PURPOSE: The purpose of this study was to evaluate the effect of abdominal massage on alleviating pain caused by the injection of recombinant gonadotropin for In Vitro Fertilization (IVF) among infertile women. METHODS: This study employed a nonequivalent control group non-synchronized design. A total sample of 149 infertile women who never experienced in vitro fertilization was recruited at C fertility center. Seventy women were assigned into experimental group and 79 into controls. The experimental group had been informed to do abdominal massage prior to the injection and to record their subjective pain using visual analogue scale. The control group had been informed to record their subjective pain in the same way just after the injection. RESULTS: Compared to the pre-tested pain scores, the pain scores in experimental group were significantly reduced by 0.7 points, whereas the control group increased by 0.9 points (t=-4.55, p=.001). CONCLUSION: This study confirms that the use of abdominal massage prior to the injection is an effective way to alleviate pain on injection site. This massage may be a useful intervention for infertile women about pain alleviation.
Female ; Fertility ; Fertilization in Vitro* ; Gonadotropins ; Humans ; In Vitro Techniques* ; Massage*

PURPOSE: This study was a comparative study to understand the levels of anxiety, pain and maternal-fetal attachment between women who became pregnant after infertility treatment and became pregnant naturally. METHODS: This study used a comparative survey design. Data were collected by 50 couples of natural pregnancy and of who became pregnant after infertility treatment who visited delivery room in C Medical hospital, Seoul. These couples were to have first baby, and cervix dilatation of women was less than 3 cm regardless of diagnosis. RESULTS: The score of anxiety of infertile women was significantly higher than that of naturally pregnant women; however, that of spouses showed no difference. The pain score for infertile women was significantly higher in both the active and transition phases. Pain scores that reported by their spouses did not show differences in either phase. The score of maternal-fetal attachment showed no difference between two groups of women. CONCLUSION: The result showed the importance of nursing intervention to reduce women's anxiety and pain, through both antenatal-childbirth education programs and assertive nursing interventions. It is necessary to develop and evaluate new intervention which would be more effective for reducing pain and anxiety for couples who became pregnant after infertility treatment.
Anxiety* ; Cervix Uteri ; Delivery Rooms ; Diagnosis ; Dilatation ; Education ; Family Characteristics ; Female ; Humans ; Infertility* ; Nursing ; Pregnancy ; Pregnant Women ; Seoul ; Spouses

BACKGROUND AND OBJECTIVES: We used virtual histology-intravascular ultrasound (VH-IVUS) to evaluate the relationship between high-sensitivity C-reactive protein (hs-CRP) levels and plaque components in 279 acute coronary syndrome (ACS) patients. SUBJECTS AND METHODS: We divided patients into three groups according to their hs-CRP levels {lowest tertile <0.07 mg/dL (n=93), middle tertile > or =0.07, <0.4 mg/dL (n=93), and highest tertile > or =0.4 mg/dL (n=93)}. Thin-cap fibroatheroma (TCFA) was defined as focal, necrotic core (NC)-rich (> or =10% of the cross-sectional area) plaques in contact with the lumen in a plaque burden > or =40%. RESULTS: The highest tertile group was mostly diabetics (20%, 27%, 40%, p=0.009), and had the greatest plaque plus media volume (163+/-139/mm3 vs. 201+/-155/mm3 vs. 232+/-176/mm3, p=0.013). The highest tertile group had the greatest absolute and % NC volumes (13.6+/-15.1 mm3 vs. 14.8+/-14.2 mm3 vs. 23.7+/-24.3 mm3, p<0.001, and 14.9+/-8.7% vs. 16.0+/-8.7% vs. 19.5+/-10.2%, p=0.024, respectively). The culprit lesion TCFA was observed most frequently in the highest tertile group (28% vs. 35% vs. 55%, p=0.006). By multivariable analysis, absolute NC volume was an independent predictor of hs-CRP elevation {odds ratio (OR); 1.03, 95% confidence interval (CI)=1.06-1.21, p=0.004}, and hs-CRP was an independent predictor of TCFA (OR; 1.86, 95% CI=1.11-2.90, p=0.010). CONCLUSION: VH-IVUS analysis has demonstrated that ACS patients with elevated hs-CRP have more vulnerable plaque component (NC-rich plaques and higher frequency of culprit lesion TCFA), compared with ACS patients with normal hs-CRP.
Acute Coronary Syndrome ; C-Reactive Protein ; Humans ; Inflammation ; Plaque, Atherosclerotic ; Ultrasonography, Interventional

Coronary arteriovenous fistula is a more prevalent, hemodynamically significant congenital malformation. Both coronary arteries arise normally from their aortic sinuses, but the branches of fistula communicate directly with cardiac chamber, pulmonary trunk, coronary sinus, superior vena cava, or pulmonary vein. Fistula associated with coronary aneurysm is an uncommon finding. We report a rare case of 76-year-old female patient who had a coronary arteriovenous fistula with giant coronary artery aneurysm. This case is clearly diagnosed by echocardiography, three-dimensional computed tomography (3D-CT), and coronary angiography (CAG).
Aged ; Aneurysm ; Arteriovenous Fistula ; Coronary Aneurysm ; Coronary Angiography ; Coronary Sinus ; Coronary Vessels ; Echocardiography, Three-Dimensional ; Female ; Fistula ; Humans ; Pulmonary Veins ; Sinus of Valsalva ; Vena Cava, Superior

Food allergy is not uncommon among small children. Cow milk and eggs are most frequently incriminated as the major cause of food allergy. A 4-month-old female infant who did not have a previous history of contact with the egg developed anaphylactic shock when an emulsion of raw egg white was rubbed on the buttock by her mother to relieve erosive diaper dermatitis. She had been fed on breast milk. She had no past medical history of any other allergy and no family history of atopy, asthma or allergic rhinitis. Her IgE PRIST was 29.46 IU/ml and multiple antigen simultaneous testing chemiluminescent assay for food specific IgE antibody showed a level 4 positive value only to egg white.
Anaphylaxis* ; Asthma ; Breast* ; Buttocks ; Child ; Dermatitis ; Egg White* ; Eggs ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Immunoglobulin E ; Infant* ; Luminescent Measurements ; Milk ; Milk, Human ; Mothers ; Ovum* ; Rhinitis ; Skin*

BACKGROUND AND OBJECTIVES: Increased QT dispersion (QTD) in patients with acute myocardial infarction (AMI) may be related with such adverse events as sudden cardiac death and ischemic heart failure. SUBJECTS AND METHODS: Two hundred eight patients (age : 62+/-10.4 years, 158 males), underwent diagnostic coronary angiography under the diagnosis of AMI between January and December 2001 at the Heart Center of Chonnam National University Hospital, and these patients were enrolled to evaluate the relationship between the QTD and myocardial injury and the complex coronary arterial lesion. RESULTS: A QTD of over 80 ms was observed in 89 patients (42.7%). There were in 61 patients with ST elevation myocardial infarction (STEMI, 68.5%) and 28 patients with non-ST elevation myocardial infarction (NSTEMI, 31.5%). There was no correlation between the QTD and such risk factors as hypertension, diabetes, gender, smoking, hyperlipidemia and family history. The level of CK-MB on admission was correlated with the QTD (112.5+/-98.1 U/L in the group with a QTD over 80 ms and 72.6+/-73.4 U/L in the group with a QTD under 80 ms, p<0.05). The ejection fraction measured by two dimensional echocardiography on admission showed correlation with the QTD (50.9+/-11.4% in the group with a QTD over 80 ms and 54.7+/-11.2% U/L in the group with a QTD under 80 ms, p<0.05). For the coronary angiographic findings, the lesion type, according to American College of Cardiology/American Heart Association classification, correlated with the QT dispersion (type B2 or C : 64.1% in the group with a QTD over 80 ms, 49.6% in the group with a QTD under 80 ms, p<0.05) CONCLUSION: There was significant correlation between the prolonged QTD and the severity of myocardial injury at admission, and the complex coronary arterial lesion in patients with AMI.
Classification ; Coronary Angiography ; Coronary Vessels* ; Death, Sudden, Cardiac ; Diagnosis ; Echocardiography ; Electrocardiography ; Heart ; Heart Failure ; Humans ; Hyperlipidemias ; Hypertension ; Jeollanam-do ; Myocardial Infarction* ; Risk Factors ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: Besides the acute coronary syndrome (ACS), the left ventricular failure (LVF) is the next important determinant of morbidity and mortality after acute coronary syndrome (ACS). The prediction of high risk groups for LVF may be in the initial management of patients with unstable angina (UA) or acute non-ST elevation myocardial infarction (NSTEMI). SUBJECTS AND METHODS: 179 patients (60.4+/-11.6 years, 121 male) who underwent diagnostic coronary angiography under the diagnosis of UA/NSTEMI between January and December, 2000, in the Chonnam National University Hospital Heart Center were enrolled for evaluation of relationship between the development LVF and various parameters, including clinical features, initial electrocardiogram, laboratory findings and coronary angiographic findings. RESULTS: Unstable angina was clinically diagnosed in 124 patients, and NSTEMI in 55 patients. During a 12-month follow-up period, less than 40% of the left ventricular ejection fraction (EF), a low amount, was observed in 28 patients (15.7%). In diabetic patients, the incidence of LVF was significantly higher than in non-diabetics (p<0.05). Patients with elevated C-reactive protein (CRP) or positive troponin I had LVF more frequently (p<0.05). On the initial electrocardiogram, the total summation of ST segment change inversely correlated with EF (p<0.05). Patients whose QT dispersion was longer than 80 ms had a higher incidence of LVF (p<0.05). Coronary angiographic findings of total occlusion correlated with the development of LVF (p<0.05), but not with other characteristics. On multiple logistic regression analysis, high CRP level (p=0.024), summation of ST change (p=0.021), total occlusion of the coronary artery (p=0.008) were independent prognostic factors of LVF. CONCLUSION: Elevated CRP, summation of ST change and total coronary artery occlusion are important predictive factors for LVF in UA/NSTEMI.
Acute Coronary Syndrome ; Angina, Unstable* ; C-Reactive Protein ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Follow-Up Studies ; Heart Failure* ; Heart* ; Humans ; Incidence ; Jeollanam-do ; Logistic Models ; Mortality ; Myocardial Infarction* ; Prognosis ; Stroke Volume ; Troponin I

PURPOSE: In this study, we tried to evaluate the clinical characteristics or circumstances that lead to unintentionally the delay in the diagnosis of intussusception or to the wrong direction that prevent the proper management early. METHODS: All the patients of intussusception with delayed diagnosis in the department of pediatrics or emergency room at Gyeongsang National University Hospital from 1990 to 2003 were enrolled and reviewed retrospectively. RESULTS: There were 8 boys and 6 girls and their median age was 8 months (range 2 months to 10 years). Their initial symptoms and signs were vomiting, seizure, diarrhea, lethargy, irritability, bloody stool, palpable abdominal mass, foul odor of urine and tachycardia. Clinical diagnosis or impressions at admission consisted of acute gastroenteritis, shigellosis and toxic encephalopathy, convulsive disorders, urinary tract infections, sepsis, abdominal mass and intestinal obstruction. Eight patients were luckily diagnosed due to the delayed manifestations of cyclic irritability or currant jelly stool. Six patients were not paid attentions for the possibilities of intussusception and diagnosed serendipitiously by the abdominal sonography or CT during the evaluation of the abdominal mass or distension. Only five of 14 cases (35.7%) were successfully managed by barium or air reductions. The other 9 cases needed surgical operations. CONCLUSION: Delayed diagnosis of intussusception arise when doctors initially diagnose the patients incorrectly due to the unusual presentations or when they overlook the newly arising symptoms or signs suggestive intussusception after the admission because they are ardently attached to the first impressions or initial clinical diagnosis.
Attention ; Barium ; Delayed Diagnosis ; Diagnosis* ; Diarrhea ; Dysentery, Bacillary ; Emergency Service, Hospital ; Female ; Gastroenteritis ; Humans ; Intestinal Obstruction ; Intussusception* ; Lethargy ; Neurotoxicity Syndromes ; Odors ; Pediatrics ; Retrospective Studies ; Seizures ; Sepsis ; Tachycardia ; Urinary Tract Infections ; Vomiting

PURPOSE: The purpose of this study was to investigate the diagnostic value of spiral computed tomography (CT) using contiguous slices with partially thin sections around the hilar level in the bronchial foreign bodies of children with a vague history of aspiration. METHODS: Fourteen children were identified to be examined with spiral CT due to obscure histories of aspiration episodes. A retrospective analysis of the medical records provided information concerning the clinical and radiological findings. RESULTS: Of the 14 patients examined with spiral CT, there were no significant differences among the clinical and initial radiological findings with the exception of gender distribution. However, the spiral CT scans allowed accurate discrimination among patients with a vague history of aspiration episodes, in which seven were identified with bronchial foreign body aspiration and seven with bronchiolitis, asthma, tracheobronchitis and/or pneumonia. CONCLUSION: We found that spiral CT using contiguous slices with partially thin sections around the hilar level are a useful non-invasive method in the early diagnosis of bronchial foreign bodies in children with a vague history of aspiration.
Asthma ; Bronchiolitis ; Child* ; Diagnosis ; Discrimination (Psychology) ; Early Diagnosis ; Foreign Bodies ; Humans ; Lung* ; Medical Records ; Pneumonia ; Retrospective Studies ; Tomography, Spiral Computed

Spontaneous uterine rupture during the second trimester of pregnancy is a rare obstetric emergency. When a patient presents with acute abdominal pain and signs of hemorrhagic shock, a number of differential diagnoses must be considered. Early diagnosis and proper management is necessary to decreased the high maternal and fetal morbidity and mortality associated with rupture of uterus. We present a case of spontaneous rupture of the uterus in the 18th week of pregnancy with a brief review of literatures.
Abdominal Pain ; Diagnosis, Differential ; Early Diagnosis ; Emergencies ; Female ; Humans ; Mortality ; Pregnancy Trimester, Second ; Pregnancy* ; Rupture ; Rupture, Spontaneous ; Shock, Hemorrhagic ; Uterine Rupture* ; Uterus