BACKGROUND AND OBJECTIVES: Candesartan cilexetil (Atacand ), a selective type I angiotensin II receptor blocker, has recently been introduced as a new antihypertensive agent. We evaluated its anti-hypertensive effect and safety in mild to moderate hypertensive patients. MATERIALS AND METHODS: Candesartan cilexetil, 8 mg or 16 mg, was administered once a day over 8 weeks period in the patients with mild to moderate hypertension (25 male, 26 female, mean age: 53.5+/-1.2 years). For safety evaluation, laboratory tests were performed before and after treatment with candesartan cilexetil. Changes in blood pressure, heart rate and electrocardiogram were also observed. RESULTS: 1) The mean blood pressures in the sitting position were systolic 164.1+/-2.1 mmHg and diastolic 106.3+/-0.8 mmHg before treatment, which were lowered to 135.4+/-2.0 mmHg and 89.1+/-1.1 mmHg, repectively after 8 weeks of treatment (p<0.05). 2) Candesartan cilexetil had a significant dose-dependent antihypertensive effect for diastolic pressure in 35 patients (8 mg: 97.8+/-0.9 mmHg, 16 mg: 91.3+/-1.1 mmHg, p<0.05). 3) Heart rate was not significantly changed before and after treatment during the treatment with candesartan cilexetil (72.2+/-1.2/min vs. 72.0+/-1.3/min: p>0.05). 4) Laboratory tests revealed no significant abnormality by the treatment with candesartan cilexetil. 5) Left ventricular hypertrophy by ECG criteria detected in 3 cases disappeared after treatment with candesartan cilexetil. 6) No significant side effects were observed during the treatment period. CONCLUSION: Candesartan cilexetil, 8 mg or 16 mg, once a day is an effective and well tolerated antihypertensive treatment. It has a significant dose-dependent antihypertensive effect.
Blood Pressure ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Receptors, Angiotensin

C2–3 disc herniation is rare and a definitive treatment of choice has not been established.The purpose of this case report is to suggest posterior approach as one of the best options.A 49-year-old man visited our clinic with a 7-year history of neck pain and occipital headache and a 2-month history of right arm pain. C2–3 intervertebral disc herniation of the central type was diagnosed on magnetic resonance imaging (MRI), and surgery was performed, including C1 laminectomy, C2–3 laminoplasty, and C2–3 posterior fixation. The posterior approach was used because the patient's neck was difficult to operate anteriorly. After 3 months postoperatively, MRI showed widened cerebrospinal fluid space at the C2–3 level.The visual analogue scale score for pain improved in the occipital area and right arm.However, the untouched protruded central disc, subjective weakness in right hand grasping, and numbness persisted. In conclusion, this case highlights posterior decompression and fixation as a good treatment of choice for decompression at the C2–3 level disc herniation, from where it is difficult to remove compressive lesions directly via the anterior corridor.

OBJECTIVE: There is a traditional assumption that to maximize stroke volume, the point beneath which the left ventricle (LV) is at its maximum diameter (P_max.LV) should be compressed. Thus, we aimed to derive and validate rules to estimate P_max.LV using anteroposterior chest radiography (chest_AP), which is performed for critically ill patients urgently needing determination of their personalized P_max.LV.METHODS: A retrospective, cross-sectional study was performed with non-cardiac arrest adults who underwent chest_AP within 1 hour of computed tomography (derivation:validation=3:2). On chest_AP, we defined cardiac diameter (CD), distance from right cardiac border to midline (RB), and cardiac height (CH) from the carina to the uppermost point of left hemi-diaphragm. Setting point zero (0, 0) at the midpoint of the xiphisternal joint and designating leftward and upward directions as positive on x- and y-axes, we located P_max.LV (x_max.LV, y_max.LV). The coefficients of the following mathematically inferred rules were sought: x_max.LV=α₀*CD-RB; y_max.LV=β₀*CH+γ₀ (α₀: mean of [x_max.LV+RB]/CD; β₀, γ₀: representative coefficient and constant of linear regression model, respectively).RESULTS: Among 360 cases (52.0±18.3 years, 102 females), we derived: x_max.LV=0.643*CD-RB and y_max.LV=55-0.390*CH. This estimated P_max.LV (19±11 mm) was as close as the averaged P_max.LV (19±11 mm, P=0.13) and closer than the three equidistant points representing the current guidelines (67±13, 56±10, and 77±17 mm; all P<0.001) to the reference identified on computed tomography. Thus, our findings were validated.CONCLUSION: Personalized P_max.LV can be estimated using chest_AP. Further studies with actual cardiac arrest victims are needed to verify the safety and effectiveness of the rule.
Adult ; Cardiopulmonary Resuscitation ; Critical Illness ; Cross-Sectional Studies ; Heart Arrest ; Heart Ventricles ; Humans ; Intensive Care Units ; Joints ; Linear Models ; Radiography ; Radiography, Thoracic ; Retrospective Studies ; Stroke Volume ; Thorax ; Tomography, X-Ray Computed

Several epidemiological studies suggest a potential association between gallstones or cholecystectomy and hepatobiliary and pancreatic cancers (HBPCs). The aim of this study was to evaluate the risk of HBPCs in patients with gallstones or patients who underwent cholecystectomy in the Korean population. A retrospective cohort was constructed using the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Gallstones and cholecystectomy were defined by diagnosis and procedure codes and treated as time-varying covariates. Hazard ratios (HRs) in relation to the risk of HBPCs were estimated by Cox proportional hazard models. Among the 704,437 individuals who were included in the final analysis, the gallstone prevalence was 2.4%, and 1.4% of individuals underwent cholecystectomy. Between 2002 and 2015, 487 and 189 individuals developed HBPCs in the gallstone and cholecystectomy groups, respectively. A significant association was observed between gallstones and all HBPCs (HR 2.16;95% CI 1.92-2.42) and cholecystectomy and all HBPCs (HR 2.03; 95% CI 1.72-2.39). However, when 1-, 3-, and 5-year lag periods were applied, the HBPC and subsites risk approached zero. A significant association was observed between cholecystectomy and intrahepatic bile duct cancer (IBDC) (HR 2.68; 95% CI 1.63-4.40). When 1-, 3- and 5-year lag periods were applied, the IBDC risk after cholecystectomy was 2.86-fold (95% CI 1.68-4.85), 2.92-fold (95% CI 1.51-5.64), and 4.08-fold (95% CI 1.94-8.61) higher, respectively, than that in the comparison group. In conclusion, gallstone diagnosis and cholecystectomy seem to correlate with HBPCs, especially cholecystectomy and IBDC.

BACKGROUND AND OBJECTIVES: HMG-CoA reductase inhibitors have been used for a decade to lower LDL cholesterol levels and to improve cardiovascular diseases and clinical outcomes. This study was designed to evaluate the clinical efficacy and safety profiles of atorvastatin, a new HMG-CoA reductase inhibitor, in patients with elevated LDL-cholesterolemia. MATERIAL AND METHODS: Eighty three patients who had high 12-hour fasting serum LDL-cholesterol level (> or =145 mg/dl and < or = 250 mg/dl) and serum TG level less than 400 mg/dl were enrolled. After completing an 4 week dietary phase, 50 patients who still had LDL-C > or =145 mg/dl and TG < or =400 mg/dl were assigned to receive atorvastatin 10 mg once daily for 4 weeks. After 4 weeks, the dose was continued for 4 weeks in each individual if serum LDL-cholesterol was maintained below 130 mg/dL. For each individual whose serum LDL-cholesterol was above 130 mg/dL, the dose was doubled (20 mg/day) and administered for 4 weeks. Serum AST, ALT and CPK were also measured in addition to blood chemistry tests for lipid profiles at 4 and 8 weeks for safety assessment. RESULTS: 1) The total study population who completed the whole protocol was composed of 46 patients (23 male, 23 female, mean age 54 years). 2) At 4 weeks, the reduction by mean percent change from the baseline in LDL-cholesterol was -44.8% (from 182.3+/-3.4 mg/dl to 99.7+/-2.9 mg/dl). The fixed goal of LDL-cholesterol less than 130 mg/dl was achieved by 95.8%. 3) At 4 weeks, the mean percent change from the baseline in TC, TG, HDL-C, LDL/HDL-C and ApoB were -32.3%, -17.4%, +9.6%, -48.5% and -36.6%, respectively. 4) At 8 weeks, the mean percent change from the baseline in LDL-cholesterol was -43.0% (from 182.3+/-3.4 mg/dl to 103+/-2.4 mg/dl). The fixed goal of LDL-cholesterol less than 130 mg/dl was achieved by 91.3% of the whole patients. 5) At 8 weeks, the mean percent change from the baseline in TC, TG, HDL-C, LDL/HDL-C and ApoB were -31.3%, -22.6%, +13.7%, -48.8% and -35.9%, respectively. 6) No serious side effects were observed during the whole period. CONCLUSION: Atorvastatin is highly effective and safe in modulating lipid profiles favorably (lower LDL-Cholesterol, lower TG, elevate HDL-Cholesterol), in patients with serum lipid abnormality.
Apolipoproteins B ; Cardiovascular Diseases ; Chemistry ; Cholesterol, LDL ; Fasting ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Male ; Oxidoreductases ; Atorvastatin Calcium

Objective: Peritonitis is a life-threatening, emergent surgical disease with very high mortality and morbidity. Currently, there are insufficient Korean studies using the P-POSSUM (Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) and the Mannheim Peritonitis Index (MPI) as risk prediction models for nontraumatic peritonitis patients who visit the emergency room. Methods: This retrospective study was carried out on 196 cases of non-traumatic peritonitis in a single emergency center from January 2015 to December 2019. Receiver operating characteristic (ROC) curves were obtained and the area under the ROC curve (AUC) was compared using both P-POSSUM and MPI. The observed mortality and expected mortality for P-POSSUM were compared using the goodness of fit assessed using the Hosmer-Lemeshow equation. Results: Diastolic blood pressure, blood urea nitrogen, potassium, length of stay, and intensive care unit admissions were significantly different between survivors and non-survivors. The AUC was 0.812 for P-POSSUM and 0.646 for MPI. The observed-to-expected mortality ratio for P-POSSUM indicated fewer than expected deaths in all quintiles of risk and this was more pronounced, especially when the expected mortality was over 60%. Conclusion In non-traumatic peritonitis patients, P-POSSUM was more useful in predicting risk than the MPI score. However, P-POSSUM overestimated the risk in high-risk patients. Although the MPI score is only somewhat useful for predicting mortality in patients with non-traumatic peritonitis, it is useful as an adjuvant.

This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.

This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.