PURPOSE: Catheter ablation for atrial fibrillation (AF) requires heavy anticoagulation and uncomfortable post-procedural hemostasis. We compared patient satisfaction with and the safety of unilateral groin (UG) puncture-single trans-septal (ST) ablation with conventional bilateral groin (BG) puncture-double trans-septal (DT) ablation in paroxysmal AF patients. MATERIALS AND METHODS: We enrolled 222 patients with paroxysmal AF (59.4±10.7 years old) who were randomized in a 2:1 manner into UG-ST ablation (n=148) and BG-DT ablation (n=74) groups. If circumferential pulmonary vein isolation could not be achieved after three attempts of touch-up ablation in the UG-ST group, the patient was crossed over to BG-DT by performing a left groin puncture. RESULTS: Ten patients in the UG-ST group (6.8%) required crossover to the BG-DT approach. There were no significant differences in procedure time (p=0.144) and major complications rate (p>0.999) between the UG-ST and BG-DT groups. Access site pain (p=0.014), back pain (p=0.023), and total pain (p=0.015) scores were significantly lower for the UG-ST than BG-DT group as assessed by the Visual Analog Scale. Over 20.2±8.7 months of follow up, there was no difference in AF recurrence free-survival rates between the two groups (Log rank, p=0.984). CONCLUSION: UG-ST AF ablation is feasible and safe, and was found to significantly reduce post-procedural hemostasis-related discomfort, compared to the conventional DT approach, in patients with paroxysmal AF.
Atrial Fibrillation ; Back Pain ; Catheter Ablation ; Follow-Up Studies ; Groin ; Hemostasis ; Humans ; Patient Satisfaction ; Prospective Studies ; Pulmonary Veins ; Punctures ; Recurrence ; Visual Analog Scale

Atrial fibrillation (AF) is the most common cardiac abnormality associated with ischemic stroke. Anticoagulant therapy plays an important role in the prevention of stroke associated with AF. Risk stratification and selection of oral anticoagulants in patients with AF are usually performed according to international guidelines from Europe or the United States of America. However, pivotal trials enrolled only a small number of Asian subjects, limiting the application of international guidelines to Korean patients with AF. The Korean Heart Rhythm Society organized a Korean AF Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. Expert consensus or guidelines for the optimal management of Korean patients with AF were achieved after a systematic review with intensive discussion. This article provides general principles for appropriate risk stratification and selection of anticoagulation therapy in Korean patients with AF.
Americas ; Anticoagulants ; Asian Continental Ancestry Group ; Atrial Fibrillation* ; Consensus ; Embolism and Thrombosis ; Europe ; Heart ; Humans ; Stroke* ; United States

This erratum is being published to correct the printing error on Table 5 of the article.

PURPOSE: This study was done to identify the retention effects of a basic life support training program for nursing students on their attitude, knowledge, and skillfulness. METHODS: A one-group repeated posttest design was employed for this study. The subjects included 44 junior nursing students from Gachon University in Incheon. Data were collected by a structured questionnaire test immediately after, 3 months after, 6 months after, and 9 months after the training respectively from May 2014 through March 2015. RESULTS: The respective attitude, knowledge and skillfulness score on BLS of the nursing students had reduced significantly at 3 months after (p<.001), 6 months after (p<.001), and 9 months after (p<.001, p=.011 for Attitudes) the training compared to immediately after the training. CONCLUSION: Re-training on basic life support for nursing students should be implemented within 3 months for retention of educational effects. Thus, it is recommended that basic life support training programs, including a curriculum for nursing students, is developed to support re-training. And it is expected that the improved skills of nursing students on basic life support would contribute to the successive first aid nursing for patients at risk of cardiac arrest.
Cardiopulmonary Resuscitation ; Curriculum ; Education* ; First Aid ; Heart Arrest ; Humans ; Incheon ; Nursing* ; Students, Nursing*

PURPOSE: This study investigated medication status by examining the effects of a medication management education program on the knowledge of medications and medication misuse behaviors in the elderly in a local community. METHODS: This study used a non-equivalent control group quasi-experimental design. For the study, 116 subjects were assigned to the control group and another 116 subjects were assigned to the experimental group. The medication management education program consisted of 1:1 education, practice in medication management, consultation, and discussion. Data were analyzed using the SPSS 21.0 program. RESULTS: Statistically significant differences were found between the experimental and control groups in terms of their knowledge of medications and medication misuse behaviors. CONCLUSION: The results indicate that the medical management education program is effective in improving the knowledge of medications and decreasing medication misuse behaviors. Therefore, this education program can be used as an intervention to improve the medication behaviors of the elderly in local communities.
Aged* ; Education* ; Humans ; Medication Therapy Management ; Prescription Drug Misuse

OBJECTIVE: To evaluate the correlation between serum levels of anti-Mullerian hormone (AMH) and ovarian response to mild stimulation in normoovulatory women and anovulatory women with polycystic ovary syndrome (PCOS). METHODS: Seventy-four cycles of mild stimulation (clomiphene citrate+gonadotropin followed by timed intercourse or intrauterine insemination) performed in normoovulatory women (57 cycles) and anovulatory women with PCOS (17 cycles). Ovarian sensitivity was defined by the number of mature follicles (> or =14 mm) on triggering day per 100 IU of gonadotropin. A correlation between ovarian sensitivity and the baseline serum AMH level (absolute or multiples of the median [MoM] value for each corresponding age) was calculated. Correlation between ovarian response and serum AMH level was evaluated. RESULTS: Ovarian sensitivity to mild stimulation was positively correlated with absolute serum AMH (r=0.535, p<0.001) or AMH-MoM value (r=0.390, p=0.003) in normoovulatory women, but this correlation was not observed in anovulatory women with PCOS (r=0.105, p>0.05, r=-0.265, p>0.05, respectively). CONCLUSION: Ovarian response to mild stimulation is possibly predicted by the serum AMH level in normoovulatory women, but not in anovulatory women with PCOS.
Anti-Mullerian Hormone ; Female ; Gonadotropins ; Humans ; Ovulation Induction ; Polycystic Ovary Syndrome

PURPOSE: Recently, vitamin D insufficiency has increased and has been correlated to growth and puberty in children. This study was conducted to find the prevalence of subclinical vitamin D insufficiency and its influence on school-aged children in Korea. METHODS: The subjects of this study were 397 children aged 7 to 15 years who had been tested for 25-OH vitamin D3 among the outpatients of the Department of Pediatrics in Eulji General Hospital from March 2007 to February 2011. Data for age, sex, comorbidities, serum 25-OH vitamin D3, height, weight, body mass index (BMI), and sunlight exposure time were collected before and after 3 months of vitamin D administration, retrospectively. RESULTS: Vitamin D insufficiency was present in 343 (86%) of the subjects. In the vitamin D insufficient group, chronological age was 8.96+/-1.72 years, mean height (z-score [z]) was 0.51+/-1.26, mean BMI (z) was 0.81+/-2.20, and bone age was 10.26+/-1.75 years. In the vitamin D sufficient group, chronological age was 9.61+/-1.77 years, mean height (z) was-0.66+/-0.98, mean BMI (z) was-0.01+/-1.16, and bone age was 9.44+/-2.12 years. A paired t-test showed that three months after vitamin D administration, the mean 25-OH vitamin D3 level in the insufficient group increased to 24.38 +/-10.03 ng/mL and mean BMI (z) decreased to 0.67+/-1.06. CONCLUSION: In Korean school-aged children, vitamin D insufficiency were relatively higher and may be closely related with higher BMI. Insufficient rise of the level of vitamin D after supplementation suggest the new supplementation guidelines, especially for Korean children.
Adolescent ; Body Mass Index ; Body Weight ; Child* ; Cholecalciferol ; Comorbidity ; Hospitals, General ; Humans ; Korea ; Outpatients ; Pediatrics ; Prevalence ; Puberty ; Retrospective Studies ; Sunlight ; Vitamin D* ; Vitamins*

The purpose of this study was to investigate the prevalence, clinical characteristics, and management of functional constipation at pediatric gastroenterology clinics. A prospective survey using the Rome III criteria was distributed to a group of parents of children with a constipation history and its control group in May 2008. The mean prevalence of constipation was 6.4%, which was similar to those in other countries. Statistically significant variables for children without constipation were that more children had a body mass index of below the 10th percentile even though they received more mother's care and ate balanced meals compared to the constipation group. Meanwhile, the constipation group frequently showed a history of constipation in infancy, picky-eating, lack of exercise, and retentive posturing. When analyzed with the Rome III criteria, the children showed greater than 60% rate of hard stools, painful stools, a history of large fecal mass in rectum, and its disappearance of constipation symptoms after passing a large stool. Our study found different approaches amongst pediatric gastroenterologists like rectal examinations, disimpaction, or drug treatment. Several factors addressed in our study can provide better guidelines for clinicians treating constipation and its future research.
Adolescent ; Body Mass Index ; Child ; Child, Preschool ; Constipation/*diagnosis/drug therapy/epidemiology ; Female ; Hospitals ; Humans ; Infant ; Laxatives/therapeutic use ; Male ; Prevalence ; Prospective Studies ; Rectum/physiopathology ; Severity of Illness Index

BACKGROUND/AIMS: Many candidate gene studies have revealed that polymorphisms of the 5'-flanking controlled SERT gene linked polymorphic region (5HTT-LPR) gene and G-protein beta3 C825T gene might be associated with functional dyspepsia (FD) and irritable bowel syndrome (IBS). This study was performed to investigate polymorphisms of the 5HTT-LPR gene and G-protein beta3 C825T gene in FD and IBS in Korean children. METHODS: In total, 102 patients with FD, 72 patients with IBS based on the Rome III criteria and 148 healthy controls without gastrointestinal symptoms were included in the study to analyze 5HTT-LPR and G-protein beta3 C825T polymorphisms. RESULTS: 5HTT-LPR genotype analysis revealed no signifi cant differences in FD and IBS patients compared with controls. The GNbeta3 C825T genotype distribution for CC, CT, and TT was 23.6%, 53.4%, and 23.0% in controls, 36.3%, 38.2%, and 25.5% in FD and 37.5%, 38.9%, and 23.6% in IBS, respectively. The CC genotype was more common in FD and IBS patients than controls (p<0.05). When the IBS patients were grouped according to IBS subtypes, CC genotype GNbeta3 C825T was common in diarrhea-dominant IBS, and the TT genotype was common in constipation-dominant IBS (p<0.05). CONCLUSIONS: The CC genotype of G-protein beta3 C825T may be associated with FD and diarrhea-predominant IBS. The TT genotype may be associated with constipation-predominant IBS.
Child ; Dyspepsia ; Genotype ; GTP-Binding Proteins ; Heterotrimeric GTP-Binding Proteins ; Humans ; Irritable Bowel Syndrome ; Rome ; Serotonin ; Serotonin Plasma Membrane Transport Proteins

Childhood functional gastrointestinal disorders are defined as a variable combination of often age-dependent, chronic, or recurrent gastrointestinal symptoms not explained by structural or biochemical abnormalities. A better understanding of genetic background of these disorders would help to better identify their complex biology and make it possible to identify subgroups of patients who respond to customized therapies. Family and twin studies have shown a genetic component in irritable bowel syndrome. Candidate gene studies have identified a few genetic polymorphisms that may be associated with functional dyspepsia and irritable bowel syndrome. Studies of associations of spontaneous genetic variations and altered functions may provide novel insights of the mechanisms contributing to the disease.
Biology ; Dyspepsia ; Gastrointestinal Diseases ; Genetic Variation ; Humans ; Irritable Bowel Syndrome ; Polymorphism, Genetic