BACKGROUND: Aging is a significant issue worldwide, and Korea is one of the most rapidly aging countries. Along with the demographic transition, the age structure of intensive care unit (ICU) patients changes as well. METHODS: The aim of this study was to analyze the change in age distribution of the ICU patients over the last 10 years and its effect on clinical outcomes. Single-center, retrospective analysis of all patients aged ≥18 years admitted to either the medical or surgical ICU at St. Paul's Hospital, The Catholic University of Korea, between January 2005 and December 2014 was conducted. For clinical outcome, in-hospital mortality, duration of ICU stay, and hospital stay were analyzed. Cost analysis was performed to show the economic burden of each age strata. RESULTS: A total of 10,366 ICU patients were admitted to the chosen ICUs during the study period. The proportion of elderly patients aged ≥65 years increased from 47.9% in 2005 to 63.7% in 2014, and the proportion of the very elderly patients aged ≥80 years increased from 12.8% to 20.7%. However, this increased proportion of elderly patients did not lead to increased in-hospital mortality. The percent of ICU treatment days attributable to elderly patients increased from 51.1% in year 2005 to 64.0% in 2014. The elderly ICU patients were associated with higher in-hospital mortality compared to younger age groups. CONCLUSIONS: The proportion of elderly patients admitted to ICUs increased over the last decade. However, overall in-hospital mortality has not increased during the same period.
Age Distribution ; Aged* ; Aging ; Costs and Cost Analysis ; Critical Care* ; Hospital Mortality ; Humans ; Intensive Care Units* ; Korea* ; Length of Stay ; Mortality ; Population Dynamics ; Retrospective Studies*

No abstract available.
Intensive Care Units ; Sepsis ; Critical Illness ; Chronic Disease ; Hospital Mortality

BACKGROUND: A randomized, multicenter, open-label, parallel group study was performed to compare the effects of remifentanil and morphine as analgesic drugs on the duration of weaning time from mechanical ventilation (MV). METHODS: A total of 96 patients with MV in 6 medical and surgical intensive care units were randomly assigned to either, remifentanil (0.1-0.2 mcg/kg/min, n = 49) or morphine (0.8-35 mg/hr, n = 47) from the weaning start. The weaning time was defined as the total ventilation time minus the sum of controlled mode duration. RESULTS: Compared with the morphine group, the remifentanil-based analgesic group showed a tendency of shorter weaning time (mean 143.9 hr, 89.7 hr, respectively: p = 0.069). Secondary outcomes such as total ventilation time, successful weaning rate at the 7th of MV day was similar in both groups. There was also no difference in the mortality rate at the 7th and 28th hospital day. Kaplan-Meyer curve for weaning was not different between the two groups. CONCLUSIONS: Remifentanil usage during the weaning phase tended to decrease weaning time compared with morphine usage.
Analgesics ; Humans ; Critical Care ; Morphine* ; Mortality ; Respiration, Artificial* ; Ventilation ; Ventilator Weaning ; Weaning*

No abstract available.
Morphine* ; Respiration, Artificial* ; Weaning*

BACKGROUND: Perioperative lidocaine infusion improves postoperative outcomes, mostly after abdominal and urologic surgeries. Knowledge of the effect of lidocaine on peripheral surgeries is limited. Presently, we investigated whether intraoperative lidocaine infusion reduced anesthetic consumption, duration of ileus, pain intensity, analgesic consumption and hospital stay after breast plastic surgeries. METHODS: Sixty female patients, aged 20-60 years, enrolled in this prospective study were randomly and equally divided to two groups. One group (n = 30) received a 1.5 mg/kg bolus of lidocaine approximately 30 min before incision followed by continuous infusion of lidocaine (1.5 mg/kg/h) until skin closure (lidocaine group). The other group (n = 30) was untreated (control group). Balanced inhalation (sevoflurane) anesthesia and multimodal postoperative analgesia were standardized. End tidal sevoflurane concentration during surgery, time to the first flatus and defecation, visual analog pain scale (0-10), analgesic consumption and associated side effects at 24, 48, and 72 h after surgery, hospital stay, and patient's general satisfaction were assessed. RESULTS: Compared to the control group, intraoperative lidocaine infusion reduced by 5% the amount of sevoflurane required at similar bispectral index (P = 0.014). However, there were no significant effects of lidocaine regarding the return of bowel function, postoperative pain intensity, analgesic sparing and side effects at all time points, hospital stay, and level of patient's satisfaction for pain control. CONCLUSIONS: Low dose intraoperative lidocaine infusion offered no beneficial effects on return of bowel function, opioid sparing, pain intensity and hospital stay after various breast plastic surgeries.
Aged ; Analgesia ; Anesthesia ; Breast ; Defecation ; Female ; Flatulence ; Humans ; Ileus ; Inhalation ; Length of Stay ; Lidocaine ; Methyl Ethers ; Pain Measurement ; Pain, Postoperative ; Prospective Studies ; Skin

Sacrococcygeal teratoma is the most common congenital tumor in neonates, and is reported in approximately 1/35,000 to 1/40,000 live births. Oligodendroglioma is a rare central nervous system tumor that is usually found in the cerebral hemisphere of young and middle aged adults. When associated with a teratoma, it is mainly identified in ovarian teratoma in adolescents and adults. We describe a rare case of a preterm infant with oligodendroglioma in a mature sacrococcygeal teratoma. The male neonate was born at a gestational age of 30 weeks with a protruding mass in the sacrococcygeal region. Pelvic magnetic resonance imaging showed a sacrococcygeal teratoma of approximately 11 cm comprising fat components and skeletal structure, that extended from the anterior part of the sacrum to the abdominal cavity. Radical resection was performed at 36 days of age. Macroscopically, the resected intra-abdominal mass had the characteristics of a cystic lesion, and the intrapelvic mass was a predominantly solid mixed cystic-solid lesion. Histologically, this solid lesion in the intrapelvic mass was composed of mature glial tissue, which comprised as a proliferation of monotonous cells with small and round nuclei, surrounded by a perinuclear halo (“fried egg” appearance). Additionally, these cells were immunohistochemically positive for glial fibrillary acidic protein. These findings confirmed the diagnosis of oligodendroglioma in sacrococcygeal mature teratoma. After the treatment, no recurrence was observed during the follow-up period, and no additional intervention was required. However, the patient is undergoing treatment for voiding dysfunction caused by a neurogenic bladder.

BACKGROUND: Numerous modalities have been used to treat scars and wrinkles. Most of them are not satisfactory and always have some degrees of complications. OBJECTIVE: This study was performed to evaluate the effect of the combination therapy of superpulse CO2 laserbrasion and dermabrasion(laser-dermabrasion) in surgical treatment of scars and wrinkles and propose that it can be a effective method to improve cosmetic results. METHODS: Twenty-eight patients with scars and wrinkles were treated using superpulse CO2 laserbrasion followed by dermabrasion. Questionnaires were completed for clinical assessments by the patients and clinicians. RESULTS: The results are summarized as follows. 1. Excellent and good results were achieved in 83.3% of scars in clinician's assessments and in 79.2% of scars in patients' assessments. 2. Excellent and good results were achieved in 100% of wrinkles in both of clinician's and patients' assessments. 3. The degrees of satisfaction were highest during 6 to 12 months after laser-dermabrasion and maintained high over 12 months. 4. Minimal and tolerable complications developed in 9 patients such as focal hyperpigmentation, changes of skin texture, erythema, milium and acne flare-up. CONCLUSION: We propose that the laser-dermabrasion would augment the effects of both laserbrasion and dermabrasion to improve cosmetic results in treatment of scars and wrinkles with minimal risks and low costs.
Acne Vulgaris ; Cicatrix* ; Dermabrasion ; Erythema ; Humans ; Hyperpigmentation ; Skin ; Surveys and Questionnaires

OBJECTIVES: This study aimed to investigate the differences in the facial emotion recognition and discrimination ability between children with attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). METHODS: Fifty-three children aged 7 to 11 years participated in this study. Among them, 43 were diagnosed with ADHD and 10 with ASD. The parents of the participants completed the Korean version of the Child Behavior Checklist, ADHD Rating Scale and Conner's scale. The participants completed the Korean Wechsler Intelligence Scale for Children-fourth edition and Advanced Test of Attention (ATA), Penn Emotion Recognition Task and Penn Emotion Discrimination Task. The group differences in the facial emotion recognition and discrimination ability were analyzed by using analysis of covariance for the purpose of controlling the visual omission error index of ATA. RESULTS: The children with ADHD showed better recognition of happy and sad faces and less false positive neutral responses than those with ASD. Also, the children with ADHD recognized emotions better than those with ASD on female faces and in extreme facial expressions, but not on male faces or in mild facial expressions. We found no differences in the facial emotion discrimination between the children with ADHD and ASD. CONCLUSION: Our results suggest that children with ADHD recognize facial emotions better than children with ASD, but they still have deficits. Interventions which consider their different emotion recognition and discrimination abilities are needed.
Autism Spectrum Disorder ; Autistic Disorder* ; Checklist ; Child Behavior ; Child* ; Discrimination (Psychology)* ; Facial Expression ; Female ; Humans ; Intelligence ; Male ; Parents

Objectives: This study examined trends in the health status and dietary behavior changes by region using the raw data from the 2008 ~ 2019 Community Health Survey. Methods: This study analyzed the data of 2,738,572 people among the raw data of the Community Health Survey from 2008 to 2019. The regional differences in health status and dietary behavior were examined by classifying the regions into capital and non-capital regions, and the non-capital regions were classified into metropolitan cities and provinces. A chi-square test was conducted on the body mass index (BMI), diagnosis of diabetes and hypertension, frequency of eating breakfast, salty taste in usual diet, recognition of nutrition labeling, reading of nutrition labeling, and utilization of nutrition labeling. Results: In determining obesity using the BMI, the normal weight by year decreased, and the obesity rate by year was 34.6% in 2019, which increased by 13% compared to 2008.In addition, the diabetes diagnosis rate and hypertension diagnosis rate continued to increase with the year. Both diabetes and hypertension diagnosis rates were higher in the non-capital regions than in the capital region. Eating breakfast five to seven times per week was most common and showed a significant decreasing trend by year (P < 0.001). The percentage of respondents who said they eat slightly bland foods increased from 19.5% in 2008 to 19.9% in 2010 and then to 22.1% in 2013. The percentage then decreased to 19.9% in 2019, but showed an overall increasing trend (P < 0.001). According to the region, the capital region had a higher percentage than the non-capital region. The nutrition labeling's recognition rate and utilization rate increased yearly, whereas the reading rate decreased. Conclusions The study results presented the primary data necessary to develop nutrition education programs and establish strategies for local nutrition management projects to improve disease prevention and dietary problems.

Background: The Wnt signaling pathway regulates crucial cellular processes, including stem cell development and tissue repair. Dysregulation of this pathway, particularly β-catenin stabilization, is linked to colorectal carcinoma and other tumors. Axin2, a critical component in the pathway, plays a role in β-catenin regulation. This study examines Axin2 expression in normal gastric mucosa and various gastric pathologies. Methods: Formalin-fixed and paraffin-embedded tissue samples from normal stomach, gastritis, intestinal metaplasia (IM), and gastric carcinoma were collected. Axin2 and β-catenin expression were evaluated using RNA in situ hybridization and immunohistochemistry, respectively. Histo-scores (H-scores) were calculated to quantify expression levels of Axin2. Associations between Axin2 expression and clinicopathological variables were examined. Results: Axin2 expression was examined in normal stomach, gastritis, and IM tissues. Axin2 expression was mainly observed in the surface and isthmus areas in the normal stomach and gastritis, whereas Axin2 expression was markedly higher at the bases of IM. Axin2 H-scores were significantly elevated in IM (mean ± standard deviation [SD], 87.0 ± 38.9) compared to normal (mean ± SD, 18.0 ± 4.5) and gastritis tissues (mean ± SD, 33.0 ± 18.6). In total, 30% of gastric carcinomas showed higher Axin2 expression. Axin2 expression did not have significant associations with age, sex, Lauren classification, histological differentiation, invasion depth, and lymph node metastasis. However, a strong positive correlation was observed between Axin2 and nuclear β-catenin in gastric carcinomas (p < .001). Conclusions Axin2 expression was significantly increased in IM compared to normal and gastritis cases. In addition, Axin2 showed a strong positive association with nuclear β-catenin expression in gastric carcinomas, demonstrating a close relationship with abnormal Wnt/β-catenin signaling pathway.