To determine the prevalence and risk factors of hypertension we performed cross-sectional study in a rural area. We measured BP and body mass index(BMI), and interviewed adult residents over 30-year-old age. 337 males and 357 females participated the survey. BP was checked twice and the mean was used to determine age and sex specific mean BP and prevalence of hypertension. Prevalence of definite hypertension(BP>or=160/95 or on medication) was 14. 0% in males and 17. 7% in females. Risk factor for hypertension was analysed by multiple logistic regression; age (10years: OR=l. 7) and BMI(1 BMI unit: OR=l. 2) were positively associated with hypertension but smoking(1 pack year: OR=0.9) was shown to have inverse relationship.
Adult* ; Cross-Sectional Studies ; Female ; Humans ; Hypertension* ; Logistic Models ; Male ; Prevalence* ; Risk Factors

The inferior vena cava (IVC) is a rare site of focal atrial tachycardia (AT). Here, we report a 20-year-old woman who underwent catheter ablation for anti-arrhythmic drug-resistant AT originating from the IVC. She had undergone open-heart surgery for patch closure of an atrial septal defect 17 years previously and permanent pacemaker implantation for sinus node dysfunction 6 years previously. The AT focus was at the anterolateral aspect of the IVC-right atrial junction, and it was successfully ablated under three-dimensional electroanatomical-mapping guidance. We suspect that the mechanism of this tachycardia was associated with previous IVC cannulation for open-heart surgery.
Catheter Ablation ; Catheterization ; Female ; Heart Septal Defects, Atrial ; Humans ; Sick Sinus Syndrome ; Tachycardia* ; Vena Cava, Inferior* ; Young Adult

Non-invasive positive pressure ventilation (NIPPV) was mainly applied to acute respiratory failure in chronic obstructive pulmonary disease (COPD) and to intrinsic lung disease such as neuromuscular disorders. It has been reported that this maneuver reduces morbidity, mortality and hospital stay in patients in the intensive care unit. We observed a 32-year-old female renal transplantation patient who developed pulmonary edema during the perioperative state. The mainteance of an endotracheal tube in intubated patients who were on immunosuppresive therapy might increase nosocomial pneumonia significantly. In this case, the mortality increase was expected, therefore we considered that early extubation and mask continuous positive airway pressure (mask CPAP) could help. By using mask CPAP, the patient showed a good response and the pulmonary edema was improved. We report a case about the benefits of NIPPV in the treatment of pulmonary edema in an immunosuppressed patient of which the result was very satisfactory.
Adult ; Continuous Positive Airway Pressure ; Female ; Humans ; Intensive Care Units ; Kidney Transplantation ; Kidney* ; Length of Stay ; Lung Diseases ; Masks ; Mortality ; Pneumonia ; Positive-Pressure Respiration* ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema* ; Respiratory Insufficiency

BACKGROUND AND PURPOSE: White-matter (WM) lesions are known to potentiate cognitive impairment in poststroke patients. The present study was designed to assess whether Ginkgo biloba extract (GB) and cilostazol, which were evaluated alone and in a combination formula (Renexin), can attenuate the WM lesions and cognitive decline caused by chronic hypoperfusion in the rat. METHODS: Animals were divided into five treatment groups: cilostazol (25 mg/kg/day), GB (20 mg/kg/day), Renexin (25 mg/kg/day cilostazol + 20 mg/kg/day GB), vehicle, and sham. The animals received the treatments orally 1 day after bilateral common carotid artery occlusion [two-vessel occlusion (2VO); except for the sham group, which underwent the surgery but the arteries were not occluded], and then the same dose every day for 21 days thereafter. Prior to sacrificing the rats, repetitive eight-arm radial maze testing was performed to examine their cognitive abilities. After drug administration and cognitive testing, brain tissues were isolated for Kluver-Barrera and terminal deoxynucleotidyl transferase-mediated biotin-dUTP nick end-labeling (TUNEL) staining, immunohistochemical assessment of glial fibrillary acidic protein (GFAP) and CD11b (OX-42), and to assay free-radical scavenging activity. RESULTS: We found that the significant WM lesions induced by 2VO was ameliorated significantly by treatment with cilostazol, GB, and Renexin, in association with increased TUNEL-positive cells. In addition, chronic cerebral hypoperfusion caused a large increase in the degree of GFAP and OX-42 immunoreactivity and free-radical activity in the optic tract. These abnormalities were significantly reversed by the three drugs, but most prominently by Renexin, suggesting a markedly enhanced or supra-additive effect of cilostazol and GB when administered together. CONCLUSIONS: Significant attenuation of cytoarchitectural damage and apoptotic cell death was found with GB and cilostazol, but a markedly enhanced effect was seen for treatment with their combination in the WM of rat brains after bilateral occlusion of the common carotid arteries. We suggest that combination therapy with GB and cilostazol provides enhanced neuroprotective effects and induces subsequent cognitive improvement in patients with chronic ischemic conditions.
Animals ; Arteries ; Brain ; Carotid Artery, Common ; Cell Death ; Ginkgo biloba ; Glial Fibrillary Acidic Protein ; Humans ; Neuroprotective Agents ; Rats ; Salicylamides ; Tetrazoles ; Visual Pathways

OBJECTIVE: To investigate the relations among pain, emotional factors and cognitive-behavioral factors in chronic musculoskeletal pain patients. METHOD: This study was designed as a questionnaire survey. 73 patients who visited our outpatient clinics due to chronic musculoskeletal pain were evaluated. They checked visual analogue scale (VAS), pain site and frequency. Beck depression inventory (BDI) and state-trait anxiety index (STAI) were checked for evaluation of emotional factors. Somatization scale of symptom checklist-revised (SCL-R- 90) and pain catastrophizing scale (PCS) were checked for cognitive-behavioral factors. Correlations among each variable were evaluated by statistical analysis. RESULTS: VAS was correlated with pain frequency (r=0.538, p<0.01), somatization and catastrophizing thought. Rumination thought was correlated with VAS (r=0.443, p<0.01), pain frequency (r=0.446, p<0.01) and static anxiety (r= 0.449, p<0.01). Magnification thought was correlated with depression (r=0.403, p<0.01) and static anxiety (r=0.447, p<0.01). Helpless thought was correlated with VAS (r= 0.442, p<0.01), pain frequency (r=0.429, p<0.01), depression (r=0.510, p<0.01), static anxiety (r=0.640, p<0.01) and somatization (r=0.504, p<0.01). Duration was not correlated with VAS, depression, anxiety, somatization and catastrophizing thought in chronic musculoskeletal pain patients (p>0.05). CONCLUSION: Cognitive-behavioral factors such as catastrophizing thought are strongly correlated with both pain aspects and emotional factors. Consideration of cognitive- behavioral factors as well as emotional factors may be important for management of chronic musculoskeletal pain.
Ambulatory Care Facilities ; Anxiety ; Catastrophization ; Depression ; Humans ; Musculoskeletal Pain ; Surveys and Questionnaires

Crossed cerebellar diaschisis has been described mostly in hemispheric stroke and supratentorial tumors with positron-emission tomography (PET) and single photon emission computed tomography (SPECT). Rarely it has been described with brain diffusion-weighted MRI of status epilepticus. We report a patient with status epilepticus, who developed MRI abnormalities in the cerebral cortex and contralateral cerebellum. EEG abnormalities correlated anatomically with the cerebral cortex of image change. An aggressive medication resulted in seizure control, reversal of neurologic deficit, and improvement or resolution of the MRI and EEG abnormalities in 3 weeks. We concluded that both localization and resolution of lesions may be explained by reversible excitotoxic cell damage due to seizure-related excessive synaptic activity.
Brain ; Cerebellum ; Cerebral Cortex ; Electroencephalography ; Humans ; Neurologic Manifestations ; Positron-Emission Tomography ; Seizures ; Status Epilepticus ; Stroke ; Supratentorial Neoplasms ; Tomography, Emission-Computed, Single-Photon

Objectives: ：The purpose of this study was to identify characteristic Vibraimage parameters in schizophrenia spectrum and other psychotic disorders. Methods: ：This study retrospectively analyzed subjects who were referred to the National Forensic Hospital in Gongju city for psychiatric evaluation between April 2019 and October 2019. After divided into two groups; Schizophrenia Spectrum Disorders group and non-organic non-psychotic disorders group, Vibraimage parameters and MMPI-2 items were compared between the two groups. In addition, we investigated the relations between Vibraimage parameters and MMPI-2 items characteristic of schizophrenia spectrum and other psychotic disorders by using the Correlation analysis. Results: ：Compared to non-organic non-psychotic disorders group, Schizophrenia Spectrum Disorders group scored low at Aggression (t=-2.752, p=0.007), Tension (t=-2.106, p=0.039), and Suspects (t=-2.617, p=0.011); high at Neuroticism (t=4,215, p<0.001) in the Vibraimage, and the group scored comparatively high at Sc (Schizophrenia) (t=-2.099, p=0.039) and low at Hy (Hysteria) (t=-2.228, p=0.029) in the MMPI-2. The Sc (Schizophrenia) item in the MMPI-2 showed a negative correlation with Suspect parameter (r=0.242 p=0.035) and positive correlation with Neuroticism parameter (r=0.267, p=0.02) in the Vibraimage. Conclusion ：Our findings suggest that Suspect and Neuroticism parameters of the Vibraimage were characteristic in schizophrenia spectrum and other psychotic disorders, and showed potential as diagnostic tools, especially in psychiatric evaluations.

Objectives: ：The purpose of this study was to identify characteristic Vibraimage parameters in schizophrenia spectrum and other psychotic disorders. Methods: ：This study retrospectively analyzed subjects who were referred to the National Forensic Hospital in Gongju city for psychiatric evaluation between April 2019 and October 2019. After divided into two groups; Schizophrenia Spectrum Disorders group and non-organic non-psychotic disorders group, Vibraimage parameters and MMPI-2 items were compared between the two groups. In addition, we investigated the relations between Vibraimage parameters and MMPI-2 items characteristic of schizophrenia spectrum and other psychotic disorders by using the Correlation analysis. Results: ：Compared to non-organic non-psychotic disorders group, Schizophrenia Spectrum Disorders group scored low at Aggression (t=-2.752, p=0.007), Tension (t=-2.106, p=0.039), and Suspects (t=-2.617, p=0.011); high at Neuroticism (t=4,215, p<0.001) in the Vibraimage, and the group scored comparatively high at Sc (Schizophrenia) (t=-2.099, p=0.039) and low at Hy (Hysteria) (t=-2.228, p=0.029) in the MMPI-2. The Sc (Schizophrenia) item in the MMPI-2 showed a negative correlation with Suspect parameter (r=0.242 p=0.035) and positive correlation with Neuroticism parameter (r=0.267, p=0.02) in the Vibraimage. Conclusion ：Our findings suggest that Suspect and Neuroticism parameters of the Vibraimage were characteristic in schizophrenia spectrum and other psychotic disorders, and showed potential as diagnostic tools, especially in psychiatric evaluations.

Multiple odontogenic keratocysts (OKC) are a distinguishing feature of nevoid basal cell carcinoma syndrome (NBCCS). Owing to the high recurrence rate of syndromes associated OKCs, complete surgical resection is generally recommended as a definitive treatment. Herein, we report the management of multiple OKCs with marsupialization followed by excision with peripheral ostectomy in an NBCCS patient. We then discuss lesion progression over 11 years of annual follow-ups.

As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gramnegative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.