From January to December 1984, 191 patients with associated ventricular septal defect(VSD) were studied in the cardiac cathetherization laboratory. Among theses 191 cases, 58 cases(30.4%) of subpulmonic VSD were identified by angiocardiography. Among the 59 cases of subpulmonic VSD, 12 cases(20.6%) were complicated with aortic infficiency(AI). The relative frequency of subpulmonic VSD increased with the increase of age and the frequency of complication of AI with the subpulmonic VSD also increased with the increase of age. The amount of left to right shunt in the patients with subpulmonic VSD and AI was small and Qp/Qs ratio was less than 2.0 in all of the 12 cases. Among the 12 patients 4 cases had a pressure gradient greater than 20 mmHg across the infundibular region of the right ventricle.
Angiocardiography ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans

No abstract available.
Polychondritis, Relapsing*

BACKGROUND: It has been reported that bilateral pediatric inguinal hernias (PIH) are around 10% and that a late contralateral herniorrhapy is needed in up to 34% of ipsilateral operations. However, clinical prediction of the contralateral patent processus vaginalis (PPV) is difficult. The aims of this study were to measure the mean diameter of the internal inguinal ring (IIR) of the PIH at rest and during straining and to define the diagnostic criterion for positive contralateral PIH (or PPV) by using ultrasonography (USG). METHODS: The diameters of both ipsilateral and contralateral IIRs at rest and during straining were measured preoperatively by USG in 104 consecutive pediatric patients (75 male, 29 female; mean age of 3 years) who had undergone an ipsilateral herniorrhaphy with contralateral exploration from March 1997 to December 1997. Fifty-seven right inguinal hernias (RIH), 43 left inguinal hernias (LIH), and 4 bilateral inguinal hernias were enrolled. The contralateral PPV was defined as a sac greater than 3 mm in diameter and longer than 2 cm in length measured intraoperatively. Statistical analysis was performed by using the t-test and the chi-square test. RESULTS: Contralateral exploration showed positive PPV in 44% of RIH and 47% of LIH (p>0.05). In RIH, the mean diameter of right IIR (RIIR) was wider than that of left IIR (LIIR) (5.02+/-0.27 mm vs 2.94+/-0.12 mm at rest and 7.50+/-0.52 mm vs. 3.82+/-0.23 mm during straining, p<0.01), and the difference in diameters between straining and rest were also significant (2.38+/-0.37 mm in RIIR and 0.76+/-0.14 mm in LIIR, p<0.01). In LIH, the mean diameter of LIIR was wider than that of RIIR (4.59+/-0.27 mm vs. 3.13+/-0.19 mm at rest, 6.82+/-0.43 mm vs. 3.61+/-0.26 mm during straining, p<0.01). The diameter difference between straining and rest of LIIR and RIIR were also significant (2.17+/-0.28 mm in LIIR, 0.60+/-0.12 mm in RIIR, p<0.01). Cases of positive contralateral PPVs in RIH had significantly wider LIIRs than those of negative PPV (3.5+/-0.16 mm vs. 2.5+/-0.14 mm at rest and 4.70+/-0.32 mm vs. 2.97+/-0.20 mm during straining, p<0.01). The difference of diameter between strainingand rest of positive and negative PPVs were significant (1.16+/-0.25 mm and 0.38+/-0.09 mm, respectively, p<0.01). Cases of positive contralateral PPVs in LIH had wider RIIRs than those of negative PPV significantly (3.83+/-0.27 mm vs. 2.52+/-0.18 mm at rest and 4.58+/-0.38 mm vs. 2.68+/-0.19 mm during straining, p<0.01). The diameter difference between straining and rest of positive and negative PPVs was significant (0.93+/-0.21 mm and 0.3+/- 0.09 mm, respectively, p<0.05). CONCLUSION: In most negative PPVs, the diameter of the IIR did not exceed 3.0 mm. Therefore, contralateral IIR with diameters wider than 3.0 mm and diameters of difference more than 1.0 mm between straining and rest, as determined by using USG need to be explored.
Female ; Hernia, Inguinal* ; Herniorrhaphy ; Humans ; Inguinal Canal* ; Male ; Ultrasonography

A total of 210 male spinal cord injury patients were studied in regard to sexual function. Data were collected by means of private interviews. All patients were arranged arbitrarily into 4 injury types, Complete (C) versus Incomplete (I) and Upper Motor Neuron (UMN) versus Lower Motor Neuron (LMN), according to the level and degree of cord injury based on the neurological examination. It was found that erection occurred in 79%, successful coitus in 45%, ejaculation in 31%, orgasm in 26 % and progeny in l9%. This findings were further classified according to injury types and following results were obtained. 1. Erection in IUMN (91%), CUMN (84% ), ILMN (74%) and CLMN (42%). 2. Successful coitus in IUMN (72%), ILMN (66%), CUMN (24%) and CLMN (19%). 3. Ejaculation in ILMN (66%). IUMN (41 % ). CLMN (15% ) and CUMN (14%). 4. Orgasm in ILMN (60% ), IUMN (37%), CUMN (9%) and CLMN (8%). 5. Progeny in ILMN (37% ), IUMN (22%), CLMN (12%) and CUMN (11%).
Coitus ; Ejaculation ; Humans ; Male* ; Motor Neurons ; Neurologic Examination ; Orgasm ; Spinal Cord Injuries* ; Spinal Cord*

BACKGROUND: For an early detection and prevention of dementia, there are growing concerns about the high-risk group for dementia and mild cognitive impairment. With an increase of obesity and its complications, obesity has become a major public health problem. Therefore, the aim of this study was to investigate the relationship between obesity and the high probability of dementia. METHODS: This study was done with subjects aged 60 to 89 years who visited a health promotion center, from April 1, 2008 to April 30, 2008. A total of 293 subjects (164 males and 129 females) were included in the evaluation of cognitive function using the Korean version of the Seven Minutes Screen test. Logistic regression models were used to analyze the association between obesity and the high-risk group for dementia. RESULTS: Among a total of 293 subjects, 71 subjects (29 males and 42 females) had a high probability of dementia. When compared to normal body mass index (BMI) group, overweight and obesity groups had about a 2.2-fold and 2.4-fold higher probability of dementia (95% confidence interval [CI], 0.97 to 4.99 and 95% CI, 1.07 to 5.46, respectively). When compared to non-obese and non-abdominal obesity group, non-obese and abdominal obesity group and obese and abdominal obesity group had about a 1.5-fold and 2.0-fold higher probability of dementia (95% CI, 0.59 to 3.95 and 95% CI, 1.09 to 3.84, respectively). CONCLUSION: This study shows that as the BMI increased, subjects had a higher probability of dementia; additionally, it suggests that abdominal obesity could be related to a higher probability of dementia.
Aged ; Body Mass Index ; Dementia ; Health Promotion ; Humans ; Logistic Models ; Male ; Mild Cognitive Impairment ; Obesity ; Obesity, Abdominal ; Overweight ; Public Health ; Waist Circumference

BACKGROUND AND OBJECTIVE: Percutaneous transluminal coronary angioplasty of chronic total occlusion has been limited by a relatively low success rate and a high restenosis rate. This study investigated procedural outcome, factors predictive of procedural success and safety of coronary angioplasty for chronic total coronary occlusion. MATERIALS AND METHODS: The study population was composed of 45 lesions attempting PTCA with or without stent implantation for recanalization of chronic total coronary occlusion between January 1997 and July 1999. The clinical and angiographic data of the 45 lesions were reviewed. The results of successful PTCA in 28 lesions were compared with those in 17 lesions whose PTCA was failed. RESULTS: The overall success of balloon angioplasty and stenting was achieved in 28 lesions (62.2%) and did not differ significantly by clinical variables. The most common cause of failure of balloon angioplasty was inability to pass the guide wire across the occlusion( 14 of 23 lesions, 61%). Procedural success was more common in patients with occlusions with a tapered entry configuration(77.2% vs. 47.8%, p=.042), with lesions without side branches(82.3% vs. 50%, p=.03). Multiple logistic regression analysis identified the absence of side branch(p<0.01) and the presence of a tapered entry configuration(p<0.05) as independent predictors of procedural success. One case(2.2%) needed emergency coronary bypass surgery after failure to recanalize the occluded vessel. There was no Q wave acute myocardial infarction, death. CONCLUSIONS: The favorable cases(>60%) of chronic total coronary occlusions can be successfully dilated by balloon angioplasty with or without stent implantation, with a major complication rate of 2.2%. Therefore, with careful patient selection, we need to try the aggressive recanalization for chronic total coronary occlusion.
Angioplasty ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary* ; Coronary Occlusion ; Emergencies ; Humans ; Logistic Models ; Myocardial Infarction ; Patient Selection ; Stents

Sinus of Valsalva aneurysms are rare cardiac anomalies and are usually caused by the separation of the aortic wall media from the valve ring tissue. These aneurysms frequently rupture into the low-pressure areas like the right ventricle and right atrium, rarely do they rupture into the left atrium, left ventricle, pericardial sac, or pulmonary artery. Cerebral infarction has been reported as a rare complication of unruptured sinus of Valsalva aneurysm. We experienced very rare two cases of Valsalva aneurysms of right coronary sinus dissecting into the interventricular septum in patients with cerebral infarction. In two cases these aneurysms ruptured into the left ventricle. These aneurysms were excised and the defect was closed with autopericardium. At the end of the surgical repair, coaptation was found to be insufficient and aortic valve replacement was undertaken.
Aneurysm* ; Aortic Valve ; Cerebral Infarction* ; Coronary Sinus ; Heart Atria ; Heart Ventricles ; Humans ; Pulmonary Artery ; Rupture ; Sinus of Valsalva*

We examined the interrelationships of depth of penetration, tumor size, and the number of positive lymph nodes in Dukes'c colorectal cancer. This report contains a retrospective study of 256 cases of colorectal cancer that underwent treatment from Jan. 1985 to Dec. 1994 at the Department of Surgery, Kangbuk Samsung Hospital. The most of the patients were on the 6th decades and male to female ratio was 1.27 : 1. By modified Astler-Coller classification, there were stage Cl 29 cases(11.3%), C2 227 cases(88.7%). Eighty patients with colon cancer(31.4%) and 176 patients with carcinoma of the rectum(68.6%) were available for analysis. Utilizing cumulative frequency distributions of tumor size, depth of invasion and the number of positive lymph nodes, comparisons were carried out among three factors. The results indicate that there was no correlation between the longest diameter of the tumor and other two factors but the number of positive lymph node was closely related to depth of invasion. In conclusion, the number of positive lymph node and depth of invasion are very important prognostic factor. But tumor size as a single factor does not correlated with prognosis in Dukes' C colorectal cancer.
Classification ; Colon ; Colorectal Neoplasms ; Female ; Humans ; Lymph Nodes ; Male ; Prognosis ; Retrospective Studies

The Iinvolvement of subaortic structures in the aortic valve endocarditis appears more commonly than previously recognized. These subaortic complications are most commonly located in the mitral-aortic intervalvular fibrosa and may be presented as abscess, or as pseudoaneurysm with or without perforation. Perforated pseudoaneurysm can lead to the development of communication between the left ventricular outflow tract and various cardiac chambers, most commonly the left atrium. These complications are related with poor prognosis. Early and precise recognition of these complications is important for optimal treatment. At present, transesophageal echocardiography (TEE) has been validated as the technique of choice. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa featuring the connection of the fistulous simultaneously to the left atrium and aorta. In our case, accurate interpretation of TEE imaging revealing the subaortic structures was not so easy due to interference of both aortic and mitral prosthetic valves. We expect the further development of (Ed-confirming that here you don't intend, "We expect to further develop") TEE and other imaging modalities to substantially improve the future diagnosis of these undesirable complications.
Abscess ; Aneurysm, False* ; Aorta ; Aortic Valve* ; Diagnosis ; Echocardiography, Transesophageal ; Endocarditis* ; Fistula* ; Heart Atria ; Prognosis

No abstract available.
Arteries* ; Atherectomy*