Coronary artery revascularization with arterial graft is believed to have superiority to that with vein graft with a long-term survival rate with its superb of patency rate. Furthermore, the bilateral internal thoracic artery grafting is an independent predictor of lower rates of angina recurrence, late myocardial infarction, and late cardiac events including reoperation or reintervention. Off-pump coronary artery bypass grafting (OPCAB), which means surgery under the beating heart without use of cardiopulmonary bypass (CPB), is a new attractive surgical strategy for coronary artery disease, because of its benefits for the patients with porcelain ascending aorta to prevent of cerebral emboli and comorbidities such as renal failure, cerebral event, right ventricle dysfunction, and pulmonary disease. The minimally invasive coronary bypass grafting, which means lesser incision, surgery without CPB, and early recovery, can be the surgical method of choice for single vessel disease or limited double vessel disease, with its advantages of early return to work and cosmetics. The OPCAB has been increasing steadily in Korea since 1996, comprising almost 900 cases among the 2,600 cases of bypass surgery performed in the whole country in 2001. The overall mortality rate of bypass surgery in Korea was near 2.3%, comparable to that in western countries. Conclusively, the surgical revascularization for coronary artery disease has the advantages of reducing the cost and lowering the cardiac event, such as reoperation or reintervention.
Aorta ; Cardiopulmonary Bypass ; Comorbidity ; Coronary Artery Bypass, Off-Pump* ; Coronary Artery Disease ; Coronary Vessels ; Dental Porcelain ; Heart ; Heart Ventricles ; Humans ; Intracranial Embolism ; Korea ; Lung Diseases ; Mammary Arteries ; Methods ; Mortality ; Myocardial Infarction ; Recurrence ; Renal Insufficiency ; Reoperation ; Return to Work ; Survival Rate ; Transplants* ; Veins

Although a family-centered approach to health care for developmentally disabled children has been advocated, existing systems of care have not adequately addressed the support needs of the family system and the essential role that parents play in the daily care of these children. The overall purpose of this research is to examine family system adaptation to the care of a developmentally disabled child using the Resiliency Model of Family Stress, Adjustment, and Adaptation Framework. Relationships among family system demands(stressors, strains, transitions, child's illness factors) and family system strengths and capabilities(resource of social support) were examined to determine their separate and combined contribution to explaining the variability inn family system outcomes(family system coping). The subject for this study was 46 families who have a child with developmental disabilities(mental retardation and/or autism) from three special educational programs in Seoul, Korea, Results from correlation and hierachial regression analysis revealed that perceived social support operated as a resiliency factor between family stress and coping. Child and family characteristics appeared to be important predictors of perceived social support and coping. In summary, there is evidence that the resource of social support as a family strength and capability was found to improve the family coping. These findings also must be viewed within the context that sample of families of children with disabilities was relatively small and eligible families from support group of special educational program.
Child ; Delivery of Health Care ; Disabled Children* ; Family Characteristics ; Humans ; Korea ; Parents ; Self-Help Groups ; Seoul ; Child Health

BACKGROUND: The high level of susceptibility of patients with liver cirrhosis (LC) to septicemic infection is thought to be due to decreased reticuloendothelial function and irnpairment of several components of cell mediated and humoral immunity. It is well known that LC may cause many characteristic skin changes including jaundice, spider angioma, palmar erythema, xanthelasrna and nail changes such as clubbing and white nails. OBJECTIVE AND METHODS: During a 7 month period frorn April to October 1995, 100 patients who had been diagnosed as having LC were evaluated for the duration of their LC, the associated diseases they had apart from LC and various skin manifestations. Also, we performed the tuberculin test in 20 patients with LC and evaluated the correlation of the tuberculin test with severity of LC divided into 3 groups according to the Childs classification. RESULTS: The results are summarized as follows ; 1. The most frequent duration of LC was under 5 years (74%). 2. The most common associated disease of patients with LC was upper GI bleeding including esophageal varix (24 cases). Also, diabetes mellitus (13 cases) and hepatic coma (11 cases) were observed. 3. Jaundice (82 cases) was the most frequent skin rnanifestation of patients with LC. In addition, vascular changes (81 cases) and various nail changes (69 cases) were observed. Onychomychosis was the most common nail change of patients with LC. 4. 60% of the patients who were given the tuberculin test showed anergy, and the frequency of anergy increased in proport on to the severity of LC. However, it was not significant statistically (p> 0.05 ). CONCLUSIONS: Some of the skin manifestations help in the diagnosis of LC. Also, increased frequency of tuberculin test anergy in proportion to the severity of LC is thought to be related to decreased cell mediated immunity, although statistically it is not significant.
Child ; Classification ; Diabetes Mellitus ; Diagnosis ; Erythema ; Esophageal and Gastric Varices ; Hemangioma ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Jaundice ; Liver Cirrhosis* ; Liver* ; Skin Manifestations* ; Skin* ; Spiders ; Tuberculin Test

BACKGROUND: Generally, there are few problems in the diagnosis of Paget's disease(PD) using the H&E stain. However, the differentiation of PD from the clonal type of Bowens disease and superficial spreading melanoma in situ that shows pagetoid spreading of tumor cells, may present diagnostic difficulties. In addition, the specia1 stains used for demonstrating the presenee of Pagets cells, such as PAS and mucicarmim, are non-specific and not always sensitive. So, inenunohistochemical stains with monoclonal antibodies against various antigens may be helpful for differentiating PD from ather morphologically similar skin lesions. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of immunohisto- chemical staining for diagnostic use in PD. METHODS: Immunohistochemical stains used in the biotin streptavidin amplificxl technique with monoclonal antibodies to several low rnolecular weight cytokeratin(CK)s, EMA and CEA, were performed on formalin-fixed, paraffin-embedded tissue. Twelve cases of PD(10 cases of extranmmmary PD and 2 cases of mammary PD), five cases of superficial spreading melanoma in situ and five cases of Bowens disease were investigated. RESULTS: The results were as follows. 1. Positive reactions with variable intensity using CK7, CKS, CK19 were seen in all cases(100%) of PD and the. staining intensity tor CK7 or CK19 was stronger than that of CKS. 2. Of the 12 cases of PD, both CK18 and CAM5.2 staining showed positivity in 11 cases(92%). 3. EMA and CEA staining showed positivity in 10(83%) and 9(75%) of 12 cases, respectively. 4. Some Pagets cells were negative for CK8, CK18 and EMA, although other positive cells were observed in the same sections. 5. All antigens were consistently negative in all cases of Bowens disease and superficial spreading melanoma in situ. CONCLUSION: The results show that moaoclonal antibodies to low molecular weight CKs are more sensitive than EMA or CEA in the demonstration of Pagets cells. Moreover, among the low molecular weight CK series, CK7 and CK19 are most useful for their high sensitivity and intensity.
Antibodies ; Antibodies, Monoclonal ; Biotin ; Bowen's Disease ; Coloring Agents ; Diagnosis ; Melanoma ; Molecular Weight ; Skin ; Streptavidin

No abstract available.
DNA*

No abstract available.
Aorta* ; Pregnancy* ; Umbilical Arteries*

Infantile myofibromatosis is an uncornmon, benign, self-limiting, localized or generalized process, probably of hamartomatous origin, which consists to a large degree of cells having the characteristics of myofibroblasts and sometimes of pericytes. Both solitary and multicentric forms occur. Most lesions are present at birth or in early infancy, and some are familial in origin. A female newborn presented with a firm, round, red colored, 3 x 3 cm sized tumor with central necrosis on the left chest. Histological examination revealed well-circumscribed nodules consisting of short bundles of plump, spindle shaped cells displaying staining characteristics intermediate between fibroblasts and smooth muscle cells. The tumor was immunoreactive for actin but did not stain for desmin. A Follow-up examination at the age of 3 months revealed a moderate degree of spontaneous regressior of the lesion.
Actins ; Desmin ; Female ; Fibroblasts ; Follow-Up Studies ; Humans ; Infant, Newborn ; Myocytes, Smooth Muscle ; Myofibroblasts ; Myofibromatosis* ; Necrosis ; Parturition ; Pericytes ; Thorax

No abstract available.
Aorta, Thoracic* ; Blood Flow Velocity* ; Pregnancy*

No abstract available.
Carcinoma, Squamous Cell* ; Female ; Ovary*

The purpose of this study were to examine the construct validation and internal reliability of the SHEQ(School Health Efficacy Questionnaire)and to establish concurrent validity for the instrument among Korean adolescents by relationship found among SHEQ and the self-reported health status. The sample was consisted 393 high school students, aged with average of 17.40( +/- 0.59) years. According to the criteria used in this validating study, a four-factor structure, which consisted of 31-items, resulting from a principal components analysis with an varimax rotation, best represented the multidimensionality of the SHEQ of adolescents in Korea. Internal consistency estimated for the four factor on the SHEQ subscales range from .68 to .83. Evidence in support of concurrent validity for both 31-item and 38-item of SHEQ was provided by statistically significant correlations found between the two scales and self-reported health. With the findings of this study, the 31-item Korean version of the SHEQ can be used in practice as a reliable and valid instrument measuring perceived self-efficacy in physical and mental health for adolescents in Korea.
Adolescent ; Humans ; Korea ; Mental Health* ; Weights and Measures ; Child Health