The chest radiographs and angiograms were retrospectively evaluated in 47 patients with pulmonary atresia (PA) and ventricular septal defect (VSD) to determine the characteristic findings of major aortopulmonary collateral arteries (MAPCSs) on the chest radiographs. Of 47 patients, 23 had MAPCAs and 24 had only PDA for blood supply of whole right and left lung. Chest radiographs enabled identification of 16 of 23 patients with MAPCAs. The most common finding of MAPCAs was inappropriately large peripheral pulmonary vasculature (n=16, 69.6%). The other findings were tortuosity of pulmonary vasculature (n=12, 52.2%), focal unevendistribution of pulmonary vasculature (n=12, 52.2%), and two descending pulmonary arteries (n=4, 17.4%). When chest radiographs showed two or more findings of MAPCAs, MAPCAs could be differentiated from PDA with statistical significance (p<0.005). It is concluded that chest radiographs may help to identify MAPCAs before angiography if two-dimensional echo ardiography suggests PA with VSD.
Angiography ; Arteries* ; Heart Septal Defects, Ventricular* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

We report a case of a skin problem induced by a visual display t rminal in a 24-year-old female. The patient had erythematcn.is rashes, crusts on both zygomatic areas and upper eyelids with itching, burning and pain sensations after she had been exposed to her visual display terminal. After the cassation of exposure, her skin lesions were markedly improved. A proioction test with her own visual display terminal was positive.
Burns ; Exanthema ; Eyelids ; Female ; Humans ; Pruritus ; Sensation ; Skin* ; Young Adult

We report a case of xanthoma disseminatum in a 24 year old male paitient. Multiple yellow-brown papules developed on the flexor aurfaces, such as the neck, axillae, antecubital fossae, groin, and perianal regions. Some papules were detected arouns the eyes and uvulai. biopsy specimen revealed a dense infiltrate of histiocytes, foam cells, Touton giant cells, and other inflammatory cells. No Langerhans granules were seen in the electron microscopic analysis.
Axilla ; Biopsy ; Foam Cells ; Giant Cells ; Groin ; Histiocytes ; Histiocytosis, Non-Langerhans-Cell* ; Humans ; Male ; Neck ; Xanthomatosis* ; Young Adult

BACKGROUND: Recent advances have been made in the treatment of acute stroke, but the effectiveness of the new therapies is highly time-dependent. The purpose of this study is to investigate the factors that influence the time from symptom onset to hospital arrival and the total arrival delay time for patients with acute stroke. METHODS: A prospective registry of patients presenting to the ED with signs or symptoms of acute stroke was established at Ewha Womans University Mokdong and Dongdaeumn hospitals from March to December 1999. We analyzed the prehospital delay time(reaction interval and total arrival delay) and factors associated with delayed arrival at the hospital. RESULTS: The study included 256 patients(49% were women) with a mean age of 62+/-13 years. 50.9% of the patients arrived within 3 hours, and 94.9% patients arrived within 24 hours after onset of symptoms of acute stroke. The total arrival delay time was 180 minutes(median time), and the reaction interval was 60 minutes(median time). Transportation by 119 or 129 ambulances was linked to shorter delay(47 minutes). Age, mental status, and degree of disability were statistically significant factors associated with delayed arrival at the hospital. CONCLUSION: Age, mental status, and degree of disability were significant factors associated with delayed arrival at the hospital. For effective treatment of acute stroke patients, increased public awareness to use an ambulance with direct transport to the acute-care hospital required.
Ambulances ; Female ; Humans ; Prospective Studies ; Stroke* ; Transportation

PURPOSE: Extended-spectrum β-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum β-lactamase urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. METHODS: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). RESULTS: Extended-spectrum β-lactamase urinary tract infection occurred in 11% patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extendedspectrum β-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum β-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. CONCLUSION: Extended-spectrum β-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum β-lactamase urinary tract infection.
Aminoglycosides ; Anti-Bacterial Agents ; Bacteria* ; C-Reactive Protein ; Carbapenems ; Cephalosporins ; Child ; Hospitalization ; Humans ; Infant ; Recurrence ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: Extended-spectrum β-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum β-lactamase urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. METHODS: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum β-lactamase-positive and extended-spectrum β-lactamase-negative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). RESULTS: Extended-spectrum β-lactamase urinary tract infection occurred in 11% patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extendedspectrum β-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum β-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. CONCLUSION: Extended-spectrum β-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum β-lactamase urinary tract infection.
Aminoglycosides ; Anti-Bacterial Agents ; Bacteria* ; C-Reactive Protein ; Carbapenems ; Cephalosporins ; Child ; Hospitalization ; Humans ; Infant ; Recurrence ; Retrospective Studies ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: The purpose of this study was to examine the relationship of mothers' recognition of Attention deficit hyperactivity disorder (ADHD), parenting stress and family support in mothers of children diagnosed with ADHD. METHODS: The data were collected from December 24, 2009 to July 23, 2010. The participants were 141 mothers of children diagnosed with ADHD and who lived in D city. Descriptive statistics, t-test, ANOVA, Pearson correlation coefficients with SPSS 17.0 were used to analyze the data. To determine the most effective variable (mothers' recognition, parenting stress and family support) to predict parental stress, data were analyzed using canonical correlation with SAS 9.1 TS. RESULTS: Canonical correlation analysis revealed that professional and teachers' roles of the 3 sub-domains of mothers' recognition were the most outstanding variables in predicting parenting stress. Parental distress/parent-child dysfunctional interaction of parenting stress was the most outstanding variable in predicting both mothers' recognition and family support. Spouse cooperation in family support was the most outstanding variable in predicting parenting stress. CONCLUSION: The results suggest that strengthening parents' recognition of ADHD and supporting interventions are important for reducing parenting stress. Professional and teachers' roles, parental distress/parent-child dysfunctional interaction and spouse cooperation should be included in the contents of structured programs.
Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Mothers ; Parenting ; Parents ; Phenothiazines ; Spouses ; Child Health

PURPOSE: The purpose of this study was to use meta-analysis to examine recent domestic articles related to attention deficit hyperactivity disorder (ADHD) in school-age children. METHODS: After reviewing 213 articles published between 1990 and 2009 from and cited in RISS, KISS, and DBpia, the researchers identified 24 studies with 440 research variables that had appropriate data for methodological study. SPSS 17.0 program was used. The outcome variables were divided into five types: Inattention, hyperactive impulsive, intrinsic, extrinsic, and academic ability variables. RESULTS: Effects size of overall core symptoms was 0.47 which is moderate level in terms of Cohen criteria and effects size of overall negative variables related ADHD was 0.27 which is small level. The most dominant variable related to ADHD was obtained from hyperactive-impulsive (0.70). Also academic ability (0.45), inattention (0.37), and intrinsic variables (0.29) had a small effect whereas extrinsic variables (0.13) had little effect on descriptive ADHD study. CONCLUSION: The results reveal that ADHD core symptoms have moderate effect size and peripheral negative variables related ADHD have small effect size. To improve the reliability of the meta-analysis results by minimizing publication bias, more intervention studies using appropriate study designs should be done.
Adolescent ; Attention ; Attention Deficit Disorder with Hyperactivity/*etiology ; Child ; Child Psychology ; Child, Preschool ; Female ; Humans ; Male ; Task Performance and Analysis

We report a case of periumbilical pseudoxanthoma elasticum in a 73-year-old female. It is characterized by a dark-yellowish plaque present on the periumbilical area of the lower abdomen. The plaque is well-demarcated and its surface is grooved or fissured, atrophic and verrucoid. This localized lesion of the periumbilical area occurs in a multiparous woman with no history of hereditary systemic pseudoxanthoma elasticum.
Abdomen ; Aged ; Female ; Humans ; Pseudoxanthoma Elasticum*

Invasive infection of the Streptococcus bovis group in a neonate is rare. In cases reported to date, the pathogen of neonatal S. bovis infections is usually Streptococcus gallolyticus subsp. pasteurianus (S. bovis biotype II/2). Streptococcus lutetiensis (S. bovis biotype II/1) was identified using 16S rRNA and tuf gene sequence analysis of the isolates from blood and cerebrospinal fluid (CSF) of a fever-presenting 28-day-old male. Blood culture analysis was performed using automatic equipment (VITEK 2) and identified Streptococcus infantarius supsp. infantarius, yet we were unable to get accurate results from the CSF culture. The fever subsided on the second day of hospitalization, and the patient was discharged without neurologic complication after 14 days of antibiotic therapy. In this case, we were able to accurately identify the pathogen using molecular genetic methods. To our knowledge, this is the first case of late onset neonatal bacteremia and meningitis caused by S. lutetiensis.
Bacteremia* ; Cerebrospinal Fluid ; Fever ; Hospitalization ; Humans ; Infant, Newborn ; Male ; Meningitis* ; Molecular Biology ; Sequence Analysis ; Streptococcus bovis ; Streptococcus*