No abstract available.
Epinephrine* ; Tonsillectomy*

No abstract available.
Cholesteatoma* ; Otitis Media* ; Otitis* ; Temporal Bone*

BACKGROUND: Circardian variation in the onset of cardiovascular events includig sudden cardiac death, myocardial infarction and ventricular arrhythmias has been discribed. The frequency of ventricular premature complexes has also been reported to demonstrate a pattern consisting of a daytime peak and nightime nadir. We tried to see if the same circardian pattern is found in dilated cardiomyopathy patients. We have also studed how various modifying factors such as left ventricular ejection fration and ACE inhibitor use may affect the circardian pattern. METHOD: 24-hour ambulatory electrocaridiographic monitorings were performed in 50 dilated cardiomyopathy patients and 20 control subjects. Patients were prospectively divided in 2 groups based on LVEF and ACE inhibitor use. RESULTS: In dilated cardiomyopathy patients, the expected morning increase in VPC frequency is absent and show a peak in evening. This pattern is not correlated with heart rate. Evening peak is more prominent in low LVEF group and ACE inhibitor non-user group. CONCLUSION: In dilated cardiomyopathy patients, VPC frequency show a peak in the evening.
Arrhythmias, Cardiac ; Cardiomyopathy, Dilated* ; Death, Sudden, Cardiac ; Heart Rate ; Humans ; Myocardial Infarction ; Prospective Studies ; Ventricular Premature Complexes*

PURPOSE: The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey. METHODS: Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2. RESULTS: Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group. CONCLUSION: Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.
Adult ; Aged ; Alcohol Drinking ; Asian Continental Ancestry Group ; Body Mass Index ; Cholesterol/blood ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*epidemiology/pathology ; Exercise ; Female ; Humans ; Hypertension/epidemiology ; Life Style ; Male ; Middle Aged ; Nutrition Surveys ; Prevalence ; Republic of Korea ; Risk Factors ; Smoking ; Socioeconomic Factors ; Stress, Psychological ; Triglycerides/blood ; Unemployment

The finger flexor injuries are very difficult to treat satisfactorily. It is usually said that the earlier the treatment performed, the better result obtained. But the delicasy of the hand anatomy and its function as well as the absence of the hand surgeon in the first aid care make the problem more complex. Even if we made the primary treatment to the flexor tendon injuries, some disabilities are often remained. We have treated fifty eight cases of old flexor tendon injuries in forty eight patients, the results can be summarized as follows. 1. The cause of the tendon damage is due to the laceration injury in the majorities of the cases. T,he tendon injuries are especially common between the late second and the early third decade. 2. In the injury of the Zone II with pulley distortion, the pulley reconstruction using palmaris longus or fascia from other sites will prevent bowstring and help the tendon function. 3. The Zone II can be subdivided into two subspecific areas. The proximal area is from the distal palmar crease to the midoprtion of porximal phalanx and the distal one is from the midportion of the proximal phalanx to the insertion of the sublimis tendon. In the proximal area one can repair the injured tendon directly after removal of the A1 and about proximal half of the A2 pulley without any subsequent bowstring if the tendon and its tunnel is relatively well preserved. Thus one can convert this proximal portion of Zone II to Zone III. So the proximal area of the Zone II should be differentiated from the remaining distal part of the Zone II. 4. At six months after the operation the result of the operation was analyzed by the percentage of the recovery, which was calculated by the postoperative active range of the interphalangeal joints divided by one hundred seventy five degrees that means the available total range of motion of normal interphalangeal joints. Excluding the cases with the tenodesis or arthrodesis, the total result revealed good or excellent in about ninty percentages with this method. 5. There were two fingers that showed a postoperative lumbrical plus state in Zone II, which were recovered spontaneously within three to four months postoperatively. So it is considered that the relative shortening of the lumbrical muscles can be treated and overcome conservatively by the active use of the fingers, and there is no need to perform an lumbrical tenotomy to correct this kind of muscle imbalance.
Arthrodesis ; Fascia ; Fingers ; First Aid ; Hand ; Humans ; Joints ; Lacerations ; Methods ; Muscles ; Patella ; Patellar Ligament ; Range of Motion, Articular ; Tendon Injuries ; Tendons ; Tenodesis ; Tenotomy ; Tibia

Purpose: The purpose of this study was to analyze the validity of the PRE-DELIRIC model and E-PRE-DELIRIC model. Methods: Patients who underwent cardiac surgery at a tertiary hospital between January 2019 and December 2022 were included. The presence or absence of delirium was determined based on risk groups, and the sensitivity, specificity, positive predictive power, and negative predictive power were verified using the Youden index. Receiver operating characteristic curves were derived for the PRE-DELIRIC model and E-PRE-DELIRIC model, the area under the curve was calculated, and the 95% confidence interval (CI) was presented. Results: The incidence of delirium was 28.8%. The average scores of the PRE-DELIRIC model and E-PRE-DELIRIC model were 49.72±29.91 and 18.14±0.41, respectively. In the PRE-DELIRIC model, for which a cut-off point of 14.05 was established using the Youden index, the sensitivity, specificity, positive predictive power, and negative predictive power were 64.8%, 83.2%, 61.0%, and 85.4%, respectively. In the E-PRE-DELIRIC model, with a cut-off point of 64.01, the corresponding indicators were 73.1%, 51.5%, 37.8%, and 82.6%, respectively. The areas under the curve for the PRE-DELIRIC model and the E-PRE-DELIRIC model were 0.77 (95% CI, 0.74~0.82) and 0.65 (95% CI, 0.61~0.69), respectively. Conclusion It may be helpful to use both the E-PRE-DELIRIC and PRE-DELIRIC models. The two prediction models are expected to help improve the quality of nursing for the early detection and prevention of delirium, enabling intensive observations and interventions for patients at high risk of delirium.

Purpose: The purpose of this study was to analyze the validity of the PRE-DELIRIC model and E-PRE-DELIRIC model. Methods: Patients who underwent cardiac surgery at a tertiary hospital between January 2019 and December 2022 were included. The presence or absence of delirium was determined based on risk groups, and the sensitivity, specificity, positive predictive power, and negative predictive power were verified using the Youden index. Receiver operating characteristic curves were derived for the PRE-DELIRIC model and E-PRE-DELIRIC model, the area under the curve was calculated, and the 95% confidence interval (CI) was presented. Results: The incidence of delirium was 28.8%. The average scores of the PRE-DELIRIC model and E-PRE-DELIRIC model were 49.72±29.91 and 18.14±0.41, respectively. In the PRE-DELIRIC model, for which a cut-off point of 14.05 was established using the Youden index, the sensitivity, specificity, positive predictive power, and negative predictive power were 64.8%, 83.2%, 61.0%, and 85.4%, respectively. In the E-PRE-DELIRIC model, with a cut-off point of 64.01, the corresponding indicators were 73.1%, 51.5%, 37.8%, and 82.6%, respectively. The areas under the curve for the PRE-DELIRIC model and the E-PRE-DELIRIC model were 0.77 (95% CI, 0.74~0.82) and 0.65 (95% CI, 0.61~0.69), respectively. Conclusion It may be helpful to use both the E-PRE-DELIRIC and PRE-DELIRIC models. The two prediction models are expected to help improve the quality of nursing for the early detection and prevention of delirium, enabling intensive observations and interventions for patients at high risk of delirium.

Purpose: The purpose of this study was to analyze the validity of the PRE-DELIRIC model and E-PRE-DELIRIC model. Methods: Patients who underwent cardiac surgery at a tertiary hospital between January 2019 and December 2022 were included. The presence or absence of delirium was determined based on risk groups, and the sensitivity, specificity, positive predictive power, and negative predictive power were verified using the Youden index. Receiver operating characteristic curves were derived for the PRE-DELIRIC model and E-PRE-DELIRIC model, the area under the curve was calculated, and the 95% confidence interval (CI) was presented. Results: The incidence of delirium was 28.8%. The average scores of the PRE-DELIRIC model and E-PRE-DELIRIC model were 49.72±29.91 and 18.14±0.41, respectively. In the PRE-DELIRIC model, for which a cut-off point of 14.05 was established using the Youden index, the sensitivity, specificity, positive predictive power, and negative predictive power were 64.8%, 83.2%, 61.0%, and 85.4%, respectively. In the E-PRE-DELIRIC model, with a cut-off point of 64.01, the corresponding indicators were 73.1%, 51.5%, 37.8%, and 82.6%, respectively. The areas under the curve for the PRE-DELIRIC model and the E-PRE-DELIRIC model were 0.77 (95% CI, 0.74~0.82) and 0.65 (95% CI, 0.61~0.69), respectively. Conclusion It may be helpful to use both the E-PRE-DELIRIC and PRE-DELIRIC models. The two prediction models are expected to help improve the quality of nursing for the early detection and prevention of delirium, enabling intensive observations and interventions for patients at high risk of delirium.

Hepatic actinomycosis is a rare condition, accounting for 15% and 5% of all abdominal and actinomycosis cases, respectively. Here, we describe a case of hepatic actinomycosis accompanied by immunoglobulin G4-related inflammatory pseudotumors. To the best of our knowledge, only two such cases have been reported to date. Here, we present the case of a 72-year-old male patient. Computed tomography and magnetic resonance imaging revealed a hepatic lesion that did not follow anatomical boundaries. The lesion showed arterial phase peripheral hyperenhancement, progressive enhancement of the central portion, sharply demarcated margins, and a radial stripe pattern. The final diagnosis for this hepatic lesion was hepatic actinomycosis accompanied by immunoglobulin G4-related inflammatory pseudotumor.

BACKGROUND: Helicobacter pylori(H. pylori) infection is known to be strongly associated with varied dermatoses such as rosacea, vasculitic purpura, and Sweet's syndrome. Also, many antibiotics including amoxicillin, clarithromycin, and tetracycline have been used to ameliorate chronic urticaria. This recent knowledge posed the plausibility that H. pylori infection might be an underlying causative factor of chronic urticaria. OBJECTIVE: This study was conducted to investigate the role of H. pylori infection in patients with chronic urticaria. METHODS: Sixty-five subjects with chronic urticaria were examined for H. pylori infection with enzyme-linked immunosorbent assay for IgG/M against H. pylori and rapid urease test(CLO test) for endoscopically biopsied gastric mucosa. Amoxicillin or clarithromycin combined with omeprazole as a therapy was administrated to the 44 patients with positive test results for 4 weeks. RESULTS: H. pylori infection was more frequently diagnosed in 44 of 65(67.7%) patients with chronic urticaria than in the control subjects(8.8%). After the completion of treatment for 4 weeks, specific IgG antibodies and a CLO test against H. pylori were negative in 28 of 38(73.7%) and 43 of 44(97.7%) patients respectively. At the post-treatment evaluation, 37 of 44(84.1%) patients with H. pylori-positive urticaria showed significant clinical remission of urticaria. CONCLUSION: Eradication of H. pylori in patients with chronic urticaria was accompanied by clinical remission of urtication. There is substantial evidence that unexplained causes of chronic urticaria may be associated with H. pylori infection.
Amoxicillin ; Anti-Bacterial Agents ; Antibodies ; Clarithromycin ; Enzyme-Linked Immunosorbent Assay ; Gastric Mucosa ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Korea* ; Omeprazole ; Prevalence* ; Prospective Studies* ; Purpura ; Rosacea ; Skin Diseases ; Sweet Syndrome ; Tetracycline ; Urease ; Urticaria*