QT interval prolongation and ventricular fibrillation in childhood end-stage renal disease.

Ventricular arrhythmia is a major cause of death in end-stage renal disease (ESRD). Corrected QT (QTc) interval prolongation, which is one of the predictors of ventricular arrhythmia, may be associated with ESRD. We report an 11-year-old boy who had ESRD with marked QTc interval prolongation and developed torsade de pointes with subsequent ventricular fibrillation during the induction of anesthesia.

The psychology of diaspora experiences: intergroup contact, perceived discrimination, and the ethnic identity of Koreans in China.

The moderating role of intergroup contact on the relationship between perceived discrimination and ethnic identity was examined in a diaspora community of Koreans living in China. It was hypothesized that Koreans with higher intergroup contact would have a lower ethnic identity under higher discrimination, whereas Koreans with lower intergroup contact would have a higher ethnic identity. Across two separate college samples, Koreans who were more willing to interact with Han Chinese had a lower ethnic identity when discrimination was higher, but this finding was not replicated within one college setting.

Impaired vascular function in patients with Fontan circulation.

Background: This study was performed to evaluate the endothelial function in Fontan patients, and to investigate the associated factors which influence the endothelial function in these patients.

Methods: Flow mediated dilatation (FMD) and nitroglycerin induced dilatation (NG) of the brachial artery, and intima media thickness (IMT) of common carotid artery (CCA) were measured in nonselected Fontan patients (n=44, age 5 to 29 years, median 14 years, 18 females) by means of high-resolution ultrasound according to the standard protocols. The results were compared to age and sex matched controls (n=25, age 5 to 27 years, median 13 years, 10 females).

Mid-term follow-up of neoaortic regurgitation after the arterial switch operation for transposition of the great arteries.

Objective: The aim of this study was to determine the outcome of the neoaortic valve after the arterial switch operation for transposition of the great arteries.

Methods: A retrospective review of arterial switch operations that were performed during the period from 1991 to 2003 was conducted. We followed patients with echocardiography.

Pediatric radiofrequency catheter ablation: results of initial 100 consecutive cases including congenital heart anomalies.

Radiofrequency catheter ablation (RFCA) has recently become a management option for pediatric tachycardia. We reviewed the records of a total of 100 patients (aged 10 months to 19 yr) who had undergone RFCA, from March 2000 to June 2004. Types of arrhythmia (age, acute success rate) were as follows: atrioventricular reentrant tachycardia (AVRT, 9.

Late occurrence of adenosine-sensitive focal junctional tachycardia in complex congenital heart disease.

Background: Although supraventricular tachycardia in complex congenital heart disease (CHD) has been reported after surgical repair, its exact electrophysiologic identification has been limited to intraatrial reentrant tachycardia (IART). Moreover, junctional tachycardia (JT) has not previously been described as a cause of late postoperative arrhythmia.

Methods And Results: Since 1993, a total of 12 patients with congenital heart disease presented with paroxysmal focal JT.

A case of congenital junctional ectopic tachycardia: diagnosis and successful radiofrequency catheter ablation in infancy.

It is difficult to make a definitive diagnosis of congenital junctional ectopic tachycardia (JET) in utero. We report a case in which congenial JET was suspected by fetal M-mode echocardiography. Fetal M-mode tracing of the atria and ventricle clearly showed a gradual acceleration of ventricular activity at the beginning of tachycardia, the warming-up sign of ectopic tachycardia, which was followed by simultaneous contractions of atrium and ventricle.

Fontan conversion with arrhythmia surgery.

Objective: Hemodynamic abnormalities and refractory atrial arrhythmias in patients late after the Fontan operation result in significant morbidity and mortality. We reviewed our experience with Fontan conversion and concomitant arrhythmia surgery.

Methods: Between January 1996 and February 2004, 16 patients underwent Fontan conversion and arrhythmia surgery.

Twin AV node and induced supraventricular tachycardia in Fontan palliation patients.

Introduction: The coexistence of two distinct atrioventricular (AV) nodes has been described in congenital heart disease requiring Fontan type palliation. The purpose of this study was to evaluate the occurrence of twin AV node according to anatomical subgroups, and to determine its relation to tachycardia.

Methods: From 2001 to 2003, we performed an electrophysiologic (EP) study upon 52 consecutive patients who had undergone cardiac catheterization after Fontan completion.

An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools.

Elastic properties of the ascending aorta in young children after successful coarctoplasty in infancy.

Background: Based on the hypothesis that vascular dysfunction in the ascending aorta can cause morbidity, we undertook this study on the elastic properties of ascending aorta and left ventricular (LV) function in young children who received coarctoplasty in early infancy.

Methods: Blood pressures (BP) in the right arm and ascending aortic internal diameters determined by M-mode ultrasound at rest and after exercise were measured in 25 patients (mean age, 6.4+/-3 years) and 22 control subjects (mean age, 5.

The usefulness of surface electrocardiogram as a prognostic predictor in children with idiopathic dilated cardiomyopathy.

We investigated the interrelations between surface electrocardiographic changes and clinical outcomes in children with idiopathic dilated cardiomyopathy (DCMP). 33 patients (19 boys, 14 girls) were classified into two groups; group I (15) who were in poor clinical status or dead; and group II (18) who showed good clinical status. Group I had larger LV dimensions compared to group II (Gr I vs.

[Nurse's perception of technological development, caring attributes and professional self-concept in YanBian].

Purpose: The purpose of this study was to describe technological development, caring attributes and professional self-concept as perceived by nurses in YanBian.

Method: Data were collected using an instrument containing 137 Likert items was administered to 477 RN's working in general hospitals in YanBian. The instrument contained sections which examined technological influences questionnaire(TIQ), caring attributes questionnaire(CAQ), and professional self-concept nursing inventory(PSCNI).

Repair of transposition of the great arteries, ventricular septal defect and left ventricular outflow tract obstruction.

Objectives: This study was undertaken to compare the outcomes of the Lecompte procedure and Rastelli repair in the transposition of the great arteries (TGA) with ventricular septal defect (VSD) and left ventricular outflow tract obstruction (LVOTO) and to determine the risk factors associated with unfavorable events.

Methods: Over a 12-year period (April 1990-October 2002), 35 patients underwent complete repair for TGA, VSD, and LVOTO. Twenty-five patients (71%) underwent the Lecompte modification, and mean age and weight were 23.

Alternate financial incentives in multi-tiered formulary systems to improve accountability for outcomes.

Background: Drug manufacturer rebates paid to health plans and pharmacy benefit management companies have come under increased public scrutiny. Over the past several years, numerous articles have appeared in the literature encouraging a shift to a more quality-based decision-making process for health plan drug formularies.

Objective: To propose a new basis for formulary placement decisions that would include consideration of health-plan-specific measures (clinical outcomes, total cost, adherence, and appropriateness of care) and align incentives for health plans, physicians, pharmacists, and pharmaceutical companies to promote high-quality care.

Sinus node dysfunction after Fontan modifications--influence of surgical method.

Background: Sinus node dysfunction (SND) is reported to be a troublesome complication following various types of Fontan operations. The correlation of post-Fontan SND with surgical methods was evaluated in this study.

Methods: By reviewing the medical records, surface ECGs, and Holter monitoring, the range of heart rate (HR) and the risk of SND at intermediate term after Fontan type operation (follow up: 41.

The effect of beta adrenergic stimulation on QT and QTc interval in syncope children with or without coexisting ventricular arrhythmias.

We investigated the effect of beta-adrenergic stimulation on the heart rate and QT interval in syncope children with or without coexisting ventricular arrhythmias (VA). Of the 24 children who presented with syncope or presyncope and showed negative tilt test, 13 were classified into a group with VA and the remaining 11 without VA. The provocative test was performed in bolus infusion and continuous infusion.

Outcomes after radical retropubic prostatectomy.

Objectives: To determine whether urinary incontinence after radical retropubic prostatectomy (RRP) for prostate cancer is improved by the preservation of the puboprostatic ligaments or bladder neck; whether impotency is reduced by the preservation of the neurovascular bundles; and whether positive surgical margins are a risk with more precise bladder neck and apical dissection.

Methods: RRP was performed sequentially in three groups using tennis racquet reconstruction, bladder neck preservation, or bladder neck and puboprostatic ligament preservation, and continence and surgical margin status were assessed. Also, recovery of potency and surgical margin status were evaluated when both, one, or no neurovascular bundles were preserved.

Relationship between technological influences and caring attributes of Korean nurses.

With many well-prepared nurse academics, a buoyant economy and an advanced health-care system, it is timely that research addresses some of the features and characteristics of Korean nurses and communicates this to the English-speaking world. This study focuses on Korean registered nurses and their views of themselves as carers in a modern technological environment. By collecting data from a sample of 560 registered nurses and using an instrument previously administered in an international sample, comparisons to normative data are presented and contrasted to recent reports.

Distal penile prosthesis extrusion: treatment with distal corporoplasty or Gortex windsock reinforcement.

Subcutaneous extrusion of penile prosthesis cylinders beneath the glans penis is an unusual but difficult complication of penile prosthesis. Without surgical repair, extrusion, infection, and corporeal fibrosis may ensue. Twenty-eight patients with distal corporeal extrusion were reviewed to identify the optimum treatment outcome for these penile prosthesis complications.

Modified extracardiac Fontan in a patient with separate hepatic venous drainage.

We describe an alternative technique to the extracardiac Fontan procedure in a patient with a univentricular heart, in which the inferior caval vein and the hepatic vein drained separately into the common atrium and the intraatrial orifice of the hepatic vein was adjacent to the opening of the left lower pulmonary vein.