BACKGROUND: Chlamydia trachomatis is one of the most common causative agents of the sexual transmitted diseases, and the accurate diagnosis and early treatment are very important to prevent the transmission. So, we evaluated the polymerase chain reaction (PCR) and QuickVue(TM) (Quidel Corp. San Diego, CA) EIA method as a routine clinical laboratory test. METHODS: The 80 cervical swab samples including pelvic inflammatory disease, cervicitis and tube-ovarian abscess were tested using PCR with plasmid specific primers T1, T2 and commercially available QuickVue(TM) EIA kit. RESULTS: The positivities of the PCR and QuickVue(TM) EIA test were 17.5% (14/80 samples) and 12.5% (10/80 samples), respectively. There were 95% (76/80 samples) of positive or negative result concordance rates and 5% (4/80 samples) of disconcordance between the two methods, in which showed PCR positive and EIA negative results. CONCLUSIONS: We assume that PCR and QuickVue(TM) method are highly confident as a routine clinical laboratory diagnostic test for C. trachomatis infection. But more careful interpretation of QuickVue(TM) EIA and the additional study for variable samples will be needed.
Abscess ; Chlamydia trachomatis* ; Chlamydia* ; Diagnosis* ; Diagnostic Tests, Routine ; Female ; Pelvic Inflammatory Disease ; Plasmids ; Polymerase Chain Reaction* ; Uterine Cervicitis

BACKGROUND: Mannitol is widely used in neurosurgical patients and may induce an increase in serum potassium concentration according to doses and administration rates with unknown mechanism. The treatment of hyperkalemia is aimed at eliminating the causes and includes calcium, sodium bicarbonate, glucose with insulin, loop diuretics and hyperventilation. This study was undertaken to observe the effects of hyperventilation on the serum potassium concentration following infusion of mannitol (2.0 gm/kg). METHODS: We studied 30 patients who were operated brain aneurysm clipping surgery and were divided into 3 groups (n=10). In control group, mild hypocapnia was maintained (PaCO2, 32 2 mmHg) before and after mannitol infusion. In group I, moderate hypocapnia was maintained (PaCO2, 27 2 mmHg) before and after mannitol infusion. In group II, mild hypocapnia (PaCO2, 32 2 mmHg) was maintained before 30 minutes of mannitol infusion and moderate hypocapnia (PaCO2, 27 2 mHg) after mannitol infusion. We started infusion of 20% mannitol with a dosage of 2.0 gm/kg, 15~20 min after cranium was opened. RESULTS: The changes of serum potassium were as follows (Mean SD mEq/l) (just before and 15min, 30min, 60min after mannitol infusion): 3.79 0.48, 4.66 0.60, 4.44 0.48, 4.13 0.40 (Control group), 3.62 0.18, 3.63 0.42, 4.14 0.51, 3.95 0.33 (Group I), 3.76 0.20, 3.91 0.15, 4.11 0.30, 4.04 0.23 (Group II). After 15 minutes of mannitol infusion, the serum potassium levels of group I and II were lower than that of control group (p<0.05) and there was no significant difference between group I and II. CONCLUSIONS: These results suggest that hyperventilation may blunt the increase in serum potassium concentration following rapid infusion of high dose mannitol.
Calcium ; Glucose ; Humans ; Hyperkalemia ; Hyperventilation* ; Hypocapnia ; Insulin ; Intracranial Aneurysm ; Mannitol* ; Potassium* ; Skull ; Sodium Bicarbonate ; Sodium Potassium Chloride Symporter Inhibitors

Through a systematic review and meta-analysis of epidemiological studies on dementia, we assessed the prevalence of dementia and its subtypes-Alzheimer' disease (AD) and vascular dementia (VaD)-in Korea. We searched for epidemiological studies on dementia published in 1990-2013 using PubMed, Scopus, EMBASE, KoreaMed, KISS, and RiCH. Dementia prevalence in elderly patients (aged> or =65 yr) was 9.2% (95% confidence interval [CI], 8.2%-10.4%) from 11 studies, which was higher than those from Western and other Asian countries. AD was the most prevalent dementia type, with a prevalence of 5.7% (95% CI, 5.0%-6.4%) from 10 studies compared with 2.1% (95% CI, 1.6%-2.7%) for VaD from 9 studies. The age-specific prevalence of dementia approximately doubled with each 5.8-yr increase of age. Although a significant increasing trend of dementia prevalence was not observed, it increased slightly from 7.3% to 8.7% after 2005; AD prevalence increased after 1995 and VaD prevalence decreased after the early 2000s. The AD/VaD ratio increased from 1.96 in the early 1990s to 4.13 in the 2010s, similar to the worldwide ratio. Owing to this high prevalence in the aging population, dementia will impose significant economic burdens to Korean society.
Age Factors ; Alzheimer Disease/epidemiology ; Asian Continental Ancestry Group ; Databases, Factual ; Dementia/*epidemiology ; Dementia, Vascular/epidemiology ; Humans ; Prevalence ; Quality Assurance, Health Care ; Republic of Korea

The ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of ovulation induction therapy with gonadotropin. The pathogenesis of OHSS is unclear, but the proposed mechanisms are the production of vasoactive substances that increase local capillary permeability resulting in shifting of fluid from the intravascular space to the third space. The clinical manifestations varies from ascites, hypovolemia, oliguria, hemoconcentration, thromboembolism, and even death. We have experienced a case of severe OHSS with severe ascites, pleural effusion and bilateral enlarged ovaries associated with spontaneous pregnancy without any ovarian stimulation for ovulation induction.
Ascites ; Capillary Permeability ; Female ; Gonadotropins ; Hypovolemia ; Oliguria ; Ovarian Hyperstimulation Syndrome* ; Ovary ; Ovulation Induction* ; Ovulation* ; Pleural Effusion ; Pregnancy* ; Thromboembolism

BACKGROUND: This study was performed to analyze cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and its impact on the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS: Five thousand five hundred and forty-nine cases of thyroid fine-needle aspiration cytology (FNAC) diagnosed between 2012 and 2014 were included in this study. Diagnostic categories based on TBSRTC were compared with final surgical diagnoses, and the ROM in each category was calculated both when NIFTP was included in malignant lesions and when excluded from malignant lesions. RESULTS: Of the 5,549 thyroid FNAC cases, 1,891 cases underwent surgical resection. In final diagnosis, 1,700 cases were revealed as papillary thyroid carcinoma (PTC), and 25 cases were reclassified as NIFTP. The cytologic diagnoses of NIFTP were non-diagnostic in one, benign in five, atypia of undetermined significance (AUS) in 14, follicular neoplasm in two, and suspicious for malignancy in three cases. Collectively, NIFTP/encapsulated follicular variant of PTC (EFVPTC) were more frequently classified as benign, AUS, or follicular neoplasm and less frequently categorized as malignant compared to conventional PTCs. Exclusion of NIFTP from malignant diagnoses resulted in a slight decrease in malignancy rates in non-diagnostic, benign, AUS, follicular neoplasm, and suspicious for malignancy categories without any statistical significance. CONCLUSIONS: The decrease in the ROM was not significant when NIFTP was excluded from malignant lesions. In thyroid FNACs, NIFTP/EFVPTCs were mostly classified into indeterminate categories. Therefore, it might be feasible to separate NIFTP/EFVPTC from conventional PTC on FNAC to guide clinicians to conservative management for patients with NIFTP/EFVPTC.
Biopsy, Fine-Needle ; Diagnosis ; Humans ; Thyroid Gland ; Thyroid Neoplasms

OBJECTIVES : This case-based, small scale study was undertaken to identify the characteristics clinical features of children who exhbiit rare prepubertal onset bipolar disorder. METHODS : We analyzed the clinical records of 13 children who had been hospitalized and diagnosed with bipolar disorder. Clinical characteristics and cognitive function of these patients was based on psychiatrists' medical records and psychologists' evaluation reports. RESULTS : Eleven (84.6%) subjects exhibited clinical features of mixed mania and had a chronic clinicalcourse. They never fulfilled the full criteria of the Diagnostic Statistical Manual of Mental disorders- Fourth Edition (DSM-IV) for manic or hypomanic episodes. Mean age at onset of typical symptoms of bipolar disorder was 9.38 (SD=1.80) and mean age at admission was 12.00 (SD=2.45). Twelve (92.3%) had psychiatric comorbidity. Attention-deficit/hyperactivity disorder was the most prevalent comorbid disease and mean age of onset of it was 6.23 (SD=2.17). CONCLUSION : Subjects with prepubertal onset bipolar disorder showed atypical clinical features. These results suggest that most prepubertal onset bipolar disorder patients fail to meet the DSM-IV criteria for typical bipolar I disorder and therefore, we need to develop alternative diagnostic criteria for pediatric bipolar disorder.
Age of Onset ; Bipolar Disorder ; Child ; Comorbidity ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Medical Records ; Pilot Projects

The uterus with rudimentary horn occurs as a result of a lack of development during fetal life of the middle and lower part of one of the M llerian ducts, in which there is a failure of fusion of the two ducts. Pregnancy in the rudimentary uterine horn is very rare, its incidence is reported nearly as 1 case per 100,000 normal pregnancy. We experience a case of ruptured rudimentary uterine horn twin pregnancy at 29-gestational week and report the case with brief review of literatures.
Animals ; Horns* ; Humans ; Incidence ; Pregnancy ; Pregnancy, Twin* ; Twins* ; Uterus

This study aims to evaluate CT (Computed Tomography) characteristics through the estimation of HU (Hounsfield Unit) and the corresponding variations using coefficient of variation values for various materials as a function of physical factor. HU values for various materials with varying densities as a function of physical factor were measured using MDCT (Siemens SOMATOM Sensation 4, Germany). The results showed that the HU values were decreased and increased as a function of kVp and material density, respectively. Especially, the HU values for bone and iodine at 140 kVp were 32% and 42% smaller than those at 80 kVp, respectively. In case of iodine, the HU values also decreased and increased as a function of kVp and concentration, respectively. While the HU values were fixed as a function of mAs. The decreased ratio of HU values between 80 keV and 140 keV was different at various concentration and maximum difference was shown as 1.73 at 3% concentration. These results indicated that it may be possible to separate composition of materials, e.g. iodine and bone, using single source CT. The results showed that dual energy techniques using single source CT can be applied to material separation and expand CT imaging techniques to other practical applications.
Iodine ; Sensation

This study aims to evaluate CT (Computed Tomography) characteristics through the estimation of HU (Hounsfield Unit) and the corresponding variations using coefficient of variation values for various materials as a function of physical factor. HU values for various materials with varying densities as a function of physical factor were measured using MDCT (Siemens SOMATOM Sensation 4, Germany). The results showed that the HU values were decreased and increased as a function of kVp and material density, respectively. Especially, the HU values for bone and iodine at 140 kVp were 32% and 42% smaller than those at 80 kVp, respectively. In case of iodine, the HU values also decreased and increased as a function of kVp and concentration, respectively. While the HU values were fixed as a function of mAs. The decreased ratio of HU values between 80 keV and 140 keV was different at various concentration and maximum difference was shown as 1.73 at 3% concentration. These results indicated that it may be possible to separate composition of materials, e.g. iodine and bone, using single source CT. The results showed that dual energy techniques using single source CT can be applied to material separation and expand CT imaging techniques to other practical applications.
Iodine ; Sensation

BACKGROUND: Cardiovascular instability after induction of intravenous anesthetics may be explained partly by direct negative inotropic effects. We studied the effects of etomidate and propofol on the inward calcium currents (ICa) of rat ventricular myocytes using the whole-cell voltage-clamp technique. METHODS: ICa was elicited by progressively depolarizing cells from -40 to -50 mV. The peak amplitude of ICa was measured before, during and after the administration of equimolar concentrations of etomidate and propofol. RESULTS: Exposure to etomidate and propofol produced a concentration-dependent inhibition of ICa.; 1, 10, 100 and 300 micrometer of etomidate decreased the peak ICa (mean +/- SEM) by 14.5 +/- 6.3, 25.9 +/- 9.4, 31.9 +/- 12.1, 42.5 +/- 8.8% and 1, 10, 100 and 300 micrometer of propofol decreased the peak ICa by 15.7 +/-3.4, 21.3 +/-2.5, 59.2 +/-2.0, 69.9 +/-2.8%, respectively. COCLUSIONS: These results suggest that etomidate and propofol have a direct negative inotropic effect via inhibition of inward calcium currents in rat ventricular myocytes.
Anesthetics, Intravenous ; Animals ; Calcium* ; Etomidate* ; Muscle Cells* ; Patch-Clamp Techniques ; Propofol* ; Rats*