• 제목/요약/키워드: Pre-Hospital

검색결과 2,087건 처리시간 0.041초

무지 외반증 환자의 원위 갈매기형 절골술시 절골면 고정유무에 따른 치료결과 비교 (A Comparison of with and without in the Fixation of Distal Chevron Osteotomies for Hallux Valgus)

  • 유성호;김부환;송무호;안성준;서상혁
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.230-233
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    • 2006
  • Purpose: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. Materials and Methods: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). Results: On group A, the mean first MTP (metatarsophalangeal) angle corrected $17^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $20-37^{\circ}$) and the mean first IM (intermetatarsal) angle corrected $10^{\circ}$ pre-operatively to average $15^{\circ}$ (range; $9-18^{\circ}$). On Group B, the mean first MTP angle corrected $16^{\circ}$ pre-operatively to average $29^{\circ}$ (range; $18-33^{\circ}$) and the mean first IM angle corrected $7^{\circ}$ pre-operatively to average $13^{\circ}$ (range; $9-16^{\circ}$) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. Conclusions: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.

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CT Findings of Persistent Pure Ground Glass Opacity: Can We Predict the Invasiveness?

  • Liu, Li-Heng;Liu, Ming;Wei, Ran;Jin, Er-Hu;Liu, Yu-Hui;Xu, Liang;Li, Wen-Wu;Huang, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권5호
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    • pp.1925-1928
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    • 2015
  • Background: To investigate whether CT findings can predict the invasiveness of persistent cancerous pure ground glass opacity (pGGO) by correlating the CT imaging features of persistent pGGO with pathological changes. Materials and Methods: Ninety five patients with persistent pGGOs were included. Three radiologists evaluated the morphologic features of these pGGOs at high resolution CT (HRCT). Binary logistic regression was used to assess the association between CT findings and histopathological classification (pre-invasive and invasive groups). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of diameters. Results: A total of 105 pGGOs were identified. Between pre-invasive (atypical adenomatous hyperplasia, AAH, and adenocarcinoma in situ, AIS) and invasive group (minimally invasive adenocarcinoma, MIA and invasive lung adenocarcinomas, ILA), there were significant differences in diameter, spiculation and vessel dilatation (p<0.05). No difference was found in air-bronchogram, bubble-lucency, lobulated-margin, pleural indentation or vascular convergence (p>0.05). The optimal threshold value of the diameters to predict the invasiveness of pGGO was 12.50mm. Conclusions: HRCT features can predict the invasiveness of persistent pGGO. The pGGO with a diameter more than 12.50mm, presences of spiculation and vessel dilatation are important factors to differentiate invasive adenocarcinoma from pre-invasive cancerous lesions.

Effects of Group Comprehensive Behavioral Intervention for Tics in Children With Tourette's Disorder and Chronic Tic Disorder

  • Kang, Na Ri;Kim, Hui-Jeong;Moon, Duk Soo;Kwack, Young Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제33권4호
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    • pp.91-98
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    • 2022
  • Objectives: Comprehensive behavioral intervention for tics (CBIT) is effective in children with chronic tic disorders. This study aimed to assess the effect of group-based CBIT (group-CBIT) on tic severity and comorbid symptoms. We compared the efficacy of group CBIT with that of a control. Methods: Thirty children with chronic tic disorder or Tourette's disorder were enrolled in this study. Eighteen were assigned to the group-CBIT for eight sessions, and 12 were assigned to the control group. Tics and comorbid symptoms were assessed pre- and post-intervention using the Yale Global Tic Severity Scale (YGTSS), Premonitory Urge for Tics Scale, attention-deficit hyperactivity disorder Rating Scale-IV, Children's Yale-Brown Obsessive-Compulsive Scale, and the Korean-Children Behavioral Checklist. We compared the pre- and post-intervention results of each group and determined the difference in the pre- and post-intervention results between intervention and the control group. Results: The YGTSS motor and vocal tic interference, global impairment, and global severity scores decreased in the intervention group only. Group CBIT was superior in reducing the motor tic interference, impairment score, and global severity score to the control group. Conclusion: The group-CBIT showed an improvement in tic symptoms, especially in reducing the level of interference and impairment of tics.

Change in fibrinogen levels and severe postoperative bleeding in cardiac surgery

  • Kim, Eun-Jung;Kim, Joo-Yun;Kim, Hee Young;Hwang, Boo-Young;Cho, Ah-Reum;Jung, Young-Hoon;Baek, Seung-Hoon;Hong, Jeong-Min
    • International Journal of Oral Biology
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    • 제45권2호
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    • pp.51-57
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    • 2020
  • Thromboelastography or rotational thromboelastometry, is being increasingly utilized in cardiac surgery of late. However, it is an indirect test and is not available in all centers. Low fibrinogen levels before and after cardiopulmonary bypass (CPB) have been described to be associated with postoperative bleeding in cardiac surgery. This study explored the usefulness of reduction ratio of the fibrinogen levels before CPB (preCPB) and after CPB (postCPB) in predicting postoperative hemorrhage. A retrospective, observational study of adult patients who underwent cardiac surgery with CPB between February 2014 and January 2016 was conducted, which included a total of 264 patients. The fibrinogen levels were measured twice, preCPB and postCPB, and the fibrinogen reduction ratio was acquired [(preCPB - postCPB)/preCPB]. Postoperative blood loss, which was defined as the blood collected from the chest drain for 12 hours following arrival at the intensive care unit, was considered severe if it was more than 1,000 mL. A multivariate analysis showed that fibrinogen reduction ratio, sex, and postCPB platelet count were significantly associated with severe postoperative bleeding. However, the pre- and postCPB fibrinogen levels were not significantly associated with severe bleeding. Furthermore, a fibrinogen reduction ratio of > 41.3% was independently associated with postoperative severe bleeding, with an odds ratio of 3.472 (1.483-8.162). These results suggest that the reduction ratio of pre- and postCPB fibrinogen levels may be utilized in predicting postoperative bleeding.

Evolution of Process and Outcome Measures during an Enhanced Recovery after Thoracic Surgery Program

  • Lee, Alex;Seyednejad, Nazgol;Lawati, Yaseen Al;Mattice, Amanda;Anstee, Caitlin;Legacy, Mark;Gilbert, Sebastien;Maziak, Donna E.;Sundaresan, Ramanadhan S.;Villeneuve, Patrick J.;Thompson, Calvin;Seely, Andrew J.E.
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.118-125
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    • 2022
  • Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

Association of Pre- and Perinatal Risk Factors With Tourette Syndrome or Chronic Tic Disorders in a Korean School-Age Population

  • Wooseok Choi;Soon-beom Hong;Johanna Inhynag Kim;Jung Lee;Soomin Jang;Yebin D Ahn;You Bin Lim;Sumin Kim;Mee Rim Oh;Bung-Nyun Kim
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제34권1호
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    • pp.37-44
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    • 2023
  • Objectives: Tic disorders are highly heritable; however, growing evidence suggests that environmental factors play a significant role in their pathogenesis. Studies on these factors have been inconsistent, with conflicting results. Therefore, this study aimed to examine the associations of pre- and perinatal exposure to Tourette syndrome (TS) or chronic tic disorders (CTD) in Korean school-aged children. Methods: This case-control study used data from a large prospective cohort study. The primary outcome was TS/CTD diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria and Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version. Demographic, pre-, and perinatal information was obtained from the maternal questionnaires. Data between the TS/CTD and control groups were compared using the chi-squared or Student's t-test, as appropriate. Two-step logistic regression analyses were used to test the association between TS/CTD and pre- and perinatal risk factors. Results: We included of 223 children (78 with TS/CTD and 145 controls). Significant differences in the demographic data between the two groups were observed. The male sex ratio, mean parental age, parental final education level, and family history of tics were included as confounders. In the final adjusted multivariable model, TS/CTD was significantly associated with antiemetic exposure during pregnancy (odds ratio [OR]=16.61, 95% confidence interval [CI] 1.49-185.22, p=0.02) and medically assisted reproduction (OR=7.89, 95% CI 2.28-27.28, p=0.01). Conclusion: Antiemetic exposure and medically assisted reproduction are significantly associated with the risk of TS/CTD. These results should be replicated in future prospective and gene-by-environment studies.

차류혈(次謬穴) 전침(電鍼)의 기능성(機能性) 배뇨장애(排尿障碍) 환자(患者)에 대한 임상적(臨床的) 관찰(觀察) - 배뇨일지(排尿日誌)와 요속검사(尿速檢査)를 중심으로 - (The Study on the Effect of Electroacupuncture at Ciliao(BL32) on Voiding Pattern and Uroflowmetry in the Patients with Functional Voiding Disease)

  • 김경태;고영진;김은정;류성룡;우현수;김창환
    • Journal of Acupuncture Research
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    • 제23권4호
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    • pp.101-113
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    • 2006
  • Objectives : This study was designed to evaluate the effect of electroacupuncture at ciliao(BL32) on voiding pattern and uroflowmetry of patients with functional voiding disease. Methods Subjects were voluntarily recruited by newspaper·s and internet. All the subjects were confirmed as International Prostatism Symptom Score(IPSS), uroflowmetry, voiding diary, symptom. The acupuncture therapy was performed 3 times a week for 3 weeks by oriental medical doctor at hospital. Acupuncture points were BL32. The patient's symptoms were assessed before and after 3 weeks treatments by IPSS. Uroflowmetry for 5minutes and voiding diary for 48 hours was measured before and after 3 weeks treatments. Results : The results were as follows; 1. After 3 weeks compared to the pre-treatment, IPSS(QOL) scores were significantly unproved. 2. After 3 weeks compared to the pre-treatment, mean voiding volume, min voiding volume and mean voiding time on voiding daiary was significantly improved. 3. After 3 weeks compared to the pre-treatment, max flow velocity and mean flow velocity on uroflowmetry in spite of increase of voiding volume show a statistically significant difference. 4. Acupunctue had hardly some side effect compared to operation and medicines and was economical. Conclusion : This study suggests that acupuncture treatments can be applicable to improve symptoms in the patients with functional voiding disease. Further study on the acupuncture and other acupoints in the patients with functional voiding disease is recommended.

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Changes in bioimpedance analysis components before and after hemodialysis

  • Kim, Hyunsuk;Choi, Gwang Ho;Shim, Kwang Eon;Lee, Jung Hoon;Heo, Nam Ju;Joo, Kwon-Wook;Yoon, Jong-Woo;Oh, Yun Kyu
    • Kidney Research and Clinical Practice
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    • 제37권4호
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    • pp.393-403
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    • 2018
  • Background: This study compared nutritional parameters in hemodialysis (HD) subjects and controls using bioimpedance analysis (BIA) and investigated how BIA components changed before and after HD. Methods: This cross-sectional study included 147 subjects on maintenance HD from two hospitals and 298 propensity score-matched controls from one healthcare center. BIA was performed pre- and post-HD at mid-week dialysis sessions. Results: Extracellular water/total body water (ECW/TBW) and waist-hip ratio were higher in the HD patients; the other variables were higher in the control group. The cardiothoracic ratio correlated best with overhydration (r = 0.425, P < 0.01) in HD subjects. Blood pressure, hemoglobin, creatinine, and uric acid positively correlated with the lean tissue index in controls; however, most of these nutritional markers did not show significant correlations in HD subjects. Normal hydrated weight was predicted to be higher in the pre-HD than post-HD measurements. Predicted ultrafiltration (UF) volume difference based on pre- and post-HD ECW/TBW and measured UF volume difference showed a close correlation ($r^2=0.924$, P < 0.01). Remarkably, the leg phase angle increased in the post-HD period. Conclusion: The estimated normal hydrated weight using ECW/TBW can be a good marker for determining dry weight. HD subjects had higher ECW/TBW but most nutritional indices were inferior to those of controls. It was possible to predict UF volume differences using BIA, but the post-HD increase in leg phase angle, a nutritional marker, must be interpreted with caution.

Altered expression of norepinephrine transporter and norepinephrine in human placenta cause pre-eclampsia through regulated trophoblast invasion

  • Na, Kyu-Hwan;Choi, Jong Ho;Kim, Chun-Hyung;Kim, Kwang-Soo;Kim, Gi Jin
    • Clinical and Experimental Reproductive Medicine
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    • 제40권1호
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    • pp.12-22
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    • 2013
  • Objective: We investigated the norepinephrine transporter (NET) expression in normal and pre-eclamptic placentas and analyzed the invasion activity of trophoblastic cells based on norepinephrine (NE)-NET regulation. Methods: NET and NE expression levels were examined by western blot and enzyme-linked immunosorbent assay, respectively. Trophoblast invasion activity, depending on NE-NET regulation, was determined by NET-small interfering RNA (siRNA) and NET transfection into the human extravillous trophoblast cells with or without NE treatment and invasion rates were analyzed by zymography and an invasion assay. Results: NET mRNA was expressed at a low level in pre-eclamptic placentas compared with normal placentas and NE concentration in maternal plasma increased significantly in pre-eclamptic women compared to normal pregnant women (p<0.05). NET gene upregulation and NE treatment stimulated trophoblast cell invasion up to 2.5-fold (p<0.05) by stimulating matrix metalloproteinase-9 activity via the phosphoinositol-3-kinase/AKT signaling pathway, whereas NET-siRNA with NE treatment reduced invasion rates. Conclusion: NET expression is reduced by inadequate regulation of NE levels during placental development. This suggests that a complementary balance between NET and NE regulates trophoblast cell invasion activities during placental development.