Aortopulmonary fistula is an exceedingly rare vascular malformation. It is commonly derived after chest injuly or from complication of chest operation and aortic dissection and congenital aortopulmonary fistula is only several cases combined with Tetralogy of Fallot or aortic stenosis. But a congenital aortopulmonary fistula without any hemodynamic abnormalities was not reported. A 56-year old man with exertional dyspnea was admitted. In an examination on admission, there were no abnomalities. Aortography showed an aortopulmonary fistula that branches from the ascending aorta adjacent to the right coronary artery, running to the main pulmonary artery. Transcatheter coil embolization was performed and he was discharged 7 day after embolization without complication. Exertional dyspnea disappeared and careful follow up has be performed periodically.
Aorta ; Aortic Valve Stenosis ; Aortography ; Coronary Vessels ; Dyspnea* ; Embolization, Therapeutic ; Fistula* ; Follow-Up Studies ; Hemodynamics ; Humans ; Middle Aged ; Pulmonary Artery ; Running ; Tetralogy of Fallot ; Thorax ; Vascular Malformations

In order to evaluate the long-term effect of single lateral rectus muscle recession for the moderate angle exotropia(20-3-PD), we retrospectively studied 30 cases which were recessed by 8-9mm. The average follow-up period was 35.8 month. At 6 month postoperatively, the success rate was 75% in 8mm recession group and 84% in 8.5mm group, 88% in 9mm group. At the last follow-up, the success rate was 62%, 38%, 22% respectively. The recession of single lareral rectus muscle for the moderate angle exotropia was successful during the early postoperative period. But, its success rate was gradually decreased in the long-term follow-up especially for exotropia over 25PD. So, we should consider to recess lateral rectus muscle more than 8-9mm or choose the classic surgical method such as both lateral rectus recession or recession-resection for exotropia over 25PD.
Exotropia* ; Follow-Up Studies ; Postoperative Period ; Retrospective Studies

One of the complication during or after subclavian vein cannulation is intravascular catheter or wire embolization. Although some studies have reported safety of retaining foreign body embolization, and even death. The intravascular foreign body can be removed surgically or non-surgically. With improvement in instrument technology and technique, percutaneous retrieval of intravascular foreign bodies has become a relatively common procedure. Commonly used methods to remove intravascular foreign bodies are loop snare and basket technique. Sometimes biopy forcep can be used. We have experienced 2 cases of non-surgical removal of intravascular foreign bodies. One of the foreign bodies was 7cm wire fragment in right atrium(RA), the other was a 50cm guide wire. We used the standard loop snare technique for removal of 7cm wire fragment in RA and stone removal basket and 3.0mm ACS PTCA balloon to remove the 50cm short guide wire.
Catheterization ; Catheters ; Foreign Bodies* ; SNARE Proteins ; Subclavian Vein ; Surgical Instruments

Primary tumors of the heart are rare, three quarter of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, however, only 3 to 4 percent of myxoma are detected in the left ventricle. We report on a 32 years old woman with left ventricular myxoma who presented with shortness of breath, chest tightness, and general weakness. Acute pulmonary embolism and left ventricular myxoma were found on a perfusion lung scan and echocadiogram. A mass located on septal wall of left ventricle was excised en bloc. The patient recovered uneventfully and careful follow up has be performed periodically.
Adult ; Dyspnea ; Female ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lung ; Myxoma* ; Perfusion ; Pulmonary Embolism* ; Thorax

BACKGROUND: Primary stenting as a direct reperfusion procedure after acute myocardial infarction might reduce recurrent myocardial infarction and target vessel revascularization. However, result of long or multiple stenting in the long or tandem lesions were not known. METHOD: From Jan. 1996 to Dec. 1998, patients with acute myocardial infarction including cardiogenic shock were undergone primary stenting using long or multiple stent. The clinical end points were death, recurrent infarction, subsequent bypass surgery, or repeat angioplasty of the infarct-related vessel. The results were compared with age, sex, lesion, and risk matched standard stenting group. RESULT: Baseline characteristics were similar for the 20 patients who underwent standard length stenting and the 13 patients who underwent long or multiple stenting. Stent diameter was similar in two group (3.4+/-0.3 mm vs. 3.5+/-0.4 mm, p=0.65), but total stent length was longer in long or multiple stenting group (15.5+/-1.8 mm vs. 40.18.4 mm, p=0.01). Average numbers of stent using in multiple stenting were 1.5+/-0.7. Stenting in the infarct-related artery was successful in all patients randomized to stent treatment. At 6 months, the incidence of the primary end point was 25% (5/20) in the standard stent group and 31%(4/13) in the long or multiple stent group (p=0.5). CONCLUSION: Outcomes of long or multiple stenting including mortality, recurrent myocardial infarction and target vessel revascularization was similar to standard stenting. Long or multiple stenting after acute myocardial infarction may possible procedure in some selective cases having long or tandem lesion.
Angioplasty* ; Arteries ; Humans ; Incidence ; Infarction ; Mortality ; Myocardial Infarction ; Reperfusion ; Shock, Cardiogenic ; Stents*

BACKGROUND: Although the superior reperfusion and improved clinical outcome following angioplasty for acute myocardial infarction (AMI) have been well known, 10 to 15% of reinfarction and recurrent ischemia in hospital are main limitation of primary percutaneous transluminal coronary angioplasty (PTCA). This study was undertaken to examine the safety and feasibility of stent-supported primary angioplasty in acute myocardial infarction. METHODS: Between July 1995 and Jun. 1997, 32 patients underwent direct or rescue PTCA, including patients with cardiogenic shock. After PTCA, stenting was attempted in patient with dissection or having more than 30% of residual stenosis. Result: In patient with direct PTCA, angiographic success rate was obtained in 91% (30/32). Stenting was attempted in 15 of 30 patients. These patients had suboptimal results (8 patients), non-occlusive dissection (3 patients) and acute occlusion (2 patient). Thrombolysis in myocardial infarction (TIMI) grade 3 flow was restored in 28 patients (93%). In one patient no-reflow phenomena was observed following stent insertion. Despite intra-aortic balloon pumping, there was one death during the hopitalization due to cardiogenic shock following PTCA. Subacute stent thrombosis developed in two patients. 27 patients (90%) were event-free and clinically improved through out the follow up period (11.5+/-5.2 month). Quantitative angiography showed excellent angiographic result after stenting compared with balloon PTCA (2.4+/-0.6 mm vs. 3.4+/-0.3 mm p<0.01). CONCLUSION: After failure of initial angioplasty, coronary stenting can be a supportive therapeutic strategy. Coronary stenting results in a high degree of angiographic success, a low incidence of subacute thrombosis.
Angiography ; Angioplasty* ; Angioplasty, Balloon* ; Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Intra-Aortic Balloon Pumping ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Shock, Cardiogenic ; Stents ; Thrombosis

OBJECTIVES: Work-family conflict can arise from two opposite directions: the experiences at work interfere with family life and the experiences in the family interfere with work life. This study explored the effects of the presence of two income sources on the association between work-family conflict and job attitude. METHODS: Responses to structured survey questionnaires were received from 236 two-income families living in the Seoul Metropolitan Area. RESULTS: A differential effect was observed between single-income families and two-income families. Higher job satisfaction was related with lower work interference with family (WIF) among single-income families and with lower family interference with work (FIW) among two-income families. CONCLUSIONS: Employee welfare programs need to be expanded to enhance job satisfaction for the increasing number of two-income families.
Humans ; Job Satisfaction ; Questionnaires

To clarify the correlation between erotic and nocturnal erection and evaluate their diagnostic efficacy in impotence, a comparative study was done with audiovisual stimulation penogram (AVS-Penogram) and nocturnal penile erection monitoring (NPEM: RigiScan) in two hundred twenty two impotent patients. The compatibility ratios of the audiovisual stimulation penogram and nocturnal penile erection monitoring were 74.2% in Type I (normal findings) and 66.6% in Type IIA penogram (unresponsive type). The ratio of type IIB (fluctuation type) was 37.9%. much lower compared to that of Type I. Based on the final diagnosis, audiovisua1 stimulation penogram-only had high compatibility ratio with psychogenic origin for Type I (77.7%) and with organic impotence for Type IIA (80%). Moreover combined audiovisual stimulation penogram and nocturnal penile erection monitoring had higher compatibility ratio (86.2%) than that of audiovisual stimulation penogram only analysis (77.7%) with psychogenic impotence. Therefore, we suggest that audiovisual stimulation penogram is an accurate method in Type I and Type IIA. Furthermore combined interpretation of audiovisual stimulation penogram and nocturnal penile erection monitoring may produce more precise diagnosis, especially in psychogenic impotence.
Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penile Erection*

OBJECTIVES: To investigate the level and variation of job stress according to social welfare organizations and work conditions among social workers in Seoul. METHODS: For this survey, a self-reported questionnaire was administrated to 1,000 social workers working in organizations for social welfare practice in Seoul. A total of 432 completed questionnaires were received (43.2% response rate). RESULTS: Social workers working in welfare organizations for the aged had higher job stress in the areas of job demand, insufficient job control and lack of reward than those in other welfare organizations. In addition, higher job stress was found in those in charge of both service and administrational work, without regular time for rest, working over 10 hours, in the frontline and senior grade. CONCLUSIONS: This study confirms the importance of guaranteeing regular time for breaks in the work schedule and of considering the service and administrational work ratio in job arrangement in order to alleviate stress of social workers.
Appointments and Schedules ; Questionnaires ; Reward ; Seoul* ; Social Welfare* ; Social Work*

Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.
Adult ; Dyspnea ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary* ; Maternal Mortality ; Mothers ; Pregnancy* ; Prognosis