BACKGROUND: To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital. METHODS: We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL. RESULTS: Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups. CONCLUSIONS: Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.
APACHE ; Body Mass Index ; Calcitriol ; Chronic Disease ; Critical Care ; Critical Illness* ; Humans ; Intensive Care Units ; Mortality ; Prevalence* ; Respiration, Artificial ; Retrospective Studies ; Tertiary Healthcare ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

PURPOSE: To compare the outcomes of indocyanine green (ICG) and triamcinolone (TA) assisted internal limiting membrane (ILM) peeling during idiopathic macular hole surgery. METHODS: Fifty-four eyes of 54 patients with idiopathic macular hole underwent pars plana vitrectomy including peeling of the posterior cortical hyaloid and peeling of the internal limiting membrane. For enhanced visualization of ILM, ICG was used in 25 eyes and TA in the remaining 29 eyes. Postoperative visual acuity was measured and OCT was performed. RESULTS: Anatomical closure was achieved in 25 eyes (100%) in ICG group and 28 eyes (97%) in TA group, Best corrected visual acuity improvement by > or =2 lines was in 15 eyes (60%) in ICG group and 18 eyes (62%) in TA group. Postoperative visual improvement rates by > or =20/50 were 10 eyes (40%) in ICG group and 9 eyes (31%) in TA group. CONCLUSIONS: Peeling of the internal limiting membrane using triamcinolone and indocyanine green was safe and effective for anatomic and functional success in idiopathic macular hole surgery. Further studies of the toxicity of TA, ICG and the result of internal limiting membrane peeling is needed.
Humans ; Indocyanine Green* ; Membranes ; Retinal Perforations* ; Triamcinolone* ; Visual Acuity ; Vitrectomy

BACKGROUND: To evaluate the safety and the efficacy of amlodipine, a dihydropyridine calcium antagonist, monotherapy in the treatment of moderate essential hypertension. METHOD: Amlodipine 5mg once a day was administered as a starting dose in 30 patients with essential hypertension in the morning and a one step upward titration was performed (amlodipine 10 mg once a day) was done at the end of 4weeks treatment. Final evaluation was done at 12weeks with laboratory test and echocardiogram. RESULT: Within 4weeks treatment with dose of 5mg amlodipine once a day, the systolic blood pressure (SBP) was decreased(184.5+/-23.3/150.5+/-16.0mmHg,p<0.000), and the diastolic blood pressure(DBP) was also decreased significantly (109.9+/-04.6/92.3+/-11.5mmHg, P<0.001). After 12 weeks of treatment with a mean dosage of 6.6mg once a day, SBP and DBP was maintained comparing with basal level (147.0+/-15.8/88.1+/-0.9mmHg, respectively). The efficacy of amlodipine treatment was noted an excellent in 16 patients(53.3%), good in 4 patient(13.3%), fair in 4 patients(13.3%), and failed in 2 patients(6.7%). There was no significant change in heart rate before and after amlodipine treatment. (80.0+/-2.3/80.9+/-10.4 beats/minute n.s). Amlodipine had not significant effects on laboratory findings such as serum creatinine, BUN, ALT/AST, hemoglobin, leukocyte count,platelet and lipid profiles. There was facial flushing 2 patients, but no need to discontinue administration of amlodipine and all patients completed for 12weeks therapy. CONCLUSION: It is concluded that amlodipine is an effective antihypertensive agent, as monotherapy once a day in patients with moderate essential hypertension.
Amlodipine ; Blood Pressure ; Calcium ; Creatinine ; Flushing ; Heart Rate ; Humans ; Hypertension* ; Leukocytes

PURPOSE:This study was conducted to analyse the characteristics of the full-term neonates admitted in neonatal period and to evaluate the relationship between readmission and perinatal, maternal factors. METHODS:We studied retrospectively the neonatal readmissions who were born in Il Sin Christian Hospital during the 18-months period (January 1, 2007 to June 30, 2008). RESULTS:After discharge, 415 neonates were readmitted during the first month of life. The most common cause for readmission was jaundice (82.7%). Among them, 211 (61.5%) neonates were fully breast feeding and 119 (34.7%) were mixed feeding infants. The second cause was rota enteritis (6.3%). Others included dehydration (4.1%), suspected sepsis (3.1%), other enteritis (1.7%), pneumonia (0.7%), cardiac problem (0.5%), meningitis (0.5%), urinary tract infection (0.2%), and other urinary problem (0.2%). There were no significant relationships between readmission and neonatal, maternal factors. CONCLUSION:While newborns discharged from hospital are at risk for readmission, but relationship among neonatal, maternal, and other factors are not proven. Education of risk factors for jaundice to parents should be done and prevention of hospital acquired infection is important. Further research should include relationships between neonatal, maternal factors and the other factors influencing neonatal readmission.
Breast Feeding ; Dehydration ; Enteritis ; Humans ; Infant ; Infant, Newborn ; Jaundice ; Meningitis ; Parents ; Pneumonia ; Retrospective Studies ; Risk Factors ; Sepsis ; Urinary Tract Infections

PURPOSE: This study was done to develop and test a structural model on smoking cessation intention in technical high school men. The conceptual model was based on the theory of reasoned action and health promotion model. METHODS: From May 29 to April 13, 2015, 413 technical high school students who smoked completed a structured questionnaire. Data were analyzed to calculate the direct and indirect effects of factors affecting smoking cessation intention. The SPSS WIN 20.0 and AMOS 21.0 programs were used. RESULTS: The hypothetical model was a good fit for the data. The model fit indices were χ²/df=2.36, GFI=.95, AGFI=.92, NFI=0.97, and RMSEA=.05. Self-esteem had direct and indirect effects on smoking cessation intention. Attitude, subjective norm, and self-efficacy had direct effects on smoking cessation intention. Smoking knowledge and environmental factor had indirect effects on smoking cessation intention. This model explained 87.0% of the variance in smoking cessation intention. CONCLUSION: These results indicate that technical high school students' intention to stop smoking can be improved through an increase in self-esteem, negative environmental factors, attitude toward smoking cessation, subjective norm about smoking cessation, and self-efficacy for smoking cessation.
Health Promotion ; Humans ; Intention* ; Male* ; Models, Structural ; Smoke* ; Smoking Cessation* ; Smoking*

BACKGROUND: It is known that left ventricular(LV) wall motion is not uniform even in normal heart, and the restoring forces make phase differences between LV wall motion and mitral flow velocity during rapid filling period. METHOD: To investigate the regional nonuniformity and restoring forces in 46 patients with hypertension(HT)(group:normal wall thickiness.n=12,II:LVH with fractional shortening(FS)>25%. n=22. III:FS<25%.n=12). We measured the time intervals from A2 to peak thinning rate point of LV posterior wall(A2-(-)dpw/dt).to mitral flow starting point (IRT).and to peak mitral flow velocity(A2-E) by M-mode and Doppler echocardiography. RESULTS: The noniformity((-)dpW/dt-dL/dt)and phase differance((-)dpw/dt-E) were increased in HT(control:HT.22+/-7.8 vs. 49+/-5.2msec, 63+/-4.5 vs, 86+/-6.2msec, p<0.05 respectively).In group comparison, nonuniformity increased in group II and III(group I: group II, III, 35+/-5.1 vs. 50+/-7.1,70+/-14msec, p<0.05 respectively). but phase difference increased only in group II(groupII: group I, III, 93+/-6.0 vs. 75+/-5.2, 80+/-20msec, p<0.05, respectively). CONCLUSION: We interpreted these data that in HT with hypertrophy or not, the nonuniformity of LV wall motion working on the restoring forces which can be expressed as phase difference between LV wall motion and mitral flow. But in HT with hypertensive heart failure group, no significant changes of phase difference and it's suggest that other mechanism could be also working on early diastolic filling.
Echocardiography* ; Echocardiography, Doppler ; Heart ; Heart Failure ; Humans ; Hypertension* ; Hypertrophy

BACKGROUND: A regional wall motion nonuniformity and a phase difference between LV posterior wall motion and transmitral flow are present during normal rapid filling period and are thought to be an evidence for involvement of ventricular restoring forces. To assess the role of nonuniformity on diastolic funtional impairment of asymmetric septal hypertrophy(ASH), the time relations between left ventricular regional wall motions and filling velocity were studied. METHOD: We measured the time intervals from A2 to peak rate of LV posterior wall(short axis) thinning(A2-(-)dpw/dt), peak rate of medial mitral annulus (long axis dimension) lengthening(A2-dL/dt) and peak mitral flow(A2-E) by M-mode and Doppler echocardiography. Result: In ASH patients, A2-(-)dpw/dt(106+/-6msec, mean SE) and the regional wall motion nonuniformity((-)dpw/dt-dL/dt, 89+/-11msec, mean SE) were increased significantly when compared with normal control values(88+/-4, 28+/-5msec, mean SE, p<0.01,respectively).In normal controls, peak mitral flow velocity lagged peak rate of regional wall motion, so the phase differences were present((-)dpw/dt-E :71+/-8msec, dL/dt-E:44+/-6msec). In ASH patients, (-)dpw/dt-E was present(90+/-16msec) but dL/dt-E was not present or reversed(-21+/-18 msec). So these chacteristic phase differences were disturbed. CONCLUSION: These data suggested that the relaxation nonuniformity of regional wall motion in ASH may act as an energy dissipating factor of restoring forces during rapid filling period.
Axis, Cervical Vertebra ; Cardiomyopathy, Hypertrophic* ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Relaxation

OBJECTIVES: Night shift workers suffer from sleep and daytime disturbances due to circadian misalignment. To investigate the role of environmental light in daytime sleep following 12 h-night shift work. METHODS: We enrolled 12 h-shift female nurses working at one university-affiliated hospital (n=10, mean age 26.6 years, shift work duration 3.8 years). This is a cross-over study to compare sleep between under light exposure (30 lux) and in the dark (<5 lux) following 12 h-night duty. Two sessions of experiments were underwent and the interval between sessions was about a month. Psychomotor vigilance test (PVT) had performed on awakening from sleep at each session and sleep-wake pattern had been monitored by actigraphy throughout the study period. Daytime sleep was also compared with night sleep of age-and gender matched daytime workers (n=10). RESULTS: Sleep parameters and PVT scores were not different between two light conditions. Activities during sleep seemed to be more abundant under 30 lux condition than in the dark, which was not significant. Compared to night sleep, daytime sleep of shift workers was different in terms of rapid eye movement (REM) sleep. Three shift workers showed sleep onset REM sleep and first REM sleep period was the longest during daytime sleep. CONCLUSIONS: Unexpectedly, daytime sleep of 12 h night shift workers was well-maintained regardless of light exposure. Early occurrence of REM sleep and shorter sleep latency during daytime sleep suggest that shift workers meet with misalignment of circadian rhythm as well as increased homeostatic sleep pressure drive.
Actigraphy ; Circadian Rhythm ; Cross-Over Studies ; Female ; Humans ; Polysomnography ; Sleep, REM

This study was designed to identify the severity of anorexia and the diet patterns in receiving chemotherapy. the identification of anorexia would provide useful and basic information to oncology nursing care. The subjects of this study were 102 hospitalized chemotherapy patients in a September 10, 1994. The subjects were 20 years old or above and who agreed to participate in this study and could understand the questionnaire. Three-days diet history were collected and analysed. The study subjects change, food aversions, the severity of anorexia. Data related to demographic and other medical characteristics such as age, diagnosis, and medication were collected by review of patient medical record. The results of this study were summarized as follows : 1) The score of anorexia was 73.7 in Anorexia Visual Analogue Scales and mean amount of fool intake per a day was 823cc. The larger the anorexia VAS score, the more severe of anorexia. 2) The food preferences of subjects were identified. Those were aversions, or dislikes the meat such as beef, pork, and chicken, and greesy or fried foods. the Caffeinated drinks such as coffee and tea were disgusted, also. The patients preferred vegetables and Korean traditional food especially kimchee and soy bean soap. 3) Those who were administered analgesics and cisplatin suffered more severe in anorexia than those who analgesics and cisplatin was not administrated. The patients with gastrointestinal cancer has more severe anorexia than those who have the other site cancer ; head and neck, genirourinary etc. The result of this study in turn provide valuable nursing practice guidelines for nutritional counseling in cancer chemotherapy patient. Nurses working with chemotherapy ward should identify the severity of anorexia and diet patterns. In conclusion, the severity of anorexia in cancer chemotherapy patients is very important problems. Health care personals recognize the potential problems of anorexia and encourage the nutritional counseling in cancer chemotherapy patients.
Analgesics ; Anorexia* ; Chickens ; Cisplatin ; Coffee ; Counseling ; Delivery of Health Care ; Diagnosis ; Diet* ; Drug Therapy* ; Food Preferences ; Gastrointestinal Neoplasms ; Head ; Humans ; Meat ; Medical Records ; Neck ; Nursing ; Oncology Nursing ; Surveys and Questionnaires ; Soaps ; Soybeans ; Tea ; Vegetables ; Weights and Measures ; Young Adult

Objectives: Carbon dioxide (CO2) accumulation in an enclosed space might cause drowsiness. This study aimed to assess the effect of bedtime exposure to low concentrations of CO2 gas on the sleep quality of adults with insomnia. Methods: In this double-blind, randomized, sham-controlled cross-over study, we consecutively recruited 24 adults (9 men; age, 55.4±6.3 y) complaining of sleep disturbances (Pittsburgh Sleep Quality Index ≥5). The following two interventions were used in the study: exposure to 2% low-concentration edible CO2 gas (experimental intervention) and exposure to room air (sham-controlled intervention). A sleep air device (Gosleep®, NYX), which atomizes CO2 gas, was used in both experimental and sham-controlled interventions. For the sham session, room air was generated for 18 min, and then, gradually reduced by degrees in the next 5 min with the device finally being turned off. Results: The group exposed to CO2 gas had longer time in bed (361.3±55.2 min vs. 347.2±35.7 min, p=0.034) and total sleep time (311.0±74.3 min vs. 287.2±69.4 min, p=0.010) than the group exposed to room air. Meanwhile, the total arousal (19.7±9.5/h vs. 24.0±13.7/h, p=0.011) and non-REM arousal (20.9±11.3/h vs. 25.1±14.9/h, p=0.008) indices were lower in the group exposed to CO2 gas than in the group exposed to room air. However, perceived total sleep time or sleep latency and Karolinska Sleepiness Scale scores were not significantly different between the two groups. Conclusion Exposure to low concentrations of CO2 improved the total sleep time and arousal index in adults with insomnia. Unexpectedly, CO2 administration was found to be effective for sleep maintenance.