STUDY DESIGN: A noninterventional, multicenter, cross-sectional study. PURPOSE: We investigated the prevalence of neuropathic pain (NP) and patient-reported outcomes (PROs) of the quality of life (QoL) and functional disability in Korean adults with chronic low back pain (CLBP). OVERVIEW OF LITERATURE: Among patients with CLBP, 20%–55% had NP. METHODS: Patients older than 20 years with CLBP lasting for longer than three months, with a visual analog scale (VAS) pain score higher than four, and with pain medications being used for at least four weeks before enrollment were recruited from 27 general hospitals between December 2014 and May 2015. Medical chart reviews were performed to collect demographic/clinical features and diagnosis of NP (douleur neuropathique 4, DN4). The QoL (EuroQoL 5-dimension, EQ-5D; EQ-VAS) and functional disability (Quebec Back Pain Disability Scale, QBPDS) were determined through patient surveys. Multiple linear regression analyses were performed to compare PROs between the NP (DN4≥4) and non-NP (DN4 < 4) groups. RESULTS: A total of 1,200 patients (females: 65.7%; mean age: 63.4±13.0 years) were enrolled. The mean scores of EQ-5D, EQ-VAS, and QBPDS were 0.5±0.3, 55.7±19.4, and 40.4±21.1, respectively. Among all patients, 492 (41.0%; 95% confidence interval, 38.2%–43.8%) suffered from NP. The prevalence of NP was higher in male patients (46.8%; p < 0.01), in patients who had pain based on radiological and neurological findings (59.0%; p < 0.01), and in patients who had severe pain (49.0%; p < 0.01). There were significant mean differences in EQ-5D (NP group vs. non-NP group: 0.4±0.3 vs. 0.5±0.3; p < 0.01) and QBPDS (NP group vs. non-NP group: 45.8±21.2 vs. 36.3±20.2; p < 0.01) scores. In the multiple linear regression, patients with NP showed lower EQ-5D (β=−0.1; p < 0.01) and higher QBPDS (β=7.0; p < 0.01) scores than those without NP. CONCLUSIONS: NP was highly prevalent in Korean patients with CLBP. Patients with CLBP having NP had a lower QoL and more severe dysfunction than those without NP. To enhance the QoL and functional status of patients with CLBP, this study highlights the importance of appropriately diagnosing and treating NP.
Adult* ; Back Pain ; Cross-Sectional Studies ; Diagnosis ; Hospitals, General ; Humans ; Linear Models ; Low Back Pain* ; Male ; Neuralgia* ; Prevalence* ; Quality of Life ; Visual Analog Scale

OBJECTIVESTo clarify the effects of acupuncture stimulation at Zusanli (ST 36) on the hormonal changes.

METHODSEight-week-old male C57BL/6 mice received acupuncture stimulation at acupoint ST 36 or Quchi (LI 11) once a day for 3 or 5 days in the acupuncture-stimulated groups, but not received in the normal group (n=6 in each group). On day 3 or 5, animals were given 0.1 mL of charcoal orally with a bulbed steel needle, 30 min after the last acupuncture stimulation. Ten minutes later, mice were anesthetized, and the intestinal transit and the concentrations of vasoactive intestinal peptide (VIP), motilin, ghrelin and gastrin in the serum were measured.

RESULTSCompared to no acupuncture stimulation, acupuncture stimulation at ST 36 for 5 days increased the intestinal transit and down-regulated the concentration of VIP and up-regulated the concentrations of motilin, ghrelin and gastrin (P<0.05 or 0.01), whereas acupuncture stimulation at LI 11 did not change them signifificantly (P>0.05).

CONCLUSIONAcupuncture stimulation at ST 36 for 5 days enhances the small intestinal motility and regulates the secretion of hormones related to small intestinal motility.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Gastrointestinal Motility ; physiology ; Hormones ; blood ; Intestine, Small ; physiology ; Male ; Mice, Inbred C57BL

PURPOSE: Transurethral resection of bladder tumor (TURBT) can be a challenging procedure for an inexperienced surgeon. We suggest an easy technique for TURBT, which we have named the "grasp and bite" technique. We describe this technique and compare its effectiveness and safety with that of conventional TURBT. MATERIALS AND METHODS: Monopolar TURBT (24-Fr Karl Storz) was performed in 35 patients who had superficial bladder tumors. After defining the tumor margin, the tumor and surrounding mucosa were grasped by use of a loop electrode and resectoscope sheath. With tight grasping, linear moving resection was performed. The patients' demographic, intraoperative, and postoperative data were analyzed between the conventional and grasp and bite TURBT groups. RESULTS: Of 35 patients, 16 patients underwent conventional TURBT (group 1), and the other 19 patients underwent grasp and bite TURBT (group 2). Both groups were similar in age, tumor multiplicity, size, anesthesia method, and location. Grasp and bite TURBT could be performed as safely and effectively as conventional TURBT. There were no significant differences in irrigation duration, urethral catheterization, postoperative hemoglobin drop, or length of hospital stay. No significant side effects such as bladder perforation, severe obturator reflex, or persistent bleeding occurred. There were no significant pathological differences between specimens according to the type of resection technique. CONCLUSIONS: The grasp and bite TURBT technique was feasible for superficial bladder tumors. It may be a good tool for inexperienced surgeons owing to its convenient and easy manner.
Aged ; Cystoscopy ; Electrodes ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Urinary Bladder/pathology/*surgery ; Urinary Bladder Neoplasms/pathology/*surgery ; Urologic Surgical Procedures/instrumentation/*methods

PURPOSE: Traffic accidents are increasing due to the development and increment of transportation. Previous studies on analysis of the correlation between environmental factors and traffic accidents have rarely been reported. The purpose of this study is to analyze the correlation between rainfall and traffic accidents including accident mechanism, incidence, and trauma severity of patients. METHODS: A retrospective review was conducted in 851 trauma patients who visited the emergency department (ED) after a traffic accident from January 2013 to December 2013; 248 patients due to a traffic accident when it was raining, and 603 patients when it was not raining. Demographic data, clinical data, and meteorological data (rainfall, daily mean air temperature, daily mean wind speed) in Busan were investigated. RESULTS: The incidence of traffic accidents was one-second and the injury severity score of patients was two points higher on rainy days. In addition, the length of hospital stay was three days longer (p=0.037), and the prognosis was poor in the rain group. Comparison of severe injury sustained over rain, injury time, and accident mechanism showed approximately a 3-fold odds increased rate of severe injury on rainy days (OR 2.55, 95% CI: 1.11-5.83, p=0.004) and a seven-fold odds increased rate of pedestrian traffic accidents (OR 7.26, 95% CI: 3.52-9.26, p<0.001) compared with car traffic accidents. In addition, a four-fold increased odds of night time (OR 3.79, 95% CI: 1.98-7.25, p<0.001) compared with day time accidents on rainy days. CONCLUSION: The incidence of traffic accidents and injury severity of patients increased on rainy days. Therefore, we suggest expansion of the scope of the emergency and trauma team activation for proper treatment on rainy days.
Accidents, Traffic* ; Busan* ; Emergencies ; Emergency Service, Hospital ; Humans ; Incidence ; Injury Severity Score ; Length of Stay ; Prognosis ; Rain ; Retrospective Studies ; Transportation ; Wind

BACKGROUND: Rosacea is characterized by erythema of the central face that persists for several months or longer. Reports of the histological changes in rosacea are scarce, and few attempts have been made to correlate such changes with clinical findings and pathophysiology. OBJECTIVE: This study aimed to elucidate the clinical manifestations of rosacea and investigate its histological features. METHODS: We performed a retrospective analysis of 278 patients with histologically confirmed rosacea who visited the Department of Dermatology at the Catholic Medical Center between January 2008 and May 2013. Clinical subtypes, disease severity, and precipitating factors were evaluated. In 115 randomly selected patients, histopathological features were evaluated as well. RESULTS: The ratio of males to females was 1:1.8. The age distribution showed a peak incidence in the fifth decade. The most common subtype was papulopustular rosacea (52.9%) followed by erythematotelangiectatic rosacea (34.9%), ocular rosacea (4.0%), and phymatous rosacea (2.9%). Granulomatous rosacea accounted for 5.4% of rosacea cases. Precipitating factors included hot weather (54.7%), stress (51.8%), sun exposure (37.4%), alcohol (37.4%), and hot baths (33.1%). Histological analysis of skin biopsies from 115 patients revealed solar elastosis in 62 patients (53.9%) and telangiectasia in 85 patients (73.9%). CONCLUSION: In this study, Korean rosacea patients were predominantly female with a peak age in the fifth decade and the majority suffered from the papulopustular and erythematotelangiectatic types of rosacea. Histological observations pertaining to each rosacea type were also discussed.
Age Distribution ; Baths ; Biopsy ; Dermatology ; Erythema ; Female ; Humans ; Incidence ; Korea ; Male ; Precipitating Factors ; Retrospective Studies ; Rosacea* ; Skin ; Solar System ; Telangiectasis ; Weather

OBJECTIVES: The purpose of this study was to investigate Korean dentists' perceived experience with and contents of education on National Health Insurance, and their competence in the practice of cases involving a health insurance claim. METHODS: A survey was conducted with 600 dentists who secured their dentist license during 2000-2004. A systemic stratified sampling, with "school graduated from" as a stratum, was conducted on a population of 3,947 dentists, using the register of the Korean Dental Association. A survey request and questionnaire sample was mailed, and responses were collected using a web-based replying method. The impact of the experience of education related to health insurance on the frequency of, and perceived competence on health insurance claims was analyzed using the chi-square test. RESULTS: Only 21% dentists replied that they had educational experiences related to health insurance when they were dental students, and the content of this education was 'health insurance system' (69%) and 'health insurance law' (59%). Only 28% of the respondents replied that they had practiced cases related to health insurance claims at dental schools. The rate of dentists who had educational experiences related to health insurance after their graduation was 73%. The experience of education related to health insurance and the perceived competency on handling health insurance claims showed a statistically significant correlation (P<0.01). CONCLUSIONS: It is necessary to develop a standardized curriculum related to health insurance and health insurance claims in dental schools.
Curriculum ; Surveys and Questionnaires ; Dentists* ; Education* ; Humans ; Insurance ; Insurance, Health ; Licensure* ; Mental Competency ; National Health Programs* ; Postal Service ; Schools, Dental ; Students, Dental

Congenital anomalies of the coronary artery are associated with various symptoms including syncope, myocardial ischemia, and sudden cardiac death. The abnormality depends on the adjacent structure and pathway of the coronary artery. Most patients with an anomalous left coronary artery that arises from a right coronary sinus of the valsalva have no symptoms and are usually diagnosed at autopsy. Therefore, their first symptom might present as sudden death, particularly when the left coronary arterial course is between the aorta and the pulmonary trunk. Symptomatic patients could be diagnosed early with an anomalous coronary artery, and the risk of fatal events could be decreased by surgical correction. Here, we report the case of 62-year-old male who experienced a first episode of syncope with an anomalous left coronary artery arising from the right sinus of the valsalva with a separate orifice from the right coronary artery. He is alive and in good health receiving medical treatment, and has had no medical events for over 2 years.
Aorta ; Autopsy ; Coronary Sinus ; Coronary Vessel Anomalies ; Coronary Vessels* ; Death, Sudden ; Death, Sudden, Cardiac ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; Sinus of Valsalva ; Syncope*

PURPOSE: According to the 2010 guidelines for cardiopulmonary resuscitation (CPR) of the American Heart association, administration of atropine for non-shockable rhythm is no longer recommended, however, there are insufficient data in humans. This study was conducted to evaluate the results of CPR, whether the combined administration of atropine and epinephrine (Atropine combined group, AG) compared with epinephrine only injection (epinephrine only group, EG) for patients with non-shockable rhythm. METHODS: A total of 449 patients who underwent CPR in the emergency department from 2009 to 2012 were included. Retrospective analysis was performed according to atropine administration during CPR. We investigated Return of Spontaneous Circulation (ROSC), sustained ROSC, 30-day survival, and 30-day neurological outcome using Utstein templates. RESULTS: There were 178 (48.9%) patients in the AG. There were no significant differences in the baseline characteristics. The two groups had similar rates of ROSC, sustained ROSC, and 30-day survival. However, AG had a significantly poor neurological outcome compared to EG, with an adjusted odds ratio of 0.074 (95% CI 0.012-0.452, p=0.005). CONCLUSION: The combination therapy of atropine and epinephrine during CPR showed poor neurological outcome compared with epinephrine alone. Atropine is not useful for adults with non-shockable rhythm in terms of 30-day neurological outcome.
Adult ; American Heart Association ; Atropine* ; Cardiopulmonary Resuscitation* ; Emergency Service, Hospital ; Epinephrine ; Heart Arrest ; Humans ; Odds Ratio ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Metabolic syndrome and high sodium intake are associated with frequent cardiovascular events. Few studies have estimated sodium intake in subjects with metabolic syndrome by 24-hour urine sodium excretion. We evaluated sodium intake in individuals with metabolic syndrome. SUBJECTS AND METHODS: Participants were recruited by random selection and through advertisement. Twenty four-hour urine collection, ambulatory blood pressure measurements, and blood test were performed. Sodium intake was estimated by 24-hour urine sodium excretion. Participants receiving antihypertensive medications were excluded from analysis. RESULTS: Among the 463 participants recruited, subjects with metabolic syndrome had higher levels of 24-hour urine sodium excretion than subjects without metabolic syndrome (p=0.0001). There was a significant relationship between the number of metabolic syndrome factors and 24-hour urine sodium excretion (p=0.001). The proportion of subjects with metabolic syndrome was increased across the tertile groups of 24-hour urine sodium excretion (p<0.0001). The association of high sodium intake and metabolic syndrome was significant only among women. Among the factors related to metabolic syndrome, body mass index had an independent association with 24-hour urine sodium excretion (p<0.0001). CONCLUSION: Women with metabolic syndrome exhibited significantly higher sodium intake, suggesting that dietary education to reduce sodium consumption should be emphasized for women with metabolic syndrome.
Blood Pressure ; Body Mass Index ; Education ; Female ; Hematologic Tests ; Humans ; Hypertension ; Sodium* ; Sodium, Dietary ; Urine Specimen Collection

PURPOSE: Transfer from long-term care (LTC) hospitals to the emergency department (ED) of larger hospitals has increased due to limited capability for management of patients needing special diagnostic tools or emergency treatment in the LTC hospital. We investigated the characteristics of geriatric trauma patients transferred from LTC hospitals to the ED. METHODS: A retrospective analysis included data on geriatric trauma patients (age> or =65) who visited two EDs in Korea. All data of patients transferred from the LTC hospital were compared with those of patients who visited the ED from home. Patients visiting from home were selected according to age, sex, and main diagnosis, using the statistical matching method. RESULTS: A total of 44 patients were transferred, and 132 patients were selected after matching. No differences in mechanism of injury, injury severity score (ISS), outcomes, transfusion, length of hospital stay, or mortality were observed between the two groups. The odds ratios (OR) of transferred patients for stroke and dementia were 5.027 (95% confidence interval (CI) 1.292-16.915) and 13.941 (95% CI: 5.112-38.015), respectively. In addition, the OR of transferred patients for dependent activities of daily living was 8.165 (95% CI: 2.886-23.104). Thirty five transferred patients (79.5%) had been injured in the LTC hospital (p<0.001). CONCLUSION: The transferred patients had more stroke, dementia, and dependent activities, but showed no significant difference in severity or prognosis. Most transferred patients had been injured in the hospital. Greater attention to hospitalized patients and system development are required in order to prevent injuries in the LTC hospital.
Activities of Daily Living ; Dementia ; Diagnosis ; Emergency Service, Hospital ; Emergency Treatment ; Geriatrics ; Humans ; Injury Severity Score ; Korea ; Length of Stay ; Long-Term Care* ; Mortality ; Odds Ratio ; Prognosis ; Propensity Score* ; Retrospective Studies ; Stroke