Doppler echocardiography was performed to evaluate the tricuspid regurgitation in 786 infants and children with heart disease. 3 Doppler methods were used. : The duration of systolic turbulence of tricuspid regurgitation in thr right atrium was evaluated by continuous wave Doppler method, the distance of systolic turbulence within right atrium from the tricuspid plane, by pulsed Doppler method and the retrograde systolic hepatic vein regurgitation, by color Doppler method. The following results were obtained. 1) Incidence of pan systolic tricuspid regurgitation in each disease were as follows. 68% of ECD, 66% of Ebstein's anomaly, 54% of pulmonary atresia, 50% of arrhythmia, 45% of ASD, 38% of TAPVR, 15% of VSD, 26% of TOF, 12% of PDA, 13% of normal children. 2) In about 90% of children with tricuspid regurgitation, hepatic vein regurgitation was detected by color Doppler echocardiography.
Arrhythmias, Cardiac ; Child* ; Ebstein Anomaly ; Echocardiography, Doppler ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Diseases* ; Heart* ; Hepatic Veins ; Humans ; Incidence ; Infant* ; Pulmonary Atresia ; Scimitar Syndrome ; Tricuspid Valve Insufficiency*

No abstract available.
Ambulances* ; Cardiopulmonary Resuscitation*

Numerous operations have been described to treat the recurrent anterior dislocation of the shoulder, but no one procedure was accepted as the choice of operation. We perforemed 6 Bristow procedures and 5 combined Bankart and Putti-Platt procedures and examined six shoulders by arthroscope from sep. 1989 to Sep. 1992, and we analysed the pathologic feature and the results of them. The average follow-up period was 2.2 years. 1. There were 8 males and 3 females and their average age was 33.7 years. The mean age in initial dislocation was 28 years. 2. The number of recurrent dislocation before operation was 17.9 times and the average duration of the disease was 5.7 years. 3. The pathologic lesions observed in intraoperative field were Hill-Sachs lesion (72.7%), Bankart lesion (90.9%), and the erosion of the glenoid rim (54.5%). On arthroscopic examination of 6 cases, Hill-Sachs lesion was found in 4 cases, Bankart lesion was seen in all of 6 cases, and the erosion of the glenoid rim was observed in 4 cases. 4. The average range of the limitation of external rotation was 17.3 and its significant difference was not observed between 2 operative groups. 5. By Rowes rating sheet, 4 cases of 5 combined Bankart and Putti-Platt operations were excellent and 1 case was good. 6. In conclusion, combined Bankart and Putt-Platt operation was considered as a good surgical procedure in the treatment of recurrent anterior dislocation of the shoulder.
Arthroscopes ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Male ; Shoulder

No abstract available.
Ductus Arteriosus, Patent*

BACKGROUND: Improvements in catheter equipments and increasing experience of the operators have brought about a broadening of the indications and applications of percutaneous transluminal coronary angioplasty(PTCA). In particular, coronary angioplasty has been employed in total occlusions.We evaluated the initial success rate and safety of PTCA total occulsive coronary artery disease. METHODS: To assess the success rate and safety of PTCA total coronary artery occlusion, the data of 24 patients(male 19, female 5, mean age 55+/-9 years), in whom PTCA for total occlusion were performed, were examined. RESULTS: Primary success rate of procedure was 66.7%(16 out of 24 lesions).The success rate according to the duration of total occlusions was 8 out of 11(72.7%) with occlusions<4 weeks duration and 3 out of 7(42.9%) with occlusions>4 weeks duration(p=0.07). There was no difference in success rate according to vassel dilate(left anterior descending 75.0%, right coronary 44.4%) and length of occluded lesion(0.93%+/-0.47%cm, p=0.35). Eight procedural failures included inability to cross the lesion with a guide wire in 6 and inability to dilate the lesion in 2, but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Even though the recanalization of occluded coronary arteries has a lower initial success rate than angioplasty for stenotic arteries, PTCA in total occlusion can be performed as a safe and effective therapeutic modality in selective patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Catheters ; Coronary Artery Disease ; Coronary Vessels* ; Death ; Emergencies ; Female ; Humans

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) have been broaden recent years. We evaluated the initial success rate and safety of PTCA in mulitiple lesions and vessels. METHODS: To assess the success rate and safety of PTCA In mulitiple lesions and vessels, the data of 60 lesions from 28 patients(male 23, female 5, mean age 56+/-12 years), in whom PTCA for multiple lesions and vessels were performed, were examined. Initial results and complications were compared in 37 lesions undergoing multivessel and 23 lesions undergoing multilesion PTCA. RESULTS: Overall primary success rate of procedure was 82%(49 out of 60 lesions). Angioplasty was attempted in mean 2.1 stenotic lesions per patient. Primary success rate per lesion was 84%(31 of 37) among those who underwent multivessel and 78%(18 of 23) among those who underwent multilesion PTCA(p>0.05). Success rate according to the combination of dilated vessels was 85.7%(12 of 14) in left anterior descending(LAD) and left circumflex(LCX), 83.3%(10 of 12) in LAD and right coronary artery(RCA), 100.0%(4 of 4) in LAD and diagonal branch, RCA and LCX in 75.0%(3 of 4), and 66.7%(2 of 3) in LAD, LCX and diagonal branch. Eleven failures(18.3%) included inability to pass the guide wire cross the lesion or inability to locate the balloon catheter in 5(8,3%), abrupt closure in 2(3,3%), coronary spasm in 1(1.7%) and major branch occlusion in 3(5.0%), but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Coronary angioplasty in selected patients with multivessel and multilesion coronary artery disease might be useful and have relatively good initial results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angioplasty* ; Catheters ; Coronary Artery Disease ; Death ; Emergencies ; Female ; Humans ; Spasm

Femoral head and neck fractures during the course of avascular necrosis are rare with only few reports in the English literature. Moreover, there are very few reports on an analysis of the patterns of these fractures. Four cases of femoral head fracture caused by minor trauma, which were quite different from the crescent fractures during the course of avascular necrosis were analyzed in regard to the underlying disease, causes, sites, types, directions, pattern of fractures and the injury mechanism of the fractures. The results are reported with special regard to the pattern of the stress fracture of the femoral head and neck during the course of avascular necrosis.
Fractures, Stress ; Head* ; Neck* ; Necrosis*

No abstract available.
Arteries* ; Echocardiography ; Fetus* ; Heart ; Humans* ; Mitral Valve* ; Tricuspid Valve*

BACKGROUND/AIMS: Ultrasonography is the easiest, fastest procedure for the diagnosis of choledocholithiasis, but the diagnostic failure are mostly because of the intrapancreatic level of this condition and the absence of bile duct dillatation. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy in the digestive gas interposition. The aim of this study was to prospectively compare the diagnostic accuracy of endoscopie ultrasonography with abdominal ultrasonography and endoscopic retrograde cholangiography in 66 patients with suspected choledocholithiasis. METHODS: All of the patients had abdominal ultrasonography, endoscopic ultrasonography ~and endoscopie retrograde cholangiography within 72 hours and final diagnosis was determined by endoseopic retrograde cholangiography with sphincterotomy. RESULTS: (l) Choledocholithiasis was confirmed in 45 patients: Thirteen patients had nondilated common bile ducts and 20 patients had stones with diamerer < 1 cm. (2) Endoscopic ultrasonography was more sensitive(95.5%) than abdominal ultrasonography (44.4%: P<0.0001) and similar to endoscopic retrograde cholangiography (97.8%). Specificity was same as 100% in 3 diagnostic tools. (3) Endoscopic ultrasonography was superior to abdommal ultrasonography for the diagnosis of choledocholithiasis with nondilated common bile duct(100% vs 15.3%, P<0.0001) and with less than 1cm sized small stone(100% vs 10.0%, P<0.0001). Endoscopic ultrasonography results did not depend on stone diameter or common bile duct dilatation. CONCLUSIONS: Endoscopic ultrasonography could be an accurate and safe diagnostic tool for the diagnosis of choledocholithiasis and could be promising especially in the cases with difficult cannulation of bile duct and gal1 stone pancreatitis.
Bile ; Bile Ducts ; Biliary Tract* ; Catheterization ; Cholangiography ; Choledocholithiasis* ; Cholestasis, Extrahepatic ; Common Bile Duct ; Diagnosis ; Dilatation ; Endosonography* ; Humans ; Pancreas* ; Pancreatitis ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography

No abstract available.
Occupational Diseases*