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

No abstract available.
Animals ; Calcitonin Gene-Related Peptide* ; Calcitonin* ; Rats* ; RNA, Messenger*

This study was conducted to determine the level of inflammatory cytokines in the cerebrospinal fluid (CSF) of patients with meningitis. All the CSF of the patients were examined by Gram and acid-fast stain, culture, and PCR for Mycobacterium tuberculosis and Mycoplasrma spp..The levels of sugar, protein and leukocytes count were also evaluated in the CSFs. Concentrations of Interleukin (IL)-1B, IL-6, IL-8, tumor necrosis factor (TNF)-a in the CSF were evaluated by the ELISA kit (Genzyme, USA). General bacteria, tubercle bacilli, and Mycoplasma spp. were not detected with stain and culture methods, but, Mycoplasma spp. was detected by PCR method from four (6.3%) patients with meningitis. The mean CSF concentration of IL-1B, IL-6, IL-8, and TNF-cx in the control group were 0.6+/-0.2, 896.8+/-107.6, 50.1+/-5.1, and 4.8+/-1.4 pg/ml, respectively. The mean CSF concentration of IL-1B, IL-6, IL-8, and TNF-a in the patients with aseptic meningitis were 3.8+/-0.6, 1261.6+/-144.3, 466.7+/-42.3, and 10.8+/-2.0 pg/ml, respectively. The mean CSF concentration of IL-1B, IL-6, IL-8, and TNF-a in the patients with mycoplasmal meningitis were 10.2+/-8.1, 1979.5+/-133.8, 459.7+/-96.4, and 17.5+/-5.1 pg/ml, respectively. There were significantly differences in the levels of IL-1B, IL-6, IL-8, and TNF-a between control and patients with aseptic meningitis or Mycoplasmal meningitis (each p<0.001). These results suggest that increased levels of IL-1B, IL-8, and TNF-a could be higly suggestive of meningitis.
Bacteria ; Cerebrospinal Fluid* ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-6* ; Interleukin-8* ; Interleukins ; Leukocytes ; Meningitis* ; Meningitis, Aseptic ; Mycobacterium tuberculosis ; Mycoplasma ; Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha

No abstract available.
Humans ; Hypothyroidism* ; Siblings*

BACKGROUND: The purpose of this study was to investigate the characteristics of and to analyze the factors re-lated to the cost of the resolution of a medical dispute. METHODS: We have reviewed 2,346 cases reported to the Korean Medical Association(KMA)mutual-aid association from Nov. 1. 1981 to Oct. 31. 1994. RESULTS: The percentage rate of reported cases of were related field as follows .' obstetric gynecology(OBGYN) 31.9%, general practitice 28.1%, general surgery 13.3%, orthopedics 6.9% and internal medicine 6.4% 1,829 cases (80.0%) were settled out of court and without public intervention. 310 cases(13.2%) were settled by the police, the public procurators office or the court. The mean settlement amount per case was 9,340,000 won with annual growth rate 10.8%, and median settlement amount was 5,890,000 won. The mean settlement amount for OBGYN was 930,000 won, surgical group 8,900,000 won, medical group 7,710,000 won, and general practitice 7,490,000 won. The cases of medical dispute according to the types of medical care were : operation 21.1%, injection 18.0%, treat-ment and care 18.0%, delivery 13.0%, artificial abortion 10.3%, Cesarian section 7.2% and anesthesia 2.5%. The mean settlement amount according to the types of medical care were: delivery and Cesarian section 15,190,000 won, operation and anesthesia 9,500,000 won, others 6,610,000 won, and injection and medication 6,230,000 won. The mean settlement amount that was settled out of court without public intervention was 7,940,000 won. The mean settlement with public intervention in the court was 17,290,000 won. The cases of medical dispute according to the patients status were .' death 37.5%, complications 20.8%, disability 12.2% and others 28.9%. The mean settlement amout for death was 16,150,000 won, disability 9,430,000 won, others 4,850,000 won and complications 3,550,000 won. The mean settlement amount where doctors have asserted that the outcome was inevitable or have not agreed that it was their fault was higher than the cost of cases where they had admitted responsibility. The settlement amout where there was a misdiagnosis present had not shown to be higher than when the misdiagnosis was absent. The mean settlement amount for cases where multiple doctors were involved was higher than for cases of a single doctor. The mean settlement amount for disturbing the medical practice and suspension of are high. The mean settlement amount for complications was lower than others, and the mean settlement amount for disability and death presented were high. Concerning the types of care, the mean settlement amount for operation/anesthesia, delivery/ Cesarian sections were higher than for injection/medication. Concerning the type of settlement, the mean settlement amount in the police and public procurators office was higher than in out of court without public intervention. CONCLUSIONS: The mean settlement amount depended on the patient's status, the type of settlement, and the disturbance of medical practice regardless of the doctors misdiagnosis, fault, and standard care. Therefore, a reason-able method of resolution for medical dispute is needed.
Anesthesia ; Diagnostic Errors ; Dissent and Disputes ; Humans ; Internal Medicine ; Malpractice* ; Orthopedics ; Police

PURPOSE: The purpose of this study were to identify the essential component and meaning structure of the experience of 'Sockalee' among abused elders. METHOD: This study was done using a phenomenological analytic method by Giorgi. The participants in this study were six elders who had the previous experience of 'Sockalee' as abused elders. The data were collected by interviewing the participants from May to September, 2003. Generally, three interviews for one person were performed and each interview lasted for one and half hours. RESULTS: The meanings of 'Sockalee' of abused elders were categorized with seven components. Those are (1) Unsolved family conflicts. (2) Being powerless. (3) Being pushed out. (4) Egocentric situation-recognition. (5) Strengthening egocentric situation-recognition (6) Attempts for re-powerfulness. (7) Release from abuse. (8) Situation recognition with others' position considered. CONCLUSION: Therefore, the nursing intervention must be focused on the above concerns to accomplish the successful solution for the abused elderly problems, especially approaching from the standpoint of the whole human.
Aged ; Family Conflict ; Humans ; Nursing

About 5% of patients with SCLC have the ectopic production of ACTH. Ectopic ACTH production of SCLC is suspected when patients of SCLC have unexplained metabolic alkalosis and hypokalemia. Most patients lack the classic feature of Cushing's syndrome. According to the recent report, they have poor prognosis, which median survival is less than 4 months and associated with a high rate of complication during chemotherapy. Also a case of paraneoplastic CRH production with SCLC can mimic the ectopic ACTH syndrome hut it can be distinguished by immunohistochemistry or direct measurement of serum CRH level. We report here a case of small cell lung cancer associated with Cushing's syndrome of ectopic ACTH production. That is immunohistochemically provened by staining with ACTH.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hypokalemia ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Prognosis ; Small Cell Lung Carcinoma

No abstract available.
Addison Disease*

PURPOSE: The purpose of this study was to investigate perceptions of adequacy and job performance of the nurse assistants' nursing job as evaluated by registered nurses and nurse assistants in geriatric hospitals, and by caregivers from the same hospitals. METHODS: Participants included 62 registered nurses, 57 nurse assistants, and 64 patient caregivers who completed a measurement scale on the job of nurse assistants. Data collection was conducted from October to December, 2015. Data were analyzed using descriptive statistics and one-way ANOVA by IBM SPSS/WIN program version 21.0. RESULTS: There were significant differences by items in perception of adequacy of nurse assistants' nursing job of among the three groups. There was also a significant difference in perception of the nurse assistants' job performance among the three groups. CONCLUSION: For nurse assistants in geriatric hospitals, the Ministry of Health and Welfare needs to develop an appropriate job practice guideline. In addition, there should be periodic courses of retraining and continuing education for nurse assistants.
Caregivers* ; Data Collection ; Education, Continuing ; Humans ; Nurses' Aides ; Nurses* ; Nursing* ; Work Performance*

Glucose intolerance commonly occurs in patients with renal failure undergoing hemodialysis. whether this mild glucose intolerance contributes to pathogenesis of uremic complication in unknown. Abnormally elevated levels of Hb A1 have been reported in patients with chronic renal failure, whether or not they were undergoing hemodialysis. However serum levels of glycosylated albumin and fructosamine were not evaluated well. Our study was designed to examine fructosamine and glycosylated albumin to assess non-enzymatic glycosylation in patients with chronic renal failure undergoing maintenance dialysis(15 CAPD and 35 hemodialysis patients) and 33 healthy control subjects. Serum fructosamine levels were high in the hemodialysis patients(391.00+/-128.43micromol/L, P<0.05) than control(268.91+/-58.31micromol/L) and CAPD patients(267.7+/-41.27micromo/L). And serum glycosylated albumin levels were also high in the hemodialysis patients(240.40+/-43.99micromol/L, P<0.05) than control (146.22+/-24.88micromol/L) and CAPD patients(172.3+/-42.89micromol/L). After correction for serum albumin concentration, glycosylated albumin was raised in hemodialysis patients(6365.74+/-1307.98micromol/g, P< 0.05) compare with control subject(3259.74+/-581.07micromol/g) and CAPD patients(4988.13+/-1316.47micromol/g). And after correction for serum albumin or protein , fructosmaine was raised in the hemodialysis patients (10282.06+/-3927.37, 3760.00+/-12600.00micromol/g, respectively, P<0.05) compared with control(5705.81+/-1411.36, 1906.67+/-6869.50micromol/g, respectively) and CAPD patients(7752.33+/-2260.16, 869.05+/-5919.35micromol/ g, respectively) This result suggest that dialysis patients have increased protein glycosylation especially in case of hemodialysis patients, most likely reflecting increased non-enzymatic glycosylation of serum protein by impaired glucose tolerance.
Dialysis* ; Fructosamine* ; Glucose ; Glucose Intolerance ; Glycosylation ; Hemoglobin A, Glycosylated ; Humans ; Kidney Failure, Chronic* ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Renal Insufficiency ; Serum Albumin