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*

The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, 22.3% of patients were malnourished and 40.7% were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p < 0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p < 0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p < 0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.
Aged ; Cholesterol ; Depression ; Humans ; Ideal Body Weight ; Korea ; Length of Stay ; Malnutrition ; Mass Screening ; Mortality ; Nutrition Assessment* ; Nutritional Status* ; Prevalence ; Seoul

This study was performed to improve the hospital food service in quality and customer satisfaction by using 6-sigma strategy which was processed by DMAIC methods. The research procedure was as follows; analyzing the main causes of customer dissatisfaction of food service by using numerical method, and then finding out the standardized problem solving methods, and finally reforming food service process. The effectiveness of 6-sigma activity was measured by 'food service quality index', 'customer satisfaction index' and 'total food service satisfaction index'. Food service quality index was calculated by adding grade of soup temperature, food service, delivery time, and setting accuracy. Statistical data analyses were completed by using the Minitab Ver. 14. By performing 6 sigma activity, food service quality index was increased from 67 to 79 points (p<0.05) and customer satisfaction index also rise from 73 to 79points (p<0.05). Satisfaction of meals' taste, diverse menu, food setting accuracy, remove of food service, overall food service were significantly improved(p<0.05). The results of capability analysis in food service quality index, customer satisfaction index, and total food service satisfaction index were improved 2.11sigma to 2.49sigma , 1.88sigma to 2.43sigma, and 2.04sigma to 2.47sigma respectively (p<0.05). Therefore this study showed that subjective food service improving process could be measured by objective numerical value which might be used for financial value in hospital management.
Data Interpretation, Statistical ; Food Service, Hospital* ; Food Services ; Problem Solving

OBJECTIVE: The purpose of this study is to determine the proper hand position during driving by measuring of the wheel rotation strength according to the wheel angle and hand position to the wheel. METHOD: BTE Work Simulator was used to measure the clockwise and counter clockwise static wheel rotation force of twenty healthy men in three different hand position (2~10 spot, 3~9 spot, and 4~8 spot) and two different wheel angle (45 degrees and 60 degrees), average and peak force were measured during maximal isometric contraction. RESULTS: The average and peak force was significantly different by the wheel angle, and hand position (p<0.01), but the direction of rotation didn't an effect on the rotation force. The hand position was the most significant factor, especially wheel rotation force at 2~10 spot hand position was significantly lower than that of 3~9 spot and 4~8 spot (p<0.05). The rotation force by the wheel angle was influenced by hand position, and lower in 60 degrees wheel angle in the 2~10 spot (p<0.05). CONCLUSION: The rotation force of wheel was influenced by the hand position. Therefore proper hand position is recommended during driving to reduce muscle fatigue.
Hand* ; Humans ; Isometric Contraction ; Male ; Muscle Fatigue

Cobb's syndrome, or cutaneomeningospinal angiomatosis, is a combination of the vascular skin nevus and angioma in the spinal cord within a corresponding segment or two to the dermatoms involved. A 15 year old girl showed the portwine nevus at T2-T11 dermatomes and multilevel spinal angioma at C7-L3 levels. She had suffered from a slowly progressive weakness of both lower extremities. Motor weakness of lower extremities improved after the combined rehabilitation management and radiation therapy for 4 months. We report the typical manifestations of Cobb's syndrome in a 15 year old girl with the brief review of literatures.
Adolescent ; Angiomatosis ; Female ; Hemangioma ; Humans ; Lower Extremity ; Nevus ; Rehabilitation ; Skin ; Spinal Cord

Motor unit number estimation(MUNE) was performed in the thenar muscles of 22 hemiplegic patients without a peripheral nerve lesion using the statistical method. The studies were done bilaterally in the affected and unaffected sides. The distal latency and conduction velocity of median nerve in the affected side were not different from those in the unaffected side. But the amplitude and area of the compound muscle action potential in the affected side were smaller than those in the unaffected side. Motor unit numbers in the affected side decreased than those of the unaffected side, especially in the first 6 months after the onset of hemiplegia. And the motor unit numbers in the affected side decreased as the muscle strength decreased. Single motor unit potential(SMUP) area in the affected side increased after 1 year from the onset of hemiplegia. The estimation of the number of motor units in the thenar muscles of hemiplegic patients could be an indicator for predicting recovery of the muscle power in hemiplegia.
Action Potentials ; Hemiplegia ; Humans ; Median Nerve ; Muscle Strength ; Muscles* ; Peripheral Nerves

The medical records of twenty-one patients with suprascapular nerve palsy were reviewed retrospectively. Nine patients had isolated suprascapular nerve lesions and twelve patients accompanied axillary nerve lesions. In trauma cases, combined nerve lesions were common and severe. In three cases isolated suprascapular nerve lesions were noted spontaneously. Isolated infraspinatus muscle lesions were noted in four cases which were due to compressions of suprascapular nerves at the spinoglenoid notch, and in one case from ganglionic cyst was diagnosed by ultrasonography. At initial examination, three patients showed complete and eighteen patients showed incomplete lesion. Eight patients with incomplete lesion and one patient with complete lesion were followed up. Seven patients with incomplete lesion showed regeneration between 1-7 months after injury. Therefore electrodiagnostic study is necessary to evaluate severity and level of nerve lesion and regeneration.
Ganglion Cysts ; Humans ; Medical Records ; Paralysis* ; Regeneration ; Retrospective Studies ; Ultrasonography

PURPOSE: Conventional contrast dacryocystography(C-DCG) has been used mainly for anatomical assessment of the lacrimal drainage apparatus, due to its limited information on the dynamics of the lacrimal system, and thus correlation role in epiphora. The purpose of study was to improve the diagnostic value in epiphora by utilizing RI dacryocystography(RI-DCG) with quantitative criteria. MATERIALS AND METHODS: The patient for RI dacryocystography set erect with the head fixed in front of gamma camera fitted with a standard 6 mm pinhole collimater. Both eyes of 85 patients(170 eyes) were scanned with 99rnTc-pertechnetate followed by conventional dacryocystography. The data from gamma camera were recorded simultaneously on a computer system for subsequent quantitative analysis. RESULTS: In 94 of 96 eyes without epiphora, RI-DCG was correlated with normal C-DCG and % of emptying was at least over 50%. In 58 of 74 eyes with epiphora, RI-DCG was correlated with abnormal C-DCG and % of emptying was at most below 50%. In 16 eyes with functional block, quantitative RI-DCG showed abnormal % of emptying. CONCLUSION: Nuclear DCG with quantitation had higher diagnostic yield in functional block and correlated higher with epiphora. Thus nuclear DCG with quantitation would be a valuable functional test after postprocedures such as dacryocystoplasty.
Computer Systems ; Drainage ; Gamma Cameras ; Head ; Humans ; Lacrimal Apparatus Diseases* ; Radionuclide Imaging*

PURPOSE: To evaluate the effectiveness of percutaneous catheter drainage in treatment of the lung abscess. MATERIALS AND METHODS: We treated the lung abscesses in 14 patients(12 men, 2 women), who did not respond to medical therapy, by percutaneous catheter drainage under fiuoroscopic or ultrasound guidance. One abscess due to infacted bulla was managed by combination treatment with alcohol sclerosing therapy. Patients were followed by serial chest radiographs every three days and the amount of drained or aspirated pus evaluated. The treatment effect and recurrence were followed by chest PA and lateral chest at one week after removal of drainage catheter. RESULTS: Thirteen patients(93%) recovered clinically and radiologically within 3 days. In 10 patients, drainage catheter could be removed within 2 weeks, and three patients, the catheter was keept longer. Most complications were mild ;vague to moderate chest pain(n=14), mild hemoptysis(n=2), and pneumothorax(n=I). One man who suffered from far advanced pulmonary tuberculosis died of asphyxia caused by massive hemoptysis 16 days after percutaneous drainage. CONCLUSION: Percutaneous catheter drainage is a safe and effective method for treating lung abscess.
Abscess ; Asphyxia ; Catheters* ; Drainage* ; Hemoptysis ; Humans ; Lung Abscess* ; Lung* ; Male ; Radiography, Thoracic ; Recurrence ; Suppuration ; Thorax ; Tuberculosis, Pulmonary ; Ultrasonography

PURPOSE: To evaluate the effectiveness of percutaneous catheter drainage in treatment of the lung abscess. MATERIALS AND METHODS: We treated the lung abscesses in 14 patients(12 men, 2 women), who did not respond to medical therapy, by percutaneous catheter drainage under fiuoroscopic or ultrasound guidance. One abscess due to infacted bulla was managed by combination treatment with alcohol sclerosing therapy. Patients were followed by serial chest radiographs every three days and the amount of drained or aspirated pus evaluated. The treatment effect and recurrence were followed by chest PA and lateral chest at one week after removal of drainage catheter. RESULTS: Thirteen patients(93%) recovered clinically and radiologically within 3 days. In 10 patients, drainage catheter could be removed within 2 weeks, and three patients, the catheter was keept longer. Most complications were mild ;vague to moderate chest pain(n=14), mild hemoptysis(n=2), and pneumothorax(n=I). One man who suffered from far advanced pulmonary tuberculosis died of asphyxia caused by massive hemoptysis 16 days after percutaneous drainage. CONCLUSION: Percutaneous catheter drainage is a safe and effective method for treating lung abscess.
Abscess ; Asphyxia ; Catheters* ; Drainage* ; Hemoptysis ; Humans ; Lung Abscess* ; Lung* ; Male ; Radiography, Thoracic ; Recurrence ; Suppuration ; Thorax ; Tuberculosis, Pulmonary ; Ultrasonography