Sodium intake reduction has been emphasized because sodium adversely impacts health, especially blood pressure (BP), and the cardiovascular (CV) disease risk. However, data obtained from several cohort studies have raised questions regarding the effects of high sodium intake on BP and the CV disease risk. In the present study, we systematically reviewed the literature to evaluate these associations. Studies showing negative associations between urine sodium and BP and CV outcomes relied on estimated 24-hour urine sodium from spot urine that is inappropriate for determining sodium intake at an individual level. Furthermore, controversy about the association between 24-hour urine sodium and BP may have been caused by different characteristics of study populations, such as age distribution, ethnicity, potassium intake and the inclusion of patients with hypertension, the different statistical methods and BP measurement methods. Regarding the association between sodium intake and the CV disease risk, studies showing negative or J- or U-shaped associations used a single baseline measurement of 24-hour urine sodium in their analyses. However, recent studies that employed average of subsequently measured 24-hour urine sodium showed positive, linear associations between sodium intake and CV outcomes, indicating that controversies are caused by the different sodium intake measurement methods and analytic designs. In conclusion, the study shows that positive associations exist between sodium intake and BP, CV outcomes, and mortality, and that the argument that reducing sodium intake is dangerous is invalid. Sodium intake reduction should be recommended to all, and not limited to patients with hypertension or CV disease.

No abstract available.
Arteriovenous Malformations* ; Uterus*

No abstract available.
Arteriovenous Malformations* ; Uterus*

No abstract available.
Drug Therapy* ; Uterine Cervical Neoplasms*

Purpose: : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome.Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann–Whitney U-test. Results: : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m2 (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p＜ .001, p= .008). The APHCHE Ⅳ was also higher in the NRHG (p＜ .001). RH occurred 25.49 (7.28–52.96) hours after TTM completion, lasting for 2 (1–3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p= .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.

BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

BACKGROUND/AIMS: It is recommended that duodenal ulcer patients who are infected with H. pylori should be treated with eradication therapy, whether the ulcer is active or in remission. However, there has been no report on the effect of eradication treatment in patients with incidentally found S-2 stage duodenal ulcer scar. METHODS: We prospectively enrolled 80 H. pylori-positive patients with S-2 stage duodenal ulcer scar who have no past history of ulcer treatment. Treatment group received triple therapy consisted of omeprazole, amoxicillin, and clarithromycin for 2 weeks, whereas control group received no treatment. The follow-up endoscopy was performed every 1 year and when the patients have symptoms of ulcer disease. Fifty-three patients were followed up for more than 1 year. RESULTS: The eradication rate of the treatment group was 92.9%. During the follow-up period of 14.7 months, 20% (5/25) of patients in the control group (2 gastric ulcers and 3 duodenal ulcers) and 3.6% (1/28) of patients in the treatment group (1 duodenal ulcer) developed active or healing stage peptic ulcers (p=0.089). CONCLUSIONS: Our results suggest that H. pylori eradication may he effective in preventing peptic ulcers in patients with S-2 stage duodenal ulcer scar.
Amoxicillin ; Cicatrix* ; Clarithromycin ; Duodenal Ulcer* ; Endoscopy ; Follow-Up Studies ; Helicobacter pylori* ; Helicobacter* ; Humans ; Omeprazole ; Peptic Ulcer ; Prospective Studies ; Stomach Ulcer ; Ulcer

BACKGROUND/AIMS: The Rockall risk assessment score was developed to predict the risk of rebleeding and death in patients with upper GI hemorrhage. The validity of this score, however, was not established in Korea. We tried to assess the reliability of the Rockall score to predict outcomes in patients with bleeding peptic ulcer. METHODS: Medical records of 175 patients with benign peptic ulcer bleeding treated in Samsung Medical Center from January 2000 to May 2003 were retrospectively analyzed. They were classified into three groups: no rebleeding rebleeding, and death and mean Rockall score was compared. Forrest classification was also compared with the Rockall score regarding the clinical usefulness of predicting poor outcomes in patients with bleeding peptic ulcer. RESUTLS: One hundred forty five patients did not show rebleeding, with mean Rockall score of 3.5 (SD=1.5). On the other hand, rebleeding occurred in 25 patients and the mean score was 6.4 (SD=1.44). There were 13 deaths with mean score of 7.0 (SD=1.08). The differences between the three groups were significant (p<0.001). In multivariate analysis, Rockall score was a independent risk factor of rebleeding and mortality (odds ratio, OR=2.73 and OR=8.74). CONCLUSIONS: The Rockall scoring system is useful to predict poor outcome such as rebleeding and death in patients with bleeding peptic ulcer.
Comparative Study ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/*classification/mortality/therapy ; Recurrence ; Risk Factors ; Survival Rate

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) is frequently performed for the treatment of gastric adenoma or early gastric cancer. These lesions are commonly associated with atrophic gastritis and synchronous lesions are not uncommon. The aim of this study was to evaluate the usefulness of chromoendoscopy with indigocarmine in detecting additional lesions patients referred for EMR. METHODS: Chromoendoscopy was performed in 51 patients (M : F=41 : 10, mean age= 60 year). After a careful examination, the stomach was stained with a 30 mL of indigocarmine (0.2%) with a spraying catheter. The changes in size of the lesions and the possibility of finding additional lesions were compared between before and after spraying dye. RESULTS: Before dye-spraying, six additional lesions were found. On the other hand, before the chromoendoscopy with indigocarmine. And among these, microscopic examination confirmed the presence of adenomas for additional three lesions. After spraying indigocarmine, eight additional lesions were found suspicious for adenoma, after the dye spraying. However, there was no neoplastic lesions histopathologically. With dye-spraying, the lesions looked bigger in four cases. And the three lesions among them showed similar size compared to the patholgic report. CONCLUSIONS: A conventional gastroscopic examination was enough to find additional adenoma or cancer, whereas chromoendoscopy was not so helpful in detecting additional lesions. In addition, because indigocarmine dye-spraying could outline mucosal elevations, chromoendoscopy was benefical in accurately measuring the size of the lesion.
Adenoma* ; Catheters ; Gastritis, Atrophic ; Hand ; Humans ; Stomach ; Stomach Neoplasms

A 34-year-old female underwent emergency cesarean section with general anesthesia. The patient was a para 1-0-0-1, referred at 39 weeks in labor with known severe aortic stenosis due to a bicuspid aortic valve. She has been treated with digoxin and furosemide for 5 years. At first, she tried a normal spontaneous vaginal delivery, but dyspnea was aggravated during delivery, so an emergency operation was decided. Anesthesia was induced using ketamine 80 mg, fentanyl 50 microgram and vecuronium 6 mg and maintained with 50% nitrous oxide in oxygen. After fetal delivery and infusion of oxytocin, the systolic blood pressure decreased to 60 mmHg or less, so we injected phenylephrine 100 microgram bolus. However, the blood pressure did not increase, so we injected phenylephrine continuously ( 0.5 microgram/kg/ min). One month postpartum, echocardiography was done. The left ventricle-aortic pressure gradient was 140 mmHg, so the cardiologist recommended an aortic valve replacement operation. She refused the operation and has been medicated with digoxin and furosemide up to date.
Adult ; Anesthesia ; Anesthesia, General* ; Aortic Valve ; Aortic Valve Stenosis* ; Bicuspid ; Blood Pressure ; Cesarean Section* ; Digoxin ; Dyspnea ; Echocardiography ; Emergencies* ; Female ; Fentanyl ; Furosemide ; Humans ; Ketamine ; Nitrous Oxide ; Oxygen ; Oxytocin ; Phenylephrine ; Postpartum Period ; Pregnancy ; Vecuronium Bromide