The radiographic measurement of the renal size and position provide important information of disease of thekidney and the adjacent organs. The author analyzed the 213 cases of intravenous pyelography of normal Koreanchildren from 0 to 18 years of age (135 males and 78 females) and measured the following points; the length of thekidney, the width of the kidney, the level of both hila, and the ratio of the kidney length to the total height ofupper 4 lumbar vertebral bodies plus intervertebral discs. The results were obtained as follows; 1. Above 4 yearsof age, the annual increase rate of the kidney length was 0.31cm, and that of the height of lumbar vertebrae was0.44cm in male and 0.55 cm in female; the height of lumbar vertebrae grew more rapidly than the kidney length. 2.The age group of the most rapid growth in the length and the width of the kidney was 16 to 18 years of age inmale, and 13 to 15 years of age in female, and that of the most delayed growth was 4 to 6 years of age in bothsexes. 3. The size of the left kidney was usually larger than that of the right. But, the right kidney was largerthan the left in 20% of the cases. 4. The right hilum was usually lower than that of the left. In the 12% of thecases, however, the right hilum was higher in position than the left. 5. The width of the kidney in most childrencorresponded to the 45 to 60% of the kidney length. 6. The kidney size in age group between 16 and 18 years waswithin the range of that of normal adults. 7. The ratios of the kidney length to the height of upper 4 lumbarvertebral bodies plus intrevertebral discs were as follows; > 1.1 below 3 years of age. 1±0.1 between 4 and 12 years of age. > 0.9 above 13 years of age.
Adult ; Child ; Female ; Humans ; Intervertebral Disc ; Kidney ; Lumbar Vertebrae ; Male ; Urography

A clinical and radiological study was done on 96 cases of spontaneous pneumothorax, encoutered in the Dept. ofRadiology, Busan National University Hospital during last 3 years from March. 1979 to March 1982. The results weresummarized as follows; 1. In the age distribution, the ages between 20 and 39 years were most highest, as 54 cases(56.3%). In the sex distribution, the ratio of male to female was 5:1 in male predominance. 2. The underlyingpathology of the total 96 cases of spontaneous pneumothorax were of tuberculous origin in 33.3% andnon-tuberculous origin in 66.7%. And below 20 years, most were of non-tuberculous origin. 3. In the cases of lungcollapse over 2/3, non-tuberculous origin was more than tuberculous origin and had characteristics of significantmediastinal shifting, in contrast to lower percentage of fluid level by chest radiography. 4. The rupture of blebsor bullae was the main immediate causes of spontaneous pneumothorax, independent of the underlying pathology. 5.In only 27 cases (28.1%) among total 96 cases, bullae or blebs could be detected on the chest radiography. 6. Intreatment of spontaneous pneumothorax, the closed thoracotomy with under water seal drainage is accepted to be thegeneral method of treatment. But open thoracotomy is considered as the best useful therapeutic procedure toprevent the recurrence, whenever bullae of blebs are found on the chest radiography. 7. In the cases of closedthoracotomy, the recurrent rate was 25.0% and most cases were found at the ipsilateral side of the first attack.8. Within a week, the collpased lung were well expanded in most cases of total 96 cases, after closed thoracotomy.
Age Distribution ; Blister ; Busan ; Drainage ; Female ; Humans ; Lung ; Male ; Methods ; Pathology ; Pneumothorax ; Radiography ; Recurrence ; Rupture ; Sex Distribution ; Thoracotomy ; Thorax ; Water

BACKGROUND/AIMS: Since population-based screening for gastric cancer in Korea was implemented, endoscopic treatment of early gastric cancer has become increasingly popular. This study investigates factors affecting endoscopic curative resection of early gastric cancer in population-based screening for gastric cancer. METHODS: We retrospectively reviewed data of patients with newly diagnosed gastric cancer who underwent treatment at Seoul St. Mary’s Hospital. All patients completed questionnaires about clinical information, including interval between surveillance tests for gastric cancer. RESULTS: Of 469 gastric cancer patients, 147 (31.3%) had undergone curative endoscopic resection, 260 (55.4%) had undergone curative surgical resection, and 62 (13.3%) underwent non-curative resection or were in an inoperable state. Patients with curative endoscopic resection had fewer alarm symptoms/signs than other groups. In multivariate analysis, regular surveillance endoscopy was the only factor predicting curative endoscopic resection (odds ratio [OR], 6.099; 95% confidence interval [CI], 2.532–14.933). In addition, patients undergoing gastric cancer screening had a significantly higher rate of endoscopic curative resection compared with subjects who had never been screened. (1-year interval: OR, 49.969; 95% CI, 6.340–393.827, 2-year interval: OR, 15.283; 95% CI, 1.833–127.406, over 2-year interval: OR, 10.651; 95% CI, 1.248–90.871). Shorter screening test intervals were associated with higher rates of endoscopic curative resection. CONCLUSIONS: Regular surveillance testing was the independent factor predicting curative endoscopic resection of gastric cancer.
Early Detection of Cancer ; Endoscopy ; Humans ; Korea ; Mass Screening* ; Multivariate Analysis ; Retrospective Studies ; Seoul ; Stomach Neoplasms*

BACKGROUND: Recent investiogations have shown that aortic valve area derived by continuity equation as well as Gorlin formula varied with transvalvular volume flow rate. This study was designed to investigate the effect of heart rate on aortic valve area calculated by continuity equation. METHODS: We studied 10 patients of with cath-proven aortic stenosis. Patients underwent echocardiography recording during right atrial pacing with 80, 100 and 120 beats/min. Flow rate and continuity equation valve area were obtained at each heart rate by doppler echocardiography. RESULTS: Transvalvular flow rates were 194+/-30 ml/sec, 208+/-38 ml/sec and 200+/-39 ml/sec with pacing at 80, 100 and 120 beats/min respectively, and there was no significant change in flow rate with heart rate. Aortic valve areas derived by continuity equation were 0.77+/-0.14cm2, 0.81+/-0.14cm2and 0.86+/-0.15cm2with pacing at 80, 100 and 120 beats/min. There was signifcant increase in aortic valve area between heart rate 120 and 100 beat/min(p=0.02), and between heart rate 120 and 80 beas/min([=0.003). there was no significant change in aortic valve area between heart rate 100 and 80 beat/min. CONCLUSION: Although there was no significant change in transvalvular flow rate with heart rate increase, aortic valve area derived by continuity equation significantly increased with increased heart rate. This relation should be considered when interpretion continuity equation valve area in aortic stenosis.
Aortic Valve Stenosis ; Aortic Valve* ; Echocardiography ; Echocardiography, Doppler ; Heart Rate* ; Heart* ; Humans

BACKGROUND AND PURPOSE: Organized inpatient stroke care is one of the most effective therapies for improving patient outcomes. Many stroke centers have been established to meet this need, however, there are limited data on the effectiveness of these organized comprehensive stroke center (CSC) in the real-world setting. Our aim is to determine whether inpatient care following the establishment of CSC lowers mortality of patients with acute ischemic stroke (AIS). METHODS: Based on a prospective stroke registry, we identified AIS patients hospitalized before and after the establishment of a CSC. We observed all-cause mortality within 30 days from time of admission. Logistic regression was used to determine whether the establishment of the CSC affects independently the 30-day all-cause mortality. RESULTS: A total of 3,117 consecutive patients with AIS were admitted within seven days after the onset of the symptoms. Unadjusted 30-day mortality was lower for patients admitted to our hospital after the establishment of the CSC than before (5.9% vs. 8.2%, P=0.012). Advanced age, female gender, previous coronary artery disease, non-smoking, stroke subtype, admission on a holiday, referral from other hospitals, high NIHSS on admission, and admission before the establishment of CSC were associated with increased 30-day stroke case fatality. After adjustment for these factors, stroke inpatient care subsequent to the establishment of the CSC was independently associated with lower 30-day mortality (OR, 0.57; 95% CI, 0.412-0.795). CONCLUSIONS: Patients treated after the establishment of a CSC had lower 30-mortality rates than ever before, even adjusting for the differences in the baseline characteristics. The present study reveals that organized stroke care in a CSC might improve the outcome after AIS.
Coronary Artery Disease ; Female ; Holidays ; Humans ; Inpatients ; Logistic Models ; Prospective Studies ; Referral and Consultation ; Stroke

BACKGROUND AND OBJECTIVES: Although percutaneous coronary intervention (PCI) is recommended to improve symptoms in patients with stable ischemic heart disease (SIHD), improvement of exercise performance is controversial. This study aimed to investigate changes in exercise duration after PCI according to functional completeness of revascularization by comparing pre- and post-PCI exercise stress test (EST). METHODS: Patients with SIHD were enrolled from a prospective PCI registry, and divided into 2 groups: 1) functional complete revascularization (CR) group had a positive EST before PCI and negative EST after PCI, 2) functional incomplete revascularization (IR) group had positive EST before and after PCI. Primary outcome was change in exercise duration after PCI and secondary outcome was major adverse cardiac events (MACE, a composite of any death, any myocardial infarction, and any ischemia-driven revascularization) at 3 years after PCI. RESULTS: A total of 256 patients (149 for CR group, and 107 for IR group) were eligible for analysis. Before PCI, exercise duration was not significantly different between the functional CR and IR groups (median 540 [interquartile range; IQR, 414, 602] vs. 480 [402, 589] seconds, p=0.091). After PCI, however, the CR group had a significantly higher increment of exercise duration than the IR group (median 62.0 [IQR, 12.0, 141.0] vs. 30.0 [−11.0, 103.5] seconds, p=0.011). The functional CR group also had a significantly lower risk of 3-year MACE (6.2% vs. 26.1%; adjusted hazard ratio, 0.19; 95% confidence interval, 0.09–0.41; p<0.001). CONCLUSIONS Functional CR showed a higher increment of exercise duration than functional IR.

BACKGROUND AND OBJECTIVES: Although percutaneous coronary intervention (PCI) is recommended to improve symptoms in patients with stable ischemic heart disease (SIHD), improvement of exercise performance is controversial. This study aimed to investigate changes in exercise duration after PCI according to functional completeness of revascularization by comparing pre- and post-PCI exercise stress test (EST).METHODS: Patients with SIHD were enrolled from a prospective PCI registry, and divided into 2 groups: 1) functional complete revascularization (CR) group had a positive EST before PCI and negative EST after PCI, 2) functional incomplete revascularization (IR) group had positive EST before and after PCI. Primary outcome was change in exercise duration after PCI and secondary outcome was major adverse cardiac events (MACE, a composite of any death, any myocardial infarction, and any ischemia-driven revascularization) at 3 years after PCI.RESULTS: A total of 256 patients (149 for CR group, and 107 for IR group) were eligible for analysis. Before PCI, exercise duration was not significantly different between the functional CR and IR groups (median 540 [interquartile range; IQR, 414, 602] vs. 480 [402, 589] seconds, p=0.091). After PCI, however, the CR group had a significantly higher increment of exercise duration than the IR group (median 62.0 [IQR, 12.0, 141.0] vs. 30.0 [−11.0, 103.5] seconds, p=0.011). The functional CR group also had a significantly lower risk of 3-year MACE (6.2% vs. 26.1%; adjusted hazard ratio, 0.19; 95% confidence interval, 0.09–0.41; p<0.001).CONCLUSIONS: Functional CR showed a higher increment of exercise duration than functional IR.
Angina, Stable ; Exercise Test ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Prognosis ; Prospective Studies

Background: There are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI). Methods: Of 2,082 consecutive patients undergoing PCI using second-generation drugeluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI. Results: In propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54–2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group. Conclusion Compared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.

Background: There are no data on comparison between clopidogrel monotherapy and prolonged dual antiplatelet therapy (DAPT) in patients at high-risk undergoing percutaneous coronary intervention (PCI). Methods: Of 2,082 consecutive patients undergoing PCI using second-generation drugeluting stent (DES), we studied 637 patients at high-risk either angiographically or clinically who received clopidogrel longer than 24 months and were event-free at 12 months after index PCI. Patients were divided into 2 groups: the clopidogrel monotherapy group and the prolonged DAPT group. The primary outcome was a composite of all-cause death, non-fatal myocardial infarction (MI), definite or probable stent thrombosis, or stroke between 12 months and 36 months after the index PCI. Results: In propensity score-matched population (246 pairs), the cumulative rate of primary outcome was 4.5% in the clopidogrel monotherapy group and 4.9% in the prolonged DAPT group (hazard ratio, 1.21; 95% confidence interval, 0.54–2.75; P = 0.643). There was no significant difference in all-cause death, MI, stent thrombosis, stroke between the clopidogrel monotherapy group and the prolonged DAPT group. Conclusion Compared with prolonged DAPT, clopidogrel monotherapy showed similar long-term outcomes in patients at high-risk after second-generation DES implantation.

BACKGROUND: Admission blood glucose (BG) level is a predictor of mortality in critically ill patients with various conditions. However, limited data are available regarding this relationship in critically ill patients with cardiovascular diseases according to diabetic status. METHODS: A total of 1,780 patients (595 with diabetes) who were admitted to cardiac intensive care unit (CICU) were enrolled from a single center registry. Admission BG level was defined as maximal serum glucose level within 24 hours of admission. Patients were divided by admission BG level: group 1 (< 7.8 mmol/L), group 2 (7.8–10.9 mmol/L), group 3 (11.0–16.5 mmol/L), and group 4 (≥ 16.6 mmol/L). RESULTS: A total of 105 patients died in CICU (62 non-diabetic patients [5.2%] and 43 diabetic patients [7.9%]; P = 0.105). The CICU mortality rate increased with admission BG level (1.7%, 4.8%, 10.3%, and 18.8% from group 1 to group 4, respectively; P < 0.001). On multivariable analysis, hypertension, mechanical ventilator, continuous renal replacement therapy, acute physiology and chronic health evaluation II (APACHE II) score, and admission BG level significantly influenced CICU mortality in non-diabetic patients (group 1 vs. group 3: hazard ratio [HR], 3.31; 95% confidence interval [CI], 1.47–7.44; P = 0.004; group 1 vs. group 4: HR, 6.56; 95% CI, 2.76–15.58; P < 0.001). However, in diabetic patients, continuous renal replacement therapy and APACHE II score influenced CICU mortality but not admission BG level. CONCLUSION: Admission BG level was associated with increased CICU mortality in critically ill, non-diabetic patients admitted to CICU but not in diabetic patients.
APACHE ; Blood Glucose ; Cardiovascular Diseases ; Critical Care ; Critical Illness ; Diabetes Mellitus ; Humans ; Hypertension ; Intensive Care Units ; Mortality ; Prognosis ; Renal Replacement Therapy ; Ventilators, Mechanical