BACKGROUND: Urography(IVU) is considered the best first investigation in patient with suspected urinary calculi, but recently ultrasonography(USG), combined with a plain film of the abdomen, has been suggested as an alternative. METHODS: We undertaken study to see if this approch can be used in emergency patients and outpatients by radiologists with different amounts of ultrasound experence. Some 192 patients with suspected urinary colic presenting to Koo Hospital Emergency Department and Youngnam Universith Hospital outward Department(IM, URO, FM) over 12-month period were studied. They had a plain abdominal film(KUB) and USG examination of the kidney, ureter, bladder following hydration and subsequently underwent IVU. Of these, 22 patients passed a stone before their IVU. The data analysis was performed on the remaining 170 patients. Urography was used as the gold standard. RESULTS: Some 170 patients subsequently underwent IVU at a mean interval of 1.8 days after the ultrasound examination. In 91 of 170 patients the IVU was positive. In 97 of 170 patients the combination of JUB plus USG was positive, leaving three false negative KUB plus USG. Thus the sensitivity of KUB plus USG was 97%, specificity was 89%, positive predictive value was 91%, and negative predictive value was 96%. CONCLUSIONS: Our findings in this study suggest that in the hydrated patient the combination of KUB plus US is a very sensitive and relative specific screening test. Because of the high negative predictive value of KUB plus US, urography is not likely to be helpful when KUB plus US are negative. Urography is indicated only if KUB plus US findings are equivocal or if intervention is necessa.ry.
Abdomen ; Colic ; Emergencies ; Emergency Service, Hospital ; Humans ; Kidney ; Mass Screening ; Outpatients ; Sensitivity and Specificity ; Statistics as Topic ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urography*

PURPOSE: The purpose of this study was to provide a basis for non-humidified low flow oxygen by nasal cannula and to provide a guide for consistent care in nursing practice. METHODS: A methodological study on the development of guidelines with experts' opinions on collected items, framing PICO questions, evaluating and synthesizing texts which were searched with the key words (low flow oxygen, nasal cannula, humidification of oxygen, guideline) from web search engines. RESULTS: Of the 45 researched texts on the web, 9 texts relevant to the theme were synthesized and evaluated. All patients with humidified or non-humidified oxygen therapy reported that they had no discomfort. CONCLUSION: The results indicate that there are no tangible grounds for patients' perceived differences between the humidified and non-humidified oxygen under 4L/min supplied by nasal cannula. with oxygen. Therefore, non-humidification oxygen therapy is strongly advised when suppling under 4L/min oxygen by nasal cannula (recommended grade A).
Catheters ; Humans ; Oxygen

BACKGROUND: Pericardiocentesis is not routinely recommended in most patients with pericardial effusion (PE), except for patients with cardiac tamponade. However, the long-term follow-up results in patients with clinically not significant PE are few. METHODS: Sixty-five consecutive patients (mean age:57 yrs, 26 males) out of 87 patients with PE, who were clinically not serious, were studied prospectively once in every two month for mean 6 months (2-12 months) without any specific treatment. The amount of PE was measured at the enddiastole period of parasternal long axis view and apical four chamber view. RESULTS: The incidence of insignificant PE in our echocardiographic laboratory is 3.4% (n=87 from 2461). The maximal accumulation site of PE was posterior (n=51, 79%). The next is anterior (n=11, 17%) and right ventricular side (3, 5%). The amount of PE is less (0.37+/-0.17cm vs 0.64+/-0.54cm, p=0.018) in localized PE (n=24, 37%) than that of diffuse form (n=41, 63%), which spreads to more than 2 chambers. The presumptive etiologies of PE were unknown (n=41), heart failure (n=5), myocardial infarction (n=6), viral (n=3), and others (n=10). The amount of PE was decreased from 0.54+/-0.46 cm to 0.30+/-0.26 cm, 0.23+/-0.24 cm, and 0.21+/-0.23 cm 2, 4, and 6 months after intial evaluation, respectively, without any complication. CONCLUSION: The patients with PE, not combining >KERN= Axis, Cervical Vertebra ; Cardiac Tamponade ; Echocardiography ; Follow-Up Studies* ; Heart Failure ; Humans ; Incidence ; Myocardial Infarction ; Pericardial Effusion* ; Pericardiocentesis ; Prospective Studies

Subclavian vein cannulation as a central venous route is a simple and rapid beside procedure and most reliable method. The supraclavicular approach to the subclavian vein depended on a fixed entry point and accurate angulation of the needle and is particularly free from infection and phlebitis although catheters have been left in situ for long-term period. Tension pneumothorax is a complication of subclavian vein cannulation. The incidence of pneumothorax in patients with chronic obstructive pulmonary disease(COPD) is higher than in the general population and can result in serious respiratory compromise. Because pneumothorax is a serious complication in COPD, its presence must be anticipated so that close and prompt treatment, including immediate re-expansion of the lung, is offered. Authors presented one case that the patient with COPD developed tension pneumothorax in right side lung resulting from inadvertent lung injury during supraclavicular subclavian vein cannulation under general anesthesia and on trendelenberg position. The patient was treated with immediate thoraeostomy and recovered uneventfully.
Anesthesia, General ; Catheterization* ; Catheters ; Humans ; Incidence ; Lung ; Lung Diseases, Obstructive ; Lung Injury ; Needles ; Phlebitis ; Pneumothorax* ; Pulmonary Disease, Chronic Obstructive* ; Subclavian Vein* ; Veins

Heorrhage and infarct-like necrosis of anterior lobe of the pituitary gland is one of the characteristic pathologic findings of the autopsied cases of Korean Hemorrhagic Fever (KHF) patients, but there has been rare reports of hypopituitarism in patients with KHF. Recently we have experienced a patient with hyponatremia who had recovered from KHF. He was admitted to our hospital due to nausea, vomiting, and epigastric discornfort. To determine the function of the anterior pituitary gland, hormonal levels of target galnds and pituitary gland were measured, and combined pituitary stimulation test was performed. ACTH, GH, and prolactin deficiency were confirmed by combined pituitary stimulation test in this patient. There was no evidence of hypothalamic or other pituitary diseases by brain MRI. Our experience shows that KHF can be a cause of hypopituitarism and these findings should alert physicians the possibility of hypopituitarisrn in patients who had recovered from KHF.
Adrenocorticotropic Hormone ; Brain ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hyponatremia ; Hypopituitarism* ; Magnetic Resonance Imaging ; Nausea ; Necrosis ; Pituitary Diseases ; Pituitary Gland ; Pituitary Gland, Anterior ; Prolactin ; Vomiting

PURPOSE: The purpose of this study was to examine the association of multiple addiction risks with life satisfaction, depression, and suicidal ideation in Korean adults. METHODS: This study was descriptive correlational. Data were collected in 800 adults (405 males, 395 females) aged 20 to 69 years recruited using the proportional allocation in a city on April 2017. The structured questionnaire consisted of the Alcohol Use Disorders Identification Test, the Internet Addiction Proneness Scale for adults, the Problem Gambling Severity Index, the Drug Screening Inventory, the Korean version of the Satisfaction with the Life Scale, the Patient Health Questionnaire-9, and the Scale for Suicidal Ideation. RESULTS: Adults with multiple addiction risks had a low level of life satisfaction (p=.003) and high levels of depression and suicidal ideation (p<.001) compared to other participants. Multiple addiction risks were associated with low life satisfaction (β=.12), high depression (β=.21), and suicidal ideation (β=.20). Significant factors of life satisfaction were low suicidal ideation, a simple functioning job, high level of education, and unemployment status. CONCLUSION: Multiple addiction risks are associated with life satisfaction, depression, and suicidal ideation. The comprehensive mental health assessment for multiple addictions should precede the development of preventive multidimensional interventions.
Adult ; Behavior, Addictive ; Depression ; Drug Evaluation, Preclinical ; Education ; Gambling ; Humans ; Internet ; Male ; Mental Health ; Personal Satisfaction ; Suicidal Ideation ; Unemployment

No abstract available.
Ossicular Prosthesis*

PURPOSE: The aim of this study was to estimate the antioxidant activities of 50%, 70%, and 100% ethanol extracts of Lycium barbarum leaf and chlorophyll removal extract. METHODS: The antioxidant activities were estimated by measuring total polyphenol content and by assays of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfate) (ABTS) radical scavenging activities and ferric reducing antioxidant power (FRAP). In addition, reactive oxygen species (ROS) production, DNA fragmentation, and antioxidant enzyme (superoxide dismutase and catalase) activities of the extracts were measured in hydrogen peroxide (H2O2)-stressed HepG2 cells. RESULTS: The total polyphenol content, DPPH and ABTS radical scavenging activities, and FRAP value of the extracts increased in an ethanol concentration-dependent manner. The antioxidant activities of the chlorophyll-removal extracts were much higher than those of the chlorophyll-containing extracts. Cytotoxicity was not observed in HepG2 cells with extracts up to 1,000 µg/mL. All extracts inhibited ROS production in a concentration-dependent manner from 31.3 µg/mL and inhibited DNA damage at 250 µg/mL. The SOD and catalase activities of cell lines treated with the extracts and H2O2 were similar to those of normal cells, indicating a strong protective effect. CONCLUSION: Lycium barbarum leaf extracts had high antioxidant activities and protected H2O2-stressed HepG2 cells. Since the chlorophyll-removal extract exhibited higher antioxidant activities than the chlorophyll-containing ones and the cytoprotective effect was similar, chlorophyll removal extract of Lycium barbarum leaf could be developed as ingredients of functional food and cosmetics.
Catalase ; Cell Line ; Chlorophyll ; DNA Damage ; DNA Fragmentation ; Ethanol ; Functional Food ; Hep G2 Cells ; Hydrogen Peroxide ; Lycium ; Reactive Oxygen Species

OBJECTIVE: Several studies have suggested the efficacy of bupropion and escitalopram on reducing the excessive internet game play. We hypothesized that both bupropion and escitalopram would be effective on reducing the severity of depressive symptoms and internet gaming disorder (IGD) symptoms in patients with both major depressive disorder and IGD. However, the changes in brain connectivity between the default mode network (DMN) and the salience network were different between bupropion and escitalopram due to their different pharmacodynamics. METHODS: This study was designed as a 12-week double blind prospective trial. Thirty patients were recruited for this research (15 bupropion group+15 escitalopram group). To assess the differential functional connectivity (FC) between the hubs of the DMN and the salience network, we selected 12 regions from the automated anatomical labeling in PickAtals software. RESULTS: After drug treatment, the depressive symptoms and IGD symptoms in both groups were improved. Impulsivity and attentional symptoms in the bupropion group were significantly decreased, compared to the escitalopram group. After treatment, FC within only the DMN in escitalopram decreased while FC between DMN and salience network in bupropion group decreased. Bupropion was associated with significantly decreased FC within the salience network and between the salience network and the DMN, compared to escitalopram. CONCLUSION: Bupropion showed greater effects than escitalopram on reducing impulsivity and attentional symptoms. Decreased brain connectivity between the salience network and the DMN appears to be associated with improved excessive IGD symptoms and impulsivity in MDD patients with IGD.
Brain ; Bupropion* ; Citalopram* ; Depression ; Depressive Disorder, Major* ; Humans ; Immunoglobulin D ; Impulsive Behavior ; Internet* ; Magnetic Resonance Imaging ; Prospective Studies ; Video Games

A 41-year-old female complaining of easy fatigue, headache, thickened extremities and deepened facial folds was admitted to the hospital. As early as 6 years ago, she had been told by family members that her voice was changed and both hands was thickened. Cranial plain radiography indicated ballooning of sella turcica. Sella MRI disclosed 2.2cm sized pituitary tumor with suprasellar extension. The pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The postoperative course was uneventful until hyponatremia with sudden headache and respiratory arrest was developed. The case was due to hyponatremic encephalopathy on the basis of the clinical course and symptoms, and 3% hypertonic saline was infused for 12 hours until the hyponatremia was corrected. We have experienced a mortality case of hyponatremic encephalopathy in which surgieal removal of a pituitary tumor from a female acromegalic patient in menstruant period was followed by the sudden occurrence of hyponatremia, which in turn was later associated with marked brain edema.
Adult ; Brain Edema ; Extremities ; Fatigue ; Female ; Hand ; Headache ; Humans ; Hyponatremia ; Magnetic Resonance Imaging ; Mortality ; Pituitary Neoplasms ; Radiography ; Sella Turcica ; Voice