Atrial fibrillation (AF) is responsible for 10–20% of cerebral infarctions. Several mobile devices have been developed to screen for AF and studies of AF screening have been conducted in several countries to evaluate the applicability of these mobile devices. In this tradition, we conducted a community-based AF screening using an automated single-lead electrocardiogram (SL-ECG). This survey examined 2,422 participants in a community dementia screening program who were aged 60 years or older in the preliminary study, and 5,366 participants at 9 Senior Welfare Centers aged 60 years or older in the expanded study. AF screening was conducted using an automated SL-ECG (Kardia Mobile, AliveCor, Mountain View, CA, USA). AF was confirmed with a 12-lead electrocardiogram in subjects classified as having AF on the SL-ECG. In the preliminary study, of the 2,422 subjects, 124 had AF on the SL-ECG. The prevalence of AF was 3.0% (95% confidence interval [CI]: 2.4–3.8). The positive predictive value (PPV) of SL-ECG was 58.9% (95% CI: 50.1–67.1). Of the subjects diagnosed with AF, 65.8% (95% CI: 54.3–75.6) were newly diagnosed. In an expanded study, of the 5,366 subjects, 289 had AF on SL-ECG. The prevalence was 2.6% (95% CI: 2.2–3.1) and PPV of SL-ECG was 48.8% (95% CI: 43.1–54.5). In this community-based AF screening, we found that AF is underdiagnosed and undertreated. These results suggest that the early detection of AF using mobile devices is needed in Korea.

BACKGROUND/AIMS: Several recent studies have reported that the early use of infliximab (IFX) improves the prognosis of Crohn's disease (CD). However, no data are available from Asian populations, as the forementioned studies have all been conducted in Western countries. The aim of the current study was to evaluate the impact of early use of IFX on the prognosis of Korean patients with CD. METHODS: Patients with a diagnosis of CD established between July 1987 and January 2012 were investigated in 12 university hospitals in Korea. Because insurance coverage for IFX treatment began in August 2005, patients were assigned to either of 2 groups based on diagnosis date. The first group included patients diagnosed from July 1987 to December 2005, and the second from January 2006 to January 2012. We compared the cumulative probabilities of operation and reoperation between the two groups using the Kaplan-Meier method and a log-rank test. RESULTS: Of the 721 patients investigated, 443 (61.4%) comprized the second group. Although the cumulative probabilities of immunosuppressant (P<0.001) and IFX use (P<0.001) after diagnosis were significantly higher in the second group, there were no significant differences in cumulative probabilities of operation (P=0.905) or reoperation (P=0.418) between two groups. CONCLUSIONS: The early use of IFX did not reduce CD-related surgery requirements in Korean patients with CD. These study results suggest that the early use of IFX may have little impact on the clinical outcome of CD in Korean patients in the setting of a conventional step-up algorithm.
Asian Continental Ancestry Group ; Crohn Disease* ; Diagnosis ; Hospitals, University ; Humans ; Infliximab ; Insurance Coverage ; Korea ; Prognosis ; Reoperation

There are still many limitations on fabricating dentures using digital method while computerized production of fixed prostheses utilizing intraoral scanner and CAD/CAM technology has propagated rapidly. Recently the digital solution of fabricating removable partial denture by applying haptic input device, electronic surveying, and rapid prototyping was introduced. In this case presentation, five patients were treated with surveyed crown and removable partial dentures by this digital solution. Fit of dentures was excellent except for one case which showed morphological difference between the actual teeth and that of master cast by the erroneous impression process. There also was not any problem of stability and retention after adaptation in the clinical setting.
Crowns ; Denture, Partial, Removable ; Dentures ; Electronics ; Electrons ; Humans ; Prostheses and Implants ; Retention (Psychology) ; Tooth

We successfully rescued a patient whose coronary artery perforated following implantation of a drug-eluting stent (DES), by deploying a stent-graft in symptomatic myocardial bridging. Our case demonstrated that coronary perforation could be handled without difficulty when perforated myocardial bridging is confined to the interventricular groove
Angioplasty, Balloon, Coronary ; Coronary Vessels ; Drug-Eluting Stents ; Humans ; Myocardial Bridging ; Stents

No abstract available.
Coronary Vessels ; Multidetector Computed Tomography ; Sinus of Valsalva

BACKGROUND: It is known that some opioids protect the myocardial tissue from myocardial ischemia-reperfusion (I/R) injury. The aim of this study was to investigate whether remifentanil, at a clinically relevant concentration that's during the peri-ischemic period, has a protective effect against a regional I/R injury in an in vivo rat heart model. METHODS: Rats were subjected to 25 minutes of coronary artery occlusion and this was followed by 24 hours of reperfusion. A microcatheter was advanced into the left ventricle and the hemodynamic function was evaluated after 24 hours of reperfusion. The infarct size was determined by triphenyltetrazolium staining. The serum level of cardiac troponin-I (cTnI) was determined by ELISA (enzyme-linked immunosorbent assay). RESULTS: Remifentanil administration during the peri-ischemic period didn't show any identifiable protective effects for the hemodynamic function or to reduce the infarct size. In the control group, the peak rate of the ventricular pressure increase (+dP/dt(max)) (P < 0.05) and the peak rate of the intraventricular pressure decline (-dP/dt(max) P < 0.05) were significantly decreased as compared to those values for the sham group. In the remifentanil group, the +dP/dt(max) and -dP/dt(max) were not improved compared to those values of the control group. The infarct size was 45.6% of the area at risk in the control group, and the infarct size was reduced by administration of remifentanil to 43.2% in the remifentanil group. The I/R-induced serum level of cTn-I was not reduced by remifentanil infusion during the peri-ischemic period. CONCLUSIONS: Remifentanil, at a clinically relevant concentration that's infused during the peri-ischemic period, has no myocardial protective effect after regional myocardial I/R injury in an in vivo rat heart model.
Analgesics, Opioid ; Animals ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Heart ; Heart Ventricles ; Hemodynamics ; Piperidines ; Rats ; Reperfusion ; Reperfusion Injury ; Salicylamides ; Tetrazolium Salts ; Troponin I ; Ventricular Pressure

BACKGROUND: It is important to assess the level of consciousness in patients with brain injuries to determine modes of treatment and prognosis. We evaluated the Bispectral Index (BIS) to determine if it could be used as an objective tool for evaluation of the level of consciousness in brain-injured patients. We also compared the BIS values to clinical sedation scales such as the Glasgow Coma Scale (GCS), Richmond Agitation-Sedation Scale (RASS), and the Reaction Level Scale (RLS). METHODS: Thirty eight patients with brain injuries that were admitted to the neurosurgery intensive care unit (NSICU) were enrolled in this study. An investigator evaluated the clinical sedation scales (GCS, RASS, RLS), while a blind observer noted the BIS in the same patient. The BIS score was obtained three times at an interval of 5 hours. The BISs were measured for 1 minute at 5 min prior to the nursing assessment, during the nursing assessment, and at 5 min after the nursing assessment. The BISs used in the data analysis were the maximal, minimal, and mean values obtained during 1 min, which were defined as BISmax, BISmin, and BISmean. A Spearman's rank correlation coefficient was used to determine if the clinical sedation scales were correlated with the BIS scores. RESULTS: In 38 patients, the BISmax, BISmin, and BISmean were found to be significantly correlated with the GCS, RASS, and RLS. The BISmean had the highest correlation with GCS (r = 0.445, P < 0.01), while the BIS min had the lowest correlation with RLS (r = -0.278, P < 0.01). CONCLUSIONS: The results of BIS monitoring were found to be significantly correlated with sedation scales in patients with brain injuries. These findings suggest that BIS can be used as an objective and continuous method for assessment of the level of consciousness in patients with brain injury.
Brain ; Brain Injuries ; Consciousness ; Consciousness Monitors ; Glasgow Coma Scale ; Humans ; Intensive Care Units ; Neurosurgery ; Nursing Assessment ; Prognosis ; Research Personnel ; Statistics as Topic ; Weights and Measures

The prevalence of colorectal cancer is increasing now in Korea and the principal strategy of its management is early detection and surgical resection. Current discussion of the topic of colorectal polyps and cancer is largely based on the concept of the adenoma-carcinoma sequence, which is thought to be the most probable pathogenesis for colorectal cancer. But the case reports about colonic adenocarcinoma arising from adenoma in clinical practice between short interval are rare in Korea. We experienced two cases of colon cancer, which were transformed from small adenoma can not be removed because of patients' refusal, 3 years ago. So we present these cases with a review of relevant literatures.
Adenocarcinoma* ; Adenoma* ; Colon* ; Colonic Neoplasms ; Colorectal Neoplasms ; Disulfiram ; Korea ; Polyps ; Prevalence