BACKGROUND: Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. METHODS: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. RESULTS: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). CONCLUSIONS: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Body Water ; Critical Illness* ; Electric Impedance* ; Humans ; Intensive Care Units ; Male ; Mortality ; Observational Study* ; Prospective Studies* ; Renal Replacement Therapy* ; Survival Rate ; Water

No abstract available.
Rectal Neoplasms*

PURPOSE: This study was to construct a structural equational model for explaining and predicting job stress of intensive care unit (ICU) nurses based on the Integrated model of stress of Ivancevich and Matteson (1980). METHODS: The subjects of this study were 220 nurses at ICU. The data were collected from August 5 to 30, 2013 through self-reporting questionnaire survey. RESULTS: According to the hypothetical model of this study, perceived nursing practice environment, perceived role conflict, perceived transformational leadership and perceived self-esteem showed statistically significant effects on job stress of ICU nurses directly. Professional self-concept indirectly affect job stress of ICU nurses. In conclusion, job stress of ICU nurses was directly influenced by nursing practice environment, role conflict, transformational leadership and self-esteem. Professional self-concept of the relationships among variables did not have a direct impact on job stress. CONCLUSION: Based on the results of this study, it is needed to develop stress management measures and programs considering these variables in order to adequately manage job stress of ICU nurses.
Intensive Care Units* ; Leadership ; Nursing ; Surveys and Questionnaires

Anesthesia, General ; Hemorrhage ; Humans ; Incidence ; Palatine Tonsil ; Postoperative Hemorrhage ; Tonsillectomy

No abstract available.
Heart* ; Thoracic Surgery* ; Thyroid Gland*

No abstract available.
Ectromelia*

OBJECTIVES: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. METHODS: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). RESULTS: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. CONCLUSIONS: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.
Carcinoma, Papillary* ; Comorbidity ; Depression ; Education ; Humans ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

No abstract available.
Asthma* ; Child* ; Dermatitis, Atopic* ; Humans ; Immunoglobulin E* ; Rhinitis*

The management of skin and soft tissue defects on the buttock, perineum and lower abdomen has been improved through the development of myocutaneous flap. However, sacrifice of the deep muscles causes some problems such as intraoperative bleeding and functional disabilities of donor sites. And we can not also control the volume of the flap for the skin reliability of myocutaneous flaps. To overcome these disadvantages, we tried perforator-based myocutaneous island flaps for the reconstruction of the sacral, ischial sores or deep wounds of the perineum and lower abdomen. During the dissection of the flap, we could control the volume and shape of the flap exactly depending on the perforators. Clinically, total of 14 cases were treated with 10 parasacral perforator-based myocutaneous island flaps and 4 perforator-based extended myocutaneous island flaps. Parasacral flap is based on the parasacral perforators along the lateral sacral border and, the degree of containing muscles can be easily decided according to the depth of wound. In the cases of the extended myocutaneous flaps, we could design the perforator-based skin flap on the tip of myocutaneous island flap and appropriate volume of skin falp was obtained with the wide arc of rotation. Finally, the donor defect could be closed primarily and there was no significant sequela. There perforator-based myocutaneous island flaps require no significant sacrifice of the muscles and can be easily dissected and applied with the appropriate volumes for the reconstruction of the defect on the buttocks, perineum and lower abdomen.
Abdomen ; Buttocks ; Hemorrhage ; Humans ; Muscles ; Myocutaneous Flap ; Perineum ; Skin ; Surgical Flaps ; Tissue Donors ; Wounds and Injuries*

The reconstruction of pressure sore is often complicated problem due to underlying disease and general condition of the patients. Sometimes, it is too radical to use the muscle or musculocutaneous flap for the patients who has severe systemic disease and can not withstand the lengthy operation or the patients who already recovered from paraplegic condition and has no risk recurrence. To get over these problems, we recently have used the parasacral perforator-based island skin flaps for the sacral pressure sores. This flap is based on the axial pattern perforators originating from the internal pudendal artery and lateral sacarl artery. We performed this operation for 11 sacral sores with reasonable results. There was no significant complication, and duration of operation was relatively short and blood loss was a little. We concluded that this flap was useful for the patient with sacral pressure sore who could be categorized nontraumatic nonparaplegic group(NTNP group) or nontraumatic paraplegic group(NTP group). But this island flap has drawback, which is elimination of sensory nerve within the flap.
Arteries ; Humans ; Myocutaneous Flap ; Pressure Ulcer* ; Recurrence ; Skin*