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*

A survey was performed in order to determine the infection status of the metacercariae of heterophyid fluke in two goby species, Boleophthalmus pectinirostris and Scartelaos sp., collected from Gangjin-gun, and Shinangun, Sooncheon-shi, Jeollanam-do, Republic of Korea. A total of three metacercariae of Heterophyopsis continua was found in only one B. pectinirostris (10.0%) from Gangjin-gun. Heterophyes nocens metacercariae were detected in 24 B. pectinirostris (96.0%) and 14 Scartelaos sp. (63.6%) from Shinan-gun. Heterophyopsis continua metacercariae were found in 11 B. pectinirostris (44.0%) and 21 Scartelaos sp. (95.5%) from Shinan-gun. Stictodora fuscata metacercariae were detected in 18 B. pectinirostris (72.0%) from Shinan-gun. No metacercariae were detected in 20 B. pectinirostris from Sooncheon-shi. From the above results, this study is the first to prove that B. pectinirostris and Scartelaos sp. serve as the second intermediate hosts of some heterophyid flukes in Korea.
Trematoda/*isolation & purification ; Perciformes/*parasitology ; Korea ; Animals

No abstract available.
Prevalence* ; Ulsan*

The thirty eight newborn infants with periventricular leukomalacia who were admitted to the neonatal intensive care unit of Gil General Hospital from March 1, 1988 to June 30, 1991, were investigated for ultrasonographic findings, risk factors and neurological outcome. The results were as follows: 1) There were 38 cases of PVL including 21 echogenic flarings and 17 cystic PVL's. 2) Mean birth weight was 2,250 gm and mean gestational age was 35 week. 3) Mean detection timing was 4th day in echogenic flarings and 18th day in cystic PVL's. 4) PVL's were located in the parietal region in 1 case and fronto-parieto-occipital in 3 cases. 5) Mean cyst size was 6 mm. 6) Multiple logistic regression analysis for the risk factors of PVL showed that low birth weight, apnea and seizure were the most significant contributing factors (p<0.05). 7) In the follow-up study of cystic PVL's, 7 cases showed improvement, 7 cases developed into multicystic encephalomalacia and 3 cases developed into atrophy. 8) Neurodevelopmental outcome of cystic PVL's showed nomal; 6.2%, minor neurodevelopmental defect; 43.8%, major neurodevelopmental defect; 31.2% and death; 18.8%. 9) Neurosonographic predictability for neurodevelopemental sequelae by cystic PVL's showed sensitivity; 63.6%%, specificity; 98.0%, positive predictive value; 92.8% and accuracy; 88.2%. 10) Major neurodevelopmental defect was more frequent, cyst size being larger and location being more extensive (p<0.05).
Apnea ; Atrophy ; Birth Weight ; Encephalomalacia ; Follow-Up Studies ; Gestational Age ; Hospitals, General ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Rabeprazole ; Risk Factors* ; Seizures ; Sensitivity and Specificity

No abstract available.
alpha-Fetoproteins ; Common Bile Duct* ; Endoderm* ; Endodermal Sinus Tumor*

Superficial siderosis (SS) is a rare disorder characterized by deposition of hemosiderin in the leptomeninges and subpial layer of the central nervous system. Recently SS suggested a subtype of cerebral amyloid angiopathy which is an important cause of lobar intracerebral hemorrhage (ICH). We present a patient with cortical SS had seizure and cognitive dysfunction as symptom and lobar ICH in the existed area of cortical SS 4 years later. This case suggested cortical SS could be a warning sign of lobar ICH.
Central Nervous System ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Hemosiderin ; Humans ; Seizures ; Siderosis

PURPOSE: To know the discrepancy of rotational alignment using human femur. MATERIALS AND METHODS: We used 22 adult human femurs which were not able to distinguish age and sex and absent articular cartilage. In a horizontal plane, we made a cross-section perpendicularly at supra-condyle of femur to a mechanical axis and took a simple roentgenogram in coronal plane focusing on the center of transepicondylar axis. In terms of roentgenogram and gross specimen, the angle between per-pendicular to the anteroposterior axis and the posterior condylar axis, the angle between the transepi-condylar axis and the posterior condylar axis were measured by 5 observers. According to t-test in statisti-cal method, we figured out the difference between two angles and made a significance at p<0.05. RESULTS: About posterior condylar axis, the line perpendicular to anteroposterior axis was observed the average 4.8(+/-1.5)degree, 6.0(+/-1.9)degree external rotation in roentgenogram and gross specimen respectively. The transepicondylar axis was observed the average 3.5(+/-1.2)degree, 3.9(+/-1.4)degree external rotation in roentgenogram and gross specimen respectively. There was statistically significant difference between two angles. Moreover, angles measured by 5 observers were found that to have a line perpendicular to the anteroposterior axis has much more external rotation respectively and there was a statistically significant difference also. CONCLUSIONS: On determination of a rotational alignment using human femur, there is statistically sig-nificant difference between the anteroposterior axis and the transepicondylar axis in gross specimen as well as roentgenogram.
Adult ; Axis, Cervical Vertebra* ; Cartilage, Articular ; Femur* ; Humans

No abstract available.
Blepharoptosis*

PURPOSE: We performed this study to evaluate the alterations in renal function for patients with ileal conduit and ileal orthotopic neobladder MATERIALS AND METHODS: From January 1999 to June 2004, 48 patients who had undergone radical cystectomy with urinary diversion were included in our study. The patients were divided into two groups according to the types of urinary diversion. One group consisted of 29 patients with ileal conduit and the other group consisted of 19 patients with ileal W neobladder. The mean age of the ileal conduit group and the ileal W neobladder group were 65.6+/-9.9 years and 60.8+/-8.3 years, respectively. The preoperative and postoperative blood urea nitrogen/creatinine (BUN/Cr) levels, postoperative complications and postoperative GFR, as measured by (99m)Tc-DTPA scans, were compared between the two groups. RESULTS: For the postoperative complications, stricture at the ureterovesical anastomosis site occurred in 1.7% (1/58 renal units) of the ileal conduit group and in 10.5% (4/38 renal units) of the ileal W neobladder group. Acute pyelonephritis occurred in 5.2% (3/58 renal units) of the ileal conduit group and in 5.3% (2/38 renal units) of the ileal W neobladder group. The pre- and postoperative serum BUN/Cr levels were 20.8/1.3 and 24.8/1.6, respectively, in the ileal conduit group, and 17.2/1.1 and 18.8/1.2, respectively, in the ileal W neobladder group. There were no statistical significant differences between the pre- and postoperative changes of the serum BUN/Cr levels for both groups. The GFR, as measured by (99m)Tc-DTPA scans, were 77.6 and 78.7ml/ min/1.73m2 in the ileal conduit group and the ileal W neobladder group, respectively. There were no statistical significant differences between the two groups. CONCLUSIONS: There were no significant differences in renal function between the ileal conduit and ileal W neobladder.
Constriction, Pathologic ; Cystectomy ; Humans ; Postoperative Complications ; Pyelonephritis ; Urea ; Urinary Diversion*

BACKGROUND: There are only a few studies regarding the causes of treatment failure for tuberculosis. Therefore, this study aimed to determine the causes of intractable tuberculosis. METHODS: M.tuberculosis, differentiated MOTT (Tycobacterium Other Than Tuberculosis) were isolated, and the RFLP (Restriction fragments length polymorphisms) pattern was analyzed from 204 patients with pulmonary tuberculosis and 53 suffering from neck tuberculosis. The IL-1β, IL-12, *1 IFNγ and *2 TNFαblood levels were measured. All patients were regularly followed for 18 months after treatment. RESULTS: There was no correlation between the RFLP patterns of M.tuberculosis treatment failure. From the 204 cases, 31.9% were intractable. The characteristics of patients with intractable tuberculosis were old age, being male and recurrent cases. The causes of treatment failure were identified as follows ; a decrease in the IL-12(59.4%) concentration, drug resistant strain(54.7%), irregular medication(15.4%), MOTT(6.2%) and a heavy infection(4.6%). The causes of all cases of intractable tuberculosis could be investigated. The IL-12 concentration in the blood was significantly lower in the intractable cases, where it disclosed a maximum sensitivity(64.7%) and specificity(75.4%) at 165.0 pg/ml. Most of the 53 cases on neck node tuberculosis were treated successfully. Therefore, we were unable to analyze the cause of treatment failure. CONCLUSION: A decrease in the blood IL-12 concentration and drug resistant strains were identified as the most significant causes of treatment failure for tuberculosis. In Korea, infection by clusters were prevalent, but no difference in the clinical course between clusters and non-clusters could be found.
Humans ; Interleukin-12 ; Korea ; Male ; Neck* ; Polymorphism, Restriction Fragment Length ; Treatment Failure* ; Tuberculosis* ; Tuberculosis, Pulmonary