PURPOSE: This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients.METHOD: From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared.RESULTS: The study found a higher rate of the use of enteral nutrition in the NST group (χ²=45.60, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (χ²=3.33, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p =.004), and higher proportion of discharge with survival rates (χ²=18.26, p < .001) in the NST group.CONCLUSION: Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.
Classification ; Critical Care ; Critical Illness ; Education ; Enteral Nutrition ; Humans ; Incidence ; Intensive Care Units ; Methods ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition ; Prescriptions ; Pressure Ulcer ; Retrospective Studies ; Survival Rate

Voltage dependent calcium channels mediate wide variety of physiological functions including neurotransmitter release, neurite outgrowth, and gene expression in neurons. omega-Conotoxin-sensitive N-type calcium channels are exclusively expressed in nervous system and involved in the control of neurotransmitter release from neurons. In this experiment, I have investigated human chromosomal location and rat neuronal distribution of N-type voltage dependent calcium channel alpha1, subunit [alpha1B]. I have localized human alpha1B subunit gene to the long arm of chromosome 9[9q34] by fluorescent in situ hybridization. The distribution of rat alphaB1 subunit mRNA has been examined in the rat brain by in situ hybridization histochemistry and high level of alpha1B subunit mRNA has been observed in olfactory bulb, anterior olfactory nucleus, cerebral cortex, piriform cortex, hippocampus, dentate gyrus, parabrachial nucleus, and cerebellum and low level of expression was also found in other areas of rat brain.
Animals ; Arm ; Brain* ; Calcium Channels* ; Calcium Channels, N-Type ; Calcium* ; Cerebellum ; Cerebral Cortex ; Dentate Gyrus ; Gene Expression ; Hippocampus ; Humans ; In Situ Hybridization ; In Situ Hybridization, Fluorescence ; Nervous System ; Neurites ; Neurons ; Neurotransmitter Agents ; Olfactory Bulb ; Rats ; RNA, Messenger

In the 1960s, Sir John Charnley introduced to clinical practice his concept of low-friction total hip arthroplasty (THA). Although early designs were plagued by poor performance and even failure, there have been steady advances in implant designs, biomaterials, surgical techniques and an understanding of the biomechanical restoration of the hip; these advances have contributed to improvements in implant survival and clinical outcomes of THA in the past three decades. With improved wear resistance and mechanical reliability, a potential to last for at least 25 to 30 years are now available for THA. In this review, we focus on the evolution of THA and review current controversies and future directions of this procedure based on a single surgeon's 29-year of experience at a single institution.
Arthroplasty, Replacement, Hip ; Biocompatible Materials ; Hip

PURPOSE: The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. METHODS: Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. RESULTS: Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. CONCLUSION: A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.
Counseling ; Humans ; Informed Consent ; Students, Medical

BACKGROUND: Despite widespread recognition of the hazardous health effects of smoking, adolescent smoking continues to increase, emerging as a public health problem. However few studies have focused on smoking cessation programs for adolescent smokers. The purpose of this study was to measure the short-term effects of the adolescent smoking cessation program performed by the Seoul School Health Center. METHODS: Four hundred and twenty adolescent smokers referred from their schools from March to December of 1996 were assessed before and immediately after the program with a self-questionnaire. The data acquired from these 420 students was analyzed. RESULTS: Males were found to have a higher rate of daily smoking as compared with females. Middle school students had a earlier starting age than those of high school students. About 70% of the students had tried to stop smoking and about 1/3 had a high level of self-efficacy in stop smoking. More than 80% of the students were current alcohol drinkers and 10% ever had experience with other drugs. Many showed poor academic performance and low degree of satisfaction with their schools. More than 50% had experienced punishment at school Middle and high economic status were more common than low status, 73.3% had smokers in their families and 43.3% showed severe dysfunction in family APGA-R. Smoking cessation rate immediately after the program was 37.4%, highest in female high school students and lowest in male high school students Factors shown to be significantly associated with smoking cessation in males were school age, FTQ scores, presence of peer smokers, smoking and alcohol status, self-efficacy in stop smoking and degree of satisfaction with their schools. School age, presence of peer smakers, smoking and other drug use status, self-efficacy in stop smoking, academic performance, degree of satisfaction with their schools, experienoe of runaway from home, economic status and presence of smokers in their families were significant factors in females. Stepwise logistic regression showed that current alcohol users were less likely to succeed in smoking cessation and those with a higher level of self-efficacy in stop smoking were more likely to succeed in males. In females, high school students with higher economic status were more likely to succeed while those with smokers in their families or experience of runaway from home were less likely to succeed. CONCLUSIONS: To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of adolescent smokers. For more effectiveness, programs will need to comprehensively include the school, the family, peers, alcohol and other drug issues as well as smoking problem itself.
Adolescent* ; Child ; Female ; Homeless Youth ; Humans ; Logistic Models ; Male ; Motivation ; Program Evaluation ; Public Health ; Punishment ; School Health Services ; Seoul ; Smoke* ; Smoking Cessation* ; Smoking*

BACKGROUND: As childhood-onset obesity has been known to have a poor prognosis, and its prevalence is rapidly increasing, many children and adolescents are becoming concerned about obesity and try various weight control methods. This study assessed the experience and behaviors of weight control in obese adolescents. METHODS: A total of 732 among 840 obese students from 28 schools in Seoul metropolitan area were assessed with a self-administered questionnaire. RESULTS: Middle school students showed the highest trial rate of weight control. Elementary and high school girls showed significantly higher trial rates of weight control than boys(P<0.05). The methods more frequently used were physical exercise, and diet, drugs and other methods, and visits to obesity clinics in that order. Elementary school girls most frequently tried physical exercise while high school girls went on a diet most frequently. All groups of girls were dieting significantly more often than boys(P<0.05). High school girls were the most frequent users of drugs and other methods while elementary school boys and middle schoolgirls visited obesity clinics most frequently. Unhealthy weight control methods observed were monodiet(2.7%), fasting(1.9%), dieting pills(1.4%), and vomiting(0.1%). The mean number of weight control methods was decreased with increasing age. The possibility of overall weight control was significantly higher in girls, having higher weight dissatisfaction levels. The possibility of physical exercise was significantly higher in younger ages, having mother with a career and a family history of obesity. The possibility of dieting was significantly higher in girls, older ages, having higher obesity index. The possibility of using drugs and other methods was significantly higher if they had higher weight dissatisfaction levels and a family history of obesity. The possibility of visiting obesity clinics was significantly higher if they had higher obesity index. CONCLUSION: Although, exercise and diet were frequently chosen by obese adolescents for weight control, the munber unhealthy methods chosen were found to be higher and physical exercise decreased with increasing age. Therefore, an appropriate weight control program that is not detrimental to normal growth and development is called for in early adolescence.
Adolescent* ; Child ; Diet ; Exercise ; Female ; Growth and Development ; Humans ; Mothers ; Obesity ; Pediatric Obesity ; Prevalence ; Prognosis ; Seoul ; Surveys and Questionnaires

PURPOSE: To evaluate the prognostic factors that predict visual outcome in eyes with successfully repaired idiopathic macular hole (MH) using optical coherence tomography (OCT). METHODS: We studied 48 eyes with stage 3 or 4 idiopathic MH that had undergone vitrectomy. All cases had anatomic closures and were followed-up for 6 months or more. We analyzed the preoperative macular hole in terms of minimum diameter, stage, hole form factor (HFF), and macular hole index (MHI), as well as the postoperative OCT images of the repaired macular hole and their relevance to visual recovery. RESULTS: We found significant differences in the preoperative minimum diameter of MH, HFF, the postoperative OCT images of the repaired macular hole, and postoperative visual acuvity. In contrast, we found no statistically significant differences in the preoperative base MH diameter, stage, HFF, MHI, and their relevance to visual recovery. CONCLUSIONS: Minimum diameter of MH, HFF, and the postoperative OCT images of the repaired MH are significant prognostic factors after vitrectomy for the treatment of idiopathic MH.
Retinal Perforations* ; Tomography, Optical Coherence ; Vitrectomy*

No abstract available.
Arthritis ; Bacteremia* ; Female* ; Humans ; Knee Joint* ; Knee* ; Listeria monocytogenes* ; Listeria*

In the article cited above, upper part page in title page has an error. Ending page of the article should be 268, not 269.

BACKGROUND: Although neuromuscular blockade can influence the bispectral index (BIS) during anesthesia, there have been contradictory reports regarding its effects. The purpose of this study was to investigate whether a muscle relaxant affected the level of BIS during propofol anesthesia. METHODS: Forty-eight healthy patients undergoing elective surgery under general anesthesia were enrolled in this prospective, randomized, double-blind study. All patients received an effect-site targeted concentration of propofol via a TCI system that was titrated until loss of consciousness occurred. The patients then received either an injection of vecuronium (relaxant group, n = 24) or normal saline as a placebo (placebo group, n = 24) at 3 minutes after loss of consciousness. The BIS and electromyogram (EMG) activity were recorded from anesthetic induction to 4 minutes after injection of the vecuronium or placebo. RESULTS: The BIS significantly decreased after injection in both groups (P < 0.05), however, the decrease in the BIS was larger in the relaxant group than in the placebo group (P < 0.05). The decrease of EMG activity was not significantly different between the two groups after administration of vecuronium or placebo. CONCLUSIONS: During propofol induction of anesthesia, a muscle relaxant decreased BIS significantly without decreasing the EMG activity.
Anesthesia ; Anesthesia, General ; Double-Blind Method ; Humans ; Muscles ; Neuromuscular Blockade ; Propofol ; Prospective Studies ; Unconsciousness ; Vecuronium Bromide