PURPOSE: This study was conducted to identify the factors that influence low back pain in nurses in Intensive Care Units (ICUs). METHODS: A descriptive-correlational design was used, with a convenience sample of 116 nurses from one university hospital in Seoul. The data collected were processed using SPSS Window 17.0 Program for actual numbers and percentages, differences in the dependent variable according to general characteristics, and mean, standard deviations, correlation coefficients and multiple regression analysis. RESULTS: The factor influencing low back pain in nurses in ICUs was functional ability (beta=.652). This one factor explained 41.9% of low back pain in nurses in ICUs. CONCLUSION: These results show that functional ability was related to nurses' low back pain in nurses in ICUs. These results further suggest that more research is needed to develop program involving functional ability to prevent and management of low back pain in nurses in ICUs.
Critical Care ; Intensive Care Units ; Low Back Pain

BACKGROUND: The worldwide standard of renal replacement therapy for acute renal failure patients is intermittent hemodialysis (IHD). Continuous renal replacement therapy (CRRT) has recently emerged as an alternative modality. We performed the study to find the effects of renal replacement therapy on outcome of the acute renal failure patients in the ICU. METHODS: 373 adult patients under the diagnosis of acute renal failure (ARF) in the ICUs (medical-surgical and coronary care unit) at Severance Hospital Yonsei University College of Medicine between January 1, 1998 and July 31, 2002 were included. Patients with ARF were divided into two groups depending on their need for renal replacement therapy. Renal replacement therapy group was subdivided into IHD and CRRT group. RESULTS: There was significant difference in the mortality between renal replacement group and non-renal replacement group, 74.4% vs. 45.2% (P < 0.001). Renal function recovery rate of renal replacement group was lower compared to that of non-renal replacement group, 36 % vs. 59% (P < 0.001). APACHE II score, ventilator support, vasopressors, number of organ failure, and oliguria during RRT were higher in CRRT group than in IHD group (P < 0.001). CRRT group was associated with higher mortality rate, CRRT 86.2% vs. IHD 42.2% and lower renal function recovery rate, CRRT 9.8% vs. IHD 63.0% (P < 0.001). CONCLUSIONS: Although the result of this study implies that IHD is associated with better survival and better renal recovery, the preferred use of CRRT in severely ill patients with an unstable circulatory system must be reminded.
Acute Kidney Injury* ; Adult ; APACHE ; Diagnosis ; Humans ; Intensive Care Units ; Mortality ; Oliguria ; Recovery of Function ; Renal Dialysis ; Renal Replacement Therapy* ; Ventilators, Mechanical

Bartha strain of pseudorabies virus[PRV-Ba] was utilized as a tracer to identify the neuronal axis of rat tongue muscles ; intrinsic muscles and extrinsic muscles, styloglossus, genioglossus, and hyoglossus muscle. After injection of 10 microliter of PRV-Ba into tongue muscles and 48-96 hours survivals, rats were perfused with 4% paraformaldehyde lysine periodate and brains were removed. PRV-Ba were localized in neural circuits by immunohistochemistry employing rabbit anti PRV-Ba as a primary antibody and ABC method. Injection of PRV-Ba into the tongue muscles resulted in uptake and retrograde transport of PRV-Ba in the rat brain. The result showed a circuit specific connection of many nerve cell groups along the time sequence : PRV-Ba immunoreactive cells appeared in hypoglossal nucleus and motor trigeminal nucleus ipsilaterally as seen with conventional tracers. Raphe nucleus, prepositus hypoglossal nucleus, spinal trigeminal nucleus, Al, A5 and facial nucleus of rhombencephalon showed immunoreactivity bilaterally. There were positive neurons in parabrachial nucleus, locus ceruleus, mesencephalic trigeminal nucleus, periaqueductal gray and A7 of mesencephalon and paraventricular nucleus, suprachiasmatic nucleus, organum vasculosum of lamina terminalis of diencephalon. Also positive reactions were showed in amygdala, insular cortex, frontal cortex and subfornical organ in telencephalon. Early immunoreactivity was appeared in hypoglossal nucleus and motor trigeminal nucleus, and there were positive neurons in the nuclei of the medulla oblongate, midbrain, pons, hypothalamus, cerebellum and medial preoptic area at middle stage. Subsequently the viral antigens were found in forebrain cell groups, paraventricular nuclei, suprachiasmatic nucleus, lateral hypothalamic area and primary motor cortex in frontal lobe bilaterally at 80-90hrs postinjection. These data demonstrate that the PRV-Ba can across synapses in the central nervous system with projection specific pattern, and this virus defines many elements of the neural network governing tongue. Therefore PRV-Ba are proved as a excellent neurotracer in the tract-tracing researches.
Amygdala ; Animals ; Antigens, Viral ; Axis, Cervical Vertebra ; Brain ; Central Nervous System ; Cerebellum ; Diencephalon ; Frontal Lobe ; Hypothalamic Area, Lateral ; Hypothalamus ; Immunohistochemistry ; Locus Coeruleus ; Lysine ; Mesencephalon ; Motor Cortex ; Muscles ; Neural Pathways* ; Neurons ; Paraventricular Hypothalamic Nucleus ; Periaqueductal Gray ; Pons ; Preoptic Area ; Prosencephalon ; Pseudorabies ; Raphe Nuclei ; Rats* ; Rhombencephalon ; Subfornical Organ ; Suprachiasmatic Nucleus ; Synapses ; Telencephalon ; Tongue* ; Trigeminal Nuclei ; Trigeminal Nucleus, Spinal

OBJECTIVE: Using Lee et al (1996) model, we assessed the effect of opioid within the PAG on the manifestations of the neuropathic pain, and we studied the effects of naloxone on the analgesic effects of opioid. METHOD: Under pentobarbital anesthesia, male Sprague-Dawley rats were implanted with cannula in the ventral (n=10) and dorsal (n=6) PAG after the unilateral tibial and sural nerves were ligated and cut, leaving the common peroneal nerve intact. Pain sensitivity was assessed using the von Frey filament (8 mN) and acetone applied to the sensitive area for 1 week postoperatively. Rats with neuropathic pain were intracerebrally microinjected with DAMGO (0.1microgram/5microliter) and enkephaline (20microgram/5microliter) into the ventral and dorsal PAG and the pain sensitivity was assessed. Naloxone was injected to assess the observed change of pain sensitivity. RESULTS: Intracerebral microinjection of DAMGO and enkephaline into the ventral PAG, but not the dorsal PAG, increased the pain threshold which was reversed by naloxone. CONCLUSION: The results suggest that stimulation of the ventral PAG in neuropathic rats may reduce neuropathic pain via opioid-mediating pathway of the descending pain inhibition system.
Acetone ; Anesthesia ; Animals ; Catheters ; Enkephalin, Ala(2)-MePhe(4)-Gly(5)- ; Enkephalins ; Humans ; Male ; Microinjections ; Naloxone ; Neuralgia* ; Pain Threshold ; Pentobarbital ; Periaqueductal Gray* ; Peroneal Nerve ; Rats* ; Rats, Sprague-Dawley ; Sural Nerve

Neonatal liver abscesses are rare, carry a high mortality rate, and are difficult to diagnose. The diagnosis of liver abscesses in the neonate cannot be established from the clinical presentation alone. Risk factors for liver abscesses in neonates are maternal infection, sepsis, umbilical venous catheterization, omphalitis, and necrotizing enterocolitis. In this report, we describe a preterm infant (32 weeks, 1,580 g) who presented with abdominal distension, respiratory difficulties, and a persistent inflammatory response in spite of broad spectrum antibiotic treatment; a large (6x5 cm) solitary pyogenic liver abscess was identified at 9 days of age. It appeared that the liver abscess had originated in the uterus and umbilical venous catheterization facilitated its spread. Percutaneous drainage under abdominal ultrasound guidance was performed and prolonged antibiotics were treated for 5 weeks, effecting a cure.
Anti-Bacterial Agents ; Catheterization ; Catheters ; Drainage ; Enterocolitis, Necrotizing ; Humans ; Infant, Newborn ; Infant, Premature ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Risk Factors ; Sepsis ; Uterus

OBJECTIVE: This study aimed to examine whether educational stressors and relational stressors are associated with burnout in medical students and to test social support as a moderator between stressors and burnout. METHODS: A total of 263 medical students attending Gyeongsang National University composed the study sample. A standardized questionnaire was used to investigate educational and relational stressors, three dimensions of burnout, and social support of medical students. RESULTS: The findings showed that overall burnout is very high among Korean medical students, with 9.9% totally burned out. Educational and relational stressors were significantly associated with the risk of burnout in medical students after controlling for socio-demographics and health behaviors. Social support moderated educational and relational stressors on personal accomplishment, but did not moderate stressors on emotional exhaustion and depersonalization. CONCLUSION: Burnout level is substantially high among Korean medical students. Educational and relational stressors are significantly associated with burnout risk in Korean medical students. Social support had moderated educational and relational stressors on personal accomplishment. The results suggest that more social support for medical students is needed to buffer stressors on and burnout.
Burns ; Depersonalization ; Health Behavior ; Humans ; Students, Medical*

Nitric oxide synthases (NOSs) that catalyzed the conversion of L-arginine to nitric oxide and L-citrulline play a role in ischemic-reperfusion injury. The purpose of this study was to observe the expression patterns of nNOS, iNOS and eNOS in the rat tibialis anterior and soleus muscles after multiple cyclic episodes of ischemic preconditioning (IP). Nine weeks old male SD rats were divided into control and IP groups. The IP group was further divided into 3 groups based on cycle of IP. For IP, left commom iliac artery was occluded 3, 6 and 10 times for 5 minutes ischemia followed by 5 minutes reperfusion using rodent vascular clamps. The animals were sacrificed at 0, 3, 6, 24 and 72 hours of reperfusion and the left tibialis anterior and soleus muscles were removed. The expression of nNOS, iNOS and eNOS were examined with immunohistochemical methods and Western blot analysis. IP increased the expression of nNOS, compared with the control. In the tibialis anterior muscle, the levels of nNOS in the 3IP and 6IP were higher than that in 10IP. IP increased the expression of iNOS, compared with the control, and the levels of iNOS in tibialis anterior muscle were higher than that in soleus muscle. The level of iNOS in the 10IP was higher than those in the 3IP and 6IP. IP increased the expression of eNOS, compared with the control, and the level of eNOS in soleus muscle were higher than that in tibialis anterior muscle. At 0 and 3 hours after reperfusion, the level of eNOS in 6IP and 10IP were higer than that in 3IP. In summary, these results suggest that the ischemic preconditioning increases the expression of nNOS, iNOS and eNOS, and 10 times of ischemic preconditioning may induce ischemic injury through upregulation of iNOS. And tibialis anterior muscle is more susceptabile to ischemic injury than soleus muscle.
Animals ; Arginine ; Blotting, Western ; Humans ; Iliac Artery ; Ischemia ; Ischemic Preconditioning* ; Male ; Muscle, Skeletal ; Muscles* ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Reperfusion ; Rodentia ; Up-Regulation

In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Hemodynamics ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Function, Left*

No abstract available.
Breast Neoplasms* ; Breast* ; Lymph Node Excision* ; Lymph Nodes* ; Mastectomy, Segmental* ; Radiotherapy*

PURPOSE: The aim of this study was to understand the clinical features and to analyze the risk factors for a severe complication such as hypoproteinemia in infants with severe atopic dermatitis. METHODS: Twenty-four infants with severe atopic dermatitis with SCORAD score >50 were enrolled, who visited pediatric allergy clinic between January 2005 and December 2007. Infants with blood protein level of <5 g/dL were classified Group A (n=8) and those of >5 g/dL as Group B (n=16). Age, sex, onset age, breast feeding, marternal protein-restriction diet during breast feeding, family history of allergy, and prior treatment before visit were studied. We examined serum ECP, total IgE, and allergen specific IgE by immuno CAP system (Phadia AB, Uppsala, Sweden) and tried to identify organisms by the culture of skin wound. Infants with blood protein level of <5 g/dL were classified Group A (n=8) and those of >5 g/dL as Group B (n=16). We also analyzed the risk factors for hypoproteinemia. RESULTS: Blood protein level was inversely correlated with total IgE (r=-0.610), SCORAD score (r=-0.686) and the number of sensitized allergens (r=-0.636). The sentisization of the house dust mite was also one of the risk factors for hypoproteinemia. CONCLUSION: Our study suggests that the risk factors for hypoproteinemia in infantile atopic dermatitis are high SCORAD score and the sentisization of the house dust mite and that hypoproteinemia associates with high serum levels of IgE and increased number of food sensitized allergens.
Age of Onset ; Allergens ; Breast Feeding ; Dermatitis, Atopic ; Diet ; Humans ; Hypersensitivity ; Hypoproteinemia ; Immunoglobulin E ; Infant ; Pyroglyphidae ; Risk Factors ; Skin