This study was designed to compare the outcomes between my ocardial infarction' participation and not-participation in cardiac rehabilitation, so explain how participation in cardiac rehabilitation can be a worthwhile intervention that facilitates recovery from MI. B furthermore this research is intended to provide the fundamental backgrounds in developing cardiac rehabilitation program that can help to improve the patients' the quality of life. A total of 80 out-patients were selected as subject to data collection from April 1th to May 10 1996. The rehabilitated group, consisting of the 40 out-patients had participated with the non-rehabilitation group of 40 out-patients had received usual care during hospitalization. The tools for this study were state-anxiety scale devised by Spielberger(1976) performance health behavior scale developed by Lee(1992) and quality of life scale producted by McGirr(1990). The data were analyzed by use of chi test, ANCOVA, t-test, ANOVA, Pearson's correlation and simple regression using the SPSS program. The study was concluded as follows : 1. Hypothesis 1 : that "the rehabilitation group's anxiety was lower than the non-rehabilitation group's was accepted(t=-2.60, p=0.011). 2. Hypothesis 2 : that "the rehabilitation group's level of performance health behavior was higher than the non-rehabilitation group's" was accepted(t=6.39, p=0.000). 3. Hypothesis 3 : that "the rehabilitation group's quality of life was higher than the non-rehabilitation group's was accepted(t=2.73, p=0.008). 4. The correlations between anxiety, performance health behavior and quality of life. The relationship between anxiety and performance health behavior revealed a significant correlation(r=-.4433, p<.05). And the relationship between anxiety and quality of life revealed a significant correlation(r=-.7679, p<.05), the relationship between performance health behavior and quality of life revealed a significant correlation(r=3934, p<.05). As a result, it was found that the cardiac rehabilitation groups' anxiety was lower than the non-rehabilitation group's, the rehabilitation group' level of performance health behavior was higher than the non-rehabilitation group's. And the rehabilitation group's quality of life was higher than the non-rehabilitation group's. Therefore this study explained how participation in cardiac rehabilitation can be a worthwhile intervention that facilitates recovery from MI.
Anxiety ; Data Collection ; Health Behavior ; Hospitalization ; Humans ; Myocardial Infarction* ; Outpatients ; Performance Anxiety ; Quality of Life ; Rehabilitation*

Recently, the radionuclide angiocardiographic study had been enhanced by rapid development of gamma scintillation camera and computer system, and utilized as noninvasive diagnostic measurement of heart disease. We obtained the following results by the radionuclide angiocardiography with human serum albumin tagged with 99m-Technetium from two groups. One of them was congenital heart disease group(n=50, ventricular septal defect 20, atrial septal defect 6, pulmonary stenosis 2, tetralogy of Fallot 10, truncus arteriousus 1, transposition of great artery 1, patent ductus arteriosus 10) operated from Oct. 1984 to Jun. 1985, and the other was the normal human group(n=10) as control. 1) In the cases of left to right shunt, Qp/Qs values were calculated by th gamma variet fit curve. The preoperative values ranged from 1.441-3.00, the postoperative values were normal among all the patients except one(atrial septal defect, postop. Qp/Qs 2.335). 2) In the cases of right to left shunt, Qp/Qs values showed no apparent change between pre. andpostoperative period, possibly due to still remained collateral circulation and hardly obtained lower value(less than QP/QS 1.0) by computer system, But the double peak curve was noticed in the left ventricular time activity curve, which indicate right to left shunt, disappeared after the surgery, suggesting shunt closed. 3) The ejection fraction of left ventricle was obtained from the congential cardiac patients, ranged 0.38-0.65 before the surgery and 0.41-0.67 after the surgery. 4) The circulation time calculated from the first-pass radionuclide angiocardiography, ranged normal in the most congenital cardiac patients, but prolonged in the severe pulmonary hypertension.
Angiocardiography ; Arteries ; Collateral Circulation ; Computer Systems ; Ductus Arteriosus, Patent ; Gamma Cameras ; Heart Defects, Congenital* ; Heart Diseases ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemodynamics* ; Humans ; Hypertension, Pulmonary ; Pulmonary Valve Stenosis ; Serum Albumin ; Tetralogy of Fallot

PURPOSE: Choledochal cyst is a rare malformation of the pancreatobiliary ductal system, manifested by dilatation of biliary tree with or without anomalous insertion of the common bile duct into pancreatic duct. The purpose of this study is to review the incidence of anomalous pancreatobiliary union(PBU) and the shape of common bile duct based on the angle of pancreatic duct and common bile duct union. MATERIALS AND METHODS: We analyzed cholangiopancreatographic findings of 21 patients with choledochal cyst, emphasizing PBU. The PBU was classified into acute-angled PBU, right-angled PBU, normal PBU, and unknown PBU on the basis of common bile duct insertion to pancreatic duct. The shape of common bile duct dilatation was evaluated with regard to angle of PBU. RESULTS: Fourteen of 21 patients had anomalous PBU with slender or ectatic form of common channels. Three patients had normal opening of common bile duct and pancreatic duct, and in remaining 4 patients the PBU was not visualized. Among 14 patients with PBU, 5 patients had right-angled PBU and 9 patients had acute-angled PBU. Cystic form of common bile duct dilatation was seen in 13 patients and cylindrical form was in 8 patients. Cystic dilatation of common bile duct was seen in 4 patients out of 5 right-angled PBU. CONCLUSION: Patients with choledochal cyst had high incidence of anomalous PBU with common channel (67%). The shape of common bile duct dilatation was cystic in 62% of patients, and the right-angled PBU was prone to be cystic dilatation (80%).
Biliary Tract ; Choledochal Cyst* ; Common Bile Duct ; Dilatation ; Humans ; Incidence ; Pancreatic Ducts

Fat can be prominet around the aortic root and within the right atrioventricular (AV) groove (1). At times, the fat can be globular, suggesting a mass especially on echocardiography. Computed tomography (CT) and masnetic resonance (MR) images are well suited for characterization of fat in and around the heart (1, 2). This report illustrates CT and MR findings of a very unusual case of prominent fat lump in the left AV groove.
Echocardiography ; Heart

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

No abstract available.
Stevens-Johnson Syndrome*

PURPOSE: Congenital limb anomalies are manifested in various degree of severity and complexity bearing confusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. MATERIALS AND METHODS: Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications;failure of formation of parts, failure of differentiation of parts, duplications, overgrowth, and undergrowth. RESULTS: The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. CONCLUSION: The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies.
Classification ; Extremities* ; Hand ; Humans ; Incidence ; Lower Extremity ; Retrospective Studies ; Upper Extremity

No abstract available.
Eisenmenger Complex* ; Humans ; Pulmonary Artery*

BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. METHODS: To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. RESULTS: Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.
Abdomen ; Cause of Death ; Diagnosis ; Emergencies* ; Head ; Humans ; Pleural Effusion ; Pneumothorax ; Radiography ; Retrospective Studies ; Thoracic Injuries ; Thoracostomy ; Thorax* ; Tomography, X-Ray Computed

BACKGROUND: Vascular endothelial dysfunction (VED) plays a pivotal role in the pathogenesis of atherosclerosis and is associated with insulin resistance and with visceral obesity. Therefore, in this study the predicting factor of vascular endothelial dysfunction was investigated in healthy premenopausal obese women by pulse-wave analysis (PWA) combined with provocative pharmacological testing. METHODS: Thirty three obese women (BMI> or =25), aged 20~45 y and 25 age-matched control subjects (BMI; 18.5~22.9) were examined. All women were sedentary (<1 hr/wk of physical activity), non-smoker and were excluded if they had type 2 diabetes melitus, hypertension, hyperlipidemia, cardiovascular disease, or acute inflammatory disease and were studied in folicullar phase of the cycle, within the first week after cessation of menstrual bleeding. They underwent determination of anthropometric measurements, metabolic variables, adipose tissue regional distribution, and endothelial function by performing pulse-wave analysis (PWA) combined with provocative pharmacological testing. RESULTS: Augmentation Index (AIx) fell significantly after the administration of salbutamol, which causes endothelium-dependent vasodilatation, but response was significantly reduced in obese women compared with controls (10.28 6.72% vs 17.2 6.84%, P=0.0003). The change in after Nitroglycerin, which causes endothelium-independent vasodilatation, did not differ significantly (30.86 9.67% vs 30.6 10.11%, P=0.9172). In our obese subjects, visceral adipose tissue area was independently a significant predictor of vascular endothelial dysfunction (beta= 0.1381, P=0.0038, Adj-R2=0.348). CONCLUSION: Increased abdominal adiposity is a powerful independent predictor of VED in obese healthy women. Future studies of vascular endothelial function should account for the independent effects of abdominal fat.
Abdominal Fat ; Adipose Tissue ; Adiposity ; Albuterol ; Atherosclerosis ; Cardiovascular Diseases ; Female ; Hemorrhage ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance ; Intra-Abdominal Fat ; Nitroglycerin ; Obesity, Abdominal ; Vasodilation