Amniotic fluid embolism, one of the leading causes of maternal death, is a rare event, however, it can cause maternal death and neonatal morbidity when it unrecognized and untreated effectively. Its pathogenesis is unclear and clinical presentations are variable without standardized means of confirming diagnosis. We experienced one case of neonatal hypoxic ischemic encephalopathy possibly due to maternal amniotic fluid embolism, which was diagnosed by brain MRI, EEG and maternal uterine pathology. We report this case with a brief review of literatures.
Amniotic Fluid* ; Brain ; Diagnosis ; Electroencephalography ; Embolism, Amniotic Fluid* ; Female ; Hypoxia-Ischemia, Brain* ; Magnetic Resonance Imaging ; Maternal Death ; Pathology ; Pregnancy

Since the economic crisis in 1997, the number of low income families has increased and the turmoil is likely to affect nutritional and health status of the children in low-income families. The purpose of this study was to investigate dietary behaviors and physical development of low income family children in the Seoul area. The subjects were 44 boys and 56 girls, between the ages of 7 and 12 years, from the beneficiary families of the governmental assistant program and enrolled in after school-care centers. A self-reported questionnaire, including general characteristics and dietary behaviors, was applied to the children and their parents. Skipping meal rate was higher in breakfast than in lunch or dinner, and was less frequent in parents and children families compared to that of the other types of families (p<0.05). Most students are shown that they usually keep the dietary guideline for Korean children. There were significant differences in keeping the dietary guidelines between the parents and children family group and other groups in several items. The results imply that the nutrition education program should be more focused on the families which are not composed of parents and children.
Breakfast ; Child* ; Education ; Female ; Humans ; Lunch ; Meals ; Nutrition Policy ; Parents ; Seoul*

Although excessive arteriovenous fistula blood flow may be a factor in the development of high-output cardiac failure, this diagnosis is easily over-looked. Surgical reduction of fistula blood flow can improve the condition. We here report a case of high-output cardiac failure due to excessive arterio-venous fistula blood flow in a hemodialysis patient. A 51-year-old man who had been treated with hemodialysis since 5 years ago was admitted for increasing cardiac failure. Echocardiographic evaluation of cardiac output and duplex measurement of the fistula confirmed the diagnosis of high-output cardiac failure due to excessive arteriovenous fistula blood flow. After surgical closure of the fistula, the signs and symptoms of cardiac failure subsequently subsided and both systolic and diastolic dimension of left ventricle much decreased.
Arteriovenous Fistula* ; Cardiac Output ; Diagnosis ; Echocardiography ; Fistula ; Heart Failure* ; Heart Ventricles ; Humans ; Middle Aged ; Renal Dialysis*

No abstract available.
Arteriovenous Fistula* ; Constriction, Pathologic* ; Dialysis* ; Humans ; Renal Dialysis* ; Urea*

Cancer of the stomach is responsible for approximately 650,000 deaths globally each year and is probably second only to lung cancer worldwide as an overall cause of cancer-related mortality. Similar to the situation with most adenocarcinomas of the gastointestinal tract, carcinomas of the stomach can spread by local extension to adjacent normal structures and can develop lymphatic, peritoneal, and distant metastases. The tumor cells, can also permeate diffusely into the lymphatic plexus of the bowel, more often at the level of the upper duodenum hut sometimes down into the distal ileum and the large bowel. We report a case of lymphatic metastasis of gastric adenocarcinoma to the ampulla of Vater with review of the literature.
Adenocarcinoma* ; Ampulla of Vater* ; Duodenum ; Ileum ; Lung Neoplasms ; Lymphatic Metastasis* ; Mortality ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms

PURPOSE: The purpose of this study was to investigate what factors are affecting job-seeking stress in nursing students. METHODS: Subjects were 463 students from two 3-year and two 4-year colleges of nursing in K-Province in Korea. Data was collected from self-administered questionnaires. t-test, ANOVA, Pearson's and Spearman's correlation coefficients, and hierarchical multiple regression with dummy variables were used for statistical analysis of data. RESULTS: Job-seeking stress was significantly different by school system (t=2.76, p=.006), family economic status (F=3.40, p=.005), characteristics (t=1.99, p=.047), academic achievement (F=6.54, p=.002), current weight control status (t=2.23, p=.026), times of cosmetic surgery (r=.11, p=.022), self-esteem (r=-.47, p<.001) and appearance stress (r=.40, p<.001). However, after controlling for general characteristics, self-esteem, and perceived appearance stress, job-seeking stress was significantly different by grade (1st vs 3rd, beta=0.163, p<.001), academic achievement (low vs. high, beta=-0.121, p=.0321), self-esteem (beta=-0.224, p<.001), and appearance stress (beta=0.099, p<.001). The explanation power of self-esteem on job-seeking stress was greater compared with that of appearance stress. CONCLUSION: Results of this study suggest that it is necessary for nursing students to develop intervention program aimed at reducing job-seeking stress, and it would be effective to focus on improving self-esteem for them.
Humans ; Korea ; Nursing ; Surveys and Questionnaires ; Students, Nursing* ; Surgery, Plastic

BACKGROUND: Several studies has been reported that T-wave normalization(TWN) in exercise ECG indicates the presence of viable myocardium. But the clinical implication of this phenomenon in patients with acute myocardial infarction who received proper revascularization therapy was not determined. The aim of this study was to investigate the relationship between TWN in exercise ECG and myocardial functional recovery after acute myocardial infarction. METHODS: We studied 30 acute myocardial infarction patients with negative T waves in infarct related electrocardiographic leads and who received successful revascularization therapy. All patients performed exercise ECG, 10-14days after infarct onset using Naughton protocol. Patients were divided into 2 groups, according to presence (group I; n=14) or not (group II; n=16) of TWN in exercise ECG. Exercise parameters, coronary angiographic findings were compared between groups. Baseline and follow up (mean 11 months) regional and global left ventricular function was analyzed by echocardiography. RESULTS: Exercise parameters was similar between groups. There were no difference in baseline ejection fraction and regional wall motion between group I and II (EF; 56+/-12% vs 52+/-11%, p=ns. WMS; 21+/-3 vs 23+/-4, p=ns) and it was improved at the tenth month by similar magnitude. (group I/group II, EF % change = 12+/-12% vs 7+/-6%, p=ns, WMS % change = 6+/-6% vs 7+/-5%, p=ns) The findings of no relation between TWN and functional recovery was observed also when the patients were analysed according to infarct location and presence of Q-waves. CONCLUSION: As the exercise induced TWN in patients with acute myocardial infarction was not related with better functional recovery of dysfunctional regional wall motion, TWN dose not appears to be a sign of myocardial viability.
Echocardiography ; Electrocardiography* ; Exercise Test ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Ventricular Function, Left

A persistent left superior vena cava(SVC) is found in about 0.3% of healthy individuals and 4.3% of patients with congenital heart disease. This anomaly is most frequently found in conjunction with a right-sided SVC, but may also be solitary. Recently, we experienced a case of persistent left SVC in patient with chronic renal failure. He required subclavian catheterization for hemodialysis due to leakage of peritoneal dialysate into external genitalia and pleural cavity. Because he had had a history of right subclavian catheterization for hemodialysis 3 months ago, the hemodialysis catheter was inserted in the left subclavian vein without any complication. Chest X-ray after insertion of the catheter showed that the distal tip of the catheter seemed to be within the aorta. Venography showed that the catheter was located within the left SVC and MRI showed isolated two SVC. He is receiving hemodialysis through the left subclavian catheter which is positioned within the left SVC without any problem.
Aorta ; Catheterization ; Catheters* ; Genitalia ; Heart Defects, Congenital ; Humans ; Kidney Failure, Chronic* ; Magnetic Resonance Imaging ; Phlebography ; Pleural Cavity ; Renal Dialysis* ; Subclavian Vein ; Thorax ; Vena Cava, Superior*

Occult breast cancer is a type of breast cancer without any symptoms on the breasts or any abnormalities upon radiologic examination such as mammography. In males, there are few cases of breast cancer, the rate of diagnosis of occult breast cancer is very low, and little is known about this disease. We experienced two cases of occult breast cancers manifesting as axillary lymph node metastasis in men. They had a palpable lesion on axillary area several years ago and had not seen a doctor about it. As such there was no abnormality on evaluations for cancer except for axillary lymph node showing signs of carcinoma (primary or metastatic) on biopsy and estrogen receptor-positive and progesterone receptor-positive on immunohistochemistry. The patients were diagnosed with occult breast cancer, and treatments were performed. Herein, we report the rare cases of occult breast cancers in men.
Axilla ; Biopsy ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Immunohistochemistry ; Lymph Nodes ; Male ; Mammography ; Neoplasm Metastasis ; Neoplasms, Unknown Primary ; Progesterone

BACKGROUND: Recently, assessment of left anterior descending (LAD) coronary flow by transthorasic Doppler echocardiography (TTDE) has been emerged as a useful tool in evaluation of microcirculatory function of coronary circulation. The measuring site of coronary flow by TTDE is distal LAD. But it was not fully investigated whether the distal flow velocity is identical to that of proximal segment. The purpose of this study is to compare coronary blood flow velocity and coronary flow reserve (CFR) in normal LAD according to its level. METHOD: 9 patients (1 male, 8 females; mean age 52.8+/-11.1years) were included for this study. Coronary flow velocity was measured with intracoronary Doppler guide wire at the proximal (before first diagonal branch), mid (after second diagonal branch), and distal segments of LAD at baseline and after intracoronary bolus injection of 18 microgram adenosine. Baseline and hyperemic average peak velocity (APV) and CFR were compared between segment. RESULTS: Baseline and hyperemic APV appears to be diminished from proximal (24.6+/-3.5 cm/sec, 55.8+/-10.7 cm/sec) to distal (21.7+/-6.9 cm/sec, 49.7+/-17.2 cm/sec) LAD without statistical significance. But, CFR showed no significant difference in each segments (proximal, mid, and distal segment; 2.3+/-0.26, 2.3+/-0.32, 2.3+/-0.48, p=0.95). As the increment of peak systolic velocity (PSV) from baseline to hyperemic state was larger than that of peak diastolic velocity (PDV), diastolic to peak systolic velocity ratio (DSVR) was decreased significantly by hyperemic state in proximal and distal segment (baseline; 2.1+/-0.8, 2.1+/-0.5 vs hyperemia; 1.8+/-0.6, 1.7+/-0.3, p<0.05). CONCLUSION: Coronary blood flow velocity appears to be decreased from proximal to distal segment of normal LAD without statistical significance. There were no differences in CFR between proximal, mid and distal segment of normal LAD.
Adenosine ; Blood Flow Velocity* ; Coronary Circulation ; Coronary Vessels* ; Echocardiography, Doppler ; Female ; Humans ; Hyperemia ; Male