BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

PURPOSE: To evaluate the correlation between diabetic retinopathy (DR) and arteriolosclerosis in patients with NIDDM (non-insulin-dependent diabetes mellitus), to investigate the risk factors of DR, and to assess the change of the correlation according to the risk factors. METHODS: The study subjects were selected from consecutive routine clinical visits by random sampling from July 2002 to June 2003. The patients were divided into two groups according to the presence of DR, and the patients' charts, fundus examination and blood test were retrospectively reviewed. ETDRS (Early Treatment DR Study) classification for DR and Scheie classification for arteriolosclerosis were used. Statistical analysis was conducted with SPSS program (version 10.0). The confidence interval was set to 95%, and the level of significance was set at p=0.05. RESULTS: DR had a statistically significant correlation with arteriolosclerosis, especially according to duration of diabetes mellitus (p<0.05). Risk factors including diabetes mellitus duration, HgA1c level, and LDL (low-density lipoprotein) cholesterol level showed statistically significant difference (p<0.05). CONCLUSIONS: From the result of analysis, DR has a statistically significant correlation with arteriolosclerosis, especially according to the duration of diabetes mellitus. To prevent vision-threatening complications of DR, the degree of arteriolosclerosis as well as risk factors such as diabetes mellitus duration, serum HgA1c level, and LDL (low-density lipoprotein) cholesterol level should be carefully considered and monitored in the evaluation, progression, and treatment of DR.
Arteriolosclerosis* ; Cholesterol ; Classification ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Retinopathy* ; Hematologic Tests ; Humans ; Retrospective Studies ; Risk Factors

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and cystic changes are commonly observed. However, there have been few reports of cases of exophytic pedunculated GIST with cystic changes. Here, we report a 45-year-old man who presented with a palpable mass in the left upper quadrant of the abdomen. The mucosal folds were endoscopically abnormal, but there was no mucosal lesion. Computed tomography demonstrated a large, low-density cystic lesion surrounding an enhanced nodule in the greater curvature of the gastric body, and there was no tumor infiltration to other organs. The patient underwent hemigastrectomy and the lesion was shown to be an exophytic pedunculated cystic tumor. Histopathological examination showed epithelioid cells with marked hemorrhaging. Immunohistochemical examination indicated that most of the tumor cell cytoplasm was positive for the c-kit protein (CD117) and CD34. The tumor was diagnosed as an exophytic pedunculated GIST of the stomach with cystic changes.
Abdomen ; Cytoplasm ; Epithelioid Cells ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Middle Aged ; Proto-Oncogene Proteins c-kit ; Stomach

The aim of this study were to measure and compare the stress level on three type brackets and each other material (stainless steel, ceramic) with tipping and torquing forces by using the finite element analysis and to design bioniechanically favorable brackets. For this study, three kinds of brackets were selected(A:Transcend-RMO, B:Signature-Unitek, C:PAW plain archwire appliance-applied for a patent in Yonsei University). The slot size of bracket was 0.022inch and the size of archwire was 0.0175x0.025inch and taper shaped archwire was used in PAW. Loading force in tipping was 4.27N and torquing force was 32.858N applied by archwire torsion with 19.7degree and 113 degree in C type bracket. The conclusions were that (1) The finite element method proved to be a useful tool in the stress analysis of orthodontic bracket subjected to various forces. (2) With tipping, the stresses were concentrated at the gingival wall of the wire slot where it meets the mesial bracket surface and the incisal wall of the wire slot where it meets the distal bracket surface and with torquing, the stresses were concentrated at the junction of the gingival or incisal wall and base of the slot. (3) The maximum stress value was higher in torquing force than tipping force and therefore it is desirable to design on the basis of torquing force. (4) It was considered that the change in material might be affect on the diminish of stress value in the place of stess concentration. (5) The maximum stress value was highest on PAW bracket when the tipping and torquing force was applied and therefore it would be desirable to use mechanically favorable material on PAW bracket.
Finite Element Analysis ; Orthodontic Brackets* ; Steel

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization(TAE) in children with blunt splenicinjury. MATERIALS AND METHODS: The results of transcatheter splenic arterial embolization in nine children whosuffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated byCT, and the findings were evaluated according to the classification of Mirvis et al. ; two patients were grade 3and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if apatient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintainhemodynamic stability ; or (2) rapid Hb/Hct decrease ; or (3) both. Splenic function was subsequently estimatedaccording to the results of 99mTc-sulfur colloid scintigraphy and/or CT scanning. RESULT: TAE was suscessful inall nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil.Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches.Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. CONCLUSION: TAEof the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injuryin children, and can preserve splenic function.
Child* ; Classification ; Colloids ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Critical Care ; Radionuclide Imaging ; Retrospective Studies ; Splenic Artery ; Tomography, X-Ray Computed

A retrospective clinical study was done on 78 cases of acute myocardial infarction admitted to Jeonje Presbyterian Medical Center from Jenuary 1972 to June 1982. The following results had been obtained. 1) The ratio of male to female patients with acute myocardial infarction was 3.9:1. Most patients were in the age group between the 6th and 7th decade(64%). 2) The number of patients admitted annually was about 8, and was increased 2.5 folds in the latter 5 years as compared with the first 5 years. 3) The most common past illnesses of patients with acute myocardial infarction were coronary insufficiency with angina pectoris, hypertension, previous myocardial infarction, diabetes mellitus, valvular heart disease and hyperthyroidism in order named. The patients without significant past illness amount to 41.0%. 4) Among the patients with acute myocardial infarction smokers were 1.9 times as many as non-smokers. 5) The chief complaints of the patients with acute myocardial infarction on admission were chest pain(60.3%), dyspnea(26.9%) and mental change(6.4%). 6) The distribution of the patients withacute myocardial infarction by Killip classification was as follows: Class I, 47.4%, class II, 16.7%, class III, 16.7% and class IV, 19.2%. 7) The most common location of acute myocardial infarction by EKG was anterior wall of the myocardium at 79.5%. 8) The patients with arrhythmia by EKG amount to 53.8% and conduction disturbance 20.5%. 9) The patients with acute myocardial infarction who expired during admission were 23%. The ratio of male to female was 2.6:1. Among the expired patients Killip class IV was 80.8% and anterior wall infarction was 77.8%.
Angina Pectoris ; Arrhythmias, Cardiac ; Classification ; Diabetes Mellitus ; Electrocardiography ; Female ; Heart Valve Diseases ; Humans ; Hypertension ; Hyperthyroidism ; Infarction ; Male ; Myocardial Infarction* ; Myocardium ; Protestantism ; Retrospective Studies ; Thorax

BACKGROUND: Peritonsillitis is a clinical condition of gross tonsillar infection in a septic patient with localized swelling in the peritonsillar region, and which encompasses both peritonsillar abscess and cellulitis. It is not rarely experienced in spite of decreasing incidence since the advent of antibiotic therapy. OBJECTIVES: Our objective was a clinical observation of many factors in relation to peritonsillitis. MATERIALS AND METHODS: A clinical observation was performed on 40 cases with peritonsillitis, who visited St. Benedict hospital during 3 years from February 1994 to March 1997. A needle aspiration was attempted at the point of maximum bulging using a 10cc syringe with an 18-gauge needle. RESULTS: Among 40 cases, 23 cases yielded pus. From those 23 cases, we could isolate 22 strains in 20 cases. Incision and drainage was performed only in cases of aspiration of pus(23 cases). There was no significant difference in duration of hospitalization between I & D group(7.17 days) and non-I & D group(6.71 days)(p>0.05). CONCLUSION: We conclude that I & D can't reduce the duration of hospitalization even though I & D is helpful for the relief of symptoms, and the adequate use of antibiotics is important for the treatment of peritonsillitis.
Anti-Bacterial Agents ; Cellulitis ; Drainage ; Hospitalization ; Humans ; Incidence ; Needles ; Peritonsillar Abscess ; Suppuration ; Syringes

OBJECTIVE: To compare key-person method with census method on the prevalence of physically disabled students and to obtain the prevalence of the physically disabled students in rural community. METHOD: Total 4,890 students of 20 schools in Kyungaido province were surveyed in 1997. Two-thousands and twenty-two students of 8 schools were surveyed by a census method and 2,868 students of 12 schools by a key-person method. RESULTS: The prevalence of the physically disabled students in rural community was 0.53% of the population. The prevalence of the physically disabled students was 0.69% by a census method and 0.42% by a key-person method. This result suggests that there is no significant difference in the prevalence of physically disabled students between the two survey methods (p>0.05). CONCLUSION: A key-person method is as effective as a census method for prevalence survey of physically disabled students in rural communities because of cost effectiveness and less personnel.
Censuses ; Cost-Benefit Analysis ; Surveys and Questionnaires ; Disabled Persons* ; Humans ; Prevalence* ; Rural Population*

The purpose of this study was to detect where the center of pressure in foot would be located at the end point of loading response and the terminal stance by the dynamic plantar pressure measurement. Seventeen adults who had the usual feet without a pathologic gait were evaulated simultaneously by the motion analysis using VICON 370, and the plantar pressure measurement using EMED-SF. Two devices were set in the 60 Hz frame. The foot was divided into 3 different zones; hindfoot, midfoot, and forefoot. The end point of loading response was located at the 1.92+/-1.46 frame distal to the hindfoot- midfoot borderline. The end point of terminal response was located at the 2.27+/-1.96 frame distal to the maximal pressure points of metatarsal head. Authors could differentiate each period of stance phase; the initial contact, loading response, mid-stance, terminal stance, and preswing, using the analysis of center of pressure by the dynamic plantar pressure measurement.
Adult ; Foot* ; Gait* ; Head ; Humans ; Metatarsal Bones

OBJECTIVE: This study was designed to evaluate the relation of leg length discrepancy on ankle muscle strength. METHOD: Twenty four adult women were tested (12 leg length equality and 12 leg length discrepancy). Leg length was measured by tape ruler from anterior superior iliac spine to medial malleolus, three times by three different trained examiners. The muscle strength (bilateral ankle dorsiflexors and plantarflexors) was measured by using Cybex 340 dynamometer at 30 degree/sec and 120 degree/sec. RESULTS: The mean value of leg length discrepancy was 0.89+/-0.24 cm. In leg length discrepancy group, the peak torque of ankle plantarflexor were 44.50+/-20.94 Nm in long leg and 51.83+/-12.75 Nm in short leg at 30 degree/sec angular velocity (p<0.05). CONCLUSION: We concluded that there were significant increase in plantar flexor peak torques of short leg than those of long legs at 30 degree/sec (P<0.05). Perhaps the difference of the muscle strength might be due to compensatory mechanism of short leg in propulsion during gait.
Adult ; Ankle* ; Female ; Gait ; Humans ; Leg* ; Muscle Strength ; Spine ; Torque