BACKGROUND: Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. METHODS: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. RESULTS: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). CONCLUSIONS: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Body Water ; Critical Illness* ; Electric Impedance* ; Humans ; Intensive Care Units ; Male ; Mortality ; Observational Study* ; Prospective Studies* ; Renal Replacement Therapy* ; Survival Rate ; Water

No abstract available.
Nose*

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

A subperiosteal ganglion has been very rarely reported, since Ollier reported first one in 1864. A subperiosteal ganglion is produced by mucoid degeneration and cyst formation within the periosteum, which results in cortical erosion. The characteristic plain radiolographic appearance of irregular cortical erosion and scalloping, with reactive periosteal bone spicules, has been considered pathognomonic of subperiosteal ganglion. Magnetic resonance imaging is performed to further characterize the soft tissue component of the mass. As in our patient, the characteristic signal intensities of magnetic resonance imaging are especially useful in identifying the lesion as a ganglion and in defining the lobular nature and the anatomical extent. We report here the case of a 35-year-old female who had a sudperiosteal ganglion of the distal radius.
Adult ; Female ; Ganglion Cysts* ; Humans ; Magnetic Resonance Imaging ; Pectinidae ; Periosteum ; Radius*

The antiphospholipid antibody syndrome is an acquired multisystemic disorder characterized by persistent elevated antiphospholipid antibodies and/or hypercoagulation in veins or arteries, or both. The clinical manifestations of the antiphospholipid antibody syodrome are recurrent thrombosis, fetal loss, thrcenbocytopenia, and various cutaneous lesions. Skin lesions are the first sign of this syndrome in 41% of patients and systemic thrombosis develops in 40% of them. Livedo reticularis is the most common cutaneous finding of the antiphosphotipid antibody syndrome. Although vasculitis has not been frequently noted in antiphospholipid antibody syndrome, some vasculitis such as polyarteritis nodosa, giant cell arteritis, and other nonspecific vasculitides have been found in association with antiphospholipid antibody syndrome. We present a male patient with typical manifestations of leukocytoclastic vasculitis with deep vein thrombosis and positive antiphospholipid antibodies. It suggests that a case of antiphospholipid antibody syndorme was accompanied with cutaneous leukocytoclastic vasculitis.
Antibodies, Antiphospholipid* ; Antiphospholipid Syndrome ; Arteries ; Giant Cell Arteritis ; Humans ; Livedo Reticularis ; Male ; Polyarteritis Nodosa ; Skin ; Thrombosis ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous ; Veins ; Venous Thrombosis

No abstract available.
Diaphragmatic Eventration* ; Humans ; Infant, Newborn*

PURPOSE: The technique of anastomosis for gastroduodenostomy is thought to be of importance to success in the postoperative period and to the development of certain complications. Most surgeons a use two-layer anastomosis method. However, interest in single-layer anastomosis has increased. Therefore, we investigated the differences between single-layer and two-layer methods for anastomosis by comparing clinicopathological parameters and clinical courses. METHODS: This report is a retrospective clinical analysis of 265 patients of gastric cancer who underwent gastroduodenostomy following distal gastrectomy at the Department of Surgery, Chonbuk National University Hospital from Jan. 1991 to Dec. 1999. RESULTS: There was no significant difference observed between the two groups with regard to the mode of presentation, mean age, sex, or pathological characteristics of the tumor. The time for the anastomosis was shorter in the single-layer group (30.1+/-1.0 vs 37.1+/-2.1 minutes, p<0.001), the time of gas out was earlier in the single-layer group (4.4+/-1.1 vs 4.7+/-1.2 days, p=0.027) and the time of food intake was earlier in the single-layer group (5.7+/-0.8 vs 6.3+/-1.4 days, p<0.001) than in the two-layer group. Although the complication rate was not significantly different between the two groups, anastomotic leak was observed in 4 cases (2.7%) of the single-layer group and 3 cases (2.6%) of the two-layer group, and passage disorders were observed in 4 cases (2.7%) of the single-layer group and 5 cases (4.3%) of the two-layer group. CONCLUSION: A gastrodudenostomy using the single-layer anastomosis method has an advantage over the two-layer method for anastomosis with respect to the time for anastomosis, the time of gas out and time of food intake. Therefore the single-layer anastomosis method can be effectively employed in gastric cancer surgery.
Anastomotic Leak ; Eating ; Gastrectomy* ; Humans ; Jeollabuk-do ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms*

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

No abstract available.
Androgen-Insensitivity Syndrome* ; Male

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy, Tubal*