Patients in the intensive care unit (ICU) easily have large amounts of extracellular fluids, such as edema or ascites, because of cardiovascular instability under septic conditions and also have high risk of malnutrition while staying in the ICU. Traditional nutritional assessment parameters like body mass index have a limitation in ICU patients due to muscle atrophy and decrease of lean body mass. Bioimpedence analyses (BIA) can be used to assess body composition and are useful in performance of nutritional assessments in ICU patients. BIA can simply and noninvasively estimate body composition (total body water, extracellular water, intracellular water, body cell mass, and free fat mass etc.) by sending a weak electric current through the body. In particular, phase angle (PhA, phase difference between the voltage applied to the impedance and the current driven through it), one of the parameters of BIA, is related to cell membrane integrity or cell size. Low PhA can possibly imply malnutrition and PhA has been reported as a useful indicator of clinical outcomes or prognosis of severe patients. Additional study with clinical application of BIA in ICU patients is needed in order to confirm the usefulness of BIA.
Ascites ; Body Composition ; Body Mass Index ; Body Water ; Cell Membrane ; Cell Size ; Critical Illness* ; Edema ; Electric Impedance* ; Extracellular Fluid ; Humans ; Intensive Care Units ; Malnutrition ; Muscular Atrophy ; Nutrition Assessment ; Nutritional Support ; Prognosis

No abstract available.
Child* ; Humans ; Rheumatic Heart Disease*

No abstract available.
Brain* ; Child* ; Humans

PURPOSE: This study provides useful basic information about caring for elderly women. It also promotes understanding by confirming what can vitalize the women and improve quality of life in elderly women as they continue to become important in the society which is moving towards being an "aged society". METHOD: Grounded theory a qualitative research method, was use to develop new thesis regarding life's vitality in elderly women. Thirteen women participated in the research. They were women without any problems in perception or communication and who agreed to participate in the research. RESULT: The results, using analysis process of Strauss and Corbin (1990), showed that life's vitality in elderly women is to bring well-being through vitalization against weakness. CONCLUSION: Based on such these results, this study will be helpful to nursing mediation and policy development which will improve the quality of life of elderly women through better understanding and promotion of life's vitality.
Aged* ; Female ; Humans ; Negotiating ; Nursing ; Policy Making ; Qualitative Research ; Quality of Life

Eisenmenger's syndrome is defined as pulmonary hypertension with right-to-left or bidirectional shunting of blood through an intracardiac or aorto-pulmonary commumication. It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. Parturients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. We experienced a case of parturient for cesarean section with Eisenmenger's syndrome and performed epidural anesthesia with fractionated doses of 2% lidocaine and fentanyl. The sensory block reached to T10 level and blood pressure was maintained with intravenous phenylephrine. After baby out, sudden hypotension with severe bradycardia developed and arterial oxygen saturation dropped. Immediate intubation and resuscitation was done, but cardiac rhythm disturbance, hypoxemia, and acidosis did not corrected. Cardiac standstill developed and stopped resuscitation. The neonate's Apgar score was 7 and he was transferred to pediatric ICU.
Acidosis ; Anesthesia, Epidural* ; Anoxia ; Apgar Score ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Ductus Arteriosus, Patent ; Eisenmenger Complex* ; Female ; Fentanyl ; Hypertension, Pulmonary ; Hypotension ; Intubation ; Lidocaine ; Mortality ; Oxygen ; Peripartum Period ; Phenylephrine ; Pregnancy ; Resuscitation

OBJECTIVES: This study was conducted in order to evaluate the effects of inhalants on color vision impairment. METHODS: The inhalation group consisted of 81 neurotoxic chemical substance abusers at Bugok National Hospital and Institute of Forensic Psychiatry, Ministry of Justice. The control group consisted of 41 employees of Bugok National Hospital. The Lanthony D-15 desaturated hue test was administered to both groups. For the qualitative analysis, we classified the results by the morphological characteristics of color vision impairment. For the quantitative analysis, we calculated the total color distance score (TCDS) and the color confusion index (CCI) and determined that the individual was abnormal if the TCDS was over 65.0 or the CCI was over 1.25. RESULTS: The TCDS of the inhalation group was 75.58+/-21.07 and the CCI was 1.34+/-0.37 in the right eye, and 75.47+/-23.63 and 1.34+/-0.42, respectively in the left eye. These results are higher than those found for the control group. In regards to the TCDS, 50 (61.8%) of the abusers in the inhalation group had color vision impairment in the right eye and 48 (59.2%) had impairment in the left eye. 11 (26.8%) of the employees in the control group had color vision impairment in the right eye and 13 (31.7%) had impairment in the left eye. In regards to the CCI, 38 (46.9%) of the abusers in the inhalation group had color vision impairment in the right eye and 35 (43.2%) had impairment in the left eye. 4 (9.8%) of the employees in the control group had color vision impairment in the right eye and 7 (17.0%) had impairment in the left eye. The results of multiple logistic regression analysis for acquired color vision impairment showed that the inhalation period (OR=1.20, 95% CI: 1.03~1.40) was the significant variable. CONCLUSIONS: These findings indicate that the inhalation of neurotoxic substances may impair the color vision, and the period inhaled with neurotoxic substances is significant variable affecting on the acquired color vision impairment.
Color Vision ; Eye ; Forensic Psychiatry ; Inhalation ; Logistic Models ; Social Justice

Legg-Calve-Perthes disease (LCP) has been reported to be associated with hypofibrinolysis and a deficiency in coagulation. The goal of this prospective study was to confirm or refute these findings and to establish a guide for a screening test. The coagulation systems of twenty-three patients with Legg-Calve-Perthes disease were evaluated by means of the tests which included prothrombin time, activated partial thromboplastin time, antithrombin-III (AT-III), protein C, protein S, lipoprotein(a), and anticardiolipin antibody (ACA). Study subjects were 21 males and 2 females. Mean age was 8.7 years. No abnormal results were found for Antithrombin-III and Protein S, but 2 patients had low Protein C level. Two of 23 patients had Lipoprotein(a) values greater than 30 mg/dl. Another two patients had positive finding for Anticardiolipin antibody. There were no statistical differences in all parameters between Catterall group stage in the patients with Legg-Calve-Perthes disease. We were unable to establish an association between thrombotic tendency and Legg-Calve-Perthes disease based on this prospective study. So, routine screening of patients with Legg-Calve-Perthes disease for abnormalities of antithrombotic factors would be not warranted.
Antibodies, Anticardiolipin ; Female ; Humans ; Legg-Calve-Perthes Disease* ; Lipoprotein(a) ; Male ; Mass Screening ; Partial Thromboplastin Time ; Prospective Studies ; Protein C ; Protein S ; Prothrombin Time

The widespread application of coronary angiography and poen heart surgery have resulted in more frequent detection of patients with coronary artery anomaly. In 0.6 to 1.2 percent of individials, the coronary arteries arise aberrantly from the aorta. Anomalous origin of the left coronary artery from the fight coronary sinus with subsequent coursing between the aorta and pulmonary artery is a rare and sometimes fatal coronary amonaly. This anomaly has been reported in young and healthy men who died suddenly during or immediately forllowing vigorous physical exercise. The exact mechanism of sudden death is unclear. It is believed to be related to either extrinsic compression of the left coronary artery or distorsion of the vessel orifice, with resultant global ischemia and ventricular fibrllation. A 13-years old healthy boy, who was completely asymptomatic until he had sudden chest pain after running, arrived at hospital with typical clinical picture of acute myocardial infarction. The electrocardiography taken on admission demonstrated pathologic Q wave changes on lead I, aVL, V2, V3 and V4. Cardiac enzymes were elevated. The selective coronary angiography demonstrated that left coronary artery arose from the right coronary sinus. The anomalous left coronary artery passed posterioly around aortic root to reach its normal position in the interventricular groove. We report the patient with anomalous origined left coronary artery which causes the acute myocardial infarction.
Adolescent ; Aorta ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessels* ; Death, Sudden ; Electrocardiography ; Exercise ; Humans ; Ischemia ; Male ; Myocardial Infarction* ; Pulmonary Artery ; Running ; Thoracic Surgery

PURPOSE: To assess the ability of MR imaging with an endorectal surface coil for the depiction of noraml anatomical structure of prostate and its adjacent organs. MATERIALS AND METHOD: MR imaging using an endorectal surface coil was performed in 23 male patients (age;20-75) to evaluate various prostatic and vasovesicular disorders, i.e., 14 cases of ejaculatory problems, 3 cases of hypogonadism, and 4 cases of prostatic cancers and 2 cases of benign prostatic hyperplasia. MR images were obtained with axial, sagittal and coronal fast spin echo long TR/TE images and axial spin echo short TR/TE images. Field of views was 10--12 cm and scan thickness was3--5 mm. RESULTS: Depiction of normal anatomcial structures was excellent in all cases. On T2WI, zonal anatomy of the prostate and prostatic urethra, urethral crest, and ejaculatory duct were cleary visualized. On T1WI, periprostatic fat plane is more cleary visualized.
Ejaculatory Ducts ; Fluconazole ; Humans ; Hypogonadism ; Magnetic Resonance Imaging* ; Male ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Urethra

PURPOSE: To determine the efficacy of Gd-ethoxybenzyl-DTPA(Gd-EOB-DTPA) in MR imaging of primary hepatictumors in rats. MATERIALS AND METHODS: Primary hepatic tumors had been induced on 12 male Sprague-Dawley rats byoral administration of an experimental diet containing 3'-methyl-4'-dimethylaminobenzene for 12 weeks. T1-weighted spin echo images were obtained with 1.5 T system before and after injection of 25 micro mol/kg ofGd-EOB-DTPA. The detection rate of tumors in each image was compared to that in resected specimens. Signal intensity of the liver and the largest tumor were measured in each rat on pre- and postcontrast images. Signal tonoise ratio(SNR) of the liver and liver-to-tumor contrast to noise ratio(CNR) were calculated. RESULTS: One hundred and twenty-five liver tumors were identified on gross examination. Fifty one lesions(41%) on precontrast images, and 80(64%) on postcontrast images were demonstrated (p<0.01). Of the 33 tumors larger than 5mm, 28lesions(85%) were demonstrated on precontrast image, and 31(94%) on postcontrast image (p>0.05). Of the 92 lesions smaller than 5mm in diameter, 23(25%) were seen on precontrast image and 49 the (53%) on postcontrast image(p<0.01). After contrast enhancement, the signal intensity of both liver and tumor increased(p<0.05), though background noise also increased (p>0.05). Consequently, SNR increased significantly in the liver from 10.89 +/-1.96(mean standard error) to 15.59 +/- 2.34(p<0.05), but not in tumors(from 8.21 +/- 3.71 to 8.85 +/- 5.42). Liver-to-tumor CNR increased from 5.55 +/- 0.94 to 13.25 +/- 2.50 (p<0.01). CONCLUSION: The use of Gd-EOB-DTPA canincrease the detection rate of primary hepatic tumors in rats, especially of small lesions.
Animals ; Diet ; Gadolinium ; Humans ; Liver ; Magnetic Resonance Imaging* ; Male ; Noise ; Rats* ; Rats, Sprague-Dawley