Fifteen cases of ventricular septal defect with aortic insufficiency were diagnosed radiographically andconfirmed after operation at Seoul National University Hospital in recent two and half years since 1979.Cineangiographies of ascending aorta and left ventricle were done in those cases and revealed some characteristicfindings. The resuls of the analysis are as follow; 1. Among the 15 cases, 14 cases were male and 1 case wasfemale. Age distribution was from 7 years to 23 years. 2. Those 15 cases were corresponded to 8% among total 193cases of ventricular septal defect, to 11% among total 135 cases of aortic insufficiency and especially to 48%among 48 cases of aortic in sufficiency below age of 20 years. 3. After operation, 11 cases were confirmed assubpulmonary type ventricular septal defect and 4 cases as subcristal type. The sizeds of the ventricular septaldefects were ranged between 0.6 and 2.5cm in diameter. 4. Regurgitation of contrast media was noticed in cineaortography of all cases, and the grades of regurgitation were II-III/IV in 13 cases. 5. Various types ofherniated aortic cusp through ventricular septal defect were seen. In the cases of subpulmonary ventricular septaldefect characteristic saccular aneurysm was found in 7 cases. Asymmetry or mild bulging of aortic sinus was foundin the cases of subcristal ventricular septal defect. 6. Infundibular stenosis was found in 3 cases with rightventriculography and those were caused by the herniated saccular aneurysm of aortic cusp. 7. It is essential forthe diagnosis of ventricular septal defect with aortic insufficiency to undertake biplane cineangiography ofascending aorta and left ventricle in long axial view and right ventriculograhy should be done in suspicion ofinfundibular pulmonary stenosis.
Age Distribution ; Aneurysm ; Aorta ; Cineangiography ; Constriction, Pathologic ; Contrast Media ; Diagnosis ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Male ; Pulmonary Valve Stenosis ; Seoul ; Sinus of Valsalva

Primary pulmonary tuberculosis is one of the common pulmonary disease affecting children in Korea. Simple chest film is essential in diagnosis of primary pulmonary tuberculosis, but it is difficult to interpret the findings in some cases. Authors reviewed chest films of 162 cases of clinically confirmed primary pulmonary tuberculosis from April 1978 to June 1981 at Seoul National University Hospital. The results are as follows; 1. Lymph node enlargement, either hilar or mediastinal, was found in 82.7% and pulmonary parenchymal infiltration in74%. 2. Incidence of unilateral and bilateral hilar lymph node enlargement is about 50% (81cases) and 30% (49cases) respectively. Incidence of unilateral and bilateral mediastinal lymph node enlargement is about 21% (34cases) and 4.3% (7 cases), more common in right side. 3. Pulmonary parenchymal lesion is demonstrated in 74% (120cases). The pattern of primary focus is as follows in order; patchy infiltration 47% (76 cases) linear-streaky infiltration 15% (25 cases), lobar or segmental homogenous infiltration 9% (14 cases), nodular infiltration 4% (7cases). The primary focus of right lung is two times as common as that of left. 4. Calcification in primary focusis noted in about 27% in pulmonary parenchyma and 49% in hilum. 5. Plerual effusion is identified in 10%, but pleural effusion without pulmonary parenchymal lesion or lymph node enlargement is noted in only 2% (3 cases).
Child ; Diagnosis ; Humans ; Incidence ; Korea ; Lung ; Lung Diseases ; Lymph Nodes ; Pleural Effusion ; Seoul ; Thorax ; Tuberculosis, Pulmonary

Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completelyfrom the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; andusually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases ofdouble-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department ofRadiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to thesegmental combinations, the height of conus the relationship of great arteries, the location of ventricular septaldefects, and associated anomalies. The resuslts were as follows; 1. Among 44 cases, 36 cases had normal cardiacposition, 4 cases had dextrocardia with situs inversus, 2 cases had dextrocardia with situs solitus, 1 case hadlevocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were[S.D.D] in 36 cases, [I.L.L] in 3 cases, [I.D.D] in 2 cases, [S.D.L], [S.L.L] and [A,D,D] in 1 case respectively.3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lowerthan pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2cases. 4. The relation of the great arteries were normal in 15 cases, side-by side in 13 cases, dextromalpositionin 13 cases, and levomal position in 3 cases. 5, The position of the ventricular septal defects with respect tothe origins of the great arteries is subaortic (type A & type B) in 23 cases, subpulmonary (type C) in 13 cases,double committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations arepulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C,left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery in 4, interrupted IVC in 1,obstructive VSD in 2, ASD in 4, PDA in 4, right aortic arch with levocardia in 5, and ectopic spleen withmesocardia in 1 case. 7. Biplane cinecardioangiogram must be performed in both ventricles to define the VSD andits relationship to the great arteries, and, if necessary, should also be performed in the aorta to rule outcoarctation and coronary artery abnormalities, and in the pulmonary artery to visiualize pulmonary venous returnand mitral valve. Angiography is of crucial importance in differentiating double-outlet right ventricle fromtetralogy of Fallot and complete transposition of the great arteries.
Angiography ; Aorta ; Aorta, Thoracic ; Aortic Valve ; Aortic Valve Stenosis ; Arteries ; Constriction, Pathologic ; Conus Snail ; Coronary Vessels ; Dextrocardia ; Double Outlet Right Ventricle ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Heterotaxy Syndrome ; Levocardia ; Mitral Valve ; Pulmonary Artery ; Pulmonary Valve ; Seoul ; Situs Inversus ; Spleen

9 cases of criss-cross heart anomaly, diagnosed by angiography from April, 1979 to Feb. 1985 at Seoul National University Hospital were reviewed. The results were as follows: 1. Of 9 cases, 6 cases were male and 3 cases werefemale and the age ranged from 2 months to 16 years of age. 2. Of 9 cases, 7 cases were concordant (D-loop) and 2cases were discordant (L-loop). segmental approaches are 2 cases of SDD(TGV) and each one case of SLD(TGV),SDD(DORV), SDL(DORV), SDD(DOLV), SLL(corrected TGV), and normal one. 3. Associated anomalies are small sized rightventricle (7 cases), especially inflow tract and sinus portion, pulmonary outflow tract obstruction(5 cases),VSD(9 cases), ASD( 7 cases), PDA(2 cases) and visceroatrial situs solitus was observed in all 9 cases but 1dextrocardia.
Angiography ; Crisscross Heart ; Humans ; Male ; Seoul

Lentigo maligna melanoma(LMM) is the least common type of melanoma. LMM is almost exclusively located on sun-exposed skin of the head and neck. We describe a case of lentigo maligna melanoma evolved from lentigo maligna in 82-year-old man. Five years ago, the patient developed a brownish pigmented lesion on the left cheek. The lesion progressed slowly, and several months ago, a black pigmented patch was developed in the periphery of the brownish pigmented patch. Histopathologic examination of the lesions revealed findings consistent with lentigo maligna and lentigo maligna melanoma.
Aged, 80 and over ; Cheek ; Head ; Humans ; Hutchinson's Melanotic Freckle* ; Lentigo* ; Melanoma* ; Neck ; Skin

Radiologic findings of the 29 cases of radiation pneumonitis and fibrosis diagnosed by chest radiography atSeoul National University Hospital were evaluated and compared with clinical symptoms according to the passage oftime after radiation therapy. The resuls were as follows; 1. The first radiographic signs of radiation pneumonitisand fibrosis were observed 7.6 weeks and 19.3 weeks after radiation therapy respectively. Especially in 8 cases ofsmall cell ca., they were found 5.6 weeks and 10.4 weeks, appearing slinghtly earlier than those of 12 cases ofsquamous cell ca. of lung. 2. The appearing time and severity of the radiographic changes of radiation pneumonitisand fibrosis had no specific relationship with field size, tumor dose or time-dose-fractionation factors of thetreatment. 3. The most constant and characteristic radiological finding of radiation pneumonitis was the sharp andstraight margin of the lesion, which was not that of normal anatomical structures of the lung. Other findings werediffuse haziness, indistinct normal pulmonary markings, alveolar and nodular densities, air-bronchograms andindistinctness of heart border. In radiation fibrosis stage, the lesion characteristic and constant finding. Otherfindings were indistinctness of heart border, diaphragmatic tenting and compensatory emphysema.
Emphysema ; Fibrosis ; Heart ; Lung ; Radiation Pneumonitis ; Radiography ; Thorax

No abstract available.
Protein-Losing Enteropathies

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

For the study on the effect of retinoic acid on the formation of palatal rugae and the cleft palate, retinoic acid was administered orally 150mg/kg of body weight by gastric tube at GD 10.5 to Sprague-Dawley rats. The pregnant rats were sacrificed on GD 17.5 under ether anesthesia, and laparatomized. After removal of uterus, the number of pregnant sacs and fetuses were counted. The fetuses weighed, the MEE (medial edge epithelium) thickness measured and the mitotic figures counted after routine processing and H·E stain. All the palates were photographed, and the number of rugae & the rugal pattern analysed. TEM photographs of MEE cells were observed after routine processing. The results were as follows ; 1. Rat fetus body weight after retinoic acid treatment increased significantly compared with the control group. 2. Mitotic figures in the retinoic acid treated group increased significantly compared with control group. 3. In the retinoic acid treated group, 79.3% of fetuses had cleft palates. Among fetuses with cleft palates, complete cleft palates were 10.6%, incomplete cleft palate 89.4%. Incomplete clefts were of two types ; median type (cleft palate at the intermolar region) and soft palate type (cleft posterior to the 8th rugae). Median type was 64.6% and the soft palate type 35.4%. 4. 2.3% of the fetuses had the numerical anomaly of the palatal rugae in the control group, but that of retinoic acid treated group 87.7%. 5. 17.4% of palatal rugae of the control group was disrupted, but 100% of the retinoic acid treated group disrupted. 6. Rugal papillae were observed in the 15.1% of fetuses of the control group and 63.1% of fetuses of the retinoic acid treated group. 7. Longitudinal rugae were observed in 19% of fetuses of the retinoic acid treated group, but not in the control group. 8. In TEM photographs, cytoplasmic processes, intercellular space, and desmosomes decreased. Swelling of mitochondria & ER were also found in the retinoic acid treated groups. According to the above results, it appears that there is close relationship between palatal rugae and cleft palates, and that excess retinoic acid induces disruption of pattern and numerical variations of rat fetus palate rugae. Also retinoic acid has an inhibitory effect on the proliferation of medial edge epithelial cells of palatal shelves. The cleft palates may be induced by the above mentioned retinoic acid effects. But, the exact mechanisms of retinoic acid on cleft palate formation is not thoroughly known and should be further studied.
Anesthesia ; Animals ; Body Weight ; Cleft Palate* ; Cytoplasm ; Desmosomes ; Epithelial Cells ; Ether ; Extracellular Space ; Fetus ; Mitochondria ; Palate ; Palate, Soft ; Rats ; Rats, Sprague-Dawley ; Tretinoin* ; Uterus

MR imaging of the brain in 34 patients were reviewed to characterize the MR findings of brain damage due to perinatal hypoxic insult All the patients had a history of perinatal hypoxia and showed abnormal brain MR findings. Out of 34, eight infants were born premature and twenty-six were born at term or post-term. MR findings were analysed for the extent and location of abnormalities of the white matter, cortical abnormality. Corpus callosum atrophy, and abnormal progression of myelination. The major abnormalities were abnormal signal lesions or atrophy of the cerebral white matter and gyral atrophy of the cerebral cortex. The distribution of white matter lesions well correlated with maturity of the brain at the time of hypoxic insult. Periventricular and deep white matter lesions predominated in the premature-born patients. Corpus callosum atrophy was frequently seen. Reflecting the location of white matter injury. Delay in myelination was present in 55%. MR is a very useful diagnostic imaging modality and guide for the prediction of prognosis by accurate depiction of the location and extent of brain damage due to perinatal hypoxic insult.
Anoxia* ; Atrophy ; Brain* ; Cerebral Cortex ; Corpus Callosum ; Diagnostic Imaging ; Humans ; Infant ; Magnetic Resonance Imaging ; Myelin Sheath ; Prognosis ; White Matter