To delineate the coronary anatomy and left ventricular function during early myocardial infarction, coronary arteriography and left ventriculogrphy were performed, prospectively in 23(22%) of 105 patients who were admitted to the coronary care unit at Masan Koryo Hospital from June 1986 to June 1988 within 4 weeks after the onset of symptoms(medium:21 days, range:18 days to 25 days). 1) Among 23 patients, male is 20 patients and female is 3 patients. The ratio of male to female was 6.6:1. The mean age was 55.4+/-10.3 years(range:34-77 years). 2) Coronary artery narrowing state which related to myocardial infarction was as follows; 2 patients(7%) had normal, 1 patients(4%) had insignificant narrowing(below 50%) 5 patients(22%) had moderate narrowing(50-75%), 10 patients(43%) had severe narrowing(75-99%), 5 patients(22%) had complete occlusion(100%). 3) The range of coronary artery disease was as follows; 9 patients had one vessel disease, 10 patients had two vessel disease, 1 patients had three vessel disease, and ejection fraction had no significant difference among 3 groups but lowest in three vessel disease. Among 23 patients, 13 patients had anterior infarction, 10 patients had inferior infarction. 4) Left ventricular ejection fraction and multiple vessel disease had no significant difference between i) the young(under 45 years old) and the old(over 45 years old) age groups, ii) presence or non presence of previous angina, iii) Killip classification I, II and III, IV) anterior infarction and inferior infarction. 5) In left ventriculography, akinesis and dyskinesis were shown at similar ratio in anterior infarction and inferior infaraction. Dyskinesis was shown in 27% of patients who have 0-1 vessel disease, 50% of patients who have 2-3 vessel disease, 62% of patients who have collateral circulation, 26% of patients who dose not have collateral circulation. 6) Collateral circulation was found in 8 patients(35%). Age and left ventricular ejection fraction were high in patients without collateral circulation than with collateral circulation, but there is no significant difference and collateral circulation exists regardless of infarction site and range of coronary artery disease. 7) As for the complication of angiocardiography in this study, there was ventricular tachycardia in 3 patients(13%) without mortality. It is concluded that coronary arteriography can be safely performed in early stage after acute myocardial infarction. Also good prognosis is anticipated since three vessel disease and complete occlusion were low in acute myocardiaol infarction of Korean People. Since these are not much case performed study, however more study on this area is required.
Angiocardiography ; Angiography* ; Classification ; Collateral Circulation ; Coronary Angiography ; Coronary Artery Disease ; Coronary Care Units ; Coronary Vessels ; Female ; Humans ; Infarction ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Prospective Studies ; Stroke Volume ; Tachycardia, Ventricular ; Ventricular Function, Left

OBJECTIVES: Aim of this study was to compare quality of life (QOL) in obsessive compulsive disorder (OCD), panic disorder (PD) and healthy controls. Additionally, relationship between clinical factors in patients and their QOL were explored. METHODS: 49 patients with OCD, 109 patients with PD and 54 healthy controls were recruited. Total scores and scores of each domain of WHO Quality of Life scale (WHOQOL) were compared in the three groups. Correlation analysis and regression analysis were performed to examine the relationship between QOL and the clinical characteristics in the patient group. RESULTS: Total scores and scores of all domains except environmental domain of WHOQOL in patient group were decreased compared to those in healthy control. Scores of social and psychological domains in the OCD group were lower than those in the PD group. The severity of agoraphobia and depression were factors affecting the QOL in the PD group. For the OCD group, comorbid depression was related to social and psychological domain of WHOQOL. CONCLUSION: QOL in patients with OCD and PD was poorer than that of healthy controls. Social relationships and psychological functioning may be poorer in patients with OCD than patients with PD. The severity of depression and agoraphobia predicted QOL in patients with PD. Comorbid depression in OCD might be a predictor of poor QOL.
Agoraphobia ; Depression ; Humans ; Obsessive-Compulsive Disorder* ; Panic Disorder* ; Panic* ; Quality of Life*

No abstract available.
Osteochondroma*

Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient's continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.
Adolescent ; Chondroblastoma ; Extremities ; Humans ; Hyperalgesia ; Male ; Natural History ; Neuralgia ; Pain, Intractable ; Upper Extremity

OBJECTIVE: Small bowel series (SBS) may be a useful test in identifying the causes of feeding intolerance in preterm infants. Unfortunately, little is known about the safety and effectiveness of SBS in preterm infants. By scrutinizing our recent experiences in performing SBS in preterm infants, we aim to provide basic data concerning the use of SBS in preterm infants with feeding intolerance. METHODS: Between January 2005 and October 2008, SBS was done in 46 preterm infants with feeding intolerance, who were admitted to the neonatal intensive care unit (NICU) of Seoul national university children's hospital. We conducted a retrospective analysis of these preterm infants. RESULTS: The average gestational age and birth weight of the 46 infants were, 30(+1)+/-3(+5) weeks, 1,435+/-623 g, respectively. The mean postconceptional age when SBS was done, was 37(+2)+/-4(+2) weeks, 46.8+/-27.3days. SBS proved that 29 infants did not have mechanical obstructions and 22 of these infants had delayed bowel transit time. Eventually, 35 infants attained full feeding except those who underwent operation. SBS was done at their bedside in 15 out of 27 infants in the group less than 1.5 kg. History of NEC, meconium related ileus, and gastrointestinal operation were more frequent in the group less than 1.5 kg. The adverse effects of SBS in preterm infants included vomiting, delayed transit of the contrast media, all of which resolved in the end and there were no reports of aspiration or sepsis. CONCLUSION: Actively performing SBS test in preterm infants with feeding intolerance will promote feeding advancement by discovering the cause of feeding intolerance and subsequent management of the specific problem.
Birth Weight ; Contrast Media ; Gestational Age ; Humans ; Ileus ; Infant ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Meconium ; Retrospective Studies ; Sepsis ; Vomiting

PURPOSE: We are inclined to analyze the relationship between the intrapulmonary right-to-left shunt and the PaO2/PaCO2 after endotracheal single-dose surfactant instillation to premature neonates with respiratory distress syndrome within 6 hours after birth. METHODS: From Jan. 1993 to Jun. 1995, we have conducted a clinical trial of surfactant replacement therapy to the premature neonates with respiratory distress syndrome at the neonatal intensive care unit of InHa University Hospital. The surfactant group (n=17) was given Surfactant-TA and mechanical ventilator care, but the control group (n=22) was treated with only mechanical ventilator. We analyzed umbilical arterial blood gases and estimated respiratoy indexes before and after treatment. RESULTS: 1) The QSP/QT decreased initially in the surfactant group, but significantly increased 24 hours after treatment in the control group (40.6+/-4.7%, P<0.05). 2) The PaO2 significantly decreased 2 hours and 24 hours after treatment in the control group (60.8+/-10.1mmHg, 63.5+/-7.6mmHg, P<0.05 respectively). There were significant correlations between the QSP/QT and the PaO2 in both groups, and specifically in the conrol group 24 hours after treatment (r=-0.94, P<0.001). 3) The PaCO2 significantly increased 1 hour after treatment, but significantly decreased specifically in the control group 24 hours after treatment (32.5+/-1.8mmHg, P<0.01). However, there were no signifacnt correlations between the QSP/QT and the PaCO2 in both groups. CONCLUSIONS: Specifically in the control group 24 hours after treatment, with hypocapnia, significant increase in pulmonary blood flow to capillary shunt and low VA/Q units (VA/Q<0.1) at high FIO2 (>0.5) resulted in a decrease in PaO2 and also a significant relationship was found between the QSP/QT and the PaO2. However, there was no significant relationship between the QSP/QT and the PaCO2.
Capillaries ; Gases ; Humans ; Hypocapnia ; Infant, Newborn* ; Intensive Care, Neonatal ; Parturition ; Pulmonary Surfactants* ; Ventilators, Mechanical

McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.
Abnormalities, Multiple ; Anal Canal ; Bardet-Biedl Syndrome ; Child ; Cystoscopy ; Female ; Foot ; Hand ; Heart Defects, Congenital ; Humans ; Hydrocolpos ; Hydronephrosis ; Infant, Newborn ; Intensive Care, Neonatal ; Kidney ; Learning Disorders ; Magnetic Resonance Imaging ; Metacarpal Bones ; Metatarsal Bones ; Obesity ; Palate, Soft ; Polydactyly ; Renal Insufficiency ; Retinal Diseases ; Uterine Diseases