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

No abstract available.
Fingers* ; Toes*

Hypertrophic scarring is common in burn patients. The treatment of such scarring is difficult, and recurrence of the hypertrophic change after scar revision is not uncommon. It has been done intramarginal excision to diminish the chances of recurrent hypertrophic scarring. Core scars in the auricle are easily separated from auricular cartilage and overlying soft tissue because there is loose areolar tissue between them. We therefore reviewed our experience with core extirpation of post-burn hypertrophic scars in the auricle. Between June 14, 1991, and August 6, 1994, we excised 10 hypertrophic scars in the auricle in 5 burn patients. Core extirpations of hypertrophic scars were performed under local anesthesia with longitudinal incision along long axis of scars. The wounds were closed directly in one layer after marginal trimming. We observed that core extirpation yielded good results in post-burn hypertrophic scars in the auricles.
Anesthesia, Local ; Axis, Cervical Vertebra ; Burns ; Cicatrix ; Cicatrix, Hypertrophic* ; Ear Cartilage ; Humans ; Recurrence ; Wounds and Injuries

A secondary cleft lip nasal deformity can be corrected by many procedures including central lip tissue transfer, forked flap, nasal floor and alar base advancement, nasal skin flaps and composite graft. These procedures have been applied for many years, but each one has some conspicuous residual problems. We propose triple V-Y advancement flaps, which we have performed on 13 secondary cleft lip and nasal deformity patients over the past 6 years. The W-shaped triple reverse V-shaped incision easily exposed the alar cartilages. We made the advancement and rotation of the nasal skin flap to lengthen the columella and project the nasal tip. Postoperatively, the columella length and nasolabial angle were found to be increased by an average of 3.7 mm and 42 degrees, respectively. In lateral view, a relatively natural nasal line was achieved. The scar in the nasal tip posed few problems. This procedure should be useful for the correction of the secondary cleft lip nasal deformity.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Lip ; Skin ; Transplants

No abstract available.
Dyspnea* ; Hypothyroidism*

No abstract available.
Colon*

PURPOSE: The aim of this research was to identify the mediating effect of sleep quality on the relationship between job stress and stress response of shift-working nurses.METHODS: The participants in this study were 150 nurses who had more than 6 months of shift-working experience. A survey was conducted from May to June 2017 in a hospital in Gyeonggi-do, South Korea. The data were collected through self-report questionnaires. The collected data were analyzed using SAS 9.4 program. The analysis was based on Baron and Kenny's model to examine the mediating effects of sleep quality on the relationship between job stress and stress response of shift-working nurses.RESULTS: In the first and second steps, job stress was identified as a significant predictor of sleep quality (β=.29, p=.001) and stress response (β=.24, p=.004). In the third step, sleep (β=.55, p < .001) was observed as a significant predictor of stress response, and the direct relationship between job stress and stress response was not significant (β=.07, p=.291). Sleep quality was found to exhibit complete mediating effect on the relationship between job stress and stress response.CONCLUSION: The results of this study suggest that strategies for managing the stress of shift-working nurses should include effective ways to ensure sleep quality.
Gyeonggi-do ; Korea ; Negotiating

PURPOSE: To investigate the clinical outcomes of scleral buckle encircling surgery for the retinal detachment of retinopathy of prematurity (ROP). METHODS: The medical records of the patients who had undergone primary scleral buckle encircling for the retinal detachment of ROP (4A, 4B, 5) between January 1989 and March 2002 were retrospectively reviewed. RESULTS: Of the 59 patients (M:F ratio= 32:27, 83 eyes), the mean gestational age, birth weight, and follow-up period were 29.2 weeks, 1244gm, and 52.8 months respectively. Just before scleral buckle encircling surgery there were 48 eyes of stage 4A, 19 of stage 4B, and 16 of stage 5. Attachment of posterior pole retina was achieved in 66.7%, 63.2%, and 25% of eyes, respectively. Final best corrected visual acuity in eyes with attached posterior pole retina was generally poor, and the rate of vision over 20/1000 was 30.3% (10/33) in the verbal group and the rate of vision with moderate fix and follow was 75% (9/12) in the nonverbal group. The mean induced anisometropia after scleral buckle encircling surgery was -12.1 D. The mean reduced myopia after removal of scleral buckling material was 3.4 D. CONCLUSIONS: An anatomic success after scleral buckle encircling surgery in infant with retinal detachment of ROP was fairly achieved, but the final results depended on the extent of retinal detachment. Although the retina was attached after surgery, a severe degree of myopia developed and resulted in low vision. Therefore once retinal detachment develops in infants with ROP, early surgery is required. Furthermore, to maximize the vision, efforts for correcting refractive errors should be made intensively.
Anisometropia ; Birth Weight ; Follow-Up Studies ; Gestational Age ; Humans ; Infant ; Medical Records ; Myopia ; Refractive Errors ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retinopathy of Prematurity* ; Retrospective Studies ; Scleral Buckling ; Vision, Low ; Visual Acuity

Most of the malignant tumors of the pancreas are adenocarcinomas arising from the ductal epithelium. Primary leiomyosarcoma of the pancreas, even though it is the most common sarcoma of the pancreas, is very rare. We present a case of leiomyosarcoma of the pancreas, probably primary, with metastases to the stomach, lymph nodes, and abdominal wall. A 52-year-old woman visited the hospital with vague right upper abdominal pain and weigh loss of 6 kg for 2 months. The radiological and endoscopic examination revealed that she had a large heterogeneous mass, 11 cm in size, in the pancreatic body and tail, a 4 cm-sized mass in the paraaortic area, and a 3 cm-sized polypoid mass in the stomach. Histologically, they were all similar to one another and composed of markedly pleomorphic cells. Immunohistochemical and electron microscopic studies showed definite smooth muscle differentiation of the tumor cells. Two months later, the patient underwent an excision of a new 3 cm mass in the right lower abdominal wall, showing features of well differentiated leiomyosarcoma.
Abdominal Pain ; Abdominal Wall ; Adenocarcinoma ; Epithelium ; Female ; Humans ; Leiomyosarcoma* ; Lymph Nodes ; Middle Aged ; Muscle, Smooth ; Neoplasm Metastasis ; Pancreas* ; Sarcoma ; Stomach

The distribution of pemphigus subclass autoantibodies in a patient with pemphigus vulgaris (PV) has been investigated by semiquantitative indirect immunofluorescence (IIF), using the HP series monoclonal antibodies specific for four human IgG subclasses on human foreskins. IgG1 and IgG4 intercellular substance-specific autoantibodies were detected in the serum of the patient, whereas IgG2 and IgG3 autoantibodies were absent. In addition to foreskins, human tonsillar epithelia were used as substrates of IIF for detecting the PV autoantibodies and it was one of satisfactory substitutes for monkey esophagus.
Antibodies, Monoclonal ; Autoantibodies* ; Esophagus ; Fluorescent Antibody Technique, Indirect ; Foreskin ; Haplorhini ; Humans ; Immunoglobulin G* ; Pemphigus*