BACKGROUND: Recently the percutaneous transradial approach for coronary angiography, transluminal coronary angioplasty or coronary stention were reported but there was no report in Korea. So we tested the safety and efficacy of the transradial appreach for coronary angiography in Korean. METHODS: Eleven patients(male 9, female 2, mean age 59.3 yeal old)with chest pain underwent percutaneous transradial coronary angiography with 5 french multipurpose catheter. We evaluated clinical efficacy and observed complication of percutaneous transradial coronary angiography by physical examination and DOpple ultrasonography of puncture site of radial artery. RESULTS: Right coronary angiography and left ventriculography were performed successfully in all cases, but left coronary angiogrphy was failed in three cases. In another three cases, the patient complained of arm pain which was aggravated during manipulation of the catheter. After the procedure, it took 10.3 minutes to stop the bleeding at the puncture site, Clinically significant complications were not observed after the procedure. The patients were not restricted to bed at all since the completion of the procedure. CONCLUSION: In our limited dexperience, percutaneous transradial coronary angiography could be performend on the outpatient basis without significant complications.
Angioplasty ; Arm ; Catheters ; Chest Pain ; Coronary Angiography* ; Female ; Hemorrhage ; Humans ; Korea ; Outpatients ; Physical Examination ; Punctures ; Radial Artery ; Ultrasonography

Oral medication is one of the most frequent treatment in clinical care, and frequently refused by children. Children's refusal spends unuseful time and require nurses' patience. So this study was attempted to develop token economy program which promote children's medication, and to evaluate its' effect to construct the experimental ground. This study was a quasi experimental study under the nonequivalent control group non-synchronized design. The subjects of this study were 48 children who were aged 3-12 years and admitted pediatric ward because of their respiratory disease. Token economy program was consisted of cartoon record paper with stickers which expresses the better medication is taken the more germs die, and gift was given for back up reinforcer. To evaluate this program, time spent for oral medication was measured six time to both experimental group and control group, and measured the perceived effectiveness of this program by nurses. To determine the effect of the program, the data were analyzed by the SAS 6.12 program with t-test and mean, standard deviation. The results of this study were as follows: 1. In experimental group, time spent for oral medication was significantly shorter than in control group(t=5.24, p=0.0001). Therefore, the hypothesis of this study was strongly accepted. 2. Nurses perceived this program as an effective one(mean=3.125 ~ 3.792). The effectiveness occurred before, during and after medication as well as in parental responses, especially in using verbal dissatisfaction after medication. In conclusion, it was found that the token economy program for admitted children was effective in inducing the children's behavior of oral medication. There was no effectiveness in very highly anxious children. Whereas, it is recommended that this program should not be used for such children until they settle down. If the token economy program was made in various situation with creative thinking, it will be very useful nursing measurement, especially in caring for children. To improve the quality of nursing care, the various programs, which can give joyfulness to stressed patients should be developed.
Child ; Disulfiram ; Humans ; Nursing ; Nursing Care ; Parents ; Thinking ; Token Economy* ; Child Health

It is well known that there is close relation of the left atrial pathology to atrial fibrillation(AF) in patients with mitral valvular disease. To evaluate such relation is existed or not in the right atrium, the right atrial wall biopsy was performed in 31 patients with mitral valvular disease during valve surgery. The specimens obtained were interpretated by the pathologist who had no information about the patients. The specimens were graded according to severity of morphological change. In Grade I, the atrial myocardium is degenerated and has moderate fibrosis in it. Grade II shows the atrial myocardial layer of the atrium and severe degenerated with pre and postoperative heart rhythm. Four patients had Grade I change and 3 patients among them had pre and postoperative AF. Eleven patients had Grade III changes and 9 among them had pre and postoperative AF. The results show there is strong tendency that the patients with pre and postopeative AF had Grade III change in the right atrium and the relation of the right atrial pathology to AF is same as that of the left atrium.
Atrial Fibrillation* ; Biopsy ; Fibrosis ; Heart ; Heart Atria ; Humans ; Myocardium ; Pathology*

BACKGROUND: Left ventricular hypertrophy is a major cardiovascular risk factor for sudden death, acute myocardial infarction and congestive heart failure. The left ventricle is generally thought to adapt to sustained arterial hypertension with increased total peripheral resistance by developing concentric hypertrophy. In recent years, the echocardiogrphy has been developed as a noninvasive method for evaluation of left ventricular geometry and left ventricular mass. However, left ventricular adaptation to hypertension has been shown to be more complex than expected. In fact, many patients with mild to moderate hypertension exhibit normal left ventricular mass and wall thickness, other hypertensive patients have eccentric ventricular hypertrophy that is not related to systolic dysfunction, but rather to increased cardiac output and preload and in some hypertensive patients absolute and relative wall thickness is increased with normal ventricular mass(concentric remodeling). There are differences in the hemodynamics, systolic function and diastolic function in each group. METHODS: From september 1992 to August 1994, in 144 patients with untreated essential hypertension and 50 age and gender matched normal adults studied by two-dimensional, M-mode and Doppler echocardiography. In the present study we used echocardiographically derived left ventricular mass and relative wall thickness to assess the patterns of ventricular geometric adaptation to systemic hypertension and their relations to systemic hemodynamics, left ventricular load and contractile performance. RESULTS: Hypertensive group was 144 cases(M:F=68:76), the mean age 56+/-13years. Normotensive group was 50 cases(M:F=22:28), the mean age 52+/-9years. Among hypertensive patients, left ventricular mass index and relative wall thickness were normal in 42 cases(29%), 24 cases(17%) had increased relative wall thickness with normal ventricular mass(concentric remodelin),48 cases(33%) had both increased relative wall thickness and ventricular mass(concentric hypertrophy), 30 cases(21%) had increased left ventricular mass with normal relative wall thickness(eccentric hypertrophy). Concentric hypertrophy and normal left ventricle group are more common in untreated hypertensive patients in Korea. Systemic hemodynamics showed tendency to paralleled ventricular geomety. In groups with concentric remodeling and hypertrophy, perpheral resistance was increased. Cardiac index was midly increased in eccentric hypertrophy. Diastolic dysfunction was prominent tn concentric hypertrophy. CONCLUSION: Each patterns of left ventricular geometry had different systemic hemodynamics, ventricular pressure overload and ventricular volume overload. Therefore, appropriate selection of antihypertensive agent for the patients with each patterns of hypertrophy reduce the left ventricular hypertrophy and may improve the prognosis.
Adult ; Cardiac Output ; Death, Sudden ; Echocardiography ; Echocardiography, Doppler ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Humans ; Hypertension* ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Korea ; Myocardial Infarction ; Prognosis ; Risk Factors ; Vascular Resistance ; Ventricular Pressure

BACKGROUND: Syncope is both one of the most common and one of the most challenging problems seen in medical practice. In spite of intensive medical evaluation, the cause of syncope remains unknown in a significant number of patients. In recent years, head-up tilt test has been of increasing interest as a diagnostic aids in patients with unexplained syncope. This study investigated the clinical utility of this technique in te evaluation of patients with vasovagal syncope. METHODS: Seven patients with unexplained syncope were evaluated with a 60 degree or 80 degree head-up tilt test with or without intravenous infusion of isoproterenol(1-4ug/min) in an attempt to provoke bradycardia, hypotension or both. There were 4 males and 3 females with a mean age of 35+/-8 years. RESULTS: 1) During head-up tilt test, vasovagal responses were provoked in 5 of 7 patients(71.4%) with syncope of unknown origin. During the test, there was no complication associated with the test. 2) During tilt-induced vasovagal reponse, mean systolic blood pressure decreased to 84+/-12mmHg from supine control of 125+/-21mmHg(p<0.01) and mean diastolic blood pressure decreased to 50+/-17mmHG from supine control of 76+/-14mmHg(p<0.01). 3) Five patients with positive results of the tests were followed up for 12months and they had a good outcome free of recurrence. CONCLUSION: Head-up tilt test appeared safely applicable test in patients with suspected vasovagal syncope and good prognosis was expected in the patients.
Blood Pressure ; Bradycardia ; Female ; Follow-Up Studies* ; Humans ; Hypotension ; Infusions, Intravenous ; Male ; Prognosis ; Recurrence ; Syncope ; Syncope, Vasovagal*

PURPOSE: This study was done to investigate the types of breastfeeding visits by mothers twenty-four months after birth and to identify the factors that increased breast feeding rates. METHODS: The subjects of this study totaled seven hundred and seventy-four mothers with infants aged 2 years or less who had visited national medical institutions including Sanhujori service facilities, breastfeeding care service facilities, and community health centers. Data was collected from June 22 to July 31, 2009. Data was analyzed using descriptive statistics, chi2 test, ANOVA with a post hoc Scheffe test, and multiple logistic regression. RESULTS: Major findings of this study were significant differences of planned length of breastfeeding and breastfeeding self-efficacy in relation to the differing types of breast feeding community visits by mothers. In multivariate logistic regression, baby's age, exclusive breastfeeding at hospital, utilization of breastfeeding care service facility, planned length of breastfeeding, and breastfeeding self-efficacy were independent predictors of the feeding type. CONCLUSION: In order to increase breastfeeding rates, programs provided by public health care services and medical facilities should start education on breast feeding in the hospital before mothers are discharged and then continue through the use of Sanhujori service facilities and workplace at 3 month and 6 month postpartum.
Aged ; Breast Feeding ; Community Health Centers ; Community Health Services ; Humans ; Infant ; Infant Formula ; Logistic Models ; Mothers ; Parturition ; Postpartum Period ; Public Health ; Rooming-in Care ; Self Efficacy

No abstract available.
Bile Ducts* ; Bile* ; Choledochal Cyst*

No abstract available.
Asthma*

PURPOSE: The purpose of this study was to develop a health education program for child care workers of infants, toddlers and preschoolers to improve their care ability. The program provided child care teachers and children with information on how to take care of their health. METHOD: This program development was based on a systematic design of instruction by Dick & Carey(1996). The process included a review of literature, setting an instructional goal, getting advice from various experts, designing instruction and instructional medias, designing formative evaluation, revising the program and making a summative evaluations. RESULT: The products of this program were the 'Teachers Guide Book & CD-ROM." The guide book included health education programs for infants, toddlers and preschoolers. The infant program included a basic baby care program for teachers. The toddlers and preschoolers program included basic health promotion, dental health, nutrition management, communicable disease prevention, substance abuse prevention and a safety program. CONCLUSION: These programs provided a systematic content of health education for children andtheir teachers, and useful data which can be applied to child care centers.
Program Development ; Male ; Korea ; Humans ; *Health Education ; Female ; Child, Preschool ; *Child Welfare ; Child Day Care Centers ; Child ; Caregivers/*education

No abstract available.
Fetus* ; Humans ; Infant*