BACKGROUND: The goal of this study was to analyze the process and characteristics of withholding or withdrawal of life support (WLS) in Korean intensive care units (ICUs). METHODS: This was a single-centered retrospective analysis of patients who died in the ICUs of a tertiary hospital in Korea from January to December 2012. WLS informed consents and clinical data were analyzed. RESULTS: Of 285 deaths during the study period, informed consents for WLS were obtained from 228 patients (80.0%). All WLS decisions were made by family members after the patient's loss of decision-making capacity. Decisions were made most frequently by the patient's son (50.6%). Patients in the WLS group were older than those in the non-WLS group, and older age was associated with the WLS decision. Thirty-seven patients (16.2%) died within one hour of WLS approval, and 182 patients (79.8%) died on the day of WLS approval. The most frequently withheld life support modality was chest compression (100%), followed by defibrillation (95.9%) and pacemaker insertion (63.3%). CONCLUSIONS: Aggressive and invasive life support measures were those most frequently withheld or withdrawn by decision-makers in Korean ICUs. The most common proxy was the son, rather than the spouse.
Humans ; Informed Consent* ; Intensive Care Units* ; Korea ; Life Support Care ; Proxy ; Retrospective Studies ; Spouses ; Tertiary Care Centers ; Thorax ; Withholding Treatment

No abstract available.
Myocarditis* ; Stomach*

Twelve patients with inflammatory bowel disease had been operated at the department of surgery, Chonnam University Hospital during the period from March 1988 to February 1997. In this study, we report on the operative cases regarding age, sex, symptoms, duration of disease, location of disease, preoperative diagnosis, operative indication, frequency of operation, histopathologic findings and follow up. The results were as follows: 1) The male to female ratio in ulcerative colitis was 1 : 1, and the mean age was 54.5 years. In Crohn's disease, male to female ratio was 2.3 : 1 and the mean age was 42.1 years. 2) The mean duration of symptoms in ulcerative colitis was 39 months and in Crohn's disease was 13.9 months. The common symptoms in ulcerative colitis were abdominal pain, bloody diarrhea, indigestion, weight loss and in Crohn's disease abdominal pain, palpable mass, weight loss, indigestion. Extraintestinal symptoms in Crohn's disease were cholelithiasis like symptom, anal fistula, anal fissure. 3) The involvement site in ulcerative colitis was large bowel only, but in Crohn's disease small bowel (50%), large bowel (20%), small and large bowel (30%) were involved. 4) Preoperative diagnosis in ulcerative colitis was accurate, but in Crohn's disease accurate diagnosis was made only in 20% and the other cases were operated under the impression of different diseases or conditions (intestinal tuberculosis (50%), bowel perforation (20%), mechanical ileus (10%)). 5) The indication of surgery in ulcerative colitis was intractability to medical treatment, on the other hand, in Crohn's disease most operative cases were made under the emergentconditions (bowel perforation, bowel obstruction, enterocutaneous fistula, abdominal mass). The frequency of operation in ulcerative colitis were two times in one case, three times in one cases. In Crohn's disease half of cases experienced two or three times of surgery. The method of operation in ulcerative colitis was total proctocolectomy with J-pouch ileoanal anastomosis. In Crohn's disease resection of diseased bowel segment was performed.
Abdominal Pain ; Cholelithiasis ; Colitis, Ulcerative ; Colonic Pouches ; Crohn Disease ; Diagnosis ; Diarrhea ; Dyspepsia ; Female ; Fissure in Ano ; Follow-Up Studies ; Hand ; Humans ; Ileus ; Inflammatory Bowel Diseases* ; Intestinal Fistula ; Jeollanam-do ; Male ; Rectal Fistula ; Tuberculosis ; Weight Loss

OBJECTIVE: Pituitary adenylate cyclase-activating polypeptide (PACAP), a novel hypothalamic neuropeptide, has been suggested to play a role in ovarian folliculogenesis. The present study evaluated the effect of PACAP on the growth of preantral follicles. METHODS: Preantral follicles were mechanically isolated from ovaries of 21-day-old rats and cultured in groups for 3 days in serum-free medium in the absence or presence of PACAP-38 (10-6 M). RESULTS: Treatment with PACAP-38 resulted in an increase in follicle diameter by 75% whereas treatment with follicle stimulating hormone (FSH) increased follicle diameter by 65%. PACAP-38 treatment enhanced the granulosa cell proliferation as measured by thymidine incorporation analysis. Furthermore, the production of progesterone by cultured granulosa cells and GFSHR-17 cell line was stimulated by PACAP-38. Interestingly, PACAP enhanced FSH action on stimulation of SF-1 and aromatase gene expression. CONCLUSION: The present results demonstrate that PACAP stimulated preantral follicle growth by potentiating proliferation and by stimulating steroidogenesis.
Animals ; Aromatase ; Cell Line ; Female ; Follicle Stimulating Hormone* ; Gene Expression ; Granulosa Cells ; Neuropeptides ; Ovarian Follicle* ; Ovary ; Pituitary Adenylate Cyclase-Activating Polypeptide* ; Progesterone ; Rats ; Thymidine

An orbital abscess is a serious complication of sinusitis that can lead to blindness and sometimes death. Immediate surgical drainage via an endonasal endoscopic approach or through a traditional Lynch-type incision is required for successful treatment. We describe a case of an orbital abscess with a medial subperiosteal abscess complicating acute sinusitis in a five-month-old infant. The patient was successfully treated with endonasal endoscopic surgery. Following an anterior ethmoidectomy and an antrostomy, the medial subperiosteal abscess was drained by removing the involved lamina papyracea and the orbital abscess was drained by incising the periorbita.
Abscess* ; Blindness ; Drainage ; Humans ; Infant ; Orbit* ; Sinusitis

Zonular traction tufts, which exist in 15% of normal population, do not cause retinal detachment by themselves but they can cause traction retinal detaehment when there is traction force added. It is thought that the possibility of development of retinal detaehment increases especially when zonular traetion tufts originate posterior to the vitreous base No case of traction retinal detachment caused by zonular traction tufts has been reported. Here, we report one suspected case of traction retinal detachment induced by zonular traction tufts and lens subluxation.
Lens Subluxation ; Retinal Detachment* ; Retinaldehyde* ; Traction*

No abstract available.
Humans ; Tracheostomy* ; Ventilators, Mechanical*

PURPOSE: The purpose of this study were to describe the level of activities of daily living (ADLs) and fatigue of stroke patients and to identify related factors of ADLs and fatigue. METHOD: A sample of 132 were used who were recovering from stroke. The face-to-face interviews were conducted to collect data. The levels of ADLs and fatigue were evaluated using the Modified Barthel Index and Kim's fatigue scale respectively. A series of t-test and analysis of variance analyses were conducted to examine study purposes using SPSS 15.0. RESULTS: The levels of fatigue and ADLs were 65.6 (SD=16.52) and 74.6 (SD=22.32) respectively. Significantly poorer ADLs were found: women (t=2.05, p=.001), older people aged > or = 70 years (F=2.74, p=.046), the duration of onset (F=4.32, p=.006), the use of assist devices (F=35.64, p<.001), the parts of paralysis (F=4.25, p=.007), the time to attack (F=3.34, p=.039), and accompanying symptoms (F=15.23, p<.001). There was a significant difference in fatigue with patients with lower accompanying symptoms having lower fatigue (F=11.08, p<.001). CONCLUSION: These findings suggest gender, the duration from onset, the use of assist device, the parts of paralysis, the time to attack and accompanying symptoms were significant factors of the ADLs and fatigue post stroke. These factors should be considered when developing and testing nursing intervention programs for stroke survivors.
Activities of Daily Living ; Aged ; Fatigue ; Female ; Humans ; Paralysis ; Stroke ; Survivors

No abstract available.
Humans ; Intensive Care Units* ; Critical Care* ; Poisoning*

No abstract available.
APACHE* ; Intensive Care Units* ; Critical Care*