Discrete subaortic stenos is one of the subtype of congenital left ventricular outflow obstruction and frequently associated with other defect such as ventricular septal defect, coarctation of the aorta, inturrupted aortic arch, double-chambered right ventricle and atrioventricular canal. It is progressive disease from the neonatal period and can be a cause of secondary endocarditis or aortic regurgitation. The authors have experienced a case of discrete subaortic stenosis without other associated lesions in 8 years old male patient who has complained chest discomfort. The diagnosis was established by the findings of echocardiography and cardiac catheterization. We report this case with a brief review of related literatures.
Aorta, Thoracic ; Aortic Coarctation ; Aortic Valve Insufficiency ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Diagnosis ; Discrete Subaortic Stenosis* ; Echocardiography ; Endocarditis ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Male ; Thorax ; Ventricular Outflow Obstruction

The antinuclear antbody (ANA) test have been used to screen the patients with systemic lupus erythematosus (SLE) and other autoimmune diseases. We had retrospectively reviewed the 263 records of pediatric patients with doing ANA tests who admitted at Department of Pediatrics, Kyung Hee University Hospital, from January 1988 to May 1993. The following results were obtained. 1) The positive rate of ANA test in patients with connective tissue diseases is 16 out of 40(40%).In patients with SLE, the positive rate of ANA test is 9 out of 11 (82%). 2) The positive predictivity for SLE is 9 out 36 (25%). 3) The positive predictivity for connective tissue disease and possible immune disease is 28 out of 36 (78%). 4) The false positive rate is 8 0ut of 36 (22%), Thus, the pediatric patients with positive ANA test should be applicable for diagnosis with prudence. 5) The positive anti-dsDNA in patients with the positive ANA is shown in 4 cases and these patients are all SLE. In conclusion, the patients who had repeated positive ANA should be tested Anti-dsDNA antibody, and further clinical and diagnostic evaluation of other ANA associated diseases.
Autoimmune Diseases ; Connective Tissue Diseases ; Diagnosis ; Humans ; Immune System Diseases ; Lupus Erythematosus, Systemic ; Pediatrics ; Retrospective Studies

BACKGROUND: The inclusion of cardiopulmonary resuscitation (CPR) in formal education has been a useful approach to providing basic life support (BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning (PAL) to train high-school students to perform BLS services. METHODS: This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS. RESULTS: We found no statistically significant difference between the control and PAL groups in their willingness to perform CPR on bystanders (control: 55.2％, PAL: 64.7％,P=0.202). The PAL group was not significantly different from the control group (control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services. CONCLUSION: In educating high school students about BLS, there was no significant difference between PAL and traditional education in increasing the willingness to provide CPR to bystanders or the ability to retain knowledge about BLS.

A case of vaginal and cervical adenocarcinoma, mostly of clear cell type, in young women have been associated with intrauterine exposure to diethystillbestrol(DES) or other nonsteroidal estrogenic substances and vaginal adenosis. We have encountered a case of clear-cell adenocarcinoma of the cervix uteri of 27years young house wife, in which there was a history of intrauterine exposure to DES. We presented a case with a brief review of related literature.
Adenocarcinoma ; Adenocarcinoma, Clear Cell* ; Cervix Uteri* ; Estrogens ; Female ; Humans ; Spouses

OBJECTIVE: To investigate the clinical results of the first metatarsophalangeal arthrodesis for treating the hallux valgus deformity of the rheumatoid arthritis, using the fixation method with 2 crossed screws. METHODS: 19 cases of the rheumatoid hallux valgus deformity were tried to treat with the first metatarsophalangeal arthrodesis, using 2 crossed screws. The follow-up period was averaged in 16 months. The subjective and objective findings were evaluated. Radiologically measurements for the hallux valgus angle, 1, 2 intermetatarsal angle and dorsiflexion angle were measured. RESULTS: Cases, of which the first metatarsophalangeal joint successfully fixated with 2 crossed screws, were 14 (73.7%). 5 failed fixations with 2 crossed screws due to breakage of the cortical bone were immediately refixed with fixation methods (the dorsal plating for three cases, additional K-wire fixation for one, and threaded Steinmann pins fixation for one case). After the arthrodesis of the first metatarsophalangeal joint, the subjective signs in pain, function and alignment were improved as all above fair grade. The radiological fusion was observed at average 8 weeks after the operation in all cases. The hallux valgus angle and 1, 2 intermetatarsal angle were reduced from 45.6+/-7.5degrees and 16.2+/-5.2degrees to 14.2+/-2.0degrees and 10.9+/-2.5degrees respectively. The dorsiflexion angle was measured in 20.5+/-2.2degrees after the fusion. CONCLUSION: To correct the rheumatoid hallux valgus deformity, the arthrodesis of the first metatarsophalangeal joint with 2 crossed screws is a method for the satisfactory results, once the fixation is achieved. However, other fixation procedures should be prepared in case of the failed fixation, which could be happened intraoperatively.
Arthritis, Rheumatoid ; Arthrodesis* ; Congenital Abnormalities ; Follow-Up Studies ; Hallux Valgus* ; Hallux* ; Metatarsophalangeal Joint*

BACKGROUND AND OBJECTIVES: Dobutamine stress echocardiography (DSE) with 2D echocardiography (2DE) is one of the time-consuming procedures in the diagnosis of coronary artery disease (CAD). Moreover, the accuracy of DSE with 2DE depends on the operator's skill or bias during the image acquisition. This study was conducted to determine the feasibility and accuracy of DSE with real-time 3D echocardiography (RT3DE) for the diagnosis of CAD. SUBJECT AND METHODS: 62 patients (RT3DE: 36, 2DE: 26), suspected of angina pectoris and post-revascularization ischemia, underwent DSE and coronary angiography (CAG). Image acquisition was performed at the baseline, and at 4 times during the dobutamine infusion and recovery stages. The procedure time (from the baseline to the end of the peak dose stage) was recorded. Off-line analyses of the volumetric images acquired with RT3DE were performed using 3D computer software (TomTec, Co.). Digitized quad-screen images acquired with 2DE were analyzed using the 2DE review system (ProSolv 4.0). >50% luminal diameter stenosis of any coronary artery on CAG was defined as significant coronary artery stenosis. RESULTS: The procedure time of DSE with RT3DE was significantly shorter than that of DSE with 2DE (25+/-4 vs. 37+/-4 mins, p<0.001). There was no significant difference in the sensitivity (p>0.05) or specificity (p>0.05) between the two procedures. CONCLUSION: DSE with RT3DE seems to be a feasible and less time consuming diagnostic procedure, probably providing comparable sensitivity and specificity for the detection of coronary artery stenosis, than DSE with 2DE.
Angina Pectoris ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diagnosis* ; Dobutamine* ; Echocardiography* ; Echocardiography, Stress* ; Echocardiography, Three-Dimensional* ; Humans ; Ischemia ; Phenobarbital ; Sensitivity and Specificity

BACKGROUND: The patient-controlled sedation (PCS) allows for rapid individualized titration of sedative drugs. Propofol has been the most widely used IV adjuvant, during the monitored anesthesia care (MAC). This study was designed to compare the sedation quality, side effect and recovery of the propofol alone, and propofol-remifentanil combination, using PCS for breast biopsy. METHODS: Seventy five outpatients, undergoing breast biopsy procedures with local anesthesia, were randomly assigned to receive propofol alone (group P), propofol-25 ug/ml of remifentanil (group PR25), and propofol-50 ug/ml of remifentanil (group PR50), using PCS. Pain visual analogue scores (VAS) and digit symbol substitution test (DSST), Vital signs, bi-spectral index (BIS) and observer assessment of alertness and sedation (OAA/S) score were recorded. RESULTS: Apply/Demand ratio in the group PR50 had a significant increase over the other groups (P < 0.05). The incidence of excessive sedation and dizziness were significantly more frequent in the group PR50 (P < 0.05). BIS and OAA/S score significantly decreased in the group PR25, PR50 at 15 min after the operation, the end of surgery (P < 0.05). At 5 min after the start of PCS, patients in the group PR25 and PR50 gave significantly less correct responses on the DSST than that of the group P (P < 0.05). CONCLUSIONS: Compared with the propofol alone, intermittent bolus injection of propofol-remifentanil mixture could be used, appropriately, for the sedation and analgesia during MAC. The group PR25 in a low dose of remifentanil has more advantages in terms of sedation and satisfaction because of the group PR50's side effects.
Analgesia ; Anesthesia ; Anesthesia, Local ; Biopsy ; Breast ; Dizziness ; Humans ; Incidence ; Outpatients ; Piperidines ; Propofol ; Vital Signs

Epidural abscess is a rare disease that can cause severe neurological complications or death if it is not recognized and treated early. Authors report a case of panspinal epidural abscess, which is diagnosed by MRI and treated with surgical drainage and antibiotics.
Anti-Bacterial Agents ; Drainage ; Epidural Abscess* ; Magnetic Resonance Imaging ; Rare Diseases

Mediastinal hemangiomas are extremely rare tumors that originate from vascular endothelial cells. It is well known that mediastinal hemangiomas appear on CT as solid masses with heterogeneous enhancement. We describe here a case of venous hemangioma, and the tumor was seen of the CT scan as a well-marginated cystic mass with a fluid-fluid level in the middle mediastinum; this mass mimicked a foregut cyst or cystic lymphangioma.
Endothelial Cells ; Hemangioma* ; Lymphangioma, Cystic ; Mediastinal Cyst* ; Mediastinum ; Tomography, X-Ray Computed

PURPOSE: The purpose of this cross-sectional study was to describe smoking characteristics, and then to examine relationships between self-efficacy for smoking cessation and preparation of smoking cessation in service and sales woman employee with smoking in department stores. METHODS: This study was a secondary data analysis carried by the smoking cessation support center. One hundred six employees smoking women participated from two department stores. Collected data were analyzed using SPSS 20.0 program. Descriptive statistics, t-test, one-way ANOVA along with Scheffé test, pearson correlation coefficients were used for statistics. RESULTS: The study results have shown that the mean score of self-efficacy for smoking cessation 5.1±2.62, preparation smoking cessation 4.0±2.89. There was positive relation between self-efficacy for smoking cessation and preparation smoking cessation. CONCLUSION: Considering the findings from this study, there is a need to develop self-efficacy for smoking cessation program for effective smoking cessation in service and sales woman smokers employee.
Commerce* ; Cross-Sectional Studies ; Female ; Humans ; Smoke* ; Smoking Cessation* ; Smoking* ; Statistics as Topic