No abstract available.
Constriction, Pathologic* ; Diagnosis*

Congenital coronary artery fistula(CCAF) is communication of a coronary artery or its main branch with one ofthe atria or ventricles, the coronary sinus, the superior vena cave, or the pulmoanry artery. In Korean peoples,only 4 cases of the CCAF were reported as rare as worldwide and authors want to report another case of CCAF,confirmed by operation. 10-years-old girl shows a fistula between sinus node artery of the right coronary arteryand right atrium on root aortogram with left-to-right shunt and Qp/Qs=1.58, in which simple ligation of the originof the sinus node atery from right coronary artery was performed. All of the 5 Korean CCAF(4 were previouslyreported and 1 of authors) were originated from right coronary artery, and of which 4 weee opening into rightventricle and 1 of authors were into right atrium. Associated cardiac anomaly was noted in only 1 case as singlecoronary artery, Ages were from 9 months of age to 10 years old and no adult left case were found. 3 were femaleand 2 were male patients.
Adult ; Arteries ; Coronary Sinus ; Coronary Vessels ; Female ; Fistula ; Heart Atria ; Humans ; Ligation ; Male ; Sinoatrial Node

Hand and wrist tuberculosis in adults are relatively rare disease. The purpose of treatment is to minimize the limitation of motion and to relieve the pain and swelling of involved joints. The treatments consist of curettage of bone, synovectomy and arthrodesis, which were combined with chemotherapeutic agents for tuberculosis. In the period from June 1989 to Oct. 1993, we performed operative treatment in twelve cases of hand and wrist tuberculosis(hand in 3, wrist in 9). We performed curettage and synovectomy in eight cases and arthrodesis in four. The length of follow up was over one year in all cases. Patients were evaluated by clinical examination, radiography and the Robins criteria for clinical results. The results were analysed, as follows, l. Eight patients who had tenosynovitis with moderate joint destruction were treated by curettage and synovectomy, and seven patients(87.5%) of them were evaluated "good" by Robins criteria. 2. Arthrodesis was performed in four patients who had severe joint destruction, and demonstrates "good" results in 75% of cases. 3. One patient who was treated by synovectomy, complaint intermittent pain after three years postoperatively, but no active lesion was visible on the bone scanning. 4. One patient who was performed wrist arthrodesis feels discomfort during lift up heavy products due to insufficient grip power. In conclusion, the synovectomy and curettage in early diagnosed and not so much advanced hand wrist tuberculsis is more preferable, but arthrodesis is inevitable in advanced cases with profound degree of bony destruction and nonviable cartilage in operative findings, for painless and powerful joint.
Adult ; Arthrodesis ; Cartilage ; Curettage ; Follow-Up Studies ; Hand Strength ; Hand ; Humans ; Joints ; Radiography ; Rare Diseases ; Songbirds ; Tenosynovitis ; Tuberculosis ; Wrist

BACKGROUND: In order to evaluate the prevalence of enterovirus and cytomegalovirus infections to terminally failing hearts, the presence of enteroviral RNA and cytomegaloviral DNA was screened in the explanted hearts of transplantation recipients. METHODS: RNA and DNA extractions were performed from explanted failing hearts (N=22) and normal hearts (N=5). Reverse transcription-polymerase chain reaction (RT-PCR) of enterovirus and polymerase chain reaction (PCR) of cytomegalovirus were performed. In situ RT-PCR and in situ PCR were performed with positive nucleic acids of viruses. RESULTS: The positivity of enterovirus in failing hearts was 4.4% (1/22) and 0% (0/5) in normal hearts in nested RT-PCR. There was no significant difference in positivity of enteroviral RNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ RT-PCR. The positivity of cytomegalovirus in failing hearts was 45% (10/22) and 40% (2/5) in nested PCR. There was no significant difference in positivity of cytomegaloviral DNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ PCR. Positive chambers of cytomegalovirus were in decreasing tendency according to increasing patient's age. CONCLUSION: Enterovirus was very rarely observed in explanted terminally failing hearts and cytomegalovirus was frequently found both in explanted failing hearts and normal. These viruses have little direct causal relationship with the development of heart failure.
Cardiomyopathy, Dilated ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Enterovirus* ; Heart Failure ; Heart* ; Humans* ; Mass Screening* ; Myocardium ; Nucleic Acids ; Polymerase Chain Reaction ; Prevalence ; RNA

No abstract available.
Humans ; Infant* ; Streptococcal Infections*

OBJECTIVE : To analyze the methylenetetrahydrofolate reductase (MTHFR) mutation in recurrent spontaneous abortion associated with hyperhomocysteinemia. MATERIAL AND METHOD: The blood Sample of habitual aborter with high fasting homocysteine level was tested by PCR-RFLP method. RESULTS: The patient was found to be a homozygosity for MTHFR gene mutation that was confirmed by the finding which is consistent with the mutation at the nucleotide 677 C to T, Corresponding to Ala to Val. CONCLUSIONS: Hyperhomocysteinemia due to MTHFR mutation is a cause of recurrent spontaneous abortion. Therefore, the MTHFR mutation should be examined in the workup of recurrent spontaneous abortion showing hyperhomocysteinemia.
Abortion, Spontaneous* ; Fasting ; Female ; Homocysteine ; Humans ; Hyperhomocysteinemia* ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Pregnancy

The purpose of this study was to use meta-analysis to analyze result of 17 studies which investigated the effects of integrated programs, and 11 studies which examined the effects of exercise programs on pain, depression, and disability. The 28 studies analyzed in this work were selected from the following sources: MEDLINE Search, bibliographies of related studies, main academic journals of nursing in Korea, and journals on arthritis issues. For the analysis of the data, homogeneity of effect sizes which were calculated based on data in the 28 studies was tested and its average effect size was computed by using meta analysis software package which was developed by Song(1992, 1998). the results can be summarized as follows: 1) Homogeneity tests were conducted on integrated programs on pain. In the preliminary homogeneity tests on effect size of all 17 studies, no homogeneity was found. When homogeneity tests on the effect size of the remaining 15 studies were performed, excluding two studies which had extremely larger effect size compared to other studies, the 15 studies were found to be homogeneous(Q=16.38, p=.23). The obtained average effect size, D(Mean Standardized Difference Between Means), was .25. When homogeneity tests on effect size on pain was conducted for the exercise programs, effect size for all nine studies wee found to be homogeneous(Q=7.42, p=.49) and the average effect size D=.30. Therefore, Hypothesis 1 was rejected from the results, that an average effect size of the integrated programs in pain was not significantly different from that of the exercise programs in pain. 2) Since only two studies investigated the effect of exercise programs n depression, comparison between the average effect size of integrated programs on depression could not be tested. Thereby, only the average effect size of integrated programs in depression was obtained. Eight studies wee tested to be positive on the homogeneity of effect sizes(Q=18.31, p=.02) at alpha <.01 and its average effect size was D=.11. 3) For the analysis of integrated program on disability, 13 studies, except for four which had an extremely large effect size compared to the others were found to be homogeneous at alpha <.01(Q=22.30, p=.04) and the average effect size on disability was D=.16. for analysis of the exercise programs on disability, eight studies, except for one which had an extremely large effect size compared to others, were found to be homogeneous(Q=7.87, p=.34) and the average effect size on disability was D=.60. Therefore, Hypothesis 3 was accepted from the results that an average effect size of exercise programs n disability was significantly larger than that of integrated programs in disability.
Arthritis* ; Depression ; Korea ; Nursing

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

There are many reports about the snapping syndrome in the hip, shoulder, ankle, but the snapping knee has rarely been reported. In general, the symptom of this disease was relatively tolerable for that seldom requires operative treatment. We experienced one case of snapping knee, for which the pain, easy fatigability and feeling of instability on both knee joint were main complaints. During an exploratory operation, we confirmed the gracilis and semitendinosus tendon passing over the medial tibial condyle. The clinical, radiologic and operative findings were reviewed.
Ankle ; Hip ; Knee Joint ; Knee ; Shoulder ; Tendons

The major purpose for the use of autotransfusion is to prevent the transmission of blood borne infectious agents, such as human immunodeficiency virus and non-A & non-B hepatitis virus. To evaluate the efficacy and quality of autolgous shed blood for autotransfusion, eighty patients who had total knee arthroplasty from Dec. 1992 to Mar. 1994, were included in one of two groups: Group I, who received the autotransfusion, or Group II, who did not. Each group included 20 patients of unilateral TKR and 20 patients of bilateral TKR. The Orth-evac system(Deknatel, USA) was used to salvage drained blood in the first six hours after the operation. All of the patients were evaluated for the postoperative blood loss, transfusion requirements, hemoglobin, hematocrit, platelet count, blood pressure and body temperatures. l. In bilateral TKR, the reinfusion of shed blood reduced the requirements for homologous blood by 41.4%(1.2 pints in group I versus 2.9 pints in group II). In unilateral TKR, it was decreased to 36.4%(0.4 pint in group I vs 1.1 pint in group II). 2. In bilateral TKR, the requirements for homologous transfusion was decreased from 95% of patients in control group to 55% in group I .In unilateral TKR, it was decreased from 60% to 20%. 3. There were four patients who had high fever above 39℃ after autotransfusion. 4. At the immediate postoperative period there were two patients who had hypovolemic shock in group I patients who had bilateral TKR. 5. There was no clotting abnormality, no transfusion reaction and no thromboembolic disease in group I patients. In conclusion, the reinfusion of autologous shed blood after TKR is an acceptable alternative to the homologous transfusion without untoward effect.
Arthroplasty, Replacement, Knee ; Blood Transfusion, Autologous ; Body Temperature ; Fever ; Hematocrit ; Hepatitis Viruses ; HIV ; Humans ; Knee ; Platelet Count ; Postoperative Hemorrhage ; Postoperative Period ; Shock ; Transfusion Reaction