The indications for placement of central venous catheters are continually expanding. The rapid growth of hemodialysis services, transplantation programs, and oncologic centers has contributed to the need for maintaining patients who require parenteral nutrition, hemodialysis, plasmapheresis, blood transfusion, blood sampling, and long-term chemotherapy for various neoplastic and infections disease. There are three basic categories of venous catheters: non-tunneled catheters, tunneled catheters and implantable ports. Each category of non-tunneled and tunneled catheter divided to infusion and high flow hemodialysis catheter. Peripherally inserted central catheter is a unique long non-tunneled catheter inserted through an arm vein. All physicians should have a deep understanding of each central venous catheters and ability to select the most appropriate one for each patient. Central venous catheterization should be performed by experts with imaging guidance. The high failure rate and high complication rate in the landmark bedside technique was revealed due to anatomical variance of veins. Appropriate management of the catheter is one of the most important parts should be understood by nurses as well as physician in central venous catheterization.
Arm ; Blood Transfusion ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Humans ; Parenteral Nutrition ; Plasmapheresis ; Renal Dialysis ; Transplants ; Veins

No abstract available.
Colon* ; Diverticulitis*

BACKGROUND: Nocturia is a common event among the elderly that is often understood to be a potential cause of sleep disorder. However, only a few such studies have been reported in Korea. The purpose of this study was to investigate physical diseases including nocturia as a risk factor for sleep disturbance in the Korean elderly. METHODS: Subjects included 433 patients older than 60 years (average age, 69.7 years) who had completed a structured questionnaire from June to August 2009. The questionnaire asked about the quality of their sleep, nocturia and physical diseases such as hypertension, diabetes mellitus, gastrointestinal problems, arthralgia and chronic obstructive pulmonary disease. Logistic regression analysis was used to evaluate the nocturia and the physical diseases associated with sleep. RESULTS: Incidence of nocturia increased with age and showed a significant variation among the different age groups (p<0.05): 35.7% in their 60s, 41.5% in their 70s and 60.4% in their 80s and older. Nocturia (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10 to 2.58) and arthralgia (OR, 1.69; 95% CI, 1.10 to 2.60) were two important factors causing sleep disorder. CONCLUSION: In conclusion, nocturia and arthralgia were the main causes of sleep disorder. As the elderly population is continually increasing, further studies are needed to improve our understanding of this subject and to find a potential cure.
Aged ; Arthralgia ; Diabetes Mellitus ; Humans ; Hypertension ; Incidence ; Korea ; Logistic Models ; Nocturia ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors

BACKGROUND: Nocturia is a common event among the elderly that is often understood to be a potential cause of sleep disorder. However, only a few such studies have been reported in Korea. The purpose of this study was to investigate physical diseases including nocturia as a risk factor for sleep disturbance in the Korean elderly. METHODS: Subjects included 433 patients older than 60 years (average age, 69.7 years) who had completed a structured questionnaire from June to August 2009. The questionnaire asked about the quality of their sleep, nocturia and physical diseases such as hypertension, diabetes mellitus, gastrointestinal problems, arthralgia and chronic obstructive pulmonary disease. Logistic regression analysis was used to evaluate the nocturia and the physical diseases associated with sleep. RESULTS: Incidence of nocturia increased with age and showed a significant variation among the different age groups (p<0.05): 35.7% in their 60s, 41.5% in their 70s and 60.4% in their 80s and older. Nocturia (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.10 to 2.58) and arthralgia (OR, 1.69; 95% CI, 1.10 to 2.60) were two important factors causing sleep disorder. CONCLUSION: In conclusion, nocturia and arthralgia were the main causes of sleep disorder. As the elderly population is continually increasing, further studies are needed to improve our understanding of this subject and to find a potential cure.
Aged ; Arthralgia ; Diabetes Mellitus ; Humans ; Hypertension ; Incidence ; Korea ; Logistic Models ; Nocturia ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors

BACKGROUND: For gastric cancer, primary prevention by risk factor modification might have some important roles. However, previous studies having investigated the factors associated with stomach cancer reported various results. In addition, there were only a few studies based on Korean population. METHODS: A case control study was carried out on 106 cases matched for age and sex with 106 controls in a tertiary care hospital. In patients who were aged 75 years or less and had been newly diagnosed as adenocarcinoma of stomach between July 1996 and January 1997 were included into the case group. Information on baseline characteristics, health habits, dietary habits of study subjects was obtained through an interview using structured questionnaire. Conditional logistic regression analysis was used to evaluate the factors associated with stomach cancer. RESULTS: Salt preference was associated with significantly increased risk of stomach cancer (odds ratio[OR]=9.81, 95% confidence interval[CI]=2.28 42.2). Eating broiled food more than three times a week significantly increased the risk of stomach cancer (OR=3.33, 95% CI=1.16 9.55) compared to eating it less than once a week. Blood type, family history of stomach cancer, smoking, and alcohol consumption were not associated with stomach cancer. CONCLUSION: Salt preference and frequent eating of broiled food are the risk factors significantly associated with stomach cancer in this study subjects.
Adenocarcinoma ; Alcohol Drinking ; Case-Control Studies* ; Diet ; Eating ; Food Habits ; Humans ; Logistic Models ; Primary Prevention ; Risk Factors* ; Smoke ; Smoking ; Stomach Neoplasms* ; Stomach* ; Tertiary Healthcare ; Surveys and Questionnaires

OBJECTIVE: The effect of cognitive-behavioral therapy on the delusion in schizophrenic patients was evaluated. METHOD: The patients admitted to a psychiatric ward from September 1999 to June 2000 and diagnosed as schizophrenia, schizophreniform disorder, and schizoaffective disorder by DSM-IV were randomly assigned to cognitive-behavioral therapy(CBT) group(n=9) and supportive psychotherapy (ST) group(n=8). During the 10 weeks' treatment period, conviction, preoccupation, and anxiety on delusion, mode of explanation about symptom, and recovery style were regularly measured and compared between groups. RESULTS: 1) As for conviction and anxiety on delusion, the patients from both groups showed gradual reduction over time, but there was no significant difference between groups. 2) As for preoccupation of delusion, patients from both groups showed gradual reduction over time, and the patients on CBT group had a significantly more reduction than ST group. 3) As for mode of explanation and recovery style, CBT group had more marked positive changes than ST group did. CONCLUSION: Cognitive-behavioral therapy is more effective on preoccupation of delusion, explanatory mode about symptom, and recovery style than supportive psychotherapy.
Anxiety ; Delusions* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychotherapy ; Psychotic Disorders ; Schizophrenia

The treatment for epilepsy has been studied throughout the course of human history. However, radical treatment of epilepsy has only been discovered recently with introduction of surgical treatment until now, palliative drug administration was common practice. During the anesthetic procedure for epilepsy surgery it is necessary for the patient to be alert and to cooperate with the surgeon while mapping and subcutaneous EEG test are carried out during the surgery. For this type of procedure, a new I.V. anesthetic, propofol is considered to be an ideal anesthetic agent because propofol is a short-acting and clear headed I.V. anesthetic agent for induction as the well as the maintenance of genenral anesthesia. In this study, only propofol was administered intravenously in 20 randomiied patients scheduled for brain surgery for epilepsy treatment. The mean infusion rate was 100 mcg/kg/min to maintain a satisfactory anesthesia. For the induction of anesthesia, slightly higher doses were required. The cardiovascular effects of propofol infusion was associated with slightly decrease of systolic, diastolic and mean arterial pressures. Arterial blood gases were analyzed for the evaluation of ventilatory function. PaCO2 were 41+/-4.23 mmHg preoperatively, 44+/-5.28 mmHg 30 min. following sedation, 42+/-6.35 mmHg 30 min. following awakening, 46+/-6.37 mmHg 30 min. following resedation, 44+/-4.79 mmHg at 2 hours and 44+/-6.51 mmHg at 4 hours after resedation and 36+/-3.98 mmHg 30 min. following recovery. PaO2 were 101+/-31.3 mmHg preoperatively, 190+/-47.13 mmHg 30 min. following sedation, 195+/-32 mmHg 30 min. following awakening, 209+/-29.23 mmHg 30 min. and 210+/-34.55 mmHg at 2 hours and 190+/-37.36 mmHg 4 hours following resedation, and 10.2+/-31.36 mmHg 30 min. following. PH were 7.38 preoperatively, 7.34+/-0.04 following sedation, 7.34+/-0.03 30 min. following awakening, 7.34+/-0.03 at 30 min. following resedation, 7.35+/-0.03 at 2 hours and 7.36+/-0.03 at 4 hours following resedation, and 7.38+/-3.98 at 30 min. after recovery. The duration of anesthesia was 8.5-12 hours. The duration of propofol anesthesia ranged from 8 to 9 hours. The awakening time from the cessation of propofol infusion ranged from 3 to 17 minutes. As the result of this study, we came to the conclusion that propofol is an ideal intravenous anesthetic for brain surgery for epilepsy treatment.
Anesthesia* ; Arterial Pressure ; Brain* ; Electroencephalography ; Epilepsy* ; Gases ; Head ; Humans ; Hydrogen-Ion Concentration ; Propofol*

The treatment for epilepsy has been studied throughout the course of human history. However, radical treatment of epilepsy has only been discovered recently with introduction of surgical treatment until now, palliative drug administration was common practice. During the anesthetic procedure for epilepsy surgery it is necessary for the patient to be alert and to cooperate with the surgeon while mapping and subcutaneous EEG test are carried out during the surgery. For this type of procedure, a new I.V. anesthetic, propofol is considered to be an ideal anesthetic agent because propofol is a short-acting and clear headed I.V. anesthetic agent for induction as the well as the maintenance of genenral anesthesia. In this study, only propofol was administered intravenously in 20 randomiied patients scheduled for brain surgery for epilepsy treatment. The mean infusion rate was 100 mcg/kg/min to maintain a satisfactory anesthesia. For the induction of anesthesia, slightly higher doses were required. The cardiovascular effects of propofol infusion was associated with slightly decrease of systolic, diastolic and mean arterial pressures. Arterial blood gases were analyzed for the evaluation of ventilatory function. PaCO2 were 41+/-4.23 mmHg preoperatively, 44+/-5.28 mmHg 30 min. following sedation, 42+/-6.35 mmHg 30 min. following awakening, 46+/-6.37 mmHg 30 min. following resedation, 44+/-4.79 mmHg at 2 hours and 44+/-6.51 mmHg at 4 hours after resedation and 36+/-3.98 mmHg 30 min. following recovery. PaO2 were 101+/-31.3 mmHg preoperatively, 190+/-47.13 mmHg 30 min. following sedation, 195+/-32 mmHg 30 min. following awakening, 209+/-29.23 mmHg 30 min. and 210+/-34.55 mmHg at 2 hours and 190+/-37.36 mmHg 4 hours following resedation, and 10.2+/-31.36 mmHg 30 min. following. PH were 7.38 preoperatively, 7.34+/-0.04 following sedation, 7.34+/-0.03 30 min. following awakening, 7.34+/-0.03 at 30 min. following resedation, 7.35+/-0.03 at 2 hours and 7.36+/-0.03 at 4 hours following resedation, and 7.38+/-3.98 at 30 min. after recovery. The duration of anesthesia was 8.5-12 hours. The duration of propofol anesthesia ranged from 8 to 9 hours. The awakening time from the cessation of propofol infusion ranged from 3 to 17 minutes. As the result of this study, we came to the conclusion that propofol is an ideal intravenous anesthetic for brain surgery for epilepsy treatment.
Anesthesia* ; Arterial Pressure ; Brain* ; Electroencephalography ; Epilepsy* ; Gases ; Head ; Humans ; Hydrogen-Ion Concentration ; Propofol*

Candidosis, the most common fungal infection involving the central nervous system, is rarely diagnosed during life. The authors present a case of candidal granuloma of the caudate area in a 31-year-old, otherwise healthy man with episode of intermittent antibiotic therapy. There was no extracranial fungal lesions, Ventriculoperitoneal shunt and biopsy followed by treatment with Amphotericin-B resulted in a favorable outcome.
Adult ; Biopsy ; Central Nervous System ; Granuloma* ; Humans ; Ventriculoperitoneal Shunt

A case of traumatic thoracolumbar epidural hemorrhage is presented in a 37-year-old man with ankylosing spondylitis. The patient complained neck and back pain right after the accident but paralegia and difficult urination followed 2 days later. Spine CT showed thoracolumbar epidural mass, which was confirmed to be hemorrhage associated with spine fracture and was solely responsible for paraplegia.
Adult ; Back Pain ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Humans ; Neck ; Paraplegia ; Spine ; Spondylitis, Ankylosing* ; Urination