In order to define the relation between echocardiographically determined left atrial size and atrial fibrillation(AF) in rheumatic mitral valvular heart disease, 44 patients with mitral valvular heart disease with AF, 29 patients with mitral valvular heart disease without AF, 24 patients with idiopathic AF and 24 normal controls were studied. In mitral valvular heart disease with AF group, AF was more common when the absolute left atrial internal diameter(LAID) was above 50 mm(86.4%) than in mitral valvular heart disease without AF group(41.4%). In addition, although the values of LAID, LA(left atrium)/Aortic Root ratio and LA/BSA(body surface area) are higher in mitral valvular heart disease with AF group than in mitral valvular heart disease without AF group(p<0.05), there was no correlation between LAID and BSA(r=0.06). These findings suggest that an absolute value of LAID is a more important factor in the development of AF in mitral valvular heart disease than LAID considered in conjunction with BSA and that an absolute LAID of 50 mm may be used as a reliable guide to therapeutic and prophylactic intervention in AF associated with mitral valular heart disease.
Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans

No abstract available.
Animals ; Brain* ; Rats* ; Serotonergic Neurons*

Septic arthritis of the children's hip causes acute or chronic inflammatory change in structure about the joint, and results in serious destruction. Due to recent advance of the diagnostic technique and of the antibiotics, the incidence of it's sequelae is decreased. The management of acute stage with antibiotics and early surgical drainage has been well established in the literature, but the management of residual anatomic deformity is less documented, and little comprehensive classification or treatment program has been outlined. We experienced two patients who had sequelae induced by delayed diagnosis and improper treatment. One had a complete loss of femoral neck with femoral head remaining in the acetabulum. Femoral neck reconstruction was performed using proximal femur : i.e., Open reduction of femoral head to femur shaft with distal transfer of greater trochanter (1st stage) followed by varus osteotomy(2nd stage) and follow-up period was 3.5 years. Another had loss of femoral head and neck, dislocation of the hip, and Larsen's trochanteric arthroplasty was performed with 6 Years follow-up. Satisfactory results were obtained in both patients who had reconstructive surgery, so we report these cases with related literatures.
Acetabulum ; Anti-Bacterial Agents ; Arthritis, Infectious ; Arthroplasty ; Child ; Classification ; Congenital Abnormalities ; Delayed Diagnosis ; Dislocations ; Drainage ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Joints ; Neck

The accuracy of fine needle aspiration cytology (FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases (43.6%) were diagnosed as tuberculosis, 4 (10.3%) as granulomatous lymphadenitis, 3 (7.7%) as necrotizing lymphadenitis, and 15 (38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

The results of alpha-acetyldigoxin(Dioxanin(R)) administration in 21 patients with congestive heart failure were as follows. Alpha-acetyldigoxin is a new oral preparation of cardiac glycoside derived from lanatosid C. 1. For rapid digitalization in 2-3 days, the initial dose was 1.2 to 2.6mg (average 1.96mg). For medium-fast digitalization in 4 days, the loading dose was 2.0 to 3.2mg (average 2.7mg). For slow digitalization 0.1 to 0.4mg was required for 5 to 6 days without loading dose. The maintenance dose was 0.1 to 0.4mg (average 0.33mg) daily. 2. The therapeutic effect of acetyldigoxin was excellent in 15 cases (71%), good in 4 cases (20%) and stationary in 2 cases (9%). 3. Side effects were observed in 2 cases with usual dosage regimen. One accidental case who took single dose of 4mg(20 tablests) developed supraventricular tachycardia with varying degree of atrioventricular block, ventricular bigeminy and premature beat but recovered completely after 6 days.
Acetyldigoxins* ; Atrioventricular Block ; Cardiac Complexes, Premature ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Tachycardia, Supraventricular

Tibric acid is a new oral hypolipidemic agent with the chemical name of 2-chloro-5(3,5-dimethyl piperidinosulfonyl) benzoic acid. The results of tibric acid administration in 22 patients with primary hyperlipidemia were as follows. 1) Serum triglyceride level was significantly decreased in 84.6% of 22 cases with an average 43.9% decrease in serum triglyceride. 2) Serum cholesterol level was decreased in 59.1% of 22 cases with an average 15.8% decrease in serum cholesterol. The decrease in serum cholesterol level was not significant. 3) It seemed that there were significant falls in the serum triglyceride of the hyperlipoproteinemia type IV and IIb patietns and in the serum cholesterol of type IIa patients 4) The side effects of tibric acid were indigestion, loose stool and anorexia. There was no side effects in 63.6% of cases.
Anorexia ; Benzoic Acid ; Cholesterol ; Dyspepsia ; Humans ; Hyperlipidemias* ; Hyperlipoproteinemia Type IV ; Triglycerides

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

This is a report of clinical study on the 63 patients of symptomatic urinary tract infection who were hospitalized at the Department of Pediatrics in Kangnam General Hospital during the period between the May of 1989 and the September of 1992. The observation results were as follows: 1) The frequency of urinary tract infection (UTI) was the highest in children under the age of one year (66.7%). 35 patients were male, while the other 28 were female. The ratio of male and female patients was 1.25:1. 2) Fever was observed in most of the cases. Systemic nonspecific manifestation was predominant in the infancy and early childhood, whereas local symptom of UTI was predominant in the late childhood. Among the 35 male patients, 32 cases were phimoses. As for the other 3 cases, Phimoses were not identified. 3) E. coli had the most frequency (65.3%), followed by Klebsiella, Enterobacter, Pseudomonas in descending order. 4) In the vitro antimicrobial susceptibility test, Gram negative organisms such as E. coli Klebsiella, Enterobacter were sensitive to cefotaxime, amikacin, and ampicillin/sulbactam. Meanwhile, Gram positive organisms such as Staphylococcus, Enterococcus were sensitive to vancomycin and cephradine. 5) The renal ultrasonography test was performed for 59 patients, 13 cases of whom showed abnormal findings. 6 cases out of the 13 abnormal patients had hydronephrosis. 6) DMSA renal scan was performed for 40 patients within 2 months of an acute pyelonephritic attack. Signs of pyelonephritic change were found in 18 patients. DMSA scan was repeated 4~12 months later in 4 of these patients. This showed renal cortical scarring in all patients. 7) Voiding cystourethrographic findings in 38 patients showed vesicoureteral reflux in 13 patients. 8) We performed urine culture again after 48 hours from the beginning of therapy and 85.5% of the cases became sterile. 9) The recurrent percentage of UTI was 23.8% with the ratio of 1:1.5 between male and female. Most of the patients were clildren under the age of one year. 10) Operations were made on two cases showing the increase of reflux during the follow-up of unilateral Grade ll and Grade 3 reflux, respectively. Operations were also performed on other two cases with bilateral Grade IV reflux. All the cases were good after the operations. In the meantime, as for another two cases having the right reflux of Grade lland the bilateral reflux of Grade lll, the refluxes were able to be reduced by prophylaxis only, in the course of following up.
Amikacin ; Cefotaxime ; Cephradine ; Child* ; Cicatrix ; Enterobacter ; Enterococcus ; Female ; Fever ; Follow-Up Studies ; Hospitals, General ; Humans ; Hydronephrosis ; Infant* ; Klebsiella ; Male ; Pediatrics ; Phimosis ; Pseudomonas ; Staphylococcus ; Succimer ; Ultrasonography ; Urinary Tract Infections* ; Urinary Tract* ; Vancomycin ; Vesico-Ureteral Reflux

A one step reverse transcription PCR (RT-PCR) combined nested PCR was set up to increase efficiency in the diagnosis of canine distemper virus (CDV) infection after developement of nested PCR. Two PCR primer sets were designed based on the sequence of nucleocapsid gene of CDV Onderstepoort strain. One-step RT-PCR with the outer primer pair was revealed to detect 10(2) PFU/ml. The sensitivity was increased hundredfold using the one-step RT-PCR combined with the nested PCR. Specificity of the PCR was also confirmed using other related canine virus and peripheral blood mononuclear cells (PBMC) and body secretes of healthy dogs. Of the 51 blood samples from dogs clinically suspected of CD, 45 samples were revealed as positive by one-step RT-PCR combined with nested PCR. However, only 15 samples were identified as positive with a single one step RT-PCR. Therefore approximately 60% increase in the efficiency of the diagnosis was observed by the combined method. These results suggested that one step RT-PCR combined with nested PCR could be a sensitive, specific, and practical method for diagnosis of CDV infection.
Animals ; Distemper Virus, Canine/genetics/*isolation & purification ; Dogs ; Polymerase Chain Reaction/*methods/*veterinary ; RNA, Viral/genetics/isolation & purification ; Reverse Transcriptase Polymerase Chain Reaction ; Vaccines, Attenuated ; Viral Vaccines

PURPOSE: The main purpose of this study was to evaluate effects of non-nutritive sucking (NNS) on the oxygen saturation level and behavioral state of preterm infants during tube feeding. METHODS: This study was performed prospectively in the NICU, Chonbuk National University Hopspital from November, 2004 through April, 2005. Preterm infants of gestational age 28 to 37 weeks, who had neither major congenital defects interfering feeding nor respiratory difficulty needing ventilatory support, were included. A total of 64 subjects were divided randomly into the control group (n=32), and the non-nutritive sucking (NNS) group (n=32). The patients in each group were tested for changes in oxygen saturation and behavioral state at 3 different times; 2 minutes before, during, and 2 minutes after feeding. RESULTS: The oxygen saturation of the NNS group increased during feeding and gradually decreased after feeding while the control group decreased during feeding and increased slightly after feeding (P<0.001). During feeding, the "quiet awake" state was observed more frequently in the NNS group and the "crying" state was observed more frequently in the control group. During the post-feeding assessment, the "sleep" state was more frequent in the NNS group and the "crying" state was more frequent in the control group. CONCLUSION: The infants in the NNS group showed significantly higher oxygen saturation level and they were less fussy during tube feeding and slept better after feeding.
Congenital Abnormalities ; Enteral Nutrition* ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Jeollabuk-do ; Oxygen* ; Prospective Studies