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*

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

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

Absent right superior vena cava in visceroatrial situs solitus is rare. It has been known the absent right superior vena cava is usually accompanied with persistent left superior vena cava. And this anomaly could be combined witk additional congenital heart disease and rhythm disturbances. We experienced one case of absent right superior vena cava accompanied by persistent left superior vena cava, secundum type atrial septal defect, and transient post-operative sinus node dysfunction.
Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Sick Sinus Syndrome ; Vena Cava, Superior*

PURPOSE: Internal mammary lymph node (IMLN) metastasis is an important prognostic indicator in breast cancer. However, the necessity of internal mammary sentinel lymph node biopsy for accurate staging, for choosing adjuvant treatment, and as a prognostic indicator, has remained controversial. METHODS: From January 2001 to December 2006, 525 female breast cancer patients underwent radical surgery after preoperative lymphatic scintigraphy. We retrospectively analyzed the follow-up results, recurrences, and deaths of all patients. RESULTS: There was no significant difference in the clinicopathological characteristics between the axilla and the IMLN groups. The median follow-up period was 118.8 months (range, 7-122 months) in the axilla group and 107.7 months (range, 14-108 months) in the IMLN group. During the median follow-up period, the breast cancer-related death rate in the axilla group was 3.6%, which was not significantly different from that of the IMLN group (1.3%) (p=0.484). The five-year survival rates did not differ between the two groups (p=0.306). The overall recurrence rate and the locoregional recurrence rate also did not differ between the two groups (p=0.835 and p=0.582, respectively). The recurrence rate of IMLN (both ipsilateral and contralateral) metastasis was very low, accounting for 0.5% in the axilla group and 1.3% in the IMLN group (p=0.416). CONCLUSION: The long-term follow-up results showed that there was no significant difference in both overall outcome and regional recurrence between the two groups. Therefore, the requirement for identification of nodal basins outside the axilla or IMLN sentinel biopsy should be reconsidered.
Accounting ; Axilla ; Biopsy ; Breast ; Breast Neoplasms ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Lymphoscintigraphy ; Neoplasm Metastasis ; Nitriles ; Prognosis ; Pyrethrins ; Recurrence ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Survival Rate

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

A 67-year-old male renal transplant patient presented with a right inguinal bulging mass, and was diagnosed with a right indirect inguinal hernia. The day following inguinal herniorrhaphy, serum creatinine became elevated. The patient was oliguric and had abdominal pain on the first day after inguinal herniorrhaphy with a mesh. We diagnosed him with acute renal failure and subsequently performed acute hemodialysis. The kidney computed tomography showed hydronephroureter, with distal ureter obstruction. With urgent percutaneous nephrostomy, we were able to relieve the obstructive uropathy with distal ureteral stenosis. Subsequently, hernia repair was performed with removal of the mesh, followed by the antegrade ureteral stent insertion. Renal function was recovered after ureteral stent insertion. This case shows that acute renal failure can occur due to ureteral obstruction, complicated by an inguinal hernia repair, and this can be successfully treated with percutaneous nephrostomy and inguinal hernia repair with mesh removal.
Abdominal Pain ; Acute Kidney Injury ; Aged ; Constriction, Pathologic ; Creatinine ; Hernia, Inguinal ; Herniorrhaphy ; Humans ; Kidney ; Male ; Nephrostomy, Percutaneous ; Renal Dialysis ; Stents ; Transplants ; Ureter ; Ureteral Obstruction