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*

Post-menopausal osteoporosis (PMO) is a major global human health concern. Owing to the need for therapeutic drugs without side effects, natural extracts containing various polyphenolic compounds that may exert estrogenic effects have been studied in depth. Rhus verniciflua Stokes (RVS), which has been used as a traditional herbal medicine for centuries in Korea, was recently revealed to exert estrogenic effects attributable to its bioactive ingredients sulfuretin and butein, which have strong estrogen receptor–binding affinities. In this study, the protective potential of RVS in PMO was evaluated by using an experimental animal model of PMO, which was established by ovariectomy (OVX) of female Sprague Dawley rats. The oral administration of RVS at 20 mg/kg or 100 mg/kg for 8 weeks markedly protected against OVX-induced atrophy of the uterine tube and reversed the elevation in the ratio of serum receptor activator of nuclear factor-κB ligand to osteoprotegerin, which is a marker of disease severity. In addition, RVS inhibited OVX-induced tibia bone loss, activated osteogenic activity, and suppressed osteoclastic activity in the tibial epiphyseal plate, a region of bone remodeling. Collectively, these factors indicated that the oral intake of RVS might be beneficial for the prevention of PMO.
Administration, Oral ; Atrophy ; Bone Remodeling ; Estrogens ; Fallopian Tubes ; Female ; Growth Plate ; Herbal Medicine ; Humans ; Korea ; Models, Animal ; Models, Theoretical* ; Osteoclasts ; Osteoporosis, Postmenopausal* ; Osteoprotegerin ; Ovariectomy ; Rats, Sprague-Dawley ; Rhus* ; Tibia

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 suggested 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. Precisely 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 had received successful revascularization therapy. Exercise ECG was performed 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 and 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 were similar between groups. There was no difference in baseline ejection fraction and wall motion score 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 finding of no relation between TWN and functional recovery was observed also when the patients were analysed according to infarct location and presence or absence 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 and ejection fraction, TWN does not appear to be an indicator of myocardial viability.
Aged ; Electrocardiography ; Exercise Test ; Female ; Human ; Male ; Middle Age ; Myocardial Infarction/*physiopathology/surgery ; Myocardial Revascularization

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: 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

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*

OBJECTIVE: Small cell carcinoma of the uterine cervix (SMCC) is extremely rare, and an aggressive disease that proliferates rapidly. It was often reported that the diagnostic accuracy of cytologic smears in diagnosing SMCC was low. This is a report of the Severance Hospital experience with the patients suffering from SMCC. METHODS: Twenty-seven patients with small cell carcinoma of the uterine cervix were diagnosed and treated at the Severance Hospital from November 1991 to January 2010. The data were analyzed retrospectively, based on the available charts and pathology reports. Various fields, such as chief complaints and symptoms present at first clinic visit, age, International Federation of Obstetrics and Gynecology (FIGO) clinical stage, treatment modality, the 5-year overall survival rate, and recurrence rate were investigated. RESULTS: Among the 27 patients diagnosed with small cell carcinoma of the uterine cervix, 18 of them (66.7%) presented with symptoms, including vaginal bleeding, at the first clinic visit, and the remaining 9 patients (33.3%) showed abnormal Pap smear screening in the process of their routine health check-up. The median age of the patients was 54 years (range, 24 to 77 years). FIGO stage IIB was the most common stage (11 of 27 patients). The 5-year overall survival rate of 21 patients, who could be followed up, was 57.2%. Six patients showed recurrence after remission, and the mean disease free interval of them was 9.2 months (range, 6 to 11 months). Abnormal Pap smear screening results of 9 patients was investigated, and the diagnostic accuracy of the cytologic findings was 22.2%. CONCLUSION: Our study was consistent with the concept that Pap smear screening might not be helpful in early diagnosis of SMCC considering its low diagnostic accuracy. Further large-scale multicenter prospective studies are definitely needed in order to produce abundant information about optimal therapy and diagnosis.
Ambulatory Care ; Carcinoma, Small Cell ; Cervix Uteri ; Early Diagnosis ; Female ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Recurrence ; Retrospective Studies ; Stress, Psychological ; Survival Rate ; Uterine Hemorrhage