Proper positioning of pulmonary artery catheter and predicting distal migration of it during cardiopulmonary bypass is important for the prevention of perioperative complication of pulmonary artery rupture. The authors therefore examined the insertion length of pulmonary artery catheter via right internal jugular vein at which catheter tip was advanced to the most proximal position where pulmonary capillary wedge pressure could be obtained. And also the distal migration is measured by comparing the difference between prebypass and postbypass corrected length. Just before bypass, pulmonary artery catheter was arbitrarily receded 5cm for the prevention of spontaneous distal migration and wedging. The subjects were 47 patients who underwent open heart surgery (valve replacement, coronary artery bypass graft) during the period of November, 1992 through April, 1993. The results were as follows. 1) The insertion length of pulmonary artery catheter from skin to the right ventricle inlet, pulmonary artery inlet and pulmonary capillary wedge position were 26.5+/-3.0 cm, 36.8+/-4.9 cm and 46.1+/-5.7 cm respectively. 2) There were no significant statistical correlations between insertion lengths and patient constitutions such as body weight and height(r=0.144, r=0.032). 3) Locations of catheter tips were distributed to the 0.9+/-3.1 cm left to the spinous process, 1.9+/-1.6 cm inferior to the carina ; mostly LLQ of the lung field(51%). 4) During cardiopulmonary bypass, pulmonary artery catheter tips were migrated distally in 93.6% of the cases and the migration lengths were 2.7+/-2.0 cm. 5) There were no major perioperative complications caused by pulmonary artery catheterization. These results suggest that 5 cm withdrawal of pulmonary axtery catheter just before cardiopulmonary bypass can prevent the fatal complication of pulmonary artery rupture owing to its spontaneous distal migration.
Bays ; Body Weight ; Capillaries ; Cardiopulmonary Bypass ; Catheterization, Swan-Ganz ; Catheters* ; Constitution and Bylaws ; Coronary Artery Bypass ; Extracorporeal Circulation* ; Heart Ventricles ; Humans ; Jugular Veins ; Lung ; Pulmonary Artery* ; Pulmonary Wedge Pressure ; Rupture ; Skin ; Thoracic Surgery

No abstract available.
Lichens*

Purpose: The purpose of this study was to compare the spatiotemporal and kinematic gait parameters and muscle activity of the lower extremities between forward walking on sand (FWS) and backward walking on sand (BWS) in normal adults. Methods: This study was conducted on 13 healthy adults. Subjects performed FWS and BWS and the spatiotemporal and kinematic gait parameters of stride time, stride length, velocity, cadence, step length, stance, swing, double support, and hip range of motion (ROM), knee ROM were measured by a wearable inertial measurement unit system. In addition, the muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GA) was measured. Results: The stride length, stride velocity, cadence, and step length in the BWS were significantly lower than FWS (p < 0.05), and stride time was significantly greater (p < 0.05). However, there was no significant difference in the ratio of stance, swing, and double support between the two (p > 0.05). The kinematic gait parameters, including hip and knee joint range of motion in BWS, were significantly lower than FWS (p < 0.05). The muscle activity of the RF in BWS was significantly higher than FWS (p < 0.05), but the muscle activity of the BF, TA, GA did not show any significant differences between the two movements (p > 0.05). Conclusion A strategy to increase stability by changing the gait parameters is used in BWS, and this study confirmed that BWS was a safe and effective movement to increase RF muscle activity without straining the joints. Therefore, BWS can be recommended for effective activation of the RF.

The idiopathic long-QT syndrome is an infrequent inherited disorder, characterized by prolonged QT interval and by the occurrence of life-threatening tachyarrhythmia, particularly in association with emotional or physical stree. In its characteristic presentation, with obvious QT prolongation and stree induced syncope with torsades de points, the diagnosis is straightforward for physicians aware of the disease. But sometimes in cases of borderline QT prolongation and vague symptom, a correct diagnosis is delayed and frequently misdiagnosed as a seizure disorder. The mortality of untreated symptomatic patients with LQTS exceeds 20% in the year after their first syncopal episode and aapproaches 50% within 10 years. But this high mortality rate has been significantly reduced by the use of pharmacological or surgical antiadrenergic therapy or both. So early detection of the disease and antiadrenergic treatment sympathetic innervation to the heart. Second, there was intrinsic gene abnormality in the mechanisms responsible for cardiac repolarization. We report one case of LQTS in a 24 years old female patient who had been suffering from stree related syncope. Her initial EKG had prologed QT interval(588msec) and increased QT intrval dispersion(200msec). In the Holter monitor, long and short cycle sequence induced (pause-dependent) torsades de pointes was detected. She has been treated by beta-blocker and has maintained her condition without recurrence of the symptoms.
Diagnosis ; Electrocardiography ; Epilepsy ; Female ; Heart ; Humans ; Long QT Syndrome ; Mortality ; Recurrence ; Syncope ; Tachycardia ; Torsades de Pointes ; Young Adult

Whole body iodine-131 scan is a well-established imaging method for the detection of metastatic or residual tumor sites in patients with well-differentiated thyroid cancer. Many false-positive iodine-131 scan findings mimicking metastatic thyroid cancer have long been reported. The authors describe a false positive uptake in normal gallbladder on post-ablative iodine-131 scan in a patient with papillary thyroid cancer. This finding should be considered to be another possible false-positive finding on iodine-131 whole body scan.
Carcinoma, Papillary/*pathology ; False Positive Reactions ; Female ; Gallbladder/*metabolism/ultrasonography ; Humans ; Iodine Radioisotopes/diagnostic use/pharmacokinetics/therapeutic use ; Middle Aged ; Thyroid Neoplasms/*pathology ; Whole-Body Counting

No abstract available.
Actins* ; Humans ; Keratosis, Actinic* ; Phototherapy*

No abstract available.
Lichen Sclerosus et Atrophicus* ; Lichens* ; Xanthomatosis*

No abstract available.
Nipples* ; Paget's Disease, Mammary*

PURPOSE: In premature, neurologic sequelae is most important long-term complication. So we investigated the relationship between brain ultrasonographic findings and neurologic outcome. METHODS: Infants weighting less than 2,000gm who were discharged from the Neonatal Intensive Care Unit of Seoul National University Children's Hospital from Jan 1, 1989 to Dec. 31 1992, were investigated. All ultrasound images were examined for evidence ICH/IVH, periventricular echogenicity, and cystic PVL. Infants were assessed neurodevelopmentally in the neonatal period and at least until 12 months corrected for gestation age. RESULTS: 1) Total 291 infants were discharged, but expired, against medical advice discharged, and lost follow-up infants were exculded, 187 infants were investigated for the realtionship between brain ultrasonographic findings and neurologic outcomes. 2) The proportion of infants with neurologic sequelae (cerebral palsy) according to birth weight was as follow: 4 cases (50%) of less than 1,000gm; 13 cases (24.5%) of between 1,001gm and 1,500gm; 11 cases (5.6%) of between 1,501gm and 2,000gm, 3) The proportion of infants with neurologic sequelae according to intraventricular hemorhage (IVH) was as follows : no IVH, 1 cases (1.4%) of 69 case; IVH gradeI, 9 cases (16.1%) of 56 cases; IVH grade II, 9 cases (17%) of 53 cases; grade III, 5 cases (55.6%) of 9 cases. 4) The proportion of infants with neurologic sequelae according to the degree of periventricular echogenisity (PVE) was as follows : normal PVE, none of 53 cases; transient increased PVE, 1 case (2.5%) of 40 cases; persistent increased PVE, 6 cases (8.3%) of 72 cases; cystic periventricular leukomalacia (PVL), 17 cases (77%) of 22 cases. 5) Mantel-Haenszel chi-square analysis for the relationship between IVH and PVE showed significant correlation (p<0.05). 6) Linear logistic regression analysis for risk factors of neurologic sequelae showed that low birth weight and PVE were significant factors (p<0.05), but IVH was not significant factor (p>0.05). 7) The severity and nature of neurologic sequelae correlated with the locations and the severity of cystic PVL. CONCLUSIONS: These data suggest that low birth weight and PVL are risk factors of neurologic sequelae, and location and extent of PVL correlate with severity and type of neurologic sequelae. So early detection and follow-up examination of PVL by brain ultrasonography are needed for early detection of neurologic sequelae and minimization of handicaps.
Birth Weight* ; Brain ; Follow-Up Studies ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Logistic Models ; Parturition* ; Pregnancy ; Risk Factors ; Seoul ; Ultrasonography

PURPOSE: In premature, neurologic sequelae is most important long-term complication. So we investigated the relationship between brain ultrasonographic findings and neurologic outcome. METHODS: Infants weighting less than 2,000gm who were discharged from the Neonatal Intensive Care Unit of Seoul National University Children's Hospital from Jan 1, 1989 to Dec. 31 1992, were investigated. All ultrasound images were examined for evidence ICH/IVH, periventricular echogenicity, and cystic PVL. Infants were assessed neurodevelopmentally in the neonatal period and at least until 12 months corrected for gestation age. RESULTS: 1) Total 291 infants were discharged, but expired, against medical advice discharged, and lost follow-up infants were exculded, 187 infants were investigated for the realtionship between brain ultrasonographic findings and neurologic outcomes. 2) The proportion of infants with neurologic sequelae (cerebral palsy) according to birth weight was as follow: 4 cases (50%) of less than 1,000gm; 13 cases (24.5%) of between 1,001gm and 1,500gm; 11 cases (5.6%) of between 1,501gm and 2,000gm, 3) The proportion of infants with neurologic sequelae according to intraventricular hemorhage (IVH) was as follows : no IVH, 1 cases (1.4%) of 69 case; IVH gradeI, 9 cases (16.1%) of 56 cases; IVH grade II, 9 cases (17%) of 53 cases; grade III, 5 cases (55.6%) of 9 cases. 4) The proportion of infants with neurologic sequelae according to the degree of periventricular echogenisity (PVE) was as follows : normal PVE, none of 53 cases; transient increased PVE, 1 case (2.5%) of 40 cases; persistent increased PVE, 6 cases (8.3%) of 72 cases; cystic periventricular leukomalacia (PVL), 17 cases (77%) of 22 cases. 5) Mantel-Haenszel chi-square analysis for the relationship between IVH and PVE showed significant correlation (p<0.05). 6) Linear logistic regression analysis for risk factors of neurologic sequelae showed that low birth weight and PVE were significant factors (p<0.05), but IVH was not significant factor (p>0.05). 7) The severity and nature of neurologic sequelae correlated with the locations and the severity of cystic PVL. CONCLUSIONS: These data suggest that low birth weight and PVL are risk factors of neurologic sequelae, and location and extent of PVL correlate with severity and type of neurologic sequelae. So early detection and follow-up examination of PVL by brain ultrasonography are needed for early detection of neurologic sequelae and minimization of handicaps.
Birth Weight* ; Brain ; Follow-Up Studies ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular ; Logistic Models ; Parturition* ; Pregnancy ; Risk Factors ; Seoul ; Ultrasonography