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.
Heart Diseases* ; Heart* ; Spleen*

No abstract available.
Endocarditis*

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*

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland

To evaluate the cardiac functions we examed the M-mode echocardiography with measurements of blood pressure, heart rate and body surface area in 55 normal Korean adults(male 30 persons, female 25 persons) of mean age, 41.7+/-12.3 years. (1) Interventricular septal thickness is 9.5+/-1.7mm and left ventricular posterior wall thickness are 8.6+/-1.5mm at end-diatole, 14.0+/-2.1mm at end-systole. (2) Diastolic and systolic left ventricular internal dimensions are 49.1+/-4.8mm and 31.3+/-5.0mm, respectively. (3) Left ventricular mass by Penn Convention method is 174.4+/-52.1g and left ventricular mass index is 103.2+/-28.8g/m2. (4) Relative wall thickness is 0.35+/-0.06. (5) Left ventricular volumes by Teichholz's method are 114.9+/-27.6ml at diastole and 40.2+/-17.2ml at systole. Therefore, stroke volume is 74.7+/-16.9ml and stroke volume index is 44.5+/-10.7 ml/m2. (6) Cardiac output is 4944+/-1058 ml/min and cardiac index is 2951+/-666 ml/min/m2. (7) Total peripheral resistance is 1454+/-356 dynes-sec-cm(-5) and total peripheral resistance index is 2472+/-623 dynes-sec-cm(-5).m2. (8) Fractional shortening is 36.5+/-6.0% and pressure-volume ratio is 3.27+/-1.19 mmHg/ml. (9) End-systolic wall stress is 61.3+/-19.7x10(3) dynes=cm2. (10) Atrial emptying index is 0.66+/-0.18.
Adult* ; Blood Pressure ; Body Surface Area ; Cardiac Output ; Diastole ; Echocardiography* ; Female ; Heart Rate ; Humans ; Stroke Volume ; Systole ; Vascular Resistance

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

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*