The Usefulness of the Doppler Echocardiography in Patient with Atrial Septal Defect: Detection of Shunt Flow and Measurement of Qp/Qs Ratio

For the determination of the usefulness of the pulsed Doppler echocardiographic diagnosis of ASD. We evaluated 185 children with congenital heart disase by subxiphoid approach. ASD was diagnosed when abnormal flow was recorded in right atrium. ASD was proved by surgery in 33 of 185 children with congenital heart disease, and all children had sugical correction of their heart deformities. On pulsed Doppler echocardiographic exmination, abnormal flow was recorded in 32 of the 33 children with ASD and 3 of 152 children without ASD. This pulsed Doppler echocardiographic diagnosis of ASD by abnormal flow in right atrium has sensitively of 97% and specificity of 98%. High correlation was found between the estimates of Qp/Qs ratio by Doppler and Fick method(r=0.90, P<0.01). So we concluded that pulsed Doppler echocardiographic diagnosis of ASD was specific and sensitive method and careful pulsed Doppler echocardiographic examination may avoid the unnecessary cardiac catheterizetion in patients with ASD.

Diagnosis of Patent Ductus Arteriosus by Pulsed Doppler Echocardiography; Sensitivity and Specificity

No abstract available.

Therapeutic Trial of Ribavirin on Chroic Hepatitis B in Children / 영남의대학술지

To study the therapeutic effect of ribavirin, a broad spectrum antiviral agent, for chronic hepatitis B in pediatric patients, 24 patients who were diagnosed as chronic hepatitis B (elevated SGOT and SGPT and positive HBsAg and HBeAg for more than 6 months) at the pediatric department of Yeungnam University Hospital from Mar. 1, 1985 to Sep. 30, 1986 were randomly divided into two groups. Ribavirin was administered to 11 patients in dose of 15mg/kg/day and 13 patients were control group and both groups were followed for 12 months. Serum HBsAg and HBeAg were measured with RIA (Ausria-II and Abbott-HBe, respectively) and compared in P/N ratio (counts per minute of patient's sample/counts per minute of normal serum). There were no statistically significant reductions in P/N ratios of HBsAg and HBeAg in both groups between prior to the therapy and 12 months follow-up period. It seems that ribavirin does not have the therapeutic effect on chronic hepatitis B in children. Also, there were no noticeable side effects from ribavirin therapy.

A Case of Neuroblastoma Presenting with Sudden Blindness / 영남의대학술지

Neuroblastoma is the most common extracranial solid tumor of childhood which presents various clinical symptoms depending on the primary and metastatic sites. However, it has been rarely reported that sudden onset of blindness was the chief complaint of neuroblastoma. A four years old boy was admitted to the Yeungnam University Hospital with the chief complaint of a sudden onset of blindness due to a distant metastasis of abdominal neuroblastoma to the sphenoid sinus. On admission, both side pupils were dilated without light reflex, fundoscopy showed pale optic disk, electroretinogram was subnormal and visual evoked potential showed no response. The liver was palpable in 3 ½ finger breadth from the right costal margin and adult fist sized mass was palpable in the right flank. Skull X-ray showed destructed sphenoid bone and clinoid process and brain CT scan showed tumor mass in the sphenoid sinus and left orbit. Ultrasonogram and CT scan of the abdomen showed large tumor masses around the right kidney and para-aortic and retropancreatic lymph node. IVP showed displaced right calyceal system with preserved contour. Left supraclavicular lymph node which appeared after admission was biopsied and it showed poorly differentiated neuroblasts. He was treated according to the multiagent chemotherapy schedule for stage IV neuroblastoma patient of children's cancer study group. Abdominal tumor masses and sphenoid sinus mass were markedly reduced after 2 courses of the combination chemotherapy of cyclophosphamide, vincristine, DTIC, adriamycin and VM-26. Eventhough the blindness was not improved, the patient has been in good clinical codition.