Background: β-blockers (BBs) are considered primary therapy in stable heart failure (HF) with reduced ejection fraction (HFrEF) without atrial fibrillation (AF); evidence-based benefits of BB on outcome have been documented. However, BBs have not been shown to improve mortality or reduce hospital admissions in HF patients with AF. This study assessed the relationship between BBs at discharge and relevant clinical outcomes in acute heart failure (AHF) patients with AF. Methods: From the Korean Acute Heart Failure Registry, 936 HFrEF and 639 HF patients with preserved ejection fraction (HFpEF) and AF were selected. Propensity score (PS) matching accounted for BB selection bias when assessing associations. Results: BB-untreated patients in the overall cohort of HFrEF and HFpEF had greater deteriorated clinical and laboratory characteristics. In the 670 PS-matched cohort of HFrEF patients, incidences of all clinical events at 60 days and 1 year were not different according to use of BBs. In the 470 PS-matched cohort of HFpEF, rehospitalization and composite outcome at 6 months and 1 year more frequently occurred in non-users of BBs. After adjusting for covariates in the multivariable Cox model of matched cohorts, BB was not associated with clinical outcomes at 60 days and 1 year in HFrEF with AF patients. In HFpEF patients with AF, BB use was associated with reduced 6-month (hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20–0.74) and 1-year rehospitalization (HR, 0.53; 95% CI, 0.34–0.82). Conclusion In the HFrEF with AF PS-matched cohort, the use of BBs at discharge was not associated with clinical outcome. However, in HFpEF with AF, the use of BB was associated with reduced rehospitalization during the 6-month and 1-year follow up.

PURPOSE: The purpose of this retrospective study was to evaluate clinical outcomes of endoscopic nerve decompression in patients with deep gluteal syndromes (DGS). MATERIALS AND METHODS: Between October 2013 and March 2015, 24 patients who underwent surgical treatment of DGS were retrospectively included in this study. The mean age was 47 years (range, 35 to 76 years), and there were 11 males and 13 females. The mean duration of pain was 12 months (range, 5 to 35 months) and the mean follow-up period was 32 months (range, 26 to 45 months). Clinical evaluations included the visual analog scale (VAS) pain score, modified Harris hip score (mHHS), and the symptom-rating scale. RESULTS: Significant improvement in symptoms following endoscopic decompression were achieved as measured using the VAS score (decrease in the mean from 7.1±0.9 to 2.5±1.5; P < 0.001) and mHHS (increase from 59.4±6.5 to 85.0±8.3; P < 0.001). CONCLUSION: Endoscopic sciatic nerve decompression was satisfactory for treating recalcitrant DGS, making it an effective treatment option to improve symptoms of DGS.
Decompression ; Female ; Follow-Up Studies ; Hip ; Humans ; Male ; Retrospective Studies ; Sciatic Nerve ; Visual Analog Scale

PURPOSE: The outcome of hip arthroscopy as a treatment of patients with hip dysplasia is variable. In patients with severe hip dysplasia, arthroscopy has the potential to exacerbate instability and unfavorable outcome. To the best of out knowledge, there has not been a report regarding arthroscopic treatment in patients with borderline hip dysplasia in Korea. We favorable outcome with using arthroscopy to treat symptomatic borderline hip dysplasia. MATERIALS AND METHODS: Between August 2010 and February 2015, 143 patients undergoing hip arthroscopy for intra-articular hip disorder were retrospectively enrolled. From this cohort, a borderline dysplasia group compromising 29 patient with lateral center edge angle (LCEA) >18° and <25° and a minimum of 1 years follow-up, was identified. Patient-reported outcome scores, including modified Harris hip score, the hip outcome score-activity of daily living, the sport-specific subscale, visual analogue scale (VAS) and satisfaction survey were obtained preoperatively and at postoperative 3 months, 6 months, 1 year, 2 years, and 3 years. Revision surgery and complications were recorded for each group. RESULTS: The mean age was 35.7 years (range, 16–63 years) years respectively. There were 16 females (55.2%) and 13 males (44.8%). The mean LCEA was 22.0° (range, 18°–25°) and the mean Tönnis angle was 6.1° (range, 0°–18°). The mean follow-up was 20.2 months (range, 12–39 months), and at the 1 year follow-up, there was significant improvement (p<0.001) in all patient reported outcome scores and VAS. Satisfaction survey showed an average score of 7.7. CONCLUSION: In patients with borderline hip dysplasia, if there is an occurrence of symptomatic labral tear, arthroscopic labral refixation has a good short-term result. Therefore, if patients have no response to conservative treatment or have severe pain, arthroscopic labral refixation is a useful treatment options to relieve symptom.
Arthroscopy* ; Cohort Studies ; Female ; Follow-Up Studies ; Hip Dislocation* ; Hip* ; Humans ; Korea ; Male ; Retrospective Studies ; Tears

With the increasing proportion of elderly and diabetic dialysis patients, permanent dual lumen catheters are becoming popular. One of the most frequent causes for the failure of hemodialysis in CRF patients with the tunneled cuffed catheter is the catheter dysfunction. It is thought to be due to encasement of the catheter by fibrin sleeve or fibrin sheath, kinking or malposition of the catheter. Catheter dysfunction due to fibrin sheath formation could sometimes be managed by reversal of arterial and venous lines, urokinase lock or infusion, and catheter exchange. Recently percutaneous fibrin sheath stripping (PFSS) became another modality of salvaging failing tunneled cuffed catheter before attempting catheter exchange. There was no report of applying PFSS to salvage the permanent dual lumen catheter in Korea. Authors recently experienced a case of successful application of PFSS to extend the life of catheter in a CRF patients as a last resort after failure of repeated urokinase trials. It is thought that PFSS is a simple and effective procedure which extends the longevity of permanent dual lumen catheter.
Aged ; Catheters* ; Dialysis ; Fibrin* ; Health Resorts ; Humans ; Korea ; Longevity ; Renal Dialysis ; Urokinase-Type Plasminogen Activator

A malignant sarcoma of soft tissue that arises near but not in a joint, most often in an adolescent or young adult, is typically slowgrowing, and may escapes notice until it causes pain. The diagnosis of this tumor can be suspected by X-ray or imaging, made by biopsy, and confirmed by chromosome studies. Cytogenic studies reveal a translocation between the X chromosome and chromosome 18 in the tumor cells. The most common treatment for the tumor is surgery to remove the entire tumor, nearby muscle, and lymph nodes. Synovial sarcoma tends to recur locally and to involve regional lymph nodes. Distant metastasis occurs in half cases. The well-documented and adequately followed cases are currently lacking and this report described an instance of Synovial sarcoma good result after treatment and review of literature.
Adolescent ; Biopsy ; Chromosomes, Human, Pair 18 ; Diagnosis ; Humans ; Joints ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Sarcoma, Synovial* ; United Nations ; X Chromosome ; Young Adult

BACKGROUND: The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. MATERIAL AND METHODS: By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. RESULTS: All of S. aureus used in this study were MRSA, and MIC90 of linezolid was below 2 microgram/ml (MIC ranged between 1-2 microgram/ml). All of Enterococcus spp. were VRE, and had MIC90 of 2 microgram/ml (MIC ranged between 1 to 4 microgram/ml). One of the VRE showed intermediate susceptibility with MIC of 4 microgram/ml. However, none was resistant with MIC breakpoint above 8 microgram/ml. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MIC90 of 1 microgram/ml(MIC range 0.5-1 microgram/ml). CONCLUSION: In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.
Agar ; Anti-Bacterial Agents ; Biological Availability ; Community-Acquired Infections ; Enterococcus ; Gram-Positive Cocci ; Humans ; Korea ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxazolidinones ; Penicillins ; Pneumonia ; Skin

BACKGROUND: The emergence of multi-drug resistant Gram-positive cocci, such as MRSA, VRE, and VRSA, necessitated to develop new antibiotics, which could replace the glycopeptide. As a result, a new antibiotics named linezolid was developed. Linezolid is different line of oxazolidinones with a good oral bioavailability, compared to other antibiotics. Since appropriate oral antibiotics are not presently available for MRSA, which is a major cause of nosocomial and community acquired infections, the introduction of linezolid will have favorable effect on treatment of infections such as pneumonia or skin infections. In this study, we investigated the antibiotic effect of linezolid on MRSA and VRE isolated from patients who were treated in Korea University Guro Hospital. MATERIAL AND METHODS: By using broth microdilution and agar dilution method we measured minimum inhibitory concentration (MIC) with sixty S. aureus, forty three Enterococcus spp., and twenty five S. pneumoniae isolates from patients who were diagnosed as skin, soft tissue, respiratory, and urinary infections in Korea University Guro Hospital from January, 1998 to December, 2002. RESULTS: All of S. aureus used in this study were MRSA, and MIC90 of linezolid was below 2 microgram/ml (MIC ranged between 1-2 microgram/ml). All of Enterococcus spp. were VRE, and had MIC90 of 2 microgram/ml (MIC ranged between 1 to 4 microgram/ml). One of the VRE showed intermediate susceptibility with MIC of 4 microgram/ml. However, none was resistant with MIC breakpoint above 8 microgram/ml. All of S. pneumoniae were resistant to penicillin, but they were susceptible to linezolid with MIC90 of 1 microgram/ml(MIC range 0.5-1 microgram/ml). CONCLUSION: In conclusions, linezolid has an excellent in vitro antibiotic effect on multi-drug resistant Gram-positive cocci, such as MRSA, PRSP, and VRE.
Agar ; Anti-Bacterial Agents ; Biological Availability ; Community-Acquired Infections ; Enterococcus ; Gram-Positive Cocci ; Humans ; Korea ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Oxazolidinones ; Penicillins ; Pneumonia ; Skin

PURPOSE: Nocturnal Enuresis, an involuntary discharge of urine after bladder control, is frequent in children. It brings patients and family many psychogenic problems. So we investigated its clinical characteristics and drug effects. METHODS: The study subjects enrolled were 36 children with nocturnal enuresis. We evaluated family history, accompanying urinary symptoms and clinical characteristics through questionnaries. We evaluated the effect of imipramine and desmopressin in 26 children among the 36 cases. RESULTS: The ratio of boys to girls was 1.6 to 1. The age range in 15 cases(41.7%) was 4-5 years, in 14 cases(38.9%) 6-7 years, in 4 cases(11.1%) 8-9 years, and in 3 cases(9.3%) it was above 10 years. Twenty four(67%) were primary enuresis and 12(33%) were secondary enuresis. In eighteen cases(50%), these was a family history of enuresis. Seven of these cases had a parental enuresis history. The accompanying urinary symptoms were urgency(47.2%), frequency (38.9%), and dysuria(13.9%). The responses to imipramine were as follows : an excellent response in 2 cases(20%), a good response in 4(40%), a transient response in 2(20%), and no response in 2(20%). The responses to desmopressin were as follows : an excellent response in 7(43.8%), a good response in 4(25%), a transient response in 3(18.7%), and no response in 2(12.5%). CONCLUSION: Enuresis is more frequent in boys and primary type. Half of 36 enuresis children had a family history of enuresis. We recommend continuous drug medication to control nocturnal enuresis along with encouragement.
Child* ; Deamino Arginine Vasopressin ; Enuresis ; Female ; Humans ; Imipramine ; Nocturnal Enuresis ; Parents ; Urinary Bladder

PURPOSE: Nocturnal Enuresis, an involuntary discharge of urine after bladder control, is frequent in children. It brings patients and family many psychogenic problems. So we investigated its clinical characteristics and drug effects. METHODS: The study subjects enrolled were 36 children with nocturnal enuresis. We evaluated family history, accompanying urinary symptoms and clinical characteristics through questionnaries. We evaluated the effect of imipramine and desmopressin in 26 children among the 36 cases. RESULTS: The ratio of boys to girls was 1.6 to 1. The age range in 15 cases(41.7%) was 4-5 years, in 14 cases(38.9%) 6-7 years, in 4 cases(11.1%) 8-9 years, and in 3 cases(9.3%) it was above 10 years. Twenty four(67%) were primary enuresis and 12(33%) were secondary enuresis. In eighteen cases(50%), these was a family history of enuresis. Seven of these cases had a parental enuresis history. The accompanying urinary symptoms were urgency(47.2%), frequency (38.9%), and dysuria(13.9%). The responses to imipramine were as follows : an excellent response in 2 cases(20%), a good response in 4(40%), a transient response in 2(20%), and no response in 2(20%). The responses to desmopressin were as follows : an excellent response in 7(43.8%), a good response in 4(25%), a transient response in 3(18.7%), and no response in 2(12.5%). CONCLUSION: Enuresis is more frequent in boys and primary type. Half of 36 enuresis children had a family history of enuresis. We recommend continuous drug medication to control nocturnal enuresis along with encouragement.
Child* ; Deamino Arginine Vasopressin ; Enuresis ; Female ; Humans ; Imipramine ; Nocturnal Enuresis ; Parents ; Urinary Bladder

PURPOSE: To analyse and compare high-resolution CT findings of pulmonary tuberculosis with consolidation and mycoplasma pneumonia. MATERIALS AND METHODS: Twenty patients with pulmonary tuberculosis [confirmed by sputum culture (n=9) and bronchoscopic biopsy (n=11)] and airspace consolidation on high-resolution CT and 17 patientswith mycoplasma pneumonia, confirmed by serologic test, were included in this study. High-resolution CT findings were analyzed in terms of ground-glass opacities, distribution of consolidation, type of nodules, cavities, interlobular septal thickening, bronchial dilatations, bronchial wall thickening and pleural effusion. RESULTS: In patients with tuberculsis, average age was 33.5 years (range, 20-67) ; in those with mycoplasma pneumonia it was 32.5 years (range, 17-74). Segmental and subsegmental distributions were most common in both diseases ; the preferred site of consolidation was different, however ; for tuberculosis it was the upper lobes (13 cases, 65% ; bilateral involvement, 7 cases) ; for mycoplasma pneumonia it was the lower lobes (11 cases, 64.7%). Non-segmental (diffuse and random) distribution of ground-glass opacities were seen in two patients(11.8%) with mycoplasma pneumonia. Centrilobular nodules, branching linear opacities and alveolar nodules were not different in both diseases, but there were nodules above 10mm in 14 cases of tuberculosis and in only one case of mycoplasma pneumonia. Tree-in-bud appearances were seen in five cases of tuberculosis. Cavities without air-fluid level were noted in ten cases of tuberculosis. Other interlobular septal thickening, bronchial wall thickening, bronchial dilatation and pleural effusion were not different in both diseases. CONCLUSION: There was considerable overlap between high resolution CT findings of tuberculosis with airspace consolidation and those of mycoplasma pneumonia. The location of consolidation, type of nodules, and the presence of tree-in-bud appearance and cavities help in the differentiation of the two diseases, however.
Adult* ; Biopsy ; Dilatation ; Humans ; Mycoplasma* ; Pleural Effusion ; Pneumonia, Mycoplasma* ; Serologic Tests ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary*