PURPOSE: To identify the key CT features of lung parenchyma over time after cardiopulmonary resuscitation (CPR). MATERIALS AND METHODS: In total, 72 patients underwent CT after CPR. Because the median time from return of spontaneous circulation (ROSC) to CT was 1 h 3 min, we divided patients into two groups: ≤ 1 h (group 1) and > 1 h (group 2), based on the ROSC to CT time. We analyzed and compared various lung parenchymal CT findings between groups. RESULTS: Each group included 36 patients. Using statistical analysis, we identified seven statistically significant imaging features. Gradient (p = 0.010), lobular gradient (p = 0.017), diffuse pattern (p = 0.000), upper distribution (p = 0.032), and peripheral portion sparing (p = 0.000) were more common in group 1 than in group 2. Dependent density (p = 0.010) and lobular consolidation (p = 0.010) were more common in group 2 than in group 1. CONCLUSION The gradient and lobular gradient tended to disappear over time after ROSC. In terms of distribution, a diffuse pattern with upper predominance and peripheral portion sparing tended to disappear over time. However, the dependent density and lobular consolidation tended to increase over time in the lung parenchyma after CPR.

OBJECTIVE: This study was performed to identify associations between the practice of health behaviors and awareness of metabolic syndrome (MetS) among adults aged 19 to 64 years in the Gwangju-Jeonnam area. METHODS: This study utilized data from the 2010 Community Health Survey (CHS). Health behaviors considered in this study were smoking, alcohol drinking, physical activity, low-salt diet, and perception of stress. The index for the health behaviors was calculated as the sum of the practice of each health behavior (range: 0-5). The analysis was weighted with a complex sampling design, and the chi-square test and multiple logistic regression analysis were used to identify the association between the practice of health behaviors and awareness of MetS. RESULTS: A total of 19.8% of the population were aware of MetS. The perception of MetS was statistically significantly associated with healthy behaviors, including nonsmoking (aOR = 1.33, 95% CI = 1.14-1.56), non-high-risk drinking (aOR = 1.54, 95% CI = 1.27-1.88), engagement in physical activity (aOR = 1.48, 95% CI = 1.28-1.72), and a low-salt diet (aOR = 1.30, 95% CI = 1.13-1.51). The ORs of the perception of MetS were significantly higher in patients with a health behavior index of 2 to 3 (aOR = 1.64, 95% CI = 1.01-2.66) and in those with an index of > or =4 (aOR = 2.47, 95% CI = 1.51-4.04) than in those with an index of 0. Among all health behaviors, physical activity had the highest OR for the perception of MetS (aOR = 1.50, 95% CI = 1.29-1.74). CONCLUSIONS: This study revealed associations between health behaviors, especially physical activity, and awareness of MetS. Therefore, integrated health promotion programs may be needed to enhance awareness of MetS and to effectively prevent MetS and non-communicable diseases.
Adult* ; Alcohol Drinking ; Diet, Sodium-Restricted ; Drinking ; Health Behavior* ; Health Promotion ; Health Surveys* ; Humans ; Logistic Models ; Motor Activity ; Smoke ; Smoking

OBJECTIVES: To investigate the rate of first-line eradication and the rate of second-line eradication of Helicobacter pylori (H. pylori) from 2001 to 2010 in a single institute in Seoul. METHODS: Among the 2,717 patients who received H. pylori eradication treatment from 2001 to 2010 at Ewha Womans University Mokdong Hospital, the medical records of 1,466 patients who satisfied the condition of execution of upper gastrointestinal endoscopy, positive H. pylori eradication results at 6~8 weeks after eradication therapy were reviewed retrospectively. Then the first-line and second-line eradication rates and the eradication rates according to endoscopy findings were also compared. RESULTS: The first-line eradication rate was 77% H. pylori eradication rate for the last 5 years was continuously increasing and no sign of decline was observed even for the whole 10 years. The rates of eradication related to endoscopic findings showed statistical significance (P<0.001) of 79.8% and 70.1% each for peptic ulcer and non-ulcerative gastric diseases, respectively. CONCLUSION: In this study, no decrease in tendency of first-line eradication rate could be found. In addition, the patients with the non-ulcerative gastric disease seemed to show significantly lower eradication rate. This finding suggests eradication treatment may be affected by the category of gastric diseases, and careful considerations should be taken assessing the effects and needs for the H. pylori eradication treatment.
Endoscopy ; Endoscopy, Gastrointestinal ; Female ; Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Peptic Ulcer ; Retrospective Studies ; Seoul* ; Stomach Diseases

Antiphospholipid antibody syndrome (APS) is characterized by raised levels of antiphospholipid antibodies (aPL), in association with thrombosis, recurrent fetal loss, and thrombocytopenia. Development of APS is related with idiopathic origin, autoimmune disease, malignancy and, on rare occasions, infection. However, in secondary APS combined with bacterial infections, aPL is usually shown with low titer and rarely associated with thrombotic events. A 52-year-old male was admitted due to pneumonia and multiple hepatosplenic abscesses. He had been treated with proper antibiotics, but he presented ascites and sudden variceal bleeding because of portal vein thrombosis. The bleeding was controlled by endoscopic variceal ligation. Acute portal vein thrombosis was successfully managed by low molecular weight heparin and hepatosplenic abscesses were completely resolved by antibiotics. This case suggests that systemic bacterial infection in immunocompetent patients possibly develops into secondary APS.
Abscess ; Anti-Bacterial Agents ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Ascites ; Bacterial Infections* ; Esophageal and Gastric Varices* ; Gastrointestinal Hemorrhage* ; Heparin, Low-Molecular-Weight ; Humans ; Ligation ; Male ; Middle Aged ; Pneumonia ; Portal Vein ; Thrombocytopenia ; Venous Thrombosis

PURPOSE: To compare the evaluation results of faculties to those of Standardized Patients (SP) participating in a Clinical Performance Examination (CPX) administered at Ewha Womans University College of Medicine. METHODS: The CPX was taken by 77 fourth year medical students. Cases and checklist were developed by the medical school consortium in capital area. Six cases were used and 24 SPs participated and evaluated the students' performances. The whole session was recorded on videotapes so that 6 medical school faculties could analyze and evaluate the students' performances as well. The results were compared and analyzed by SPSS package. RESULTS: The agreement between the faculties and the SPs was relatively good (r=0.79), but not good enough. In every case, SPs gave higher marks than did the faculties. Clear disease entity cases like "hepatitis" and "anemia" showed better agreement than obscure clinical contexts such as "bad news delivery". Better agreement was seen in the items of physical exam category (r=0.91), but the agreement was very poor in the items of doctor-patient (Dr-Pt) relationship category (r=0.54). The construction of checklist and the character of each evaluation item should influence the differences. CONCLUSION: More detailed guidelines and clear/specific evaluating items are necessary to improve the agreement rate. In certain categories like physical exam and brief history taking, the SP' s evaluation can replace the faculties', but for complex contexts like Dr-Pt relationship.
Checklist ; Female ; Humans ; Schools, Medical ; Students, Medical ; Videotape Recording

PURPOSE: We evaluated the diagnostic value of susceptibility-weighted imaging (SWI) for the detection of developmental venous anomaly (DVA). MATERIALS AND METHODS: Retrospective review of 1068 brain MR examinations found 28 DVAs in 28 patients (2.6%) on contrast-enhanced T1-weighted images. SWI, T2, and FLAIR images of 28 patients with DVA and 28 sex- and age-matched control patients without DVA were analyzed by blinded readers on each type of sequences. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. In cases of discrepancy, two reviewers reached a consensus later. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each MR sequence for the detection of DVA were determined. Statistical analysis was performed by using the Mcnemar test. The significance level was p < 0.05. RESULTS: The sensitivity, specificity, PPV, and NPV of SWI for the detection of DVA were 85.7%, 92.9%, 92.3%, and 86.7%, respectively. T2 and FLAIR images showed sensitivity of 35.7% and 35.7%, specificity of 92.9% and 96.4%, PPV of 83.3% and 90.9%, and NPV of 59.1% and 60.0%, respectively. On SWI, the sensitivity and NPV for the detection of DVAs were significantly higher than those of T2 and FLAIR images (p < 0.05). CONCLUSION: SWI was sensitive and specific for the detection of DVA.
Brain ; Consensus ; Humans ; Magnetic Resonance Imaging* ; Retrospective Studies ; Sensitivity and Specificity

Cooperation of the patients in orthodontic treatment is an essential element. This study examines the internal and external restriction factors and level of cooperation for orthodontic treatment of adolescent orthodontic treatment patients, and the factors that impart influence on the level of cooperation for orthodontic treatment. ‘Form for students’ among the indices of internal and external restrictions for orthodontics, which is an adaption of ‘Orthodontic Locus of Control Scale’ was used as survey tool, and ‘Reliability and Stability of the Orthodontic Patient Cooperation Scale’ was used as survey tool for the level of cooperation of orthodontic patients. As the result of examination of the effect of internal and external restriction factors on level of cooperation for orthodontic treatment by compensating the general characteristics in the multiple regression analysis, it was found that the level of cooperation for orthodontic treatment is higher for the patients who believe there is strong influence of external restrictions–patents–on the events that determines orthodontic treatment. In order to enhance the level of cooperation for orthodontic treatment of adolescent orthodontic patients, there is a need to assess the relationship between the patient and parents as well as the attitude or psychological state of the patients on orthodontic treatment.
Adolescent* ; Humans ; Internal-External Control ; Orthodontics ; Parents ; Patient Compliance

Background: The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. Methods: In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin. Results: Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222–1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225–1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050–2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075–2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke. Conclusion This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients.

Background: The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes. Methods: In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin. Results: Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222–1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225–1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050–2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075–2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke. Conclusion This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients.

The efficacy and safety of endovascular treatment (EVT) for moyamoya disease (MMD) have rarely been investigated. The objective of this study was to summarize the clinical outcomes of EVT for MMD and determine the potential role of EVT in treating symptomatic steno-occlusive lesions in MMD. Reports from January 2000 to December 2021 describing EVT in MMD were collected through a literature search. The search terms included “moyamoya”, “stent”, “angioplasty”, and “endovascular”. Data regarding baseline demographics, previous medical history, treated vessel, periprocedural complications, and angiographical recurrence were retrieved. This review included 10 studies with details of 19 patients undergoing a total of 31 EVT procedures. Twenty-one EVTs were performed as initial treatments for MMD, and 10 were performed as additional treatments for angiographical recurrence. The mean follow-up period of the initial EVTs was 9.0±11.9 months, with angiographical recurrence in 11 (68.8%) cases. The mean follow-up period of additional EVTs was 4.3±3.9 months, and seven (70.0%) EVTs showed restenosis of the re-treated vessel. Across all initial and additional EVTs, there were no differences in characteristics between the recurrence and non-recurrence groups. Overall, two periprocedural complications (9.5%) occurred, one vessel rupture and one massive intracerebral hemorrhage with subarachnoid hemorrhage. EVT plays a limited role in the management of symptomatic intracranial arterial steno-occlusive lesions of MMD. Recent advances in understanding the pathomechanism of MMD may urge neuro-interventionists to find a new endovascular approach with better balloon angioplasty or stenting mechanisms.