PURPOSE: The aim of this study is to better understand the pattern and nature of reverse redistribution (RR) in myocardial perfusion imaging. MATERIALS AND METHODS: In consecutive 20 acute myocardial infarction (MI) patients, frequency of RR was correlated with that of subendocardial MI that was detected by myocardial contrast echocardiography (MCE). RR was judged to be present when there was more than one grade of worsening in perfusion at 24 hr delayed images compared with the initial rest images. MCE evaluated the significant lack of opacification in the subendocardial myocardium relative to the subepi-cardial myocardium to suggest the subendocardial MI. Kendall's nonparametric correlation coefficiency was calculated. RESULTS: Concordant cases were 15 of 20 (75%) and correlation was statistically significant (p=0.0285). CONCLUSION: Our results suggested that RR was correlated with MCE-detected nontransmural MI.
Echocardiography* ; Humans ; Myocardial Infarction* ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion

No abstract available.

PURPOSE: To investigate the effect of steroid treatment (intravenous injection, oral) in patients with non-arteritic anterior ischemic optic neuropathy (NAION). METHODS: From January, 2005 to December, 2016, 41 patients who were diagnosed with NAION and observed for more than 6 months were included in this study. The treatment was decided based on patient's choice after explaining the advantages and disadvantages of steroid therapy. The patients were divided into three groups (intravenous steroid injection, oral steroid, no treatment). Initial visual acuity, final visual acuity, degree of visual field defect, fluorescein angiography, visual evoked potential and brain magnetic resonance imaging were analyzed by chart review. RESULTS: The chief complaints of the 41 NAION patients at the first visit were decreased visual acuity (n = 24), visual field defect (n = 10), no symptoms (n = 4), diplopia (n = 2), and floaters (n = 1). The distribution of the patients according to steroid administration method was 15 patients with intravenous steroid injection, 14 patients with oral steroid and 12 patients with no treatment. The improvement in visual acuity was greatest in intravenous steroid injection (87%), oral steroid (43%) and no treatment (33%) in that order. CONCLUSIONS: In a retrospective comparison of treatment effects after explaining the advantages and disadvantages of steroid therapy in patients with NAION, the intravenous steroid injection group showed 87% improvement in visual acuity and an odds ratio of 5.5 (95% confidence interval [CI] 1.05–28.88, p-value 0.04), while the oral steroid group showed 43% improvement and an odds ratio of 1.5 (95% CI 0.30–7.43, p-value 0.62). The steroid treatment group showed better visual acuity improvement than the no treatment group, and the intravenous steroid injection group showed 5.5 times greater improvement in visual acuity compared to the no treatment group.
Brain ; Diplopia ; Evoked Potentials, Visual ; Fluorescein Angiography ; Humans ; Magnetic Resonance Imaging ; Methods ; Odds Ratio ; Optic Neuropathy, Ischemic* ; Retrospective Studies ; Steroids* ; Visual Acuity ; Visual Fields

PURPOSE: To report a case of posterior ischemic optic neuropathy accompanied by carotid artery plaque in a patient with retrobulbar optic neuritis. CASE SUMMARY: A 48-year-old man visited our clinic complaining of headache, decreasing visual acuity and defect of inferior visual field in his left eye for 3 days. The best corrected visual acuity was 1.0 in the right eye and 0.1 in the left eye. The anterior segment state, intraocular pressure, fundus examination and optical coherence tomography were normal in both eyes. Relative afferent pupillary defect, color vision deficiency and total scotoma were observed in his left eye. The results of the laboratory test and brain magnetic resonance imaging were normal. He was discharged from the hospital after 3 days of systemic steroid treatment on the basis of retrobulbar optic neuritis. A week later, fluorescent angiography and carotid ultrasonography were performed because of his history memory loss and left upper limb weakness before admission. A focal filling defect of the peripapillary area was found on fluorescent angiography. A plaque with a thickness of 1.9 mm and a length of 1.4 cm was found on carotid ultrasonography. After 6 months, the best corrected visual acuity was 0.4 in the left eye and the visual field showed a partially improved defect. CONCLUSIONS: Fluorescent angiography is recommended for potential posterior ischemic optic neuropathy in patients with retrobulbar optic neuritis, even though it is rare. Carotid ultrasonography is useful in finding atherosclerosis to prevent stroke or cardiovascular disease if ischemic cause is suspected on fluorescent angiography.
Angiography ; Atherosclerosis ; Brain ; Cardiovascular Diseases ; Carotid Arteries* ; Carotid Stenosis* ; Color Vision Defects ; Headache ; Humans ; Intraocular Pressure ; Magnetic Resonance Imaging ; Memory Disorders ; Middle Aged ; Optic Neuritis ; Optic Neuropathy, Ischemic* ; Pupil Disorders ; Scotoma ; Stroke ; Tomography, Optical Coherence ; Ultrasonography ; Upper Extremity ; Visual Acuity ; Visual Fields

Factor XIII (fibrin stabilizing factor) has roles of stabilizing clot and cross-linking fibrin polymer, so the congenital factor XIII deficient patient has clot unstability and delayed bleeding episodes. We experienced a case of 11 years old girl who had experienced delayed umbilical healing, several episodes of intraabdominal and intracranial hemorrhage. But her coagulation screening studies with prothrombin time, aPTT (activated partial thromboplastin time), bleeding time showed normal value at each episode. These findings suggested typical features of congenital factor XIII deficiency. We used semiquantitative method to diagnose Factor XIII deficiency and quantify Factor XIII. We has treated her successfully with prophylactic fresh frozen plasma through plasmapheresis from two donors.
Bleeding Time ; Child ; Factor XIII Deficiency* ; Factor XIII* ; Female ; Fibrin ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Mass Screening ; Plasma ; Plasmapheresis ; Polymers ; Prothrombin Time ; Reference Values ; Thromboplastin ; Tissue Donors

Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

No abstract available.
Humans

The persistent left superior vena cava (LSVC) is not rare cardiovascular developmental anomaly occurring both in association with congenital heart disease and as an isolated anomaly of no hemodynamic importance. We have studied 73 cases of the LSCV out of 1,060 cases of congenital heart disease catheterized at Yonsei Cardiovascular Center. We conducted the study with a view point of position of the heart and abdominal organs and segmental analysis of the underlying congenital heart disease. We also analysed the associated extracardiac vascular anomalies. The following results were obtained: 1) The incidence of this anomaly among congenital heart disease was 6.9% and 41 cases(56.2%) had cyanosis. 2) We observed 20 cases(27.3%) with the malposition of the heart and 17 cases(23.3%) with malposition of the abdominal organs. The ventricular loops revealed D-loop in 60 cases, L-loop in 7 cases and in the remaining 6 cases, it was uncertain. 3) With a view point of type of LSVC by Lucas & Krabill, type A was in 50 cases(68.5%), type D in 14 cases(19.2%), type B in 5 cases(6.8%) and type C in 4 cases(5.5%). 4) Associated cardiovascular anomalies were as follows: ventricular septal defect; 42 cases(57.5%), atrial septal defect; 33 cases(45.2%), patent ductus arteriosus; 27 cases(36.9%), and tetralogy of Fallot; 18 cases(24.7%). In conclusion, LSVC usually has no hemodynamic importance, but this cardiac anomaly is frequently combined with complex intracardiac anomalies. Therefore, it is important to making accurate diagnosis and successful management for preventing the risk of it.
Catheters ; Classification* ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Heart ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hemodynamics ; Incidence ; Tetralogy of Fallot ; Vena Cava, Superior*

PURPOSE: This study was conducted to analyze and clarify the meaning of the concept for relocation stress -focusing on patients transferred from an intensive care unit to a general ward. METHODS: This study used Walker and Avant's process of concept analysis. RESULTS: Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control. CONCLUSION: Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.
Adaptation, Psychological ; Caregivers ; Concept Formation ; Humans ; *Intensive Care Units ; *Patient Transfer ; Patients' Rooms ; *Stress, Psychological

The purpose of this study was to explore and describe the experience of Dan-Jeon breathing training and of Qi as a essential substance in forming human body. The sample consists of 7 participants who are Dan-Jeon Breathing training in a Training center, Pusan, Korea. They were asked open-ended questions in order for them to talk about their experiences. With permission of the subjects, the interviews were recorded and transcribed. 1. The purpose of Dan-Jeon Breathing The interview data was organized by themes into 4 categories: hope for health recovery, a concern about Dan-Jeon Breathing, seeking meaning of life, change of lifestyle. 2. The experience of Qi during Dan-Jeon Breathing training The interview data was organized by themes into 3 categories: an autonomic movement of body, spiritual experience, conviction of existence of Qi. 3. The change after Dan-Jeon Breathing training The interview data was organized by themes into 7 categories: physical health promotion, emotional relaxation, promoting brain function, positive attitude about life, love to others, investigation for self, improvement on Qi feeling.
Brain ; Busan ; Health Promotion ; Hope ; Human Body ; Korea ; Life Style ; Love ; Qi ; Relaxation ; Respiration*