Journal of Korean medical science
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J. Korean Med. Sci. · Feb 2014
Relationship between dietary mercury intake and blood mercury level in Korea.
This study was performed to evaluate the effect of dietary factors for mercury exposure by comparing with blood mercury concentration. Study population consisted of 1,866 adults (839 men and 1,027 women) in randomly-selected 30 districts in southeast Korea. Dietary mercury intake was calculated from food frequency questionnaire (FFQ) on seafood items and 24 hr recall record. ⋯ In comparison with the blood mercury concentration, age group, sex, household income, education, drinking status and coastal area were statistically significant (P < 0.001). In multiple regression analysis, coefficient from the FFQ (β = 0.003) had greater effect on the blood mercury than the recall record (β = 0.002), but the effect was restricted (adjusted R(2) = 0.234). Further studies with more precise estimation of dietary mercury intake were required to evaluate the risk for mercury exposure by foods and assure risk communication with heavily-exposed group.
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J. Korean Med. Sci. · Feb 2014
Case ReportsAcute myocardial infarction after radiofrequency catheter ablation of typical atrial flutter.
A 53-yr-old man underwent radiofrequency ablation to treat persistent atrial flutter. After the procedure, the chest pain was getting worse, and the electrocardiogram showed ST-segment elevation in inferior leads with reciprocal changes. Immediate coronary angiography showed total occlusion with thrombi at the distal portion of the right coronary artery, which was very close to the ablation site. ⋯ Although the exact mechanism is obscure, the most likely explanation is a thermal injury to the vascular wall that ruptured into the lumen and formed thrombus. Vasospasm and thromboembolism can also be other possibilities. This case raise the alarm to cardiologists who perform radiofrequency ablation to treat various kinds of cardiac arrhythmias, in that myocardial infarction has been rarely considered one of the complications.
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J. Korean Med. Sci. · Feb 2014
Case ReportsSuccessful pregnancy in a patient with autosomal dominant polycystic kidney disease on long-term hemodialysis.
Recent advances in dialysis and a multidisciplinary approach to pregnant patients with advanced chronic kidney disease provide a better outcome. A 38-yr-old female with autosomal dominant polycystic kidney disease (ADPKD) became pregnant. ⋯ By means of intensive HD and optimal management of anemia, pregnancy was successfully maintained until vaginal delivery at 34.5 weeks of gestation. We discuss the special considerations involved in managing our patient with regard to the underlying ADPKD and its influence on pregnancy.
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J. Korean Med. Sci. · Feb 2014
Utilization patterns of disease-modifying antirheumatic drugs in elderly rheumatoid arthritis patients.
This study was conducted to investigate disease-modifying antirheumatic drug (DMARD) utilization in Korean elderly patients with rheumatoid arthritis (RA). We used data from January 1, 2005 to June 30, 2006 from the Health Insurance Review and Assessment Service claims database. The study subjects were defined as patients aged 65 yr or older with at least two claims with a diagnosis of RA. ⋯ The proportion of DMARD use was higher in the younger elderly, females, and patients treated in big cities. Hydroxychloroquine was the most commonly used DMARD in monotherapy, and most of the combination therapies prescribed it with methotrexate. DMARD use in elderly RA patients was noticeably low, although drug prescriptions showed an increasing trend during the study period, clinicians may need to pay more attention to elderly RA patients.
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J. Korean Med. Sci. · Feb 2014
Case ReportsA case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.
Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. ⋯ Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.