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

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

PURPOSE: The purpose of this study was to develop a program promoting self-esteem and to determine the effectiveness of the program for hospitalized school-aged children. METHOD: The sample group consisted of 68 hospitalized children in a University Hospital located in Busan. The experimental group was given the program and feedback was obtained 3 times up until the day of discharge. Data were analyzed using t-test and 2-way ANOVA with the SPSS program package. RESULT: There was a significant difference between experimental and control groups in self-esteem. CONCLUSION: It was found that the program promoting self-esteem in school aged children was effective. The program, which was based on learning theory, was shown to be an effective and strong method to promote adjustment in hospitalized school-aged children.
Busan ; Child* ; Child, Hospitalized ; Humans ; Learning ; Child Health

BACKGROUND: Left ventricular hypertrophy is an independent risk factor for coronary artery disease, hypertension or other cardiovasular diseases, and normal health person due to cardiac arrhythmia or coronary microcirculatory insufficiency. According to development of echocardiography, left ventricular mass and the patterns of left ventricular hypertrophy can be measured. Therefore, we tried to classify the left ventricular hypertrophy in coronary artery disease and to differentiate cardiac function and severity of coronary artery disease in these groups. METHOD: From September 1993 to August 1995, in 44 cases(23 males, 21 females) without hypertension with normal coronary angiography and 84 cases(62 males, 22 females) without hypertension with coronary artery disease on coronary angiography were compared by two-dimensional, M-mode, and Doppler echocardiography. RESULTS: In normal control group, mean age was 51+/-11years, and in coronary artery disease group, mean age was 58+/-10years. Atherosclerotic risk factors showed no significant differences in each groups. LVH patterns in normal control group were 31 cases(70%) of normal left ventricle, 6 cases(14%) concentric remodelling, 2 cases(5%) concentric hypertrophy, and 5 cases(11%) eccentric hypertrophy. In coronary artery disease group, 30 cases(36%) were normal left ventricle, 17 cases(20%) concentric remodelling, 14 cases(17%) concentric hypertrophy, and 23 cases(27%) eccentric hypertrophy. CONCLUSIONS: In this study, concentric and eccentric hypertrophy were more common in coronary artery disease group than normal control group. And comparing to one vessel disease grroup, multi-vessel disease group had more common concentric and eccentric hypertrophy. This result were considered that left ventricular concentric hypertrophy may induce coronary heart disease because more oxygen demand required and fixed coronary circulation, and essentric hypertrophy was due to post-infarct left ventricular remodelling and wall thinning.
Arrhythmias, Cardiac ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Circulation ; Coronary Disease ; Coronary Vessels* ; Echocardiography* ; Echocardiography, Doppler ; Heart Ventricles ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Male ; Oxygen ; Risk Factors

The purpose of this study was to develop a nutrition education program for preschoolers, and to measure it's effects. This program consisted of text. pictures (cartoons), games and topics of discussion. This study was an experimental study undertaken by one pretest-posttest design group. The subjects were 17 preschoolers who were aged 5 and attending an educare center in Seoul. These were the effects of this program: The hypothesis of this study was that "the preschooler's score will be improved after education" was supported (t=5.177, p=.000). Several correlates were examined. There weren't significant differences between pretest and posttest in the importance of balanced nutrition; in the result of under-nutrition; that the black food-group precipitated dental carries and obesity; or the reaction of foods after meals. It is recommended that the nutrition education program not only contain content about the prevent of obesity, but also about the knowledge of various foods and their effects on the human body.
Education* ; Human Body ; Meals ; Obesity ; Seoul ; Child Health

In order to evaluate the effecacy of 2D-Doppler echocardiography for the measurement of pulmonary flow(Qp), systolic flow(Qs), the ratio of pulmonary flow and systemic flow and systemic flow(Qp/Qs), 19 membranous ventricular septal defect patients were examined in the period from July, 1986 to October, 1987 at Ewha Women's university hospital. The measurement of Qp, Qs, Qp/Qs by 2D-Doppler echocardiography were compared with the results by the Fick's method of cardiac catheterization.The following results were obtained. 1) The total of the 19 patients consisted of 15 males and 4 females. The mean age of the patients was 8.2 years. 2) It was found that the Fick's method and 2D-Doppler measurements of Qp (n=19, r=0.67), Qs (n=19, r=0.88), and Qp/Qs ratio(n=19, r=0.62) were highly correlated(p<0.01). 3) It is understood that the measurement of Qp, Qs, Qp/Qs ratio by 2D-Doppler echocardiography were quite useful to the noninvative diagnosis of ventricular septal defect.
Cardiac Catheterization* ; Cardiac Catheters* ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler ; Female ; Heart Septal Defects, Ventricular* ; Humans ; Male

BACKGROUND: Circadian rhythms have been described for acute myocardial infarction, sudden cardiac death, cerebrovascular disease, ischemic heart disease, and ventricular arrhythmia. Most of studies reported that the frequency of ventricular permature contractions(VPC's) shows a peak in day time. We tried to see that the circadian rhythm of VPC's in hypertension and ischemic heart disease(IHD) patients. And we will also studied the relationship between heart rate and frequencey of VPC's. METHOD: Twenty four hour holter monitoring was performed in hypertensive patients (N=23), ischemic heart disease patients(N=25), and normal control group(N=30). We tested the circadian pattern of VPC's and heart rates and the relationships of the frequency of VPC's and heart rates. RESULT: In hypertension group, a peak incidence of heart rate is between 5 and 8 P.M., in ischemic heart disease group, between 3 and 6 P.M.. In control group, the heart rate shows a peak beteen 1 and 3 P.M.. The frequency of VPC's in hypertension group shows the first peak between 4 and 10 P.M., and the second peak beteen 7 and 10 A.M.. In ischemic heart disease group, they show a peak between 2 and 8 P.M..In control group, there was no circadian variation for the frequency of VPC;s. Both in hypertension and IHD patients group, there was significant correlation between the frequency of VPC's and the heart rates. CONCLUSION: It seemed that VPC' were more frequently occurred in relation to the increase of heart rate in the afternoon, in hypertensive and ischemic heart disease patients.
Arrhythmias, Cardiac ; Circadian Rhythm ; Death, Sudden, Cardiac ; Electrocardiography, Ambulatory ; Heart ; Heart Rate ; Humans ; Hypertension* ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Ventricular Premature Complexes*

BACKGROUND: Established risk factors for coronary artery disease include smoking, hypertension, diabetes mellitus and hypercholesterolemia. However, these account for less than 50% of the actual incidence of coronary artery disease and the importance of other risk factors is being increasingly realized. It has been known that insulin resistance associated with hyperinsulinemia is a pivotal link to several risk factors of coronary artery disease, including hypertension, glucose intolerance, dyslipidemia and obesity. Recently both experimental and clinical studies have produced evidence suggesting that high plasma insulin level may promote the development of atherosclerotic vascular diseasa. Several prospective studies showed independently that high plasma insulin is associated with an increased risk of major coronary artery disease. In our study, plasma glucose, insulin and C-peptide level were determined with oral glucose tolerance test to assess the insulin resistance or hyperinsulinemia as a risk factory of coronary artery disease. METHOD: From September 1993 to April 1995, after excluding patients with hypertension, diabetes mellitus, hypercholesterolemia and obesity, 17 patients with significant coronary artery stenosis and 10 control subjects with normal coronary finding were selected among the 226 patients who undertook coronary angiography. In the 17 cases(M:F=15:2) of coronary artery disease group, the mean age was 54+/-10 years, and in the 10 cases(M:F=8:2) of control group, 51+/-9 years. All were matched for age, gender and body mass index. Blood pressure, lipid and lipoprotein were measured and smoking history was assessed. Glucose, insulin and C-peptide responses to oral glucose tolerance test were also determined. RESULT: 1) There was no significant difference in systolic and diastolic and diastolic blood pressure, total-cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, ApoA and smoking history except ApoB between the subjects with coronary artery disease and normal control subjects. 2) In oral glucose tolerance test, the plasma glucose levels were not significantly different in the two groups. plasma insulin and C-peptide levels at 60 and 120 minutes were higher in the patient group than control, but the results lack statistical significance. The area under the insulin curve and C-peptide curve were larger in patient group than control, but the result lack statistical significance also. CONCLUSION: Although our study dose not prove the hypothesis that insulin resistance or hyperinsulinemia is statistically an independent risk factor for coronary artery disease, this study showed the tendency of insulinresistance to be correlated with development of coronary artery disease. As this study has limitations due to small sample size, further study is required to confirm the role of hyperinsulinemia using a larger sample size.
Apolipoproteins A ; Apolipoproteins B ; Blood Glucose ; Blood Pressure ; Body Mass Index ; C-Peptide ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Diabetes Mellitus ; Dyslipidemias ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hypercholesterolemia ; Hyperinsulinism ; Hypertension ; Incidence ; Insulin Resistance* ; Insulin* ; Lipoproteins ; Obesity ; Plasma ; Prospective Studies ; Risk Factors* ; Sample Size ; Smoke ; Smoking ; Triglycerides

A total of the 16 cases of rheumatic vavular heart desease were examined in order to compare fibrillatriy F wave with left atrial size and biopsy findings from October 1986 to April 1987 at the Ewha Womans University Hospital. The results were as follows : 1) Of the 16 patients, there were 5 males and 11 females. The mean age of the patients was 41.9+/-12.7 years old. 2) Among the 16 patients PTF-V1 was lesser than -0.04nn-sec, the left atrial size measured by M-mode echocardiography was 57.1+/-8.9mm. Inverse correlation between PTF-V1 and the left atrial size measured by M-mode echocardiography was observed(P<0.01). 3) No significant correlation between PTF-V1 and left atrial was found(P>0.01). 4) There was a tendency that the size of the left atrium was, the more degeneration, necrosis and fibrosis of the left atrial wall appeared through pathological findings.
Atrial Fibrillation ; Biopsy* ; Echocardiography ; Female ; Fibrosis ; Heart ; Heart Atria ; Heart Valve Diseases* ; Humans ; Male ; Necrosis