No abstract available.
Amniotic Fluid* ; Corticotropin-Releasing Hormone* ; Female ; Obstetric Labor, Premature* ; Pregnancy

Interrupted aortic arch is a extreme type of coarctation of aorta and mostly associated with other cardiac anomalies. Unless there were no proper management, about 90% of babies would be dead in their neonatal period. A 28-year-old nulliparous woman was refered to our hospital for fetal echocardiography at 23 weeks' gestation with an abnormal prenatal ultrasonographic findings. We found interrupted aortic arch(type A), which was located in distal portion of the left subclavian artery, and ventricular septal defect. After 5 months follow up, the baby was vaginally delivered at 40 weeks' gestation. This baby was delivered at 40 weeks' gestation of a male infant with APGAR scores of 8 and 9 at 1 and 5 minutes, respectively. Neonatal echocardiography and electron beam tomography revealed interrupted aortic arch(type A), ventricular septal defect(subaortic type), patent ductus arteriosus, and atrial septal defect(ostium secondum defect). At the 10th day of birth, the infant was performed the operation of end to end anastomosis of desending aorta, patch repair of atrial septal defect, ligation of patent ductus arteriosus, and direct closure of patent foramen ovale.
Adult ; Aorta ; Aorta, Thoracic* ; Aortic Coarctation ; Ductus Arteriosus, Patent ; Echocardiography* ; Female ; Follow-Up Studies ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Infant ; Ligation ; Male ; Parturition ; Pregnancy ; Subclavian Artery ; Tomography, X-Ray Computed

We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.
Aorta ; Atrial Appendage ; Bradycardia ; Cardiopulmonary Resuscitation* ; Catheterization ; Extracorporeal Membrane Oxygenation* ; Heart Failure ; Heart Septal Defects, Ventricular ; Heart* ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Infant ; Critical Care ; Male ; Membranes ; Tachycardia, Ectopic Junctional ; Thoracic Surgery*

No abstract available.

No abstract available.
Cisterna Magna*

OBJECTIVES: The critical pathways provide high quality of medical services in a cost-effective manner. To investigate the decrease in length of hospital stay and increase of cost effectiveness by using critical pathways, we compared hospital stay, cost of treatment, and the patient's satisfaction before and after critical pathway use. METHODS: We made a critical pathway team, which consisted of obstetric staff members, a resident, two nurses, a pharmacist, two clerical staff members. We made critical pathways for the medical team and patients. A prospective evaluation of a critical pathway for cesarean section was used as a comparison for control patients. RESULTS: The data for 305 patients with a critical pathway were compared to those of 136 control patients. The mean hospital stay is shorter in critical pathway patients than control patients. The cost of treatment decreased and differences between DRG (Diagnosed Related Groups) and cost of treatment increased in critical pathway patients. CONCLUSIONS: Using critical pathways in cesarean section decreased the duration of hospital stay and increased cost effectivesess. The critical pathways were useful as a means to minimize cost while increasing patient satisfaction.
Cesarean Section* ; Cost-Benefit Analysis ; Critical Pathways* ; Diagnosis-Related Groups ; Female ; Humans ; Length of Stay ; Patient Satisfaction ; Pharmacists ; Pregnancy ; Prospective Studies

OBJECTIVE: There have been conflicting reports as to whether higher rates of poor perinatal outcome carry over in cases of idiopathic hydramnios. Thus, this study was undertaken to determine whether there is any association between idiopathic hydramnios and adverse perinatal outcome. METHODS: From January 1995 to December 1999, 103 consecutive women with singleton pregnancies complicated by idiopathic hydramnios(amniotic fluid index>or=25cm) who were delivered at the Severance hospital were studied. Measured perinatal outcomes and maternal complications included preterm delivery, small for gestational age, large for gestational age, malpresentation at delivery, primary cesarean section rate, Apgar score at 5 minutes<7, admission to the neonatal intensive care unit, perinatal death, and postpartum hemorrhage. These findings were compared by means of the chi-square test, Fisher exact test, student's t-test, and logistic regression test with those of 320 control subjects with normal amniotic fluid index(5 Amniotic Fluid ; Apgar Score ; Cesarean Section ; Female ; Fetal Development ; Gestational Age ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Logistic Models ; Polyhydramnios* ; Postpartum Hemorrhage ; Pregnancy ; Pregnancy Outcome* ; Pregnancy*

OBJECTIVE: To identify the effects of isokinetic strengthening of trunk muscles on balance in hemiplegic patients after stroke. METHOD: All participants were ambulatory hemiplegic patients, injured at least 6 months prior to study. The patients (n=16) were randomly divided into two groups. The control group received neurodevelopmental treatments and gait training 3 times a week. In addition to the same treatments provided for the control group, the experimental group received trunk isokinetic strengthening exercises using isokinetic dynamometer 3 times a week. Trunk muscle peak torque and balance in the experimental group were compared with those in control group at baseline and 4 weeks after treatments. RESULTS: There were no significant differences in age, lesion of hemiplegia, time after stroke onset, trunk muscle strength and Berg balance score before treatments between two groups. In the experimental group, peak torques of trunk extensor increased significantly at 60degrees/sec and 90degrees/sec at 4 weeks (p<0.05), but there were no significant improvements in peak torques of trunk flexor at all degree and extensor peak torques at 120degrees/sec. Both the extensor and flexors showed no significant changes in the control groups. In the experimental group, a mean percent change in peak torque involving the trunk extensor was significantly increased at 60degrees/sec. In the experimental group, Berg balance scores, 10 m gait velocity, sit to stand and gait 3 m and return, and 10 seconds stair up and down were improved (p<0.05). No significant improvements were noted in the control group. CONCLUSION: Isokinetic strengthening of trunk muscles can improve balance in hemiplegic patients.
Exercise ; Gait ; Hemiplegia ; Humans ; Muscle Strength ; Muscles ; Stroke ; Torque

Vaccination is an important strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. We conducted a web-based cross-sectional survey based on Google Forms to collect data on adverse events (AEs) after the first dose of the ChAdOx1 nCoV-19 vaccine for healthcare workers (HCWs). Among the 1,676 vaccinated HCWs, 59.5% (998/1,676) responded to the survey. In total, 809 (81.1%) respondents reported experiencing AEs. There were no serious AEs, such as anaphylaxis. The most common AE was pain at the injection site (76.2%), followed by fatigue (75.9%), myalgia (74.9%), and fever (58.4%). HCWs in the younger age group experienced significantly more AEs than in the older age group.

Vaccination is an important strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. We conducted a web-based cross-sectional survey based on Google Forms to collect data on adverse events (AEs) after the first dose of the ChAdOx1 nCoV-19 vaccine for healthcare workers (HCWs). Among the 1,676 vaccinated HCWs, 59.5% (998/1,676) responded to the survey. In total, 809 (81.1%) respondents reported experiencing AEs. There were no serious AEs, such as anaphylaxis. The most common AE was pain at the injection site (76.2%), followed by fatigue (75.9%), myalgia (74.9%), and fever (58.4%). HCWs in the younger age group experienced significantly more AEs than in the older age group.