Proper positioning of pulmonary artery catheter and predicting distal migration of it during cardiopulmonary bypass is important for the prevention of perioperative complication of pulmonary artery rupture. The authors therefore examined the insertion length of pulmonary artery catheter via right internal jugular vein at which catheter tip was advanced to the most proximal position where pulmonary capillary wedge pressure could be obtained. And also the distal migration is measured by comparing the difference between prebypass and postbypass corrected length. Just before bypass, pulmonary artery catheter was arbitrarily receded 5cm for the prevention of spontaneous distal migration and wedging. The subjects were 47 patients who underwent open heart surgery (valve replacement, coronary artery bypass graft) during the period of November, 1992 through April, 1993. The results were as follows. 1) The insertion length of pulmonary artery catheter from skin to the right ventricle inlet, pulmonary artery inlet and pulmonary capillary wedge position were 26.5+/-3.0 cm, 36.8+/-4.9 cm and 46.1+/-5.7 cm respectively. 2) There were no significant statistical correlations between insertion lengths and patient constitutions such as body weight and height(r=0.144, r=0.032). 3) Locations of catheter tips were distributed to the 0.9+/-3.1 cm left to the spinous process, 1.9+/-1.6 cm inferior to the carina ; mostly LLQ of the lung field(51%). 4) During cardiopulmonary bypass, pulmonary artery catheter tips were migrated distally in 93.6% of the cases and the migration lengths were 2.7+/-2.0 cm. 5) There were no major perioperative complications caused by pulmonary artery catheterization. These results suggest that 5 cm withdrawal of pulmonary axtery catheter just before cardiopulmonary bypass can prevent the fatal complication of pulmonary artery rupture owing to its spontaneous distal migration.
Bays ; Body Weight ; Capillaries ; Cardiopulmonary Bypass ; Catheterization, Swan-Ganz ; Catheters* ; Constitution and Bylaws ; Coronary Artery Bypass ; Extracorporeal Circulation* ; Heart Ventricles ; Humans ; Jugular Veins ; Lung ; Pulmonary Artery* ; Pulmonary Wedge Pressure ; Rupture ; Skin ; Thoracic Surgery

A 65-year-old female patient visited our clinic complaining of multiple skin lesions since one year ago. There were yellowish to brownish colored, bean to walnut-sized nodules on both lower extremities. Dylon stain with polarizing microscopy, immunohistochemical stain to amyloid P and immunoglobuhn-kappa chain showed positive reactivities but keratin stain was negative. According to histopathologic and immunohistochemical findings, she was diagnosed as nodular amyloidosis.
Aged ; Amyloid ; Amyloidosis* ; Female ; Humans ; Lower Extremity ; Microscopy ; Skin

No abstract available.
Biopsy*

Melkersson-Rosenthal (M-R) syndrome consists of a triad of (1) recurrent peripheral facial nerve paralysis which develops alternatively on both sides of face, (2) non-inflammatory facial edema, and (3) furrowed tongue. Since the cause of M-R syndrome is unknown, various forms of therapy have been tried, but there were no conclusive evidence that they altered the course of the disease. A 27-year-old female and a 44-year-old male patient with recurrent facial nerve paralysis were diagnosed with M-R syndrome. We report the two cases of M-R syndrome with the brief review of literatures.
Adult ; Edema ; Facial Nerve ; Female ; Humans ; Male ; Melkersson-Rosenthal Syndrome* ; Paralysis ; Tongue, Fissured

OBJECTIVE: This study proposes a hospital information system through the design and actualization of the Health Level 7 Development Framework (HDF) as a medical standard data model to sharing medical records between different hospital systems. The Health Level 7 Development Framework is a technique designed to capture domain expertise in a manner that it to be structured to create and validate models, which are subsequently translated into messages. METHODS: The process used Health Level 7 Development Framework methodology with Health Level 7 tools. RESULTS: We drew diagrams for each steps of the Health Level 7 Development Framework and an Extensible Markup Language (XML) schema for chemotherapy order system. CONCLUSION: This study applied Health Level 7 Development Framework methodology to practice. It is a good reference for the hospital information system (HIS) and enables information sharing among healthcare institutions.
Delivery of Health Care ; Drug Therapy* ; Health Level Seven ; Hospital Information Systems ; Information Dissemination ; Medical Records

PURPOSE: To evaluate the influence of a silicone tube on tear drainage in patients with a healed rhinostomy site after dacryocystorhinostomy. METHODS: The subjects of the present study included the patients for whom the removal of a silicone tube was performed after dacryocystorhinostomy for acquired nasolacrimal duct obstruction. The silicone tube was removed after the rhinostomy site was completely healed. The tear drainage function was evaluated using the fluorescein dye disappearance test at the following 3 time points: immediately before, immediately after, and 1 month after silicone tube removal. In addition, a Schirmer test was performed and tear break-up time was measured at each time point. To study the correlation between the measured values and subjective tearing symptoms, self-report questionnaires were given to each patient at his/her last visit. RESULTS: The 3 measured values showed no statistical difference between the 3 time points, immediately before, immediately after, and 1 month after silicone tube removal. When the patients were divided into groups according to their subjective symptomatic changes after silicone tube removal, no group showed statistically significant difference in the 3 measured values before, between, and after silicone tube removal. CONCLUSIONS: In patients with a healed rhinostomy site after dacryocystorhinostomy, the removal of the silicone tube did not induce a change of tear drainage function. Therefore, based on the results from the present study, a silicone tube may not have influence on tear drainage functions.
Dacryocystorhinostomy ; Drainage ; Fluorescein ; Humans ; Nasolacrimal Duct ; Surveys and Questionnaires ; Silicones ; Tears

PURPOSE: The objective of this survey was to develop an operational plan for breast feeding education. In order to comprehend current breast feeding patterns, we aimed to examine the knowledge, attitude and practices regarding breast feeding of mothers and to compare the data with a similar study done 6 years ago. METHODS: A total of 127 mothers who delivered healthy babies at Ewha Womans University Dongdaemun Hospital were interviewed and asked to complete a survey on their perception of breast feeding during their postpartum stay in the hospital. A follow up phone interview was carried out at 1, 2 and 3 months after delivery and similar questions were asked. RESULTS: At the time of delivery, 96.1 percent of mothers planned to breast feed, including 73.2 percent of exclusive breast feeding and 22.8 percent of mixed feeding. The duration of breast feeding planned was mostly 7-12 months. Breast feeding had been recommended by family members. Between 1-3 months, exclusive breast feeding was maintained at least 50 percent but a large number of mothers who had practiced mixed feeding changed to formula feeding. This trend demonstrates an increase in the rate of breast feeding at 3 months compared to a similar study done in 1999. The main reasons for discontinuing breast feeding were insufficient amount of milk (35.0 percent) and return to work (27.5 percent). CONCLUSION: Breast feeding rate has increased in Korea since 1999 but failure to continue exclusive breast feeding still occurs mainly within the first month after delivery. Breast feeding education should focus on supportive care to mothers practicing mixed feeding.

PURPOSE: The aim of this study was to determine the genotype frequencies of interleukin 10 (IL-10) gene polymorphisms and to investigate their association with the risk of respiratory distress syndrome (RDS) in preterm Korean infants. METHODS: Two hundred fourteen preterm infants born at Ewha Womans University Mok Dong Hospital between November 2003 and July 2008 were studied. The cord blood of preterm neonates and the corresponding maternal blood were analyzed by PCR for IL-10 gene (IL-10 -1082A/G, -819T/C, and -592A/C) polymorphisms. The clinical data of patients were collected retrospectively by chart review. RESULTS: The genotype frequencies of IL-10 genes in Korean mothers with preterm infants differ from other reports. The prevalence of two promoter SNPs of the IL-10 cytokine gene was similar but none had the IL-10-1082GG homozygote. Multiple logistic regression analysis demonstrated the risk of RDS to be significantly lower in the infants of the mothers with an IL-10-592AC/CC genotype than in those with an AA genotype (P= 0.033). The risk of RDS was significantly lower in the mother with an IL-10-819TC/CC genotype than in those with a TT genotype (P=0.030). However, IL-10 polymorphisms in the cord blood were not significantly different in preterm infants with RDS compared with the preterm infants without RDS. When we compared the incidence of RDS and each IL-10 A-1082G/T-819C/A-592C haplotype, the ACC haplotype had a protective effect on RDS (P=0.007). CONCLUSION: We conclude that the maternal IL-10-592A/C and IL-10-819T/C polymorphisms may have a role in the development of the RDS in preterm infants.
Female ; Fetal Blood ; Genotype ; Haplotypes ; Homozygote ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Interleukin-10 ; Logistic Models ; Mothers ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prevalence ; Retrospective Studies

The purpose of this study was to evaluate effects of a nutrition education focused on Food Exchange System for the higher grades elementary children. Nutrition education lessons (40 min/lesson, 4 times), '5 major nutrients and functions', '6 food groups', 'daily needed energy and food exchange units', 'good choice of snacks and balanced exercise' were provided to elementary students (5th grade students). This research was based on the data from two groups of elementary school children in the 'education' group (n = 31) and 'non-education' group (n = 31). We assessed the changes in dietary attitude, food habit and nutrition knowledge using questionnaire and nutrient intake using 24hr recall method by nutrition education using the developed pamphlet. After education, there was a significant difference in the dietary attitude score only in attitude of 'balanced meal' (p < 0.001) in the education group compared to the non-education group. In food habit, there were significant positive changes in the type of breakfast and in the priority of choosing snack in the educated group. In nutrition knowledge, there were significant increases in scores of 'function of carbohydrate' (p < 0.05), 'function of fat' (p < 0.01), 'function of vitamin' (p < 0.01), 'foods of carbohydrate' (p < 0.01), and 'foods of vitamin' (p < 0.01) in the educated group. After education,carbohydrate: protein: fat (CPF) ratio was significantly different between the two groups (education group, 59 : 16 : 26 vs. non-education group, 63 : 15 : 23). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), there were significant positive effects in energy (p < 0.05), thiamin (p < 0.05), riboflavin (p < 0.05), vitamin C (p < 0.05), phosphorus (p < 0.01), Fe (p < 0.01) and zinc (p < 0.01) in the education group compared to the non-education group. In conclusion, the developed 4 times' nutritional education pamphlet focused on individual daily energy requirements and food exchange units using food exchange system for higher grades' elementary student may positively change nutrition knowledge and dietary intakes.
Ascorbic Acid ; Breakfast ; Child ; Food Habits ; Humans ; Pamphlets ; Phosphorus ; Surveys and Questionnaires ; Riboflavin ; Snacks ; Zinc

PURPOSE:There are some cases of false positive in neonatal screening for congenital adrenal hyperplasia. To understand its significance of the increased 17 alpha-hydroxyprogesterone(17 alpha-OHP) levels in the cases of positive result, we followed its levels during infancy. METHODS:From July 1997 to June 1998, totally 1,730 babies were screened for congenital adrenal hyperplasia(CAH) measuring 17 alpha-hydroxyprogesterone(17 alpha- OHP) using an enzyme immunoassay(EIA) on dried blood spots. In infants of positive result, the radioimmunoassay(RIA) was used measuring 17 alpha-OHP in serum. And we followed up the levels of 17 alpha-OHP during infancy. Cortisol and ACTH were also measured and followed up in the morning simultaneously. RESULTS:No CAH was detected during the study period. With the 13 ng/mL cutoff limit for 17 alpha-OHP before March 1998, the recall rate was 3.09%. With the 20 ng/mL cutoff limit after March 1998, the recall rate was decreased to 1.58%. Follow-up of the high levels of 17 alpha-OHP in positive cases showed a sharply decreased curve according to age. CONCLUSION: In clinically normal neonates, the high levels of 17 alpha-OHP at screening decreased continuously during infancy.
17-alpha-Hydroxyprogesterone* ; Adrenal Hyperplasia, Congenital ; Adrenocorticotropic Hormone ; Follow-Up Studies ; Humans ; Hydrocortisone ; Infant ; Infant, Newborn ; Mass Screening ; Neonatal Screening*