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*

This study concerns norm-referenced criteria for isokinetic strength of the lower limbs for the Korean high school baseball players. Two hundred one high school baseball players were participated in this study. They didn't have any medical problem at the lower limbs. Each test was conducted four times in the ankle plantar flexion/dorsiflexion test at 30°/sec speed, knee flexion/ extension test was conducted four times at 60°/sec speed. Humac Norm (CSMI, USA) system was used to obtained the value of peak torque, peak torque % body weight. The results were presented as a norm-referenced criterion value using 5-point scale of cajori, by 5 group (6.06%, 24.17%, 38.30%, 24.17%, and 6.06%) and a few suggestions from this study as follows. The provided criterion of peak torque and peak torque % body weight are very useful information for baseball palyers, baseball coach, athletic trainers and sports injury rehabilitation experts, to utilize as an objective clinical assessment data.
Ankle ; Athletic Injuries ; Baseball* ; Body Weight ; Humans ; Knee ; Lower Extremity* ; Rehabilitation ; Sports ; Torque

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

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

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

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