Atrial flutter is and infrequent, but potentially unstable tachyarrythmia that occurs in pediatric ages. Transesophageal atrial pacing was used for treatment of 10 episodes of atrial flutter in 7 patients. At the time of atrial flutter conversion, patients were 6 days to 14 years old. 6 patients had associated with congenital heart disease. The atrial cycle length of atrial flutter ranged from 140 to 280 msec with variable atrioventricular conduction. Transesophageal atrial pacing was performed using a bipolar 4 F transesophageal electrode catheter. Atrial flutter conversion was accomplished with stimulation bursts using about 5 seconds of stimuli, 10 msec in duration at 20 to 27 mA. Pacing cycle length was 45 to 110 msec less than the atrial cycle length of tachycardia in 6 episodes. But in a neonate, underdrive pacing converted atrial flutter to sinus rhythm. Conversion attempts were unsuccessful on 2 occasions. Transesophageal atrial pacing is a safe and effective, minimally invasive technique for treatment of atrial flutter in infants and children.
Adolescent ; Atrial Flutter* ; Catheters ; Child* ; Electrodes ; Heart Defects, Congenital ; Humans ; Infant* ; Infant, Newborn ; Tachycardia

PURPOSE: This study was to identify what experience meant for the wives that attempted IVF-ET(In Vitro Fertilization-Embryo Transfer) program due to the spouse's infertility and provide fundamental materials to improve nursing interventions. METHOD: Giorgi's phenomenological method was employed, the subjects were five wives who had ever attempted IVF-ET program due to the infertility of their spouses. In-depth interview and observation method were utilized to gather information from April to December 2003. RESULT: The significant results from analyzing the interviews can be grouped into 34 themes, 8 categories. The essential themes for the experiences of the wives were 'shocked by the unbelievable reality', 'can't give up the connection to the blood', 'Lack of social education on pregnancy, and childbirth', 'self-pity', 'feelings of both families', 'Being afraid of the unexpected result', 'physical and mental agony', 'Positively coping with the reality. CONCLUSION: The results show that infertility is not a mere personal matter, and infertile people, their families and society should team up with in tackling it. The physical, psychological and social problems triggered by infertility could be ironed out by making both personal and collaborative approaches to that.
Humans ; Infertility ; Iron ; Pregnancy ; Social Problems ; Spouses

Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.
Adult ; Male ; Female ; Humans

The purpose of this study was to establish a model for constructing longitudinal data for medical school, and to structure cohort and longitudinal data using data from Yonsei University College of Medicine (YUCM) according to the established input-environment-output (I-E-O) model. The study was conducted according to the following procedure. First, the data that YUCM has collected was reviewed through data analysis and interviews with the person in charge of each questionnaire. Second, the opinions of experts on the validity of the I-E-O model were collected through the first expert consultation, and as a result, a model was established for each stage of medical education based on the I-E-O model. Finally, in order to further materialize and refine the previously established model for each stage of medical education, secondary expert consultation was conducted. As a result, the survey areas and time period for collecting longitudinal data were organized according to the model for each stage of medical education, and an example of the YUCM cohort constructed according to the established model for each stage of medical education was presented. The results derived from this study constitute a basic step toward building data from universities in longitudinal form, and if longitudinal data are actually constructed through this method, they could be used as an important basis for determining major policies or reorganizing the curricula of universities. These research results have implications in terms of the management and utilization of existing survey data, the composition of cohorts, and longitudinal studies for many medical schools that are conducting surveys in various areas targeting students, such as lecture evaluation and satisfaction surveys.

Longitudinal data can provide important evidence with the potential to stimulate innovation and affect policies in medical education and can serve as a driving force for further developments in medical education through evidence-based decisions. Tracking and observing cohorts of students and graduates using longitudinal data can be a way to link the past, present, and future of medical education. This study reviewed practical methods and technical, administrative, and ethical considerations for the establishment and operation of a longitudinal database and presented examples of longitudinal databases. Cohort study design methods and previous examples of research using longitudinal databases to explore major topics in medical education were also reviewed. The implications of this study are as follows: (1) a systematic design process is required to establish longitudinal data, and each university should engage in ongoing deliberation about this issue; (2) efforts are needed to alleviate “survey fatigue” among respondents and reduce the administrative burden of those conducting data collection and analysis; (3) it is necessary to regularly review issues of personal information protection, data security, and ethics regarding the survey respondents; and (4) a system should be established that integrates and manages a longitudinal database of medical education at the national level. The hope is that establishing longitudinal data and cohorts at individual medical schools will not be a temporary phenomenon, but rather that they will be well utilized at the national level to innovate and implement ongoing changes in medical education.

No abstract available.
Child* ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Hepatitis ; Humans ; Immunoglobulin M* ; Pneumonia

Proximal interruption of unilateral pulmonary artery is an uncommon developmental anomaly. Patients without associated cardiac defects may remain asymptomatic but many develop recurrent pulmonary infections, hemoptysis, pneumonitis, bronchiectasis or pulmonary hypertension. We herein reported two cases of interruption of right pulmonary artery which were diagnosed beyond infancy. A remnant of patent ductus arteriosus was revealed on an angiogram in both cases. Surgical intervention could not be considered due to severe hypoplastic right pulmonary artery. Early surgical intervention should be considered to rescue a pulmonary circulation and prevent secondary lung hypoplasia.
Bronchiectasis ; Ductus Arteriosus, Patent* ; Hemoptysis ; Humans ; Hypertension, Pulmonary ; Lung ; Pneumonia ; Pulmonary Artery* ; Pulmonary Circulation

OBJECTIVE: We studied to determine the effect of blood or meconium contamination on the TDx-FLM assay for the assessment of fetal lung maturity. We also studied to evaluate the degree of diluted contaminants that affect the results. METHODS: Nineteen samples of amnotic fluid-14 cases < GA 37weeks and 5 cases > GA 37weeks-were collected and assayed for assessment of fetal lung maturity using tbe TDx-FLM assay. Among the above 19 samples, we used 12 samples-7 cases < GA 37weeks and 5 cases > GA37 weeks-to contaminate with blood or meconium. Maternal blood was added to the amniotic fluid at increasing concentrations fro 1:10 to 1:1280. Diluted meconium (0.5g meconium/10ml amniotic fluid) was added at increasing concentration fiom 1:1 to 1:128. Each samples were assessed by TDx assay. RESULTS: TDx values in the cases of gestational age 37 weeks or more were matured level or borderline level(TDx value > 50mg/g), but below 37 weeks, TDx values wae immature level(TDx value < 50mg/g) except one case. In preterm cases, blood or meconium contamination did not affect the TDx values significantly, although the thick meamium contamination (diluted meconium: amniotic fluid 1:1 - 1:4) increased the TDx values. In term cases, they did not affect the TDx values. CONCLUSION: TDx test was suitable for the evaluation of fetal lung maturity regardless of blood or meconium contamination.
Amniotic Fluid ; Female ; Gestational Age ; Lung* ; Meconium*

Primary malignant melanoma of the vagina is an exceedingly rare entity, accounting for about 3% of all primary vagina1 malignant tumors and 0.3% of all melanoma. The overall 5-year survival in patients with primary vaginal melanoma is notoriously poor, estimated to be between 13% and 19%. A case of primary malignant melanoma of the vagina treated with the wide local excision of vagina and rectum was presented with a brief review of literature.
Humans ; Melanoma* ; Rectum* ; Vagina*

To analyze medical professors’ evaluation of their online education experiences in an attempt to support faculty members and indicate the future direction of medical education. Faculty members who taught online in the first semester of 2020 at Yonsei University College of Medicine in South Korea were surveyed. The results of the survey were analyzed in June 2020. There were 88 respondents (35.1% of 251): 59 professors (67.0%), 16 associate professors (18.2%), and 13 assistant professors (14.8%). Their specialties lay in basic medicine (25.0%), clinical medicine (65.9%), and research and special purposes (9.1%). Sixteen participants (18.2%) had previous experience in online lectures; 23 (26.1%) reported that preparation time for online lectures was the same as before; 65 (73.9%) reported that the preparation time had increased; 38 (43.2%) faced difficulties in preparation and lecturing online, and among them 16 (42.1%) indicated inadequate interaction with students; 11 (28.9%) needed extra preparation time; and 11 (28.9%) attributed their difficulties to technical issues with the online platform. Participants’ satisfaction with online lectures was low (p<0.001). In the free response question on overall experience with online education, 38.3% mentioned the need for an instructional design that allows students to actively participate and interact with professors, 29.5% mentioned the need for the establishment of an information & communications technology system, and 17.0% mentioned the necessity of faculty development. To prepare for the current pandemic and more in the long term, an appropriate educational support system must be constructed, and a learner-centered instructional design that enables wider interactions and active learning is needed.