No abstract available.
Accessory Atrioventricular Bundle ; Electrocardiography ; Tachycardia*

PURPOSE: The aim of the present study is to assess the importance of proper treatment timing for dental emergency patients by characterizing current patient care in the emergency room. MATERIALS AND METHODS: A retrospective chart review of 3,211 patients who visited the Chosun University Hospital's dental emergency department (Gwangju, Korea) was conducted from January 1, 2011 to May 31, 2014. Information regarding age, gender, onset date, main causes, and diagnoses were collected and analyzed. The main causes were divided into six categories: assault, household/play, sports, traffic, work, and others. RESULT: Emergency visits were more common for men (69%), and the ratio of males to females was 2.2:1 On average, the major cause was household/play (49.8%), followed by others (18.9%), traffic (16.6%), assault (9.1%), sports (2.9%), and work (2.6%). The most frequent diagnosis on average was dental trauma with 82.4%, followed by infection (10.7%), others (4.7%), and bleeding (2.2%). CONCLUSION: The main reasons for visits to the dental emergency department are dental trauma, dental infection, bleeding, and others. The most frequent reason for dental emergency patients to visit the emergency department was dental trauma (82.4%).
Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Male ; Patient Care ; Retrospective Studies* ; Sports

Spontaneous spinal epidural hematoma is extremely rare. It can cause fatal complication such as permanent neurologic deficit. Even though the exact cause of epidural hematoma is not known in most cases, anticoagulation treatment is associated in some cases. In this situation, prompt reversal of anticoagulation and immediate decompression surgery is required. Seventy-year-old woman presesnted with sudden hemiplegia. She had history of hypertension, dyslipidemia, and paroxysmal atrial fibrillation and had taken antihypertensive agent, statin, and warfarin. She did not have any history of trauma and her international normalized ratio was within therapeutic range during follow-up and at the time of event. Physical examination revealed decreased right extremities' motor and sensory function but cognitive function was normal. Detailed neurologic examination and spinal magnetic resonance imaging identified extensive, spontaneous spinal epidural hematoma. After the reversal of anticoagulation with vitamin K injection, the patient underwent emergent hematoma removal surgery and recovered completely. Our case suggests epidural hematoma should be considered in sudden hemiplegia patients with anticoagulation therapy. Immediate reversal of anticoagulation and decompression surgery can avoid neurologic deficit.
Atrial Fibrillation ; Decompression ; Dyslipidemias ; Female ; Follow-Up Studies ; Hematoma* ; Hematoma, Epidural, Spinal ; Hemiplegia* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypertension ; International Normalized Ratio* ; Magnetic Resonance Imaging ; Neurologic Examination ; Neurologic Manifestations ; Physical Examination ; Sensation ; Vitamin K ; Warfarin*

BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus ; Biopsy ; Chest Pain ; Cough ; Esophagus ; Gastroesophageal Reflux ; Heartburn ; Hoarseness ; Light ; Metaplasia ; Microscopy ; Prospective Studies ; Proton Pumps ; Sensation

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

Stent thrombosis is a fatal complication in patients who have undergone percutaneous coronary intervention, and discontinuation of anti-platelet agent is a major risk factor of stent thrombosis. We report a rare case of very late stent thrombosis (VLST) following discontinuation of anti-platelet agents in a patient who experienced acute myocardial infarction and essential thrombocytosis. She had undergone implantation of a drug eluting stent (DES) and a bare metal stent (BMS) two and half years prior to her presentation. VLST developed in DES, not in BMS, following interruption of anti-platelet therapy.
Drug-Eluting Stents ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Risk Factors ; Stents ; Thrombocythemia, Essential ; Thrombocytosis ; Thrombosis

BACKGROUND AND OBJECTIVES: It is well known that atherosclerosis is characterized by chronic inflammation of an injured intima and the pathological processes are initiated by an accumulation of morphologically distinct, modified forms of low density lipoprotein (LDL)-cholesterol. However, it is not well known whether the level of modified LDL-cholesterol has clinical significance for the patients who underwent percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: Eighty seven patients (mean age: 63.0 +/- 11.1 years, 58 men) who underwent PCI were enrolled. The patients with stable or unstable angina pectoris were classified as group I (n=44, mean age: 62.4 +/- 9.3 years), and the patients with acute myocardial infarction were classified as group II (n=43, mean age: 63.6 +/- 12.7 years). Modified LDL-cholesterol was expressed semiquantitatively by agarose gel electrophoresis with using the charge modification frequency (CMF). The clinical and coronary angiographic data was analyzed. RESULTS: The clinical diagnosis was stable angina in 13 patients, unstable angina in 31 patients, non-ST elevation myocardial infarction in 5 patients and ST elevation myocardial infarction in 38 patients. There were no significant differences of the CMF between two groups (3.0 +/- 7.9 vs. 2.1 +/- 10.9, respectively, p=0.671). The diameter stenosis was severe in the patients with a CMF greater than 10 (84.0 +/- 10.4% vs. 78.6 +/- 13.7%, respectively, p=0.047). The six-month major adverse cardio-vascular events (MACEs) had no relationship with the CMF in group I. However, in group II, the 6-month MACEs developed more frequently in the patients with a CMF higher than 10 {2 (28%) for group ll vs. 2 (5%) for group 1, p=0.031}. The patients with acute myocardial infarction and whose CMF was higher than 10 had in-stent restenosis observed on their follow-up coronary angiography (p=0.003). CONCLUSION: A higher level of modified LDL-cholesterol is associated with severe angiographic findings and a poor prognosis for patients with acute myocardial infarction.
Acute Coronary Syndrome ; Angina, Stable ; Angina, Unstable ; Atherosclerosis ; Constriction, Pathologic ; Coronary Angiography ; Electrophoresis, Agar Gel ; Fees and Charges ; Follow-Up Studies ; Humans ; Inflammation ; Lipoproteins ; Myocardial Infarction ; Pathologic Processes ; Percutaneous Coronary Intervention ; Prognosis

BACKGROUND/AIMS: Behcet's disease (BD) is a systemic disorder associated with a characteristic vasculitis that can involve both veins and arteries of all sizes. Endothelial activation or injury is a characteristic feature of BD. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis. The carotid artery intima-media thickness (IMT) is a widely accepted marker of subclinical atherosclerosis. We aimed to determine the carotid IMT in BD patients with using high-resolution B-mode Doppler ultrasonography. METHODS: We studied 40 patients (24 males, mean age: 39.1+/-8.5 years) who were diagnosed by the international diagnostic criteria of Behcet's disease and 20 healthy controls (13 males, mean age: 40.2+/-5.1 years), and the two groups were matched by age and gender. No subject in either group had a history of atherosclerosis or its complications. The clinical data, including the age of onset, the duration of disease, a history of medication, the activity score and the laboratory data were analyzed. RESULTS: The carotid IMT in the BD group was significantly higher than that in the control group (0.71+/-0.22 mm vs. 0.59+/-0.09 mm, respectively, p<0.01). Cardiac and major vessel involvements were not identified in the BD group. However, minor vascular involvements were documented in 2 patients with deep vein thrombosis, in 4 patients with superficial thrombophlebitis and in 2 patients with pseudoaneurysm. The carotid IMT in the patients with posterior uveitis or retinal vasculitis was higher than that of the patients without these findings (0.85+/-0.21 mm vs. 0.64+/-0.10 mm, respectively, p=0.007), but there was no difference of the IMT according to minor vascular involvement. CONCLUSIONS: Despite that there was no significant cardiovascular involvement in the BD patients, the carotid IMT was significantly higher in the BD patients as compared with the healthy controls.
Adult ; Behcet Syndrome/complications/diagnosis/*pathology ; Carotid Arteries/*pathology/ultrasonography ; Case-Control Studies ; Endothelium, Vascular/pathology ; Female ; Humans ; Male ; Prognosis ; Prospective Studies ; Risk Factors ; Tunica Intima/*pathology/ultrasonography ; Tunica Media/*pathology/ultrasonography ; Ultrasonography, Doppler ; Vasculitis/pathology

BACKGROUND: Obesity is one of the major risk factors for coronary artery disease. However, the long-term clinical effects of obesity after percutaneus coronary intervention (PCI) in Korean patients with acute myocardial infarction (AMI) have not been sufficiently evaluated. METHODS: A total of 309 patients (mean age 60.5+/-11.3 years, M:F=243:66) that underwent PCI with a diagnosis of AMI between February 2002 and June 2006. Thepatients were divided into two groups according to the body mass index (BMI): group I (n=194; BMI <25 kg/m2; mean age 61.7+/-11.1 years, M:F=151:43) and group II (n=115; BMI> or =25 kg/m2, mean age 58.2+/-11.3 years, M:F=92:23). Clinical characteristics and risk factors, and major adverse cardiac events during a six-month follow-up were compared between patients in the two gropus. RESULTS: The mean age of group I patients was older than that of group II patients (61.7+/-11.1 years vs. 58.6+/-11.5 years, p=0.017). The prevalence of hypertension was higher in group II patients (75/194, 38.7% vs.59/115, 51.3%, p=0.033) and hyperlipidemia was more prevalent in group II patients (75/194, 38.7% vs. 60/115, 52.2%, p=0.024). The levels of total cholesterol (184.3+/-39.9 mg/dL vs. 201.4+/-42.6 mg/dL, p=0.001), triglycerides (121.2+/-61.6 mg/dL vs. 147.1+/-96.2 mg/dL, p=0.005), low-density lipoprotein-cholesterol (120.3+/-35.1 mg/dL vs. 134.1+/-37.8 mg/dL, p=0.002) were lower in group I patients than in group II patients. The restenosis rate on a follow-up coronary angiogram was higher in group II patients (18/69, 26.1%) than in group I patients (14/109, 12.8%, p=0.025). CONCLUSIONS: Obesity is associated with hyperlipidemia and hypertension in patients with AMI. The restenosis rate after PCI was higher in obese AMI patients.
Body Mass Index* ; Cholesterol ; Coronary Artery Disease ; Diagnosis ; Follow-Up Studies ; Humans ; Hyperlipidemias ; Hypertension ; Myocardial Infarction* ; Obesity ; Percutaneous Coronary Intervention* ; Prevalence ; Prognosis ; Risk Factors ; Triglycerides