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.

No abstract available.
Echocardiography* ; Heart Defects, Congenital*

TGF-p receptor mutation is now considered as one of the carcinogenic process of many tumors. To evaluate whether there is an abnormality in TGF-p type II receptor in osteosarcoma cell lines, we performed Northern analysis, cross-linking assay, luciferase activity and TGF-p growth inhibition assay in four osteosarcoma cell lines: G292, U202, HOS and SaOS. We also transfected the tumor cells with normal TGF-p type II receptor sequence to find if there is a possibility of gene therapy in osteosarcoma. In Northern analysis, Type II receptor expressions were decreased at SaOS, U202 and HOS cell lines. In cross-linking assay, all four cell lines didnt show type II receptor at their cell surface. The growth of these tumor cells were not suppressed by TGF-p. From these findings, we concluded that the normal production of TGF-p type II receptor was impaired in osteosarcoma. The transfection of these tumor cells with normal type II receptor sequence restored growth inhibition by TGF-p. This means even though TGF-p type II receptor is abnormal in osteosarcoma, we can restore its function by transfection of normal sequence. We think that the TGF-p type Il receptor gene therapy can be one of the treatment method for osteosarcoma in the future.
Cell Line* ; Genetic Therapy ; Luciferases ; Osteosarcoma* ; Transfection

The individual onset of action of pancuronium and vecuronium has been examined with a priming dose of same or the other agent or two times priming. Measurement of changes in the Tl% of TOF ratio of the adductor pollicis muscle were performed by Accelograph (Biometer). Sixty adult patients were administered Vecuronium(V) 0.015mg/kg (group 1), V 0.005mg/kg 3 minutes after 0.01mg/ kg(group 2), Pancuronium(P) 0. 015 mg/kg(group 3,4) as a priming agents. After 5 minutes, the intubating dose of V 0.085mg/kg (group 1,2,3), P 0.085 mg/kg (group 4) were administered with the induction agent, thiopental sodium 5 mg/kg. All sixty patients underwent orotracheal intubation at 60 seconds after the injection of intubating dose. Intubation condition, reduction of Tl% at 60 seconds, the onset time of maximal blockade (Tl 0%) were evaluated. There was no difficulty in intubation. Fifty-two (86%) patients were distributed in exellent and satisfactory grade of largest in group 2. While group 3 showed more rapid than group 4, group 2 showed the most rapid onset time significantly. These results indicate that the twicely divided dose of vecuronium for priming agent may be adequate and vecuronium after priming with pancuronium is more rapid than priming with same agent.
Adult ; Humans ; Intubation ; Intubation, Intratracheal* ; Pancuronium* ; Thiopental ; Vecuronium Bromide*

Transforming growth factor-beta (TGF-beta) has been suspected as a possible gene therapy candidate for orthopedic diseases. We demonstrated that the TGF-beta gene therapy can be applicable to orthopedic patients. After transfection of TGF-beta cDNA sequence to myoblasts [C2 (280)] and fibroblasts (NIH 3T3), stable cell lines with TGF-beta mRNA expression were selected by Northern analysis. To evaluate the possibility of clinical application of these cells to orthopedic diseases, the cells were injected into rabbit achilles tendon. Intratendinous injection was done to evaluate the viability of the cells and to determine the optimal concentration for in vivo expression. At 6 weeks after injection, the injected tendon was thickened with newly formed collagen. The results from this experiment indicates that these cells survived and stimulated matrix formation in rabbit achilles tendon. We concluded that TGF-beta cDNA transfected cells can be useful in the evaluation of TGF-beta biology in vivo.
Achilles Tendon* ; Biology ; Cell Line* ; Collagen ; DNA, Complementary ; Fibroblasts* ; Genetic Therapy ; Humans ; Myoblasts* ; Orthopedics ; RNA, Messenger ; Tendons ; Transfection ; Transforming Growth Factor beta*

No abstract available.
Asthma*

PURPOSE: We reviewed 5 years worth of experience with peritoneal drainage and dialysis in infants who underwent open heart surgery. The aim of this study was to investigate the effect of peritoneal drainage and peritoneal dialysis on fluid balance and several parameters of intensive care. METHODS: Six(10%) of 60 consecutive infants who underwent open heart surgery required peritoneal dialysis during peritoneal drainage. Simple peritoneal drainage was performed in the remaining 54 infants. The silicone rubber peritoneal dialysis catheter was inserted into the center of abdominal cavity just after operation, and subsequent peritoneal drainage was maintained during intensive care. RESULTS: Mean age of the study group was 0.48+/-0.21 years(M: F=32: 28). Early postoperative mortality amang the infants with congenital heart disease was 1.6%. Total amount of output was 7.0+/-2.28mL/kg/hr, urine output 5.14+/-2.9lmL/kg/hr, pleural fluid 0.80+/-0.5lmL/kg/hr, and peritoneal fluid 1.20+/-0.90mL/kg/hr. The ratio of output to intake(O/I) was 1.06. None of the complications required early termination of peritoneal drainage or peritoneal dialysis. Hemodynamics and pulmonary function were maintained steadily during postoperative intensive care. CONCLUSION: The early institution of peritoneal drainage and peritoneal dialysis in infants with congenital heart disease after cardiac operations not only removes fluid, thus easing fluid restriction, but may also improve cardiopulmonary function.
Abdominal Cavity ; Ascitic Fluid ; Catheters ; Dialysis ; Drainage* ; Heart Defects, Congenital* ; Heart* ; Hemodynamics ; Humans ; Infant* ; Critical Care ; Mortality ; Peritoneal Dialysis ; Silicone Elastomers ; Thoracic Surgery ; Water-Electrolyte Balance

BACKGROUND: Tracheal intubation commonly results in sympathetic stimulation manifested by increased heart rate and arterial blood pressure. This study was carried out to determine whether lightwand would result in less hemodynamic changes than direct laryngoscopy. METHODS: With informed consent, fourty healthy female patients scheduled of elective surgical procedures were randomly allocated into two groups; lightwand (LW) or direct laryngoscopy (DL) group. Mean arterial pressure (MAP) and heart rate (HR) were recorded upon arrival. Under a standardized anesthetic technique, the patients were intubated either with no. 3 curved blade direct laryngoscopy (DL group) or with lightwand (LW group). The MAP and HR were recorded before intubation and every 1 minutes following intubaion. Time to intubation (TTI) was also recorded. All patients were intubated by a same fourth grade resident. RESULTS: Fourty patients were studied. Every intubation was successed in first attempt. The TTI was significantly shorter in LW group. Even while there was no significant difference in HR changes, there was significant difference in the increase of MAP following intubation. The increase of MAP was significantly greater with DL than with LW. CONCLUSIONS: This study suggests that lightwand intubation requires shorter TTI and may give rise to less blood pressure change than direct laryngoscopy. So we found no difference in disadvantage and may offers advantage in terms of hemodynamic stability.
Arterial Pressure* ; Blood Pressure ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Informed Consent ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy* ; Surgical Procedures, Elective

No Abstract Available.
Pterygium*