BACKGROUND: The objective of this study was to examine the correlation between arterial blood gas (ABG) and peripheral venous blood gas (VBG) samples for all commonly used parameters in patients admitted to a medical intensive care unit (ICU). METHODS: A single-center, prospective trial was carried out in a medical ICU in order to determine the level of correlation of ABG and peripheral VBG measurements. A maximum of five paired ABG-VBG samples were obtained per patient to prevent a single patient from dominating the data set. RESULTS: Regression equations were derived to predict arterial values from venous values as follows: arterial pH=-1.108+1.145xvenous pH+0.008xPCO2-0.012xvenous HCO3+0.002xvenous total CO2 (R2=0.655), arterial PCO2=88.6-10.888xvenous pH+0.150xPCO2+0.812xvenous HCO3+0.124xvenous total CO2 (R2=0.609), arterial HCO3=-89.266+12.677xvenous pH+0.042xPCO2+0.675xvenous HCO3+0.185xvenous total CO2 (R2=0.782). The mean ABG minus peripheral VBG differences for pH, PCO2, and bicarbonates were not clinically important for between-person heterogeneity. CONCLUSION: Peripheral venous pH, PCO2, bicarbonates, and total CO2 may be used as alternatives to their arterial equivalents in many clinical contexts encountered in the ICU.
Bicarbonates ; Blood Gas Analysis ; Humans ; Hydrogen-Ion Concentration ; Critical Care ; Intensive Care Units ; Prospective Studies

BACKGROUND: The objective of this study was to examine the correlation between arterial blood gas (ABG) and peripheral venous blood gas (VBG) samples for all commonly used parameters in patients admitted to a medical intensive care unit (ICU). METHODS: A single-center, prospective trial was carried out in a medical ICU in order to determine the level of correlation of ABG and peripheral VBG measurements. A maximum of five paired ABG-VBG samples were obtained per patient to prevent a single patient from dominating the data set. RESULTS: Regression equations were derived to predict arterial values from venous values as follows: arterial pH=-1.108+1.145xvenous pH+0.008xPCO2-0.012xvenous HCO3+0.002xvenous total CO2 (R2=0.655), arterial PCO2=88.6-10.888xvenous pH+0.150xPCO2+0.812xvenous HCO3+0.124xvenous total CO2 (R2=0.609), arterial HCO3=-89.266+12.677xvenous pH+0.042xPCO2+0.675xvenous HCO3+0.185xvenous total CO2 (R2=0.782). The mean ABG minus peripheral VBG differences for pH, PCO2, and bicarbonates were not clinically important for between-person heterogeneity. CONCLUSION: Peripheral venous pH, PCO2, bicarbonates, and total CO2 may be used as alternatives to their arterial equivalents in many clinical contexts encountered in the ICU.
Bicarbonates ; Blood Gas Analysis ; Humans ; Hydrogen-Ion Concentration ; Critical Care ; Intensive Care Units ; Prospective Studies

BACKGROUND: Atherosclerotic vascular disease is major cause of morbidity and mortality in dialysis patients. C-reactive protein(CRP) as a marker of inflammmation appears to be clinically useful in prediction of coronary heart disease and mortality. This study is designed to test whether plasma concentration of CRP correlates with coronary heart disease and mortality in CAPD patients. METHODS: A total of 137 end-stage-renal disease patients undergoing CAPD were included. The measurement of baseline CRP and stress thallium SPECT were performed in all patients. Patients were followed prospectively from initiation of dialysis to June 1999 for analysis of survival rate and cause of death. Coronary angiography performed in 16 of 32 patients showed all positive results. RESULTS: 32 patients showed positive results in thallium SPECT. The baseline CRP concentration were higher among patients with positive results in thallium SPECT than those with negative results(1.05 g/L vs 1.30mg/dL, p<0.001). The survival rate was significantly lower in lower CRP group than higher CRP group (44months vs 26 months, p<0.001). However, There was no difference in cause of death according to serum CRP level. Death from cardiac cause is significantly higher among patients with positive thallium SPECT than negative results. The most common cause of death are, in descending order of frequency, cardiac disease including acute MI, sepsis, cerebrovascular disease. CONCLUSION: The baseline level of inflammation as assessed by the plasma concentration of CRP independently predicts the risk of coronary heart disease and survival in CAPD patients.
C-Reactive Protein* ; Cause of Death ; Coronary Angiography ; Coronary Disease* ; Dialysis ; Heart Diseases ; Humans ; Inflammation ; Mortality* ; Peritoneal Dialysis, Continuous Ambulatory* ; Plasma ; Prospective Studies ; Sepsis ; Survival Rate ; Thallium ; Tomography, Emission-Computed, Single-Photon ; Vascular Diseases

PURPOSE: In this single-center, prospective, randomized, cross-over study, we compared the efficiency of oxygen supply between OxyMask and non-rebreather mask (NRM), depending on the position of the mask. METHODS: Either OxyMask or NRM was applied to 33 healthy volunteers, in a random manner, on the upper (that 1 cm upper to it), lower (that 1 cm inferior to it) and lateral malposition (that 1 cm lateral to it). After a 3-minute oxygenation, at a flow rate of 15 L/min, we measured the fractional expired oxygen concentration (F(E)O₂), fractional expired carbon dioxide concentration (F(E)CO₂), and visual analogue scale (VAS) scores for the degree-of-wearing sensation. RESULTS: OxyMask showed a lower level of F(E)O₂ as compared with NRM in all positions. Moreover, OxyMask showed no significant difference between F(E)O₂ and the position of the mask. However, NRM showed a significantly lower F(E)O₂ in the upper and lateral malposition. F(E)CO₂ had no significant difference with the types and position of the mask. The mean VAS scores for the degree-of-wearing sensation were 2.2±1.5 in the OxyMask and 4.3±1.5 in the NRM (p<0.001). CONCLUSION: OxyMask may offer greater benefit in maintaining the concentration of supplied oxygen and provide greater comfort than NRM in patients with difficulty applying the mask on an adequate location and maintaining the seal.
Adult* ; Carbon Dioxide ; Cross-Over Studies* ; Healthy Volunteers ; Humans ; Masks* ; Oxygen* ; Prospective Studies* ; Sensation

PURPOSE: Medical students' communication and interpersonal skills can be evaluated by standardized patients in a clinical performance examination (CPX). The purpose of this study is to investigate which communication and interpersonal skills are more closely correlated between medical students and residents. METHODS: This study included 2nd-year residents in 2009 who took the eight-station CPX as 4th-year medical students in 2006. In-patients who were cared for by the residents were asked the seven items related to interpersonal and communication skills. The correlation between the scores of these seven items in the 2006 CPX and the scores in the 2009 patient survey was evaluated. RESULTS: Twenty-six residents, 11 in medical wards and 15 in surgical wards, participated in the study. The medical students' total scores tended to be correlated with the residents' scores (r=0.381, p=0.055). There was significant correlation between the scores for students and residents for 'Explaining more explicably' (r=0.470, p=0.015), and marginally significant correlation (r=0.385, p=0.052) for 'Listening attentively.' There was no significant correlation for the other five items. CONCLUSION: 'Explaining more explicably' and 'Listening attentively', these skills were more closely correlated between medical students and residents. These basic communication skills should be included in graduate or licensing evaluations.
Clinical Competence ; Humans ; Interpersonal Relations ; Licensure ; Physician-Patient Relations ; Students, Medical

Background: Folic acid is involved in inflammatory reactions; however, the association between folic acid and allergic diseases, particularly asthma, remains unclear. Thus, this study aimed to evaluate the association between serum folic acid levels and asthma in Koreans. Methods: This study analyzed the serum folic acid levels of 6,615 individuals included in the 2016–2018 Korea National Health and Nutrition Examination Survey. The prevalence of asthma was determined using a questionnaire that identified cases of physician-diagnosed asthma. The relationship between serum folic acid levels and asthma was analyzed using logistic regression analysis. Results: Multiple logistic regression analysis showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of asthma after adjusting for confounding factors including sex, age, household income, current smoking, current alcohol use, and body mass index (odds ratio [OR], 0.930; 95% confidence interval [CI], 0.876– 0.987; P=0.017). The relationship between the adjusted odds of asthma and serum folic acid levels were consistently inverse (OR, 2.266; 95% CI, 1.126–4.420; P for trend=0.038). Conclusion Serum folic acid levels are inversely associated with physician-diagnosed asthma in the Korean population.

An anomalous pancreaticobiliary ductal union is a rare anomaly occurring in the biliary tract. This anomaly has been implicated as a cause of choledochal cysts, bile duct and gallbladder carcinoma, and recurrent pancreatitis. A case is herein reported of a 63 year-old woman who suffered from gallbladder cancer associated with a choledochal cyst and an anomalous pancreaticobiliary union.
Bile Ducts ; Biliary Tract ; Choledochal Cyst* ; Female ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Middle Aged ; Pancreatitis

PURPOSE: The aim of this study was to describe our experience of a class, using a film that deals with the social issues of human immunodeficiency virus (HIV), and the results of surveys before and after the class. METHODS: One hundred fifty-six second-year medical students were surveyed with self-questionnaires (9-point Likert scale) before, immediately after, and 2 years after a class that viewed a film ('Philadelphia', 1993). The same survey, comprising 4 items, was administered to 81 non-medical students in the same university. RESULTS: In 156 medical students, 153 (98%) answered the questionnaires. Before the class, there was no significant difference between medical and non-medical students with regard to the cognition of social isolation of HIV-infected persons (4.13 vs. 4.43, p=0.307). immediately after the class, medical student' cognition changed significantly in the positive direction on all items, irrespective of age, sex, and course grade. Two years after the class, this positive effect remained significant on 2 items: 'social isolation of HIV-infected persons' and 'casual contact with an HIV-infected person.' CONCLUSION: A film can be used to reinforce medical education in the affective domain.
Cognition ; Education, Medical ; HIV ; Humans ; Motion Pictures as Topic ; Social Isolation ; Students, Medical ; Surveys and Questionnaires

An ampulla within a diverticulum is not rare especially in elderly patients with duct stones, but may pose a problem in identifying the papilla and properly orienting this structure for cannulation during endoscopic retrograde cholangiopancreatography. We therefore have used a new technique using the application of an additional catheter to keep the ampulla outside the diverticulum. When we pushed the duodenal fold downward and laterally with the first catheter, the ampulla was everted from the diverticulum and the hidden papilla was brought into view. Once the papilla was visible, the second catheter which was identical to the first, was advanced alongside it and inserted into the papillary orifice without difficulty. Eventually a successful cholangiogram was obtained. With the insertion of a guidewire through the second catheter, sphincterotomy and insertion of endoscopic nasobiliary drainage tube were also performed successfully.
Aged ; Catheterization* ; Catheters ; Cholangiopancreatography, Endoscopic Retrograde ; Diverticulum* ; Drainage ; Humans

BACKGROUND/AIMS: Deficiencies of 25-hydroxyvitamin D (25(OH)D) are prevalent in patients with chronic liver disease (CLD). Liver fibrosis is the main determinant of CLD prognosis. The present study was performed to evaluate the correlation between 25(OH)D levels and liver fibrosis as assessed by transient elastography (TE) in patients with compensated CLD. METHODS: Serum 25(OH)D levels and liver stiffness were determined in a total of 207 patients who were subjected to the following exclusion criteria: patients with decompensated CLD; patients who had malignancies; patients who were taking medications; and patients who were pregnant. RESULTS: The most common etiology was chronic hepatitis B (53.1%). Advanced liver fibrosis (defined by TE [≥9.5 kPa]) was present in 75 patients (36.2%). There was a significant correlation between 25(OH)D deficiency and liver stiffness. Based on the multivariate analysis, the following factors were independently associated with advanced liver fibrosis: 25(OH)D deficiency (odds ratio [OR], 3.46; p=0.004), diabetes mellitus (OR, 3.04; p=0.041), and fibrosis-4 index (OR, 2.01; p<0.001). CONCLUSIONS: Patients with compensated CLD exhibit a close correlation between vitamin D level and liver stiffness as assessed by TE. Vitamin D deficiency was independently associated with advanced liver fibrosis.
Diabetes Mellitus ; Elasticity Imaging Techniques* ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis* ; Liver Diseases* ; Liver* ; Multivariate Analysis ; Prognosis ; Vitamin D ; Vitamin D Deficiency