A 30-year-old man was transferred to Yonsei Cardiovascular Hospital after 20 days of hospitalization under the diagnosis of bacterial endocarditis with mitral regurgitation and septic splenic infarct. He had suffered from intermittent high fever and general weakness for 3 months. Echocardiogram showed moderate mitral regurgitation and multiple large vegetations in both leaflets. Streptococcus viridans was confirmed by blood cultures, and administration of cefazoline and gentamycin was initiated. During the antibiotic therapy, abdominal and left calf pain developed, and abdominal computed tomography showed splenic and right renal infarct. He also complained intermittent headache and visual distrubance. Brain computed tomography and four vessels angiography showed a small aneurysm in right hemisphere and other small aneurysm in fronto-occipital area of left middle cerebral artery. No more systemic embolization developed until the completion of six weeks of antibiotic therapy. The patient underwent mitral valve replacement with #29 Carpenitier-Edwards Bioprosthesis. At operation, the anterior and posterior mitral leaflets were found perforated and covered with leaflets were found perforated and covered with multiple vegetations. Follow-up cerebral angiography taken at seventh postoperative day, showed enlargement of cerebral aneurysm. Clipping of saccular aneurysms on left M3 and M4 were performed and complete resolution of aneurysm was confirmed by brain computed tomography. On operative finding, an aneurysm was found on with saccular type. The patient was dischanged without complication on eighth postoperative day.
Adult ; Aneurysm ; Aneurysm, Infected* ; Angiography ; Bioprosthesis ; Brain ; Cefazolin ; Cerebral Angiography ; Diagnosis ; Endocarditis, Bacterial ; Endocarditis, Subacute Bacterial* ; Fever ; Follow-Up Studies ; Gentamicins ; Headache ; Hospitalization ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Mitral Valve ; Mitral Valve Insufficiency ; Viridans Streptococci

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

PURPOSE: We studied the crystallographic component of the prostatic calculi according to the location on the transrectal prostatic ultrasonography to know the mechanism of the formation of the calculus. MATERIALS AND METHODS: From August, 1995 until May, 1997, 33 prostatic calculi from 24 patients(mean age 59 years, mean size 3.1mm) operated on for prostatism were analyzed by polarization microscopy(ZeissR), X-ray diffraction(PW-1720R, Philips) and infrared spectrophotometer(FTIR-205R, Nicolet). Location of calculi was divided two groups under guide of transrectal prostatic ultrasonography; periurethral and periadenoma type. The periurethral type showed hyperechoic density around the prostatic urethra and the periadenoma type showed hyperechoic density between adenoma and false prostatic capsule(peripheral zone). RESULTS: 22 calculi were the periurethral type and 11 were periadenoma type. Thirty stones from 20 periurethral type and 10 periadenoma type consisted two or three of the following calcium phospate, calcium oxalate and tricalcium phospate. These are mixed by the endogenous origin formed from the prostatic fluid and the exogenous origin formed at least in part from urine. Three stones (2 calcium oxalate, 1 uric acid) contained only one compound which participitate from urine. All of 11 calculi of the pericapsular type had an oxalate component. CONCLUSIONS: The calculi around the periadenoma region may be formed from not only endogenous component(calcium apatite stone) but also exogenous component(calcium oxalate) or intraductal precipitation of oxalate component which has never found in the prostatic fluid. These results may suggest the necessity of reevaluation about oxalate component within the prostatic fluid.
Adenoma ; Calcium ; Calcium Oxalate ; Calculi* ; Prostatism ; Ultrasonography* ; Urethra

The purpose of this study was to investigate the difference of body composition, eating habits and dietary intake in three Sasang constitutions. This survey was carried out using anthropometry, a questionnaire about eating habits, and 24-hour recall of dietary intake on 45 male and 29 female students of the fifth grade at C elementary school. The results are summarized as follows: A total of 44.6% of the subjects were Taeumin, 35.1% were Soyangin, and 20.3% were Soeumin. The average weight, WHR, Triceps, Rhrer index and BMI in the Taeumin group were significantly higher than those of the Soeumin and Soyangin groups. The body fat mass (kg) and abdominal fat (%) in the Taeumin group were significantly higher than those of the Soeumin and Soyangin groups. The soft body mass (%) in the Soeumin group was significantly higher than that of the Soeumi and Soyangin groups. The Taeumin's energy expenditure in physical activities was little high than that of the Soyangin and Soeumin groups, but the Soyangin's energy expenditure in physical activities per weight was a little higher than that of the Taeumin and Soeumin groups. The calorie and most of the nutrient intake were lower than those of Korean RDA. In the case of males, most nutrient intake, except for fiber, carotene and vitamin C were high in the Taeumin. For females, most nutrient intake, except for calcium and retinol were significantly higher in the Taeumin group. Conclusively, anthropometry characteristics, body composition, energy expenditure in physical activities, eating habits and dietary intake are different among the three Sasang constitutions. This study suggests the possibility of using Sasang consitutions as a basis for providing nutritional education and health guidelines.
Abdominal Fat ; Adipose Tissue ; Anthropometry ; Ascorbic Acid ; Body Composition* ; Calcium ; Carotenoids ; Child* ; Constitution and Bylaws* ; Eating* ; Education ; Energy Metabolism ; Female ; Humans ; Male ; Motor Activity ; Vitamin A ; Surveys and Questionnaires

T cell lymphoblastic lymphoma is characterized by immature lymphoid cells that are indistinguishable from the lymphoblasts and prolymphocytes of acute lymphoblastic leukemia. Several characteristic clinical features of lymphoblastic lymphoma, with include a high male-to-female ratio, a relatively high incidence in older children and young adults, the frequent presence of mediastinal involvement at the time of diagnosis. Also, this disease is rapidly progressive, and early dissemination to the bone marrow, blood, and central nervous system leads to the evolution of a picture resembling a acute lymphoblastic leukemia. We have experienced a rare case of congenital T-cell lymphoblastic lymphoma in which 1/365 year old female newborn had generalized multiple irregular protruding mass on her body. On bone marrow biopsy, CSF analysis, ultrasonogram and whole body MRI studies. We found metastasized tumor mass to, orbit, abdominal cavity, bulva, skin, and lower extremities. Histopathologically, specimen from mass on the right thigh showed diffuse infiltration of poorly differentiated and immature lymphoid cells in the skelectal muscle and subcutaneous soft tissue. By immunophenotyping studies using anti T cell and B cell monoclonal antibody, these cells were reactive with UCHL-1, MB2, but unreactive with MB1, L26. Based on these findings, the lesion was diagnosed as lymphoblastic lymphoma of the T-cell type, which occurred congenitally. Most T cell lymphoblastic lymphoma are noted, but congenital case was not reported. So we report it with a brief review of literature.
Abdominal Cavity ; Biopsy ; Bone Marrow ; Central Nervous System ; Child ; Diagnosis ; Female ; Humans ; Immunophenotyping ; Incidence ; Infant, Newborn ; Lower Extremity ; Lymphocytes ; Magnetic Resonance Imaging ; Orbit ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Skin ; T-Lymphocytes ; Thigh ; Ultrasonography ; Young Adult

The purpose of this review is to present the basic concepts of attachment theory and temperament traits and to discuss the integration of these concepts into parenting practices. Attachment is a basic human need for a close and intimate relationship between infants and their caregivers. Responsive and contingent parenting produces securely attached children who show more curiosity, self-reliance, and independence. Securely attached children also tend to become more resilient and competent adults. In contrast, those who do not experience a secure attachment with their caregivers may have difficulty getting along with others and be unable to develop a sense of confidence or trust in others. Children who are slow to adjust or are shy or irritable are likely to experience conflict with their parents and are likely to receive less parental acceptance or encouragement, which can make the children feel inadequate or unworthy. However, the influence of children's temperament or other attributes may be mitigated if parents adjust their caregiving behaviors to better fit the needs of the particular child. Reflecting on these arguments and our childhood relationships with our own parents can help us develop the skills needed to provide effective guidance and nurturance.
Adult ; Caregivers ; Child ; Exploratory Behavior ; Human Development ; Humans ; Infant ; Parenting ; Parents ; Temperament

A prospective study was carried out on the efficacy of a circular grip which we devised to facilitate a non-sterile intermittent catheterization. The series included 16 females, the mean follow-up time being 7 months. Most patients were suffering from neurogenic bladder disorders and bladder retention after operation. All of them used the circular grip during intermittent catheterization and continued to undergo intermittent catheterization. The technique of the use of the circular grip during intermittent catheterization was usually learnt easily and provided reassurance to the patient and family about intermittent catheterization.
Catheterization* ; Catheters* ; Female ; Follow-Up Studies ; Hand Strength* ; Humans ; Prospective Studies ; Urinary Bladder ; Urinary Bladder, Neurogenic

No abstract available.

No abstract available.
Curettage* ; Female ; Humans ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Humans ; Interleukin-2* ; Leukemia*