No abstract available.
Pancreatitis, Chronic*

No abstract available.
Humans ; Male*

PURPOSE: Prevalence estimates and management methods for urinary incontinence among elderly patients aged 65 and over at sanatoriums in Busan area were investigated. MATERIALS AND METHODS: A sample of 834 institutionalized patients was randomly selected from 13 sanatoriums with 100 and more beds in Busan. The study was designed as a cross-sectional study. Data were collected via face-to-face interviews using Appendix about general status, obstetric history, incontinence, and management method for incontinence. The survey was conducted from February to September 2008. RESULTS: Overall prevalence of urinary incontinence in all of 834 respondents was found to be 48.1%: prevalences of stress incontinence, urge incontinence, mixed incontinence, and functional incontinence were 25.7%, 6.5%, 8.0% and 59.9%, respectively. Among the patients with urinary incontinence symptoms, 28.6% had associated-dermatologic problems. CONCLUSIONS: The estimated prevalence of incontinence for elderly patients aged 65 and more cared at Sanatoriums in Busan area was 48.1%. However, systemic approaches in the management of urinary incontinence in such patients were lacking. Further efforts should be made for proper management of urinary incontinence among elderly patients cared at Sanatorium.
Aged ; Appendix ; Cross-Sectional Studies ; Surveys and Questionnaires ; Humans ; Patient Care Management ; Prevalence ; Urinary Incontinence ; Urinary Incontinence, Urge

Colonization of the pre-transplant lung by multidrug-resistant bacteria affects short- and long-term outcomes of lung transplantation. However, there are no case reports on the colonization of a pre-transplant lung by drug-resistant Acinetobacter baumannii. We report a case of extensively drug resistant (XDR) A. baumannii colonization in the tracheobronchial tree that caused severe infectious complications after bilateral lung transplantation. A 23-year-old man diagnosed with bronchiolitis obliterans syndrome (BOS) 4 years earlier with a history of allogenic bone marrow transplantation for acute lymphoblastic leukemia was admitted to the hospital with dyspnea. Due to progressive hypercapnic respiratory failure, long-term mechanical ventilation was started after a tracheostomy was performed, and the patient underwent a bilateral lung transplantation to treat end-stage BOS. After the transplantation, the colonization of XDR A. baumannii caused severe bacterial pneumonia in the early postoperative period. Combined treatment with colistin and meropenem led to recovery from the pneumonia but caused drug-induced renal failure. Because many centers are willing to transplant candidates who are on mechanical ventilation or extracorporeal life support, the incidence of XDR A. baumannii colonization of pretransplant lungs is expected to increase. Further studies are needed to examine pre-transplant management strategies in patients colonized with XDR A. baumannii.
Acinetobacter baumannii* ; Bacteria ; Bone Marrow Transplantation ; Bronchiolitis Obliterans ; Colistin ; Colon* ; Drug Resistance ; Dyspnea ; Humans ; Incidence ; Lung ; Lung Transplantation* ; Pneumonia ; Pneumonia, Bacterial ; Postoperative Period ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Renal Insufficiency ; Respiration, Artificial ; Respiratory Insufficiency ; Tracheostomy ; Young Adult

No abstract available.
Glomerulonephritis* ; Humans ; Proteinuria*

PURPOSE: During hemodialysis, various methods are used to evaluate adequate water removal; however, few of them are currently clinically applicable. To evaluate the differences of body fluid changes, we have compared changes of ICW (intracellular water) and ECW (extracellular water) before and after hemodialysis in diabetic and non-diabetic patients with MF-BIA. Also various factors influencing in this transcellular body fluid shift were evaluated. METHODS: TBW (total body water), ICW, ECW were measured before and after hemodialysis by using MF-BIA in 85 stable maintenance hemodialysis patients in a university hospital. Among these patients, 30 patients (mean age 55.6+/-12.4 year-old, average dialysis duration 26 months) were diabetic, while 55 patients (mean age 47.1+/-13.0 year-old, average dialysis duration 69 months) were non-diabetic. RESULTS: ECW/TBW in diabetic and non-diabetic patients were 0.338+/-0.02, 0.334+/-0.02, respectively. There was no significant difference between two groups. There were also no significant differences in the sex, age, duration of dialysis, BMI, hemoglobin, total protein, osmolarity of ICW loss/TBW removal. But there was a significant positive correlation between the increase in ultrafiltration volume (UFV:%) and ICW loss in diabetic patients (R=0.51, p=0.019); however, such correlation was not observed in non-diabetic patients. CONCLUSION: We found that ICW of diabetic patients moved to extracellular spaces even before achieving appropriate dry body weight or less amount of fluid was removed compared to non-diabetic patients. This finding might imply diabetic ESRD patient has relatively low cellular membrane integrity and oncotic pressure maintenance ability to physical transmembrane pressure.
Body Fluids ; Body Weight ; Diabetes Mellitus ; Dialysis ; Electric Impedance ; Extracellular Space ; Hemoglobins ; Humans ; Kidney Failure, Chronic ; Maintenance ; Membranes ; Osmolar Concentration ; Renal Dialysis ; Ultrafiltration

OBJECTIVE: There is no data on which is more important for the intensity of intra-amniotic inflammation (IAI) between total grade or involved anatomical region in acute histologic chorioamnionitis (acute-HCA) of preterm-gestations. The objective of current study is to examine this issue. METHODS: The intensity of IAI was measured by amniotic fluid (AF) white blood cell (WBC) count and matrix metalloproteinase-8 (MMP-8) concentration in 225 singleton preterm-gestations (<36 weeks) who had acute-HCA including chorio-decidua involvement and delivered within 5 days of amniocentesis. Acute-HCA was defined in the presence of acute inflammatory changes in each anatomical region (i.e., chorio-decidua, amnion or chorionic plate). Patients were divided into 6 groups according to total grade (i.e., 1-6) and the presence or absence of chorio-decidua restriction (i.e., chorio-decidua restriction vs. extension beyond chorio-decidua) of acute-HCA. RESULTS: There was no significant difference in a median AF WBC and MMP-8 between the two groups (group-1, cases with total grade 1 vs. group-2, cases with total grade 2) among cases with chorio-decidua restriction (each for P>0.05) and between the four groups (group-3, cases with total grade 2 vs. group-4, cases with total grade 3 vs. group-5, cases with total grade 4 vs. group-6, cases with total grade 5-6) among cases with extension beyond chorio-decidua (each for P>0.05). However, group-3 (cases with extension beyond chorio-decidua) had a significantly higher median AF WBC and MMP-8 than group-2 (cases with chorio-decidua restriction) among cases with total grade 2 (each for P<0.05). CONCLUSION: Involved anatomical region is more important than total grade for the intensity of IAI in acute-HCA of preterm-gestations.
Amniocentesis ; Amnion ; Amniotic Fluid ; Chorioamnionitis ; Chorion ; Female ; Humans ; Inflammation ; Leukocytes ; Matrix Metalloproteinase 8 ; Pregnancy

PURPOSE: This current study examined the clinicopathologic characteristics of patients with splenic flexure (SF) colon cancer and the association with the surgical outcomes to find the optimal procedure to treat this malady. MATERIALS AND METHODS: A total of 167 operated patients with SF colon cancer were consecutively recruited between 1993 and 2003. The clinicopathological, operative and survival data was reviewed and analyzed. RESULTS: For the SF colon cancer patients, the proportion of males was higher than that for the right-sided colon patients or the sigmoid-descending junction & sigmoid (SD & S) colon patients (p< or =0.05, respectively) and the age at the time of diagnosis was younger (p< or =0.05). Obstruction was more frequent in the patients with SF colon cancer than that for the patients with colon cancer at other sites (p< or =0.001). The incidence of mucinous adenocarcinoma for the SF patients was similar to that for the patients with right-sided colon cancer, but it was higher than that for the patients with SD & S colon cancer (11.4% vs. 6.5%, p=0.248 or 2.5%, respectively, p=0.001). Disease-free and overall survival did not differ between the patients who underwent a left hemicolectomy and extended surgery such as combined splenectomy or subtotal colectomy. Multivariate analysis showed that old age (> or =60 years) and a N1-2 and M1 status were the independent risk factors for overall survival. CONCLUSION: The SF colon cancers exhibited exclusively different characteristics as compared to colon cancers at other site colon cancers. It appears that left hemicolectomy was generally sufficient for a satisfactory oncological outcome, obviating concurrent splenectomy.
Adenocarcinoma, Mucinous ; Colectomy ; Colon ; Colon, Sigmoid ; Colon, Transverse ; Colonic Neoplasms ; Humans ; Incidence ; Male ; Multivariate Analysis ; Risk Factors ; Splenectomy

Lipedema is a chronic disease of lipid metabolism that results in the symmetrical impairment of fatty tissue distribution and storage combined with the hyperplasia of individual fat cells. Lipedema occurs almost exclusively in women and is usually associated with a family history and characteristic features. It can be diagnosed based on clinical history and physical examination. Lipedema is usually symmetrical, but spares the feet, is often painful to palpation, and is negative for Stemmer's sign. Additionally, lipedema patients can present with microangiopathies and lipomas. The well-known therapies for lipedema include complex decongestive therapy, pneumatic compression, and diet modifications. However, whether these treatments help reduce swelling is debatable. We encountered a case of lipedema that was initially misdiagnosed as lymphedema. The patient's clinical features and history were different from those typical of lymphedema, prompting a diagnosis of lipedema and she was treated with a complex decongestive therapy program.
Adipocytes ; Adipose Tissue ; Chronic Disease ; Female ; Food Habits ; Foot ; Humans ; Hyperplasia ; Lipid Metabolism ; Lipoma ; Lymphedema ; Palpation ; Physical Examination ; Rare Diseases

Narcotics and Some Neuromuscular blockers are used for open heart sugery anesthesia. Rapid induction of intravenous narcotics techniques may cause some reductjon in blood pressure and systemic vascular resistance, however, the selection of a narcotic and neuromuscular blocker influences subsequent Hemodynamic responses. 72 patients having open heart surgery were investigated using three combination of a narcotic and neuromuscular blocker: Group I (fentanyl 50 ug/kg, pancuronium 100 ug/kg): Group II (fentanyl 50 ug/kg, Vecuronium 80 ug/kg) Group III (sufentanil 10 u/kg, vecuronium 80 u/kg), each combination being administered over 2 minutes. Hemodynamic functions were then monitored for 10 minutes before tracheal intubation. 1) Significant changes included increases in heart nate in the groups receiving pancuronium and decrease in those receiving vecuronium. 2) In all groups mean arterial pressure initially decreased: systemic vascular resistance index decreased significantly in all groups except sufentanil and vecuronium group. 3) Cardiac index decreased significantly only in ufentanil-Vecuronium groups. Time of onset of neuromuscular blockade did not differ among the three groups, but transient chest wall rigidity occurred significantly more often with sufentanil than with fentanyl. Overall, the fentanyl-Pancuronium combination afforded the greatest hemodynamic stability, whereas the sufentanil-Vecuronium Combination proved least Satisfactory because of bradycardia, hypotension, increase of chest wall rigidity.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Cardiovascular System* ; Fentanyl ; Heart* ; Hemodynamics ; Humans ; Hypotension ; Intubation ; Narcotics ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Pancuronium ; Sufentanil* ; Thoracic Surgery ; Thoracic Wall ; Vascular Resistance ; Vecuronium Bromide*