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

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*

Bunazosin is a alpha-1 blocker that is more selective and effective than other alpha-1 receptor blockers. Bunazosin has been shown to lower intraocular pressure but it's mechanism is uncertain. The purpose of this study is to know the morphological changes in the ciliary epithelium by bunazosin. 0.1% Bunazosin was instilled on the eye of the rabbits and the eyes were enucleated on 1, 2, 6 and 24 hours after instillation to find out the tissue response under the electronmicroscopy. As a result, widening of the cell membranes and swelling of the mitochondria were observed in the pigmented and non-pigmented epithelium and these changes were recovered with time and seem to be the morphological changes of bunazosin against aqueous formation in the ciliary body.
Cell Membrane ; Ciliary Body ; Epithelium* ; Intraocular Pressure ; Mitochondria ; Rabbits*

No abstract available.

OBJECTIVES: Diabetes is a chronic disease of continuously increasing prevalence. It is a disease with risks of serious complications, thus warranting its long-term management. However, current health management and education programs for diabetes mainly consist of one-way communication, and systematic social support backup to solve diabetics' emotional problems is insufficient. METHODS: According to individual behavioral changes based on the Transtheoretical Model, we designed a non-drug intervention, including exercise, and applied it to a mobile based application. For effective data sharing between patients and physicians, we adopted an SNS function for our application in order to offer a social support environment. RESULTS: To induce continual and comprehensive care for diabetes, rigorous self-management is essential during the diabetic's life; this is possible through a collaborative patient-physician healthcare model. We designed and developed an SNS-based diabetes self-management mobile application that supports the use of social groups, which are present in three social GYM types. With simple testing of patients in their 20s and 30s, we were able to validate the usefulness of our application. CONCLUSIONS: Mobile gadget-based chronic disease symptom management and intervention has the merit that health management can be conducted anywhere and anytime in order to cope with increases in the demand for health and medical services that are occurring due to the aging of the population and to cope with the surge of national medical service costs. This patient-driven and SNS-based intervention program is expected to contribute to promoting the health management habits of diabetics, who need to constantly receive health guidance.
Aging ; Chronic Disease ; Clinical Trial ; Delivery of Health Care ; Diabetes Mellitus ; Education ; Humans ; Information Dissemination ; Mobile Applications ; Prevalence ; Self Care* ; Telemedicine

BACKGROUND: Pulmonary arterial hypertension (PAH) in systemic lupus erythematosus (SLE) has very poor prognosis and the prevalence of the disease is also not well delineated. This study was designed to assess the prevalence of PAH in asymptomatic SLE patients and to analyze the potential association between the presence of PAH and SLE including disease activity, organ involvement, and serology. METHODS: Asymptomatic 50 SLE patients and 50 healthy controls of a similar age and sex were assessed by an echocardiographic and clinical study. The diagnosis of PAH was made when the right ventricular systolic pressure (RVSP), measured by 2-dimensional echocardiography, was > or =40 mmHg. RESULTS: Compared to control subjects, lupus patients had significantly increased RVSP (mean+/-SD, 34.9+/-8.9 vs 31.2+/-3.6 mmHg, p=0.008). Patients with SLE were divided into three groups: RVSP> or =40 mmHg, RVSP=30~39 mmHg, RVSP<30 mmHg. Seven patients (14%) had RVSP> or =40 mmHg, 36 patients (72%) had RVSP=30~39 mmHg and 7 patients (14%) had RVSP<30 mmHg. In the healthy controls, none of them had RVSP> or =40 mm Hg. Of the controls, 43 (86%) had RVSP=30~39 mmHg and 7 (14%) had RVSP<30 mmHg. There was no statistical difference in organ involvement, Raynaud's phenomenon, vasculitis, anti-RNP and anti-cardiolipin Ab among the three SLE groups. However, lupus disease activity (checked by SLEDAI-2K) was associated with PAH (p=0.014). CONCLUSIONS: The prevalence of PAH as seen on echocardiograms in SLE patients was 14%. Organ involvement, Raynaud's phenomenon, vasculitis, antiphopholipid antibodies and anti-RNP except SLEDAI-2K were not associated with pulmonary arterial pressure.
Antibodies ; Arterial Pressure ; Blood Pressure ; Diagnosis ; Echocardiography ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Prevalence ; Prognosis ; Vasculitis

OBJECTIVES: This study was performed to consider the clinical experience of surgical outcome of single port access (SPA) laparoscopic myomectomy according to suturing methods. METHODS: The authors operated with 2 suturing method in SPA laparoscopic myomectomy for 246 patients and compared the surgical outcomes. RESULTS: The some significant difference of surgical outcome according to two suturing methods was demonstrated. Operating time was 100.50 minutes (+/- 42.09 minutes) in interrupted suture method group than 121.04 minutes (+/- 61.56 minutes) in continuous interlocking suture method group (P = 0.021). Estimated blood loss was less 222.59 mL (+/- 144.94 mL) in interrupted suture group than 340.11 mL (+/- 380.62 mL) in continuous interlocking suture method group (P = 0.042). CONCLUSION: This experience suggests that interrupted suture method was effective for operating time and estimated blood loss than continuous interlocking method in SPA laparoscopic myomectomy.
Humans ; Laparoscopy ; Leiomyoma ; Suture Techniques ; Sutures ; Treatment Outcome

Authors experienced a case of Morquio' s syndrome accompanied by respiratory failure in a aged fifteen year old boy. Patient showed normal intelligence, but stunted growth with short trunk and unproportionately large head, pectus carinatum, kyposcoliosis, muscular weakness, paralysis and genu valgum. No other member of family was affected with this syndrome. There were radiological findings of subluxation between first and second cervical vertevrae, central beaking with thoracolumbar vertebra plana, wine glass appeared pelvis and shortening of carpal & metacarpal bones of both hands. There were biochemical findings of large proportion of chondroitin sulfate (87%) on urinary mucopolysaccharides examination. Resipratory failure occurred due to compression of cervical spinal cord by subluxation between first and second cervival vertebra. He was maintanied by ventilator, discharged. And he died.
Animals ; Beak ; Chondroitin Sulfates ; Genu Valgum ; Glass ; Glycosaminoglycans ; Hand ; Head ; Humans ; Intelligence ; Male ; Metacarpal Bones ; Muscle Weakness ; Paralysis ; Pelvis ; Respiratory Insufficiency* ; Spinal Cord ; Spine ; Ventilators, Mechanical ; Wine

OBJECTIVES: The main purpose of this study was to investigate relationship between cumulative trauma disorders(CTDs) and the types of workstation and chair in workers with repetitive motion tasks. METHODS: The study subjects were 77 repetitive motion tasks workers at small manufacturing industries in Seoul and Gyung-gi district area. A questionnaire was used to obtain about health practice for prevention and prevalence of CTDs by worker. The type of Workstations and chairs in workers were measured and analyzed with prevalence of CTDs by logistic regression. RESULTS: Eighty-six percent of workers recognized that work posture was related to workstation and chair. Most employers and employees didn't follow the work practice guidelines for workers with repetitive motion tasks. The prevalence of CTDs was 64% by questionnaire. The prevalence of pain in shoulder, neck, back, and arm were 38%, 15%, 6%, and 5%, respectively, and the pain started after working an average duration of 16.5 months. The CTDs symptoms were significantly related to thickness of workstation, height of workstation, length of knee depth under workstation, height of back rest, height of seat pan, depth of sitting surface, width of sitting surface, and length from workstation surface edge to shoulder. By multiple regression analysis of each risk factor, prevalence of CTDs was highly correlated with height of back rest, height of seat pan, and depth of sitting surface. CONCLUSIONS: This study suggests that workstations should be made adjustable for height and chairs should be equipped with seat pan height control, enough sitting surface for depth and width, back rest height and angle control. The workers should use the right working postures, exercise for health, occupational health education, and rest breaks and the manager of company should be educated for the preventing of CTDs.
Arm ; Cumulative Trauma Disorders* ; Health Education ; Knee ; Logistic Models ; Neck ; Occupational Health ; Posture ; Prevalence ; Questionnaires ; Risk Factors ; Seoul ; Shoulder

Tooth movement by orthodontic force effects great tissue changes within the periodontium, especially by shifting the blood flow in the pressure side and resulting in a hypoxic state of low oxygen tension. The aim of this study is to elucidate the possible mechanism of apoptosis in response to hypoxia in MC3T3E1 osteoblasts, the main cells in bone remodeling during orthodontic tooth movement. MC3T3E1 osteoblasts under hypoxic conditions (2% oxygen) resulted in apoptosis in a time-dependent manner as estimated by DNA fragmentation assay and nuclear morphology stained with fluorescent dye, Hoechst 33258. Pretreatment with Z-VAD-FMK, a pan-caspase inhibitor, or Z-DEVD-CHO, a specific caspase-3 inhibitor, completely suppressed the DNA ladder in response to hypoxia. An increase in caspase-3-like protease (DEVDase) activity was observed during apoptosis, but no caspase-1 activity (YVADase) was detected. To confirm what caspases are involved in apoptosis, Western blot analysis was performed using anti-caspase-3 or -6 antibodies. The 10-kDa protein, corresponding to the active products of caspase-3, and the 10-kDa protein of the active protein of caspase-6 were generated in hypoxia-challenged cells in which the processing of the full length form of caspase-3 and -6 was evident. While a time course similar to this caspase-3 and -6 activation was evident, hypoxic stress caused the cleavage of lamin A, which was typical of caspase-6 activity. In addition, the stress elicited the release of cytochrome c into the cytosol during apoptosis. Furthermore, we observed that pre-treatment with SB203580, a selective p38 mitogen activated protein kinase inhibitor, attenuated the hypoxia-induced apoptosis. The addition of SB203580 suppressed caspase-3 and -6-like protease activity by hypoxia up to 50%. In contrast, PD98059 had no effect on the hypoxia-induced apoptosis. To confirm the involvement of MAP kinase, JNK/SAPK, ERK, or p38 kinase assay was performed. Although p38 MAPK was activated in response to hypoxic treatment, the other MAPK -JNK/SAPK or ERK- was either only modestly activated or not at all. These results suggest that p38 MAPK is involved in hypoxia-induced apoptosis in MC3T3E1 osteoblasts.
Anoxia ; Antibodies ; Apoptosis* ; Bisbenzimidazole ; Blotting, Western ; Bone Remodeling ; Caspase 3 ; Caspase 6 ; Caspases ; Cytochromes c ; Cytosol ; DNA ; DNA Fragmentation ; Lamin Type A ; Osteoblasts* ; Oxygen ; p38 Mitogen-Activated Protein Kinases ; Periodontium ; Phosphotransferases* ; Protein Kinases ; Tooth Movement