BACKGROUND: Alterations in ventricular loading conditions lead to changes in action potential duration via mechanoelectrical feedback. A decrease in load immediately leads to prolongation of repolarization. QT interval and QT dispersion were measured to determine the long-term effect of changes in ventricular systolic load on the ventricular repolarization. METHOD: Corrected QT interval and QT dispersion were measured in 26 patients before and 3-6 months after valvuloplasty for pulmonary stenosis. To determine the effect of ventricular load on ventricular repolarization, patients were divided in 2 groups; Group 1 was those patients with a greater than 30 mmHg and Group 2 was those patients with a less than 30 mmHg decrease in right ventricular systolic pressure. RESULTS: Corrected QT interval (412.6+/-14.5 msec vs 426.4+/-16.8 msec, p < 0.05) and QT dispersion (35.0+/-7.3 msec vs 45.7+/-14..1 msec, p < 0.05)were increased significantly only in Group 1 after vlavuloplasty. CONCLUSION: It suggested that mechanoelectrical interactions are operative for long duration in humans that changes in ventricular load after successful pulmonary valvuloplasty showed long-term effect on the ventricular repolarization.
Action Potentials ; Balloon Valvuloplasty* ; Blood Pressure ; Humans ; Pulmonary Valve Stenosis*

Porokeratosis may be due to an abnormal clone of cells, predisposing affected individusls to development of malignant neoplssm over involved area. A 58-year old female is prsented with basal cell epithelioma associated with PPPD, exhibiting the classical histopathologic criteria of the disease. Total excision for basal cell epithelioma and oral administration of etretinate for the treatment of porokeratosis plantaris, palmaris et disseminata and for the prevention of cancer developrnent resulted in good response.
Acitretin ; Administration, Oral ; Carcinoma, Basal Cell* ; Clone Cells ; Etretinate ; Female ; Humans ; Middle Aged ; Porokeratosis*

PURPOSE: The purpose of this study was to investigate relations among lifestyle, depression and health-related quality of life (HRQoL) of adult women in the Jeju Province. METHODS: This study sampled 154 women aged 20 or older through convenience sampling and surveyed them from January to February, 2008. RESULTS: The mean score for lifestyle was 3.7, for depression 12.1, and for HRQoL 75.2. There were significant negative correlations between lifestyle and depression, and between depression and HRQoL. There was a significant positive correlation between lifestyle and HRQoL. CONCLUSION: The results indicate that HRQoL of women is associated with lifestyle and depression. When developing programs to enhance health in women, consideration should be given to lifestyle and depression.
Adult ; Depression* ; Female ; Humans ; Life Style* ; Quality of Life*

A 21-year-old female is presented with semicircular lipoatrophy, which had developed since birth with annular depressed strophic lesion of the left thigh. Biopsy specimen from the depressed area of left thigh showed no abnormal pathologic findings. But X-ray and CT scan of the lower extremity revealed remarkably reduced fat layer of the left thigh, compared to the right side.
Biopsy ; Female ; Humans ; Lower Extremity ; Parturition ; Thigh ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: Chaotic atrial rhythm (CAR) is characterized by the presence of three or more P-wave morphologic features on the surface electrogram, absence of a dominant atrial pacemaker, and variable P-P, R-R, and P-R intervals with an atrial rate of over 100 beats/min. CAR is infrequently seen in pediatric ages and its clinical course, management and underlying mechanism are uncertain. We report our recent experience with 11 infants with CAR and describe their clinical characteristics and reponse to treatment. METHODS: We retrospectively reveiwed the medical records, electrocardiograms, Holter recordings, echocrdiographic reports of 11 cases of CAR managed at Sejong general hospital and Asan medical center from January 1991 to June 1995. RESULTS: 1) All patients were < or =6 months old and 5 of 11 patients had symptoms at neonatal period. The duration of follow-up was 3-42 months(mean : 18 months). 2 patients had structural heart disease and 3 patients showed signs of ventricular dysfunction. In 10 of 11 patients tachycardia was sustained or recurrent. 1 patient died of severe congestive heart failure due to incessant rapid tachycardia. 2) 3 of 10 patients took digoxin only and others took more than 2 medications. Full control within 1 month after medication was in 2 patients, with digoxin only in one and digoxin and amiodarone in another patient. At discharge, state of arrhythmia control in 8 patients with medications were full control in 2, good control in 3, and partial control in 3. At last follow-up, full control in 5, good control in 1 were confirmed through Holter recordings and the other 4 patients showed sinus rhythm in surface electrocardiograms. The total duration of medications were < or =1 year except 1 patient. 3) In 3 patients with ventricular dysfunction, ventricular function was normalized after restoration of sinus rhythm. CONCLUSION: CAR in children usually occurs in the first month of life and genenally takes benign course, but sometimes it causes severe congestive heart failure or ventricular dysfunction. Frequently, the patients remain asymptomatic despite persistence of the tachycardia for weeks or months. CAR is difficult to convert to sinus rhythm with medications but tends to resolve spontaneously within 1 year. We think treatment is necessary only in the symptomatic patients with rapid ventricular response and it is enough to control the ventricular rate with antiarrhythmic agents.
Amiodarone ; Arrhythmias, Cardiac ; Child ; Chungcheongnam-do ; Digoxin ; Electrocardiography ; Follow-Up Studies ; Heart Diseases ; Heart Failure ; Hospitals, General ; Humans ; Infant ; Medical Records ; Retrospective Studies ; Tachycardia ; Ventricular Dysfunction ; Ventricular Function

BACKGROUND: Idiopathic left ventricular tachycardia with a QRS pattern of right bundle branch block and left axis deviation that is sensitive to verapamil is electrophysiologically distinct arrhythmia entity but descriptions in pediatric ages are infrequent. This study attempted to describe the clinical presentation and dignostic clues from the surface ECG in children with idiopathic left venteicular tachycardia. METHODS: We retrospectively reviewed the medical records, electrocardiograms, Holter recordings, echocardiographic reports of 10 children with idiopathic left ventricular tachycardia who have been managed at Sejong General Hospital and Asan Medical Center, Seoul, Korea from January 1991 to July 1996. Follow-up periods are 2 months to 5 years(mean=26 months). RESULTS: 1) Age of tachycardia onset was 8 months to 14 years(median=4.3 years). In 3 children tachycardia began from infancy. The main complaint in older children was palpitation and chest discomfort but young childen complained abdominal pain during tachycardia attack. Tachycardia was paroxysmal and sustained. Tachycardia responded to intravenous use of verapamil in 9 patients and was controlled by chronic verapamil medication in 6 patients. 2 patients were well without medication. Radiofrequency catheter ablation was done in an adolescent patient successfully. 2) In sinus rhythm, surface ECG showed normal QRS axis and normal QRS morphologies in all patients. During ventricular tachycardia, the heart rate was 183 to 270 beats/min. The taxhycardia of RBBB morphology was observed in all patients. The mean QRS duration was 109+-12ms and the QRS axis was -50* to -90*. Themean RS interval was 60+-12ms. AVdissociation was found on surface RCG in all patients and confirmed in 4 patients by transesophageal ECG. We tried rapid transesophageal atrial pacing in 3 patients and could induce and terminate the ventricular tachycardia. CONCLUSIONS: Idiopathic left ventricular tachycaedia is rare in childhood and is seen from infancy. Idiopathic left ventricular tachycardia is generally benign but occasionally causesmyocardial dysfunction. Idiopathic ventricular tachycardia with a QRS pattern of right bundle branch block amd left axis deviation that is sensitive to verapamil in children should not be confused with supraventricular tachycardia with aberrancy and most helpful diagnostic clue is AV dissociation in surface ECG.
Abdominal Pain ; Adolescent ; Arrhythmias, Cardiac ; Axis, Cervical Vertebra ; Bundle-Branch Block ; Catheter Ablation ; Child ; Chungcheongnam-do ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Hospitals, General ; Humans ; Korea ; Medical Records ; Retrospective Studies ; Seoul ; Tachycardia ; Tachycardia, Supraventricular ; Tachycardia, Ventricular* ; Thorax ; Verapamil

PURPOSE: The purpose of this study was to analyze intervention studies related to Snoezelen (multisensory environment). METHODS: Studies related to Snoezelen (multisensory environment) published between 1995 and 2010 in both Korean and International journals were systematically reviewed, and analyzed following guidelines. Based on inclusion criteria, 23 studies including 5 Korean and 18 International articles were selected. RESULTS: Most studies were conducted in various area of research such as medicine, nursing, and occupational therapy. There was no publication related to Snoezelen (multisensory environment) in Korean nursing journals. In terms of target population, more than 65% of the study subjects were patients with dementia, mental retardation, and learning disability. Intervention was implemented mostly in less than 30 minutes, once a week for 2 to 4 weeks. The effects on behavior, physical, and psychological contexts were assessed as outcome indicators. There was more 'positive' than 'no effect' in self-stimulatory behaviors, problem behaviors, heart rate, pain, mood state, and anxiety, whereas more 'no effect' than 'positive' in blood pressure, respiration, enjoyment, and relaxation. CONCLUSION: Future studies are needed to develop the protocol and outcome indicators for effective use of this new intervention in Korea.
Anxiety ; Blood Pressure ; Dementia ; Health Services Needs and Demand ; Heart Rate ; Humans ; Intellectual Disability ; Clinical Trial ; Korea ; Learning Disorders ; Occupational Therapy ; Publications ; Respiration

PURPOSE: The risk factors and clinical characteristics in young patients with deep venous thrombosis (DVT) were analyzed. METHOD: The clinical characteristics of the 118 patients registered at our DVT clinic, from September 2000 to August 2002, were retrospectively reviewed. Information reviewed included sex ratio, site and extent of DVT, frequency of pulmonary embolism (PE), recurrence rate, and thrombophilic states. The patients were dichotomized into two groups according to their age, less than 40 years vs. older than 40 years. Their risk factors were also analyzed according to "Reporting Standards in Venous Disease". RESULT: Among 118 patients, 48 (40.7%) were younger than 40 years. Right leg DVT was more common (37.5% vs. 18.2%) in the younger group although the more common site for DVT was in the left leg. Also, PE (14.6% vs. 10.0%) and mesenteric venous thrombosis (14.6% vs. 4.3%) were more common, with higher recurrence rates (35.4% vs. 21.4%), in the younger group. However, there was no significant difference. Except for age or pregnancy and postpartum state, mean total scores of risk factors were higher in the older group (1.06 vs. 1.77). On the contrary, positive family history of DVT (10.4%) was found only in the younger group. Thrombophilic states, including antithrombin III, protein C, and protein S deficiencies, and Behcet's disease were more prevalent in the younger group whereas activated protein C resistance was found more often in the older group. In patients who had thrombophilic states, recurrence rate of DVT was much higher. CONCLUSION: For proper diagnosis and management of young DVT patients, especially to prevent a disastrous PE and recurrence, we must make efforts to identify risk factors including thrombophilic states.
Activated Protein C Resistance ; Antithrombin III ; Diagnosis ; Humans ; Leg ; Postpartum Period ; Pregnancy ; Protein C ; Protein S Deficiency ; Pulmonary Embolism ; Recurrence ; Retrospective Studies ; Risk Factors ; Sex Ratio ; Thrombophilia ; Venous Thrombosis*

PURPOSE: Dilated cardiomyopathy in children is usually progressive and leads to death in several years. Chronic tachyarrhythmia has been shown to cause dilated cardiomyopathy in human and animals and this ventricular dysfuntion is usually reversible after control of the arrhythmia. The uncontrolled chronic tachycardia may be a curable cause of dilated cardiomyopathy in some patients. We describe six children who had persistent chronic tachycardia and ventricular dysfunction that improve significantly after control of the arrhythmia. METHODS: We retrosepctively reveiwed the medical records, electrocardiograms, Holter recordings, Echcardiographic reports of 6 children with the tachycardia induced ventricular dysfunction who have been managed at Sejong general hospital and Asan medical center from January 1992 to June 1995. RESULTS: 1) The causes of referral were dilated cardiomyopathy in 2 and tachyarrhythmia in 4. The age at diagnosis was 4 to 36 months old and follow-up period was 6 to 29 months. The symptoms of congestive heart failure were seen in 3 children. 2) The mechanisms of thachyarrhythmia causing cardiomyopathy were atrial ectopic tachycardia in 2, chaotic atrial rhythm in 3 and junctional ectopic tachycardia in 1. Atrial ectopic tachycardia has improved after combined treatment with amidarone and atenonl. One case of chaotic atrial rhythm has improved spontaneously and other 2 cases of chaotic arial rthythm have improved after treatment with digoxin or after combined therapy with amidarone and digoxin. Junctional ectopic tachycardia is partially controlled with mexiletine. 3) The shortening fractions of left ventricle at diagnosis were 14-21% and improved to over 30% in all after 2 to 9 months of follow-up. CONCLUSIONS: We have shown that control of persistent tachycardia resolved the left ventricular dysfunction. We suggest that patients with dilated cardiomyopathy be carefully screened for tachyarrhythmia as a curable cause of ventricular dysfunction and that left ventricular function be assessed in the asymptomatic patients with persistent tachycardia.
Animals ; Arrhythmias, Cardiac ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Child ; Child, Preschool ; Chungcheongnam-do ; Diagnosis ; Digoxin ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Heart Ventricles ; Hospitals, General ; Humans ; Medical Records ; Mexiletine ; Referral and Consultation ; Tachycardia* ; Tachycardia, Ectopic Atrial ; Tachycardia, Ectopic Junctional ; Ventricular Dysfunction ; Ventricular Dysfunction, Left ; Ventricular Function, Left

PURPOSE: Dilated cardiomyopathy in children is usually progressive and leads to death in several years. Chronic tachyarrhythmia has been shown to cause dilated cardiomyopathy in human and animals and this ventricular dysfuntion is usually reversible after control of the arrhythmia. The uncontrolled chronic tachycardia may be a curable cause of dilated cardiomyopathy in some patients. We describe six children who had persistent chronic tachycardia and ventricular dysfunction that improve significantly after control of the arrhythmia. METHODS: We retrosepctively reveiwed the medical records, electrocardiograms, Holter recordings, Echcardiographic reports of 6 children with the tachycardia induced ventricular dysfunction who have been managed at Sejong general hospital and Asan medical center from January 1992 to June 1995. RESULTS: 1) The causes of referral were dilated cardiomyopathy in 2 and tachyarrhythmia in 4. The age at diagnosis was 4 to 36 months old and follow-up period was 6 to 29 months. The symptoms of congestive heart failure were seen in 3 children. 2) The mechanisms of thachyarrhythmia causing cardiomyopathy were atrial ectopic tachycardia in 2, chaotic atrial rhythm in 3 and junctional ectopic tachycardia in 1. Atrial ectopic tachycardia has improved after combined treatment with amidarone and atenonl. One case of chaotic atrial rhythm has improved spontaneously and other 2 cases of chaotic arial rthythm have improved after treatment with digoxin or after combined therapy with amidarone and digoxin. Junctional ectopic tachycardia is partially controlled with mexiletine. 3) The shortening fractions of left ventricle at diagnosis were 14-21% and improved to over 30% in all after 2 to 9 months of follow-up. CONCLUSIONS: We have shown that control of persistent tachycardia resolved the left ventricular dysfunction. We suggest that patients with dilated cardiomyopathy be carefully screened for tachyarrhythmia as a curable cause of ventricular dysfunction and that left ventricular function be assessed in the asymptomatic patients with persistent tachycardia.
Animals ; Arrhythmias, Cardiac ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Child ; Child, Preschool ; Chungcheongnam-do ; Diagnosis ; Digoxin ; Electrocardiography ; Follow-Up Studies ; Heart Failure ; Heart Ventricles ; Hospitals, General ; Humans ; Medical Records ; Mexiletine ; Referral and Consultation ; Tachycardia* ; Tachycardia, Ectopic Atrial ; Tachycardia, Ectopic Junctional ; Ventricular Dysfunction ; Ventricular Dysfunction, Left ; Ventricular Function, Left