Doppler echocardiography was performed to evaluate the tricuspid regurgitation in 786 infants and children with heart disease. 3 Doppler methods were used. : The duration of systolic turbulence of tricuspid regurgitation in thr right atrium was evaluated by continuous wave Doppler method, the distance of systolic turbulence within right atrium from the tricuspid plane, by pulsed Doppler method and the retrograde systolic hepatic vein regurgitation, by color Doppler method. The following results were obtained. 1) Incidence of pan systolic tricuspid regurgitation in each disease were as follows. 68% of ECD, 66% of Ebstein's anomaly, 54% of pulmonary atresia, 50% of arrhythmia, 45% of ASD, 38% of TAPVR, 15% of VSD, 26% of TOF, 12% of PDA, 13% of normal children. 2) In about 90% of children with tricuspid regurgitation, hepatic vein regurgitation was detected by color Doppler echocardiography.
Arrhythmias, Cardiac ; Child* ; Ebstein Anomaly ; Echocardiography, Doppler ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Diseases* ; Heart* ; Hepatic Veins ; Humans ; Incidence ; Infant* ; Pulmonary Atresia ; Scimitar Syndrome ; Tricuspid Valve Insufficiency*

No abstract available.
Aneurysm* ; Heart Septal Defects, Ventricular*

Percutaneous biliary drainage is an effective new nonsurgical method for combined external/internal catheterdecompression of obstructed extrahepatic bile ducts. Molnar and Stockum, and more recently others, have reportedsucdess utilizing this approach to establish biliary drainage in patients with obstructive jaundice. Percutaneousbiliary drainage was performed in 9 patients with obstructive jaundice. Internal drainage was accomplished in 4patients (44.4%), and external drainage in 5 patients (55.6%). Major complications occurred in 2 patients; bileleakage, one; sepsis, one. Minor complications occurred in 7 patients; mild or high fever, 5 cases; transienthemobilia, 2 cases. The catheter management problems encoutered including pain, catheter dislodgement ormigration, lumen occulusion, and external bile leakage.
Bile ; Bile Ducts, Extrahepatic ; Catheters ; Drainage ; Fever ; Humans ; Jaundice, Obstructive ; Methods ; Sepsis

No abstract available.
Endocarditis*

No abstract available.
Heart Diseases* ; Heart* ; Spleen*

BACKGROUND: Adenosine has gained wide popularity in the emergency medical service system(EMS) since its approval for use in the treatment of paroxysmal supraventricular tachycardia(PSVT). But, few study about its efficacy and safety have been reported in this country. Therefore we had studied the efficacy of adenosine in the patients with PSVT in the emergency department(ED). METHOD: A prospective outcome study was performed from July, 1996 to June, 1997 at the Sanggye Paik Hospital. Inje University. PSVT was diagnosised based on emergency physician's interpretation of the 12 channel ECG. patient's age, sex, symptoms, systolic blood pressure, heart rate, elapse time to sinus rhythm and side effects were recorded. RESULTS: Twenty seven cases received adenosine for diagnosed PSVT in the ED for 1 year. The cases were 6 man and 21 women. The mean age was 53.4 years old. Three cases were considered unstable PSVT. In twenty six cases(96.3%) were converted to normal sinus rhythm after adenosine therapy. None of the patients who converted to sinus rhythm had recurrent PSVT or required additional medication. Various adverse effects of adenosine were noted in all patients but were transient and clinically insignificant. CONCLUSION: Intrvenous adenosine is an effective, safe and urgent treatment PSVT and no significant side effects were happened in emergency department.
Adenosine* ; Blood Pressure ; Diagnosis ; Electrocardiography ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Female ; Heart Rate ; Humans ; Outcome Assessment (Health Care) ; Prospective Studies ; Tachycardia*

Ventricular arrhythmia and left ventricular dysfunction after hospital discharge in acute myocardial infarction are powerful predictors of sudden death. We evaluated the ventricular extrasystoles with 24 hour ambulatory electrocardiography at convalescent phase in 34 patients of acute myocardial infarction. Ventricular extrasystoles were observed in 19 patients (56%) and classified by Lown's grading system as grade 1 for 8 cases, grade 2 for 3 cases, grade 3 for 3 cases, grade 4 for 3 cases, and grade 5 for 2 cases. There was no relation between the develoment of ventricular extrasytoles and the risk factors of ischemic heart discase such as smoking, hypertension, hyperlipidemia, diabetes mellitus, and male sex. Also, the development of ventricular extrasystoles was independent to infarct site, regional wall motion abnormalities, and clinical manifestations of left ventricular dysfunction such as congestive heart failure and cardiomegaly. In conclusion, ventricular arrhythmia might independently predict the prognosis in survivors of acute myocardial infarction.
Arrhythmias, Cardiac ; Cardiomegaly ; Chymopapain ; Death, Sudden ; Diabetes Mellitus ; Electrocardiography, Ambulatory ; Heart ; Heart Failure ; Humans ; Hyperlipidemias ; Hypertension ; Male ; Myocardial Infarction* ; Prognosis ; Risk Factors ; Smoke ; Smoking ; Survivors ; Ventricular Dysfunction, Left ; Ventricular Premature Complexes*

We evaluated the accuracy of a noninvasive method for estimating right ventricular systolic pressures in patients with atrial septal defect and tricuspid regurgitation defected by two-dimensional and Doppler ultrasound. Of 54 patients with atrial septal defect, 24(44%) had jets of tricuspid regurgitation. By use of the maximum velocity(V) of the regurgitatant jet recorded by continuous wave Doppler ultrasound and the Bernoulli equation, we predicted right ventricular systolic pressure(RVP) calculated by the equation of RVP=4V2+10 proposed by Tei et al.The values correlated well with catheterization values(r=0.851, standerd error of estimate=4mmHg). In addition the relation between the Lt to Rt shunt amount and the severity of tricuspid regurgitation was assessed. The severity of tricuspid regurgitation graded on a four-pointscali by pulsed Doppler and two-dimensional echocardiography correlated with Qp/Qs ratio calculated by the Fick's method(p<0.05).
Catheterization ; Catheters ; Echocardiography ; Heart Septal Defects, Atrial* ; Humans ; Tricuspid Valve Insufficiency* ; Ultrasonography

PURPOSE: Three-dimensional(3D) magnetic resonance(MR) projection imaging was evaluated as a noninvasive alternative to direct cholangiography for the assessment of its reliability in patients with obsructive jaundice. METHODS AND MATERIALS: A heavily T2-weighted gradient-echo sequence(PSIF) was used for 3D MR projecion imaging of the biliary system in five healthy volunteers and 25 patients with obstructive jaundice. The 3D images of the bile ducts were formed by stacking consecutive coronal MR images obtained with a fast imaging method to a maximum-intensity projection algorithm. RESULTS: In the volunteers, MR cholangiography could demonstrate the anatomy of the biliary tract in only two subjects. The extrahepatic and intraheparic bile ducts were well visualized in 23 patients with obstructive jaundice. The leve of obstruction and the grade of dilatation were dipicted with MR cholangiography in all cases. And the cause of obstruction could be determined with MR cholangiography in 18 cases, MR cholangiography was successful in two patients in whom ERCP failed. The gallbladder or dilated pancreatic duct not demonstrated by means of direct cholangiography was demonstrated with MR cholangiography in six cases.
Bile Ducts ; Biliary Tract ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Dilatation ; Gallbladder ; Healthy Volunteers ; Humans ; Jaundice ; Jaundice, Obstructive* ; Pancreatic Ducts ; Volunteers

PURPOSE: The aim of this study was to identify the present situation of hospital infection and route of infection by clarifying the transmission aspect of methicillin-resistant Staphylococcus aureus(MRSA) in a Neurosurgical Intensive Care Unit by analysing genotype. METHODS: MRSA was cultured from twenty five patients with a tracheostomy, twenty five health care workers, and environments in the Neurosurgical Intensive Care Unit of one hospital in D city. Data was collected from December 21, 2004 to November 5, 2005. MRSA isolates representing each genotype were analyzed by spaA typing and a multiplex PCR method capable of identifying the structural type of the staphylococcal cassette chromosome mec(SCCmec) carried by the bacteria. RESULTS: As the same genotype and gene sequence were found among health care workers, patients, and environments, it was assumed that there was cross transmission among them. CONCLUSION: This study suggests that first, as the hospital infection by MRSA between health care workers and patients in the Neurosurgical Intensive Care Unit was due to result of cross transmission and the relevance of transmission between them was verified, it is necessary to take preventive measures and conduct education. Secondly, development of nursing interventions and study of infection are needed. Thirdly, consistent investment in prevention against hospital infections and environmental renovation is needed.
Bacterial Proteins/genetics ; Drug Resistance, Bacterial ; Genotype ; Humans ; *Infectious Disease Transmission, Patient-to-Professional ; *Infectious Disease Transmission, Professional-to-Patient ; Intensive Care Units ; *Methicillin Resistance ; Neurosurgery ; Polymerase Chain Reaction ; Staphylococcal Infections/microbiology/*transmission ; Staphylococcus aureus/drug effects/genetics/*isolation & purification ; Tracheostomy