PURPOSE: We investigated the role of myocardial perfusion SPECT in prediction of ventricular dilatation and the role of revascularization including thrombolytic therapy and PTCA in prevention of ventricular dilatation after an acute myocardial infarction (AMI). MATERIALS AND METHODS: We performed dipyridamole stress, 4 hour redistribution, and 24 hour reinjection Tl-201 SPECT in 16 patients with AMI two to nine days after attack. Perfusion and wall motion abnormalities were quantified by perfusion index (PI) and wall motion index (WMI). Left ventricular ejection fraction (LVEF), WMI and ventricular volume were measured within 1 week of AMI and after average of 6 months. According to serial changes of left ventricular end-diastolic volume (LVEDV), patients were divided into two groups. We compared WMI, PI and LVEF between the two groups. Relationships among degree of volume, stress-rest PI, WMI, CKMB, Q wave, LVEF and revascularization were analysed using multivariate analysis. RESULTS: Only initial rest perfusion index was significantly different between the two groups (p<0.05). While initial LVEF, stress PI, CKMB, trial of revascularization procedure, presence of Q wave and WMI were not significantly different between the two groups. Eight of 16 patients (50%) showed LV dilatation on follow-up echocardiography. Three of 3 patients (100%) who did not undergo revascualrization procedure documented LV dilatation. And only 5 (38%) of the remaining 13 patients who underwent revascularization revealed LV dilatation. There was no difference in infarct location between the two groups. By multivariate linear regression analysis in patients only undergoing revascularization, rest perfusion index was the only significant factor. CONCLUSION: Myocardial perfusion SPECT performed prior to revascularization was useful in prediction of LV dilatation after an AMI. Rest perfusion index on myocardial perfusion plays as a significant predictor of left ventricular dilatation after AMI. And revascularization appears to be a valuable procedure in alleviating LV dilatation after AMI with or without viable myocardium in a limited number of patients studied retrospectively.
Dilatation ; Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Linear Models ; Multivariate Analysis ; Myocardial Infarction* ; Myocardium ; Perfusion* ; Retrospective Studies ; Stroke Volume ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon* ; Ventricular Remodeling*

No abstract available.
Drug Therapy* ; Liver* ; Plasma*

No abstract available.
Child* ; Humans ; Parents*

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

No abstract available.

With the widespread dissemination of picture archiving and communication systems (PACSs) in hospitals, the amount of imaging data is rapidly increasing. Effective image retrieval systems are required to manage these complex and large image databases. The authors reviewed the past development and the present state of medical image retrieval systems including text-based and content-based systems. In order to provide a more effective image retrieval service, the intelligent content-based retrieval systems combined with semantic systems are required.
Radiology Information Systems ; Semantics

Here, a case of a 59-year-old man with rotator cuff tear and impingement syndrome caused by an ossified coracoacromial ligament is presented. Ossification of the coracoacromial ligaments can occur because of degenerative changes due to trauma or repeated stress, which can lead to impingement syndrome. Therefore, when coracoacromial ligament ossification is present, rotator cuff damage due to impingement syndrome should be considered. Here, we conducted arthroscopic subacromial decompression, removal of the ossified coracoacromial ligament, and supraspinatus and subscapularis tendon repairs. We achieved satisfactory surgical outcomes without relapse; therefore, we report this case with a literature review.
Decompression ; Humans ; Ligaments* ; Middle Aged ; Recurrence ; Rotator Cuff ; Shoulder ; Shoulder Impingement Syndrome* ; Tears ; Tendons

No abstract available.

Chronic cough is a symptom frequently encountered by the pediatrician. Although most coughs are self-limited, chronic cough often proves to be a frustrating problem. This study was performed at Kangnam St. Mary's Hospital from January 1, 1992 to December 31, 1992, and 83 children with chronic cough persisting for longer than 3 weeks was evaluated. We categorized these patients into 5 age groups (1. Infant: uner 12 months of age, 2. Toddler: above age 1~below age 3, 3. Preschool: above age 3~below age 6,4. School: above age 6~below age 6~below age 12, 5. Adolecent: above age 12). The most common cause of chronic cough was the reactive airway disease (71.1%) such as asthma with or without sinusitis (56.6%) and bronchiolitis-reactive (14.5%). In infant age group, the most frequent causes of chronic cough were reactive airway disease(52.4%)such as bronchiolitis-reactive (28.6%) and infantile asthma (23.8%). The second and third common causes were congenital anomalies(23.8%) and bronchiolitis-nonreactive (23.8%). In toddler age, the most common cause was the reactive airway disease such as infantile asthma (10 cases: 50%) and bronchiolitis reactive (6cases; 30%) and congenital anomalies were the second common causes of chronic cough. In preschool, school and adolescent age group, asthma and sinusitis were the main causes of chronic cough. In the groups above age 3,73.2% of chronic cough were associated with sinusitis. Therefore, in the diagnostic and therapeutic approach of chronic cough, it should be considered that the cause of cough is either reactive airway disease with or without sinusitis or not. In infant and toddler age, congenital anomaly should be considered.
Adolescent ; Asthma ; Bronchiolitis ; Child* ; Cough* ; Humans ; Infant ; Sinusitis