In order to observe the arrhythmia which occured in early convalescent phase of acute myocardial infarction, a 24 hour ambulartory ECG monitiring was performed in 15 patients who is admitted at dept of Int Medicine, Ewha Womans University hospital from Aug. 1985 to Sept. 1986. during 7.5+/-3.4 days after admission. In all cases one or more of the following arrhythmias were observed;atrial premature beat, ventricular premature beat(VPB), transient paroxysmal ventricular thchycardia, atrial fibrillation, sinus arrest and junctional beat. Of 15 cases, 11(77.3%) had VPB's:Simple VPB's in 4 cases(26.7%) and complex VPB's(6.52+/-2.52)(P<0.05). But there were no difference of premature and abberancy index between complex VPB's and simple VPB's(P>0.1). In addition, we compaired the arrhythmias in CCU with those of early convalescent phase of acute myocardial infarction. But there was no correlation between them.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Cardiac Complexes, Premature ; Electrocardiography* ; Female ; Humans ; Myocardial Infarction*

Diffuse panbronchiolitis (DPB) is a progressive inflammatory respiratory disease of unknown cause mainly occurring in East Asian people. Studies on causes of the disease point to a genetic predisposition unique to Asians, but the cause remains unknown. If untreated, DPB progresses to bronchiectasis, respiratory failure, and death. The age of patients at onset of the disease varies from young to elderly people with a peak at 40-60 years. A few cases of DPB have been reported in Korean adults since 1992; however, the case of DPB in children is uncommon. Herein, we describe a 16-year-old girl with DPB who presented with chronic cough and sputum.
Adolescent* ; Adult ; Aged ; Asian Continental Ancestry Group ; Bronchiectasis ; Child ; Cough ; Female* ; Genetic Predisposition to Disease ; Humans ; Macrolides ; Respiratory Insufficiency ; Sputum

PURPOSE: Pneumomediastinum is rare in children and adolescents, and its causes have not yet been clearly determined. We aimed to identify the causes, clinical manifestations and prognosis of noniatrogenic pneumomediastinum in children. METHODS: From February 2007 to June 2014, we retrospectively investigated 121 patients with pneumomediastinum under 18 years of age in 2 hospitals. Eighteen patients with pneumomediastinum after thoracotomy and 35 patients with iatrogenic pneumomediastinum were excluded. RESULTS: Sixty-eight patients were divided into 4 age groups: those under 1 year of age (n=9, 13.2%), those 1 to 5 years of age (n=9, 13.2%), those 6 to 10 years of age (n=17, 25.0%) and those over 11 years of age (n=33, 48.5%). Chest pain (n=43, 63.2%) was the most common initial complaint and subcutaneous emphysema was identified in 18 patients (26.5%). Chest x-ray was diagnostic in all except 9 patients (13.2%). Predisposing causes of pneumomediastinum were idiopathic (n=26, 38.2%), respiratory tract infection (n=23, 33.8%), asthma exacerbation (n=4, 5.9%), trauma (n=4, 5.9%), endobronchial foreign body (n=2, 2.9%), interstitial lung disease (n=5, 7.4%), and neonatal respiratory disease (n=4, 5.9%). Chest pain (P<0.001) and idiopathic cause (P=0.001) were shown to linearly increase with age. On the contrary, tachypnea (P<0.001), dyspnea (P=0.016), and interstitial lung disease (P=0.008) were shown to have a decreasing linear association with age. The length of hospital stay was significantly increased in patients with interstitial lung disease (P=0.042), those with pneumothorax (P=0.044), and those without chest pain (P=0.013). CONCLUSION: According to age groups, there were significant differences in causes and clinical manifestations. In particular, pneumomediastinum that developed in younger patients with interstitial lung disease showed unfavorable outcomes, such as dyspnea, pneumothorax, and increased length of hospital stay. Therefore, precise evaluation of predisposing causes and careful management are needed for children with pneumomediastinum.
Adolescent ; Asthma ; Chest Pain ; Child ; Dyspnea ; Foreign Bodies ; Humans ; Length of Stay ; Lung Diseases, Interstitial ; Mediastinal Emphysema ; Pneumothorax ; Prognosis ; Respiratory Tract Infections ; Retrospective Studies ; Subcutaneous Emphysema ; Tachypnea ; Thoracotomy ; Thorax

OBJECTIVES: This study was performed to assess the risk factors, histologic and clinical features of breast cancer in postmenopausal women receiving hormone therapy (HT). METHODS: We evaluated 40 breast cancer patients who received HT due to postmenopausal symptoms by reviewing their medical charts at Pusan National University Hospital. Research variables, including patients' history, type and duration of received HT, moment of cancer debut after starting HT, radiological characteristics of breast cancer stage, histologic type, tumor size, grade, lymph node metastasis, estrogen and progesterone receptor status and 5-year survival were investigated. RESULTS: In the risk factors of breast cancer patients, only one patient had familial history of breast cancer. No patient had smoking history. The average body mass index (BMI) was 23.2 kg/m2. Twelve patients (30%) had estrogen only therapy, 13 patients (32.5%) had combined estrogen and progesterone therapy, 10 patients (25%) had tibolone therapy and the others consecutively received combination therapy of the above regimens. The mean duration of treatment was 31 +/- 27.9 months (range 0.4-115 months). In the distribution of the cancer debut after starting HT, in 4 cases (10%) was within 1 year, 5 cases (12.5%) within 1-2 years, 10 cases (25%) within 2-3 years, 4 cases (10%) within 3-4 years, 1 case (2.5%) within 4-5 years, and 16 cases (40%) within more than 5 years. The average diameter of tumor size was 1.7 cm. In 92.5% of cases, the tumor was of ductal type. Tumor stage 0 and 1 appeared in 66% and grade I was present in 38% of investigated cases. Hormone receptor-positive breast cancers were 85% and 70% of patients had negative lymph node metastases. The 5-year survival rate was 92%. CONCLUSION: The breast cancers which emerged during HT in postmenopausal women had hormone receptor-positive tendency. The size and stage of these breast cancers were shown as small and low, and represented low-grade differentiation. Recurrences of disease were uncommon and we found favorable 5-year survival rates and good prognosis.
Body Mass Index ; Breast ; Breast Neoplasms ; Estrogens ; Female ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Norpregnenes ; Progesterone ; Prognosis ; Receptors, Progesterone ; Recurrence ; Risk Factors ; Smoke ; Smoking ; Survival Rate

OBJECTIVE: We aimed to introduce our method involving prepuncture ultrasound scan for cannulation of the common femoral artery (CFA) during transfemoral cerebral angiography (TFCA), and to assess the clinical and radiological outcomes. MATERIAL AND METHODS: Our study included 90 patients who underwent prepuncture ultrasound examination of the inguinal area for TFCA between April 2015 and June 2015. Prior to skin preparation and draping of the inguinal area, we identified the CFA and its bifurcation using ultrasound. Based on the ultrasound findings, we marked cruciate lines in the inguinal area. Thereafter, we inserted a puncture needle at the interface between the horizontal and vertical lines at a 30–45° angle, simultaneously palpating the pulsation of the femoral artery. After TFCA was completed, femoral artery angiography was performed in the anteroposterior and oblique directions. Clinical and radiological parameters, including CFA cannulation, the ultrasound scan time, the first pass success rate, the time required for the passage of the wire, and complications, were evaluated. RESULTS: The mean ultrasound scan time of the CFA and its bifurcation was 72.6 seconds, and the mean time between administration of local anesthesia and wire passage was 67.44 seconds. The first pass success rate was 77.8% (70/90 patients), and the CFA puncture rate was 98.8% (89/90 patients). Although minor complications were noted in 7 patients, no patient reported serious complications (a large hematoma [≥ 5 cm], pseudoaneurysms, dissection, and/or a retroperitoneal hematoma.) CONCLUSION: Prepuncture ultrasound examination might be a simple, safe, and accurate technique for cannulation of the CFA during TFCA.
Anesthesia, Local ; Aneurysm, False ; Angiography ; Catheterization ; Cerebral Angiography* ; Femoral Artery* ; Hematoma ; Humans ; Methods ; Needles ; Punctures ; Skin ; Ultrasonography*

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) strategy is proposed to reduce the ventilator-induced lung injury in acute respiratory distress syndrome (ARDS). As ECMO use has increased, a number of studies on prognostic factors have been published. Age is estimated to be an important prognostic factor. However, clinical evidences about ECMO use in elderly patients are limited. Therefore, we investigated clinical courses and outcomes of ECMO in elderly patients with ARDS. METHODS: We reviewed medical records of patients with severe ARDS who required ECMO support. Study patients were classified into an elderly group (> or = 65 years) and a non-elderly group (< 65 years). Baseline characteristics, ECMO related outcomes and associated factors were retrospectively analyzed according to group. RESULTS: From February 2011 to June 2013, a total of 31 patients with severe ARDS were treated with ECMO. Overall, 14 (45.2%) were weaned from ECMO, 9 (29.0%) survived to the general ward and 7 (22.6%) survived to discharge. Among the 18 elderly group patients, 7 (38.9%) were weaned from ECMO, 4 (22.2%) were survived to the general ward and 2 (11.1%) were survived to discharge. Overall intensive care unit survival was inversely correlated with concomitant acute kidney injury or septic shock. CONCLUSIONS: In this study, ECMO outcome was poor in severe ARDS patients aged over 65 years. Therefore, the routine use of ECMO in elderly patients with severe ARDS is not warranted except in highly selective cases.
Acute Kidney Injury ; Aged* ; Extracorporeal Membrane Oxygenation ; Humans ; Intensive Care Units ; Medical Records ; Patients' Rooms ; Respiratory Distress Syndrome, Adult* ; Retrospective Studies ; Shock, Septic ; Ventilator-Induced Lung Injury

Central diabetes insipidus caused by pineal gland neoplasm is rare. Here, we describe a case of central diabetes insipidus and pineal germinoma with seeding to pituitary stalk along CSF pathway. A 27 year-old male patient was admitted due to polyuria, polydipsia, headache, vomiting, diplopia, and decreased visual acuity for recent two months. Urine osmolality measured after water deprivation was below 100mOsm/kg. However, urine osmolality increasd above 300 mOsm/kg with pitressin administration. Brain MRI showed a 2cm sized mass with seeding into pituitary stalk along CSF in pineal region. Surgical biopsy revealed pineal germinoma. Two cycles of chemotherapy with etoposide and cis-platin were done followed by brain irradiation(2,500cGy). Follow up brain MRI after second chemotherapy showed complete remission. The patient had no neurologic and endocrinologic deficit after the treatment.
Adult ; Biopsy ; Brain ; Diabetes Insipidus* ; Diabetes Insipidus, Neurogenic ; Diplopia ; Drug Therapy ; Etoposide ; Follow-Up Studies ; Germinoma ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Osmolar Concentration ; Pineal Gland ; Pinealoma ; Pituitary Gland ; Polydipsia ; Polyuria ; Vasopressins ; Visual Acuity ; Vomiting ; Water Deprivation

Background: The workload of organ transplant coordinators is increasing as administrative tasks become more diverse with changing laws and regulations. These changes have heightened the demand for organ transplant coordinators with expertise in the field. This study aimed to determine the status of human resources of organ transplant coordinators and conduct job analysis using the Developing A Curriculum (DACUM) method. Methods: We conducted a questionnaire survey with 107 transplant coordinators employed at medical centers across Korea. The questionnaire gathered data on general and job-related characteristics of organ transplant coordinators and assessed the importance, difficulty, and frequency of their task elements. Results: The job of organ transplantation was categorized into five duties, 14 tasks, and 97 task elements. These duties included recipient management, donor management, organ donation activation management, organ transplantation administration, and professional capability development. We noted statistically significant differences in the importance scores of organ donation activation based on age, as well as in the difficulty scores for recipient management and administrative tasks based on work experience. Furthermore, the frequency of task performance varied significantly according to the number of coworkers and the total number of transplants conducted. Conclusions This study confirmed the current status of the workforce and task performance of organ transplant coordinators. The findings will serve as basic data to enhance the expertise of coordinators in the future.

Background: The workload of organ transplant coordinators is increasing as administrative tasks become more diverse with changing laws and regulations. These changes have heightened the demand for organ transplant coordinators with expertise in the field. This study aimed to determine the status of human resources of organ transplant coordinators and conduct job analysis using the Developing A Curriculum (DACUM) method. Methods: We conducted a questionnaire survey with 107 transplant coordinators employed at medical centers across Korea. The questionnaire gathered data on general and job-related characteristics of organ transplant coordinators and assessed the importance, difficulty, and frequency of their task elements. Results: The job of organ transplantation was categorized into five duties, 14 tasks, and 97 task elements. These duties included recipient management, donor management, organ donation activation management, organ transplantation administration, and professional capability development. We noted statistically significant differences in the importance scores of organ donation activation based on age, as well as in the difficulty scores for recipient management and administrative tasks based on work experience. Furthermore, the frequency of task performance varied significantly according to the number of coworkers and the total number of transplants conducted. Conclusions This study confirmed the current status of the workforce and task performance of organ transplant coordinators. The findings will serve as basic data to enhance the expertise of coordinators in the future.

Background: The workload of organ transplant coordinators is increasing as administrative tasks become more diverse with changing laws and regulations. These changes have heightened the demand for organ transplant coordinators with expertise in the field. This study aimed to determine the status of human resources of organ transplant coordinators and conduct job analysis using the Developing A Curriculum (DACUM) method. Methods: We conducted a questionnaire survey with 107 transplant coordinators employed at medical centers across Korea. The questionnaire gathered data on general and job-related characteristics of organ transplant coordinators and assessed the importance, difficulty, and frequency of their task elements. Results: The job of organ transplantation was categorized into five duties, 14 tasks, and 97 task elements. These duties included recipient management, donor management, organ donation activation management, organ transplantation administration, and professional capability development. We noted statistically significant differences in the importance scores of organ donation activation based on age, as well as in the difficulty scores for recipient management and administrative tasks based on work experience. Furthermore, the frequency of task performance varied significantly according to the number of coworkers and the total number of transplants conducted. Conclusions This study confirmed the current status of the workforce and task performance of organ transplant coordinators. The findings will serve as basic data to enhance the expertise of coordinators in the future.