We reviewed the clinical and hemodynamic studies in 10 patients with the isolated congenital mitral insufficiency. The patients ranged in age from 6 months to 16 years at the time of diagnosis and the incidence was 0.26% among the total congenital heart disease proven by cardiac catheterization and angiography. In two cases anterior mitral cleft was demonstrated by 2-D echocardiography and/or operation. In two cases left coronary artery was originated from pulmonary artery. Eight cases out of ten presented symptoms indicating varying degrees of left ventricular failure. Apical systolic murmur was heard in all except one, who had only triple rhythm. The electrocardiograms revealed left ventricular hypertrophy in 8 cases and biventricular hypertrophy in 2 cases. Roentgenographically left atrial enlargement was observed in 4 cases. Left arterial and ventricular dimension were increased in 7 cases by echocardiography. In 5 cases of them, pulmonary artery wedge pressure or left atrial pressure was increased. One patient died in congestive heart failure at the age of 10 months and one patient died postoperatively. Other 4 patients have been managed with medication without difficulty.
Angiography ; Atrial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Electrocardiography ; Heart Defects, Congenital ; Heart Failure ; Hemodynamics ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular ; Incidence ; Mitral Valve Insufficiency* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Systolic Murmurs

No abstract available.
Evoked Potentials* ; Intercostal Nerves* ; Neural Conduction*

BACKGROUND: In congenital heart disease, the lung perfusion through stenosed pulmonary artery is usually decreased. And this decrement of lung perfusion also occurs with diaphragmatic palsy after the operation of congenital heart disease. It is difficult to delineate the amount of lung perfusion in case of combination of pulmonary artery stenosis and diaphragmatic palsy. We examined the change of lung perfusion after the induction of diaphragmatic palsy in rabbits. METHODS: We dissected left phrenic nerves in 20 rabbits to induce left diaphragmatic palsy. The lung perfusion scan was performed with 99mTc-MAA and the movement of diaphragm was examined with fluoroscopy. They were performed as baseline data and on 3rd and 10th day postoperatively. The amount of left lung pefusion before and after diaphragmatic palsy was compared and analysed in 12 rabbits which definitely had diaphragmatic palsy. RESULTS: Weight of the rabbits was 1.65+/-0.26 kg. Left lung perfusion percent was 45.93+/-6.42% before operation and these were 32.48+/-6.09% and 37.62+/-3.39% on the 3rd and 10th postoperative day, respectively. Left lung perfusion was significantly decreased just after diaphragmatic palsy but it was not changed thereafter. The decrement of lung perfusion was not affected by the body weight. The decreased amount of left lung perfusion was reciprocally correlated with the body weight of the rabbits on the postoperative 3rd day but not 10th day. CONCLUSION: Left lung perfusion percent of the rabbits was decreased 7% with the induction of diaphragmatic palsy and the decreased amount was reciprocally correlated with the body weight just after the diaphragmatic palsy was induced.
Body Weight ; Constriction, Pathologic ; Diaphragm ; Fluoroscopy ; Heart Defects, Congenital ; Lung* ; Paralysis* ; Perfusion* ; Phrenic Nerve ; Pulmonary Artery ; Rabbits

OBJECTIVE: To determine the relationship of the Mini-Mental State Examination (MMSE) scores to the functional improvement of the brain-injured patients with a traumatic brain injury or cerebrovascular accident. METHOD: Thirty patients who were admitted to a rehabilitation hospital for their initial brain injury were retrospectively studied. Subjects were administerd a MMSE as cognitive assessment and a Functional Independence Measure (FIM) and Modified Barthel Index (MBI) as functional assessment upon referral for the rehabilitation and at discharge. RESULTS: MMSE scores, FIM scores and MBI scores at discharge increased significantly compared to the scores at the start of rehabilitation. The changes of MMSE scores significantly correlated with the changes of FIM scores and MBI scores in 30 brain injured patients (p<0.001). Among the subitems of FIM, the social cognition, communication, self care, and sphincter control were strongly correlated with the MMSE scores. CONCLUSION: We conclude that the MMSE can be a relevant predicting factor for the changes of functional status of brain-injured patients from a inpatient stroke rehabilitation and post brain- injury rehabilitation.
Brain Injuries ; Brain* ; Cognition ; Humans ; Inpatients ; Referral and Consultation ; Rehabilitation ; Retrospective Studies ; Self Care ; Stroke

To evaluate the predictive values of oxygenation index (OI), arterial-alveolar oxygen tension ratio (a/APO)2, and alveolar-arterial oxygen gradient ((A-a)DO2) for early recognition of responsiveness to high frequency oscillatory ventilation (HFOV) in very low birth weight infants with respiratory distress syndrome (RDS), 23 infants who received HFOV treatment for severe RDS after failing to be improved with conventional mechanical ventilation from July 1995 to February 1998 were included. Twelve infants survived with HFOV (Responder group), while 11 infants could not maintain oxygenation with HFOV and died (Non-responder group). Clinical record (of each patient) were retrospectively reviewed and compared with the respiratory indices. Mean (A-a)DO2 was significantly lower in the responder group than in the non-responder group at 2 hr after HFOV (p=0.024), and the difference was more remarkable at 6 hr (p=0.005). Death in the patient with (A-a)DO2 over 350 at 2 hr after HFOV therapy was 100% in sensitivity and 80% in specificity. The earliest significant difference of mean a/APO2 between two groups was noted at 6 hr after HFOV treatment (p=0.019). OI showed no significant differences between two groups. In summary, (A-a)DO2 was the most effective and sensitive respiratory index for predicting the responsiveness to HFOV in infants with severe RDS providing due as early as 2 hr.
Comparative Study ; High-Frequency Ventilation* ; Human ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Oxygen/blood ; Predictive Value of Tests ; Prognosis ; Pulmonary Gas Exchange* ; Respiratory Distress Syndrome/therapy* ; Respiratory Distress Syndrome/mortality ; Respiratory Distress Syndrome/diagnosis* ; Retrospective Studies ; Sensitivity and Specificity ; Treatment Outcome

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

Asymmetrical Septal Hypertrophy(ASH), Characterized by interventricular septal hypertrophy, is not an uncommon cardiac disease. Arrythmia occuring in ASH are supraventricular tachycardia, atrial premature beats, and ventricular premature beats. In about 10% of patients, there is a short P-R interval and a partial delta wave, suggestive of a variant of the Wolff-Parkinson-White syndrome. We reported here a case of ASH associated with W-P-W syndrome and paroxysmal atrial fibrillation with review of pertinent literatures.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiac Complexes, Premature ; Heart Diseases ; Humans ; Hypertrophy* ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome

According to the reports, the prevalence of anti-HCV is about 1%. In past, the results of the prevalence of HBs Ag & HBs Ab in the patients of Hansen's disease were reported. But we don't know about that of anti-HCV. So we study about the prevalence of serum anti-HCV of 60 patients & PALS of Hansen's disease. And we test about Alk. Phosp., ALT, AST, Gtlc HBs Ag & HBs Ab. 1. The prevalence of anti-HCV is 8.33%. It is higher than past reports(about 1-2%). 2. The prevalence of HBs Ag is 3.4% & that of HBs Ab is 36.3%. 3. Because of the high prevalence of anti-HCV in the patients of Hansen's disease & PALS, we think that more studies are need about it.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Humans ; Leprosy ; Prevalence

No abstract available.