PURPOSE: This study was conducted to evaluate nutritional status, and the effects of lifestyles and depression on nutritional status of elderly people (NSE). METHOD: The participants were 280 elders who visited the Y city Senior Welfare Center between August 2006 and October 2006. Data were collected using a structured questionnaire that included general characteristics, lifestyle checklist, depression scale, and nutritional risk index. Also, Body Mass Index (BMI) was calculated from height and weight. T-test, ANOVA, Duncan test, Pearson coefficients correlation and stepwise multiple regression were used to analyze the data using the SPSS Win 12.0 program. RESULTS: The NSE mean score was mid level at 5.03. BMI was 23.42 which indicates overweight. Depression was the factor that influenced the nutritional risk index most strongly, accounting for 17.3% of the total variance in the NSE. A combination of significance of health, concerns about health, housing, condition of teeth, activity, and smoking pattern accounted for 29.8% of the variance in the NSE. Condition of teeth accounted for only 3.8% of the variance in BMI. CONCLUSION: It is necessary to be aware that variance in the NSE can be affected by several factors including depression and lifestyle and that depression is strongly related to poorer NSE.
Aged* ; Body Mass Index ; Checklist ; Depression* ; Housing ; Humans ; Life Style* ; Nutritional Status* ; Overweight ; Questionnaires ; Smoke ; Smoking ; Tooth

PURPOSE: The purpose of this study was to compare the two-dimensional with three-dimensional radiographic measurements of polyethylene liner wear in the Harris-Galante II acetabular cup. MATERIALS AND METHODS: We measured the polyethylene liner wear amount and the wear rate of 64 hips with Harris-Galante II acetabular cup by two methods: Livermore's method and modified Devane's method. We evaluated the relationships between the two methods. RESULTS: The average total amount of wear and the average wear rate are 0.86+/-1.01 mm and 0.18+/-0.20 mm/year using the two-dimensional method and 0.99+/-1.01 mm and 0.21+/-0.2 mm/year using three-dimensional method respectively. The amount of wear and the wear rate by the three-dimensional method was larger than those by the two dimensional method. CONCLUSION: The amount of polyethylene liner wear can be measured by the two-dimensional method because it is highly correlated with the amount that is measured by the three-dimensional method, since there was no differences between the two methods.
Acetabulum* ; Hip ; Polyethylene*

PURPOSE: To develop a model based on non-invasive clinical and ultrasonographic parameters for predicting the likelihood of subsequent histologic chorioamnionitis in women with preterm premature rupture of membranes (PPROM) and to determine whether the inclusion of invasive test results improves the predictive value of the model. MATERIALS AND METHODS: This retrospective cohort study included 146 consecutive women presenting with PPROM (20-33 weeks). Transvaginal ultrasonographic assessment of cervical length was performed. Maternal serum C-reactive protein (CRP) levels and white blood cell (WBC) counts were measured after amniocentesis. Amniotic fluid (AF) obtained by amniocentesis was cultured, and interleukin-6 (IL-6) levels and WBC counts were determined. The primary outcome measure was histologic chorioamnionitis. RESULTS: Risk scores based on serum CRP concentrations and gestational age (model 1) were calculated for each patient. The model was shown to have adequate goodness of fit and an area under the receiver operating characteristic curve (AUC) of 0.742. When including AF test results (e.g., AF IL-6 levels) in model 1, serum CRP concentrations were found to be insignificant, and thus, were excluded from model 2, comprising AF IL-6 levels and gestational age. No significant difference in AUC was found between models 1 and 2. CONCLUSION: For women with PPROM, the newly developed model incorporating non-invasive parameters (serum CRP and gestational age) was moderately predictive of histologic chorioamnionitis. The inclusion of invasive test results added no predictive information to the model in this setting.
Adult ; *Amniocentesis ; Amniotic Fluid/*cytology/microbiology ; C-Reactive Protein/*metabolism ; Chorioamnionitis/blood/*diagnosis/metabolism ; Cohort Studies ; Female ; Fetal Membranes, Premature Rupture/*blood ; *Gestational Age ; Humans ; Infant, Newborn ; Interleukin-6/blood ; Leukocyte Count ; Predictive Value of Tests ; Pregnancy ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity

A hepatodiaphragmatic interposition of the small or large intestine, which is known as Chilaiditi's syndrome, is generally asymptomatic and rarely requires surgical intervention. However, it can be associated with symptoms ranging from mild abdominal pain to a severe complicated intestinal obstruction. We report a case of Chilaiditi's syndrome associated with an ileal obstruction. A 69 year-old female patient presented with abdominal pain, vomiting and an abdominal distension. The abdominal CT and upper endoscopy findings showed an intestinal obstruction and gastric cancer, requiring surgery.
Abdominal Pain ; Aged ; Chilaiditi Syndrome* ; Endoscopy ; Female ; Humans ; Ileum* ; Intestinal Obstruction* ; Intestine, Large ; Stomach Neoplasms ; Tomography, X-Ray Computed ; Vomiting

PURPOSE: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. MATERIALS AND METHODS: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. RESULTS: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the 7th postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was 7.7% (2/26), and the variance rate was 30.8% (8/26). The mean hospital stay was 11.3 days (10~15 days) for the CP group compared with 17.5 days (9~68 days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days (7~68 days) and 8.3 days (7~12 days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group (W6,292,200) than in the CP group (W4,863,685). The charge per hospital day was higher in the CP group (W430,414) than in the non-CP group (W359,554). Patient satisfaction was higher in the CP group than in the non-CP group. CONCLUSION: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.
Critical Pathways* ; Gastrectomy ; Gastroparesis ; Humans ; Korea ; Length of Stay ; Nutritionists ; Patient Satisfaction ; Surveys and Questionnaires ; Stomach Neoplasms*

PURPOSE: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. MATERIALS AND METHODS: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. RESULTS: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the 7th postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was 7.7% (2/26), and the variance rate was 30.8% (8/26). The mean hospital stay was 11.3 days (10~15 days) for the CP group compared with 17.5 days (9~68 days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days (7~68 days) and 8.3 days (7~12 days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group (W6,292,200) than in the CP group (W4,863,685). The charge per hospital day was higher in the CP group (W430,414) than in the non-CP group (W359,554). Patient satisfaction was higher in the CP group than in the non-CP group. CONCLUSION: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.
Critical Pathways* ; Gastrectomy ; Gastroparesis ; Humans ; Korea ; Length of Stay ; Nutritionists ; Patient Satisfaction ; Surveys and Questionnaires ; Stomach Neoplasms*

The incidence of W-P-W syndrome is often noted in patients without other evidence of heart diseases. However, most of them wlll have supraventricular arrhythmias, characterized by paroxismal tachyarrhythmias. W-P-W- syndrome may be complicated by severe hypotension, syncope, congestive heart failure, atrial and/or ventrioular fibrillation and even sudden death, We experienced a case of W-P-W syndrome Immediately after induction of general anes-thesia on a patient with preoperatively normal ECG patterne and no evidence of otder heart disease.
Anesthesia, General* ; Arrhythmias, Cardiac ; Death, Sudden ; Electrocardiography ; Heart Diseases ; Heart Failure ; Humans ; Hypotension ; Incidence ; Syncope ; Tachycardia

PURPOSE: There is concern about the potential adverse effects on hepatic function due to increased intraabdominal pressure during pneumoperitoneum. The changes in hepatic function following a laparoscopy assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) for gastric cancer were compared. METHODS: Between July 2004 and May 2005, 60 patients diagnosed with early gastric cancer at Kangnam St' Mary's hospital; 30 each having undergone LADG and ODG were studied. The levels of alkaline phosphatase (ALP), total bilirubin (TB), aspartate transferase (AST) and alanine transferase (ALT) between the two groups were compared at 24 and 72 hours postoperatively. RESULTS: The age, sex, body mass index and preoperative hepatic function were not different between the two groups. The operative times were significantly longer in the LADG than the ODG group (298 vs. 184 minutes, P < 0.000). There was no postoperative hepatic failure or mortality in either group. The levels of ALP decreased, but those of total bilirubin remained unchanged from the preoperative baselines in both groups, with no significant difference between the two groups. After a LADG, the levels of AST and ALT increased 3.7 and 3.5 fold 24 hours after surgery, whereas after an ODG, the levels of AST and ALT increased 1.9 and 1.5 fold. In the LADG group, the levels of AST and ALT were significantly increased compared to the ODG group (P < 0.05), but returned close to the baseline levels within 72 hours. On the third postoperative day, there were no significant differences in the levels of AST and ALT between the two groups (P > 0.05). CONCLUSION: After a LADG, the levels of hepatic transaminases were immediately elevated, but returned to normal levels within 72 hours. A LADG with prolonged pneumoperitoneum is considered safe in patients with normal liver function prior to the operation. In addition, to evaluate the safety of a LADG in the patients with decreased hepatic function, a large scaled randomized prospective trial will be required.
Alanine ; Alkaline Phosphatase ; Aspartic Acid ; Bilirubin ; Body Mass Index ; Gastrectomy* ; Humans ; Laparoscopy ; Liver ; Liver Failure ; Mortality ; Operative Time ; Pneumoperitoneum ; Prospective Studies* ; Stomach Neoplasms ; Transaminases ; Transferases

Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.
Afferent Loop Syndrome* ; Carcinoma ; Drainage* ; Humans ; Stents* ; Stomach Neoplasms*

Asthma is a common medical syndrome which significantly increases the morbidity and mortality of surgical and anesthetic procedures. The anesthesiologist should be closely involved in the preoperative assessment and Prep-aration of these patients for, surgery and anesthesia and should be continually aware of the possibility of bronchospasm. The safe clinical management of this challenging population group demands not only expertise in carefully planning an anesthetic technique best suited to an individual patient and his specific disease process. We reported a case of bronchospasm after injection of neostigmine intravenously in 34-rear old female patient during endotracheal general inhalation anesthesia, together with brief of review of literature.
Anesthesia ; Anesthesia, Inhalation ; Asthma ; Bronchial Spasm* ; Female ; Humans ; Mortality ; Neostigmine* ; Population Groups