Sodium and potassium intake was assessed on the basis of its respective excretion levels in 24 hr urine samples. However, owing to the inconvenience of collection, we evaluated random spot urine for alternative sodium and potassium excretion markers. We included 250 patients who submitted 24 hr- and spot urine for clinical tests. However, 22 patients who showed 24 hr urine creatinine excretion levels <500 mg/day were excluded, because these samples possibly resulted from incomplete urine collection. Moreover, 24 patients were excluded because of their use of diuretics during the urine collection period. We observed significant correlations between 24 hr urine sodium excretion and both the sodium/creatinine (r=0.34, P<0.0001) and the sodium/specific gravity unit (SGU) ratios (r=0.19, P=0.007) in random urine samples. Similarly, 24 hr urine potassium excretion and both the spot urine potassium/creatinine (r=0.47, P<0.0001) and potassium/SGU ratios (r=0.28, P<0.0001) were significantly correlated. Although the estimated sodium/creatinine and potassium/creatinine ratios showed a significant correlation with 24 hr urine sodium and potassium excretion, respectively, further studies are required to develop a spot urine test for individualized monitoring of sodium and potassium excretion.
Biomarkers/urine ; Creatinine/*urine ; Humans ; Hypertension/pathology/urine ; Potassium/*urine ; Sodium/*urine ; Urinalysis ; Urine Specimen Collection

BACKGROUND: Neisseria gonorrhoeae infection remains prevalent, and the emergence of antimicrobial resistance has made the treatment and control of gonorrhea more difficult. Therefore, it is important to compare isolation methods and transport media to overcome gonorrhea via epidemiologic understanding and to determine co-infection rates with other sexually transmitted diseases among primary-care hospitals. In this study, we determine the recovery rate of transferred specimens according to type of transport media and co-infection rate using PCR. METHODS: Genital specimens were collected at three primary-care hospitals from January 2010 to November 2012 using transgrow media and commercial BD transport media. Culture and multiplex PCR were conducted to isolate N. gonorrhoeae. RESULTS: Among 162 specimens, 57 (35.2%) isolates were recovered, and 146 (90.1%) specimens were positive for multiplex PCR. The recovery rate was 29.9% (78/261) using transgrow media and 19.2% (50/261) using BD transport media. The most common co-infected bacteria with N. gonorrhoeae was Chlamydia trachomatis (15.8%), followed by Mycoplasma hominis (6.2%) and M. genitalium (3.4%). CONCLUSION: Under general transport conditions, the rate of recovery of N. gonorrhoeae was as low as 19.2-29.9% depending on the type of transport media, suggesting that molecular diagnostic methods are required to detect the remaining 70% of gonorrhea-infected patients. Co-infection with other sexually transmitted diseases was not rare, and other tests for accurate additional antimicrobial regimens should also be considered.
Bacteria ; Chlamydia trachomatis ; Coinfection* ; Gonorrhea ; Humans ; Multiplex Polymerase Chain Reaction ; Mycoplasma hominis ; Neisseria gonorrhoeae* ; Pathology, Molecular ; Polymerase Chain Reaction ; Prevalence* ; Sexually Transmitted Diseases

PURPOSE: Patients with brain damage suffer from limitations in performing the activities of daily living (ADL) because of their motor function and visual perception impairment. The aim of this study was to help improve the motor function and visual perception ability of patients with brain damage by providing them with virtual reality-based contents. The usability results of the patients and specialists group were also evaluated. METHODS: The ADL contents consisted of living room, kitchen, veranda, and convenience store, similar to a real home environment, and these were organized by a rehabilitation specialist (e.g., neurologist, physiotherapist, and occupational therapist). The contents consisted of tasks, such as turning on the living room lights, organizing the drawers, organizing the kitchen, watering the plants on the veranda, and buying products at convenience stores. To evaluate the usability of the virtual reality-based visual cognitive rehabilitation service, general elderly subjects (n=11), stroke patients (n=7), stroke patients with visual impairment (n=4), and rehabilitation specialists (n=11) were selected. The questionnaires were distributed to the subjects who were using the service, and the subjective satisfaction of individual users was obtained as data. The data were analyzed using SPSS 21.0 software. The general characteristics of the users and the evaluation scores of the experts were analyzed using descriptive statistics. RESULTS: The usability test result of this study showed that the mean value of the questionnaire related to content understanding and difficulty was high, between 4–5 points. CONCLUSION: The virtual reality rehabilitation service of this study is an efficient service that can improve the function, interest, and motivation of stroke patients.
Activities of Daily Living ; Aged ; Brain ; Cognitive Therapy ; Humans ; Motivation ; Physical Therapists ; Rehabilitation ; Specialization ; Stroke ; Vision Disorders ; Visual Perception ; Water

In fully edentulous cases, which are accompanied by severe residual ridge resorption and impairment of supporting tissues of complete dentures, proper diagnosis and systemic treatment planning are required for the improvement in retention, stability, and support of prosthesis. Provisional restoration, while it is unfamiliar in complete denture restoration, can be used as a valuable tool, which makes possible to evaluate the stability of complete dentures and receive feedback from patients in complex clinical situations. In this case, a provisional denture was used to improve stability of impression, polished, and occlusal surfaces of complete denture, and to consider esthetic requirements before final denture construction. The result was clinically satisfactory in terms of functional and esthetical aspects.
Denture, Complete ; Dentures* ; Diagnosis* ; Humans ; Mouth, Edentulous ; Prostheses and Implants

Although rare, intraoperative allergic reaction can lead to significant morbidity and mortality. Clinical diagnosis is difficult as there is a need to differentiate from other causes of perioperative adverse reactions, such as side effects of administered drugs, or patients' medical conditions which may present with bronchospasm or hypotension. Intraoperative allergic reaction may be triggered by various agents. Among those, opioid-induced allergic reaction is scarcely reported. We report a case of a patient who has previously had allergic reaction to meperidine and intraoperatively showed fentanyl induced anaphylaxis or anaphylactoid reaction with literature reviews.
Anaphylaxis ; Bronchial Spasm ; Fentanyl ; Humans ; Hypersensitivity ; Hypotension ; Meperidine

Hematopoietic stem cell transplantation remains the only curative option for myelodysplastic syndrome (MDS), but the prevalence of the disease in elderly people limits broad application of the procedure, particularly in lower risk group. Azacitidine has been recently approved by the U.S. Food and Drug Administration for MDS regardless of subtype on French-American-British classification. Adverse effects of azacitidine include gastrointestinal, hematological and infusion-related reactions. Azacitidine induced hepatotoxicity has been reported mainly in patients with previous hepatobiliary disease, e.g., extensive tumor infiltration in liver, liver cirrhosis and cholelithiasis. We report here a case of azacitidine-induced hepatitis under no predisposition to hepatobiliary disease.
Aged ; Azacitidine ; Cholelithiasis ; Classification ; Hematopoietic Stem Cell Transplantation ; Hepatitis ; Humans ; Liver ; Liver Cirrhosis ; Myelodysplastic Syndromes* ; Prevalence ; United States Food and Drug Administration

Management of Takayasu's arteritis of the left main coronary artery (LMCA) is difficult because of the possibility of restenosis. Clinically significant stenotic lesions must be considered anatomical correlation. Many studies have reported that the management of stenotic lesions of the LMCA with endoluminal stenting and balloon angioplasty and de-novo stenting is safe and effective for patients with Takayasu's arteritis. We report the case of a patient with Takayasu's arteritis of the LMCA. The patient had undergone two consecutive percutaneous coronary interventions because of recurrent restenosis of in-stent lesions, and eventually underwent coronary artery bypass graft (CABG) surgery for myocardial infarction in the same lesion. We suggested treatment with CABG because the pathophysiology of Takayasu's arteritis is different from that of atherosclerotic stenosis.
Angioplasty, Balloon ; Angioplasty, Balloon, Coronary ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Stents ; Takayasu Arteritis ; Transplants

PURPOSE: The dose of drug and the size of instrument are determined based on children's weight. We aimed to validate the finger counting method (FCM) for weight estimation in Korean children using the Monte Carlo simulation. METHODS: We estimated the weight of Korean children aged 1 to 9 years by the FCM. These measurements were compared with the weight extracted by the Monte Carlo simulation applied to the “2007 Korean Children and Adolescents Growth Standard”. Pearson correlation coefficients (r) were measured to assess the correlation between the weight extracted by the simulation and that estimated by FCM. Bland-Altman analyses were performed to assess the agreement between the weight extracted by the simulation and that estimated by FCM and 2 other well-known pediatric weight estimation formulas (the Advanced Pediatric Life Support and Luscombe formulas). RESULTS: Data regarding 9,000 children's weight selected by age and gender was randomly extracted using the simulation. We found a positive correlation between the weight estimated by the FCM and the weight extracted (in boys, r = 0.896, P < 0.001; in girls, r = 0.899, P < 0.001). The FCM tended to underestimate weight in the children aged 7 years or old. CONCLUSION: This article suggests the usefulness of FCM in weight estimation, particularly in children younger than 7 years. With appreciation of the limitation in older children, the FCM could be applied to emergency practice.
Adolescent ; Body Weight ; Child ; Emergencies ; Emergency Service, Hospital ; Female ; Fingers* ; Humans ; Methods* ; Monte Carlo Method ; Resuscitation

Although it is rare, the right atrium can be encroached on by abnormal mediastinal structures, including aortic aneurysms, carcinomas, hepatic cysts and diaphragmatic paralysis. Extrinsic compression of the right atrium causes significant hemodynamic compromise and can lead to fatal outcomes. We describe the case of a 66-year old man with a past history of pulmonary tuberculosis that had undergone right pneumonectomy 40 years previously. He then presented with signs and symptoms of right-sided heart failure. These new signs and symptoms were recognized to be secondary to extrinsic compression of the right atrium, which was due to late-onset postpneumonectomy empyema, and the signs and symptoms were successfully relieved by performing open drainage of the empyema.
Aortic Aneurysm ; Drainage ; Empyema ; Empyema, Pleural ; Fatal Outcome ; Heart ; Heart Atria ; Heart Failure ; Hemodynamics ; Pneumonectomy ; Respiratory Paralysis ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: Invasive coronary angiography remains the gold standard in the diagnosis of coronary artery disease. However, multidetector CT (MDCT) coronary angiography is an emerging technique that is available for the non-invasive detection of coronary artery stenoses. While the diagnostic accuracy of first generation MDCT is limited, recently released 64-slice MDCT has yielded promising results due to increased temporal and spatial resolution. The objective of this study was to investigate the diagnostic accuracy of non-invasive 64-slice MDCT for coronary artery disease. METHODS: One hundred one patients (63 males and 38 females; mean age, 63.7+/-10.5 years) undergoing conventional coronary angiography were included in this study. All coronary arteries, including the distal segments and side branches, were analyzed for the presence of significant stenosis (> or =50% diameter stenosis) and compared with of the quantitative coronary angiographic findings. RESULTS: Of the 1,440 coronary artery segments studied, 1,348 segments were assessed quantitatively by both MDCT and conventional coronary angiography (94%). Two hundred nine significant stenoses were detected by conventional coronary angiography. On a segment-based analysis, the senisitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. On a vessel-based analysis, the sensitivity, specificity, and positive and negative predictive values of 64-slice MDCT were 96, 97, 85, and 99%, respectively. The corresponding values obtained on a patient-based analysis were 100, 94, 97, and 100%, respectively. Coronary calcification was the major cause of false-positive findings. CONCLUSIONS: This study demonstrated that 64-slice MDCT coronary angiography is of similar accuracy as conventional coronary angiography for the detection of coronary artery disease. In selected groups of patients, 64-slice MDCT may replace the more invasive coronary angiography.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Humans ; Male ; Sensitivity and Specificity