No abstract available.
Critical Illness ; Humans ; Renal Replacement Therapy ; Vancomycin

PURPOSE: This study attempted to identify influential variables on types of smoking in adult smokers, which have been derived from Q-study. METHODS: A survey was conducted with 328 adult smokers at community settings in Seoul, South Korea from April 2006 to July 2006. To identify the influential variables related to smoking, variables from the Trans-theoretical model(i.e., self-efficacy for smoking abstinence, smoking temptation, process of change, decisional balance(pros and cons)) and nicotine dependency were analysed by ANOVA. Post-comparison tests were also done. RESULTS: The scores of nicotine dependency and smoking temptation were higher in habitual craving types than any other types, while the scores of self-liberation and self-efficacy for smoking abstinence were higher in self control types than any other types. CONCLUSION: Specific smoking intervention methods for each of the smoking types needs to be developed, based on how different groups of individuals gets into a decisions to quit smoking within their contexts.
Adult ; Dependency (Psychology) ; Humans ; Nicotine ; Republic of Korea ; Smoke ; Smoking

PURPOSE: This study was done to identify types of smoking decision making-temptation in adolescents and characteristics related to type among student smokers. METHOD: Data collection was done from March to July. 2006. A survey was administered to 275 students in 13 high schools and 15 middle schools in Seoul, South Korea. To identify types and characteristics smoking decision making-temptation in adolescents, cluster analysis using the K-mean method was employed. Characteristics of the influential variables according to the identified types of adolescent smokers were evaluated using ANOVA. RESULTS: Four types of smoking pattern in adolescents were identified: habitual craving (17.7%), nicotine dependence (35.8%), feeblemindedness (28.4%), and self control p=.001), while the score for self efficacy for smoking abstinence was higher in the self control type (F=23.06, p=.000). Conclusions: Findings from this study suggest that effective interventions for smoking cessation in adolescents require not only active implementation of nicotine replacement therapy but also development of individualized approaches for each person targeting change in the social environment that may lead to positive smoking decisional balance.
Adolescent ; Data Collection ; Humans ; Nicotine ; Republic of Korea ; Self Efficacy ; Smoke ; Smoking ; Smoking Cessation ; Social Environment ; Tobacco Use Disorder

BACKGROUND/AIMS: The present study aimed to determine the role of cystatin C as a prognostic factor for acute kidney injury and survival in cirrhotic patients. METHODS: The study investigated 53 liver cirrhosis patients. The renal function was evaluated by serum creatinine, serum and urine cystatin C, and 24-hour creatinine clearance on admission. Acute kidney injury was defined as a serum creatinine level exceeding the normal range (>1.2 mg/dl) and an increase of at least 50% from the baseline value. Multivariate analysis, receiver operating characteristic curve, and survival analysis were used to investigate prognostic factors for acute kidney injury and survival. RESULTS: Nine of the 53 cirrhotic patients (17.0%) developed acute kidney injury within 3 months. Both serum creatinine and cystatin C were predictive factors for acute kidney injury in univariate analysis, with a diagnostic accuracy of 0.735 (95% confidence interval (CI), 0.525-0.945; p=0.028) for serum cystatin C and 0.698 (95% CI, 0.495-0.901, p=0.063) for creatinine. In multivariate analysis, only serum cystatin C was an independent risk factor for acute kidney injury. The sensitivity and specificity of a serum cystatin C level of >1.23 mg/L to acute kidney injury were 66% and 86%, respectively. Serum cystatin C was positively correlated with the Model for End-Stage Liver Disease (MELD) and MELD-Na scores (r=0.346 and p=0.011, and r=0.427 and p=0.001, respectively). Comparison of the survival rates over the observation period revealed that a serum cystatin C level of >1.23 mg/L was a useful marker for short-term mortality (p<0.001). CONCLUSIONS: The accuracy in predicting acute kidney injury and short-term mortality was higher for a serum cystatin C level of >1.23 mg/L than for the serum creatinine concentration in patients with cirrhosis.
Acute Kidney Injury/complications/*diagnosis/mortality ; Adult ; Aged ; Creatinine/blood ; Cystatin C/*analysis/blood/urine ; Female ; Humans ; Liver Cirrhosis/blood/*complications ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; ROC Curve ; Risk Factors ; Severity of Illness Index ; Survival Rate

Ochrobactrum anthropi is a ubiquitous gram-negative bacillus and currently thought to be an opportunistic pathogen. We experienced a 66-year-old male patient with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis caused by O. anthropi. Susceptible antibiotic therapy including amikacin and ciprofloxacin improved the patient's clinical status. However, peritoneal effluent showed sustained leukocytosis, thus CAPD catheter was removed. After 2 weeks of temporary hemodialysis, CAPD was successfully restarted with reinsertion of catheter. This is, to our knowledge, the first case of CAPD-related peritonitis caused by O. anthropi in Korea.
Aged ; Amikacin ; Bacillus ; Catheters ; Ciprofloxacin ; Humans ; Korea ; Leukocytosis ; Male ; Ochrobactrum ; Ochrobactrum anthropi ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis

This study investigated the comparison of electromyographic change of neuromuscular blocking effect induced vecuronium between the ulnar, facial and tibial nerve in 24 healthy adult patients anesthetized with thiopental, N2O and enflurane. Neuromuscular monitoring commenced immediately after administration of thiopental. After supramaximal stimulation was achieved, a bolus of vecuronlum 0.08mg/kg was injected intravenously. And then single twitch nerve stimulation(T1) was applied to the nerves using surface electrodes and the electrical response of muscles recorded using the RELAXOGRAPH(Dates Co.). The patients were allocated randomly to 3 groups of 8 patients respectively: the ulnar nerve troup was the control, and the facial nerve group and the tibial nerve group were the studing group. We assessed electromyographic responses from abductor digiti minimi muscle in the ulnar nerve, orbicularis oris muscle in the facial nerve and flexor hallucis brevis muscle in the tibial nerve to single twitch nerve stimulation respectively. And the onset time, the time from injection of vecuronium to 25% and 75% recovery to T1, and recovery index of the ulnar, facial and tibial nerve groups were measured. The obtained results were as follos: 1) The onset time was faster in the facial nerve group compared with the ulnar nerve group. 2) The time from injection of vecuronium to 25% recovery of T1 was more prolonged in the facial nerve group compared with the ulnar nerve group. 3) The time from injection of vecuronium to 75% recovery of T1 and recovery index were more shorter in the tibial nerve group compared with ulnar nerve group.
Adult ; Electrodes ; Enflurane ; Facial Nerve ; Humans ; Muscles ; Neuromuscular Blockade ; Neuromuscular Monitoring ; Thiopental ; Tibial Nerve* ; Ulnar Nerve ; Vecuronium Bromide*

BACKGROUND: Severe dehydration decreases renal perfusion. However, it is unclear whether sub-morbid dehydration affects kidney function similarly. Although there have been numerous animal and human studies that have suggested mild dehydration is associated with glomerular hyperfiltration, it has not been confirmed on a large-scale in the general population. Therefore, we aimed to identify the relationship between hydration status and kidney function. METHODS: We reviewed the data of 28,342 adults who participated in the Korea National Health and Nutrition Examination Surveys. Urine specific gravity unit (SGU) was the primary variable that indicated hydration status, and the estimated glomerular filtration rate (eGFR) was used as the primary outcome. RESULTS: Multivariate linear regression analysis showed urine SGU was positively associated with eGFR, which was J-shaped in the multivariate generalized additive model plot. In the penalized spline curve analysis, the odds ratio for high eGFR was steadily increased. Although increased urine SGU was associated with decreased blood pressure and pulse rate, it had no effect on increased fasting glucose and total cholesterol, suggesting conflicting cardio-metabolic dehydration effects. CONCLUSION: Dehydration, presumably sub-morbid in an ambulatory community-dwelling general population, is associated with higher kidney function. The clinical significance of sub-morbid dehydration-associated glomerular hyperfiltration needs further investigation.
Adult ; Animals ; Blood Pressure ; Cholesterol ; Dehydration ; Fasting ; Glomerular Filtration Rate ; Glucose ; Heart Rate ; Humans ; Kidney ; Korea ; Linear Models ; Odds Ratio ; Perfusion ; Renal Insufficiency, Chronic ; Specific Gravity

We report a case of central venous stenosis due to a structural deformity caused by a tuberculosis-destroyed lung in a 65-year-old woman. The patient presented with left facial edema. She had a history of pulmonary tuberculosis, and the chest X-ray revealed a collapsed left lung. Angiography showed leftward deviation of the innominate vein leading to kinking and stenosis of the internal jugular vein. Stent insertion improved her facial edema.
Aged ; Brachiocephalic Veins/*pathology/radiography ; *Central Venous Pressure ; Constriction, Pathologic/*etiology/pathology/therapy ; Edema/therapy ; Female ; Humans ; Jugular Veins/pathology/radiography ; Stents ; Tuberculosis, Pulmonary/*complications/pathology/radiography ; Vascular Diseases/*etiology/pathology/therapy

BACKGROUND: Serum cystatin C has been suggested to be a better marker for GFR than creatinine because believed to be produced at a constant rate by most nucleated cells, and eliminated exclusively by glomerular filtration We compared serum cystatin C with creatinine-based estimates, especially in patients with old age or extreme protein composition to investigate the utility of cystatin C and to identify factors that influence on cystatin C other than renal function. METHODS: A total of 446 patients, admitted to department of nephrology of Korea University Anam Hospital From September 2003 to March 2004, had their glomerular filtration rate (GFR) estimated by DTPA scintigraphy, clearance of creatinine, and calculated from Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) formula. A body composition, the serum creatinine and cystatin C levels were also measured. RESULTS: Serum cystatin C showed similar correlation with DTPA GFR to serum creatinine. The formula, GFR (mL/min/1.73m2) = 61.84 x cystatin C(-0.8135), was derived with better precision than either Cockcroft-Gault or MDRD. The diagnostic accuracy of cystatin C was not better than creatinine in older patients as well as those with overweight, or an extreme protein composition. The addition of age, body surface area, and gender increased the R2 for both serum creatinine and cystatin C. CONCLUSION: Serum cystatin C is a good marker for GFR, but not superior to serum creatinine even in patients with old age, overweight, or an extreme protein composition, and affected by age, body surface area, and gender independent on renal function.
Body Composition ; Body Surface Area ; Creatinine ; Cystatin C* ; Diet ; Filtration ; Glomerular Filtration Rate* ; Humans ; Korea ; Nephrology ; Overweight ; Pentetic Acid ; Radionuclide Imaging

We describe a case of infrarenal aortic hypoplasia in a 52-yr-old woman who presented with claudication. Computed tomographic angiography revealed an abrupt absence of the infrarenal aorta, with collateral flow reconstituting the iliofemoral systems. After a polytetrafluoroethylene graft was interposed between the aortic stump and the iliac bifurcation, the patient's claudication resolved.