No abstract available.
Muscle, Skeletal* ; Tibial Nerve*

PURPOSE: Severe abdominal pain and signs of peritoneal irritation in some patients with hemorrhagic fever with renal syndrome (HFRS) can mimic an acute surgical disease of the abdomen. We performed this study to analyze the clinical features and the laboratory and radiographic findings of HFRS patients who had acute abdominal pain upon visiting the emergency department (ED). METHODS: The electronic medical records were retrospectively investigated during a 3 year period between January 2006 and December 2008. RESULTS: Among the 44 patients with HFRS at the ED, 21 patients (47.7%) complained of acute abdominal pain. On physical examination, three patients (14.3%) had rebound tenderness. The most common laboratory findings were thrombocytopenia, azotemia and proteinuria. Ascites, pericholecystic fluid collection, peri-renal fluid collection and pleural effusion were the major findings of abdominal computed tomography. CONCLUSION: Acute abdominal pain can be a presenting symptom of HFRS at the ED. In an endemic area, HFRS should be suspected in young patients who have acute abdominal pain, fever (or history of fever), tenderness (and rebound tenderness) of the abdomen, thrombocytopenia and proteinuria. Failure to recognize HFRS might delay the appropriate diagnostic approach and treatment.
Abdomen ; Abdomen, Acute ; Abdominal Pain ; Ascites ; Azotemia ; Electronic Health Records ; Emergencies ; Fever ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hydrazines ; Military Personnel ; Physical Examination ; Pleural Effusion ; Proteinuria ; Retrospective Studies ; Thrombocytopenia

PURPOSE: For tachycardic patients not in need of immediate cardioversion, the International Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care emphasize specific rhythm diagnosis and avoidance of simplistic overuse of adenosine. The purpose of this study was to identify the rhythms for which adenosine was inappropriately prescribed at the emergency department after the International Guidelines 2000 had been adopted. METHODS: We retrospectively investigated 128 tachycardic patients who had been prescribed adenosine at the emergency department from September 2000 to March 2003. Patients were divided into two groups. The Appropriate Use Group was comprised of patients for whom had been prescribed for narrow QRS-complex tachycardia on the initial ECG. The Inappropriate Use Group was comprised of patients for whom adenosine had been prescribed for atrial fibrillation, atrial flutter, atrial tachycardia, sinus tachycardia, and wide QRS-complex tachycardia of unknown origin on the initial ECG. RESULTS: Of the 128 patients, 31 (24.2%) were in the Inappropriate Use Group. Among them, atrial fibrillation was involved in 15, atrial flutter in 3, atrial tachycardia in 2, sinus tachycardia in 8, and wide QRS-complex tachycardia of unknown origin in 3. CONCLUSION: Approximately 24% of the emergency department patients who were treated with adenosine received the medication unnecessarily for atrial fibrillation, atrial flutter, atrial tachycardia, sinus tachycardia, and wide QRS-complex tachycardia of unknown origin. Additional education on electrocardiographic recognition of tachyarrhythmias, and the Tachycardia Algorithms of Guidelines 2000 may be necessary for residents of emergency department.
Adenosine* ; Atrial Fibrillation ; Atrial Flutter ; Cardiopulmonary Resuscitation ; Diagnosis ; Education ; Electric Countershock ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Retrospective Studies ; Tachycardia ; Tachycardia, Sinus

PURPOSE: We performed this study to evaluate the clinical characteristics, including risk factors and etiologic subtypes, of ischemic stroke in young adults. METHODS: One hundred thirty-two patients with acute ischemic stroke and between 15 and 44 years of age who visited the Emergency Department of Samsung Medical Center from January 1999 to December 2003 were included. We retrospectively reviewed their medical records and the result of brain CT, brain MRI/MRA, transcranial doppler sonography, echocardiography, electrocardiography, and laboratory studies for coagulopathy, autoimmune disease, and vasculitis according to the Young-age Stroke Protocol of Samsung Medical Center. Stroke subtypes were classified based on the TOAST criteria. RESULTS: In this study, men (77.3%) significantly outnumbered women. The prevalence of cigarette smoking, habitual alcohol ingestion, hyperlipidemia, and DM was significantly higher in men than women. Stroke subtypes were large-artery thrombosis 26.5%, small-artery occlusive disease 20.5%, cardioembolism 17.4%, other determined etiologies 12.7%, and undetermined causes 22.7%. Among the 17 patients with other determined etiologies, arterial dissection (9 patients) was most common. Our Young-age Stroke Protocol identified a clinically significant result in only one patient. CONCLUSION: Smoking and alcohol ingestion were the most important risk factors. The proportion of large-artery thrombosis and small-artery occlusion was relatively high compared to previous western studies. Arterial dissection was the most common cause in other determined etiologies. The current Young-age Stroke Protocol has limited value for stroke in young Korean adults.
Adult ; Autoimmune Diseases ; Brain ; Eating ; Echocardiography ; Electrocardiography ; Emergency Service, Hospital ; Female ; Humans ; Hyperlipidemias ; Male ; Medical Records ; Prevalence ; Retrospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke* ; Thrombosis ; Ultrasonography, Doppler, Transcranial ; Vasculitis ; Young Adult*

BACKGROUND/AIMS: Vaccination against hepatitis A virus (HAV) is recommended for patients with chronic hepatitis B (CHB), since they are potentially at an increased risk of HAV-related morbidity and mortality. However, little is known about the adherence to these recommendations in the community. This study evaluated the current vaccination status and immunity against HAV among Korean military soldiers with CHB. METHODS: We performed a prospective study of Korean military soldiers from August 2008 to January 2009. We enrolled 96 soldiers with CHB on a consecutive basis. We assessed their vaccination history and the presence of anti-HAV immunoglobulin G (IgG). RESULTS: The HAV vaccination rate of the soldiers enrolled in our study was 2% (2 of the 96 soldiers). The seroprevalence rates of anti-HAV IgG among military soldiers without a vaccination history were 0%, 50%, and 100% for those aged 19-29 years (n=71), 30-39 years (n=8), and 40 years or older (n=15), respectively (p<0.001). CONCLUSIONS: The HAV vaccination rate is very low among military soldiers. Public health efforts aimed at raising awareness about HAV vaccination in patients with CHB should be strongly encouraged.
Aged ; Hepatitis ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis A virus ; Hepatitis B, Chronic ; Humans ; Immunoglobulin G ; Military Personnel ; Prospective Studies ; Public Health ; Seroepidemiologic Studies ; Vaccination

BACKGROUND/AIMS: Little information is available on whether the speed of eating differs between individuals with and without dyspepsia, mainly because controlled studies are usually not feasible. METHODS: A survey was applied to 89 individuals with relatively controlled eating patterns, using questionnaires that assessed eating time and functional dyspepsia (FD) based on the Rome III criteria. RESULTS: The prevalence of FD was 12% (11 of 89 participants), and 7% (6 of 89) were diagnosed with gastroesophageal reflux disease (GERD). The proportion of individuals reporting that they ate their meals rapidly was higher for those with FD than for those without FD or GERD (control) (46% vs 17%, p=0.043), as was the reported eating speed (7.1+/-1.5 vs 5.8+/-2.0 [mean+/-SD], p=0.045; visual analog scale on which a higher score indicated faster eating). However, the measured eating time did not differ significantly between FD and controls (11.0+/-2.8 vs 12.8+/-3.3 minutes, p=0.098). The proportion of individuals who ate their meals within 13 minutes was significantly higher for those with FD than for controls (91% vs 51%, p=0.020). CONCLUSIONS: The results of this study suggest that eating speed affects dyspepsia. Further studies are warranted.
Dyspepsia ; Eating ; Female ; Food Habits ; Gastroesophageal Reflux ; Humans ; Meals ; Prevalence ; Rome ; Surveys and Questionnaires

Background/Aims: This study aimed to investigate whether pretransplant frailty can predict postoperative morbidity and mortality after liver transplantation (LT) in patients with cirrhosis. Methods: We retrospectively reviewed 242 patients who underwent LT between 2018 and 2020 at a tertiary hospital in Korea. Results: Among them, 189 patients (78.1%) received LT from a living donor. Physical frailty at baseline was assessed by the Short Physical Performance Battery (SPPB), by which patientswere categorized into two groups: frail (SPPB <10) and non-frail (SPPB ≥10). Among the whole cohort (age, 55.0±9.2 years; male, 165 [68.2%]), 182 patients were classified as non-frail and 60 patients were classified as frail. Posttransplant survival was shorter in the frail group than the non-frail group (9.3 months vs 11.6 months). Postoperative intensive care unit stay was longer in the frail group than in the non-frail group (median, 6 days vs 4 days), and the 30-day complication rate was higher in the frail group than in the non-frail group (78.3% vs 59.3%). Frailty was an independent risk factor for posttransplant mortality (adjusted hazard ratio, 2.38; 95% confidence interval, 1.02 to 5.57). In subgroup analysis, frail patients showed lower posttransplant survival regardless of history of hepatocellular carcinoma and donor type. Conclusions Assessment of pretransplant frailty, as measured by SPPB, provides important prognostic information for clinical outcomes in cirrhotic patients undergoing LT.