No abstract available.

Pulmonary atresia with major aorto-pulmonart collateral arteries(abbreviated as MAPCA in the following)as a route for pulmonary blood flow presents many problem in diagnosis and management and recently new approach to surgical management (unifocalization)was suggested and few reported it's application. Nineteen cases who had pulmonary with MAPCA, diagnosed at Seoul National University Children's Hospital from October 1987 to May 1989, were studied to lool at the relationship between MAPCA, central pulmonary artery and segmental pulmonary arteries. Also was observed the clinical course and operative management. The average number of MACPA in each patient was 4, two toward right lung and the other two toward left lung. MACPA arose most frequently from descending aorta and innominate artery contralateral to the side of aortic arch. Central pulmonary artery was identified in 86.7%. The number of bronchopulmonary segment connected to central pulmonary artery directly or indrectly was very variable so was the number of bronchopulmonary segment connected to MAPCA only. Three had a total correction and 14 had a various kinds of palliative operation once or twice. Seven had a called "unifocalization"(connection of MAPCA to central pulmonary artery) to correct arborization abnormality but the result was not satisfactory for technical reason.
Aorta, Thoracic ; Arteries* ; Brachiocephalic Trunk ; Diagnosis* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Seoul

No abstract available.
Heart Defects, Congenital*

A particular problem associated with osseointegrated implants is the fact that the implants lack a periodontal ligament. Thereby, marginal inflammation around an implant may cause more serious bone loss than does marginal inflammation around teeth with a periodontal ligament. In addition, osseointegrated implants are ankylosed and do not haute the same mobility as natural teeth with a periodontal ligament. Implants with a periodontal ligament would eliminate these problems. In order to explore the possibility of producing a periodontal ligament around titanium dental implants, a study of the attachment of cultured periodontal ligament cells to titanium was carried out. Periodontal ligament cells obtained from premolar teeth of individuals undergoing tooth extraction for orthodontic reasons were cultured on titanium-coated epon blocks. Sections of the blocks were cut perpendicular to the surface of the cell layer. Transmission electron microscopy of the periodntal ligament cells/titanium interface showed that there was no evidence of attachment at the cultured periodontal ligament cells titanium interface. The microfilaments, commonly located adjacent to the titanium surface, run mostly parallel to the titanium surface. The study showed that cultured periodontal ligament cells did not create an attachment structure on a titanium surface similar to that of natural teeth.
Actin Cytoskeleton ; Bicuspid ; Dental Implants ; Inflammation ; Ligaments ; Microscopy, Electron, Transmission ; Periodontal Ligament* ; Titanium* ; Tooth ; Tooth Extraction

The usefulness of two-dimensional echocardiography to measure the right ventricular volume was assessed in 58 normal children (mean age 5 years and 3 months). From the apical 4-chamber view (A4CV), the subcostal RV sagittal view (SCRVSV), the subcostal right anterior oblique view (SCRAOV), and the subcostal RV coronal view (SCRVCV), the dimensions and areas of the right ventricle were measured. The right ventricular volumes and ejection fractions were calculated from these data by pyramid model and single plane area/length method. We could obtain subcostal right ventricular sagittal view in 98%, apical 4-chamber view in 90%, subcostal right anterior oblique view in 79%, and subcostal right ventricular coronal view in 71% of our children. The areas and dimensions correlated with all growth indices, such as age, height, weight, and body surface area. In general the areas showed higher correlation with body surface area, and dimensions with height. correlations of parameters obtained from the subcostal right anterior oblique view and subcostal right ventricular sagittal view with the growth indices were better than those of the subcostal right ventricular coronal view. The calculated right ventricular volume and ejection fraction showed a great varibility depending on the model used. The right ventricular volume calculated by pyramid model correlated better with the growth indices than that by single plane area/length method. the right ventricular volume calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model is the model which showed the best correlation with growth indices. Right ventricular ejection fraction did not change with any growth indices. Among the right ventricular volumes and ejection fractions by single plane area/length method, the volume(59.9+/-29.9 ml/m(2)) and ejection fracton (58.7+/-10.9%) from the subcostal right anterior oblique view were similar to those (51.0+/-17.3ml/m(2), 51.3+/-10.2%) calculated from the apical 4-chamber view dimension and the subcostal right ventricular sagittal view area by pyramid model. The subcostal right anterior oblique view reflects three parts of the right ventricle. Its area and dimension are well correlated with growth indices. Also the right ventricular volume and ejection fraction obtained by single plane area/length method using the subcostal right anterior oblique view correlate with the growth indices. Therefore the subcostal right anterior oblique view is the most valuable single view representing the right ventricle.
Body Surface Area ; Child* ; Echocardiography* ; Heart Ventricles ; Humans ; Stroke Volume

No abstract available.

No abstract available.
Angiography* ; Heart Septal Defects, Ventricular* ; Pulmonary Artery* ; Pulmonary Atresia*

BACKGROUND: To get the information about the clinical characteristics of the paroxysmal junctional tachycardia in children and to get the general principle in managing these children. METHOD: Analysis of the medical records of the 43 patients(male 30, female 13) with paroxysmal junctional tachycardia(JT) who had been followed-up in this hospital for a mean of 4.6 years(range 1 month up to 12 years) was done. RESULT: In 19 patients, JT started before 1 years of age : in 2, during gestational period, in 15, within 4 months of age, in 2, after 4 months of age. The next peak was 7 in the age of 5 years. The associated cardiac abnormalities were complex congenital defects in 2, tumor in 1, dilated and hypertrophic cardiomyopathy in 1 each. The significant hemodynamic disturbances during JT were noticed in 25. Among those whose surface electrocardiogram during JT were available, mean heart rate during JT was 232rpm(range 160-310) ; narrow QRS complex in 33 and wide in 1 ; P` wave in ST segment or T wave in 22. The delta waves were noticed after stopping JT and during followe up in 20. The types of delta waves were A in 7, B in 9, and indeterminate in 4. The different forms of delta waves unrelated to the degree of fusion were noticed in 6 ; disappearance or intermittent form of delta wave in 4. The efficacy of stopping JT was as follows : ATP 84.4%(38/45), diving reflex 50%(7/14), other vagal stimulation 71.4%(5/7), digoxin 72.7%(8/11), verapamil 54.5%(12/22), D/C cardioversion 62.5%(5/8), neosynephrine 100%(2/2). There were 2 deaths due to associated cardiac defects and 2 elective catheter ablations during the followe up period. The preventive medication with digoxin, beta blocker, and/or verapamil was succesful in 14, partially succesful in 11, failed in 14. The 7 persistent JT were treated with amiodarone in 3, with amiodarone and beta blocker in 1, with flecainide and digoxin in 1. In 1, surgical ablation of accessory pathway was done due to persistent JT. At present, JT do not recur or occur transiently without drugs in 29 ; with drugs, JT become controlled without recurrence in 4, with transient episodes in 4 and with intermittent episodes in 1. CONCLUSION: Althouh the JT in children is benign in most cases spite of the severity during the early period, JT is persistent in cases and needs potent drugs to control JT. Ablation of the foci may be necessary in these cases. Even in patients whose long-term results are benign, it is necessary to choose the optimal drugs to terminate and prevent the JT during the intervening period.
Adenosine Triphosphate ; Amiodarone ; Cardiomyopathy, Hypertrophic ; Catheters ; Child* ; Congenital Abnormalities ; Digoxin ; Diving ; Electric Countershock ; Electrocardiography ; Female ; Flecainide ; Heart Rate ; Hemodynamics ; Humans ; Medical Records ; Phenylephrine ; Recurrence ; Reflex ; Tachycardia* ; Verapamil

No abstract available.
Heterotaxy Syndrome*

No abstract available.
Child* ; Humans ; Urodynamics*