PURPOSE: The purpose of this study was to identify differences between intake and output balance and body weight changes and to identify factors related to differences in critically ill patients. METHODS: The participants for this descriptive correlational study were 65 medical surgical ICU patients. The data were collected from patient medical records. RESULTS: Mean age of the patients was 63.80 years (+/-15.21). Body weight changes for 48 hours averaged 281.54g (+/-2210.48). I&O balance for 48 hours corrected for insensible loss averaged 398.1mL. Differences ranged from 45mL to 7,535mL. In the distribution of absolute difference between body weight change and intake and output balance, only 40% of the patients were within less than 1,000mL. Factors relating to accurate measure of intake and output were ventilation methods, respiration patterns, and edema status. CONCLUSION: Although mean values of weight change and I&O balance for all patients were very close, the range of differences was very wide indicating that, for many patients, intake and output is not an appropriate indicator of body fluid balance. Therefore, because of the frequency fever and/or hyperventilation, nurses need to use caution when using intake and output balance only to estimate current body fluid status for critically ill patients.
Body Fluids ; Body Weight ; Body Weight Changes ; Critical Illness ; Edema ; Fever ; Humans ; Hyperventilation ; Critical Care ; Intensive Care Units ; Respiration ; Ventilation ; Water-Electrolyte Balance

PURPOSE: To evaluate the long-term patency of the Hanaro spiral stent (Solco Intermed, Seoul, Korea) when used as a palliative in patients with inoperable malignant biliary obstruction. MATERIALS AND METHODS: Between April 1996 and July 1998, 39 patients with malignant biliary obstruction underwent percutaneous placement of 48 Hanaro spiral stents. The causes of obstruction were bile duct carcinoma(n=18), pancreatic carcinoma (n=8), metastatic lymphadenopathy (n=5), gallbladder carcinoma (n=5), hepatocellular carcinoma (n=1) and other tumors (n=2). Using the kaplan-Meier method, patient survival and stent patency rates were estimated with regard to level of obstruction. RESULTS: As regards stent insertion, there was no technical failure. Overall 25- and 50-week survival rates for the entire patient group were 50% and 11%, respectively, while overall stent patency rates at 25 and 50 weeks were 42 % and 11 %, respectively. Twenty-five-week stent patency rates in patients with common bile duct (CBD) and hilar obstruction were 51 % and 18 %, respectively. The stent patency rates in the CBD obstruction group was significantly higher than that in the hilar obstruction group (p < 0.05). CONCLUSION: In patients with CBD obstruction, the clinical efficacy of Hanaro spiral stent was superior to that in patients with hilar obstruction. However, Hanaro spiral stents showed a lower patency rate with regard to patient survival, and further investigation is required.
Bile Ducts ; Carcinoma, Hepatocellular ; Common Bile Duct ; Gallbladder ; Humans ; Lymphatic Diseases ; Seoul ; Stents* ; Survival Rate

PURPOSE: This cross-sectional study was designed to explore the relationship among social support, experienced stressful life events and health behaviors of Korean undergraduate students, and validate the mediator effect of social support. METHOD: One thousand four hundred fifty-three undergraduate students were randomly selected from five universities located in the middle area of Korea. RESULT: The health behaviors of Korean undergraduates tend to have unhealthy patterns. In the case of the students living without family, experiencing more stressful life events and perceiving lower social support, health behaviors are poor. The relationship between perceived social supports, the frequency of the experienced stressful life events and the score of health behavior patterns is statistically significant. After controlling the effect of social support, the correlation coefficient between the frequency of experienced stressful life events and the score of health behavior patterns was slightly lower. The score of health behaviors between the group with an extremely high score of social support and the group with an extremely low score were statistically significantly different. CONCLUSION: Future studies need to be pursued to develop various strategies such as a health education programs and counseling programs for health maintenance and health promotion of undergraduates.
Counseling ; Cross-Sectional Studies ; Health Behavior* ; Health Education ; Health Promotion ; Humans ; Korea

This meta-analysis was conducted to evaluate the effects of the supportive nursing intervention and analyze its components in 14 studies carried out from Jan. 1980 to Jun. 1997. The supportive nursing intervention studies divided into three types according to the components of conceptual definitons.; (1)supportive nursing behavior, (2)social support, and (3)combination of social support and supportive nursing behavior. The various terms referred to the supportive nursing intervention didn't have the clear differentiating conceptual and operational definitions and the logical relationship among them. The effects of supportive nursing intervention were measured by the 23 dependent variables using self-report and the 5 dependent variables using physiological indices. The dependent variables were measured more than two were role behavior compliance, anxiety, depression, health belief, knowledge about the disease, helplessness and stressful behavior response. The average effects of the supportive nursing intervention ranged from 0.218 to 2.745 for the d index. The three variables of them, which were anxiety, depression and stressful behavior response, were homogeneous statistically by homogeniety test. Results of the meta- analysis indicated that the supportive nursing intervention had moderate to large effects on anxiety(d=0.41), depression (d=0.66) and stressful behavior response (d=0.86).
Anxiety ; Compliance ; Depression ; Intervention Studies ; Logic ; Nursing ; Child Health

PURPOSE: A structural equation model was analysed to explore the determinants of health behaviors of university students in Korea. METNOD: Nine hundred sixty nine university students were selected by random cluster sampling from five universities located in the central area of Korea. DATA COLLECTION: The data was collected by questionnaires about demographic characteristics, stressful life events, perceived social support, perceived health status and health behaviors. RESULTS: 1. Gender showed indirect effect on health behaviors. 2. Living together with(out) family had a direct effecton health behaviors: students living with family showed more positive health behaviors. 3. Stressful life events had an indirect effect on health behaviors via perceived health status;a higher score of stressful life events was the predictor for negative health behaviors. 4. A higher score of perceived health status predicted positive health behaviors. RECOMMENDATION: Each university should be encouraged to develop a health behavior control program and health promotion program for their own university students. It would be more effective to develop health programs separately according to the demographic or social characteristics of the students. It is also necessary for the Ministry of Education to reform the School Health Act and school health policy to strengthen a health promotion program for university students. In conclusion, following studies should identify and promote the validity and reliability of perceived health status and health behaviors measurements.
Adult ; Attitude to Health ; Female ; *Health Behavior ; Health Status ; Humans ; Korea ; Life Change Events ; Male ; Social Support ; *Students/psychology ; Universities

PURPOSE: To determine the usefulness of transrectal ultrasonography (TRUS) in diagnosing prostate cancer bycomparing the sensitivity, specificity, accuracy, and positive and negative predictive values of TRUS with thoseof serum prostate-specific antigen (PSA), prostate-specific antigen density (PSAD) and digital rectal examination(DRE). MATERIALS AND METHODS: Two hundred and ten consecutive patients underwent TRUS-guided prostate biopsy dueto elevated PSA and/or abnormal findings on TRUS or DRE. The TRUS findings were analyzed and correlated withpathological diagnosis. PSAD was calculated by dividing the serum PSA level by the prostate volume calculated onTRUS. The sensitivity, specificity, accuracy, and positive and negative predictive values of TRUS were comparedwith those of PSA, PSAD and DRE. Using ROC curve analysis, the combinations of these diagnostic methods were alsoevaluated for the determination of efficacy in diagnosing prostate cancer. RESULTS: The sensitivity andspecificity of serum PSA (cut-off level, 4ng/ml), PSAD (cut-off level, 0.15ng/ml/cm3), DRE, and trus were 96%/17%,96%/37%, 72%/62%, and 89%/68%, respectively. On TRUS, the sensitivity and specificity of low echoic lesions andthose of irregular outer margin were 89%/69%, and 60%/90%, respectively. TRUS was statistically more accurate thanother diagnostic methods. Of the combinations of diagnostic methods, TRUS and PSAD were most accurate. CONCLUSION: TRUS demonstrated lower sensitivity but higher specificity than PSA or PSAD. Although it is an accurate modalityfor the diagnosis of prostate cancer, it cannot be used as a confirmative test due to its relatively low positivepredictive value. A combination of diagnostic methods and random biopsy is needed in patients in whom prostatecancer is suspected.
Biopsy ; Diagnosis ; Humans ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; ROC Curve ; Sensitivity and Specificity ; Ultrasonography*

PURPOSES: The respiratory tract infection is one of the most prevalent and serious complications following hematopoietic stem cell transplantation (HSCT). Reports not only for the respiratory tract infection but, unlikely for bacteria or fungi, for the infections caused by the respiratory viruses have been rarely reported in Korea. During the winter of 2000~2001, authors wanted to know the prevalence rate of the respiratory tract infection and the kinds of causative microorganisms, especially the community respiratory viruses (CRV). Based on these data, we attempted to evaluate the clinical courses and prognosis of the patients. METHODS: From October 2000 to February 2001, specimens were collected from the patients who visited Catholic hemopoietic stem cell transplantation center, showing symptoms and signs of respiratory tract infection after HSCT. Standard methods have been applied to isolate and identify bacterial and fungal species. Measles was diagnosed based on the typical symptoms, rash, fever, and Koplik spot. For the four different CRV (adenovirus, RSV, influenza virus, parainfluenza virus), multiplex PCR and conventional culture method were used for the identification. RESULTS: Eighty-four specimens were collected from 66 patients for 4 month period. Average age of patients was 35+/-8 years. Sixty patients (90%) were received allogeneic HSCT. Sample collection was performed between 10 and 3,740 days (average 370 days, median 215 days) after HSCT. Forty-seven patients (71.2%) have been received immunosuppressants at the time of respiratory tract infection. Forty patients (60.6 %) were suffered lower respiratory tract infection and forty-four patients (66.7%) had community-acquired infection. Sixty microorganisms were identified from 45 patients out of total 66 patients. Identified microoganisms were bacteria accounting for 2 cases (3.4%), fungi for 11 (18.3%), tuberculosis for 5 (8.3%), and viruses for 42 (70.0%). Among viruses, 16 cases were measles (39%), 14 adenovirus (33%), 9 cytomegalovirus (21%), 2 parainfluenza virus (5%), 1 was influenza virus (2%). However, no RSV was identified. Most of patients showed good prognosis without any complications. Ten (15.2%) out of total 66 patients were expired. The direct cause of death for all 8 among 10 patients was pneumonia. CONCLUSION: Of the respiratory tract infection fol-lowing HSCT, most common causative microorganisms were viruses - measles, adenovirus in order. No case of RSV infection was found. No epidemic must be occurred by influenza virus because only 1 case was found. Fourteen patients were infected by more than one microorganisms. Overall mortality rate was 15.2%. This study is still undergoing and once accumulated data for more than 1 year, it might be possible to work out a strategies of treatment and prevention for respiratory tract infections. We also expect that these data might be able to provide the basis of efficient infection control in HSCT unit.
Adenoviridae ; Bacteria ; Bone Marrow Transplantation ; Cause of Death ; Community-Acquired Infections ; Cytomegalovirus ; Exanthema ; Fever ; Fungi ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Immunosuppressive Agents ; Infection Control ; Korea ; Measles ; Mortality ; Multiplex Polymerase Chain Reaction ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia ; Prevalence ; Prognosis ; Respiratory System* ; Respiratory Tract Infections* ; Stem Cell Transplantation ; Tuberculosis

BACKGROUND: The organ transplantation becomes the management of choice for many patients with chronic and life threatening heart, liver, kidney, bone marrow, and pancreatic diseases. A new set of side effects unique to this groups of patients has become recognized. Bone disease is one of these complications. It is well known that there is an interplay between the cells in the bone marrow and the surrounding bone tissue. Marrow stromal cells include the progenitors of the osteoblastic lineage are the sources of effector molecules that support and regulate both hematopoiesis and bone remodeling. But little is known about the effects of myeloablative treatment followed by bone marrow transplantation(BMT) on bone metabolism. METHODS: We have investigated prospectively in 29 patients undergoing BMT(4 autologous, 25 allogenic) for hematologic diseases(19 leukemia, 9 severe aplastic anemia, 1 myelodyspoietic syndrome). Serum concentrations of calcium, phosphorus, creatinine, gonadotropins, sex hormones and biochemical markers of bone turnover(osteocalcin and carboxyterminal cross-linked telopeptide of type I collagen(ICTP)] were measured. The samples were collected before BMT and 1, 2, 3, 4, 12 weeks, 6 months and 1 year thereafter. Bone mineral density was measured with DEXA(Dual Energy X-ray Absorptiometry) before and after 1 year of BMT. RESULTS: 1. ICIP was progressively increased until 4 weeks after BMT when peak values were reached. And then decreased thereafter and basal values were regained after 1 year. Osteocalcin was progressively decreased until 3 weeks after BMT when nadir values were reached. And then increased thereafter and basal values were regained after 3 months. No distinct differences were observed in serum biochemical turnover marker between both sexes and between patients who received total body irradiation and those who did not. 2. Lumbar BMD was 2.1% decreased from 1.113 +/- 0.132 g/cm to 1.089 +/- 0.137 g/cm, and femoral BMD was 6.2% decreased fiom 1.078 +/- 0.156 g/cm to 1.011 +/- 0.157 g/cm. 3. 92% of the women (11/12) became menopausal manifested by high gonadotropin and low estradiol levels immediately after BMT. In contrast to women, gonadotropins and testosterone levels were not changed significantly in men after BMT. CONCLUSION: The rapid impairment of bone formation and also increase in bone resorption, as mirrored by the biochemical markers in this study, might play a role for the post-BMT bone loss. Further studies over many patients with a longer follow up will be needed.
Anemia, Aplastic ; Biomarkers ; Bone and Bones ; Bone Density ; Bone Diseases ; Bone Marrow Transplantation* ; Bone Marrow* ; Bone Remodeling ; Bone Resorption ; Calcium ; Creatinine ; Estradiol ; Female ; Follow-Up Studies ; Gonadal Steroid Hormones ; Gonadotropins ; Heart ; Hematopoiesis ; Humans ; Kidney ; Leukemia ; Liver ; Male ; Metabolism* ; Organ Transplantation ; Osteoblasts ; Osteocalcin ; Osteogenesis ; Pancreatic Diseases ; Phosphorus ; Prospective Studies ; Stromal Cells ; Testosterone ; Transplants ; Whole-Body Irradiation