BACKGROUND: Noninvasive estimation of pulmonary artery pressure is an important component of echocardiographic studies. A number of methods are available for estimation of pulmenary pressure, each with varying degrees of reported accuracy. To assess accuracy and difficulties, noninvasive pulmonary artery pressure estimates were performed in infants and children with congenital heart diseases. METHODS: Noninvasive estimates from 8 methods were compared with catheterization measurements. Systolic pressure was estimated by the Burstin method and from perak tricuspid regurgitation velocity, and also from systolic pressure gradients through the VSD(ventricular septal defect) and PDA(patent ductus arteriosus). Mean pressure was estimated by acceleration time divided by ejection time measured from Koppler spectrum obtained at the right ventricular out flow tract. Diastolic pressure was estimated from pulmonary regurgitation velocity spentrum at end-diastolic, and also from diastolic pressure gradient through the patent ductus arteriosus. RESULTS: IN systolic pressure, Burstin and tricuspid regurgitation velocities estimates correlated significantly(r=0.92, 0.90 respectively), whereas VSD and PDA estimates correlated less well with catheterization estimates(r=0.83, 0.65 respectively). The mean pressure, measured from RVOT(right ventricular outflow tract) Doppler spectrum corresponded well with catheterization pressure(r=0.89), whereas those obtained from the main pulmonary artery correlated less well(r=0.74). The diastolic pressure estimates from pulmonary regurgitation velocity spectrum, revealed good correlation(r=0.79), but those from diastolic Doppler spectrum at PDA correlated less well with catheterization estimates(r=0.63). CONCLUSION: All of eight Doppler echocardiographic methods seemed to be easily performable for estimation of pulmonary artery pressure. But, the degree of accuracy was variable. Because a pressure estimante from only a single method may be in error, care should be taken in combining use of other(one or two) methods.
Acceleration ; Blood Pressure ; Catheterization ; Catheters ; Child ; Ductus Arteriosus, Patent ; Echocardiography* ; Echocardiography, Doppler ; Heart Diseases ; Humans ; Infant ; Pulmonary Artery* ; Pulmonary Valve Insufficiency ; Tricuspid Valve Insufficiency

Many kinds of operations have been devised to treat Kienböck's disease with variable results. But no one have mentioned about the advantage of early motion in distraction to prevent the fibro-osseous ankylosis and carpal collapse. Two cases with Kienböck's disease were treated by the complete excision of the lunate and replacement of it with pronator quadratus muscle pedicled rectangular bone graft. Once these procedures were accomplished, the distraction-motion devices were used to maintain the joint surfaces separated at predetermined distances while kinematically normal joint motion was gradually restored. Although the experience is limited to two cases, the final results seem to be very promising.
Ankylosis ; Arthroplasty ; Joints ; Transplants

No abstract available.
Anemia, Hemolytic* ; Cholelithiasis* ; Hepatolenticular Degeneration*

This study is a methodical research to develop a health behavior assessment scale for patients with rheumatoid arthritis, and to test the validity and reliability of the instrument. The research procedure was as follows; 1) The first step was to develop conceptual framework based on a comprehensive review of the literature, in-depth interviews patients with rheumatoid arthritis. This conceptual framework was organized in eight dimensions; pain management, exercise, rest, diet control, active committment, self-management, positive thinking, interpersonal maintenance. Initially 56 items were selected from 164 statement. 2) These items were reviewed by panel of eight specialists and the Index of Content validity (CVI) was calculated, and forty six items were selected which met more than 70% on the CVI. 3) 174 rheumatoid arthritis pateints were interviewed, and data was gathered from Jan. 25 to Feb. 18, 1999 for test reliabilities and validities of the scale. The item analysis was carried out and 40 items were selected. Factor analysis by varimax rotation was carried out to test construct validity. The internal consistency by chronbach's alpha was calculated. The findings were as follows; 1) Item analysis and factor analysis were carried out to test the validity of the health behavior assessment scale. The item analysis was based on the corrected item`s to total correlation coefficient (.30 or more), and information about the alpha estimate. However, this was only if this item was deleted from the scale. As a result of the item analysis, forty items were selected. Thirty items were selected by a initial factor analysis by varimax rotation, and ten items were deleted because of factor complexity. In the secondary factor analysis, eight factors were labled as 'positive thinking', 'exercise', 'rest', 'pain management', 'active committment', 'self-management', 'diet control', and 'interpersonal maintenance', each similar with the conceptual framework. 2) Chronbach's alpha coefficient to test reliability of the scale was. 903 for total the thirty items. The Scale for assessing health behavior developed in this study was identified to be a tool with a high degree of reliability and validity. Therefore this scale can be effectively utilized for assessment in the health behaviors of the patients with rheumatoid arthritis.
Arthritis, Rheumatoid* ; Diet ; Health Behavior* ; Humans ; Pain Management ; Reproducibility of Results ; Self Care ; Specialization ; Thinking

No abstract available.

A case of rare subcutaneous sparganosis in thigh treated by surgical excision is reported. In this 49year-old male with a palpable mass on the anteromedial aspect of mid-thigh (5x7x5cm sized) which was misdiagnosed with a soft tissue tumor initially, a sparganosis was suspected by a plain x-rays, bone scan and his past history which he frequently had raw snakes, frogs and raw fishes before but confirmed by MRI and surgical excision. This represents tor warning to some Koreans who have frequently comsumed raw fishes, snakes or frogs etc., and to some doctors because it is easily confused with a soft tissue tumor.
Fishes ; Humans ; Magnetic Resonance Imaging ; Male ; Snakes ; Sparganosis* ; Subcutaneous Tissue* ; Thigh*

Purpose: To evaluate the efficacy of the preventive abduction brace in dementia patients after bipolar hemiarthroplasty of the hip. Materials and Method: A review of 30 patients who had dementia prior to bipolar hemiarthroplasty of the hip. 20 females and 10 males were evaluated and their mean age was 80.4 years old (range, 68 to -92 years old). The average MMSE-K in dementia patients was 14.2 (range, 8 to 20). The reasons for the bipolar hemiarthroplasties were femoral neck fractures in all the cases. We analyzed the dislocation rates of those who had preventive abduction braces applied prospectively. Results: The average follow-up period after hemiarthroplasty was 2.2 years. All 30 patients had preventive abduction braces and no dislocations occurred after the bipolar hemiarthroplasties. Conclusion: Hip dislocations were not detected in those patients who preventive abduction braces applied. The present findings suggest that having a preventive abduction brace will definitely reduce the dislocation rate in dementia patients who have difficulties with rehabilitation after their operations.
Braces* ; Dementia* ; Dislocations ; Female ; Femoral Neck Fractures ; Follow-Up Studies ; Hemiarthroplasty* ; Hip Dislocation ; Hip* ; Humans ; Male ; Prospective Studies ; Rehabilitation

The long term administration of anti-convulsants on children with convulsive disorders may cause osteomalacia, depending on the dosage, duration, type and combination of anti-convulsants administred. Fifteen children, comprising 10 male and 5 female, dignosed with convulsive disorders and administered with phenobarbital for a long term period of more than 9 months but less than 84 months and 15 healthy children of a similar age-group were selected for the investigation the density of she spinal backbone of each individual was measured by means of the "QDR-2000 X-ray bone densitometer's (made by Hologic company) which uses the double energy X-ray absorption technique. The levels of serum calcium, phosphrus and alkaline phosphatase for each child were also measured for comparative analysis. The results were as follows: 1) The mean bone density for the healthy group of chlidren was 0.69+/-0.09g/cm(2) and that for the group of children administered with phenobarbital was 0.59+/-0.07cm(2) indicating a significant decrease in density for the latter group (p<0.05). 2) As for the relationship between the duration of phenonbarbital and the decrease in bone mineral density, 5 of 6 patients(83%) administered with phenobarbital for more than 4 years showed a decrease in bone mineral density and 5 of 9 patients (56%) administered with phenobarbital for less than 4 years showed a decrease in bone mineral density. 3) the mean vitamin D level for the healthy group of chlidren was 26.8+/-2.5pg/ml indicating a significant decrease in vitamin D3 level for this group(p<0.05). 4) The mean serum alkaline phospatase evel for the health group of children was 240+/-50u/L and 462+/-110u/L for those administered with phenobarbital. This indicate a significant increase in ALP for phenobarbital group(p<0.05). 5) The posphorus and calcium levels were within the normal range for all the groups of children.
Absorption ; Alkaline Phosphatase ; Bone Density* ; Calcium ; Child* ; Cholecalciferol ; Female ; Humans ; Male ; Osteomalacia ; Phenobarbital* ; Reference Values ; Vitamin D

No abstract available.
Granuloma* ; Intubation*

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy and an increasing global public health problem. OSCC frequently invades the jaw bone. OSCC-induced bone invasion has a significant impact on tumor stage, treatment selection, patient outcome, and quality of life. A number of studies have shown that osteoclast-mediated bone resorption is a major step in the progression of bone invasion by OSCC; however, the molecular mechanisms involved in OSCC bone invasion are not yet clear. In this review, we present the clinical types of OSCC bone invasion and summarize the role of key molecules, including proteases, cytokines, and growth factors, in the sequential process of bone invasion. A better understanding of bone invasion will facilitate the discovery of molecular targets for early detection and treatment of OSCC bone invasion.
Bone Resorption ; Carcinoma, Squamous Cell ; Cytokines ; Epithelial Cells ; Intercellular Signaling Peptides and Proteins ; Jaw ; Patient Selection ; Peptide Hydrolases ; Public Health ; Quality of Life