Truncus arteriosus is characterized by a single arterial vessel arising from the base of the heart and giving origin to the systemic, pulmonary and coronary circulation. To evaluate the incidence, types, and associated anomalies, 18cases of truncus arteriosus diagnosed by angiocardiography, were reviewed and were compared with other reports. Ten of them were confirmed by operation. The overall incidence of truncus arteriosus was 0.127%. Accordin to Collett and Edwards classification. Type I was encountered in 11cases(61%), type II in 4cases(22%), and type III in 3cases(17%), All the patients had subtruncal ventricular septal defects. Eight patients showed truncal valve regurgitation and valve stenosis was noted in one case. A right aortic arch was present in 9 cases. Associated anomalies were atrial septal defect(8cases), patent ductus arteriosus(3cases), coarctation of the aorta(2cases), isolation of the left subclavian artery(2 cases), and right aortic arch with an aberrant left subclavian artery(1case). Truncus arteriosus is an uncommon congenital cardio vascular malformation. In the group of cases which we encountered, type I was the most common anomaly. Frequently associated anomalies were right aortic arch, incompetent truncal valve and atrial septal defect.
Angiocardiography ; Aorta, Thoracic ; Classification ; Constriction, Pathologic ; Coronary Circulation ; Heart ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence* ; Truncus Arteriosus* ; Vascular Malformations

No abstract available.
Angiofibroma* ; Carbon Dioxide* ; Carbon* ; Lasers, Gas* ; Sirolimus* ; Tuberous Sclerosis*

Bacterial endocarditis is a disease with protean manifestations whose presentation has recently changed greatly. Right-sided endocarditis associated with congenital heart lesions is now relatively less common. Patients with ventricular septal defect are at risk for right-sided endocarditis, but its incidence is low in children and adolescents. The organism is frequently a staphylococcus and the clinical course is dominated by septic pulmonary infarction and septicemia. We reported two cases of pulmonic vegetation and pulmonary infarction associated VSD with brief review of literature.
Adolescent ; Child ; Endocarditis ; Endocarditis, Bacterial ; Heart ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Pulmonary Infarction* ; Sepsis ; Staphylococcus

We report a 33-year-old man with AIDS dementia complex, which is one of the most common neurologic complica-tion of HIV-1 infection. The man presented with mild psychomotor slowing and episodic loss of consciousness about 5 years after the detection of the HIV-1 infection. His symptoms included forgetfulness, concentration difficulties, apathy, and psychomotor retardation which progressed rapidly evolving into the characteristic features of terminal HIV-1-asso-ciated dementia complex, such as severe dementia, mutism, incontinence, and paraparesis before death. Brain MRIrevealed diffuse confluent high signal intensity lesions in the subcortical white matter on the T2 weighted image. HIV encephalitis (AIDS dementia complex) was confirmed by a brain autopsy.
Acquired Immunodeficiency Syndrome ; Adult ; AIDS Dementia Complex* ; Apathy ; Autopsy* ; Brain ; Dementia ; Encephalitis ; HIV ; HIV-1 ; Humans ; Mutism ; Paraparesis ; Unconsciousness

Rupture limited to the lobar bronchus from blunt trauma is especially rare, and the symptoms are light so diagnosis is difficult. In a patient who visited the hospital complaining of shortness of breath after falling down, atelectasis continued in the chest x-ray. Four days after visiting the hospital, a left upper lobar bronchial rupture was diagnosed through a bronchoscopy and 3 dimensional chest computerized tomography. When diagnosis is delayed in the case of a rupture limited to the lobar bronchus, bronchial obstruction can occur from the formation of granulation tissue, so regular monitoring is important. Therefore, when atelectasis continues after blunt trauma, it is important to differentially diagnose a lobar bronchial rupture through tests such as bronchoscopy.
Bronchi ; Bronchoscopy ; Diagnosis ; Dyspnea ; Granulation Tissue ; Humans ; Lung Injury ; Pulmonary Atelectasis* ; Rupture* ; Thorax

BACKGROUND: Simplified acute physiology score 3 (SAPS3) was developed in 2005 to evaluate intensive care unit (ICU) performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. METHODS: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC) of the total scores and each subset were evaluated. RESULTS: The ICC (95% confidence interval) of SAPS3 score was 0.89 (0.82-0.95), that of subset I was 0.90 (0.82-0.95), subset II was 0.54 (0.35-0.73), and subset III was 0.95 (0.91-0.97). The ICC of predicted mortality was 0.91 (0.85-0.96). CONCLUSIONS: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component.
Critical Care ; Education ; Humans ; Intensive Care Units* ; Mortality ; Observer Variation ; Physiology* ; Severity of Illness Index

PURPOSE: This study was carried out to identify and re-establish the professional identity in clinical nurses. METHOD: From Dec. 1999, for 4 months, the study had been conducted by narrative analysis method based on hermeneutic principles. Subjects were ten nurses with 3-4 years of nursing experience at a university hospital. The data were collected and transcribed through narrative interviews. RESULT: As a result, the maternal role was identified as the most dominant discourse in which nurses formed their identity. Subjects felt that a maternity is socio-culturally needed in case of nursing. Reconstruction of professional identity consists of 3 stages, Telling, Retelling and Rebuilding. At first, nurses felt confused by skeptism of the profession, interpersonal difficulties, and heavy work loads. However, during the interviews, nurses recognized that nursing is not regarded as significant, effort to make nursing meaningful were small, and there was a lack of understanding others. From this new insight, they re-established a new image of nursing "through better understanding of others, seeking knowledge, and making positive efforts towards qualified nursing". CONCLUSION: The above narrative interviews may help nurses reflect and contextually interpret themselves, so that a new identity could be established. Furthermore researchers can obtain new insight from the subjects, while the subjects form a new nursing image from self-reflection.
Nursing

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

No abstract available.
Neurofibromatoses* ; Neurofibromatosis 1* ; Neurofibromin 1 ; Vitiligo*

To determine whether indol-3-carbinol (I3C, C9H9NO), an autolysis product of a glucosinolate and a glucobrassicin in vegetables, regulated tight junction proteins (TJ) and suppressed cell invasion in colon cancer cells,this experiment was performed. Our results indicate that I3C inhibit cell growth of HT-29 cells in a dose (0, 50, 100 micrometer) and time (0, 24 and 48 h) dependent manner. Using the wound healing and matrigel invasion study, respectively, I3C inhibits the cell motility and invasion of the ovarian cancer cell line. The TEER values were increased in HT-29 cells grown in transwells treated with I3C, reversely, paracellular permeability was decreased in those of condition. Claudin-1, claudin-5, ZO-1 and occuldin have been shown to be positively expressed in HT-29 coloncancer cells. I3C occurs concurrently with a significant decrease in the levels of those of proteins in HT-29 cells. But E-cadherin level in the HT-29 was increased by I3C. The reduction of claudin-1 and claudin-5 protein levels occurred post-transcriptionaly since their mRNA levels are no difference by I3C. Therefore, our results suggest that I3C may be expected to inhibit cancer metastasis and invasion by tighten the cell junction and restoring tight junction in colon cancer cell line, HT-29.
Autolysis ; Cadherins ; Cell Line ; Cell Movement ; Claudin-1 ; Claudin-5 ; Collagen ; Colon ; Colonic Neoplasms ; Drug Combinations ; Glucosinolates ; HT29 Cells ; Humans ; Indoles ; Intercellular Junctions ; Laminin ; Neoplasm Metastasis ; Ovarian Neoplasms ; Permeability ; Proteins ; Proteoglycans ; RNA, Messenger ; Tight Junction Proteins ; Tight Junctions ; Vegetables ; Wound Healing