The coronary arteries of young individuals are histologically studied. Fourteen cases in pediatric age group and three adult hearts were used. No case had clinical and pathological evidences of heart disease. Inner circumference, thickness of tunicae intima, media and adventitia were measured at eight different sites of coronary arteries. The thickness of tunica media was used as a standard scale of cardiac growth, and the heart weight, body weight, height and age were compared with the medial thickness. The morphological changes were assessed in five groups by the heart weights. Group I ( less than 10 gm) showed single endothelial lining with cytoplasmic vacuolization or endothelial denudation. Group II (more than 10 but less than 20 gm) consisted of full term babies and showed first stigma of focal intimal thickening and intimal collagen fibers. Diffuse intimal thickening more than 1/1 of medial thickness was first seen in a case with 46 gm of heart weight. Elastic fiber was not seen in internal elastic laminae of groups I and II. Fragmentation of internal elastic lamina and smooth muscle proliferation as a form of musculoelastic layer were the major findings of intimal thickening in childhood and no case showed complicated atherosclerotic lesions.
Child ; Adult ; Male ; Female ; Humans

No abstract available.

No abstract available.
Magnetic Resonance Imaging* ; Moyamoya Disease*

Purpose: This study aimed to identify the types of perception toward non-face-to-face clinical practice and to characterize the types of students who experienced online clinical practice during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Q-methodology was used in this study, and 270 Q populations were formed based on in-depth interviews with 10 nursing students who had experienced non-face-to-face clinical practice, as well as related literature. Interviews were performed from August 1 to 31, 2022. A total of 42 Q samples were extracted, and Q sorting was performed on 33 nursing students who had experienced non-face-to-face clinical practice. A Q factor analysis was performed using the PC-QUANL program. Results: The nursing students’ perceptions of non-face-to-face clinical practice were classified into the following five types: “future professional competency-focused type,” “realistic convenience priority type,” “task burden awareness type,” “negative critic type,” and “limited experience dissatisfaction type.” Conclusion This study revealed non-face-to-face clinical practice’s positive and negative aspects in nursing education. Moreover, it identified the aspects of clinical practice that cannot be replaced by non-face-to-face clinical practice and the elements of non-face-to-face practice that can complement clinical practice. These findings can be used as fundamental data to establish a stable and efficient system for improving the quality of clinical practice in the post-COVID-19 era and to implement effective non-face-to-face clinical practice according to student types.

The brain MR images of 23 patients with angiographically proved moyamoya disease were reviewed to evaluate the capability of MR to demonstrate vascular and parenchymal abnormalities. All the MR images were obtained on a 2.0 T superconducting system and included T1-weighted sagittal and T2-weighted axial images without implementation of flow compensation (FC). The vascular abnormalities demonstrated on MR images were narrowing of the cavernous internal carotid artery (ICA) (73%), narrowing or occlusion of the supraclinoid ICA (87%) and proximal middle cerebral artery (MCA) (91%), and multiple collateral vessels in the basal ganglia and/or thalamus (96%). The parenchymal abnormalities included ischemic infarctions (74%), predominantly located in watershed areas, hemorrhagic infarctions (26%), intracerebral hematomas (13%), and intraventricular hemorrhage (13%). In conclusion, MR imaging was a useful diagnostic modality for detecting both vascular and parenchymal abnormalities associated with moyamoya disease. This may obviate the need for invasive angiography as far as the diagnosis is wanted at the non-quantitative level.
Adolescent ; Adult ; Basal Ganglia/pathology/radiography ; Carotid Artery, Internal/pathology/radiography ; Cerebral Angiography ; Child ; Female ; Hematoma/complications/diagnosis/pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Moyamoya Disease/complications/*diagnosis/pathology ; Myocardial Infarction/complications/diagnosis/pathology

BACKGROUND: Ambulatory surgery has become popular because patients believe it allows them greater control over their business and personal lives and because third party payers find it reduces cost. This study was designed to compare the characteristics of induction and recovery as well as the safety of propofol with those of midazolam used for intravenous anesthesia in outpatient cystoscopy. METHODS: 56 healthy consenting outpatients were randomly assigned to receive either bolus of propofol (2 mg/kg, n=29) or midazolam (0.1 mg/kg, n=27) for anesthesia in outpatients cystoscopic procedure. All patients also received bolus of fentanyl 1ug/kg before induction and N-M blocking agent was not injected for maintenance of spontaneous respiration. Mean arterial pressure, HR and SpO2 were recorded and induction time (time to spontaneous eye closure), recovery time (time to response, time to orientation, time to ambulation) and adverse effects were evaluated. RESULTS: The results were as follows; 1) Both propofol and midazolam produced smooth induction, but caused significant respiratory depression. 2) The time of induction and postoperative recovery (time to ambulation) was faster in propofol than in midazolam. 3) There were less postoperative side effects (nausea, vomiting, dizziness) in propofol than in midazolam. 4) There were more cardiovascular depression in propofol than in midazolam. CONCLUSION: These results suggest 1) that propofol has significant advantage over midazolam in outpatient surgery, where early ambulation and discharge is desirable and 2) that both propofol and midazolam should be administered by expert anesthesiologist only when ventilatory assistant device with oxygen is immediately available.
Ambulatory Surgical Procedures ; Anesthesia* ; Anesthesia, Intravenous ; Arterial Pressure ; Commerce ; Cystoscopy* ; Depression ; Early Ambulation ; Fentanyl ; Humans ; Insurance, Health, Reimbursement ; Midazolam* ; Outpatients* ; Oxygen ; Propofol* ; Respiration ; Respiratory Insufficiency ; Vomiting

The common bile duct normally enters the posteromedial aspect of the second part of the duodenum. However, anomalous drainage of the common bile duct into the stomach, pyloric channel, duodenal bulb and fourth portion of the duodenum has been reported in the literature. An anomalous pancreatic duct, with ectopic drainage of the common bile duct, is particularly rare. Herein, we report the case of a 69-year-old woman who showed pancreatic ductal variation and anomalous drainage of the common bile duct into the duodenal bulb. The patient required a cholecystectomy and choledochoenteric anastomosis to relieve the obstructive jaundice and abdominal pain.
Abdominal Pain ; Aged ; Cholecystectomy ; Common Bile Duct* ; Drainage* ; Duodenum ; Female ; Humans ; Jaundice, Obstructive ; Pancreatic Ducts* ; Stomach

When doctors evaluate the complaints of dizziness, they often perform a series of clinical tests to look for the evidence of a vestibular dysfunction. A useful procedure is to ask the patient to take deep breaths and observe the gaze behind Frenzel goggles. If hyperventilation-induced nystagmus(HIN) is detected, it is the evidence for an underlying vestibular imbalance. The authors evaluated nystagmus with electronystagmography after hyperventilation for 50 seconds. Brain imaging was performed to search the responsible lesion for dizziness. Brain MRI revealed a brain tumor suggesting vestibular schwannoma in the left cerebellopontine angle. After hyperventilation, dizziness and the right beating horizontal nystagmus with Alexander law could be detected. By precisely measuring the HIN, we determined that inputs arising from the horizontal semicircular canal were mainly responsible. The contralaterality of the direction of the horizontal component of the nystagmus was detected. We suggest that clinicians should routinely check the nystagmus after hyperventilation, when they evaluate patients complaining of dizziness.
Brain ; Brain Neoplasms ; Cerebellopontine Angle ; Dizziness ; Electronystagmography ; Eye Protective Devices ; Humans ; Hyperventilation* ; Jurisprudence ; Magnetic Resonance Imaging ; Neuroimaging ; Neuroma, Acoustic* ; Nystagmus, Pathologic ; Semicircular Canals

PURPOSE: The purpose of this study was to evaluate the radiologic and clinical outcomes after intramedullary nailing with Poller screw insertion at initial stage in infraisthmal femur shaft fractures. MATERIALS AND METHODS: Seven consecutive patients (7 femurs) treated with antegrade intramedullary nailing with Poller screw insertion for the infraisthmal femur shaft fracture were reviewed retrospectively. There were 4 male and 3 female patients. Mean age was 46.1 years (20-72 years). Operative time including Poller screw insertion, time for union, malalignment, and range of motion were evaluated. RESULTS: All 7 cases had primarily healed successfully. Mean time for radiologic union was 19.1 weeks (16-24 weeks) postoperatively. One case had 5 degree valgus malalignment. One case of 15 mm shortening was reported and he required shoe lift orthosis. All cases had a full range of motion in hip and knee joint. CONCLUSION: Antegrade intramedullary nailing with Poller screw insertion is useful in the initial treatment of infraisthmal femur shaft fracture, because it could provide additional stability. An additional 20 minutes were required but a Poller screw should be considered according to the anatomic location of a femur shaft fracture.
Female ; Femur* ; Fracture Fixation ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Knee Joint ; Male ; Operative Time ; Orthotic Devices ; Range of Motion, Articular ; Retrospective Studies ; Shoes

BACKGROUND: Current researeh indicates that making among young adults tends to persist into later life. Furthermare, numerous studies have proven the harmful effects of female stmoking on their offspring. These trends have produced a wide variety of(social, medical and economic) problems. This study is aimed at obtaining basic information to help prevent patential smokers from trying their first cigarette as well as to instruct to stop smoking. This study involves the following: a) investigating general factors affecting the smoking status of college students in addition to the deterents to smoking b) seeking to understand the familial influence on smoking status c) resesrching how smokers, ex-smokers and non-smakers perceive their familial influence on their smoking status. METHODS: In June 1998, a self-administered questiannaire was distributed to 800 students of two junior colleges by random sampling in Po'hang. 720 were returned and 642 displayed adequate respanses. The questionnaires were analyzed using SPSS and EXCEL software. RESULTS: Among the tatal of 642 subjects studied, 220 were males(34.3%) and 422 femaks(66.7%). Of the male subjets 149(67%) were smokers, 46(21% ) were ex-smokers and 25(11.3%) were non smokers. Of the female subjcts 22(5.2%) were smokers, 399(92.9%) were ex-smokers and 11(2.6%) were non smokers. The number of cigarettes smoked per day was as follows:79 subjects(46.2%) smoked 10-20 cigarettes, 55(33.2%) smoked less than 10 and 37(21.6%) smoked more than a pack of cigarette. When considering the related factors which affect student smoking it is evident that there is a growing tendency toward smoking among male students when they have dose friends who are smokers and who cansume alcohol on a weekly basis. About the motives of smoking, there was a significant difference between the following two cases. Those(36.2%) who successfully quit smoking had started to smoke through solicitation by friends, but only 2.7% were successful if they had started to smoke to relieve stress When it comes to the influence of familial factors on successful versus unsuccessful attempts to quit smoking, the status of family smokers, whether or not smokers made their habit obvious to family members and whether or not the family allowed smoking did nat have any noticeable statistical difference between continuation of smoking and smoking cessation. However there was an obviaus difference among ex-smokers, non smokers and smokers when they responded as to whether or not their family had an effect on smoking status and smoking cessation:ex-smokers(38.4%), non-smokers(30.6%) and smokers(17.0%). CONCLUSIONS: In the light of the related factors attributed to the continuation of smoking in this study, it was revealed that there was a higher possibility of current smoking when the subject were a male and have close friends who smoked and had a higher level of average alcohol cansumption. this study also indicated that the continued smoking rate was higher among irdividuals who started smoking because of stress than those who began smoking as a result of peer pressure. There was no significant relatianship between smoking status and familial influence on smoking cessation between smokers and ex-smokers, but ex-smokers and non smokers had more awarness of familial influence than smokers.
Female ; Friends ; Humans ; Male ; Smoke* ; Smoking Cessation ; Smoking* ; Tobacco Products ; Young Adult ; Surveys and Questionnaires