The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. The results of this study were as follows: 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04 +/-2.21), Time 2 (4.82+/-2.58) and Time 3(4.73+/-2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p <0.01) and the opioid use (p <0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p <0.05) and the amount of physical care the participants received (p <0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.
Analgesics, Opioid ; Delivery of Health Care ; Depression ; Diagnosis ; Hospices* ; Humans ; Logic ; Lung Neoplasms ; Middle Aged ; Surveys and Questionnaires ; Rectal Neoplasms ; Spirituality ; Stomach Neoplasms ; Terminally Ill*

PURPOSE: Obesity, a worldwide epidemic, is associated with insulin resistance, hyperlipidemia, hypertension, cardiovascular disease, and certain cancers. Many strategies, including natural alternative anti-obesity agents, are used widely to prevent obesity. This study examined the effects of silkworm hemolymph on the weight control of C57BL/6N mice fed with a high-fat diet. METHODS: The mice were divided into five groups: normal group (N), high-fat diet group (HFC), high-fat diet and silkworm hemolymph (at dose of 1 mL/kg BW (HFS-1), 5 mL/kg BW (HFS-5) and 10 mL/kg (HFS-10) for 12 weeks. RESULTS: After 12 weeks treatment, the administration of silkworm hemolymph decreased the final body weight significantly along with a decrease in the weights of epididymal fat and total fat. The plasma LDL-cholesterol concentration was significantly lower in the HFS-1, HFS-5, and HFS-10 groups than in the HFC group. In addition, the leptin level of the HFS groups was significantly lower than those of the HFC group without a change in the plasma insulin concentration. CONCLUSION: These findings suggest that the silkworm hemolymph may have the potential to prevent obesity.
Animals ; Anti-Obesity Agents ; Body Weight ; Bombyx* ; Cardiovascular Diseases ; Diet, High-Fat* ; Hemolymph* ; Hyperlipidemias ; Hypertension ; Insulin ; Insulin Resistance ; Leptin ; Mice* ; Obesity ; Plasma ; Weights and Measures

PURPOSE: Clostridium difficile (C. difficile) is an important cause of nosocomial diarrhea. Diagnostic methods for detection of C. difficile infection (CDI) are shifting to molecular techniques, which are faster and more sensitive than conventional methods. Although recent advances in these methods have been made in terms of their cost-benefit, ease of use, and turnaround time, anaerobic culture remains an important method for detection of CDI. MATERIALS AND METHODS: In efforts to evaluate a novel chromogenic medium for the detection of C. difficile (chromID CD agar), 289 fecal specimens were analyzed using two other culture media of blood agar and cycloserine-cefoxitin-fructose-egg yolk agar while enzyme immunosorbent assay and polymerase chain reaction-based assay were used for toxin detection. RESULTS: ChromID showed the highest detection rate among the three culture media. Both positive rate and sensitivity were higher from chromID than other culture media. ChromID was better at detecting toxin producing C. difficile at 24 h and showed the highest detection rate at both 24 h and 48 h. CONCLUSION: Simultaneous use of toxin assay and anaerobic culture has been considered as the most accurate and sensitive diagnostic approach of CDI. Utilization of a more rapid and sensitive chromogenic medium will aid in the dianogsis of CDI.
Chromogenic Compounds/chemistry ; Clostridium difficile/chemistry/*isolation & purification ; Culture Media/*chemistry

We report a recent case in which ciprofloxacin-resistant Shigella flexneri was isolated from a 23-yr-old female patient with a history of travel to India. Prior to her admission to our internal medicine department, she experienced symptoms of high fever and generalized weakness from continuous watery diarrhea that developed midway during the trip. S. flexneri was isolated from the stool culture. Despite initial treatment with ciprofloxacin, the stool cultures continued to show S. flexneri growth. In the susceptibility test for antibiotics of the quinolone family, the isolate showed resistance to ciprofloxacin (minimum inhibitory concentration [MIC], 8 microg/mL), norfloxacin (MIC, 32 microg/mL), ofloxacin (MIC, 8 microg/mL), nalidixic acid (MIC, 256 microg/mL), and intermediate resistance to levofloxacin (MIC, 4 microg/mL). In molecular studies for quinolone resistance related genes, plasmid borne-quinolone resistance genes such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB were not detected. Two mutations were observed in gyrA (248C-->T, 259G-->A) and 1 mutation in parC (239G-->T). The molecular characteristics of the isolated S. flexneri showed that the isolate was more similar to the strains isolated from the dysentery outbreak in India than those isolated from Korea.
Anti-Bacterial Agents/pharmacology ; Bacterial Proteins/genetics/metabolism ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/microbiology ; Feces/microbiology ; Female ; Humans ; India ; Mutation ; Quinolones/*pharmacology ; Shigella flexneri/drug effects/*isolation & purification/metabolism ; Travel ; Young Adult

In the RNA-based study, it is important to extract high-quality RNA. However, RNA extraction from Mycobacterium tuberculosis is problematic due to its thick, waxy cell wall rich in mycolic acid, which renders the cells resistant to lysis. Using TRIzol reagent and several powerful bead-beating steps, a high quantity of RNA was obtained.
Cell Wall ; Mycobacterium tuberculosis* ; Mycobacterium* ; Mycolic Acids ; RNA*

It is not a common case for neurosurgery department and the other departments to perform joint operation at the same time. Patients with severe head injury are a condition in which vital signs are unstable due to severe brain swelling and increased intracranial pressure, and emergency surgery is required. A 44-year-old man visited the trauma center with a motorcycle accident. The Glasgow Coma Scale score at the time of emergency department was 3 points, and the pupil was fixed at 6 mm on both sides. His medical history was unknown. His vital signs including blood pressure (BP), heart rate, respiratory rate and oxygen saturation were stable. Associated injuries included multiple fractures of whole body. Brain computed tomography revealed subarachnoid hemorrhage, intraventricular hemorrhage and severe cerebral edema. During the preparation of the craniectomy, abdominal ultrasonography performed because of decreased BP resulted in a large amount of hemoperitoneum. The bi-coronal craniectomy and splenectomy were performed simultaneously for about 4 hours. After fifty days of treatment, he was discharged with Glasgow Outcome Scale-extended 4 points and is undergoing rehabilitation. In severe polytrauma patients, active concurrent surgery is a good method to save their lives.
Adult ; Blood Pressure ; Brain ; Brain Edema ; Craniocerebral Trauma* ; Emergencies ; Emergency Service, Hospital ; Fractures, Multiple ; Glasgow Coma Scale ; Head* ; Heart Rate ; Hemoperitoneum ; Hemorrhage ; Humans ; Intracranial Pressure ; Joints ; Methods ; Motorcycles ; Multiple Trauma ; Neurosurgery ; Oxygen ; Pupil ; Rehabilitation ; Respiratory Rate ; Splenectomy* ; Subarachnoid Hemorrhage ; Trauma Centers ; Ultrasonography ; Vital Signs

BACKGROUND: Transfusion service, as a task directly affecting the patient's life, must be performed as expeditiously as possible. However, for various reasons, we have experienced difficulty in supplying blood products in a timely manner. In this study, we analyzed the turnaround time (TAT) of blood issue and attempted to find a solution. METHODS: We evaluated the TATs for the request and preparation of blood transfusions in our hospital from January to December 2011. The time of blood issue, from acceptance of the request to preparation in the blood bank, was calculated from computerized medical records. In cases in which the TAT exceeded 24 hours, we investigated the type of blood component and the cause of the delay. RESULTS: A total of 12,856 units of blood were issued during the study year. Of these, 1,333 units (10.4%) had TATs exceeding 24 hours. These units included 148 units of red blood cells (RBC) (2.1%), 49 units of leukocyte-filtered red blood cells (F-RBC) (69.0%), 92 units of fresh frozen plasma (FFP) (3.9%), six units of cryoprecipitates (CRYO) (7.4%), 818 units of platelets (PLT) (27.1%), and 220 units of apheresis platelets (A-PLT) (66.5%). The preparation times for PLT and A-PLT were more delayed. The cause of the delays was lack of inventory at the blood center. CONCLUSION: We recommend that the blood center keep blood products even at the risk that they will be discarded for exceeding the expiration date. In addition, we suggest that testing of donated blood be performed within the region.
Blood Banks ; Blood Component Removal ; Blood Platelets ; Blood Transfusion ; Erythrocytes ; Medical Records Systems, Computerized ; Plasma

BACKGROUND: Transfusion service, as a task directly affecting the patient's life, must be performed as expeditiously as possible. However, for various reasons, we have experienced difficulty in supplying blood products in a timely manner. In this study, we analyzed the turnaround time (TAT) of blood issue and attempted to find a solution. METHODS: We evaluated the TATs for the request and preparation of blood transfusions in our hospital from January to December 2011. The time of blood issue, from acceptance of the request to preparation in the blood bank, was calculated from computerized medical records. In cases in which the TAT exceeded 24 hours, we investigated the type of blood component and the cause of the delay. RESULTS: A total of 12,856 units of blood were issued during the study year. Of these, 1,333 units (10.4%) had TATs exceeding 24 hours. These units included 148 units of red blood cells (RBC) (2.1%), 49 units of leukocyte-filtered red blood cells (F-RBC) (69.0%), 92 units of fresh frozen plasma (FFP) (3.9%), six units of cryoprecipitates (CRYO) (7.4%), 818 units of platelets (PLT) (27.1%), and 220 units of apheresis platelets (A-PLT) (66.5%). The preparation times for PLT and A-PLT were more delayed. The cause of the delays was lack of inventory at the blood center. CONCLUSION: We recommend that the blood center keep blood products even at the risk that they will be discarded for exceeding the expiration date. In addition, we suggest that testing of donated blood be performed within the region.
Blood Banks ; Blood Component Removal ; Blood Platelets ; Blood Transfusion ; Erythrocytes ; Medical Records Systems, Computerized ; Plasma

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.
Adult* ; Blood Pressure ; Body Weight ; Diabetes Mellitus* ; Diagnosis ; Fasting* ; Female ; Glucose* ; Humans ; Logistic Models ; Male ; Overweight ; Prevalence* ; Risk Factors* ; Seoul ; Triglycerides

BACKGROUND: Bipolar hip hemiarthroplasty (BH) was known to require a large amount of transfusion. And, patients who underwent BH were extreme old age and had underlying medical diseases such as hypertension and diabetes mellitus. The aim of this study was to evaluate packed RBC (Red blood cell) transfusion and pre- and intraoperative variables during BH in elderly patients over 75 years in one university hospital. METHODS: A total of 36 patients who underwent BH from September 2013 to August 2014 in our hospital were evaluated through a retrospective study using computerized medical records and archived documents. RESULTS: Average age of patients was 81.5+/-5.3 years and packed RBC transfusion was performed in 41.6% of all enrolled patients. There was no significant difference in age, weight, height, and time of operation between transfused patients and non-transfused patients. Intraoperative volume of packed RBC transfusion was 0.6 (minimum value: 0, maximum value: 4) units. CONCLUSION: Preparation of blood components such as packed RBC is required in elderly patients over 75 years who were planned BH.
Aged* ; Diabetes Mellitus ; Hemiarthroplasty* ; Hip ; Humans ; Hypertension ; Medical Records Systems, Computerized ; Retrospective Studies