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

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

No abstract available.
Rectal Neoplasms*

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

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

In order to investigate the occurrence characteristics of cancer in terms of industry in Kwangju-Chonnam area, medical utilization records of industrial medical insurance corporations during the period of 1987 to 1988 were reviewed for the identification of neoplastic disease. The cases obtained from the medical records were followed up for the verification and to get additional information. Standardized incidence data were compared by occupational characteristics. Multiple logistic regression analysis was applied to analyze the difference of incidence or distribution of cancer as a whole or of some selected cancer. Total cases of cancer identified were 242 during the study period. Annual incidence rate was calculated as 123.1 per 100,000 person. The frequent types of cancer were cancers of stomach, liver, lung, colon and rectum, bladder and lymphoma in descending order. Employees of mine and other sand handling industries showed significantly higher risks for cancer of stomach and cancer as a whole. Employees of the transportation industry showed the higher risk for cancer of liver. Workers in small-sized industry (< or = 100) had a higher risk for cancer than who in large-sized industry (>100). These findings suggested the effect of occupational environmental exposure to cancer development.
Colon ; Environmental Exposure ; Humans ; Incidence ; Insurance* ; Liver ; Liver Neoplasms ; Logistic Models ; Lung ; Lymphoma ; Medical Records ; Occupations ; Rectum ; Silicon Dioxide ; Stomach ; Stomach Neoplasms ; Transportation ; Urinary Bladder

A localized area of alopecia of the scalp can be a challenge in diagnosis. We report two patients with alopecia which was found to be associated with underlying congenital melanocytic nevus. Congenital melanocytic nevus should be taken into consideration in the differential diagnosis of alopecic plaques of the scalp.
Alopecia* ; Diagnosis ; Diagnosis, Differential ; Humans ; Nevus, Pigmented* ; Scalp

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

BACKGROUND: When one of family members must be treated, the others are required to get various forms of changes including modification of their proper roles in the family. Particularily when he or she can not perform his or her activities of daily living(ADL) owing to functional impairment by himself or herself, there seems to be greater dependence upon his or her family. Accordingly, we tried to give help in the treatment of patients through the comparative analysis concerning functional impairment in both groups on the assumption that there is difference of family function between two family groups which have a patient in family, or not. METHODS: This study was carried out to 83 inpatients in Sun Hospital in Dae Jeon and local rehabilitation clinics in Iksan from 1. July. 1995 to 31. Jun. 1996. We evaluated activites of daily living by using modified Barthel Index(MBI) and classified them into dependent group with 60 points or less(6roup I ), and independent group with more than 60 points(Group II). We also used Family APGAR score and FACES III to evaluate their family functions. RESULTS: MBI scores to evaluate ADL were 42.9+/-15.6 in Group I and 82.1+/-17.9 in Group II. Family APGAR scores were 6.93+/-2.52 in Group I and 7.24+/-17.9 in Group II but there was no significance between two groups. Types of family according to Family APGAR score were highly functional, morderate dysfunctional, and severly dysfunctional one in order of frequency in both groups, but there was no significance in their frequencies in both groups. Types of Family in view of cohesion was disengaged, separated, connected, and enmeshed one in order of frequency in Group I, and separated, disengaged, connected, and enmeshed one in order of frequency in Group II but there was no significance between two groups. Types of family in view of adaptability were rigid, chaotic structured,and flexible one in order of frequency in Group I, and were flexible, structured, rigid, and chaotic one in orders in Group II, which showed significance between two groups. Extremal types of family structure were large in numbers in Group I, but it didnt show significance. CONCLUSIONS: Assuming that there were large numbers of rigid and chaotic family in Group I, it is considered that tne family which has a patient with severely impaired function seems to have weaker adaptability to their family stresses than otherwise. Therefore, it is desirable that physicians who take charge of such patients provide continuous and comprehensive medical care for them including their family with greater concerns and through analysis and assessment of their family functions.
Activities of Daily Living ; Apgar Score ; Daejeon ; Humans ; Inpatients* ; Jeollabuk-do ; Rehabilitation* ; Solar System

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation