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The Prognostic Factors Influencing on the Therapeutic Effect of Percutaneous Vertebroplasty in Treating Osteoporotic Vertebral Compression Fractures

  • Ryu, Kyeong-Sik;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.45 no.1
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    • pp.16-23
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    • 2009
  • Objective : This retrospective study of 215 patients with 383 symptomatic osteoporotic vertebral compression fractures (VCFs) treated by percutaneous vertebroplasty (PVP), was performed to evaluate the clinical outcomes, and to analyze the various clinical factors affecting these results. Methods : The authors assessed the clinical outcome under the criteria such as the pain improvement, activity, requirement of analgesics, and the patient's satisfaction, and determined the relation to various peri- and intra-operative factors, and postoperative imaging findings. Results : The outcome was determined as 84.2% in relief of pain, 72.0% in change in activity, 65.7% in analgesics use, and 84.7% of satisfaction rate. More severe focal back pain, high uptake bone scan, and the lower mean T-score were related to the better pain relief following PVP. The longer the duration between fracture and PVP, the less severe focal back pain, low uptake bone scan, and leakage of PMMA into the paravertebral space were related to the less improvement in activity. Female and low uptake bone scan showed a correlation with more analgesic use. The longer the duration between fracture and PVP, low uptake bone scan, and the higher the mean T-score were correlated with the less the patients satisfaction. Conclusion : Our study suggests that PVP may be more effective in the acute phase of VCFs, more severe focal pain, and far advanced osteoporosis on BMD. Leakage of PMMA into the paravertebral spcae also could be affecting the surgical results.

The Effect of the Treatment with Venesection on Treating Low Back Pain of Acute Stage (급성기(急性期) 요통(腰痛)의 치료(治療)에 자락요법(刺絡療法)의 병행(竝行)이 미치는 영향(影響))

  • Song, Hyong-gun;Song, Min-sik;Kim, Jeong-ho;Kang, Jae-hui;Kim, Young-hwa;Kim, Young-il;Hong, Kwon-eui;Lee, Hyeon;Lee, Hwan-dong
    • Journal of Acupuncture Research
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    • v.21 no.5
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    • pp.113-122
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    • 2004
  • Objective : This study is designed in order to evaluate the therapeutic effect of venesection on acute low back pain. Methods : From Nov. 1st 2003 to Apr. 30th 2004, 40 cases of low back pain patients at acute stage were divided into 2 groups; one group(control group) took only acupuncture therapy, and the other group(test group) took acupuncture and venesection therapy. Pain rating score(PRS) was used to assess the pain for its intensity, frequency, duration, and aggravating factors. And visual analog scale(VAS) was used, too. PRS and VAS was checked twice, before the treatment and after the treatment. Treatment was done twice a day. Results : Both acupuncture therapy and acupuncture with venesection therapy showed good effect on low back pain of acute stage. And the latter group showed better effect on decreasing pain than former. It was proved by the difference between PRS and VAS checked before treatment and what checked after treatment. But it was not proved statistically. Conclusion : Only acupuncture and acupuncture with venesection can be recommended as a useful therapy to treat low back pain of acute stage.

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Ventilator-Associated Pneumonia (인공호흡기연관 폐렴)

  • Jeon, Kyeong-Man
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.3
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    • pp.191-198
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    • 2011
  • Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

Child Care Teachers' Reflective Assessment on Practical Training Experiences (보육교사의 실습지도 경험에 관한 반성적 평가)

  • You, Byoungye;Yang, Sungeun
    • Journal of Families and Better Life
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    • v.31 no.5
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    • pp.143-157
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    • 2013
  • This study used a qualitative research method to comprehensively deal with child care training in depth with the following content: the goals of child care teachers preparing for practical training; how they perform and feel about their roles throughout the training period as child care teachers; and their evaluation after the training period. A total of 10 people participated in the research and the training activities of child care teachers were qualitatively explored based on the results. The research findings are as follows. First, child care teachers have expectations for prospective teachers and take time for self-evaluation while preparing for teaching. Also, child care teachers set a goal of helping prospective teachers develop into outstanding teachers and have expectations for it. Second, child care teachers evaluate prospective teachers by treating them as colleagues while teaching them. Furthermore, child care teachers consider themselves as educators who train and produce child care professionals. Prospective teachers define their roles as assistants and learners in the actual educational scene. In addition, child care teachers feel a sense of pride by performing as hands-on training teachers. At the same time, they reflect on themselves by evaluating their duties as educators in their relationships with prospective teachers. Third, child care teachers suggested the need for changing the training system for themselves and prospective teachers after training. In addition, they argued that the gaps between school education and the actual educational scene should be reduced through solid training for acquiring new knowledge and information in both places in accordance with the rapidly-changing child care environment. Finally, the suggested the necessity of establishing a standard training curriculum and educational programs within their institution.

Full mouth prosthodontic reconstruction on patient with occlusion collapse & decreased vertical dimension (교합 붕괴 환자의 수직고경거상을 동반한 완전 구강회복 증례)

  • Yoo, H.J.;Choi, M.H.;Kim, C.H.;Park, Y.R.;Kang, D.W.
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.2
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    • pp.115-124
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    • 2003
  • One of the important things in the full mouth reconstruction is the determination of therapeutic position. Centric jaw relation is used as a therapeutic position for the full mouth reconstruction. There are several techniques associated with recording this position. Five clinically acceptable techniques are as follows: 1) Swallowing or free closure, 2) Chin point guidance, 3) Bimanual method 4) Myo-monitor technique, 5) Anterior deprogrammer. Centric relation obtained utilizing the anterior acrylic resin platform in this case. Another important thing in full mouth reconstruction is provisional restoration. Provisional restorations are an excellent diagnostic instrument, especially in full remain esthetics, phonetics, function, parafunction, and dysfunction after evaluation and acceptance through clinical trial with the provisional restorations should be accurately transferred to the final restorations to ensure the same clinical success. Especially, anterior guidance should be accurately transferred to the final restorations. An accurate anterior guidance is critical for optimal esthetics, phonetics, comfort, function, stress minimization, and longevity of teeth and restorations. To record optimum anterior guidance, customized anterior guide table is used in this case. Considering previously mentioned points, we did successive treatment. And it resulted in a better situation esthetically and functionally. Followings are what we cared in treating a patient in this case. 1) Accurate centric relation recording 2) Accurate transference of anterior guidance to the final restorations.

Design of Space-Time Trellis Code with Uniform Error Property (균일 오율의 시공간 격자상 부호 설계)

  • Jung Young-Seok;Lee Jae-Hong
    • Journal of the Institute of Electronics Engineers of Korea TC
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    • v.43 no.8 s.350
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    • pp.59-68
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    • 2006
  • The study on the uniform error property of codes has been restricted to additive white Gaussian noise (AWGN) channel, which is generally referred to as geometrical uniformity. In this paper, we extend the uniform error property to space-time codes in multiple-input multiple-output (MIMO) channel by directly treating the probability density functions fully describing the transmission channel and the receiver. Moreover, we provide the code construction procedure for the geometrically uniform space-time trellis codes in fast MIMO channels, which consider the distance spectrum. Due to the uniform error property, the complexity of code search is extensively reduced. Such reduction makes it possible to obtain the optimal space-time trellis codes with high order states. Simulation results show that new codes offer a better performance in fast MIMO channels than other known codes.

Haploidentical hematopoietic stem cell transplantation in children and adolescents with acquired severe aplastic anemia

  • Im, Ho Joon;Koh, Kyung-Nam;Seo, Jong Jin
    • Clinical and Experimental Pediatrics
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    • v.58 no.6
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    • pp.199-205
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    • 2015
  • Severe aplastic anemia (SAA) is a life-threatening disorder for which allogeneic hematopoietic stem cell transplantation (HSCT) is the current available curative treatment. HSCT from matched sibling donors (MSDs) is the preferred therapy for children with acquired SAA. For patients who lack MSDs, immunosuppressive therapy (IST) is widely accepted as a first-line treatment before considering HCT from an unrelated donor (URD). Given the recent progress in HSCT using URDs for childhood SAA, well-matched URDs became a realistic alternative for pediatric patients who have no suitable related donors and who are refractory to IST. However, it is quite challenging to treat patients with refractory SAA who lack suitable related or URDs. Even though haploidentical HSCT from genetically mismatched family members seemed to be an attractive procedure with the amazing benefit of readily available donors for most patients, early attempts were disappointing because of refractory graft-versus-host disease (GVHD) and excessively high transplant-related mortality. Recent advances with effective ex vivo depletion of T cells or unmanipulated in vivo regulation of T cells, better supportive care, and optimal conditioning regimens have significantly improved the outcome of haploidentical transplant. Besides considerable progress in the treatment of malignant diseases, recent emerging evidences for haploidentical HSCT in SAA has provided additional therapeutic options for patients with refractory diseases. Further improvements to decrease the rates of graft failure, GVHD, and infectious complications will facilitate the emergence of haploidentical HSCT as a front-line therapy for treating acquired SAA in children and adolescents who have no suitably matched donors.

PET-Based Molecular Nuclear Neuro-Imaging

  • Kim, Jong-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.2
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    • pp.161-170
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    • 2004
  • Molecular Nuclear Neuro-Imaging in "CNS" drug discovery and development tan be divided into four categories that are clearly inter-related.(1) Neuroreceptor mapping to examine the involvement of specific neurotransmitter system in CNS diseases, drug occupancy characteristics and perhaps examine mechanisms of action;(2) Structural and spectroscopic imaging to examine morphological changes and their consequences;(3) Metabolic mapping to provide evidence of central activity and "CNS fingerprinting" the neuroanatomy of drug effects;(4) Functional mapping to examing disease-drug interactions. In addition, targeted delivery of therapeutic agents could be achieved by modifying stem cells to release specific drugs at the site of transplantation('stem cell pharmacology'). Future exploitation of stem cell biology, including enhanced release of therapeutic factors through genetic stem cell engineering, might thus constitute promising pharmaceutical approaches to treating diseases of the nervous system. With continued improvements in instrumentation, identification of better imaging probes by innovative chemistry, molecular nuclear neuro-imaging promise to play increasingly important roles in disease diagnosis and therapy.

Exogenous Morphine Inhibits Human Gastric Cancer MGC-803 Cell Growth by Cell Cycle Arrest and Apoptosis Induction

  • Qin, Yi;Chen, Jing;Li, Li;Liao, Chun-Jie;Liang, Yu-Bing;Guan, En-Jian;Xie, Yu-Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1377-1382
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    • 2012
  • Morphine is not only an analgesic treating pain for patients with cancer but also a potential anticancer drug inhibiting tumor growth and proliferation. To gain better insight into the involvement of morphine in the biological characteristics of gastric cancer, we investigated effects on progression of gastric carcinoma cells and the expression of some apoptosis-related genes including caspase-9, caspase-3, survivin and NF-${\kappa}B$ using the MGC-803 human gastric cancer cell line. The viability of cells was assessed by MTT assay, proliferation by colony formation assay, cell cycle progression and apoptosis by flow cytometry and ultrastructural alteration by transmission electron microscopy. The influences of morphine on caspase-9, caspase-3, survivin and NF-${\kappa}B$ were evaluated by semi-quantitative RT-PCR and Western blot. Our data showed that morphine could significantly inhibit cell growth and proliferation and cause cell cycle arrest in the G2/M phase. MGC-803 cells which were incubated with morphine also had a higher apoptotic rate than control cells. Morphine also led to morphological changes of gastric cancer cells. The mechanism of morphine inhibiting gastric cancer progression in vitro might be associated with activation of caspase-9 and caspase-3 and inhibition of survivin and NF-${\kappa}B$.

Characteristics of Growth and Physiological Changes during Cold Treatment in Dormant Hanabusaya asiatica

  • Lee, Ho-Sun;Yoo, Dong-Lim;Ryu, Seung-Yeol;Sung, Jeong-Suk;Baek, Hyung-Jin;Lee, Young-Yi;Lee, Sok-Young
    • Korean Journal of Plant Resources
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    • v.24 no.3
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    • pp.292-297
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    • 2011
  • This experiment was carried out to investigate the appropriate chilling requirements for breaking dormancy by treating the dormant plant of Hanabusaya asiatica with low temperature ($4^{\circ}C$) for different time periods. The rates of sprouting and flowering were higher with longer treatment periods at low temperature. In addition, the growth and flowering of the plant were better when it was potted after treatment at a low temperature for 90 days. The abscisic acid levels and polyphenoloxidase activity of the dormant plant increased during the low temperature treatment, reached a climax 90 days and decreased thereafter. The catalase activity was the lowest after the low temperature treatment for 90 days and increased subsequently. The peroxidase activity increased and showed a sharp rise after the low temperature treatment for more than 90 days. Considering the physiological activities of the enzymes, the changes in the abscisic acid levels, and the characteristics of growth and flowering after sprouting of the plant, the appropriate cold periods required for breaking dormancy could be 90 days.