Factors Influencing on Quality of Sleep among Patients at Surgical Intensive Care Units / 성인간호학회지

PURPOSE: This study was conducted to evaluate quality of sleep and to assess the factors that influence quality of sleep in surgical ICU. METHODS: The subject of the study were consisted 109 adult patients who admitted to surgical ICU. The data were collected from May 20 to December 10, 2007 by structured questionnaires. The data were analyzed with descriptive analysis, paired t-test, Pearson correlation coefficient and stepwise multiple regression. RESULTS: The score of quality of sleep was 4.57 point. The main sleep disturbance factors related to quality of sleep in surgical ICU inpatient were sleep time, machinery alarm and noise(adjusted R2=33.2). CONCLUSION: Based on the finding of this study, it is needed to develop a nursing intervention program that including to promote quality of sleep and to decrease machinery alarm and noise in surgical ICU.

Usefulness of Resistive Index and Pulsatility Index in Patient with Diabetic Nephropathy as Early Markers / 대한신장학회잡지

BACKGROUND: Diabetic nephropathy has long been known as most common culprit of ESRD. In NIDDM, histopathologically intrarenal hemodynamic changes are nonspecific, frequently with global glomerulosclerosis, interstitial fibrosis, tubular atrophy and severe arterosclerosis. Duplex renal Doppler sonography is useful in the noninvasive assessment of intrarenal hemodynamic change and Doppler indices reflect increased renal vascular resistance. So we compared the values of R.I. and P.I., in NIDDM patients, with several clinical parameters to identify that R.I. and P.I. values can reflect increased renal vascular resistance and predict diabetic nephropathy as early markers. METHODS: Renal Doppler US scan was performed on 40 patients with NIDDM to obtain Doppler signals from arcuate artery or interlobar artery and thereby calculate the R.I. and P.I. From every each individual, clinical and laboratory data including age, sex, morbidity period, BMI, mean blood pressure, total cholesterol, serum creatinine, BUN, HbA1c, 24 hr urine protein and creatinine clearance were analyzed. We analyzed the correlation between values of R.I. and P.I. with clinical parameters by using univariate and multiple linear regression analysis. The patients were classified as three groups on the basis of the amount of 24 hour urine protein and value of serum creatinine : Group 1(n=15) was defined as patients with 24 hr urine protein less than 150mg/day and serum creatinine less than 1.5mg/ dL, group 2(n=12) as between 150mg/day and 500mg/ day and serum creatinine less than 1.5mg/dL and group 3(n=13) as more than 500mg/day or serum creatinine above 1.5mg/dL. RESULTS: 1) R.I. values showed correlation with age, morbidity period, mean blood pressure, HbA1c, serum creatinine, BUN, creatinine clearance and 24 hour urine total protein. P.I. values showed correlation with age, morbidity period, mean blood pressure, serum creatinine, BUN, creatinine clearance and 24 hour urine total protein. 2) R.I. and P.I. values were significantly affected by creatinine clearance and age in multiple regression analysis. 3) There were statistically positive correlation between 24 hour urine protein and R.I. and P.I.. But when we divided into three groups based on their amount of 24 hour urine protein. R.I. didn't show statistical correlation but P.I. showed significant correlation in the group of patients with proteinuria over 500mg/day(p<0.05). CONCLUSION: Renal doppler indices reflect increased renal vascular resistance in NIDDM patients and correlate with clinical parameters of diabetic nephropathy. We suggest that the R.I. and P.I. are useful marker for indicating diabetic vascular complication in NIDDM patients. However, further comparative studies should be carried out to elucidate the usefulness of R.I. and P.I. as early markers or advantaging parameters in predicting diabetic nephropathy.

Free Cancer Cell Detection in Peritoneal Cavitr of Gastric Cancer Patients by RT-PCR for CEA / 대한암학회지

PURPOSE: This study is aimed to evaluate the efficacy of a novel method (RT-PCR for CEA) to diagnose free cancer cells in peritoneal cavity of gastric cancer patients, which can be used as a indication of prophylactic treatment to prevent peritoneal recurrence after curative resection of gastric cancer. MATERIALS AND METHODS: 114 gastric adenocarcinoma patients were included for this study. With pellet of peritoneal washing fluid, cytology and RT-PCR for CEA were performed with specific primers. RESULTS: Positive rate of PCR as a whole was 55.3% (63 cases); however, that of cytology was 15.8% (18 cases). Positive rate of PCR increased with depth of invasion of the lesion (p=0.026); however, that of cytology didn't (p=0.233). In early gastric cancer and seeding cases, PCR was not more sensitive than cytologic examination in detection of free cancer cell, but in pm, ss and si cancers, PCR was much more sensitive than cytology (p<0.001). CONCLUSION: PCR was more sensitive to diagnose free cancer cells in peritoneal cavity of gastric cancer patients especially in pm, ss and si cancers than conventional cytologic examination, and it can be a good candidate of indication of prophylactic treatment to prevent peritoneal recurrence after curative resection.