• Title/Summary/Keyword: First-onset

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The impact of magnesium sulfate as adjuvant to intrathecal bupivacaine on intra-operative surgeon satisfaction and postoperative analgesia during laparoscopic gynecological surgery: randomized clinical study

  • Mohamed, Khaled Salah;Abd-Elshafy, Sayed Kaoud;El Saman, Ali Mahmoud
    • The Korean Journal of Pain
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    • v.30 no.3
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    • pp.207-213
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    • 2017
  • Background: Surgeon satisfaction and patient analgesia during the procedure of laparoscopic surgery are important issues. The aim of this work was to study if an intrathecal (IT) Bupivacaine combined with Magnesium sulfate may or may not provide good surgeon satisfaction in addition to improvement of intraoperative and postoperative analgesia. Methods: Sixty female patients were enrolled in this prospective, randomized, double-blind controlled clinical trial study. All patients were operated for gynecological laparoscopic surgery under spinal anesthesia. Patients were divided into two groups (Bupivacaine and Magnesium). Group Bupivacaine (30 patients) received intrathecal Bupivacaine 0.5% only (15 mg), while 30 patients in group Magnesium received intrathecal Bupivacaine (15 mg) in addition to intrathecal Magnesium sulfate (50 mg). The sensory block level, the intensity of motor block, the surgeon satisfaction, the intraoperative visual analog scale (VAS) for pain assessment, the postoperative VAS, and side effects were recorded during the intraoperative period and within the first 24 hours after surgery in the post-anesthesia care unit. Results: Surgeon satisfaction, intraoperative shoulder pain, postoperative pain after 2 h, and perioperative analgesic consumption (ketorolac) were significant better in group Magnesium than in group Bupivacaine. (P < 0.05). The onset of motor and sensory blocks was significant longer in group Magnesium than the other one. The incidence of PONV, pruritus and urinary retention was insignificant statistically between both groups. Conclusions: Magnesium sulfate if used intrathecally as an adjuvant to Bupivacaine would provide a better surgeon satisfaction and would improve the analgesic effect of spinal anesthesia used for gynecological laparoscopic surgery.

A case of spinal muscular atrophy typeⅡ (제 2 형 척수근위축증(SMA type II; Spinal muscular atrophy typeⅡ) 환아 1례에 대한 증례보고)

  • Jo Hyeong-Jun;Lee Jin-Yong;Kim Deok-Gon
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.1
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    • pp.197-204
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    • 2000
  • Neuromuscular disorders are common causes of weakness and hypotonia in the infantile period and in childhood. Accurate diagnosis of specific neuromuscular disorders depends first on identification of which aspect of the peripheral neuromuscular system is affected-the motor neuron in the spinal cord, the nerve root or peripheral nerve, the neuromuscular junction, or the muscle-and then on the determination of the etiology and specific clinical entity. Spinal muscular atrophy(SMA) is the most common autosomal-recessive genetic disorder lethal to infants. The three major childhood-onset forms of SMA are now usually called type I, type II and typeⅢ. Progression of the disease is due to loss of anterior horn cells, thought to be caused by apoptosis. Diagnosis is based on the course of the illness, as well as certain changes seen on nerve and muscle biopsy and electrodiagnostic studies. More recently, our understanding of the genetics of this disorder has provided a noninvasive approach to diagnosis. We report on a 3-year-old male patient with spinal muscular atrophy type II. He had progressive muscular weakness since 18 months of age. The upper arms were slightly, and the thighs moderately atrophic. There was muscle weakness of both the upper and lower limbs, being more proximal in distribution. Electromyogram revealed a neurogenic pattern.

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A Study on Maritime Claims based on the ICOW Project and Its Implications to the Dokdo Issue (ICOW 데이터를 활용한 해양관할권 분쟁 연구 동향 및 독도 문제에 대한 함의)

  • Han, Jong-Hwan
    • Strategy21
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    • s.45
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    • pp.91-115
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    • 2019
  • When compared to land territorial claims, maritime claims have not attracted as much attention from the public as well as the academia. However, after the ICOW (Issue Correlates of War) data was published and was expanded to include maritime and river claims, there have been many quantitative studies that analyze maritime claims or separate different types of territorial claims to explain various mechanisms over different types of territorial claims. These quantitative studies have provided valuable explanations about the onset and the management of maritime claims. This research tries to review these quantitative research. Most studies about maritime claims, especially regarding the management of claims, analyze maritime claims based on two different levels of factors. First, from the perspective of systemic level, several studies focus on the role of international institutions and systemic level of democracy to explain the management of maritime claims. Second, at the dyadic level, many studies explain how the issue salience, past experience, the presence of resources, joint democracy, and relative power influence the occurrence of peaceful settlement attempts or conflictual behaviors over maritime claims. Based on the review of these literature, this research tries to identify several factors to explain the Dokdo issue and to encourage peaceful settlement attempts over the Dokdo issue.

Processing of Korean Compounds with Saisios (사이시옷이 단어 재인에 미치는 영향)

  • Bae, Sung-Bong;Yi, Kwang-Oh
    • Korean Journal of Cognitive Science
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    • v.23 no.3
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    • pp.349-366
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    • 2012
  • Two experiments were conducted to examine the processing of Korean compounds in relation to saisios. Saisios is a letter interposed between constituents when a phonological change takes place on the onset of the first syllable of the second constituent. This saisios rule is often violated by writers, resulting in many words having two spellings: one with saisios and the other without saisios. Among two spellings, some words are more familiar with saisios, some are usually spelled without saisios, and some are balanced. In Experiment 1 using the go/no-go lexical decision task, participants were asked to judge compounds with/without saisios. Saisios-dominant words (나뭇잎 > 나무잎) were responded faster when they appeared with saisios, whereas the opposite was true for words that usually appear without saisios (북엇국 < 북어국). In experiment 2, we presented participants compound words that were balanced on saisios. The results showed that words without saisios were responded faster than words with saisios. To summarize, the results of Experiment 1 and 2 were consistent with the APPLE model. Some problems related to the saisios rule were discussed in terms of reading process.

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HEMANGIOPERICYTOMA ON BUCCAL MUCOSA (협점막에 발생된 혈관외피세포종)

  • Sung, Dae-Kyung;Jeong, Jong-Cheol;Kim, Ho-Sung;Seo, Ji-Hun;Kim, Seong-Beom;Choi, Jae-Uk;Lee, Gye-Hyeok;Ryu, Geun-Shin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.3
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    • pp.301-304
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    • 2000
  • Hemangiopericytoma is uncommon vascular neoplasm that arises from pericytes arround the capillary walls. It was first described as a distinct vascular neoplasm by Stout and Murray in 1942 The anatomic distribution is widespread throughout the body, with approximately one third occur in the head and neck. No sex predilection has been found. Although middle age appears to be the most prevalent time of onset, this neoplasm has been found in all age groups. The differentiation between benign and malignant hemangiopericytoma can be difficult. Although the majority of these tumors are benign, there are malignant variants that can metastasize. Metastasis of seemingly benign tumors may appear year of decade later, so long term close follow-up is needed. The treatment of choice is complete surgical excision of the tumor. Despite their vascular origin, these tumors are relatively radioresistant. Radiation therapy is reserved for inoperable metastases or treatment of postoperative surgical fields. Here we present a case of hemangiopericytoma occuring on the Lt. buccal mucosa.

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A Study on the Competitiveness of ASEAN and Korea′s Container Ports In International Logistics Strategies (국제물류전략에 있어서 ASEAN과 한국의 컨테이너항만 경쟁력에 관한 연구)

  • Gim, Jin-Goo;Lee, Jong-In
    • Journal of Navigation and Port Research
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    • v.28 no.3
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    • pp.177-184
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    • 2004
  • The purpose of this study is to identify and evaluate the competitiveness of container ports in ASEAN(Association of Southeast Asian Nations) and Korea, which plays a leading role in basing the hub of international logistics strategies at the onset of the 21st century. Its ultimate purpose is to consider the relevant policy-making by comparing the competitiveness of ASEAN and Korea's container ports. This paper adopted the HFP method, which is an empirical analysis that evaluated the port competitiveness by quantifying it a, a qualitative attribute in the aforementioned area, where both ASEAN and Korea vie with each other for increasing container throughput. The results of this study showed that Singapore ranked the first in the subject of study in view of the competitiveness, followed by Busan(2) and Manila(2) as a leading group of the relevant ports in international logistics strategies. This analytic evaluation contributes to the empirical approach applied to policy-making by the HFP method, which is the newest research technique in social science through the comparative study of port competitiveness between ASEAN and Korea.

Functional Linkage Analysis of Sit-to-Stand With Changes of Pelvic Tilting (골반 자세 변화에 따른 일어서기의 기능적 연결분석의 접근)

  • Choi, Jong-Duk;Kwon, Oh-Yun;Yi, Chung-Hwi;Kim, Jong-Man;Kim, Jin-Kyung
    • Physical Therapy Korea
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    • v.10 no.2
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    • pp.11-22
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    • 2003
  • The purpose of this study was to analyze the effects of three different pelvic tilts on a sit-to-stand (STS) and to suggest a new assessment approach based on biomechanical analysis. The three difrent pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To determine the onset time of muscle contraction surface electrodes were applied to the rectus femoris muscle (RF), vastus lateralis muscle (VL), biceps femoris muscle (BF), tibialis anterior muscle (TA), gastrocnemius muscle (GCM), and soleus muscle (SOL). The ICC was used for functional linkage analysis. The findings of this study were as follows. First, significant differences were found in kinematic variables and in muscle activation pattern among the three activities. Second, the results of functional integrated analysis revealed that recruited muscle activation patterns changed when the thigh-off was viewed as a reference point. Third, there were independent functional units between the thigh-off and the VL and between the thigh-off and the RF in the functional linkage analysis. The VL and RF acted as prime mover muscles, and more postural adjustment muscle recruitment was required as the demand of postural muscle control increased (PPT STS, APT STS, and CPT STS in order). In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity. APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated. However, excessive APT would change the muscle activation patterns of BF and SOL and require additional postural muscle control to cause abnormal control patterns.

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Comparison of Neuropsychological Deficits between Depressed Episode and Remission in First-onset Patients with Major Depressive Disorder (초발 주요우울장애 환자의 우울 삽화 및 관해 상태에서 신경인지기능 결함 비교)

  • Hur, Ji-Won;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.15 no.2
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    • pp.92-100
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    • 2008
  • Objectives : The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. Methods : 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. Results : Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. Conclusions : This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

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Clinical course and prognostic factors of childhood immune thrombocytopenia: single center experience of 10 years

  • Jung, Jae Yeob;O, A Rum;Kim, Je Keong;Park, Meerim
    • Clinical and Experimental Pediatrics
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    • v.59 no.8
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    • pp.335-340
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    • 2016
  • Purpose: This study aimed to evaluate the clinical course of childhood immune thrombocytopenia (ITP) and to assess the risk factors for developing chronic ITP Methods: The records of 64 children diagnosed with ITP from November 2005 and December 2014 at single center were retrospectively analyzed. Results: The median age at diagnosis and the median platelet count were 1 year (range, 1 month to 15 years) and $9{\times}10^9/L$ (range, $0-84{\times}10^9/L$), respectively. No patient experienced severe bleeding. Nineteen children (29.7%) spontaneously recovered their platelet count to ${\geq}100{\times}10^9/L$ at a median of 10 days. In total 45 patients (70.3%) received intravenous immunoglobulin (IVIG) as first-line therapy, and showed platelet recovery at 1 week. The final diagnosis of 55 (85.9%) and 9 patients (14.1%) was acute and chronic ITP, respectively. Older age, absence of prior infection and insidious onset of symptoms were significantly associated with the development of chronic ITP. Among the patients who received IVIG, those with platelet count <$45{\times}10^9/L$ at 1 month after IVIG showed a significantly higher incidence of chronic ITP compared to those with platelet count ${\geq}45{\times}10^9/L$ (88.8% vs. 44.4%, P<0.01). Conclusion: In most patients, ITP runs a benign course and approximately 86% of them recover within 1 year of their initial diagnosis. The potential impact of the risk factors of chronic ITP on clinical practice needs to be explored and further studies are warranted to determine whether IVIG influences the course of ITP.

Study on the Diagnostic Indicators of Fire-heat Pattern Identification in Stroke Patients (중풍환자의 화열변증 진단지표에 관한 연구)

  • Lee, Jung-Sup;Ko, Mi-Mi;Kang, Byoung-Kab;Kim, Jeong-Cheol;Kim, Bo-Young;Lee, In;Kim, Yun-Sik;Choi, Sun-Mi;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.2
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    • pp.499-504
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    • 2009
  • The purpose of this study was to evaluate the diagnostic indicators which are used for the identification of fire-heat pattern in stroke patients. For evaluation of diagnostic indicator, we analyzed the indicators which are composed of symptoms and signs collected from stroke patients based on the clinical records using case report form (CRF). Patients had a first-ever stroke within 1 month after the onset of stroke. Pattern identification was performed and decided by two independent physicians. Two patient groups that consist of fire-heat pattern and the other patterns were compared to isolate important indicators affecting the fire-heat pattern identification of stroke patients. The 8 indicators among 16 fire-heat pattern indicators were significantly more frequent compared with non fire-heat pattern group. Logistic regression analysis revealed that 5 indicators among fire-heat indicators were significantly sensitive indicators being capable of identification of fire-heat pattern. But two of them was from the indicators of dampness-phlegm pattern and yin deficiency pattern. Therefore, further studies are required for the development of Korean standard indicators of Fire-heat pattern identification.