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*

To evaluate the lipid-lowering effect of lovastatin(Mevacor(R)), lovastatin was administered to 38 patients with non-familial hypertcholesterolemia(>220mg/dl). The analysis of the effect was made with 25 patients(58.2+/-7.5 years ; 13 male, 12 female)who had received lovastatin more than 12 weeks. The drug was administered as a single dose with evening meal 20mg at the begining and adding another 20mg if the total cholesterol level was persistently higher than 200mg/dl at the end of each 4 week-period. 1) Total cholesterol level was decreased from 256.6+/-36.9mg/dl to 20932+/-50.1mg/dl at the end of the 4th week, 201.9+/-44.2mg/dl the 8th week and 203.6+/-39.6mg/dl the 12th week (p<0.001), respectively). 2) Triglyceride level was decreased from 196.4+/-104.1mg/dl to 163.4+/-74.4mg/dl at the end of the 4th week(p<0.05) but no significant change at the end of the 8th week showing 169.8+/-73.2mg/dl and 162.7+/-54.8mg/dl the 12th week(p<0.05). 3) High density lipoprotein cholesterol(HDL-C) level was not significantly changed with the drug during the 12 week treatment period. 4) Low density lipoprotein cholesterol(LDL-C) level was decreased remarkably similar to that of total cholesterol. 5) Total cholesterol/HDL-C ratio was decreased from 5.05+/-0.92 to 4.06+/-1.40 at the end of the 4th week(p<0.05), 3.89+/-0.99 the 8th week(p<0.001). 4.20+/-1.10 the 12th week(p<0.01). 6) LDL-C/HDL-C ratio was decreased from 3.24+/-0.94 to 2.43+/-1.21 at the end of the 4th week(p<0.05), 2.23+/-0.86 the 8th week(p<0.001) and 2.54+/-0.98 the 12th week(p<0.05). 7) There was no significant side effect on lovastatin therapy of 12 weeks duration. 8) The laboratory findings including liver function test, uric acid, creatinine, creatine phosphokinase and blood glucose were not changed significantly. From above results we concluded that lovastatin is safe and effective hypocholesterolemic agent in its clinical use.
Blood Glucose ; Cholesterol ; Creatine Kinase ; Creatinine ; Humans ; Hypercholesterolemia* ; Lipoproteins ; Liver Function Tests ; Lovastatin ; Male ; Meals ; Triglycerides ; Uric Acid

We have experienced two cases of Wernicke's encephalopathy associated with hypere-mesis gravidarum. Delay in it's diagnosis caused a protracted illness and persisting neurol-ogic deficits. Because of its association with chronic alcoholism, possibility of Wernicke's encephalopathy may not be considered in early stage of disease. The clinical feature, the principle of management and the prevention of Wernicke's encephalopathy are discussed.
Alcoholism ; Diagnosis ; Female ; Hyperemesis Gravidarum* ; Pregnancy ; Wernicke Encephalopathy*

BACKGROUND: The purpose of this study was to identify the clinical and radiological outcomes of hook plate fixation for lateral end fracture of the clavicle and acromioclavicular dislocation. METHODS: There were a total of 20 cases with lateral end fracture of the clavicle and 16 cases with acromioclavicular dislocation. All patients were evaluated for range of motion, functional score by using Constant score, and American Shoulder and Elbow Surgeons shoulder index at just before implant removal and at final follow-up. Coracoclavicular distance was measured in acromioclavicular dislocation and bony union was evaluated in the lateral end fracture of the clavicle. RESULTS: The clinical outcomes and range of motion were increased at the final follow-up compared with just before implant removal in both the lateral end fracture of the clavicle and acromioclavicular dislocation. In acromioclavicular dislocation, all cases—except one—showed maintenance of reduction after implant removal. Moreover, in the lateral end fracture of the clavicle, all cases—except one—showed bony union. CONCLUSIONS: Hook plate fixation in the lateral end fracture of the clavicle and acromioclavicular dislocation resulted in good clinical and radiological results.
Clavicle* ; Dislocations* ; Elbow ; Follow-Up Studies ; Humans ; Range of Motion, Articular ; Shoulder ; Surgeons

OBJECTIVES: The purpose of this study was to examine the electromyographic activities of the erector spinae muscle of the back and the rectus femoris muscle of the thigh, and to measure the angles of the spinal and knee flexions in order to determine the effect of wearing a back belt. METHODS: Fifteen healthy males participated in the study. Surface electromyography was used to measure the level of muscle activities at the two muscle groups. The Simi system, utilizing two-dimensional analysis of movement, was used to examine the range of motion of the back and low extremity. RESULTS: Firstly, the angle of the spinal flexion was significantly less in the back-belt-wearing group than in the control, and that of the knee flexion was significantly increased in the back-belt-wearing group. Secondly, there was no significant change in the electromyographic signals of the erector spinae muscle of the back and the rectus femoris muscle of the thigh. CONCLUSIONS: The use of back belts helps workers to correct their posture when lifting boxes. It can therefore protect workers from acute back injuries.
Back Injuries ; Electromyography ; Extremities* ; Humans ; Knee ; Lifting* ; Male ; Posture ; Quadriceps Muscle ; Range of Motion, Articular ; Thigh

A 81-year-old man was referred for respiratory failure by emergency medical technicians. He admitted at intensive care unit for ventilator treatment. Several hours before admission, he took sildenafil 100 mg for erectile dysfunction without prescription. The episodes of hemoptysis occurred several hours later. Computed tomography revealed multifocal diffuse ground-glass attenuation in both lungs. And the more we performed bronchoalveolar lavage, the more the color of it was turned into red. We treated him with empirical antibiotics and tranexamic acid, and hemoptysis was stopped in one day after admission. But in the 5th admission day, he died from sepsis combined with pneumonia caused by Acinetobacter baumannii abruptly.
Acinetobacter baumannii ; Aged, 80 and over ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Emergency Medical Technicians ; Erectile Dysfunction* ; Hemoptysis* ; Hemorrhage* ; Humans ; Intensive Care Units ; Lung ; Male ; Pneumonia ; Prescriptions ; Respiratory Insufficiency ; Sepsis ; Tranexamic Acid ; Ventilators, Mechanical ; Sildenafil Citrate

PURPOSE: The purpose of this study was to investigate the relationship between sexual knowledge, attitude, and satisfaction of sex education in university freshman. METHODS: The participants were 275 freshman students under the age of 20 years old. Data were collected in 2017 using a self-report questionnaire. RESULTS: The average scores of participants' sexual knowledge, attitude, and satisfaction of sex education were 24.22±4.94 out of 38 points, 90.81±15.86 out of 168 points, and 11.05±3.08 out of 20 points, respectively. With respect to the demographic characteristics, there were statically significant differences in sexual knowledge according to chances of relationship engagement (F=6.19, p=.002) and residence type (F=3.67, p=.013). Both sexual attitudes and satisfaction of sex education showed significant differences by major (t=3.20, p=.002; t=2.65, p=.009), types of high school (F=3.39, p=.019; F=3.53, p=.015), and interest in previous sex education during teenage years (F=2.88, p=.015; F=6.22, p<.001). Sexual knowledge showed a statistically significant correlation with attitudes (r=.153, p=.011). CONCLUSION: There is insufficient sex information available for college students. It is necessary in the future to develop sex education programs that are matched to college students' needs.
Education ; Humans ; Sex Education ; Sexuality

No abstract available.
Drug Eruptions*

Dieulafoy's vascular malformation is a rare cause of massive gastrointestinal bleeding. Most often it occurs in stomach within 6 cm from the gastroesophageal junction. Only a few cases have been reported to occur in the small intestine and colon. Occasionally, Dieulafoy's lesion of small intestine is difficult to recognize because of rarity, a paucity of symptoms and negative findings on barium studies. Therefore, this lesion needs to be considered in a patient with massive lower gastrointestinal bleeding. We report a case of Dieulafoy's vascular malformation in ileum 2 m proximal to ileocecal value in a 41-year-old woman who visited emergency clinic because of hematemesis, dizziness and vomiting. Small intestine revealed a wide-caliber artery within the submucosa showing intimal thickening, medial muscular hypertrophy and thrombosis.
Adult ; Arteries ; Barium ; Colon ; Dizziness ; Emergencies ; Esophagogastric Junction ; Female ; Hematemesis ; Hemorrhage* ; Humans ; Hypertrophy ; Ileum* ; Intestine, Small ; Stomach ; Thrombosis ; Vascular Malformations* ; Vomiting

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*