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Comparison of lidocaine with articaine buccal injection in reducing complications following impacted mandibular third molar surgery: a split-mouth randomized clinical trial

  • Naghipour, Amin;Esmaeelinejad, Mohammad;Dehnad, Seyed Vahid;Shahi, Anahita;Jarrahi, Alireza
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.213-221
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    • 2020
  • Background: Complications following impacted third molar surgery significantly affect patients' quality of life during the immediate postoperative period. This study aimed to achieve the proper anesthesia method by comparing the effect of the application of lidocaine alone with the application of lidocaine and articaine simultaneously in reducing the complications during and following impacted mandibular third molar surgery. Methods: The study design was a split-mouth double-blind randomized clinical trial. The study was conducted on 13 patients (26 samples) referred for elective surgical removal of bilateral impacted mandibular third molar with similar difficulty on both sides. Each patient underwent similar surgical procedures on two separate appointments. Each patient randomly received 2% lidocaine for conventional inferior alveolar nerve block and 4% articaine for local infiltration before the surgery on one side (group A) and 2% lidocaine alone (for both block anesthesia and infiltration) before the surgery on the other side (group B). Intraoperative and postoperative variables for both groups were established and statistically analyzed. Results: The findings showed that pain on the first day after surgery in group A was significantly lower than that in group B. The patients in group A mentioned experiencing less discomfort following the surgery. The increased horizontal swelling on the first and third days following surgery and oblique swelling on the seventh day in patients in group B were statistically significant. Conclusion: Choosing an appropriate anesthetic drug for oral surgery, specifically impacted third molar surgery, is dependent on the clinician's opinion, however; it seems that the combination of lidocaine and articaine may control the patient's pain significantly better than lidocaine alone.

A prospective randomized trial of xylometazoline drops and epinephrine merocele nasal pack for reducing epistaxis during nasotracheal intubation

  • Patel, Sonam;Hazarika, Amarjyoti;Agrawal, Prachi;Jain, Divya;Panda, Naresh Kumar
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.223-231
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    • 2020
  • Background: The most frequent complication of nasotracheal intubation (NTI) is epistaxis. Epinephrine nasal gauze packing has been used conventionally as a pre-treatment for reducing epistaxis, but it carries a disadvantage of pain and anxiety in patients. However, xylometazoline drops are easier to administer and more convenient for patients. We aimed at comparing the effectiveness of xylometazoline drops and epinephrine merocele packing in reducing bleeding and postoperative complications in our population. Methods: Our study enrolled 120 patients in a double-blind randomized controlled trial. We randomly allocated ASA1 or 2 adult patients into 2 groups: Group X and Group E. Group X received 0.1% xylometazoline nasal drops, and epinephrine (1:10,000) merocele nasal packing was used in Group E. The primary outcome was the incidence of bleeding during NTI; the severity of bleeding, navigability, bleeding during extubation, and postoperative complications were secondary outcomes. We used IBM SPSS and Minitab software for statistical analysis, and P < 0.05 was considered statistically significant. Results: We analyzed the data of 110 patients: 55 in Group X and 55 in Group E. The two groups did not have different bleeding incidence (56.4% vs 60.0%; P = 0.70); however, the incidence of severe bleeding was less with xylometazoline than with epinephrine (3.63% vs 14.54%; P < 0.05). We also observed less bleeding during extubation (38.2% vs 68.5%; P < 0.05) with xylometazoline. Other secondary outcomes were akin to both groups. Conclusion: The incidence of severe and post-extubation bleeding was significantly less with xylometazoline. Hence, it may be an effective alternative for reducing the incidence and severity of epistaxis during NTI.

A Randomized Controlled Clinical Trial of Topical Herbal Gel Treatment for Chronic Shoulder Pain (만성 어깨 통증의 한약 추출 외용 젤 치료에 대한 임상연구)

  • Jo, Su Jeong;Choi, Young Doo;Jang, Jin Taek;Kim, Kap Sung;Lee, Seung Deok
    • Journal of Acupuncture Research
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    • v.31 no.4
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    • pp.1-9
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    • 2014
  • Objectives : The aim of this study is to evaluate the efficacy of a topical herbal gel application for the treatment of chronic shoulder pain. Methods : We compared the effects of Dapureo gel, which contains several herbal medicines known to improve shoulder pain, with those of placebo gel by double-blind method. 30 participants were randomized - 15 were assigned to treatment group and the other 15 were assigned to control group. Either Dapureo gel(treatment group) or placebo gel(control group) was applied topically by themselves, once a day for 2 weeks. Primary outcome was daily visual analogue scale(VAS) changes for shoulder pain which was self-reported for 2 weeks. Secondary outcome was the difference in the total shoulder pain and disability index(SPADI) which was measured at a baseline and 2 weeks after the treatment. Results : Primary outcome: Subjects of treatment group showed statistically significant improvement in VAS compared to control subjects continuously from the second day(p <0.05) to the fifteenth day(p <0.001). The treatment group showed 31% of pain reduction on the fifteenth day, while the control group showed only 7%. Secondary outcome: In terms of SPADI changes, the treatment group showed improvement compared to the control group(p <0.01). Conclusions : These results suggest that the topical herbal gel treatment used in this study is effective in improving chronic shoulder pain.

The Effects of 30-Minutes of Pre-Warming on Core Body Temperature, Systolic Blood Pressure, Heart Rate, Postoperative Shivering, and Inflammation Response in Elderly Patients with Total Hip Replacement under Spinal Anesthesia: A Randomized Double-blind Controlled Trial (30분의 수술전 가온이 고관절 전치환술 노인 환자의 수술중 심부체온, 수축기압, 심박동수, 수술후 전율 및 염증반응에 미치는 효과)

  • Cheon, You Mi;Yoon, Haesang
    • Journal of Korean Academy of Nursing
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    • v.47 no.4
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    • pp.456-466
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    • 2017
  • Purpose: This study was designed to determine the effects of pre-warming on core body temperature (CBT) and hemodynamics from the induction of spinal anesthesia until 30 min postoperatively in surgical patients who undergo total hip replacement under spinal anesthesia. Our goal was to assess postoperative shivering and inflammatory response. Methods: Sixty-two surgical patients were recruited by informed notice. Data for this study were collected at a 1,300-bed university hospital in Incheon, South Korea from January 15 through November 15, 2013. Data on CBT, systemic blood pressure (SBP), and heart rate were measured from arrival in the pre-anesthesia room to 3 hours after the induction of spinal anesthesia. Shivering was measured for 30 minutes post-operatively. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured pre-operatively, and 1 and 2 days postoperatively. The 62 patients were randomly allocated to an experimental group (EG), which underwent pre-warming for 30 minutes, or a control group (CG), which did not undergo pre-warming. Results: Analysis of CBT from induction of spinal anesthesia to 3 hours after induction revealed significant interaction between group and time (F=3.85, p=.008). In addition, the incidence of shivering in the EG was lower than that in the CG ($x^2=6.15$, p=.013). However, analyses of SBP, heart rate, CRP, and ESR did not reveal significant interaction between time and group. Conclusion: Pre-warming for 30 minutes is effective in increasing CBT 2 and 3 hours after induction of spinal anesthesia. In addition, pre-warming is effective in decreasing post-operative shivering.

Potential Safety Benefit Analysis of Cooperative Driver Assistance Systems Via Vehicle-to-vehicle Communications (협력형 차량 안전 시스템의 잠재적 안전 효과 분석 연구)

  • Kang, Ji woong;Song, Bongsob
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.17 no.2
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    • pp.128-141
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    • 2018
  • In this paper, a methodology to analyze the potential safe benefit of six cooperative driver assistance systems via V2V (vehicle-to-vehicle) communications is proposed. Although it is quite necessary to assess social impact with respect to new safety technologies for cooperative vehicles with V2V communications, there are few studies in Korea to predict the quantitative safety benefit analysis. In this study, traffic accident scenarios are classified based on traffic fatality between passenger cars. The sequential collision type is classified for a multiple pile-up with respect to collision direction such as forward, side, head-on collisions. Then movement of surrounding vehicle is considered for the scenario classification. Next, the cooperative driver assistance systems such as forward collision warning, blind spot detection, and intersection movement assistance are related with the corresponding accident scenarios. Finally, it is summarized how much traffic fatality may be reduced potentially due to the V2V communication based safety services.

A Study on Reliability and Evaluate Deficiency and Excess on Visual Inspection of Eyes (안진(眼診)을 통한 허실(虛實) 평가 및 신뢰도 연구)

  • Seo, Jae-Ho;Choi, Jin-Yong;Oh, Whan-Sup;Park, Young-Bae;Park, Young-Jae
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.18 no.1
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    • pp.1-10
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    • 2014
  • Objectives Visual inspection is the first diagnostic method in Oriental medicine, and visual inspection of eyes is the one among them. This study was written in order to complement further understanding on visual inspection of eyes. Methods 1. Out of 102 photographs submitted to the Society of HyungSang Medicine in 2009, 27 portrait pictures were selected as samples in blind by 2 clinicians. The samples were copied to make 54 sample pictures, and then randomly assigned to 4 clinicians. 2. The 4 clinicians evaluated the 54 samples for excess and deficiency of the eyes. The results were recorded as 5-points-scale, and their average and standard deviation was calculated. 3. Intra and inter class reliability test were measured using SPSS 13. Results For intra- and inter-class correlation coefficient (ICC) values were measured as 0.654~0.967 and 0.756~ 0.783 respectively, with the P-value below 0.05. Out of 27 originally selected samples, 7 pictures were selected as Deficiency Samples (with 3 pictures of male and 4 of females), and 20 as Excess Samples (with 4 of male and 16 of female). Among them, Sample No. 1, 9, 22, and 26 were selected as models of 'Excessive Eyes' for females, no. 4 and 5 as 'Very Excessive Eyes' for male and females, and no. 15 as 'Moderate Eyes' for females. Conclusion This study is the first attempt of quantitative measurement of excess and deficiency using the Visual Inspection of eyes by the visual inspection experts. Still, additional studies are needed regarding the relationship visual inspection methods have with existing standards of diagnosis.

Independent Component Analysis of Fixed-Point Algorithm for Clustering Components Using Kurtosis (첨도를 이용한 군집성을 가진 고정점 알고리즘의 독립성분분석)

  • Cho, Yong-Hyun;Kim, A-Ram
    • The KIPS Transactions:PartB
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    • v.11B no.3
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    • pp.381-386
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    • 2004
  • This paper proposes an independent component analysis(ICA) of the fixed-point(FP) algorithm based on Newton method by adding the kurtosis. The kurtosis is applied for clustering the components, and the FP algorithm of Newton method is applied for improving the analysis speed and performance. The proposed ICA has been applied to the problems for separating the 6-mixed signals of 500 samples and 8-mixed images of $512\times512$pixels, respectively. The experimental results show that the proposed ICA has always a fixed analysis sequence. The result can be solved the limit of conventional ICA which has a variable sequence depending on the running of algorithm. Especially, the proposed ICA can be used to classify and identify the signals or the images.

Ensuring the Evacuation Path Based on Inundation & Refuge Approach Vulnerability Analysis in Residential Buildings - Focused on Daegu Bukgu Inundation Case District - (침수 시 주거용 건축물에서 대피시설로의 접근 취약성 분석을 통한 피난경로 확보방안 - 대구시 북구 침수 사례지를 중심으로 -)

  • Lee, Ji-Soo;Hong, Won-Hwa;Kim, Gwang-Seob
    • Journal of the Korean housing association
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    • v.23 no.5
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    • pp.1-8
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    • 2012
  • Recently, there have been frequent occurrence of the damage to lives and properties due to the torrential rain caused by climate change. In consideration of the current situations in which the underlying data related to flooding are lacking, this study conducted to build up the basic data on the flooded areas and suggested methods to secure the evacuation routes that can be accessible to evacuation facilities in the residential buildings. Methods of the study are as follows. First, We calculated the flood risk grades of residential buildings based on elevations, considering the flooding characteristics of the flooded areas in Buk-gu, Daegu. Second, We constructed baseline data on the evacuation routes through site investigation and reviewed of drawing using Arc GIS to identify vulnerability to access to the evacuation facilities, targeting the residential buildings. Third, We carried out the proximity analysis through a near analysis of analysis functions in ARC GIS. Forth, We deduced 115 residential buildings in which access to evacuation facilities is considered to be difficult based on the analysis results. Finally, We proposed extension of a blind alley as a means for achieving connectivity to evacuation facilities. And to evaluate the alternatives presented, we reconstructed route data. As a result, about 53% improvement was identified through the proximity analysis.

A New Carrier frequency Offset Estimation Using CP-ICA Scheme in OFDM Systems (OFDM 시스템에서 CP-ICA 기법을 이용한 새로운 주파수 옵셋 추정)

  • Kim, Jong-Deuk;Byun, Youn-Shik
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.31 no.12C
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    • pp.1257-1264
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    • 2006
  • The carrier frequency offset causes loss of orthogonality between sub-carriers, thus leads to inter-carrier interference (ICI) in the OFDM symbol. This ICI causes severe degradation of the BER performance of the OFDM receiver. In this paper, we propose a new ICI cancellation algorithm which estimates frequency offset at the time-domain by using CP-ICA method to the received sub-carriers phase rotation. This algorithm is based on a statistical blind estimation method, which mainly utilizes the EVD, rotating phase and the $4^{th}-cumulants$. Since our scheme does not need any training and pilot symbol in estimation, we can expect enhanced bandwidth efficiency in OFDM systems. Simulation results show that the proposed frequency offset estimator is more accurate than the other estimators in $0.0<\varepsilon<1.0$.

Systemic Review of Hyaluronate for the Treatment of Osteoarthritis (골관절염 치료제 히알우론산 임상연구결과의 Systemic Review)

  • Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.38-45
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    • 2007
  • Background: The multitude of the therapeutic usefulness of intra-articular injection of hyaluronate on oateoarthritis of the knee is still in question. The objective of this systemic review was to elucidate both the therapeutic efficacy and the safety of intra-articular administration of hyaluronic acid for degenerative osteoarthritis of the knee joints. Methods: I searched MEDLINE and Korea Medical Database (KMbase) from January 1990 to April 2007 using a combination search terms for knee osteoarthritis and hyaluronic acid and a filter for randomized controlled trials. I extracted data on pain at rest, and during or just after movement, on joint function, and on adverse events. Results: Ten trials that reported usable quantitative information on any of the predefined end points were identified and included in the systemic review. Intra-articular injection of hyaluronic acid can decrease symptoms of osteoarthritis of the knee. The study revealed significant improvements in pain and functional outcomes with few adverse effects. However, there was significant between-study heterogeneity in the estimates of the efficacy of hyaluronic acid. Sub-group analysis showed that lower methodological quality such as a single-blind or single-center design resulted in higher estimates hyaluronic acid efficacy, and that patients older than sixty years of age and those with the most advanced radiographic stage of osteoarthritis were less likely to benefit from intra-articular injection of hyaluronic acid. Conclusion: According to the currently available evidence, intra-articular hyaluronic acid has been proven clinically effective for the patients bearing the knee osteoarthritis with NSAID-induced GI troubles or inapplicable to any surgery, and may be associated with lower risk of adverse events.

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