BACKGROUND AND OBJECTIVES: Although increasing evidence has indicated that radial access is a beneficial technique, few studies have focused on Korean subjects. The aim of this study was to evaluate current practice of coronary angiography (CAG) and percutaneous coronary intervention (PCI) using radial access in South Korea. SUBJECTS AND METHODS: A total of 6338 subjects were analyzed from Korean Transradial Intervention prospective registry that was conducted at 20 centers in Korea. After evaluating the initial access, subjects intended for radial access were assessed for their baseline, procedure-related, and complication data. Subjects were categorized into three groups: group of overall subjects (n=5554); group of subjects who underwent PCI (n=1780); and group of subjects who underwent primary percutaneous coronary intervention (PPCI) (n=167). RESULTS: The rate of radial artery as an initial access and the rate of access site crossover was 87.6% and 4.4%, respectively, in overall subjects. Those rates were 82.4% and 8.1%, respectively, in subjects who underwent PCI, and 60.1% and 4.8%, respectively, in subjects who underwent PPCI. For subjects who underwent CAG, a 6-F introducer sheath and a 5-F angiographic catheter was the most commonly used. During PCI, a 6-F introducer sheath (90.6%) and a 6-F guiding catheter were standardly used. CONCLUSION: The large prospective registry allowed us to present the current practice of CAG and PCI using radial access. These data provides evidence to achieve consensus on radial access in CAG and PCI in the Korean population.
Catheters ; Consensus ; Coronary Angiography* ; Korea ; Percutaneous Coronary Intervention ; Prospective Studies* ; Radial Artery ; Registries

BACKGROUND: Because hemodiafiltration (HDF) involves large amounts of ultra-filtration and substitution fluid infusion, its effects on serum electrolytes may be different from those of hemodialysis (HD). Serum sodium and blood pressures were compared between patients undergoing online HDF and high-flux HD (HFHD). METHODS: Thirty-two of 101 patients on HFHD switched voluntarily to online HDF. Their pre- and postdialysis serum measurements were compared with those of the remaining 69 HFHD patients. RESULTS: Online HDF patients had lower pre- and postdialysis systolic blood pressures (SBPs) than HFHD patients (predialysis, 136+/-21 vs. 145+/-19 mmHg, P<0.05; postdialysis, 129+/-22 vs. 142+/-25 mmHg, P<0.05). Pre- and postdialysis serum sodium concentrations were not significantly different between online HDF and HFHD (predialysis, 138+/-2 vs. 137+/-3 mEq/L; postdialysis, 134+/-2 vs. 134+/-2mEq/L). However, the change in serum sodium concentration after dialysis was greater in online HDF than HFHD patients (-3.7+/-2.2 vs. -2.5+/-2.8 mEq/L, P<0.05). The change in serum sodium concentrationwas correlated with postdialysis SBP (r=0.304, P<0.005) and pulse pressure (r=0.299, P<0.005). Predialysis SBP (r=0.317, P<0.005) and pulse pressure (r=0.324, P=0.001) were also correlated with the postdialysis serum sodium change. CONCLUSION: Compared with HFHD, online HDF has a greater serum sodium lowering effect. This might contribute to the ability of online HDF to stabilize both pre- and postdialysis SBP.
Blood Pressure ; Dialysis ; Electrolytes ; Hemodiafiltration ; Humans ; Renal Dialysis ; Sodium

PURPOSE: This study was undertaken to examine whether differences exist in the hemoglobin variability according to the types of erythropoiesis stimulating agent (ESA) in hemodialysis (HD) patients. METHODS: Clinical data were retrospectively analyzed from 72 patients on maintenance hemodialysis who were using darbepoetin alfa (n=27), epoetin beta (n=27), and epoetin alpha (n=18). As parameters of hemoglobin variability, hemoglobin cycling, the variance of hemoglobin and the SD/mean of hemoglobin were analyzed. Hemoglobin cycling was defined as the presence of cycles with an amplitude >1.5 g/dL and lasting more than 2 months. RESULTS: Hemoglobin cycling was present in 53 (73.6%) out of 72 HD patients. Hemoglobin cycling in patients receiving darbepoetin alfa had greater frequency (1.63+/-0.93 vs. 1.00+/-0.88 times/year, p<0.05), amplitude (2.88+/-1.48 vs. 1.88+/-1.60 g/dL, p<0.05), and velocity (1.21+/-0.74 vs. 0.73+/-0.66 g/dL/month, p<0.05) than that in patients receiving epoetin beta. The variance of hemoglobin in patients receiving epoetin beta (0.79+/-0.53 g/dL) was smaller than that in patients receiving darbepoetin alfa (1.29+/-0.70 g/dL, p<0.05) and epoetin alfa (1.08+/-0.52 g/dL, p<0.05). Also, the ratio of SD/mean of hemoglobin in patients receiving epoetin beta (8.20+/-2.59%) was lower than that in patients receiving darbepoetin alfa (10.81+/-2.10%, p<0.05) and epoetin alfa (10.30+/-2.10%, p<0.05). CONCLUSION: Hemoglobin variability is differential according to various ESAs, and it may be less with epoetin beta compared with darbepoetin alpha and epoetin alpha.
Anemia ; Erythropoiesis ; Erythropoietin ; Hematinics ; Hemoglobins ; Humans ; Recombinant Proteins ; Renal Dialysis ; Retrospective Studies ; Darbepoetin alfa ; Epoetin Alfa

Although coagulase-negative staphyloccus is the most common organism causing peritonitis in peritoneal dialysis (PD) patients, only one case of PD peritonitis due to Staphylococcus auricularis, the normal flora of external auditory meatus, has been reported over the world. Here we add a case of PD peritonitis caused by methicillin-resistant Staphylococcus auricularis, which was successfully treated with vancomycin. A 79-year-old male PD patient was admitted because of abdominal pain and cloudy peritoneal fluid. At admission, the exit site was clear, and no rebound tenderness was noted although the abdominal wall was diffusely tender. Gram stain of the peritoneal fluid did not reveal any organism, but white blood cell count was 1,210/mm3, with 80% polymorphonuclear cells and 10% lymphocytes. Empirical antibiotic therapy was started with intraperitoneal cefazolin and ceftazidime. Over the next few days, however, the peritoneal fluid was still turbid and showed an elevated cell count. Then, the result of peritoneal fluid culture identified that the organism was oxacillin-resistant Staphylococcus auricularis. Thus the antibiotics were switched into vancomycin, and intraperitoneal vancomycin 1 gm was administered three times at 5 days' intervals to achieve completely clear peritoneal fluid. Staphylococcus auricularis should be considered as a new potential skin organism causing PD peritonitis.
Abdominal Pain ; Abdominal Wall ; Aged ; Anti-Bacterial Agents ; Ascitic Fluid ; Cefazolin ; Ceftazidime ; Cell Count ; Humans ; Leukocyte Count ; Lymphocytes ; Male ; Methicillin Resistance ; Peritoneal Dialysis ; Peritonitis ; Skin ; Staphylococcus ; Vancomycin

BACKGROUND/AIMS: This study characterized the cisplatin nephrotoxicity occurring in patients treated with chemotherapy for lung cancer. METHODS: In all, 124 patients with lung cancer received cisplatin 70 mg/m2 on day 1 every three weeks for up to six cycles with preventive hydration using 3 L of 0.45% saline. Acute and chronic cisplatin nephropathy were defined as an increase in serum creatinine > or =30% at 3 weeks after each cisplatin administration and an increase in serum creatinine > or = 50% after the six cycles of chemotherapy, respectively. RESULTS: Acute cisplatin nephropathy occurred in 23 of 124, 8 of 110, 6 of 92, 10 of 68, 7 of 59, and 7 of 45 patients after the 1st to 6th cycle of chemotherapy, respectively. In all, 51 patients (51.5%) experienced acute cisplatin nephropathy. Chronic cisplatin nephropathy occurred in 25 out of 45 patients (55.5%). The occurrence of chronic cisplatin nephropathy was significantly associated with that of acute cisplatin nephropathy (p<0.01). In chronic cisplatin nephropathy, the serum creatinine increased to 1.82+/-1.18 mg/dL from the basal 0.82+/-0.11 mg/dL (p<0.01). It was 1.60+/-1.05 mg/dL at the end of the follow-up period (112+/-90 days). CONCLUSIONS: Despite prophylactic hydration, the incidence of cisplatin nephropathy in patients with lung cancer is still high. Acute cisplatin nephropathy may predispose patients to chronic cisplatin nephropathy, but the latter does not seem to be progressive.
Cisplatin ; Creatinine ; Follow-Up Studies ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Renal Insufficiency

We investigated the seasonality of Anopheles mosquitoes, including its species composition, density, parity, and population densities of mosquitoes infected with the parasite in Ganghwa-do (Island), a vivax malaria endemic area in the Republic of Korea. Mosquitoes were collected periodically with a dry-ice-tent trap and a blacklight trap during the mosquito season (April-October) in 2008. Anopheles sinensis (94.9%) was the most abundant species collected, followed by Anopheles belenrae (3.8%), Anopheles pullus (1.2%), and Anopheles lesteri (0.1%). Hibernating Anopheles mosquitoes were also collected from December 2007 to March 2008. An. pullus (72.1%) was the most frequently collected, followed by An. sinensis (18.4%) and An. belenrae (9.5%). The composition of Anopheles species differed between the mosquito season and hibernation seasons. The parous rate fluctuated from 0% to 92.9%, and the highest rate was recorded on 10 September 2008. Sporozoite infections were detected by PCR in the head and thorax of female Anopheles mosquitoes. The annual sporozoite rate of mosquitoes was 0.11% (2 of 1,845 mosquitoes). The 2 mosquitoes that tested positive for sporozoites were An. sinensis. Malarial infections in anopheline mosquitoes from a population pool were also tried irrespective of the mosquito species. Nine of 2,331 pools of Anopheles mosquitoes were positive. From our study, it can be concluded that An. sinensis, which was the predominant vector species and confirmed as sporozoite-infected, plays an important role in malaria transmission in Ganghwa-do.
Animals ; Anopheles/*classification ; *Disease Vectors ; *Endemic Diseases ; Head/parasitology ; Malaria/*epidemiology/*transmission ; Plasmodium/isolation & purification ; Population Dynamics ; Republic of Korea/epidemiology ; Seasons ; Thorax/parasitology

The incidence of malignant disease increases in kidney transplant recipients taking immunosuppressive therapy. Extramammary Paget's disease, a very rare dermatologic malignancy, is characterized by frequent recurrences and coexistence with other malignancies. Although skin cancer is the most common malignancy occurring after kidney transplantation, extramammary Paget's disease has not been reported in Korea. In this paper, we report a case of recurrent extramammary Paget's disease after renal transplantation. A 66-year old man, who underwent renal transplantation from a living unrelated donor 15 years ago, was diagnosed to have extramammary Paget's disease 7 years ago. At this admission he was troubled with a pruritic skin lesion in his suprapubic area which previously occurred twice. The recurring Paget's disease was treated with radical resection and coverage. No further recurrences have been developed during the following 12 months until now.
Humans ; Incidence ; Kidney ; Kidney Transplantation ; Korea ; Paget Disease, Extramammary ; Recurrence ; Skin ; Skin Neoplasms ; Unrelated Donors

No abstract available.
Nicotine ; Psychometrics ; Substance Withdrawal Syndrome ; Tobacco Use Disorder

Ileal atresia, a subtype of intestinal atresia, is one of the well-recognized causes of bowel obstruction in newborns. Prenatal diagnosis of intestinal atresia is very important in its management and outcome. Unfortunately, there are few cases of ileal atresia diagnosed prenatally, so more appropriate diagnoses and management plans are needed. As an associated gastrointestinal malformation with ileal atresia, hypertrophic pyloric stenosis is rarely reported. We report one case of postnatally diagnosed ileal atresia associated with hypertrophic pyloric stenosis which was complicated initially by bowel perforation and later by vomiting due to pyloric obstruction. Vomiting in the postoperative period is a common problem. But, if vomiting continues after the operation for ileal atresia, hypertrophic pyloric stenosis should be considered as a possible cause of medically retractable non-bilious vomiting.
Diagnosis ; Humans ; Infant, Newborn ; Intestinal Atresia ; Postoperative Period ; Prenatal Diagnosis ; Pyloric Stenosis, Hypertrophic* ; Vomiting

BACKGROUND: We compared the results of liver biopsy and the levels of serum type IV collagen of the hepatitis B carriers with normal liver function test (LFT) to evaluate the clinical usefulness of serum type IV collagen in predicting the progression of histopathological findings. METHODS : Thirty one chronic hepatitis B carriers with normal LFT and no significant clinical symptoms, who were Korean combat police, were classified into three groups according to their histologic results of the liver biopsies. The classification followed the standard proposed by Korean Society of Pathology. Blood samplings for serum type IVcollagen (reference : less than 5 ng/mL) were done in the morning of the same day of the liver biopsy. RESULTS: Of thirty one patients, thirteen patients showed normal histologic findings (41.9%, Group A), eleven patients revealed histologic abnormalities without fibrosis (35.5%, Group B) and seven patients were with fibrosis on liver biopsy (22.6%, Group C). Serum type IV collagen levels of Group A, B and C were 3.53 +/- .57 ng/mL, 3.56 +/- .17 ng/mL and 3.97 +/- .88 ng/mL, respectively. The average of serum type IV collagen levels of Group C was higher than of Group B and the average of Group B higher than that of Group A without any statistical significance (p > 0.05). The averages of serum type IV collagen of eighteen patients with histologic abnormalities (Group B and C) and twenty four patients without fibrosis (Group A and B) were 3.73 +/- 1.06 ng/mL and 3.55 +/- .88 ng/mL respectively. Upon comparison of these averages with the those of Group A and C, no statistical significance was established (p > 0.05). CONCLUSION : In chronic hepatitis B carriers with normal LFT findings, levels of serum type IV collagen were elevated along with histologic severities without statistical significance, therefore can not represent the changing degree of the histologic findings. Liver biopsy is considered to be one of the most accurate tool to assess the histologic status of the liver.
Biopsy* ; Classification ; Collagen Type IV* ; Collagen* ; Fibrosis ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Liver Function Tests* ; Liver* ; Needles ; Pathology ; Police