BACKGROUND: The purpose of this study was to measure and compare the optimum depth of the internal jugular venous catheterization between the right and left side. METHODS: Forty-four patients were enrolled for this study and divided into two groups (22 patients each). The optimum depth of the catheterization was calculated using the sum of two component (A and B); the advanced length of the catheter from the level of the cricoid cartilage (A) and the distance from the catheter tip to the junction of the superier vena cava and right atrium (B). RESULT: The optimum depths of the internal jugular venous catheterization were 16.0 1.0 cm (right) and 18.4 1.5 cm (left) respectively. Left side was significantly longer than right side (p<0.05). In this study, we experienced some complications; arterial punctures (5 cases) and migration of the catheter to the opposite subclavian vein (1 case). Five complications were associated with left internal jugular venous cannulation and one was associated with the right side cannulation. CONCLUSION: We concluded that the optimum depth of the internal jugular venous catheterization was longer in the left side than in the right side.
Catheterization* ; Catheters* ; Cricoid Cartilage ; Heart Atria ; Humans ; Punctures ; Subclavian Vein

Electroretinograms (ERGs) were measured in 65 patients with diabetes and 10 control subjects. The single flash ERGs were recorded as a function of the stimulus intensity. A Naka-Rushton-type function was fit to b-wave amplitudes, measured as a function of stimulus intensity, to evaluate changes in ERG amplitude and sensitivity. We also measured the temporal aspects of the ERG b-waves. The ERG sensitivity tended to decrease as the retinopathy progressed. An average sensitivity loss in eyes with diabetic retinopathy was statistically significant. However, the eyes of diabetic patients without visible retinopathy did not show significant ERG sensitivity loss. There was less variability in temporal compared with amplitude measurements of ERG components, and significantly prolonged b-wave implicit times were found in all stages of retinopathy and in eyes of diabetic patients without retinopathy.
Adolescent ; Adult ; Aged ; Diabetic Retinopathy/*physiopathology ; Electroretinography ; Humans ; Middle Aged ; Retina/physiology ; Sensitivity and Specificity ; Sensory Thresholds/physiology

Nutrition during childhood is essential for growth and maintenance of health. Good food habits developed during the childhood will contribute both to the healthy growth and the prevention of the degenerative disease of later life. Both parents and the providers in child care centers play an important role for children's good eating behavior. Therefore all child care programs should achieve recommended standards for meeting children's nutritional and educational needs in a safe, sanitary, and supportive environment to promote the healthy growth and development of children. The purposes of this study were to evaluate the foodservice management practices and assess the needs for a Central Production Unit by contacting the child care center' providers. This approach was achieved using a variety of qualitative and quantitative information including the general foodservice management practices and the needs for a Central Production Unit. An indepth face-to-face interview with structured-questionnaires was undertaken at 32 representative child-care centers in Seoul. Statistical data analysis was done using the SAS program for descriptive analysis and ANOVA. The number of national/public and private sectors were 11 respectively, followed by 10 licensed home day-care centers. Total average number of children in child-care centers was 54.3+/-48.5. The foodservice productivity index in child-care centers was 4.8 minutes per meal for public child care centers, 6.0 for private child-care centers, and 9.8 for home child care centers. Home child care centers were found to have the lowest productivity index which indicated inefficient foodservice practice. The important factors in group purchasing were menus(39.6%) or close distance(39.6%) > type of foodservice operation(32.8%) > total number of meals(19.9%) > food costs(16.2%) in order. Average score of the efficiency for central food production in child-care centers was 3.80+/-0.84 out of 5.
Child ; Child Care* ; Child* ; Data Interpretation, Statistical ; Efficiency ; Feeding Behavior ; Food Habits ; Group Purchasing ; Growth and Development ; Humans ; Meals ; Parents ; Private Sector ; Seoul

BACKGROUND: Adolescent smoking is one of the most serious social problems. This study was conducted to investigate the effect of the attitude of parent and school on smoking status and to help to reduce the smoke rate in high school students. METHODS: Data was collected by self-administered questionnaire between September and October 2002. The study subjects were 977 students of 7 high schools in the Nonsan area. The data was analysed by using the SPSS program which included t-test, X2-test and logistic regression test. RESULTS: The smoking rates were 18.1% of general school students and 20.8% of vocational school in males, while 2.6% of general school students and 7.9% of vocational school in females. The mean starting age for the first cigarette was 15.3+/-1.9 in males and 15.6+/-1.3 in females. The mean age for regular smoking was 16.0+/-1.3 in males and 16.2+/-1.3 in females. Multiple logistic regression analyses indicated that the smoking rate increased in males (OR=2.75), early age for the first cigarette (OR=7.04), small family (OR=8.60), high family income (OR=1.95), colleagae smoking (OR=5.68), strict attitude by school (OR=0.28) and loss of one's parents (OR=2.58). Among smokers, 71.4% of male smokers and 75% of female smokers wanted to quit. CONCLUSION: This study suggests that the strict attitude of parents on their children's smoking decreased the smoking rate, while the stern attitude of school on their students increased it. Therefore, in order to decrease smoking rate, the strict attitude of parents on smoking should be continued and the attitude of school will have to consider aspects of students' characteristics and their interests when they propose to practice a school-based education program. It may have an effect on smoking prevention and reduction of the smoking rate.
Adolescent ; Chungcheongnam-do ; Education ; Female ; Humans ; Logistic Models ; Male ; Parents* ; Smoke* ; Smoking Cessation ; Smoking* ; Social Problems ; Tobacco Products ; Surveys and Questionnaires

BACKGROUND: As of 2011, among 250 administrative districts in Korea, 54 districts did not have obstetrics and gynecology clinics or hospitals providing prenatal care and delivery services. The Korean government designated 38 regions among 54 districts as “Obstetric Care Underserved Areas (OCUA).” However, little is known there are any differences in pregnancy, prenatal care, and outcomes of women dwelling in OCUA compared to women in other areas. The purposes of this study were to compare the pregnancy related indicators (PRIs) and adequacy of prenatal care between OCUA region and non-OCUA region. METHODS: Using National Health Insurance database in Korea from January 1, 2012 to December 31, 2014, we constructed the whole dataset of women who terminated pregnancy including delivery and abortion. We assessed incidence rate of 17 PRIs and adequacy of prenatal care. All indicators were compared between OCUA group and non-OCUA group. RESULTS: The women dwelling in OCUA regions were more likely to get abortion (4.6% in OCUA vs. 3.6% in non-OCUA) and receive inadequate prenatal care (7.2% vs. 4.4%). Regarding abortion rate, there were significant regional differences in abortion rate. The highest abortion rate was 10.3% and the lowest region was 1.2%. Among 38 OCUA regions, 29 regions' abortion rates were higher than the national average of abortion rate (3.56%) and there were 10 regions in which abortion rates were higher than 7.0%. In addition, some PRIs such as acute pyelonephritis and transfusion in obstetric hemorrhage were more worse in OCUA regions compared to non-OCUA regions. CONCLUSION: PRIs are different according to the regions where women are living. The Korean government should make an effort reducing these gaps of obstetric cares between OCUA and non-OCUA.
Abortion, Induced ; Dataset ; Female ; Gynecology ; Hemorrhage ; Humans ; Incidence ; Korea ; Medically Underserved Area ; National Health Programs ; Obstetrics ; Pregnancy ; Pregnant Women* ; Prenatal Care* ; Pyelonephritis

No abstract available.
Morphine* ; Respiration, Artificial* ; Weaning*

BACKGROUND: A randomized, multicenter, open-label, parallel group study was performed to compare the effects of remifentanil and morphine as analgesic drugs on the duration of weaning time from mechanical ventilation (MV). METHODS: A total of 96 patients with MV in 6 medical and surgical intensive care units were randomly assigned to either, remifentanil (0.1-0.2 mcg/kg/min, n = 49) or morphine (0.8-35 mg/hr, n = 47) from the weaning start. The weaning time was defined as the total ventilation time minus the sum of controlled mode duration. RESULTS: Compared with the morphine group, the remifentanil-based analgesic group showed a tendency of shorter weaning time (mean 143.9 hr, 89.7 hr, respectively: p = 0.069). Secondary outcomes such as total ventilation time, successful weaning rate at the 7th of MV day was similar in both groups. There was also no difference in the mortality rate at the 7th and 28th hospital day. Kaplan-Meyer curve for weaning was not different between the two groups. CONCLUSIONS: Remifentanil usage during the weaning phase tended to decrease weaning time compared with morphine usage.
Analgesics ; Humans ; Critical Care ; Morphine* ; Mortality ; Respiration, Artificial* ; Ventilation ; Ventilator Weaning ; Weaning*

Urinary ascites in newborns is a rare event that usually is associated with posterior urethral valves and other obstructing anomalies of the genitourinary tract. A case of neonatal urinary ascites without genitourinary tract abnormalities is reported. This premature male neonate was treated by artificial ventilation due to respiratory distress syndrome. The umbilical artery catheter was placed without difficulties and functioned well until removal. Periumbilical leak of urine was not observed. He showed abdominal distension and oliguria on second postnatal day. He was found to have ascites, hyponatremia and elevation of BUN content disproportionate to the mild elevated serum creatinine value. Radiological examination revealed normal genitourinary tract except intraperitoneal extravasation of contrast material from the bladder. Conservative management resulted in complete resolution of the lesion in this patient.
Ascites* ; Catheters ; Creatinine ; Drainage* ; Humans ; Hyponatremia ; Infant, Newborn ; Male ; Oliguria ; Umbilical Arteries ; Urinary Bladder* ; Ventilation

PURPOSE: Most terminally ill cancer patients die from cancer anorexia-cachexia syndrome. This study evaluated a prognostic role of plasma leptin levels in terminally ill cancer patients. METHODS: This study enrolled 69 terminally ill cancer patients who were aged above 20 years old from July 2009 to July 2010. For univariate analysis, an association between leptin levels and patient's characteristics or other variables was examined using Spearman's correlation analysis, Wilcoxon's rank-sum test or Kruskal-Wallis test, as appropriately. For multivariable analysis, Cox's proportional hazard regression model was used to evaluate a clinical significance of plasma leptin levels as a prognostic factor and to determine factors which affect the risk of death in terminally ill cancer patients. RESULTS: A statistically significant positive correlation between plasma leptin levels and survival time was found. Univariate Cox's proportional hazard regression analyses also showed a moderately significant association between plasma leptin levels and survival time. However, after adjusting variables for sex, white blood cell counts, total bilirubin, AST, ALT, albumin and CRP levels, plasma leptin levels were not significantly associated with survival time. CONCLUSION: No significant association was found between plasma leptin levels and survival time in terminally ill cancer patients. However, this study suggested a prognostic value of plasma leptin levels in gastrointestinal cancer patients.
Aged ; Bilirubin ; Gastrointestinal Neoplasms ; Hospice Care ; Humans ; Leptin ; Leukocyte Count ; Life Expectancy ; Plasma ; Survival Rate ; Terminally Ill

Cancer stem cells (CSCs) are a subset of tumor cells, which are characterized by resistance against chemotherapy and environmental stress, and are known to cause tumor relapse after therapy. A number of molecular mechanisms underlie the chemoresistance of CSCs, including high expression levels of drug efflux transporters. We investigated the role of the antioxidant transcription factor NF-E2-related factor 2 (NRF2) in chemoresistance development, using a CSC-enriched colonosphere system. HCT116 colonospheres were more resistant to doxorubicin-induced cell death and expressed higher levels of drug efflux transporters such as P-glycoprotein (Pgp) and breast cancer resistance protein (BCRP) compared to HCT116 monolayers. Notably, levels of NRF2 and expression of its target genes were substantially elevated in colonospheres, and these increases were linked to doxorubicin resistance. When NRF2 expression was silenced in colonospheres, Pgp and BCRP expression was downregulated, and doxorubicin resistance was diminished. Collectively, these results indicate that NRF2 activation contributes to chemoresistance acquisition in CSC-enriched colonospheres through the upregulation of drug efflux transporters.
Breast Neoplasms ; Cell Death ; Doxorubicin* ; Drug Therapy ; Neoplastic Stem Cells ; NF-E2-Related Factor 2 ; P-Glycoprotein ; Recurrence ; Transcription Factors ; Up-Regulation