The congenital long-QT syndrome (LQTS) is characterized by recurrent syncope, prolonged QT intervals, QT interval lability, polymorphic ventricular tachycardia, and sudden death. We report a case of congenital long QT syndrome in a 28-day-old male infant who presented with syncope, bradycardia with 2: 1 pseudo-atrioventricular block and a markedly prolonged QT inteval. One episode occured after crying and degenerated into ventricular fibrillation and terminated after cardioversion. A VVI type cardiac pacemaker was implanted. Subsequently, the infant's heart rate was over 110/min and 2: 1 AV block and any other arrhythmia were absent. The infant recovered from the accompanied pneumonia and sepsis and was discharged 47 days after adrnission. However, 13 days after discharge, the infant returned to our hospital ER with syncope. Ventricular fibrillation ceased after cardioversion. Despite medication with propranolol, ventricular tachycardia persisted. The infant expired the day after he was discharged against medical advice.
Arrhythmias, Cardiac ; Atrioventricular Block* ; Bradycardia ; Crying ; Death, Sudden ; Electric Countershock ; Heart Rate ; Hospitals ; Humans ; Infant ; Long QT Syndrome ; Male ; Pneumonia ; Propranolol ; Sepsis ; Syncope ; Tachycardia, Ventricular ; Ventricular Fibrillation

Hospitals are increasingly concerned with the construction of computer-based medical order communication system (MOCS), despite the fact that they are financially being pressed. With limited budget, management in hospitals ought to be pursuing both methodologically effective and technically sound way of constructing MOCS. This paper intends to contribute itself toward better design of database for MOCS with reference to a university hospital. Some structural characteristics pertaining to MOCS are identified in ways of systems approach. Based on those findings, construction methodologies are reviewed and put forward with flexibility to differing requirements of hospitals. Suggestions include the followings. (1) Designing step has to be distinguished among conceptual, logical, and physical design while prototyping for user interface is utilized only for the logical design. (2) Many modeling tools including entity life cycle diagram can be effective for system integration with other units. (3) 3 different types of distributed database servers are recommended.
Budgets ; Computer Communication Networks ; Hospital Information Systems* ; Life Cycle Stages ; Logic ; Pliability

Hospitals are increasingly concerned with the construction of computer-based medical order communication system (MOCS), despite the fact that they are financially being pressed. With limited budget, management in hospitals ought to be pursuing both methodologically effective and technically sound way of constructing MOCS. This paper intends to contribute itself toward better design of database for MOCS with reference to a university hospital. Some structural characteristics pertaining to MOCS are identified in ways of systems approach. Based on those findings, construction methodologies are reviewed and put forward with flexibility to differing requirements of hospitals. Suggestions include the followings. (1) Designing step has to be distinguished among conceptual, logical, and physical design while prototyping for user interface is utilized only for the logical design. (2) Many modeling tools including entity life cycle diagram can be effective for system integration with other units. (3) 3 different types of distributed database servers are recommended.
Budgets ; Computer Communication Networks ; Hospital Information Systems* ; Life Cycle Stages ; Logic ; Pliability

Basal cell carcinoma(BCC) and squamous cell carcinoma (SCC) are very prevalent neoplasms of the human skin. Ultraviolet radiation in sunlight is a well-established mutagen of the p53 gene and is one of basal cell carcinoma and squamous cell carcinoma. The newly-formed vascular network is important for neoplasms to grow beyond a size of about 1 mm2. Recent reports have suggested the hypothesis that a mutant p53 protein is closely related with capillary density. Immumohistochemistry for p53 protein and CD34 was performed in 20 cases of BCCs and 14 SCCs to evaluated the relationship between p53 protein and capillary density. The results were as follows:1. The microvessels stained by CD34 were mainly located in the interface of tumor cells and stroma. 2. There was no difference in the microvessel density according to the histologic types and age of the patients, but a higher microvessel density was noted in male patients. 3. The aggressive BCCs and the less-differentiated SCCs showed higher p53 immunostaining. 4. The mean microvessel density of cases showing strong positive immunostaining of the p53 gene(54.73+/-17.75) was higher than that of others(39.75+/-18.30). These results suggested that p53 protein expression and microvessel density are not related to the histologic types and age of the patients, but that differentiation and biologic behavior such as the infiltrating property of tumors and the microvessel density are closely related to p53 protein expression.
Capillaries ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell* ; Genes, p53 ; Humans ; Male ; Microvessels* ; Skin* ; Sunlight

We report a case of stress incontinence in 51 year old female treated by Marshall Marchetti operation with the review of literatures.
Female ; Humans ; Middle Aged ; Urinary Incontinence, Stress*

Classical molluscum contagiosum can be easily diagnosed from clinical examination because of the characteristic cutaneous lesions of umbilicated papules. However, when it occurs as a single growth with atypical presentation, especially on an unusual site, this common disease may give rise to difficulty in diagnosis. Thus, at times histopathological examination is necessary for the proper diagnosis and treatment. We herein describe 5 patients with this solitary molluscum contagiosum, clinically mistaken but histopathologically proven.
Diagnosis ; Humans ; Molluscum Contagiosum*

No abstract available.
Female ; Fertilization in Vitro* ; Follicular Fluid*

No abstract available.
Spine

PURPOSE: The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies.METHOD: Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program.RESULTS: The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased.CONCLUSION: Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.
Compliance ; Critical Care Nursing ; Critical Care ; Data Mining ; Delirium ; Education ; Humans ; Korea ; Methods ; Nursing Research ; Nursing ; Vancomycin-Resistant Enterococci

PURPOSE: Although the screening with a mammography has been shown to reduce breast cancer mortality, it has limitations relating to its sensitivity and efficacy. Interval cancers are those that become symptomatic, and are detected between screening examinations. The success of a screening program in reducing the rate of mortality due to breast cancer relies on keeping the number of interval cancers at a minimum. This study was performed to review the mammographic features of interval cancers, and to compare their clinicopathological factors with those cancers detected by screening. METHODS: Of the 881 women who had operations for breast cancer performed between 1995 and 1999, we retrospectively analyzed the medical records and mammograms of 57 who received at least a mammogram before the diagnosis of their breast cancer. These patients were divided into an interval cancer group, who had symptoms, and a screen detected cancer group, who had not. The factors compared included the clinical, radiographic, histopathological, and immunohistochemical features. RESULTS: Interval cancers were more likely to have masses, than microcalcifications, in their mammographic features, and were more likely to be invasive and at a higher stage according to their histopathological features. The false negative rate was 48% for the screen detected cancers, and 35% for the interval cancers (P=0.414). HRT users had the higher false negative rate of 51.6% than the 26.9% for the nonuser (P=0.103). CONCLUSION: The interval cancers were found to be different from the screen detected cancers in terms of their radiological and pathological features. The standardization of screen interval, and additional magnification mammography, or ultrasonography may contribute to reduce false negative rates of mammography.
Breast Neoplasms ; Breast* ; Diagnosis ; Female ; Humans ; Mammography ; Mass Screening ; Medical Records ; Morinda ; Mortality ; Retrospective Studies ; Ultrasonography