Objective: High-quality intensive care, including targeted temperature management (TTM) for patients with postcardiac arrest syndrome, is a key element for improving outcomes after out-of-hospital cardiac arrest (OHCA). We aimed to assess the status of postcardiac arrest syndrome care, including TTM and 6-month survival with neurologically favorable outcomes, after adult OHCA patients were treated with TTM, using data from the Korean Hypothermia Network prospective registry. Methods: We used the Korean Hypothermia Network prospective registry, a web-based multicenter registry that includes data from 22 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TTM between October 2015 and December 2018 were included. The primary outcome was neurological outcome at 6 months. Results: Of the 1,354 registered OHCA survivors treated with TTM, 550 (40.6%) survived 6 months, and 413 (30.5%) had good neurological outcomes. We identified 839 (62.0%) patients with preClinsumed cardiac etiology. A total of 937 (69.2%) collapses were witnessed, shockable rhythms were demonstrated in 482 (35.6%) patients, and 421 (31.1%) patients arrived at the emergency department with prehospital return of spontaneous circulation. The most common target temperature was 33°C, and the most common target duration was 24 hours. Conclusion The survival and good neurologic outcome rates of this prospective registry show great improvements compared with those of an earlier registry. While the optimal target temperature and duration are still unknown, the most common target temperature was 33°C, and the most common target duration was 24 hours.

BACKGROUND: Skin laser treatment has improved significantly and has become an effective treatment approach for many skin diseases while also having applications for beauty treatments. However, since skin laser transfers energy directly to the skin, the misuse of such treatment may result in permanent damage to skin tissues. OBJECTIVE: This survey of Korean adults, conducted to obtain their perspectives on and their treatment experience with skin laser treatment, will be used to determine the current status of skin laser treatment and to identify necessary changes to ensure proper and safe conduct of skin laser treatment. METHODS: From April 5th to April 12th, 2016, a survey was conducted to obtain information regarding the perspectives and the treatment experience of adults aged 20~59 years. RESULTS: Approximately 50% of the participants had experience with skin laser treatment, and among these, 24.7% had not received treatment at a dermatology clinic. Compared to treatment at a dermatology clinic, the danger of side effects was 1.7 times higher at a non-dermatology clinic, 2 times higher at a skin care shop, and 5.3 times higher at an Oriental medical clinic. Among patients who received skin laser treatment, 16.1% experienced side effects, and among these, 1 out of 4 patients visited a non-dermatologist for treatment of these side effects. CONCLUSION: The results of the survey showed that in order for the public to receive safe and effective skin laser treatment based on professional diagnosis, there is a definitive need to provide correct information to the public and to implement changes to ensure proper understanding of skin laser treatment among this population.
Adult ; Beauty ; Dermatology ; Diagnosis ; Humans ; Skin Care ; Skin Diseases ; Skin*

PURPOSE: The studies concerning the clinical features of patients with anaphylaxis, who meet the newly established diagnostic criteria, are reported in Korea, but comparative studies regarding the clinical features of children and adult patients with anaphylaxis are lacking. The purpose of this study is to compare the clinical features of the children and adults with anaphylaxis, who meet the new diagnostic criteria at a single hospital. METHODS: We reviewed the medical records of patients who were diagnosed with anaphylaxis, anaphylactic shock, urticaria, and angioedema, including inpatients, outpatients and emergency room visited patients, at the National Medical Center from July, 2005 to August, 2011. The clinical characteristics of children and adults, who met the new diagnostic criteria for anaphylaxis, were analyzed. RESULTS: We identified 91 patients with anaphylaxis. Sixteen were children and 75 were adults. The sex ratio (male:female) and the mean age were 1:1.7 and 9.6 years among children, respectively, and 1:2.3 and 42.3 years, respectively, among adults. The most common cause of anaphylaxis based on clinical history was foods in 15 children (93.7%) and 35 adults (46.7%). Twelve children (75%) and 36 adults (48%) were rediagnosed with anaphylaxis. Patients with cardiovascular symptoms and severe severity were 1 (6.3%) and 1 (6.3%), respectively, among children, and 28 (37.3%) and 23 (30.3%), respectively, among adults. CONCLUSION: We rediagnosed some cases of anaphylaxis, using the new diagnostic criteria and most of the cases were diagnosed initially as urticaria or angioedema. The adults had more severe and more cardiovascular symptoms than children. In the future, a nationwide, multiinstitutional research will be necessary for the prevalence and the clinical features of anaphylaxis by the new diagnostic criteria in Korea.
Adult ; Anaphylaxis ; Angioedema ; Child ; Emergencies ; Humans ; Inpatients ; Korea ; Medical Records ; Outpatients ; Prevalence ; Sex Ratio ; Urticaria

PURPOSE: To report our results on urinary continence after bladder neck preservation (BNP) and posterior urethral reconstruction (PUR) during robot-assisted laparoscopic radical prostatectomy (RALP). MATERIALS AND METHODS: Data from 107 patients who underwent RALP were compared on the basis of whether the patients underwent BNP and PUR, BNP only, or the standard technique (ST). In group A (n=31 patients), ST was performed by using Ven velthoven continuous suturing for urethrovesical anastomosis. In group B (n=28 patients), ST with only PUR was performed. In group C (n=48 patients), both the BNP and PUR techniques were used. "Recovery of continence" was defined as the use of 1 pad (50 ml) or less within 24 hours. RESULTS: The three groups were comparable in terms of patient demographics. The mean operative time and the mean blood loss decreased significantly from group A to group C (p=0.021 for mean operative time and p=0.004 for the mean blood loss). Mean catheterization time was 8.9, 7.8, and 7.1 days in each group (p=0.047). Early return of urinary continence at 3 months was observed in group B (89.2%) and group C (90.6%) compared with group A (71%). However, continence at 6 months was comparable in the 3 groups (87.5% in group A, 92.8% in group B, and 92.3% in group C). Rates of positive surgical margins decreased from 30.2% in group A to 20% in group B and 12% in group C. CONCLUSIONS: BNP and PUR during RALP showed a favorable impact on the early postoperative recovery of continence while not affecting positive surgical margins.
Catheterization ; Catheters ; Demography ; Humans ; Neck ; Operative Time ; Prostatectomy ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Incontinence

PURPOSE: The aim of this report was to describe a new reconstructive technique of pancreaticogastrostomy and to also discuss this procedure's effectiveness for reducing the incidence of postoperative complications. METHODS: We retrospectively analyzed early surgical outcomes in 21 consecutive patients who underwent this novel pancreaticogastrostomy after pancreaticoduodenectomy. Pancreaticogastrostomy was completed with 2 transpancreatic sutures with buttresses on both the upper and lower edges of the implanted pancreas through the retracted anterior gastrotomy. RESULTS: Operative mortality was zero and morbidity was 23.8%. A significant pancreatic fistula occurred in 1 patient (4.7%; grade B). CONCLUSION: This technique is very easy to perform, less traumatic to the pancreatic stump, can be performed through a mini-laparotomy due to good vision and straight sutures, and it is secure owing to anchoring of the invaginated pancreatic stump to the stomach's posterior wall with buttresses. The results of this pilot study indicate that the technique may provide a favorable outcome and could be an alternative method of pancreatoenteric anastomosis. However, to determine its superiority over the conventional procedures, this operative technique should be evaluated more comprehensively in a larger series.
Humans ; Incidence ; Pancreas ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Pilot Projects ; Retrospective Studies ; Sutures ; Vision, Ocular

PURPOSE: The aim of this report was to describe a new reconstructive technique of pancreaticogastrostomy and to also discuss this procedure's effectiveness for reducing the incidence of postoperative complications. METHODS: We retrospectively analyzed early surgical outcomes in 21 consecutive patients who underwent this novel pancreaticogastrostomy after pancreaticoduodenectomy. Pancreaticogastrostomy was completed with 2 transpancreatic sutures with buttresses on both the upper and lower edges of the implanted pancreas through the retracted anterior gastrotomy. RESULTS: Operative mortality was zero and morbidity was 23.8%. A significant pancreatic fistula occurred in 1 patient (4.7%; grade B). CONCLUSION: This technique is very easy to perform, less traumatic to the pancreatic stump, can be performed through a mini-laparotomy due to good vision and straight sutures, and it is secure owing to anchoring of the invaginated pancreatic stump to the stomach's posterior wall with buttresses. The results of this pilot study indicate that the technique may provide a favorable outcome and could be an alternative method of pancreatoenteric anastomosis. However, to determine its superiority over the conventional procedures, this operative technique should be evaluated more comprehensively in a larger series.
Humans ; Incidence ; Pancreas ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Pilot Projects ; Retrospective Studies ; Sutures ; Vision, Ocular

PURPOSE: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. METHODS: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. RESULTS: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2+/-18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. CONCLUSIONS: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.
Age Distribution ; Aged ; Corneal Perforation ; Female ; Gram-Positive Bacteria ; Humans ; Keratitis ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus epidermidis ; Vegetables

No abstract available.

BACKGROUND AND OBJECTIVES: Pentraxin 3 (PTX3) was shown to be elevated in the acute phase of acute myocardial infarction (AMI) and to have prognostic significance in AMI patients. The aim of this study was to estimate whether the value of PTX3 could be used as a prognostic biomarker, with the global registry of acute coronary events (GRACE) risk assessment tool, in patients with acute coronary syndrome (ACS). SUBJECTS AND METHODS: Between July 2007 and June 2008, 137 patient subjects (mean age : 61+/-12 years, M : F=108 : 29) with ACS who underwent coronary intervention, but did not have a prior percutaneous coronary intervention (PCI) and/or follow-up coronary angiogram, were enrolled. We estimated the all-cause mortality or death/MI, in-hospital and to 6 months, using the GRACE risk scores and compared these estimates with serum PTX3 concentrations. RESULTS: The serum PTX3 concentration showed a significant increase in ST segment elevation myocardial infarction (STEMI) greater than the unstable angina pectoris (UAP) group (2.4+/-2.1 ng/mL vs. 1.3+/-0.9 ng/mL, p= 0.017, respectively), but did not show a significant difference between non-ST segment elevation myocardial infarction (NSTEMI) and the UAP group (1.9+/-1.4 ng/mL vs. 1.3+/-0.9 ng/mL, p=0.083, respectively). The serum PTX3 concentration was closely related to death/MI in-hospital (r=0.242, p=0.015) and death/MI to 6 months (r=0.224, p=0.023), respectively. The serum PTX3 concentration was not related to all-cause mortality in-hospital (r=0.112, p=0.269) and to 6 months (r=0.132, p=0.191), respectively. Among the parameters determining the GRACE risk scores, the degree of Killip class in congestive heart failure (CHF) was independently associated with the supramedian PTX3 concentration [odds ratio: 2.229 (95% confidence interval: 1.038-4.787), p=0.040]. CONCLUSION: The serum PTX3 level provides important information for the risk stratification of CHF among the parameters determining the GRACE risk scores in subjects with ACS.
Acute Coronary Syndrome ; Angina, Unstable ; C-Reactive Protein ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Heart Failure ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Risk Assessment ; Serum Amyloid P-Component

OBJECTIVE: To investigate the effects of sono-guided intraarticular steroid injection followed by sodium hyaluronate injection weekly for 2 weeks on adhesive capsulitis of the shoulder. METHOD: In this prospective randomized controlled trial, 16 patients (group A) were treated with intraarticular injection with a mixture of 0.5% lidocaine 9 ml and triamcinolone 40 mg once a week for 3 weeks, and 13 patients (group B) were treated with intraarticular injection with a mixture of 0.5% lidocaine 9 ml and triamcinolone 40 mg for the first week, and subsequently a mixture of 0.5% lidocaine 8 ml and sodium hyaluronate 2 ml once a week for the next 3 weeks. A self exercise program was instructed for all subjects. The effects were assessed using visual numeric scale (VNS), shoulder pain and disability index (SPADI), and range of shoulder motion (flexion, abduction, internal rotation. external rotation, and extension) at study entry, every week until 2 weeks have passed after the last injection. RESULTS: The VNS, SPADI, and range of shoulder motion improved 1 week after 1st injection and continued to improve until 2 weeks after last injection in both two groups. There were no difference in changes of VNS and SPADI between these two groups, but range of shoulder motion especially in passive and active internal rotation of patients in group A improved more than those in group B. CONCLUSION: Steroid injection combined with hyaluronic acid injection has comparable effects with triamcinolone for treatment of adhesive capsulitis of the shoulder. Sono-guided intraarticular injection of steroid combined with hyaluronic acid can substitute for intraarticular injection of triamcinolone and be useful especially for patients susceptible to adverse effects of steroid injection.
Adhesives ; Bursitis ; Humans ; Hyaluronic Acid ; Injections, Intra-Articular ; Lidocaine ; Prospective Studies ; Shoulder ; Shoulder Pain ; Triamcinolone