The incidence, type arid distribution of polyneuropathy in patients with chronic obstructive pulmonary disease (COPD) were assessed and also analyzed the causative factors. Forty-four patients, mean age 66.1 years (42 male, 2 female), have been investigated with arterial gas analysis, pulmonary function test, clinical and electrodiagnostic studies. None of them had conditions known to affect the peripheral nervous system such as metabolic disorders or drugs. In a selected group of 44 patients, electrophysiological findings of polyneuropathy were found in 22 patients(50%), clinical polyneurtpathy were diagnosed in 13 patients(9 patients were diagnosed by electrophysiological studies, 4 patients were normal by electrophysiological studies). These findings indicate that subclinical polyneuropathy( 13 patisnts, 30%) more conimorily occurs than clinical polyneuropathy( 9 patients, 20%) in associated with COPD. In the patients with polyneuropathy, the lesions were predominant axonal degeneration, the changes were more involved in leg than arm, more frequently affected sensory fibers. We could not find etiologic factor to cause polyneuropathy in COPD patients.
Arm ; Axons ; Humans ; Incidence ; Leg ; Male ; Peripheral Nervous System ; Polyneuropathies* ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests

PURPOSE: This study was performed to determine whether the anion gap, the base excess, the lactate, and the strong ion gap obtained in the emergency department correlate with the prognosis and whether the strong ion gap is the most useful marker compared to the prognostic ability of the anion gap, the base excess, and the lactate. METHODS: We reviewed the records of 106 patients admitted to the intensive care unit via the emergency department. We measured the anion gap, the base excess, and the lactate and we calculated strong anion gap by using a formula. We divided the patients into survivors and nonsurvivors and compared the prognostic abilities of the four variables by using the Student's t-test and receiver operator characteristic curves. RESULTS: The mean age of the patients was 67+/-14, and the numbers of males and females were similar (58 males vs 48 females). The number of survivors was 92 (86.7%), and that of nonsurvivors was 14 (3.2%). The anion gap ( 24.8+/-8.8 vs. 16.4+/-4.8 mmol/L, p value=0.000), the base excess (-11.9+/-8.7 vs. -3.49+/-6.5 mmol/L, p value = 0.001), the lactate (9.1+/-7.7 vs. 4.5+/-3.1 mmol/L, p value = 0.011 ) and the strong ion gap (16.6+/-3.6 vs. 10.9+/-3.7, p value=0.000) of the nonsurvivors were higher. All of the four varibles were associated with the prognosis, but among them, the strong ion gap discriminated most strongly with an area under the receiver operator characteristic curve of 0.866 (95% confidence interval, 0.787 to 0.92). CONCLUSION: The initial emergency-department acid-base variables, the anion gap, the base excess, the lactate and the strong ion gap have prognostic abilities, but the strong ion gap is the variable that most strongly predicts of mortality.
Acid-Base Equilibrium ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Intensive Care Units ; Lactic Acid ; Male ; Mortality ; Prognosis ; Survivors

PURPOSE: To determine whether initial corrected anion gap (C(o)AG), base excess caused by unmeasured anions (BEua), and strong ion gap (SIG) can predict the morbidity of critically ill patients admitted to emergency department (ED). METHODS: 138 patients who visited the critical section of the ED and were admitted to intensive care unit (ICU) were enrolled. We calculated the C(o)AG, BEua, and SIG from the initial blood samples of the patients and initial logistic organ dysfunction score (LODS) also. Then we measured the LODS at the last day of ICU stay again. Comparing with the initial LODS, we divided the patients into two groups based on the changes of the values: favorable group and poor group. RESULTS: There was a significant difference in the mean AGcorr (p=0.007), BEua (p=0.008), SIG (p=0.037) between favorable and poor group. The area under the receiver operating characteristic (AUROC) curves for morbidity prediction were relatively small: 0.66 (95% CI, 0.56-0.77) for C(o)AG, 0.65 (95% CI, 0.54-0.76) for BEua, and 0.59 (95% CI, 0.49-0.70) for SIG. CONCLUSION: We found the initial unmeasured anions at the ED of the patients who eventually showed improved LODS during ICU period are significantly different to those of the other patients. But they failed to show enough capability of discriminating the morbidities between two groups.
Acid-Base Equilibrium ; Anions* ; Critical Illness* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Intensive Care Units ; Organ Dysfunction Scores ; Organization and Administration ; ROC Curve

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018–May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017–May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

This is a retrospective review of 33 patients with large cell lung carcinoma treated at Yonsei University Cancer Center between Jan. 1985 and Dec. 1989. Of the thirty-three patients, twenty eight were men and five women. Median age was 59 years. Large cell undifferentiated carcinoma was the most common pathologic type, 78.8%. Twenty one of thirty three patients had far advanced diseases, stage IIIB-IV at the time of initial diagnosis. Pleural effusion was initially presented in 12 patients, and SVC syndrome appeared in 5 patients. As to location of the primary tumor, 19(57.6%) appeared in the right lung and 14 (42.4%) in the left. Patients with a centrally located primary tumor mass were nearly the same as those peripherally located (17 vs. 16). Fifteen of thirty three patients developed metastasis involving not only bone, brain, the opposite lung, adrenal gland but also soft tissue, skin, pancreas and appendix. Treatment was individualized with 19 treated radically and 14 palliatively. After treatment, only two patients showed a complete response. Long term survival was observed in 4 patients: 1 (24 mo.), 2 (41 mo.) and 1 (54 mo.). The overall 2 year survival rate was 14.3% while the median survival time was 6.0 months. Through the analysis of the various factors affecting survival, we observed that pleural effusion-absent group and complete response group had a statistical significant better survival rate (p<0.01).
Adrenal Glands ; Appendix ; Brain ; Carcinoma ; Carcinoma, Large Cell* ; Diagnosis ; Female ; Humans ; Lung* ; Male ; Neoplasm Metastasis ; Pancreas ; Pleural Effusion ; Retrospective Studies ; Skin ; Survival Rate