Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

PURPOSE: The purpose of this research was to examine the effects of a Mindfulness-based Stress Reduction (MBSR) program on stress response and power in psychiatric inpatients in a closed ward. METHODS: For this study a quasi-experiment design was used to examine the effects of the intervention. The MBSR program conducted in this study was a six-session program, in which participants were asked to meditate for 45 minutes twice a week for 3 weeks. Homogeneity between the experimental and control group was assessed using χ² test, t-test, and Fisher's exact test. The results of the assessment showed that the variances of the two groups were equal. Demographic variables of the study participants were analyzed using descriptive statistics. The study hypotheses were verified using t-test. Cronbach's α was measured to assess the reliability of each test. RESULTS: Compared with the control group, patients in the experimental group showed significant improvement in scores for stress response (t=3.62, p=.001) and power (t=-3.42, p=.001). CONCLUSION: These results suggest that the mindfulness meditation program can be used as a psychosocial rehabilitation intervention for psychiatric inpatients by capitalizing on its positive effects on emotional reactivity and behavioral regulation.
Humans ; Inpatients* ; Meditation ; Mindfulness ; Psychiatric Nursing ; Psychiatric Rehabilitation

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1*

BACKGROUND/AIMS: A laparoscopic cholecystectomy (LC) has many clinical advantages and is now recognize as the choice of treatment for gallstones. However a laparoscopic cholecystectomy is often not feasible or is converted to the conventional open method in patients with acute cholecystitis because of inflammation around the gallbladder, adhesion, unclear anatomy, or intraoperative complications. Recent studies recommended that acute cholecystitis patients or gallbladder empyema patients undergo a percutaneous transhepatic GB drainage (PTGBD) first and a laparoscopic cholecystectomy later because PTGBD can be very helpful for improving the patient's state. METHODS: This study was carried out on 99 patients with acute cholecystitis or GB empyema who underwent a laparoscopic cholecystectomy after PTGBD at Eulji University School of Medicine from January 1996. These cases were compared with a control group of 41 patients who showed similar symptoms, ultrasonographic finding, operative finding, and pathologic results. RESULTS: There were no differences in the age and the sex distributions, the symptom duration, laboratory finding except alkaline phosphatase and leucocytosis. Among PTGBD group, a successful laparoscopic cholecystectomy was possible in 63 patients (63.6%), the other 36 patients were converted to open cholecystectomy. In control group, only 15 patients (36.6%) out of 41 underwent a successful laparoscopic cholecystectomy. This difference was statistically significant (P= 0.003). We analyze two groups about factors that can affect open conversion during laparoscopic cholecystectomy. In multivariate analysis, preoperative PTGBD and degree of wall thickening are the independent risk factors that can convert LC into open cholecystectomy. CONCLUSION: We think that a laparoscopic cholecystectomy performed some time after PTGBD to improve the patient's condition by eliminating acute inflammation or decompressing the gallbladder may be recommended for management of acute cholecystitis patients with severe clinical symptoms and ultrasonographic findings of marked gallbladder dilatation or pericholecystic fluid collection.
Alkaline Phosphatase ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Cholecystitis ; Cholecystitis, Acute* ; Dilatation ; Drainage ; Empyema ; Gallbladder ; Gallstones ; Humans ; Inflammation ; Intraoperative Complications ; Multivariate Analysis ; Risk Factors ; Sex Distribution

No abstract available.
Genes, ras* ; Humans*

Purpose: Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU). Methods: Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015. Results: The time to the initiation of enteral nutrition decreased significantly (P＜0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group. Conclusion The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.

Purpose: Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU). Methods: Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015. Results: The time to the initiation of enteral nutrition decreased significantly (P＜0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group. Conclusion The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.

Desmoid tumors are rare soft tissue tumors arising from the fascia or from musculoaponeurotic structures. They are commonly seen in the extremities, but are rarely found in the thorax. Thoracic desmoid tumors commonly arise from the chest wall and rarely in the thoracic cavity. Imaging diagnosis of an intrathoracic desmoid tumor is difficult because there are no specific imaging findings for a desmoid tumor that can be differentiated from the various tumors of the chest wall, including a solitary fibrous tumor of the pleura. All desmoid tumor cells show negative immunohistochemical staining for CD34 in pathological specimen, a feature that makes it possible to differentiate a desmoid tumor from a solitary fibrous tumor of the pleura. Desmoid tumors are locally aggressive and the rate of local recurrence is very high. Consequently, wide radical resection is required and a preoperative accurate diagnosis of desmoid tumors is warranted. We describe the radiological findings of various imaging studies for an intrathoracic desmoid tumor. Our findings should facilitate a proper diagnosis of desmoid tumors.
Diagnosis ; Extremities ; Fascia ; Fibromatosis, Aggressive* ; Recurrence ; Solitary Fibrous Tumor, Pleural ; Thoracic Cavity ; Thoracic Wall ; Thorax

Benign cystic teratoma is the common ovarian tumor, and the incidence reported about 20%. Between 1 and 2% of mature cystic teratomas undergo malignant trasformation. This occurs most frequently in postmenopausal women, who account for only 10% of mature cystic teratomas. Among the malignant transformations, squamous cell carcinoma is the most common type (over 75%), and adenocarcinoma, undifferentiated carcinoma, malignant melanoma, thyroid adenocarcinoma, and sarcoma have been reported in the literature. Because of its rarity, the clinico-pathologic characteristics are not well established, and there is no consensus on optimal therapy. There is also no consensus regarding the efficacy of postoperative therapy. We experienced a case of sarcoma of the ovary arising in mature cystic teratoma, which is presented with a brief review of literature.
Adenocarcinoma ; Carcinoma ; Carcinoma, Squamous Cell ; Consensus ; Female ; Humans ; Incidence ; Melanoma ; Ovary ; Sarcoma* ; Teratoma* ; Thyroid Gland