BACKGROUND: Transradial coronary intervention was introduced recently. It has less bleeding and vascular complications and advantage of early ambulation. METHODS: We compared 142 transradial coronary interventions (101 stents, 56 balloon angioplasty and 18 rotablation) with 120 transfemoral interventions in 230 patients from January to August 1998. RESULTS: Overall success rate was not different between two approaches (92% vs 89%), but smaller sized sheath and less amount of contrast agent were required in transradial interventions compared to transfemoral interventions. Conventional guiding catheters which are used in transfemoral approach were used in most cases (94%) of transradial interventions. Judkins left 3.5 (in stead of JL4.0 in femoral approach) and Judkins right 4.0 were the most frequently used guiding catheters in transradial approach. Stent implantation was successfully done in 99 out of 101 lesions (98%) in transradial intervention and 76 out of 78 lesions (97%) in transfemoral intervention. Rotational atherectomy and primary balloon angioplasty or stenting were done successfully in 10 - 20% of the patients in both groups. All procedures were done successfully without any major procedure-related complications (myocardial infarction, death, bypass surgery) or major vascular complications in both groups. During the clinical follow-up of transradial group, punctured arteries showed 10% incidence of radial artery pulse weakness with 3% of pulse loss. CONCLUSION: Transradial approach is useful another feasible route for coronary interventions. The feasibility of primary balloon angioplasty or stenting and rotational atherectomy by transradial approach should be evaluated in the future.
Angioplasty, Balloon ; Arteries ; Atherectomy, Coronary ; Catheters ; Coronary Artery Disease* ; Coronary Vessels* ; Early Ambulation ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Infarction ; Radial Artery ; Stents

BACKGROUND: Carotid artery stenosis is not infrequently associated with coronary artery disease. However, the technique performing selective carotid angiography is not established during right transradial coronary angiography. We investigated the reliability and safety of selective carotid angiography from the right transradial approach. MATERIALS AND METHODS: Following right transradial coronary angiography, selective carotid angio-graphy was performed using a 5 Fr Simmons-2 catheter in 103 patients (59+/-8 years [range, 18-80], 78 males). Ninety five (92%) patients had significant coronary artery disease. Subclavian and innominate arteries were moderately tortuous in 25 (24%) patients and aortic arch was elongated, more vertically oriented in 20 (19%). After forming a loop in ascending (n=65, 63%) or descending (n=38, 37%) aorta, the catheter was withdrawn and rotated counterclockwise to engage its tip in left carotid artery and innominate artery subsequently. After the catheter tip was adjusted at each ostia of carotid arteries, contrast material was delivered. In 63 (61%) patients, the procedures were performed on outpatient basis. RESULTS: Bilateral selective carotid angiography was successfully performed in 101 (98%) patients. In two patients with severely tortuous subclavian artery, the catheter was not engaged selectively in left carotid artery. The image quality of the angiograms performed by manual injection was determined satisfactory. Significant carotid stenosis was found in 17 (17%) patients. There were no complications, including thromboembolism and arterial dissection. CONCLUSION: Selective carotid angiography can be performed reliably and safely using a 5 Fr Simmons catheter from the right transradial approach. This technique is useful for evaluation of isolated or associated carotid artery stenosis from the right transradial approach.
Angiography* ; Aorta ; Aorta, Thoracic ; Brachiocephalic Trunk ; Carotid Arteries ; Carotid Stenosis ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Outpatients ; Radial Artery ; Subclavian Artery ; Thromboembolism

Malignant melanomas have the potential to metastasize to any site in the body. They commonly invade the gastrointestinal tract. The small bowel is most commonly involved, followed by the stomach, large bowel, and esophagus. The vast majority of gastrointestinal melanomas are metastatic from a cutaneous lesion. An abdominal CT scan revealed multiple and variable sized low density lesions throughout the whole liver. Endoscopy revealed multiple black pigmentations at the distal esophagus, stomach, duodenum and rectum. The brain CT showed multiple hemorrhagic metastases in the brain. This 72-year-old man had malignant melanoma in his right thumb one year ago. It had metastasized to the liver, lung, gastrointestinal tract and brain. Here we report this case of whole body metastatic malignant melanoma and review the literature.
Aged ; Brain ; Duodenum ; Endoscopy ; Esophagus ; Gastrointestinal Tract ; Humans ; Liver ; Lung ; Melanoma ; Neoplasm Metastasis ; Pigmentation ; Rectum ; Stomach ; Thumb

PURPOSE: This study was to describe the burden of aged parents caring for adult children with disabilities and related factors. METHODS: The subjects were 123 caregivers aged over 65 who were caring for 18-year-old or older children with disabilities. The research tool of this study was a structured questionnaire on family burden. Data were collected from June 3 to 25, 2010, and analyzed by Cronbach's alpha, mean, standard deviation, t-test, and ANOVA using SAS 9.2 program. RESULTS: The major findings of this study were as follows. Elderly parents caring for adult children with disabilities perceived a moderate level of burden. The burden from concern over their children's future was highest, and economic and physical burdens were higher when the parents were younger. Burden was significantly different according to parents' characteristics such as gender, perceived health status, disease, the costs of caring for disabled children, and children's characteristics such as disability rating, health status, and ADL. CONCLUSION: In order to reduce the burden of elderly parents caring for adult children with disabilities, we need to improve their health status and assess comprehensive policies.
Activities of Daily Living ; Adolescent ; Adult Children* ; Adult* ; Aged ; Caregivers ; Disabled Children ; Humans ; Parents* ; Surveys and Questionnaires

Sporotrichosis is an infection of worldwide distribution caused by the fungal organiam sporotrichum schenckii. The disease is usually of the primary cutaneous variety with involvement of regionaI lymphatics, although dissemination may occur. A case of lymphatic type of Syorotrichosis affecting 33 years old, barber, who has been suffering from painless multiple nodules on right hand 4 forearm, is presented. The skin lesions developed about 3months ago, and increased sise and numbers of the lesion insidiously. Diagnosis was confirmed by characterietic clinical, mycological, histopathological studies He was treated with potassium iodide and there was markedly improved.
Adult ; Diagnosis ; Forearm ; Hand ; Humans ; Potassium Iodide ; Skin ; Sporothrix ; Sporotrichosis*

Art therapy 1. is a health service profession based on knowledge of human development and psychological theories and research with integrative approach involving both sides of the brain, the mind, body and spirit, 2. utilizes art media (such as drawing, painting, clay), images, the creative process, and client response to create products that reflect the individual's personal development, abilities, personality, interest, concerns, and conflicts. and 3. has been implemented in assessment as well as treatment since 1961 when Ulman initiated a new terminology "Art Therapy" as described in the "Bulletin of Art Therapy". Art Therapy 1. endorses the idea that the process of making art is inherently therapeutic, 2. takes into consideration thoughts, feelings, behaviors and spirituality within the counselling process, 3. can be used to explore issues of relationships, family, loss, life transitions, abuse, and development, and 4. includes interventions to resolve emotional conflict, increase self-awareness and self-esteem, build social skills, change behaviour, increase coping skills, and to develop strategies for problem solving. For the past four decades in some developed countries like United States, France, Germany, and Japan, art therapy has been actively and positively applied in the fields of psychiatry, pediatrics, and rehabilitation medicine, and also in management of chronic pain and cancer patients as a complementary therapeutic modality and basic research tool as well. In approximately 2001 in Korea, educational program of art therapy on a post-graduate level at medical schools and art therapy clinics at university hospitals were begun. Ever since that time the clinical, academic, and research activities are noticeably growing in number and quality. It is anticipated that if the theories and skills of western medicine, oriental medicine and complementary alternative medicine are put together, the newly established integrative art therapy will make significant contribution toward overall improvement in future medicine.
Adaptation, Psychological ; Art Therapy* ; Brain ; Chronic Pain ; Complementary Therapies ; Developed Countries ; France ; Germany ; Health Services ; Hospitals, University ; Human Development ; Humans ; Integrative Medicine ; Japan ; Korea ; Medicine, East Asian Traditional ; Paint ; Paintings ; Pediatrics ; Problem Solving ; Psychological Theory ; Rehabilitation ; Schools, Medical ; Spirituality ; United States

OBJECTIVE: To evaluate the association of maternal age with occurrence of fetal chromosomal abnormalities in Korean pregnant women of advanced maternal age (AMA). METHODS: A retrospective review of the amniocentesis or chorionic villous sampling (CVS) database at Gangnam and Bundang CHA Medical Centers, between January 2001 and February 2012, was conducted. This study analyzed the incidence of fetal chromosomal abnormalities according to maternal age and the correlation between maternal age and fetal chromosomal abnormalities in Korean pregnant women > or =35 years of age. In addition, we compared the prevalence of fetal chromosomal abnormalities between women of AMA only and the others as the indication for amniocentesis or CVS. RESULTS: A total of 15,381 pregnant women were selected for this study. The incidence of aneuploidies increased exponentially with maternal age (P<0.0001). In particular, the risk of trisomy 21 (standard error [SE], 0.0378; odds ratio, 1.177; P<0.001) and trisomy 18 (SE, 0.0583; odds ratio, 1.182; P=0.0040) showed significant correlation with maternal age. Comparison between women of AMA only and the others as the indication for amniocentesis or CVS showed a significantly lower rate of fetal chromosomal abnormalities only in the AMA group, compared with the others (P<0.0001). CONCLUSION: This study demonstrates that AMA is no longer used as a threshold for determination of who is offered prenatal diagnosis, but is a common risk factor for fetal chromosomal abnormalities.
Amniocentesis ; Aneuploidy ; Chorion ; Chromosome Aberrations ; Down Syndrome ; Female ; Humans ; Incidence ; Maternal Age ; Odds Ratio ; Pregnant Women ; Prenatal Diagnosis ; Prevalence ; Retrospective Studies ; Risk Factors ; Trisomy

Background: Recently clinical trials have expanded extensively in Korea; thus, ensuring the rights of subjects participating in clinical trials is imperative. Accordingly, national regulations on subject recruitment advertisement were enforced from October 25, 2018. In this study, the effect of this regulation was evaluated by analyzing the difference in the provision of information before and after enforcement of the regulation. Methods: Recruitment advertisements for clinical trial subjects 3 years before and after enforcement of the regulation were collated by the significance sampling approach. Print-based (newspapers, buses, and subways) and web-based (clinical trial center websites and online platforms) materials for recruitment in clinical trials of phase 1 to 4 for investigational drugs, medical devices, and oriental medicine were considered. Chi-square tests were conducted for inter-group comparisons. SPSS version 26 was employed for statistical analyses. Results: A total of 137 advertisements were collected comprising 60 pre- and 77 post-regulation enforcement. The overall rate of delivery of critical information in advertisements increased significantly from 47.5% before regulation to 93.2% after regulation enforcement. Particularly, details on expected adverse events augmented significantly (p<0.001). Benefits from participation in clinical trial reduced significantly from 88.3% to 70.1% (p<0.05). As the information provision amplified, the inclusion of professional terms increased. Conclusions Enforcement of regulations has led to a surge in the amount of information and challenging terms contained in advertisements for recruiting subjects. Therefore, additional efforts are required by subjects to completely understand the information provided in the advertisements.

No abstract available.
Thanatophoric Dysplasia*

We report a case of a 13-year-old girl who was noted to have combined malformation of complete septate uterus, obstructed hemivagina and ipsilateral renal agenesis with complaints of dysmenorrhea. Hematometrocolpos was developed in the result of retained menstrual blood since menarche. This rare congenital anomaly is supposed to be derived from disorders of mesonephric and M llerian developement in embryogenesis of female genitouinary tract. An accurate preoperative diagnosis of this syndrome is critical because of the difference in therapeutic strategy and prognosis. Simple and definite treatment of the condition is excision of the obstructed vaginal septum with prompt exit of retained blood. We present here a interesting case of M llerian anomaly in attempt to alert gynecologist to the possible occurrence of such a malformation with a brief review of concerned literatures.
Adolescent ; Diagnosis ; Dysmenorrhea ; Embryonic Development ; Female ; Humans ; Menarche ; Pregnancy ; Prognosis ; Uterus*