The purpose of this study was to evaluate the relative importance among various biological and environmental factors on refractive errors. Various factors such as diseases, health related behavior such as drinking, smoking and exercise, as well as dietary factors were considered as a possible determinant. Surveys of 492 residents over 20 years of age in Kuri city were conducted during 1998. The survey included a refractive error test adopting a autokerato-refractometer, dietary survey using a 24 hour recall method, disease survey including blood and other diagnosis tests, and a health behavior survey using questionnaires with variables of smoking, drinking, and exercise. A stepwise logistic regression analysis was adopted to analyse the relative importance among independent variables of health behaviors, disease, and dietary factors on ametropias. As a result, in the case of myopia, liver dysfunction appeared to be the most important factors followed by the health related behavior of smoking and exercise as the second most important factors. Nutrient factors such as carotene and protein appeared to be the third most important factors. Similar results had been shown in the case of the hyperopia. In summary, liver dysfunction and the health related behaviors of drinking and smoking appeared to be more influential factors on abnormal eye sight of myopia and hyperopia than dietary factors.
Carotenoids ; Diagnosis ; Drinking ; Health Behavior ; Hyperopia ; Liver Diseases ; Logistic Models ; Myopia ; Refractive Errors* ; Smoke ; Smoking ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to check the degree of residual microbial contamination after disinfection of reusable suction containers, used in an intensive care unit (ICU) and present basic data for efficient use through cost analysis in comparison to disposable suction containers. METHODS: This study was conducted on 32 reusable suction containers used in an ICU on a selected specific day. After disinfection and washing, specimens were collected from the used containers and cultured to check for microbial contamination. Additionally, a comparative narrative study analyzes the cost of using reusable suction containers and disposable suction containers. Data were analyzed with the SPSS WIN 20.0 program using real numbers and percentage χ²-test. RESULTS: As a result of the study, microorganisms were found in all samples where in 30 were gram-positive (62.5%) while 13 were gram-negative (27.1%). Based on level of contamination, microorganisms were less than 10CFU/ml in 18 samples (56.3%); 11–99CFU/ml in six samples (18.8%); and more than 100CFU/ml in eight samples (25%). Cost per day for a reusable suction container was 10,655 + α while cost per day for a disposable suction container was 10,666 won. CONCLUSION: This study found that reusable suction containers, even after disinfection, accounted for factors of potential infection as well as microbial contamination. So, disposable suction containers are superior in cost-effectiveness and highly efficient for use with infected patients.
Costs and Cost Analysis ; Disinfection ; Drainage ; Humans ; Intensive Care Units ; Microbial Interactions ; Suction

Anomalous aortic origin of the left subclavian artery (LSCA) from the left pulmonary artery (LPA) is a rare congenital cardiac malformation. We describe a case of LSCA from the LPA via ductus arteriosus in association with a double-outlet right ventricle, which never has been reported previously in Korea.
Double Outlet Right Ventricle* ; Ductus Arteriosus ; Embryology ; Heart Defects, Congenital ; Humans ; Korea ; Pulmonary Artery* ; Subclavian Artery*

PURPOSE: The pathogensis and etiologic agents are still unknown but clinical studies suggest that Kawasaki disease (KD) is an autoimmune disease caused by infectious agents associated with the early development of acute myocarditis and coronary artery abnormalities. The study investigates serum troponin I (cTnI) and creatine kinase (CK)-MB in the acute stage of KD before diagnosis the use of intravenous immunoglobulin (IVIG) treatment to confirm and find early diagnosis of acute myocarditis. METHODS: The patient group consisted of 36 cases of KD in the acute stage before IVIG treatment, and the control group consisted of 10 cases who didn't suffer from KD. The obtained sera was measured by using the Chemiluminoimmunoassay method, and compared with the results of both groups. RESULTS: The sex ratio of male to female was 1.5 : 1, and the male age was 2.6 +/- 1.6 years old. The level of cTnI increased in 14 cases (31.9%), and CK-MB increased in 9 cases (25%). Five cases (13.9%) in the patient group increased in both cTnI and CK-MB levels which correlated with each other significantly (P<0.05). But the levels of cTnI and CK-MB were negative in the control group. Acute phase reactants such as CRP, C3, ESR were positive and WBC increased in the acute stage of both groups. CONCLUSION: The level of cTnI correlates accurately to myocardial cell injury, so increasing the level of cTnI in the acute stage of KD is recommended for acute myocarditis or myocardial cell injure in the early stage before onset of clinical symptoms and signs. Therefore, the measurement of cTnI can be a more useful method for early diagnosis and confirmation of acute myocarditis than a CK-MB test, and may help in the early treatment of IVIG by reducing cardiovascular abnormalities in KD.
Acute-Phase Proteins ; Autoimmune Diseases ; Cardiovascular Abnormalities ; Coronary Vessels ; Creatine Kinase ; Diagnosis ; Early Diagnosis ; Female ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Male ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis ; Sex Ratio ; Troponin I* ; Troponin*

Pseudoaneurysm of the right ventricular outflow tract (RVOT) has been reported as a rare complication of RVOT reconstruction performed using conduit replacement or patch repair. Rarely, it may present alongside symptoms secondary to the compression of adjoining mediastinal structures. We report the case of a patient who developed a symptomatic RVOT pseudoaneurysm one month after a total correction of tetralogy of Fallot. In the present case, superior vena cava syndrome was caused by compression of the superior vena cava, which was a very unusual presentation.
Aneurysm, False* ; Humans ; Superior Vena Cava Syndrome* ; Tetralogy of Fallot ; Vena Cava, Superior

Right atrial aneurysm is an extremity rare congenital heart defect. We report a case which was diagnosed during the early fetal stage and operated on in a 2 week old neonate. Following median sternotomy, aneurysmectomy was performed under a cardiopulmonary bypass. Histopathological examination of the resected atiral tissue showed a lipotomatous degeneration and reduction of the muscular elements. There were no postoperative complications.
Aneurysm ; Cardiopulmonary Bypass ; Extremities ; Heart Aneurysm ; Heart Atria ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Postoperative Complications ; Sternotomy

BACKGROUND: Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. METHODS: Between March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups. RESULTS: At the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were 2.1±1.0 m/sec and 0.9±0.9 m/sec, respectively (p=0.001). Although the incidence of grade 3–4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: 6.5±3.4 years; group II: 3.8±2.2 years; p=0.037). CONCLUSION: Monocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3–4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction.
Angioplasty* ; Echocardiography ; Follow-Up Studies ; Hemodynamics ; Humans ; Hypertension ; Incidence ; Postoperative Period ; Pulmonary Valve ; Pulmonary Valve Insufficiency ; Pulmonary Valve Stenosis ; Residual Volume ; Tetralogy of Fallot*

Cardiovascular disease is very prevalent in Korea, and many risk factors, if properly identified are possibly corrected. However, the study results on prevalence and distribution of risk factors may not be reliable while the risk factors of disease are always issued on health promotion projects conducted recently in a community. The subjects of this study were 854 adults who participated in the health and nutrition survey in a community. They were aged between 20 and 69 and sampled representatively. This study intended to estimate the prevalence and the distribution of risk factors of cardiovascular disease such as hypertention, diabetes mellitus, hypercholesterolemia, and obesity. Systolic blood pressure and diastolic blood pressure levels were estimated at 123.9+/-2.2mgHg(men), 117.9+/-1.7mgHg(women), and 80.4+/-1.5mg(men), 74.9+/-1.1mgHg(women), respectively. Glucose level was estimated at 99.1+/-2.3mg/dl in men, and 95.7+/-1.7mg/dl in women. The estimated level of total cholesterol and HDL-cholesterol were 183.4+/-3.8mg/dl(men), 181.7+/-3.1mg/dl(men), and 122.0+/-4.5mg/dl (women), and body mass index was estimated at 24.0+/-0.4kg/m2 in men and 23.9+/-0.4kg/m2 in men and 23.9+/-0.3kg/m2 in women. The prevalence of hypertension was 20.5% for men, and 14.4% for women. The prevalence of diabetes mellitus was estimated to 6.9% for men, and 6.1% for women. The estimated prevalence of hypercholesterolemia was 3.8%(men), 3.9%(women). The rate of obesity was estimated to 28.5%(men), 28.4% (women), respectively. The levels of blood pressure, glucose, and cholesterol were higher in men than in women in almost all the almost ate groups. The prevalence of hypertension for men is about 20%. It was found that the prevalence of diabetes mellitus for males aged between 40 and 59 was rapidly increased. The risk factor with highest prevalence was obesity, and hypertension and diabetes mellitus were the second and third most prevalent.
Adult ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Cholesterol ; Diabetes Mellitus ; Epidemiology ; Female ; Glucose ; Health Promotion ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Male ; Multiple Endocrine Neoplasia Type 1 ; Nutrition Surveys ; Obesity ; Prevalence* ; Risk Factors*

The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length.
Aorta, Thoracic* ; Aortic Aneurysm, Thoracic ; Blood Vessel Prosthesis* ; Endovascular Procedures ; Polyethylene Terephthalates* ; Rupture* ; Stents* ; Thoracotomy ; Transplants*

BACKGROUND: An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments. METHODS: This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES, December 2013–February 2014; after implementation of the MES, December 2014–February 2015 and December 2015–February 2016). RESULTS: A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation. CONCLUSIONS: Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.
Cardiopulmonary Resuscitation ; Clinical Alarms ; Comorbidity ; Critical Care ; Emergencies* ; Humans ; Intensive Care Units ; Internal Medicine ; Korea* ; Length of Stay ; Monitoring, Physiologic ; Mortality ; Observational Study ; Patients' Rooms ; Pilot Projects* ; Retrospective Studies ; Vital Signs