BACKGROUND: The Stroop color word test is useful to examines the frontal lobe function of selective attention and inhibition. The Korean Color Word Stroop Test(K-CWST) was widely used in Korea. But, it was difficult in elderly individual with low educational level and visual problem and in patients with more progressed dementia. So we developed the Korean Stroop Test(KST). METHODS: The KST consist of word reading(WR), color naming(CN), interference word reading(IWR) and interference color naming (ICN). The interference tasks are naming the ink color of color words which were mismatched with word meaning. We measured reaction time and number of error. This study used the K-CWST to assess and compare the KST in eighteen probable alcohol related dementia patients and nineteen normal control. All subjects received the Korean version of Mini-Mental State Examination (K-MMSE) and the K-CWST and the KST. We tested reliability and validity of the KST. Also we enrolled normal adult from 41 to 80 year old for evaluating the change of the KST test with age. RESULTS: The KST tasks were correlated with K-MMSE -0.33(p<0.05) to -0.63(p<0.001) and K-CWST correlated with K-MMSE 0.37 (p<0.05) to 0.55(p<0.01). The interference color naming of KST was correlated the most to K-MMSE -0.78(p<0.001). The interference color naming of KST and interference color naming of K-CWST was correlated by 0.81(p<0.001). The internal consistency were 0.78 (Cronbach's alpha). The KST score was statistically different between alcohol related dementia patients and normal subjects in CN, ICN and ICN error. The KST was not differ in old age group except some tasks. CONCLUSION: The KST has a excellent reliability and validity. It takes less time and easy than the K-CWST. So the KST is a good test for evaluating frontal lobe function in elderly with low educational level of older people.
Adult ; Aged ; Aged, 80 and over ; Dementia ; Frontal Lobe ; Humans ; Ink ; Korea ; Reaction Time ; Reproducibility of Results ; Stroop Test*

Microphallus species occur primarily as intestinal parasites of birds and mammals, and metacercariae of a new species belonging to this genus have been discovered from the crab, Macrophthalmus dilatatus, in the Republic of Korea. The metacercaria of this fluke was round with 2 thick walls, and the excysted one had mature genital organs. The adult flukes recovered from experimentally infected chicks had numerous intrauterine eggs, well-developed pars prostatica, widely bifurcating ceca, and prominent uterine bulge. After observing internal structures, it was concluded that this species is different from any other known Microphallus spp. Based on the morphology of metacercariae and adult flukes, we describe this specimen as a new species, Microphallus koreana n. sp.
Animals ; Brachyura/*parasitology ; Chickens ; Rats ; Trematoda/*anatomy & histology/*classification/isolation & purification ; Trematode Infections/parasitology/transmission

PURPOSE: This study was conducted in order to evaluate the possibility of improving the comprehension and satisfaction of patients discharged after receiving discharge instructions using a tablet personal computer (tablet PC), compared with conventional discharge instructions. METHODS: A randomized, prospective, consecutive, exploratory study was conducted on patients with ureteral stones in an emergency department (ED). The patients' objective comprehension, satisfaction, and subjective comprehension regarding their discharge instructions were compared with regard to discharge instruction (traditional verbal method, N=53 versus tablet PC method, N=53). RESULTS: No statistically significant differences in age, gender, or level of education were observed between the two groups. The mean number of correct answers regarding ureteral stones on the questionnaire was 2.35+/-1.02 in the conventional group (CG) and 3.37+/-0.9 in the tablet PC group (TG) (p<0.05). The score for satisfaction was 7.75 in the CG and 8.03 in the TG (p>0.05). The subjective comprehension score was 7.42 in the CG and 7.8 in the TG (p>0.05). CONCLUSION: Objective comprehension of ureteral stones showed improvement in the group with discharge instructions provided by the tablet PC. However, satisfaction and subjective comprehension did not show improvement.
Comprehension ; Computer-Assisted Instruction ; Computers, Handheld ; Emergencies ; Humans ; Microcomputers ; Patient Discharge ; Prospective Studies ; Surveys and Questionnaires ; Ureter ; Urolithiasis

Commotio cordis is induction of sudden cardiac arrest and ventricular fibrillation (VF) by chest blunt trauma and nonpenetrating injury without damage to the rib, sternum, and heart in a person without underlying cardiovascular disease. Commotio cordis has been rarely reported worldwide, and it is particularly rare in the case of traffic accident (TA). We experienced a case of commotio cordis in a healthy 20-year-old man who was involved in a TA. The patient had no other signs of trauma except blunt chest trauma, and the initial electrocardiography (ECG) rhythm checked by the emergency medical technician (EMT) team was VF. They performed defibrillation and cardiopulmonary resuscitation (CPR) during transfer. CPR including defibrillation was performed because VF continued upon arrival at the emergency department, and therapeutic hypothermia (THT) was performed because glasgow coma scale (GCS) score was 3 after return of spontaneous circulation (ROSC). The patient's mental status became alert after performance of THT and cerebral performance category (CPC) score was 1 without neurological symptoms at the time of discharge. In trauma patients who may be have blunt chest trauma, including TA, emergency medical service providers must perform continuous monitoring with commotio cordis in mind, and perform defibrillation and CPR immediately if VF arises. With training in basic CPR and a supply of automated external defibrillators (AED) for application to trauma patients, the survival rate of commotio cordis patients can be increased.
Accidents, Traffic* ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Commotio Cordis* ; Death, Sudden, Cardiac ; Defibrillators ; Electrocardiography ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital* ; Glasgow Coma Scale ; Heart ; Humans ; Hypothermia ; Ribs ; Sternum ; Survival Rate ; Thoracic Injuries ; Thorax ; Ventricular Fibrillation ; Wounds, Nonpenetrating ; Young Adult

A 30-year-old man suffering from anaphylactoid attack after exercise was admitted. He had asthma, atopy, and a family history of allergic diseases. He suffered from dyspnea, wheezing, dizziness, angioedema, urticaria after exercise such as climbing. Although many cases of exercise-induced anaphylaxis have been reported, most of them were food-dependent exercise-induced anaphylaxis rather than classic exercise-induced anaphylaxis. We performed exercise provocation test, which resulted in anaphylactoid shock accompanied with hypotension. angioedema, wheezing, dyspnea and a fall of FEV1(Forced expiratory volume in one second). These reactions were related with only exercise but not foods. Because there are few cases of classic exercise-induced anaphylaxis, we report this case in consideration with its clinical importance and fatality. Physicians should be alerted on the many manifestations occuring after physical activities.
Adult ; Anaphylaxis* ; Angioedema ; Asthma ; Dizziness ; Dyspnea ; Humans ; Hypotension ; Motor Activity ; Respiratory Sounds ; Shock ; Urticaria

OBJECTIVES: To investigate the association between abnormal inhibin-A level in Quad test during the 15 and 18 weeks of gestation and adverse pregnancy outcomes. METHODS: From January 2005 to March 2007, women who delivered their babies at our institute after Quad test in second trimester of gestation (N=140) were enrolled. We measured inhibin-A levels (MoM) and other serum markers of the Quad test. And we analyzed the incidence of adverse pregnancy outcomes such as preterm birth, fetal growth restriction, pregnancy induced hypertension, fetal loss, and intrauterine fetal death. RESULTS: When the pregnancy outcomes are hypertensive disorders and fetal losses, the inhibin-A levels are is more elevated with statistically significance. Inhibin-A and hCG levels are elevated with significantly at hypertensive disorders and fetal losses. But inhibin-A levels are more significantly associated with abnormal pregnancy outcomes than hCG. CONCLUSIONS: Measurement of inhibin-A levels may be the most useful among other serum markers of the Quad test in predicting adverse obstetric outcomes.
Adenine ; Biomarkers ; Carbamates ; Deoxycytidine ; Drug Combinations ; Female ; Fetal Death ; Fetal Development ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Inhibins ; Organophosphonates ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, Second ; Premature Birth ; Quinolones ; Thiazoles ; Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination

BACKGROUND: Specific IgE responses to allergens provide useful models for evaluating the genetic factors that control human immune responses. HLA class II gene products are involved in the antigen presentation of exogenous antigens. OBJECTIVE: The aim of this study was to evaluate whether susceptibility or resistance to asthma induced by the citrus red mite (Panonychus citri, CRM) was associated with HLA class II gene-encoded antigens. METHODS: Peripheral venous blood samples were collected from two groups of unrelated Korean adults. Ninety-one patients with citrus red mite-induced asthma and 98 exposed, healthy control subjects. The second exon of the HLA-DRB1 genes was selectively amplified by the polymerase chain reaction method. HLA typing was carried out using PCR-sequence specific oligonucleotide probes(PCR-SSOP). RESULTS: The frequency of HLA-DR7 was significantly higher among the CRM-sensitive asthmatics than among the controls (17.6% vs 4.1%, RR=3.92, p=0.01). Conversely, the frequency of HLA-DR4 was significantly lower among the CRM-sensitive asthmatics than among the controls(19.8% vs 40.8%, RR=0.36, p=0.01). No significant difference was found in the distributions of the other HLA-DRB1 gene-encoded antigens between the two groups. CONCLUSION: HLA-DRB1 genes may be involved in the development of citrus red mite-induced asthma. In addition, HLA-DR7 may increase, and DR4 decrease, the risk of developing asthma in exposed individuals.
Adult ; Allergens ; Antigen Presentation ; Asthma* ; Citrus* ; Exons ; Genes, MHC Class II ; Histocompatibility Testing ; HLA-DR Antigens ; HLA-DR4 Antigen ; HLA-DR7 Antigen ; HLA-DRB1 Chains ; Humans ; Immunoglobulin E ; Mites* ; Polymerase Chain Reaction

BACKGROUND: While aspirin sensitivity has been known to be common among patients with severe asthma, its frequency among asthmatics with mild to moderate severity remains to be learned. OBJECTIVES: To elucidate the frequency of aspirin sensitivity and its clinical characteristics among asthma patients with mild to moderate severity. MATERIAL AND METHODS: A total of 96 asthmatics with mild to moderate severity were enrolled. They underwent lysine-aspirin and methacholine bronchial provocation tests, and gave their induced sputum after the lysine-aspirin challenge. RESULTS: FEV1 declined greater than 20% compared with baseline FEV1 in 11 of 96 patients on the lysine-aspirin challenge. The frequency of aspirin sensitivity was higher among patients with enhanced bronchial hyperresponsiveness to methacholine (PC20 < 1 mg/ml) than among those without it (27.3% vs. 6.8%). The frequency was also higher in those with induced sputum eosinophil count higher than 3% than among those without it (38.9% vs. 0%). However, it was not associated with other risk factors such as age, sex, atopy, nasal polyps, and rhinosinusitis. CONCLUSION: More than 10% of mild to moderate asthmatics have aspirin sensitivity even though they have experienced no history of aspirin sensitivity which may be related with bronchial hyperresponsiveness to methacholine and eosinophil activation.
Aspirin* ; Asthma ; Asthma, Aspirin-Induced ; Bronchial Provocation Tests ; Eosinophils ; Humans ; Methacholine Chloride ; Nasal Polyps ; Prevalence* ; Risk Factors ; Sputum

Alcohol-induced asthma is defined as exacerbation of asthmatic symptoms after drinking alcoholic beverages. This phenomenon is rare in Caucasians and is more specific to Asians. It has been observed among 50% of Japanese asthmatic patients and genetic predisposition in acetal-dehyde metabolism is thought to be a main factor in alcohol-induced asthma. Although the genetic predisposition of acetaldehyde metabolism in Koreans may be similar to the Japanese, alcohol-induced asthma has not been reported in Korea. We experienced two cases of alcohol-induced asthma which were confirmed by oral ethanol provocation test. In the first case, a 60-year-old male asthma patient presenting a recurrent episode of wheezing and dyspnea after alcohol consumption visited our clinic. After an oral challenge with 300ml of 10% ethanol solution dissolved in 5% glucose solution, dyspnea and wheezing episode were reproduced and 23% decrease in FEV1 compared to basal level was also shown at 20 minutes after ingestion. In the second case, a 32-year-old female asthma patient was presented with the same symptoms. After oral challenge, dyspnea and wheezing episode were reproduced and 30% decrease in FEV1 compared to basal level was shown at 60 minutes after ingestion. Short acting bronchodilator was applied and 21% increase in FEV1 resulted. They were instructed to avoid alcohol consumption with good results.
Acetaldehyde ; Adult ; Alcohol Drinking ; Alcoholic Beverages ; Asian Continental Ancestry Group ; Asthma* ; Drinking ; Dyspnea ; Eating ; Ethanol ; Female ; Genetic Predisposition to Disease ; Glucose ; Humans ; Korea ; Male ; Metabolism ; Middle Aged ; Respiratory Sounds

Tolosa-Hunt syndrome is a rare self-limiting disease characterized by a painful, unilateral ophthalmoplegia caused by an idiopathic granulomatous inflammation in cavernous sinus, the superior orbital fissure or the orbital apex. We report a case of a 51-year-old man who presented at the emergency department with periocular pain and diplopia. Physical examination, and radiological and laboratory testing performed at that time were diagnostically inconclusive. After hospitalization, the patient was diagnosed with Tolosa-Hunt syndrome. Treatment with high dose steroid was started; by 2 days later, the periocular pain was relieved and other symptoms had improved. The rarity of Tolosa-Hunt syndrome calls for knowledge of the disease and attention by an emergency physician. The case report includes as summary of the syndrome, its' diagnosis and treatment.
Cavernous Sinus ; Diplopia ; Emergencies ; Hospitalization ; Humans ; Inflammation ; Male ; Middle Aged ; Ophthalmoplegia ; Orbit ; Physical Examination ; Tolosa-Hunt Syndrome