No abstract available.
Doxorubicin* ; Myocytes, Cardiac*

The purpose of this study is to evaluate pulsed Doppler echocardiographic method (PD) for the measurement of pulmonary to systemic flow ratio (QP/Qs) and pulmonary arterial pressure in children. We studied 32 children with left to right shunt who had undergone cardiac catheterization, 11 children who had heart diseases without shunt and 14 normal children. Velocity time intergral (VTI) was calculated by triangulated meansurement [1/2(maximum blood velocityxejection time)]. Doppler blood flow was calculated from the equation : Doppler blood flow=VTIxcross sectional areaxheart rate. The following Doppler time intervals and ratio of intervals were also measured : preejection period(PEP), acceleration time(AT), ejection time (ET), PEP/AT, PEP/ET and AT/ET. Qp/Qs measured by PD was 1.09+/-0.15 (mean+/-SD) in children with no shunt and normal children. A high correlation was found between Fick and Doppler-derived Qp/Qs in children with left to right shunt (r=0.87). All the children with Qp/Qs less than 1.5 showed no significant discrepancy between two methods. The best correlation with pulmonary arterial pressure was achieved by the PEP/AT (r=0.84 vs systolic pressure). Sensitivity and specificity of PEP/AT for predicting pulmonary arterial hypertension were 79% and 95%, respecitively. In conclusion, it is thought that determination of Qp/Qs and prediction of pulmonary arterial pressure in children by PD is a useful, noninvasive method and triangulated measurement may be used as a simple and easy method for the measurement of Qp/Qs.
Acceleration ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Echocardiography ; Echocardiography, Doppler, Pulsed* ; Heart Diseases ; Humans ; Hypertension ; Sensitivity and Specificity

To determine normal values for Doppler parameters of left ventricular function, ascending aortic blood flow velocity was measured by pulsed wave Doppler echocardiography in 63 healthy children with body surface area (BSA) <1 m(2) (age <10 yr). Peak velocity was independent of sex, but increased with body size. Mean acceleration was related to peak velocity (r=0.75, p<0.0001). Both stroke distance and ejection time had strong negative correlations with heart rate and positive correlations with BSA, suggesting that these parameters should be evaluated in relation to heart rate and body size. Mean intra- and interobserver variability for peak velocity, ejection time, stroke and minute distance ranged from 3 to 7%, whereas variability for acceleration time was 9 to 13%. These data may be used as reference values for the assessment of hemodynamic states in young children with cardiac disease.
Age Factors ; Aorta/*physiology ; Blood Flow Velocity ; Body Constitution ; Child ; Child, Preschool ; Echocardiography, Doppler/*standards/statistics & numerical data ; Female ; Heart Rate ; Human ; Infant ; Infant, Newborn ; Male ; Observer Variation ; Reference Values ; Stroke Volume

Outcome of adult patients with repaired tetralogy of Fallot (TOF) was studied with emphasis on postrepair problems. A retrospective review of clinical, echocardiographic, catheterization, and surgical data was performed for 48 patients who underwent corrective repair of TOF after 15 years of age. All patients survived total repair and have been followed up from 3 months to 11 years (median 4.6 years). Postoperatively, 81.3% of patients were in functional class I and 85.4% had normal right ventricular function. One patient (2.1%) died during follow-up. There were 6 reoperations (12.5%) in 5 patients. The indications for reoperation included residual ventricular septal defect (VSD) (n=1), right ventricular outflow obstruction with VSD (n=4), and pulmonary regurgitation (n=1). The 10-year actuarial survival rate was 97.1%, and the 10-year freedom from reoperation was 81.3%. Aortic regurgitation was seen preoperatively in 6 patients (12.5%) and there were 2 newly developed aortic regurgitations after operation, one of which was caused by infective endocarditis. Corrective repair of TOF can be recommended in this patient group since the survival rate, postrepair functional status and hemodynamics are acceptable. Continued close follow-up, however, is essential for early identification and correction of post-repair problems.
Adolescence ; Adult ; Aortic Valve Insufficiency/etiology ; Electrocardiography ; Female ; Follow-Up Studies ; Human ; Male ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Tetralogy of Fallot/surgery* ; Treatment Outcome

No abstract available.
Colitis, Ulcerative* ; Ulcer*

No abstract available.
Mucocutaneous Lymph Node Syndrome*

PURPOSE: The purpose of this study was to determine whether erythema at the BCG inoculation site in young infants is likely to be a diagnostic clue to Kawasaki disease (KD). METHODS: A retrospective study was performed in infants with KD aged < or = 3 months treated at our hospital from January 1998 to August 2003. RESULTS: Of 428 patients treated during the study period, 14(3.3%) were < or = 3 months of age. Of them, 13 had atypical presentations, with fewer classic findings in the required criteria of KD. The most common findings were fever(100%) and oral mucosal changes(78.5%). Erythema at the BCG inoculation site was observed in at least nine patients. This feature proved to be a definite evidence of the disease in three patients who had developed cardiac complications, and a strong diagnostic clue in the remaining six patients not having cardiac complications. Seven patients(50%) had developed cardiac complications:coronary dilatation in four patients, coronary wall irregularity in two, and mitral valve prolapse with regurgitation in one. During follow-up for 6 to 20 months, cardiac complications disappeared in all patients except for one who had mitral regurgitation. CONCLUSION: Most patients with KD < or = 3 months of age have atypical presentations, with a high rate of cardiac complications. Erythema at the site of BCG inoculation could be used as a reliable diagnostic tool for atypical KD in this young age group.
Dilatation ; Erythema* ; Follow-Up Studies ; Humans ; Infant* ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mucocutaneous Lymph Node Syndrome* ; Mycobacterium bovis* ; Retrospective Studies

No Abstract available.
Diagnosis* ; Heart Defects, Congenital*

No Abstract available.
Echocardiography* ; Thoracic Surgery*

PURPOSE: The ratio of time to peak velocity(AT) and right ventricular ejection time(ET) as measured from the pulmonary artery Doppler waveform showed a close inverse correlation with pulmonary arterial pressure. The purpose of this study was to see the pattern of change in pulmonary arterial pressure assessed by AT/ET in preterm infants with respiratory distress syndrome (RDS). METHODS: The changes in pulmonary arterial pressure were assessed by serial AT/ET measurements in 18 preterm infants with RDS. RESULTS: The mean AT/ET was significantly lower in the acute phase of RDS. The pattern of change in AT/ET during recovery from RDS fell into three groups. In group 1(n=11), there was a normalization of AT/ET. Four infants showed a rapid normalization of the ratio within 24 hours of the oxygen requirements falling and the remaining 7 showed a delayed normalization. In group 2(n=4), AT/ET did not rise into the normal range during the time of study. All of the infants developed bronchopulmonary dysplasia(BPD). In 2 of the 4 infants, the ratio rose towards the normal range in the early recovery phase, but fell as the recovery period continued whereas in the remaining 2, the ratio remained at a consistent low level throughout the recovery period. One infant died of severe BPD at 36 days of age and 3 were breathing air at the time of discharge. In group 3(n=3), AT/ET decreased during a relatively short period, leading to death in all infants. CONCLUSION: Pulmonary hypertension in the acute phase of RDS is usually normalized during the recovery period. In infants who develop BPD, however, pulmonary pressure persistently remains high and in those with mortality, it is aggravated during a short-term interval.
Arterial Pressure* ; Echocardiography* ; Humans ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature* ; Mortality ; Oxygen ; Pulmonary Artery ; Reference Values ; Respiration