No abstract available.
Frontal Sinus*

BACKGROUND AND PURPOSE: The purpose of this study is to compare two clinical predictive rules, the pre-arrestmorbidity(PAM) index and the prognosis-after-resuscitation(PAR) score, which predict failure to survive following in-hospital cardiopulmonary resuscitation(CPR). METHOD: The study population consisted of 162 consecutive adult patients who underwent CPR at Wonju Christian Hospital over a year period. The PAM index and PAR score were calculated from the most recent data available for each variable prior to cardiac arrest. Each predictive tool was compared between the group of discharge alive and the group of in-hospital mortality. Performance of the predictive scores was also compared by receiver-operating characteristic(ROC) curves where appropriate. RESULTS: PAM index of study population was 4.39+/-2.69 and PAR score was 2.99+/-3.36. PAM index in the group of discharge alive was 1.87+/-2.79, and PAM index in the group of ih-hospital mortality was 4.51+/-2.62. PAR score in the group of discharge alive was 0.75+/-1.75, and PAR score in the group of in-hospital mortality was 3.1+/-3.4. The PAM index identified 15 patients with a score>8, while the PAR score identified 39 patients with a score>4, none of whom survived. The sensitivity of the PAR score for the prediction of failure to survive was 25%, while that of the PAM index was 10%; neither index incorrectly identified a patient as a non-survivor who eventually survived. Both of predictive methods were not significantly different in the ROC curve. CONCLUSION: Although further confirmation is necessary, PAM index and PAR score may provide useful prognostic information to physicians and patients involved with decisions about do-no- resuscitate orders.
Adult ; Cardiopulmonary Resuscitation* ; Gangwon-do ; Heart Arrest ; Hospital Mortality ; Humans ; Mortality ; ROC Curve

BACKGROUND AND PURPOSE: The systemic inflammatory response syndrome(SIRS), as defied recently by critical-care specialists, may result from various etiologies including infection, bum, or trauma. The purpose of this study was to determine whether TNF- alpha is associated with the development of systemic inflammatory response syndrome caused by multiple trauma. METHODS: The study population consisted of 21 patients with multiple trauma presented emergency department within 2 hours after insult were enrolled in this study Multiple blood samples were serially drawn to measure seam TNF-alpha level on admission, 12 hours, 24 hours, and every day until 5 days after injury. Serum TNF-alpha was measured by ELISA ("Sandwich type"). Blood samples of fifteen volunteers were used as a reference value far serum TNF-alpha. RESULTS: Serum TNF-alpha. levels of SIRS group were persistency elevated above reference value until 3 days after on admission. Peak seam TNF-alpha level at 12 hours after admission was higher in SIRS group than non-SIRS group(p< 0.05). There was no significant correlation between injury severity score and TNF-alpha levels on regression analysis, all patients with ISS higher than 16 had SIRS. No one had SIRS among patients with ISS less than 16. CONCLUSION: the result of this study suggests that persistent elevation of TNF-alpha and degree of injury severity are associated with the development of systemic inflammatory response syndrome in multiple trauma.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Multiple Trauma* ; Reference Values ; Specialization ; Systemic Inflammatory Response Syndrome* ; Tumor Necrosis Factor-alpha* ; Volunteers

PURPOSE: In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. METHODS: All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. RESULTS: Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P=0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P=0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P=0.001). CONCLUSION: The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.
Anti-Bacterial Agents ; Bacteremia ; Catheters ; Central Venous Catheters ; Child ; Fetal Blood ; Fever ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Humans ; Neutropenia ; Pediatrics ; Transplants

No abstract available.
Family Practice* ; Humans

No abstract available.
Krukenberg Tumor*

No abstract available.
Krukenberg Tumor*

PURPOSE: To summarize and review the methodological quality of the evidence from trials examining the effectiveness of physical exercise in patients undergoing allogeneic hematopoietic stem cell transplantation (Allo-HSCT). METHODS: Six randomized clinical trials (RCTs) were identified, reviewed for substantive results, and assessed for methodological quality. RESULTS: Six trials met all methodological criteria on the modified Jadad score above 3 out of 5 points. Failure to blind the outcome assessor, and failure to describe the method of blinding of outcome assessor appropriately were the most prevalent methodological shortcomings. Various exercise modalities have been applied, differing in content, frequency, intensity, and duration. Positive results have been observed in part for a diverse set of outcomes, including physical and psychological performance. CONCLUSION: The trials reviewed in this study were of moderate methodological quality. They suggest that exercise in patients undergoing Allo-HSCT may be safe and feasible, and in part patients benefit from increased physical performance both during and after transplantation. Future RCTs should use larger samples, appropriate comparison groups, and a standard of outcome measures, and examine what kind of exercise intervention (aerobic vs. resistance vs. combined) is the most effective for Allo-HSCT patients. It would be necessary to define contraindication for exercise to guarantee its safety.
Exercise ; Exercise Therapy ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Outcome Assessment (Health Care) ; Quality of Life ; Transplants

PURPOSE: This study was done to evaluate the factors that influence secondary traumatic stress, burnout, and physical symptoms experienced by firefighters. In addition, a hypothetical model was developed. METHOD: The data were collected using self-reported questionnaires from 410 field service firefighters. Data analysis was done with the SPSSWIN 10.0 program for descriptive statistics and Windows LISREL program to determine the causal relationship between the measurement variables. RESULTS: The hypothetical model which was developed fits well with actual data(chi-square=3.16, p=0.99, GFI=1.00, AGFI=0.99, NFI=0.99, and NNFI=1.06). The variable, personality type, social support, and impact mobilization frequency had a significant effect and accounted for 7% of the secondary traumatic stress in firefighters. The variables, career, social support, and secondary traumatic stress had a significant effect and accounted for 24% of the burnout in firefighters. Social support, impact mobilization frequency, and secondary traumatic stress were important variables and accounted for 31% of the physical symptoms in firefighters. CONCLUSION: It is necessary for firefighters to manage themselves according to their personality types. Strategies that can increase the firefighters' social support and decrease their perceived secondary traumatic stress also need to be developed to minimize or prevent a negative effect on their health.
Firefighters* ; Humans ; Surveys and Questionnaires ; Rescue Work ; Statistics as Topic ; Stress Disorders, Post-Traumatic

PURPOSE: This study was done to compare of adult body composition and body image before and after regular exercise program at a sports center. METHOD: The participants were 32 adults who were beginning regular exercise at a sports center in D city. The body composition was measured by body weight, soft lean mass, fat mass, percent body fat, fat distribution, degree of obesity and BMI, using the Inbody 3.0. Body image. Data were collected using structured questionnaires and analyzed using paired t-test. RESULTS: 1. Significant improvement was shown in body composition. 2. The score for body image increased after the program, but the change was not statistically significant. CONCLUSION: The short-term exercise program was very effective in improving body composition, but changes in the evaluation of body image need long-term exercise. Also, we were concluded that it is very important to consider preference level when evaluating body composition and body image.
Adipose Tissue ; Adult* ; Body Composition* ; Body Image* ; Body Weight ; Fitness Centers* ; Humans ; Obesity ; Surveys and Questionnaires ; Sports