PURPOSE: The purpose of this study is to build an evidence for adjusting the guideline of our hospital for changing peripheral intravenous catheter interval from 72 hour to 96hour through the checklist based on the Hospital nursing association intravenous infusion therapy practice in burn patients who have special characteristics comparing with other patient. METHODS: From 9 July 2014 to 20 July 2014, 30 burn patients who need a peripheral intravenous catheter were enrolled. The catheter insertion site was observed 3 times a day and it was analyzed by the time passage. Phlebitis scale for Hallym medical center was used for the diagnosis of phlebitis. Phlebitis was reported from phlebitis scale grade 2. RESULTS: Peripheral catheter was removed in 10 patients (34%) for phlebitis scale grade 2. Among the patients, 8 patients had edema and 2 patients had erythema. There were only 5 patients (17%) who had maintained peripheral catheter for more than 96 hours. Most of the patients were given 5% dextrose fluid. Some patients had a high osmolar (883~1058 g) nutritional therapy during early post-burn period. CONCLUSION: In burn patient, peripheral venous catheter is usually inserted to the extremity area of which the vessel is relatively weak due to the burn wound and immobilization. And it was difficult to maintain the peripheral catheter for more than 96 hours. Because the burn patients should receive the hyperosmolar fluid and medications during the early post-burn period. Further investigation through comparing analysis should be performed for developing intravenous infusion therapy practice in burn patients
Burns* ; Catheterization, Peripheral ; Catheters* ; Checklist ; Diagnosis ; Edema ; Erythema ; Extremities ; Glucose ; Humans ; Immobilization ; Infusions, Intravenous ; Nursing ; Phlebitis* ; Wounds and Injuries

BACKGROUND: Although leptin and its principal mediators, neuropeptide Y (NPY) and -melanocyte stimulating hormone (MSH) are postulated to play a pivotal role in the energy balance in experimental animals, the physiologic roles of leptin and its molecular targets are not fully identified in cases of human obesity. METHODS: The subjects consisted of 16 obese women (mean BMI 35.6 kg/m2) before and after weight loss that was induced by a 2 week-very low caloric diet (800 kcal/day) and 14 normal weight women (who had a mean BMI of 20.4 kg/m2). We evaluated the plasma and cerebrospinal fluid (CSF) leptin, NPY and alpha -MSH levels and their relationship in normal weight and obese women. Additionally, changes of these peptides during a negative energy balance (800 kcal/day) were assessed in causes of human obesity. RESULTS: Obese subjects exhibited a 6.3-fold higher plasma leptin level (21.9+/-1.2 vs 3.5+/-0.4 ng/mL, p<0.05) and a 2.8-fold higher CSF leptin level (0.29+/-0.02 vs 0.10+/-0.01 ng/mL, p<0.05) compared to control subjects. The CSF/plasma leptin ratio in normal weight subjects was 2.3-fold higher than that in obese subjects. After a weight loss in obese subjects, the plasma leptin level decreased by 40% and the CSF level decreased by 51%. The CSF/plasma leptin ratio was slightly lower than the baseline level. There was a positive linear correlation between CSF and plasma leptin level at the baseline in obese subjects (r= 0.74, p<0.05) and a positive logarithmic correlation in normal weight subjects and in obese subjects after a weight loss (r= 0.66, p<0.05). The BMI negatively correlated with the CSF/plasma leptin ratio (r=-0.86, p<0.05) in any subjects. Neither the baseline plasma levels nor the baseline CSF levels of NPY were different between the normal weight subjects and obese subjects. After a weight loss the CSF NPY level decreased significantly compared to the baseline values in obese subjects. The alpha -MSH levels in plasma and CSF did not differ significantly from controls in obese subjects at the baseline or after a weight loss. The baseline CSF leptin level neither correlated with the baseline CSF NPY level nor the baseline CSF alpha -MSH level. CONCLUSION: These results demonstrated that the efficiency of leptin delivery to the CNS is reduced in human obesity and that the CNS leptin uptake involves the combination of saturable and unsaturable mechanisms. A marked reduction in the CSF leptin levels compared to the plasma level after a weight loss in obese subjects can be a potent stimulus for the body to regain weight. In contrast to the results that were observed in experimental animals, the CSF NPY and alpha -MSH did not differ from the controls in human obesity and there was no significant correlation between the CSF leptin and CSF of these neuropeptides. This could have resulted from leptin resistance in cases of human obesity although the mechanisms for this resistance remain to be determined.
alpha-MSH ; Animals ; Cerebrospinal Fluid* ; Diet ; Female ; Humans ; Leptin* ; Neuropeptide Y ; Neuropeptides ; Obesity ; Peptides ; Plasma* ; Weight Loss*

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.

Peritoneal dialysis (PD) is associated with the development of various complications, such as exit site infection or peritonitis, and rarely, intestinal obstruction in prolonged PD patients with recurrent peritonitis. However, post-colonoscopy acute intestinal obstruction has not been reported in PD patients to date. Herein, we report a case of severe ileus after a colonoscopy without previous episodes of peritonitis in a PD patient. A 51-year-old man undergoing PD for 7 years visited our emergency department due to severe abdominal pain and vomiting after colonoscopic polypectomy. A simple abdominal radiography and abdominal computed tomography showed ileus with collapsed distal ileal loop. A peritoneal dialysate study revealed no evidence of peritonitis. The patient was treated with decompression therapy, and ileus was successfully treated without complications. This case suggests that it is not only necessary to prevent peritonitis, but also important to monitor the development of ileus after colonoscopy in PD patients.
Abdominal Pain ; Colonoscopy* ; Decompression ; Emergency Service, Hospital ; Humans ; Ileus* ; Intestinal Obstruction ; Middle Aged ; Peritoneal Dialysis* ; Peritonitis ; Radiography, Abdominal ; Vomiting

BACKGROUND/AIMS: This study evaluated the prevalence and location of colonic adenomatous polyps in asymptomatic adults. METHODS: A total of 2,849 asymptomatic adults underwent colonscopic screening as a part of health evaluation from January 2003 to September 2005. Completed questionnaires as well as the colonoscopic and pathologic findings were analyzed. RESULTS: There were 406 (14.3%) subjects with adenomatous polyps including 78 (2.7%) with advanced polyps. There was a trend toward an increased prevalence of adenomatous polyps with age. The relative risk of a proximal polyp according to the distal findings was 5.7 (95% CI 4.3 ~ 7.4) for adenoma, 4.9 (95% CI 3.0 ~ 7.7) for advanced adenoma compared with that for no adenomatous polyp. There were no index polyps at the distal colon in 30% of the 406 subjects. CONCLUSIONS: Though distal polyps are associated with the proximal polyps, 30% of asymptomatic adults with proximal polyps are not associated with any distal index polyps. For those without any contraindication to the procedure, colonoscopy performed by experienced colonoscopists as a screening test is feasible for detecting those patients with colorectal polyps.
Adenoma ; Adenomatous Polyps ; Adult* ; Colon* ; Colonic Neoplasms* ; Colonoscopy* ; Humans ; Mass Screening* ; Polyps ; Prevalence ; Surveys and Questionnaires

OBJECTIVES: This survey was designed to conduct the first nationwide dietary exposure assessment on hazardous substances including the intakes of functional food and herbal medicine. In this paper, we introduced the survey design and the results of the dietary exposure status and internal exposure levels of lead (Pb), cadmium (Cd), and mercury (Hg). METHODS: We selected 4867 subjects of all ages throughout Korea. We conducted a food survey, dietary survey, biomonitoring, and health survey. RESULTS: Pb and Cd were the highest (median value) in the seaweed (94.2 mug/kg for Pb; 594 mug/kg for Cd), and Hg was the highest in the fish (46.4 mug/kg). The dietary exposure level (median value) of Pb was 0.14 mug/kg body weight (bw)/d, 0.18 mug/kg bw/d for Cd, and 0.07 mug/kg bw/d for Hg. Those with a blood Pb level of less than 5.00 mug/dL (US Centers for Disease Control and Prevention, reference value for those 1 to 5 years of age) were 99.0% of all the subjects. Those with a blood Cd level with less than 0.30 mug/L (German Federal Environmental Agency, reference value for non-smoking children) were 24.5%. For those with a blood Hg level with less than 5.00 mug/L (human biomonitoring I, references value for children and adults, German Federal Environmental Agency) was 81.0 % of all the subjects. CONCLUSIONS: The main dietary exposure of heavy metals occurs through food consumed in a large quantity and high frequency. The blood Hg level and dietary exposure level of Hg were both higher than those in the European Union.
Adult ; Body Weight ; Cadmium ; Centers for Disease Control and Prevention (U.S.) ; Child ; Eating ; Environmental Monitoring ; European Union ; Food Safety* ; Functional Food ; Hazardous Substances* ; Health Surveys ; Herbal Medicine ; Humans ; Korea ; Metals, Heavy ; Reference Values ; Seaweed

OBJECTIVES: This survey was designed to conduct the first nationwide dietary exposure assessment on hazardous substances including the intakes of functional food and herbal medicine. In this paper, we introduced the survey design and the results of the dietary exposure status and internal exposure levels of lead (Pb), cadmium (Cd), and mercury (Hg). METHODS: We selected 4867 subjects of all ages throughout Korea. We conducted a food survey, dietary survey, biomonitoring, and health survey. RESULTS: Pb and Cd were the highest (median value) in the seaweed (94.2 mug/kg for Pb; 594 mug/kg for Cd), and Hg was the highest in the fish (46.4 mug/kg). The dietary exposure level (median value) of Pb was 0.14 mug/kg body weight (bw)/d, 0.18 mug/kg bw/d for Cd, and 0.07 mug/kg bw/d for Hg. Those with a blood Pb level of less than 5.00 mug/dL (US Centers for Disease Control and Prevention, reference value for those 1 to 5 years of age) were 99.0% of all the subjects. Those with a blood Cd level with less than 0.30 mug/L (German Federal Environmental Agency, reference value for non-smoking children) were 24.5%. For those with a blood Hg level with less than 5.00 mug/L (human biomonitoring I, references value for children and adults, German Federal Environmental Agency) was 81.0 % of all the subjects. CONCLUSIONS: The main dietary exposure of heavy metals occurs through food consumed in a large quantity and high frequency. The blood Hg level and dietary exposure level of Hg were both higher than those in the European Union.
Adult ; Body Weight ; Cadmium ; Centers for Disease Control and Prevention (U.S.) ; Child ; Eating ; Environmental Monitoring ; European Union ; Food Safety* ; Functional Food ; Hazardous Substances* ; Health Surveys ; Herbal Medicine ; Humans ; Korea ; Metals, Heavy ; Reference Values ; Seaweed