No abstract available.
Holoprosencephaly* ; Prune Belly Syndrome*

PURPOSE: The purpose of this study was to develop Situation, Background, Assessment, Recommendations(SBAR) program and to test the effects of the program on communication clarity, clinical competence, and self-efficacy for clinical nurses in cancer hospitals. METHODS: This study applied a nonequivalent control group non-synchronized design. There were 28 participants in the intervention group and 27 in the control group. SBAR program consisted of 4 parts and applied for 6 weeks in the intervention group. Data were analyzed with χ² test, Fisher's exact test, t-test and ANCOVA using the SPSS program. RESULTS: Communication clarity, clinical competence and self efficacy were significantly increased in the intervention group compared to those in the control group. CONCLUSION: These results suggest that SBAR program may improve communication clarity, clinical competence and self-efficacy for clinical nurses in cancer hospitals. Therefore, it is required to actively take advantage of this program to improve communication clarity among medical staffs, clinical competence, and self-efficacy in clinical nursing practices.
Cancer Care Facilities* ; Clinical Competence* ; Humans ; Medical Staff ; Nursing ; Self Efficacy

BACKGROUND AND OBJECTIVES: Corrected transposition of the great arteries (C-TGA) is a rare congenital heart disease, of which prognosis depends on the associated cardiac defects, systemic ventricular function, competency of atrioventricular valves, and the presence of conduction disturbances. This study was aimed to assess the midterm follow-up status of C-TGA. PATIENTS AND METHODS: Retrospective review was performed on 89 cases with C-TGA and two ventricles of adequate size, which were diagnosed between January 1980 and June 1997. RESULTS: Study subjects consisted of 56 males and 33 females (average age at diagnosis, 9 months). Mean follow-up duration was 98 months (range, 2 months - 23 years 8 months). Based on the associated cardiac anomalies, there were 6 simple C-TGA and 83 complex C-TGA patients. Surgery including 19 palliative and 47 corrective operations was attempted on 61 cases at mean age of 69 months. Tricuspid regurgitation (TR) was noted at the time of first examination in 52 (mild in 39; moderate in 8; severe in 5) and progressed in 18 patients. TVR was done on 5 patients and double switch on 7 patients. Arrhythmia was noted preoperatively (complete AV block in 3) in 11 and postoperatively (postoperative complete AV block in 3) in 22 patients. A total of 13 cases died including 10 perioperative deaths during follow-up. Actuarial survival rate at 10 year was 84.5%. CONCLUSION: In this study, the midterm outcome of corrected TGA is acceptable. However, long-term follow-up is required in respect to the function of atrioventricular valve and the systemic ventricle.
Arrhythmias, Cardiac ; Arteries* ; Atrioventricular Block ; Child* ; Diagnosis ; Female ; Follow-Up Studies* ; Heart Defects, Congenital ; Humans ; Male ; Prognosis ; Retrospective Studies ; Survival Rate ; Tricuspid Valve Insufficiency ; Ventricular Function

PURPOSE: To evaluate the results of physeal bar resection and free fat graft as a treatment method for partial epiphyseal closure. MATERIALS AND METHODS: Thirteen cases of partial epiphyseal closure (4 of the distal femur, 8 of the distal tibia and one of the distal radius) were subjected to physeal bar resection. All of the cases were caused by trauma. The physeal bar was central in 3 cases, peripheral in 9, and mixed (central-peripheral) in 1. Mean patient age at surgery was 10.7 years and mean follow-up period was 47 months. Final results were evaluated by a modified Williamson-Staheli classification. RESULTS: Results at final follow-up were as follows: 6 satisfactory (3 excellent and 3 good) and 7 unsatisfactory (5 fair and 2 poor). Satisfactory results according to location and region of the physeal bar were as follows: distal tibia, 5 of 8 cases; distal femur, 1 of 4; central, 1 of 3; peripheral, 4 of 9; and mixed, 1 of 1. When considered by areal extent, physeal bars occupying 30% or less of the bone's cross-sectional area showed satisfactory results in 5 of 7 cases, while in 6 cases with the physeal bar over 30%, 5 were unsatisfactory. CONCLUSION: Accurate preoperative evaluation of the size and type of the physeal bar, and meticulous surgical technique, are important predictors of satisfactory outcome of physeal bar resection. Cases where the physeal bar extent exceeded 30% had mostly unsatisfactory results.
Femur ; Follow-Up Studies ; Humans ; Tibia ; Transplants

PURPOSE: The purpose of this study was to identify the relationship between psychosocial factors and symptom experience of patients with cardiovascular disease over a 6-month follow-up period. METHOD: Baseline data for each of the 138 patients were collected. Eighteen patients were dropped for a final total of 120 patients in the present study. To monitor patients' symptom experience after discharge, each patient was interviewed by telephone, and interviewed directly with a questionnaire at each clinic visit. RESULTS: Mean scores for hostility, anger, anxiety, and depression were 51.63, 22.87, 48.95, and 41.21, respectively. Mean scores for the level of symptom experience at discharge, 3 months and 6 months after discharge were 32.83, 24.79, and 26.70, respectively. There were significant differences in the level of hostility by gender, BMI, job, and monthly income. Also the differences in the level of anxiety and depression were statistically significant according to gender and existence of spouse. In the regression analysis, depression was identified as the significant factor associated with symptom experience at discharge, 3 months, and 6 months after discharge. CONCLUSION: This study presented baseline data to elucidate whether psychosocial factors were associated with the progression of cardiovascular diseases. Accordingly, it suggests that nurses need to take into consideration psychosocial factor as well as physiological factor in symptom management for patients with cardiovascular disease.
Ambulatory Care ; Anger ; Anxiety ; Cardiovascular Diseases* ; Depression ; Follow-Up Studies* ; Hostility ; Humans ; Psychology* ; Surveys and Questionnaires ; Spouses ; Telephone

BACKGROUND: The arterial switch operation (ASO) has become a procedure of choice for transposition of the great arteries (TGA) with or without ventricular septal defect (VSD). In spite of current low surgical mortality in immediate surgical period, there are potential problems of late morbidity and mortality. In this study, we evaluate the prevalence and severity of aortic insufficiency (AI) and associated factors with AI. METHOD: We retrospectively reviewed medical records and echocardiogram of 125 patients (M89, F36) underwent ASO for TGA at Seoul National University Children's Hospital from July, 1987 to June, 1997. To evaluate for associated factors, we divided patients of TGA to four hemodynamic groups (Group I, simple TGA (n-53); Group II, associated with ventricular septal defect (VSD) (n-50); Group III, associated with VSD and PS (n-18); Group IV, associated with PS (n-4)). Grade of AI was assessed by color Doppler analysis (Perry's et al). RESULTS: Total prevalence rate of AI was 35.2% (31/88) and grade of AI were mild in 61%, moderate in 39%. The incidence of AI in each group was: Group I 25.0% (10/40), Group II 26.0% (9/36), Group III 92.0% (12/13). According to this study, pulmonary stenosis was the only significant factor to AI. During follow-up (39+/-24 Months), in spite of the normal left ventricular function in most patients with AI, a few patients (3 cases) suffered from progressive AI and some moderate AI patients (2 cases) showed slightly decreased LV function. Two moderate and progressive AI lossed. CONCLUSION: In this study, AI (after ASO) was not uncommon and pulmonary stenosis was an important factor to AI. In some cases, AI became worse and developed decreased LV function. This suggests that meticulous follow-up after ASO is necessary.
Arteries* ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Incidence ; Medical Records ; Mortality ; Prevalence ; Pulmonary Valve Stenosis ; Retrospective Studies ; Seoul ; Ventricular Function, Left

Trichostatin A (TSA), originally developed as an antifungal agent, is one of potent histone deacetylase (HDAC) inhibitors, which are known to cause growth arrest and apoptosis induction of transformed cells, including urinary bladder, breast, prostate, ovary, and colon cancers. However, the effect of HDAC inhibitors on human non-small cell lung cancer cells is not clearly known yet. Herein, we demonstrated that treatment of TSA resulted in a significant decrease of the viability of H157 cells in a dose-dependent manner, which was revealed as apoptosis accompanying with nuclear fragmentation and an increase in sub-G0/G1 fraction. In addition, it induced the expression of Fas/FasL, which further triggered the activation of caspase-8. Catalytic activation of caspase-9 and decreased expression of anti-aptototic Bcl-2 and Bcl-XL proteins were observed in TSA-treated cells. Catalytic activation of caspase-3 by TSA was further confirmed by cleavage of pro-caspase-3 and intracellular substrates, including poly (ADP-ribose) polymerase (PARP) and inhibitor of caspase-activated deoxyribonuclease (ICAD). In addition, a characteristic phenomenon of mitochondrial dysfunction, including mitochondrial membrane potential transition and release of mitochondrial cytochrome c into the cytosol was apparent in TSA-treated cells. Taken together, our data indicate that inhibition of HDAC by TSA induces the apoptosis of H157 cells through signaling cascade of Fas/FasL-mediated extrinsic and mitocondria-mediated intrinsic caspases pathway.
Signal Transduction ; Receptors, Death Domain/*metabolism ; Protein Isoforms/metabolism ; Mitochondria/*drug effects/*metabolism ; Lung Neoplasms/*metabolism/*pathology ; Hydroxamic Acids/*pharmacology ; Humans ; Histones/metabolism ; Enzyme Activation ; Cell Line, Tumor ; Catalysis ; Caspase 9/metabolism ; Caspase 8/metabolism ; Caspase 3/metabolism ; Apoptosis/*drug effects ; Acetylation

BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
Angiotensin-Converting Enzyme Inhibitors ; Arteries* ; Atrial Flutter ; Digoxin ; Female ; Follow-Up Studies* ; Furosemide ; Heart ; Humans ; Male ; Mortality ; Mustard Plant ; Postoperative Complications ; Retrospective Studies ; Seoul ; Sick Sinus Syndrome ; Survival Rate ; Survivors ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes

BACKGROUND: Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA) has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. METHODS: We analyzed the data of 51 patients who underwent the atrial switch operation for complete TGA at Seoul National University Hospital between January 1981 and June 1993 retrospectively. RESULTS: The patients were composed of 36 males and 15 females (mean age at operation, 15+/-30 months, range 2 months-18 years). Senning operation was undertaken in 43 and Mustard operation in 8. Among these, 27 had simple and 24 complex complete TGA. The early mortality rate within 1 month postoperatively was 39% and the late mortality rate 16%. The actuarial survival rate after 10 years was 78%. Of these, 17 cases have been followed up so far. Although the significant tricuspid regurgitation was noted in 9, right ventricular systolic function was maintained in all of them. Preoperative sinus node dysfunction was noted in 1 case. Postoperatively, premature ventricular contractions were found in 8 cases, atrial flutter in 4, and sinus node dysfunction in 7. Subclinical pulmonary venous obstruction was found in 2 and systemic venous obstruction in 1. At present, one takes digoxin for prevention of atrial flutter and 7 take digoxin, furosemide, and/or angiotensin-converting enzyme inhibitors for prevention of ventricular functional deterioration. Twelve cases were in New York Heart Association functional class I at the latest follow-up and 5 were in class II. CONCLUSION: This study revealed that morbidity and mortality were not low after atrial switch operation. However, considering the good long-term functional status in the survivors, atrial switch operation could be an alternative to arterial switch operation in complicated cases of TGA.
Angiotensin-Converting Enzyme Inhibitors ; Arteries* ; Atrial Flutter ; Digoxin ; Female ; Follow-Up Studies* ; Furosemide ; Heart ; Humans ; Male ; Mortality ; Mustard Plant ; Postoperative Complications ; Retrospective Studies ; Seoul ; Sick Sinus Syndrome ; Survival Rate ; Survivors ; Tricuspid Valve Insufficiency ; Ventricular Premature Complexes

Ketoconazole is one of the broad-spectrum oral antimycotic agents recently developed from imidazole derivatives. Authors performed multicenter trials to evaluate the therapeutic effect of ketoconazole in superficial fungal diseases. One hundred and eighty-four patients with superficial fungaI diseases were included in this study during 7 months from April to October, 1983 Patiets were treated with oral administration of 200 mg of ketoconazole(Nizoral) once a day for 4 weeks.-countinue-
Administration, Oral ; Humans ; Ketoconazole*