese children and non-obese children(0.87+/-.19 g/cm2 vs 0.81+/-.13 g/cm2). BMD increased according to the Tanner' pubertal staging, and the most marked increment was observed at overt puberty. No sex difference in BMD was seen in both obese and non-obese children. BMD was highly correlated with age, height, weight and body mass index(BMI), but there was no significant correlation between BMD and osteocalcin. CONCLUSION: BMD of obese children was not significantly different from that of non-obese children, and BMD also was not changed according to the degree of obesity. These findings suggest that BMD is not influenced by obesity in children.
Adolescent ; Bone Density* ; Calcification, Physiologic ; Child* ; Humans ; Obesity* ; Osteocalcin ; Pediatric Obesity ; Puberty ; Sex Characteristics ; Sexual Maturation ; Skeleton