No abstract available.
Borrelia burgdorferi* ; Borrelia* ; Humans ; Korea*

The beneficial effect of morphine in pulmonary edema and congstive heart failure is probably due to a variety of factors, venous pooling of blood, rise in pulmonary arteriorlar resistance protecting the alveoli against plasma transudation, decreased ventilation without dyspnea, sedative effect and reduction of left ventricular work. Some reports suggested that the effects of morphine on the central nervous system may also be important. Nine partients with mitral vavular disease were given 0.1mg/kg morphine after diagnostic heart catheterization. Some, but statistically insignificant, fall in the aortic blood pressure and the systemic vascular resistance, and some, but again statistically insignificant, rise in pulmonary vascular resisstance were observed 10 minutes after the injection of morphine in most of the nine patients. The effects on cardiac output, heart rate, mean pulmonary artery pressure and pulmonary capillary wedge pressure were also within the ranges of statistical insignificance. All nine patients tolerated the intravenous injection of morphine without any ill effects.

Percutaneous radial artery cannulation has become a common technique for continuous monitoring of arterial blood pressure and serial sampling fo arterial blood in critically ill patients and hypotensive anesthesia. Although the method is generally safe and simple it frequently results in temporary radial artery occlusion, which is usually asymptomatic and resolves spontaneously. But occationally which the ulnar arterial collateral circulation is poor, occlusion of the radial artery can cause ischemia or even frank gangrene of the hand. The influence of cannula size or shape, duration of cannulation, frequency of puncture trial and patient's age on the incidence of vessel occlusion remains controversial. We evaluated radial arterial function utilizeing physical examination and Doppler flow measurement in fourty-seven patients following percutaneous cannulation. Arterial occlusion occured in 12.8% and hematoma in 31.9% of fourty-seven patients. The incidences of occlusion and hematoma were more frequent when the attempted puncture was more than three times and the duraion of cannulation was more than six hours. Hematoma disappeared spontaneously several days after and collateral circulation was good without other vascular complication in all six patients who had arteiral occlusion.
Anesthesia ; Arterial Pressure ; Catheterization* ; Catheters ; Collateral Circulation ; Critical Illness ; Gangrene ; Hand ; Hematoma ; Humans ; Incidence ; Ischemia ; Physical Examination ; Punctures ; Radial Artery*

BACKGROUND AND OBJECTIVES: We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea. METHODS: From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed. RESULTS: The mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011–2012 and 2014–2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011–2012 and 2014–2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%). CONCLUSIONS: Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.
Angina Pectoris ; Angioplasty, Balloon ; Angiotensins ; Blood Platelets ; Coronary Artery Disease ; Delivery of Health Care ; Drug-Eluting Stents ; Hospital Mortality ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Hypertension ; Korea ; Male ; Myocardial Infarction ; National Health Programs ; Peptidyl-Dipeptidase A ; Percutaneous Coronary Intervention ; Stents

BACKGROUND AND OBJECTIVES: We sought to evaluate nationwide trends, characteristics, and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) in Korea. METHODS: From National Health Insurance claims data in Korea, 81,115 patients, who underwent PCI for the first episode of coronary artery disease between 2011 and 2015, were enrolled. Patients were categorized into angina (n=49,288) or acute myocardial infarction (AMI, n=31,887) groups and analyzed. RESULTS: The mean age of patients was 64.4±12.2 years and 56,576 (69.7%) were men. Diabetes, hyperlipidemia, and hypertension were observed in 27,086 (33.4%), 30,675 (37.8%), and 45,389 (56.0%) patients, respectively. There was a 10% increase in the number of patients undergoing PCI for angina between 2011–2012 and 2014–2015 (11,105 vs. 13,261; p=0.021). However, the number of patients undergoing PCI for AMI marginally decreased between 2011–2012 and 2014–2015 (8,068 vs. 7,823; p=0.052). In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. The mean in-hospital and 1-year total medical costs were 8,628,768±4,832,075 and 13,128,158±9,758,753 Korean Won, respectively. In-hospital mortality occurred in 2,094 patients (2.6%). CONCLUSIONS Appropriate healthcare strategies reflecting trends, characteristics, and clinical outcomes of PCI are needed in Korea.

Spinal epidural abscess is one of the rare disease, especially in child. We had experienced a case in 15 months old who was diagnosed by spinal tapping and epidurogram. Total laminectomy of L 1-2 and drainage of the abscess was successfuly performed and he recovered without residual symtoms after operation. A brief review of literatures was made.
Abscess ; Child* ; Drainage ; Epidural Abscess* ; Humans ; Infant ; Laminectomy ; Rare Diseases ; Spinal Puncture

Scrub typhus is an acute, febrile disease of humans that is caused by Orentia Tsutsugamushi. It is transmitted through the bite of chiggers. The spectrum of the clinical severity for scrub typhus ranges from mild to sever e with fatal complication such as meningoencephalitis, pneumonitis, myocarditis. Severe pulmonary involvement e.g. acute respiratory distress syndrome(ARDS) and meningoencephalitis have rarely been obseved since the introduction of specific antibiotic therapy. We experienced a case of scrub typhus manifested with ARDS and meningoencephalitis. The patient was treated with doxycycline, anticonvulsant and mechanical ventilator thrapy.
Doxycycline ; Humans ; Meningoencephalitis* ; Myocarditis ; Pneumonia ; Scrub Typhus* ; Trombiculidae ; Ventilators, Mechanical