PURPOSE: This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU).METHODS: This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records.RESULTS: Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters.CONCLUSION: The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.
Catheters ; Critical Care ; Delirium ; Education ; Electronic Health Records ; Humans ; Narcotics ; Prevalence ; Restraint, Physical ; Retrospective Studies ; Risk Factors ; Ventilators, Mechanical

No abstract available.
Compressed Air* ; Explosions* ; Orbit* ; Orbital Cellulitis*

PURPOSE: To investigate the clinical presentation and treatment outcomes of recurrent corneal erosion patients. METHODS: Retrospective analysis was performed on the medical records of 48 patients (53 eyes) diagnosed with recurrent corneal erosion by our ophthalmology department between January 2008 and March 2015. Patient age, gender, lesion location, and cause of disease were analyzed against occurrence of disease. Patients were classified by treatment method into group A, which was treated with eye drops; group B, which was treated with therapeutic contact lenses and eye drops; group C, which was treated with amniotic membrane transplantation; and group D, which was treated with other procedures, and the recurrence rates were compared. RESULTS: The mean age of patients was 45.6 ± 14.3 years (19-76 years), with no significant difference in recurrence rates dependent on gender or eye. Patients in their 50s were most affected, excluding refractive surgery patients. The most frequent lesion location was the inferior area of the cornea (58.5%), followed by the central area (30.2%), and the most common cause of disease was trauma, followed by unknown causes, past refractive surgery, and complications from other eye diseases. Group A had 11 eyes (20.8%), while groups B, C, and D had 30 eyes (56.6%), 8 eyes (15.1%) and 4 eyes (7.3%), respectively. The recurrence rates according to treatment method were 27.3% in group A, 23.3% in group B, and 12.5% in group C. The lower recurrence rate in the group treated with amniotic membrane transplantation was not significant compared to that of conservatively treated groups. CONCLUSIONS: Recurrent corneal erosion mostly affects patients in their 50s, excluding refractive surgery patients, and occurs frequently in the inferior area of the cornea due to mild trauma. Surgical treatment including amniotic membrane transplantation should be considered instead of conservative treatment in order to prevent reoccurrence.
Amnion ; Contact Lenses ; Cornea ; Eye Diseases ; Humans ; Medical Records ; Ophthalmic Solutions ; Ophthalmology ; Recurrence ; Refractive Surgical Procedures ; Retrospective Studies

PURPOSE: To investigate the clinical presentation and treatment outcomes of recurrent corneal erosion patients. METHODS: Retrospective analysis was performed on the medical records of 48 patients (53 eyes) diagnosed with recurrent corneal erosion by our ophthalmology department between January 2008 and March 2015. Patient age, gender, lesion location, and cause of disease were analyzed against occurrence of disease. Patients were classified by treatment method into group A, which was treated with eye drops; group B, which was treated with therapeutic contact lenses and eye drops; group C, which was treated with amniotic membrane transplantation; and group D, which was treated with other procedures, and the recurrence rates were compared. RESULTS: The mean age of patients was 45.6 ± 14.3 years (19-76 years), with no significant difference in recurrence rates dependent on gender or eye. Patients in their 50s were most affected, excluding refractive surgery patients. The most frequent lesion location was the inferior area of the cornea (58.5%), followed by the central area (30.2%), and the most common cause of disease was trauma, followed by unknown causes, past refractive surgery, and complications from other eye diseases. Group A had 11 eyes (20.8%), while groups B, C, and D had 30 eyes (56.6%), 8 eyes (15.1%) and 4 eyes (7.3%), respectively. The recurrence rates according to treatment method were 27.3% in group A, 23.3% in group B, and 12.5% in group C. The lower recurrence rate in the group treated with amniotic membrane transplantation was not significant compared to that of conservatively treated groups. CONCLUSIONS: Recurrent corneal erosion mostly affects patients in their 50s, excluding refractive surgery patients, and occurs frequently in the inferior area of the cornea due to mild trauma. Surgical treatment including amniotic membrane transplantation should be considered instead of conservative treatment in order to prevent reoccurrence.
Amnion ; Contact Lenses ; Cornea ; Eye Diseases ; Humans ; Medical Records ; Ophthalmic Solutions ; Ophthalmology ; Recurrence ; Refractive Surgical Procedures ; Retrospective Studies

PURPOSE: Survival outcome of locally advanced pancreatic cancer has been poor and little is known about prognostic factors of the disease, especially in locally advanced cases treated with concurrent chemoradiation. This study was to analyze overall survival and prognostic factors of patients treated with concurrent chemoradiotherapy (CCRT) in locally advanced pancreatic cancer. MATERIALS AND METHODS: Medical records of 34 patients diagnosed with unresectable pancreatic cancer and treated with definitive CCRT, from December 2003 to December 2012, were reviewed. Median prescribed radiation dose was 50.4 Gy (range, 41.4 to 55.8 Gy), once daily, five times per week, 1.8 to 3 Gy per fraction. RESULTS: With a mean follow-up of 10 months (range, 0 to 49 months), median overall survival was 9 months. The 1- and 2-year survival rates were 40% and 10%, respectively. Median and mean time to progression were 5 and 7 months, respectively. Prognostic parameters related to overall survival were post-CCRT CA19-9 (p = 0.02), the Eastern Cooperative Oncology Group (ECOG) status (p < 0.01), and radiation dose (p = 0.04) according to univariate analysis. In multivariate analysis, post-CCRT CA19-9 value below 180 U/mL and ECOG status 0 or 1 were statistically significant independent prognostic factors associated with improved overall survival (p < 0.01 and p = 0.02, respectively). CONCLUSION: Overall treatment results in locally advanced pancreatic cancer are relatively poor and few improvements have been accomplished in the past decades. Post-treatment CA19-9 below 180 U/mL and ECOG performance status 0 and 1 were significantly associated with an improved overall survival.
Chemoradiotherapy* ; Follow-Up Studies ; Humans ; Medical Records ; Multivariate Analysis ; Pancreatic Neoplasms* ; Survival Rate

Systemic lupus erythematosus(SLE) is the prototypic immune complex disease which involves various organs. Chronic interstitial cystitis and protein-losing enteropathy are uncommon manifestations of SLE and have good response to steroid. Only one case of SLE associated with chronic interstitial cystitis and protein-losing enteropathy has been reported which was resistant to steroid treatment but dramatically responded to cyclophosphamide. We describe a case of a female patient who developed systemic lupus erythematosus associated with chylothorax, interstitial cystitis and protein-losing enteropathy with literature review. This case was initially resistant to steroid but with the addition of cyclophosphamide, chylothorax, chronic interstitial cystitis and protein-losing enteropathy markedly improved. This is the first case of SLE that developed chylothorax as well as chronic interstitial cystitis and protein-losing enteropathy.
Chylothorax* ; Cyclophosphamide ; Cystitis, Interstitial* ; Female ; Humans ; Immune Complex Diseases ; Lupus Erythematosus, Systemic* ; Protein-Losing Enteropathies*

Elevated intraocular pressure (IOP) is one of the major risk factors for glaucomatous visual field defects. Each individual systemic risk factor of coronary heart disease (CHD) is associated with elevated IOP, although no reports have argued for a correlation between the risk factors for CHD and IOP after a comprehensive or collective analysis. The National Cholesterol Education Program Adult Treatment Panel III presented the Framingham projection, which can predict the risk of CHD quantitatively. We investigated the association between IOP and the Framingham projection in 16,383 Korean subjects. The Framingham projection was applied using the indicated risk factors. The associations between the Framingham projection and IOP and the influences of the risk factors on the IOP were examined. The Framingham projection was correlated with the mean IOP in women (p<0.05). The relationship between IOP and systemic variables other than smoking was significant (p<0.05). The mean IOP was significantly higher in the high-risk CHD group than in the low-risk group based on the Framingham projection (p<0.05). Because an elevated IOP was associated with cardiovascular risk factors, subjects with a high CHD risk based on the Framingham projection need continuous monitoring for IOP to prevent glaucomatous visual field defects.
Adult ; Aged ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Coronary Disease/blood/*etiology/physiopathology ; Female ; Humans ; *Intraocular Pressure ; Male ; Middle Aged ; Regression Analysis ; Risk Factors

PURPOSE: The prognosis of breast cancer in very young women is generally considered to be unfavorable. In addition, younger patients (<35 years) with estrogen- receptor (ER) positive tumor had shown a significantly worse disease- free survival than younger patients with ER negative tumors. To confirm the prognostic effects of ER on the survival in very young Korean women with early breast cancer, we performed a retrospective study with survival analyses according to the expression of hormonal receptors. METHODS: Total 74 very young women with early breast cancer (invasive ductal carcinoma, NOS, < or=35 years, and stage Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Case-Control Studies ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Medical Records ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVE: To provide more useful guidelines for methotrexate (MTX) treatment in ectopic pregnancy, including patient selection, therapeutic dose, and reproductive outcome. METHODS: Retrospectively, records of 54 patients treated for ectopic pregnancy with systemic MTX were reviewed. MTX was administered 1.0 mg/kg intramuscularly, alternatively with leucovorin 0.1 mg/kg intramuscularly for up to four daily doses of each drug. Samples for beta-hCG detection were obtained on days +3, +7 after beginning of the therapy and then weekly until values were undetectable. RESULTS: 50 patients (92.6%) were treated successfully. 4 patients (7.4%) for whom MTX therapy failed, were treated surgically. The endometrial thickness significantly increased in the failed group, compared to the successful group (14.3+/-4.0 mm vs 7.0+/-2.8 mm, P=0.0001). The serum hemoglobin levels significantly changed in the failed group, compared to the successful group (2.1+/-0.9 g/dL vs 1.0+/-0.8 g/dL, P=0.044). Patients were divided into increasing group and decreasing group according to beta-hCG levels on day 0, that were higher or lower than day -2 level. The resolution time of beta-hCG between increasing group and decreasing group was significantly different (27.6+/-14.0 days vs 17.7+/-8.6 days, p=0.016). In 8 patients (15.1%), an immediate rise of beta-hCG was recorded on day 3 after MTX treatment, but on day 7, a rapid decrease was recorded. Women were treated with significantly different therapeutic dose of MTX according to initial level of serum beta-hCG (p=0.021). There were mild complications (12%). MTX treatment preserved the fallopian tube and thus preserved fertility (70%). CONCLUSION: Systemic MTX use with the dose according to initial level of serum beta-hCG is a safe and highly effective treatment in clinically stable ectopic pregnancy.
Fallopian Tubes ; Female ; Fertility ; Humans ; Leucovorin ; Methotrexate* ; Patient Selection ; Pregnancy ; Pregnancy, Ectopic* ; Retrospective Studies

BACKGROUND/AIMS: Replacement of a percutaneous transhepatic biliary drainage (PTBD) catheter with inside stents using endoscopic retrograde cholangiography is difficult in patients with angulated or twisted biliary anastomotic stricture after living donor liver transplantation (LDLT). We evaluated the usefulness and safety of the rendezvous technique for the management of biliary stricture after LDLT. METHODS: Twenty patients with PTBD because of biliary stricture after LDLT with duct-to-duct anastomosis underwent the placement of inside stents using the rendezvous technique. RESULTS: Inside stents were successfully placed in the 20 patients using the rendezvous technique. The median procedure time was 29.6 (range, 7.5-71.8) minutes. The number of inside stents placed was one in 12 patients and two in eight patients. One mild acute pancreatitis and one acute cholangitis occurred, which improved within a few days. Inside stent related sludge or stone was identified in 12 patients during follow-up. Thirteen patients achieved stent-free status for a median of 281 (range, 70-1,351) days after removal of the inside stents. CONCLUSIONS: The rendezvous technique is a useful and safe method for the replacement of PTBD catheter with inside stent in patients with biliary stricture after LDLT with duct-to-duct anastomosis. The rendezvous technique could be recommended to patients with angulated or twisted strictures.
Adult ; Catheters ; Cholangiography ; Cholangitis ; Constriction, Pathologic ; Dioxolanes ; Drainage ; Fluorocarbons ; Follow-Up Studies ; Humans ; Liver ; Liver Transplantation ; Living Donors ; Pancreatitis ; Sewage ; Stents