The usefulness of two-dimensional echocardiography to measure the right ventricular volume was assessed in 58 normal children (mean age 5 years and 3 months). From the apical 4-chamber view (A4CV), the subcostal RV sagittal view (SCRVSV), the subcostal right anterior oblique view (SCRAOV), and the subcostal RV coronal view (SCRVCV), the dimensions and areas of the right ventricle were measured. The right ventricular volumes and ejection fractions were calculated from these data by pyramid model and single plane area/length method. We could obtain subcostal right ventricular sagittal view in 98%, apical 4-chamber view in 90%, subcostal right anterior oblique view in 79%, and subcostal right ventricular coronal view in 71% of our children. The areas and dimensions correlated with all growth indices, such as age, height, weight, and body surface area. In general the areas showed higher correlation with body surface area, and dimensions with height. correlations of parameters obtained from the subcostal right anterior oblique view and subcostal right ventricular sagittal view with the growth indices were better than those of the subcostal right ventricular coronal view. The calculated right ventricular volume and ejection fraction showed a great varibility depending on the model used. The right ventricular volume calculated by pyramid model correlated better with the growth indices than that by single plane area/length method. the right ventricular volume calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model is the model which showed the best correlation with growth indices. Right ventricular ejection fraction did not change with any growth indices. Among the right ventricular volumes and ejection fractions by single plane area/length method, the volume(59.9+/-29.9 ml/m(2)) and ejection fracton (58.7+/-10.9%) from the subcostal right anterior oblique view were similar to those (51.0+/-17.3ml/m(2), 51.3+/-10.2%) calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model. The subcostal right anterior oblique view reflects three parts of the right ventricle. Its area and dimension are well correlated with growth indices. Also the right ventricular volume and ejection fraction obtained by single plane area/length method using the subcostal right anterior oblique view correlate with the growth indices. Therefore the subcostal right anterior oblique view is the most valuable single view representing the right ventricle.
Body Surface Area ; Child* ; Echocardiography* ; Heart Ventricles ; Humans ; Stroke Volume

Because changes in rat and dog hematological parameters according to storage conditions have been poorly documented, we sought to examine such changes. Blood analysis was performed using two hematology analyzers (ADVIA 2120i and Sysmex XN-V) after storage at room temperature and in cold storage for 5, 24, and 48 h, respectively. Interassay coefficients of variation for hematological parameters analyzed with the ADVIA 2120i and the XN-V showed similar. The levels of hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and platelet (PLT) showed significant variations with time in blood samples of rats and dogs. The leukocyte subpopulation showed high variation with storage conditions. The data for leukocyte differential counts obtained using the ADVIA 2120i, XN-V, and a manual differential counting procedure showed good agreement for neutrophils and lymphocyte counts, but monocytes, eosinophils, and basophils showed differences between the procedures. In conclusions, most rat and dog hematological parameters showed minimal changes; however, some showed high variation with storage time and temperature, especially PLT and leukocyte subpopulations. In conclusion, when performing hematological analysis in dogs and rats, it will be exactitude to analyze blood samples in fresh condition and at least within 24 h in the cold storage.
Animals ; Basophils ; Blood Platelets ; Dogs* ; Eosinophils ; Erythrocyte Indices ; Hematocrit ; Hematology ; Leukocytes ; Lymphocyte Count ; Monocytes ; Neutrophils ; Rats*

No abstract available.
Angiography ; Coronary Angiography* ; Coronary Vessels ; Echocardiography* ; Mucocutaneous Lymph Node Syndrome*

The clinical signs of acquired hypothyroidism are usually manifested insidiously over several months to years. The incidence increases after 6 years of age and peaks at 11 to 18 years of age. The clinical symptoms and signs are fatigue, constipation, decreased growth velocity and delayed bone age, compromised intellectual performance, obesity, myxedema, hyperlipidemia, peripheral neuropathy and delayed or precocious puberty. Two children were referred to our hospital for the evaluation of severe obesity and short stature. During the evaluation we found they also had hyperlipidemia, cardiomegaly with or without pericardial effusion. Thyroid function test revealed decreased serum thyroid hormone levels with positive anti- microsome and anti-thyroglobulin antibodies consistent with long-standing acquired hypothyroidism. After the supplement of L-thyroxine, both of them showed rapid improvement of above symptoms, except for the incomplete catch-up growth. We herein report two cases of acquired hypothyroidism with severe obesity, short stature, hyperlipidemia and cardiomegaly with review of literatures.
Antibodies ; Cardiomegaly* ; Child ; Constipation ; Fatigue ; Humans ; Hyperlipidemias ; Hypothyroidism* ; Incidence ; Microsomes ; Myxedema ; Obesity ; Obesity, Morbid* ; Pericardial Effusion ; Peripheral Nervous System Diseases ; Puberty, Precocious ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

The clinical signs of acquired hypothyroidism are usually manifested insidiously over several months to years. The incidence increases after 6 years of age and peaks at 11 to 18 years of age. The clinical symptoms and signs are fatigue, constipation, decreased growth velocity and delayed bone age, compromised intellectual performance, obesity, myxedema, hyperlipidemia, peripheral neuropathy and delayed or precocious puberty. Two children were referred to our hospital for the evaluation of severe obesity and short stature. During the evaluation we found they also had hyperlipidemia, cardiomegaly with or without pericardial effusion. Thyroid function test revealed decreased serum thyroid hormone levels with positive anti- microsome and anti-thyroglobulin antibodies consistent with long-standing acquired hypothyroidism. After the supplement of L-thyroxine, both of them showed rapid improvement of above symptoms, except for the incomplete catch-up growth. We herein report two cases of acquired hypothyroidism with severe obesity, short stature, hyperlipidemia and cardiomegaly with review of literatures.
Antibodies ; Cardiomegaly* ; Child ; Constipation ; Fatigue ; Humans ; Hyperlipidemias ; Hypothyroidism* ; Incidence ; Microsomes ; Myxedema ; Obesity ; Obesity, Morbid* ; Pericardial Effusion ; Peripheral Nervous System Diseases ; Puberty, Precocious ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

No abstract available.
Child ; Humans

Loss of best corrected visual acuity(BCVA)is a landmark of safety, as one of important complications of refractive surgery. To evaluate causes of 2 lines or more loss of BCVA after laser in situ keratomileusis(LASIK), 206 eyes of 139 patients, who had undergone LASIK and had been followed up for 6 months or more, were included in this study. During the follow-up, nineteen eyes(9.2%, 19/206)showed 2 lines or more loss of BCVA postoperatively. The causes of BCVA were irregular astigmatism(15 eyes, 7.3%), retinal complications(3 eyes, 1.5%), and infectious keratitis(1 eye, 0.5%). All irregular astigmatisms had occured within 1 month postoperatively and 13 eyes of all 15 eyes spontaneously recovered after postoperative 3 months. The persistent loss of BCVA occurred in 5 eyes(2.4%, 5/206). Three cases of all 5 persistent losses of BCVA were due to retinal complications. In conclusion, our results suggest that the most common cause of loss of BCVA after LASIK is irregular astigmatism. Irregular astigmatism is a temporary situation which has a tendancy of spontaneous recovery. Thus careful observation is recommended in irregular astigmatism after LASIK. The retinal complications of LASIK may lead to permanent loss of BCVA. Therefore it is needed to examine preoperative fundus closely and to explain possible postoperative complicaitons to the patients and their family.
Astigmatism ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ* ; Refractive Surgical Procedures ; Retinaldehyde ; Visual Acuity*

Atrial flutter is and infrequent, but potentially unstable tachyarrythmia that occurs in pediatric ages. Transesophageal atrial pacing was used for treatment of 10 episodes of atrial flutter in 7 patients. At the time of atrial flutter conversion, patients were 6 days to 14 years old. 6 patients had associated with congenital heart disease. The atrial cycle length of atrial flutter ranged from 140 to 280 msec with variable atrioventricular conduction. Transesophageal atrial pacing was performed using a bipolar 4 F transesophageal electrode catheter. Atrial flutter conversion was accomplished with stimulation bursts using about 5 seconds of stimuli, 10 msec in duration at 20 to 27 mA. Pacing cycle length was 45 to 110 msec less than the atrial cycle length of tachycardia in 6 episodes. But in a neonate, underdrive pacing converted atrial flutter to sinus rhythm. Conversion attempts were unsuccessful on 2 occasions. Transesophageal atrial pacing is a safe and effective, minimally invasive technique for treatment of atrial flutter in infants and children.
Adolescent ; Atrial Flutter* ; Catheters ; Child* ; Electrodes ; Heart Defects, Congenital ; Humans ; Infant* ; Infant, Newborn ; Tachycardia

No abstract available.
Echocardiography* ; Echocardiography, Doppler, Color ; Ligation*

BACKGROUND: Staphylococcal scalded skin syndrome (SSSS) is defined as a spectrum of superficial blistering skin disease caused by the exfoliative toxins of Staphylococcus (S.) aureus. The spectrum of the disease includes generalized, localized (bullous impetigo), abortive and intermediate forms. OBJECTIVE: The purpose of this study is to reclassify clinical types of SSSS by reviewing the clinical and microbiologic features of SSSS and to redefine the clinical types exactly. METHODS: We retrospectively reviewed medical records, clinical photographs and the microbiologic results of 25 patients with SSSS and studied them according to the new classification. We defined the 3 clinical types as follows: i) The Generalized type is defined as a case where tender erythroderma and large thin bullae occur on the whole body excluding the mucous membrane, palms and soles. The nikolsky sign is positive. ii) The intermediate type is defined as a case where tender erythroderma and vesicles or pustules occur in the regionally limited area. The Nikolsky sign is positive. iii) The abortive type is defined as a case where tender erythema occurs only on the whole body or in regionally limited areas. The nikolsky sign is negative. All patients of SSSS have periorificial, radial crusting and fissuring. RESULTS: We could reclassify the clinical types of SSSS into 3 types (generalized, intermediate, abortive) according to this retrospective clinical study. Of the 25 patients, 3 patients were of the generalized type, 13 patients were of the intermediate type and 9 patients were of the abortive type. All the types have the acute eczematous lesion on the periorbital and perioral areas. The male to female sex ratio was 1: 1.3. The mean age of onset was 2.9 years. Cultures from the suspected site of the primary infection were positive in 14 out of 21 patients, and colonized sites were the throat (29%), conjunctiva (21%), nasal cavity (21%), ear (21%) and skin (8%) in 14 patients. Methicillin-sensitive S. aureus and methicillin-resistant S. aureus were 8 cases and 6 cases, respectively. In all clinical types, the most common complication was conjunctivitis (54.5%). Four cases were accompanied by atopic dermatitis. All the patients were cured with first generation cephalosporin without significant sequelae. CONCLUSION: We reclassified SSSS into generalized, intermediate and abortive types with reference to our 25 cases and previously existing papers, and offered a correct definition for the 3 types.
Age of Onset ; Blister ; Classification ; Colon ; Conjunctiva ; Conjunctivitis ; Dermatitis, Atopic ; Dermatitis, Exfoliative ; Ear ; Erythema ; Exfoliatins ; Female ; Humans ; Male ; Medical Records ; Methicillin Resistance ; Mucous Membrane ; Nasal Cavity ; Pharynx ; Retrospective Studies ; Sex Ratio ; Skin ; Skin Diseases ; Staphylococcal Scalded Skin Syndrome* ; Staphylococcus