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: 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

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

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

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: Biliary stricture is the most common and important complication after right-lobe living-donor liver transplantation (RL-LDLT) with duct-to-duct biliary anastomosis. This study evaluated the efficacy and long-term outcome of endoscopic treatment for biliary stricture after LDLT, with the aim of identifying the factors that influence the outcome. METHODS: Three hundred and thirty-nine adults received RL-LDLTs with duct-to-duct biliary anastomosis between January 2000 and May 2008 at Kangnam St. Mary's Hospital. Endoscopic retrograde cholangiography (ERC) was performed in 113 patients who had biliary stricture after LDLT. We evaluated the incidence of post-LDLT biliary stricture and the long-term outcome of endoscopic treatment for biliary stricture. The factors related to the outcome were analyzed. RESULTS: Biliary strictures developed in 121 (35.7%) patients, 95 (78.5%) of them within 1 year of surgery. The mean number of ERCs performed per patient was 3.2 (range, 1 to 11). The serum biochemical markers decreased significantly after ERC (p<0.001). Stent insertion or stricture dilatation during ERC was successful in 90 (79.6%) patients. After a median follow-up period of 33 months from the first successful treatment with ERC, 48 (42.5%) patients achieved treatment success and 12 (10.6%) patients remained under treatment. The factors related to the outcome of endoscopic treatment were nonanastomotic stricture and stenosis of the hepatic artery (p=0.016). CONCLUSIONS: Endoscopic treatment is efficacious and has an acceptable long-term outcome in the management of biliary strictures related to RL-LDLT with duct-to-duct biliary anastomosis. Nonanastomotic stricture and stenosis of the hepatic artery are correlated with a worse outcome of endoscopic treatment.
Adult ; Cholangiography ; Constriction, Pathologic ; Dilatation ; Follow-Up Studies ; Hepatic Artery ; Humans ; Incidence ; Liver ; Liver Transplantation ; Stents ; Biomarkers

PURPOSE: To evaluate the effect of Optibiol(R), which is composed of multiple anti-oxidative and anti-inflammatory dietary elements, on the symptoms, clinical manifestations, and expression of various inflammatory cytokines in dry eye patients. METHODS: Patients suffering from dry eye were given Optibiol(R) for 3 months. They completed questionnaires regarding dry eye symptom and underwent slit lamp biomicroscopic examinations, tear film breakup times, Shirmer tests, and conjunctival fluorescein staining examinations on a monthly basis during the intake of Optibiol(R). Sampling of serum and tears was conducted at baseline and 3 months after taking Optibiol(R), and various inflammatory cytokines in the serum and tears were measured with multiplex bead immunoassay. RESULTS: Sixty-three patients were included in this study. After taking Optibiol(R), the dry eye symptoms, Schirmer scores, tear film breakup times, and conjunctival staining scores (Oxford scale) showed significant improvement, and the expression of most inflammatory cytokines had decreased: in particular, IL-1 beta and MIP-1 beta in serum, and IL-17 and MIP-1 beta in tears were significantly lower. CONCLUSIONS: Optibiol(R), an anti-oxidative and anti-inflammatory functional dietary supplement, is an effective dietary supplement in patients with dry eye syndrome. We posit that the decreased expression of inflammatory cytokines is an important mechanism in this effect.
Cytokines ; Dietary Supplements ; Dry Eye Syndromes ; Eye ; Fluorescein ; Humans ; Immunoassay ; Interleukin-17 ; Interleukin-1beta ; Surveys and Questionnaires ; Stress, Psychological ; Tears