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The Effect of Matrix Metalloproteinase Inhibitor for Left Ventricular Remodeling after Myocardial Infarction in a Rabbit Model (토끼에서 Myocardial Infarction 후 Left Ventricular Remodeling에 대한 Matrix Metalloproteinase의 차단 효과)

  • Kim, Soo-Hyun;Jung, Tae-Eun;Hong, Geu-Ru;Han, Sung-Sae
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.329-340
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    • 2007
  • Background: Matrix Metalloproteinase (MMP) inhibition has emerged as a potential therapeutic strategy for the left ventricular dilatation that occurs after myocardial infarction. This study is designed to evaluate which treatment is better for attenuating the left ventricular remodeling via MMP inhibition 1) during the early, short highly MMP producing period of the initial phase or 2) during most of the period of the initial phase after myocardial infarction. Material and Method: Myocardial infarction was induced by ligation of the left anterior descending coronary artery in rabbits. The experimental group was divided into 3 groups. The myocardial infarction only (MI only) group consisted of 7 cases. The MMP inhibitor administered for 5 days after MI (MMPI 50) group had 6 cases, and these rabbits were given MMP inhibitor for 5 days after myocardial infarction, beginning with the postoperative first day. MMP inhibitor administered for 9 days (MMPI 90) group consisted of 5 cases and these rabbits were given MMPI for 9 days the same manner as above. CG2300 was used as a selective MMPI; this is a potent MMP-2 and -9 inhibitor Two-D echocardiograms were performed on all the groups at the time of preoperative period, the post-operative 1st week, the postoperative 20 week and the postoperative 30 week, and we measured the end-diastolic dimension (EDD), the end-systolic dimension (ESD), and the ejection fraction (EF). Result: The echocardiograms generally showed postoperative left ventricular dilatation in the MI only group. The EDD was increased significantly higher in the postoperative 1 week compared to the preoperative value (p<0.05). The ESD was also increased significantly higher in the postoperative 1st week, the postoperative 20 week and the postoperative 30 week compared to the preoperative value (p<0.05). Left ventricular dilatation was noted to be less In the MMPI 9d group than in the MI only and MMPI 5d groups. In the MMPI 9d group, there was no significant change of EF postoperatively compared to the preoperative period. MMP-2 and MMP-9 were measured from the infarcted myocardial tissue at post-MI 4 weeks by performing western blotting and zymography. The changes the of protein expression and activity of MMP-2 and MMP-9 were not significant in the three MI groups and the normal heart group. Histopathologic examination revealed severe collagen deposition in the MI only group. Collagen accumulation was reduced in both the MMPI groups. The MMPI 9d group revealed an increased number of capillaries. Conclusion: Left ventricular dilatation developed rapidly after, MI from ligation of the coronary artery and MMPI attenuated the ventricular dilatation. The effect of MMPI seemed to have better a result from its usage during most of the period of the initial phase after myocardial infarction. This suggested that increased neovascularization by MMPI may also contribute to attenuation of the left ventricular remodeling.

Training Program to Raise Consciousness Among Adolescents for Protection Against Skin Cancer through Performance of Skin Self Examination

  • Balyaci, Ozum Erkin;Kostu, Nazan;Temel, Ayla Bayik
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5011-5017
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    • 2012
  • Background: Overexposure to sunlight in childhood and the adolescent period and associsated sunburns significantly increase the risk of skin cancer in adulthood. In Turkey, the incidence of skin cancer in the general population is 0.8%. The incidence is 0.6% and the mortality rate is 0.4% for men, while these rates are 1.0% and 0.7%, respectively, for women. If skin cancer is found early, its treatment is facilitated. Therefore, personal skin examination is important for early diagnosis. Objectives: Our aim was to determine the effects of training for raising consciousness among adolescents to protect against skin cancer by influencing skin self examination behavior. Method: This quasi experimental intervention study was conducted between February and April 2012 in Izmir. The study population consisted of students attending $6^{th}$, $7^{th}$ and $8^{th}$ classes of a primary school (n:302). No sampling was performed. Data were collected with a form developed by the researchers based on the literature. The first part of form is aimed to determine demographic characteristics of adolescents (3 questions) and their risk status of skin cancer (6 questions). The second part was prepared for skin cancer risks of adolescents (8 questions) and indications of skin cancer (12 questions). The last part was intended to determine their knowledge about skin self examination (4 questions) and behavioral stages of skin self examination (1 question). Data collection was achieved with a questionnaire form in three phases. In the 1st phase, data about demographic characteristics of students, risk status of skin cancer, knowledge level of skin cancer and behavior stages were collected. In the $2^{nd}$ phase, skin self examination training based on the transtheoretical model was performed within the same day just after obtaining preliminary data. In the $3^{rd}$ phase, adolescents were followed up three times to establish the efficacy of the training (on the $15^{th}$ day after training program and at end of the $1^{st}$ and $2^{nd}$ months). Follow-up data were evaluated by questioning skin self examination performing behavior stages through electronic mail. Results: Half of the adolescents (50.5%) are male, and 58.4% of them are 13 years old with a mean age of $12{\pm}1.15$ years. About 29.4% of adolescents had brown hair color, 37.9% had brown/hazel eye color, 29.4% had white skin, and 47.2% had fewer than 10 moles in their body. The pretest mean score on knowledge level about risks of skin cancer was found to be $4.19{\pm}1.96$, while the post-test mean score was $6.79{\pm}1.67$ (min:0, max:8).The pretest mean score about indications of skin cancer was $7.45{\pm}3.76$, while the post-test mean score was $10.7{\pm}2.60$ (min:0, max:12). The increases were statistically significant (p<0.05). The behavior "I do not perform skin self examination regularly in every month and I do not think to perform it in the next 6 months" was reduced from 52.8 to 35.5% after training. Conclusion: The training program organized to raise consciousness among adolescents for protection against skin cancer increased the knowledge level about risks and indications of skin cancer and it also improved the behavior of performing skin self examination.

The Usefulness of $^{18}F$-FDG PET/CT for Predicting the Response of Locally Advanced Rectal Cancer to Neoadjuvant Chemoradiation Therapy (국소 진행된 직장암의 $^{18}F$-FDG PET/CT를 이용한 항암방사선치료의 반응성 예측)

  • Kang, Jin-Kyu;Kim, Mi-Sook;Choi, Chul-Won;Jeong, Su-Young;Yoo, Seong-Yul;Cho, Chul-Koo;Yang, Kwang-Mo;Yoo, Hyung-Jun;Cheon, Gi-Jeong;Shin, Young-Joo;Seo, Young-Seok
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.111-119
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    • 2009
  • Purpose: This study aimed at assessing the value of fluorine-18 fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET) for predicting the response of locally advanced rectal cancer to neoadjuvant CRT. Materials and Methods: Between August 2006 and January 2008, we prospectively enrolled 20 patients with locally advanced rectal cancer and who were treated with neoadjuvant CRT at the Korea Institute of Radiological and Medical Sciences. The treatment consisted of radiation therapy and chemotherapy, and this was followed by curative resection 6 weeks later. All the patients underwent $^{18}F$-FDG PET/CT both before CRT and 6 weeks after completing CRT. The measurements of the FDG uptake ($SUV_{max}$), the absolute difference (${\Delta}SUV_{max}$) and the percent $SUV_{max}$ difference (response index, $RI_{SUV}$) between the pre- and post-CRT $^{18}F$-FDG PET/CT scans were assessed. The measurements of the metabolic volume, the absolute difference (${\Delta}$metabolic volume) and the percent metabolic volume difference (response index, $RI_{metabolic\;volume}$) were also assessed. Results: Of the 20 patients who underwent surgery, 11 patients (55%) were classified as responders according to Dworak's classification. The post-CRT $SUV_{max}$ was significantly lower than the pre-CRT $SUV_{max}$. However, there were no significant differences in the $SUV_{max}$ and the metabolic volume reduction between the responders and non-responders. We used a minimum $SUV_{max}$ reduction of 67% as the cut-off value for defining a response, with a sensitivity of 45.5%, a specificity of 88.9%, a positive predictive value of 77% and a negative predictive value of 53.8%. Conclusion: Although there were no statistically significant results in this study, other studies have revealed that $^{18}F$-FDG PET/CT has the potential to assess the tumor response to neoadjuvant CRT in patients with locally advanced rectal cancer.

Evaluation of shear-bond strength between different self-adhesive resin cements with phosphate monomer and zirconia ceramic before and after thermocycling (인산염계 기능성 단량체가 첨가된 수종의 자가 접착 레진시멘트와 지르코니아 세라믹 사이 열순환 전후 전단결합강도 비교)

  • Lee, Ji-Hun;Kim, Min-Kyung;Lee, Jung-Jin;Ahn, Seung-Geun;Park, Ju-Mi;Seo, Jae-Min
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.4
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    • pp.318-324
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    • 2015
  • Purpose: This study compared shear bond strengths of five self-adhesive cements with phosphate monomer to zirconium oxide ceramic with and without airborn particle abrasion. Materials and methods: One hundred zirconia samples were air-abraded ($50{\mu}mAl_2O_3$). One hundred composite resin cylinders were fabricated. Composite cylinders were bonded to the zirconia samples with either Permacem 2.0 (P), $Clearfil^{TM}$ SA Luting (C), $Multilink^{(R)}$ Speed (M), $RelyX^{TM}$ U200 Automix (R), G-Cem $LinkAce^{TM}$ (G). All bonded specimens were stored in distilled water ($37^{\circ}C$) for 24 h and half of them were additionally aged by thermocycling ($5^{\circ}C$, $55^{\circ}C$, 5,000 times). The bonded specimens were loaded in shear force until fracture (1 mm/min) by using Universal Testing Machine (Model 4201, Instron Co, Canton, MA, USA). The failure sites were inspected under field-emission scanning electron microscopy. The data was analyzed with ANOVA, Tukey HSD post-hoc test and paired samples t-test ($\alpha$=.05). Results: Before and after thermocycling, $Multilink^{(R)}$ Speed (M) revealed higher shear-bond strength than the other cements. G-Cem $LinkAce^{TM}$ (G) showed significantly lower bond strengths after thermocycling than before treatment (P<.05), but the other groups were not significantly different (P>.05). Conclusion: Most self-adhesive cements with phosphate monomer showed high shear bond strength with zirconia ceramic and weren't influenced by thermocycling, so they seem to valuable to zirconia ceramic bonding.

An Analysis of the Relationship between Climacteric Symptoms and Management of Menopause in Middle-aged Women (일 지역 중년여성의 폐경증상과 폐경관리와의 관계에 대한 연구)

  • Song, Ae-Ri
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.308-322
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    • 2001
  • The purpose of this study was to investigate the relationship between climacteric symptoms and management of menopause of middle -aged women. The subjects of this study were 261 women(40 to 60 years old). Data were collected from Jun. 1 to Jul. 15, 2001 by a structured questionnaire. The instruments employed were : 1) The Climacteric Symptoms Scale developed by Aeri Song and Eun soon Chung(1998). 2) The Management of Menopause Scale developed by Aeri Song(1997). The data were analyzed by the SPSS p.c. program using t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows : 1. Mean score of climacteric symptoms was $2.18{\pm}0.39$(Maximum 4, Minimum 1). The mean scores among the categories of climacteric symptoms, in descending order, were : a) physical and physiological reactions ($2.62{\pm}0.53$), b) social and family relationships ($2.23{\pm}0.50$), c) psychiatric and psychological reactions ($2.08{\pm}0.49$), d) relationship with sexual partner($1.73{\pm}0.54$), e) genitourinary reactions ($1.72{\pm}0.55$). 2. Mean score of management of menopause was $1.79{\pm}0.45$ (Maximum 4, Minimum 1). The mean scores among the categories of management of menopause, in descending order, were : a) dietary management($2.57{\pm}0.52$), b) self control ($2.24{\pm}0.57$), c) management of exercise and physical activity($2.14{\pm}0.75$), d) management of sex life($1.71{\pm}0.47$), e) management of professional health maintenance($1.61{\pm}0.59$). 3. There were statistically significant differences in the score of middle-aged women's self reported climacteric symptoms according to : a) occupation (t=-2.79, p<0.001) b) marriage state (t=-2.29, p<0.05) c) age of menarche (F=4.66, p<0.001) d) method of Sanhujori (post natal care & treatment) (F=4.22, p<0.001) e) hormone replacement therapy (t=-3.09, p<0.05). From the above statistics, several significant findings were noted : a) There were more climacteric symptoms from those who were unemployed, those who had no partner or were divorced and those who started a menarche earlier. b) There were less climacteric symptoms reported from those on hormone replacement therapy and those who followed their parents or parents-in-law advice regarding Sanhujori (postnatal care) 4. There were statistically significant differences in the score of middle-aged women's self reported management of menopause according to : The educational background (F=7.63, p<0.001), religion (F=3.74, p<0.001), income (F=3.65, p<0.001), number of parity (F=4.87, p<0.001), method of Sanhujori(postnatal care) (F=5.73, p<0.001), period of Sanhujori (postnatal care) (F=2.81, p<0.05), hormone replacement therapy (t=3.81, p<0.001). Women with higher educational background, strong religion, higher income, large number of parity, managed their post natal care well, were on HRT, managed their menopause significantly better than the others who took part in the survey. 5. It will be noted from the above that women's degree of climacteric symptoms showed a negative correlation to the management of menopause(r=-0.2146, p<0.001). The findings shown above suggest the need to develop a variable management of menopause, in order to improve climacteric symptoms of middle-aged women. It is hoped that the above findings will stimulate more detailed research into this matter, and thereby enable guidance to be given to women going through the menopause to cope with it in a less stressful way.

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Antiemetic Effect of Dexamethasone in Dogs Sedated with Xylazine (Xylazine hydrochloride로 진정시킨 개에 대한 Dexamethasone의 항구토 효과)

  • Yang Jung-hoon;Kang Han-sem;Bae Jae-sung;Song Chang-hyun;Kim Jung-eun;Jin Hee-kyung;Jang Kwang-ho
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.94-99
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    • 2005
  • This prospective study aimed to assess the efficacy of dexamethasone to prevent xylazine induced emesis in dogs. The antiemetic effect of graded, single high-dose intravenous dexamethasone against xylazine hydrochloride was studied. Clinically healthy mixed breed dogs that weighed $ 4.64\pm1.25kg$ were used in this study. Food and water were given 3 hours before the experiment. Venous blood specimens were collected from all experimental animals for hema-tological and blood chemical test pre- and post-experiment. Twenty-eight experimental animals were randomly divided into 4 groups; the group treated with 0.2ml/kg of normal saline (Control group), the groups treated with 1mg/kg (D1 group), 2mg/kg (D2 group) and 4 mg/kg of dexamethasone (D4 group). Three doses of the dexamethasone or normal saline was administered intravenousely to each group and after 5 minutes, xylazine (2.2 mg/kg) was administered intramuscularly. The time until onset of the first emetic episode and rate of emesis were investigated. At the same time, the extent of sedation was scored subjectively 5, 15, 30 and 60 minutes after injection of xylazine hydrochloride using Visual Sedation Score. The time until onset of the first emetic episode was $203.25\pm11.35$ sec in Control group, $187.33\pm48.0l$ sec in D1 group and 218.33± 13.58 sec in D2 group. The rate of xylazine induced emesis were $57\%$ in Control group and $43\%$ in D1 and D2 group respectively. On the other hand, any emetic episodes were not observed in 04 group. At extent of sedation score, all experimental animals especially including the animals in D1 group were highly sedated at 15 minutes after administration of xylazine hydrochloride. Hematological and blood chemical values showed normal ranges pre- and post-experiment. We concluded that prior treatment with 4 mg/kg of dexamethasone hardly caused xylazine-induced emesis without disturbing the sedative effect of xylazine in dogs.

Transhiatal Esophagectomy in Cardia and Esophageal Cancer (위분문부 및 식도암 환자에서 경열공 식도절제술)

  • Choi Dong-Hui;Jung Kyoung-Won;Kim Dong-Heon
    • Journal of Gastric Cancer
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    • v.5 no.1
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    • pp.1-9
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    • 2005
  • Purpose: The debate is still on-going as to whether a transthoracic esophagectomy (TTE) or a transhiatal esophagectomy(THE) is the proper treatment for patients with cardia and esophageal cancers. This study tries to demonstrate and assess the efficacy and the validity of both surgeries. Materials and Methods: In a retrospective study, data from 52 cases of patients with esophageal and/or cardia cancer who received a surgical operation during the last decade were analyzed. Results: A TTE was done in 20 cases and a THE in 32 cases. The average times for the operations were 558.0 min for a TTE and 451.7 min for a THE (P>0.05). The estimated blood loss was 1,825.0 ml in a TTE and 1459.4 ml in a THE (P>0.05). The amounts of transfusion during the operations were 3.9 units in a TTE and 2.6 units in a THE (P<0.05). Post-operative complications occurred in 15 cases of TTE and 23 cases of THE. The average length of stay in the hospital was 25.6 days for a TTE and 20.6 days for a THE. The 5-year survival rate was $10\%$ for TTE patients and $28\%$ for THE patients (P>0.05). Conclusion: For most factors, including morbidity and mortality, there was no statistically significant difference between a TTE and a THE. However, a THE is expected to be more convenient, leading to a shorter operative duration, a shorter post-operative hospitalization and lesser amounts of hemorrhage and transfusion. Hence, the THE may be a more valid or efficient surgical method for those patients with cardia and esophagus cancer who require a resection of the esophagus. (J Korean Gastric Cancer Assoc 2005;5:1-9)

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Performance Status of Sanitary Management of School Food Service in the Jeonnam Area (전남지역 학교급식의 위생관리 실태)

  • 고무석;정난희;이전옥
    • Korean Journal of Human Ecology
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    • v.7 no.1
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    • pp.51-67
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    • 2004
  • This study analyzed the effects of nutrition technicians' hygiene education on cooking workers' performance of hygiene management in order to ensure the security of school meals. The situation of cooking workers' disposition in subject schools was elementary school(51.1%) and middle school(48.9%) and the type of meals was rural area type(54.2%), urban type(36.5%). and island and isolated area type(9.3%). The methods of meals management were single cooking(88.2%) and joint cooking and management(11.8%). The type of distributing meals was distributing in a dining room(93.5%), in a classroom(3.7%), and in both dining room and classroom(2.8%). Nutrition technicians' employment form included regular(53.5%) and daily(88.2%). Their education was junior college graduate(50.2%), university graduate(44.8%). and graduate school students(5.0%). Cooking workers' employment form included daily(88.2%) and regular (11.1%). suggesting that most were regular. Most cooking workers(77.4%) had at least high school certificate. Regarding the situation of cooking workers' disposition in subject schools, the number of student per one cooking worker was found as 91-120(37.2%), 61-90(22.6%). 60 and under(21.l %). 121-15006.7%). and 151 and over(2.5%). Cooking workers' level of performance of hygiene management was post-working stage(66.37/75 marks), pre-working stage(64.22/75 marks). and working stage(20.34/25 marks), The counting of meals articles in a pre-working stage(20.34/25 marks). temperature and required time in a working stage(18.78/25 marks), and machinery equipment and hygiene in a pre-working stage(21.40/25 marks) showed lowest of performance, which suggest poor service of hygiene. Cooking workers' performance of hygiene management by working stage showed the significant difference with school class(p<.001), type of schools with meals(p<.05). state of cooking workers' employment(p<.001), and cooking worker's disposition(p<.05). A working stage showed the significant difference with type of schools with meals(p<.05). A post-working stage showed the significant difference according to type of schools with meals(p<.05), and the methods of meals management(p<.05), and cooking workers' disposition(p<.05). In the execution of hygiene education, individual hygiene was highest(94.8%), followed by the management of machinery equipment and tools(89.7%), food poisoning and microorganism(94.7%), and the method of food treatment(76.4%). A yearly plan of hygiene education included established(83.9%) and not established(l6.1%). Regular education included not executed(25.1%), 2-3 times a month(l6.1%), and more than 4 a month(4.0%) and occasional education was not executed(57.0%), 1-3 times a month(26.3%), and more than 4 a month(l5.7%). In the methods for hygiene education, oral education(95.7%) was used most, followed by demonstration(10.5%), poster/photo(10.5%), video/slide(3.7%), and computer(3.7%). Frequency of improvement and complement of hygiene education included once a month(56.3%), once a year(20.7%), by quarter(l1.5%), and every six months(1l.5%). Newspaper was used most in materials of hygiene education, followed by internet, TV, nutrition technician's reeducation, information exchange between members, educational office's training, and reference book, and educational office's material. and symposium. Cooking workers' assessment of the effect of hygiene education was conducted through observation(56.8%), check table(l5.2%), question(l4.0%), and examination(14.0%). The reason of cooking workers' low level of performance included habitual custom(53.9%), lack of understanding(20.4%), overwork(l4.6%), and lack of knowledge(l1.l%) and the reason of difficulty in hygiene education included lack of time(55.3%), lack of understanding(27.6%), lack of knowledge and information(8.7%), and lack of budget(48.0%).

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The Effects of Science Class Using Multimedia Materials on High School Students' Attitude toward Science (멀티미디어 자료를 활용한 과학수업이 고등학생의 과학에 대한 태도에 미치는 영향)

  • Yoo, Mi-Hyun;Park, Hyun-Ju
    • Journal of Science Education
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    • v.35 no.1
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    • pp.1-12
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    • 2011
  • The purpose of this study was to examine the effects of science class using the multimedia materials on high school students' attitude toward science. The subjects were 222 high school students. For this study, 11th graders at a high school were assigned to a comparison group and an experimental group. The experimental group was received science class using multimedia materials for 3 months. The research design was pretest-posttest control group design, the data were analyzed using PASW statistics 18.0 program. The types of multimedia materials used in experimental group were science fiction movies, science documentaries, TV programs, and Power Point presentations created by students. Before and after treatment, the attitude toward science tests were administered. Pre-tests and post-test score differences between 2 groups were analyzed by ANCOVA. The differences of attitude toward science based on gender were compared by analysis of covariance. And the perception on science class with multimedia materials were also investigated. The results of this study were as follows: First, the attitude toward science was improved significantly after applying science classes using multimedia materials. Especially, there were significant difference between pre-test and post-test in the score of attitude toward science class and attitude toward science content which were sub-area of attitude toward science. Second, there was no significant difference between female and male students in total score of attitude toward science. However, the attitude toward science, scientists and society, which was a sub-area of attitude toward science, female students scored significantly higher than male students. Third, 84% student showed a positive perception that the science class enhanced their interest in science. 69% the students responded that we had thought about Science-Technology-Society. Multimedia material types which the students prefered were science fiction movie, science documentaries, science TV programs, respectively.

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Mid to Long Term Outcomes of Surgical Treatment for Isolated Coarctation of Aorta (단순 대동맥 축착의 외과적 치료 후 중.장기 결과)

  • Lee, Seung-Cheol;Yoon, Tae-Jin;Park, Jeong-Jun;Song, Meong-Gun;Kim, Young-Hwee;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.83-89
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    • 2007
  • Background: The surgical repair of an isolated coarctation of the aorta, without complex cardiac anomalies, has improved, with very good results. However, despite the success of surgical repair, many long-term complications, such as hypertension, re-coarctation and an aortic aneurysm, still exist. Material and Method: Between 1991 and 2006, 50 patients diagnosed with an isolated coarctation of the aorta were reviewed retrospectively. The incidence of re-coarctation and hypertension were compared with respect to age and surgical methods. Result: There were no early & late mortality, or post operative aortic aneurysms. Hypertension developed in 11 patients (22%). A greater number of patients in the child/adult group had hypertension (52.4%) than in the neonate/infant group (0%). With respect to the surgical methods, the patients in the graft interposition group suffered more hypertension (88.9%) than those in the EEEA (extended end to end anastomosis) group (5.3%). Post operative re-coarctation developed in 2 out of the 29 patients (6.9%) in the neonate/infant group and 2 out of the 21 patients (9.5%) in the child/adult group, but without any statistical difference. There were no statistical differences between the operative type-related groups. Conclusion: Even though the surgical outcomes have greatly improved, an isolated coarctation of the aorta still has many long-term problems, such as hypertension and re-coarctation. An isolated coarctation is accepted as a systemic vascular dysfunction, and often progresses to other cardiovascular diseases. Therefore, patients with a coarctation of the aorta have to be carefully followed-up, and aggressive management must be given when required.