PURPOSE: Determination of pulmonary to systemic blood flow ratio (QP/QS) is important for the management of patients with left-to-right shunt. This study was performed to assess the agreement of Qp/Qs ratio using the radionuclide method and oxymetry, to investigate the factors influencing the agreement, and to know how interchangeable the results of each technique. MATERIALS AND METHODS: We compared the Qp/Qs measured by single-pass radionuclide angiocardiography and oxymetry during catheterization in 207 patients who underwent both studies. In radionuclide method, Qp/Qs was calculated from the pulmonary time-activity curves using a gamma variate fit. The correlation and Bland-Altman analysis were performed according to the levels of shunt and associated lesions. RESULTS: The mean Qp/Qs was 1.83+/10.50 by radionuclide, and 1.74+/10.51 by oxymetry. The overall correlation coefficient was 0.86(p<0.001), and Bland-Altman range of agreement encompassing 4SD was 1.05. For atrial septal defect, ventricular septal defect, patent ductus arteriosus, tricuspid and mitral insufficiency, the correlation coefficient was 0.78, 0.90, 0.84, 0.63 and 0.44, and Bland-Altman range was 1.52, 0.74, 0.96, 1.57, and 1.50, respectively. CONCLUSION: There is good agreement but wide variance between the Qp/Qs ratios by radionuclide method and oxymetry. Associated atrioventricular valvar insufficiency decreases the correlation coefficient and widens the variance. Wide overall variance suggests that Qp/Qs measurements by two techniques should not be used interchangeably.
Angiocardiography* ; Catheterization ; Catheters ; Ductus Arteriosus, Patent ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Mitral Valve Insufficiency

Local anesthesia is administered to control pain, but it may induce fear and anxiety. Root planing is a non-surgical periodontal therapy; however, when it is performed in an extensive manner, some tissue removal is inevitable. Notably, this removal may be so painful that local anesthesia is required to be administered to the area scheduled for the treatment. Although patients tend to accept root planing easily, they frequently express a fear of local anesthesia. Intraosseous anesthesia (IA) is an intraosseous injection technique, whereby local anesthetic is injected into the cancellous bone supporting the teeth. A computer-controlled IA system (CIAS) exhibits multiple benefits, such as less painful anesthesia, reduced soft tissue numbness, and the provision of palatal or lingual, as well as buccal, anesthesia via single needle penetration. In this report, we present two cases of root planing that were performed under local anesthesia, using a CIAS.
Anesthesia ; Anesthesia, Local ; Anxiety ; Humans ; Hypesthesia ; Needles ; Root Planing ; Tooth

Recently, the prevalence of diabetic mellitus patients in Korea has been increasing, and it increasing with age. The treatment goal of diabetes is to prevent complications through blood sugar management, for which it is important to maintain an appropriate nutritional state. Unbalanced diet refers to excessive or insufficient nutrition, which can be generally confirmed through weight conditions. Therefore, medical nutrition therapy in diabetic patients with unbalanced diet aims to maintain a moderate body mass index. Older people with diabetes have a higher risk of unbalanced diet than those without diabetes. Clinical nutritional intervention in diabetic patients should shift from strict dietary restrictions for treatment of metabolic syndrome/obesity to diet for prevention of frailty and sarcopenia with age. Therefore, clinical nutrition therapy for diabetic patients with unbalanced diet should be individualized in consideration of age, gender, and medical condition. Medical nutrition therapy tailored for each patient can contribute to improving the nutritional status of diabetic patients, prolonging healthy life expectancy and improving quality of life.

Motor impairment due to stroke limits patients’ mobility, activities of daily living, and negatively affects their return to the workplace. It also reduces patients’ quality of life and increases the socioeconomic burden of stroke. Therefore, optimizing the recovery of motor impairment after stroke is a very important goal for both individuals and society as a whole. The emergence and improvement of various technologies in the Fourth Industrial Revolution have exerted a major influence on the development of new rehabilitation methods and efficiency enhancements for existing methods. This review categorizes rehabilitation methods that promote the recovery of motor function into upper limb function and lower limb function and summarizes recent advances in stroke rehabilitation. Although debate continues regarding the effects of some rehabilitation therapies, it is hoped that the evidence will be improved through ongoing research so that clinicians can treat patients with a higher level of evidence.

An internal hernia is defined as the protrusion of an internal organ through a defect in the abdominal cavity. Broad ligament hernia (BLH) is an extremely rare type of internal hernia that is difficult to diagnose preoperatively because the symptoms are nonspecific. However, early diagnosis is crucial, and early surgery is required to reduce complications such as strangulation. Laparoscopy has the advantage of enabling simultaneous diagnosis and treatment of BLH. With the advancement of the laparoscopic techniques, several cases of laparoscopic treatment of BLH have been reported. Nevertheless, open surgery is primarily performed in patients requiring bowel resection. We present a case of laparoscopic surgery for a strangulated internal hernia through a broad ligament defect. We successfully resected the strangulated small intestine and closed the defect of the broad ligament laparoscopically with a minor incision.

No Abstract available.
Echocardiography* ; Echocardiography, Transesophageal*

No abstract available.
Diagnosis* ; Mucocutaneous Lymph Node Syndrome*

No Abstract available.
Heart Defects, Congenital*

No Abstract available.
Heart Defects, Congenital* ; Humans

Background: Infection prevention and control (IPC) to manage healthcare-associated infection (HCAI) has emerged as one of the most significant public health issues in Korea. The purpose of this study is to draw implications in IPC policies by analyzing the context, process, and major actors in policy development and comparatively analyzing IPC policy contents of Korea with three other countries. Additionally, IPC policies were analyzed in the context of coronavirus disease 2019 (COVID-19) to provide implications for future pandemics and HCAI events. Methods: This study incorporates a qualitative approach based on document and content analysis, applying codes and thematic categorization. IPC policy contents are comparatively analyzed by adopting the concept model, developed by the World Health Organization, which consists of core components of IPC structure at the national and facility level. Results: National IPC policies were developed within a complex social and political context, through the involvement of various stakeholders. IPC policies in Korea place a high emphasis on establishing IPC programs and built environments in healthcare facilities, whereas there were potentials for improvement in policies involving patients and promoting a safety culture. IPC policies, which currently focus on general hospitals and certain functions of hospitals, should further be expanded to target all healthcare facilities and functions, to ensure more efficient and sustainable IPC responses in the current and future disease outbreaks. Conclusion IPC is a complex policy arena and lessons learned from the analysis of existing policies in the context of COVID-19 should provide valuable strategic implications for future policies.