• Title/Summary/Keyword: Preemptive

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Tolvaptan: a possible preemptive treatment option in children with autosomal dominant polycystic kidney disease?

  • Hee Sun Beak;Min Hyun Cho
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.76-81
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    • 2023
  • Tolvaptan is a highly selective vasopressin receptor 2 antagonist that regulates cyclic adenosine monophosphate levels to inhibit both epithelial cell proliferation and chloride ion excretion, two mechanisms known to induce cyst expansion in autosomal dominant polycystic kidney disease (ADPKD). Tolvaptan is currently the preferred treatment of rapidly progressive disease ADPKD in adult patients; however, since cyst formation in ADPKD begins early in life, (frequently in utero), and significant disease progression with cyst expansion occurs in the first decade, tolvaptan may be advantageous as a preemptive treatment in children with ADPKD. Tolvaptan has already been used to successfully treat refractory edema or hyponatremia in children; this literature review provides insight into the biochemical basis of its action to contextualize its use in the pediatric population.

Effects of Agmatine on GABAA Receptor Antagonist-induced Tactile Allodynia (Agmatine이 GABAA 수용체 길항제로 유도한 촉각이질통에 미치는 효과)

  • Lee, Youn Woo;Ishikawa, Toshizo
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.173-178
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    • 2008
  • Background: The intrathecal (IT) $GABA_A$ receptor antagonist, bicuculline (BIC), results in tactile allodynia (TA) through disinhibition in the spinal cord. Such disinhibition is considered to be an important mechanism for neuropathic pain. Agmatine, an endogenous polyamine, has a neuro-protective effect in the central nervous system. We investigated the analgesic effects and mechanisms of agmatine action on BIC-induced TA. Methods: Male Sprague-Dawley rats, weighting 250-300 g, were subjected to implantations of PE-10 into the lumbar subarachnoid space for IT drug injection. Five days after surgery, either $10{\mu}l$ of normal saline (NS) or agmatine ($30{\mu}g$ or $10{\mu}g$) in $10{\mu}l$ NS were injected 10 min prior to BIC ($10{\mu}g$) or NMDA ($5{\mu}g$). We assessed the degree of TA (graded 0: no response, 1: mild response, 2: moderate response, 3: strong response) every 5 min for 30 min. Areas under curves and degree of TA were expressed as mean ${\pm}$ SEM. Results were analyzed using one-way ANOVA followed by a Tukey test for multiple comparisons. P < 0.05 was considered significant. Results: IT BIC-induced strong TA reached its peak and plateaued between 10 to 15 min. IT NS-NMDA induced mild transient TA for up to 15 min. Preemptive IT AG attenuated IT BIC-induced TA dose dependently and preemptive IT AG10 completely abolished the IT NMDA-induced TA. Conclusions: Preemptive IT AG attenuated the IT BIC-induced TA through inhibitory actions on postsynaptic NMDA receptor activation. AG might be a viable therapeutic option in the treatment of neuropathic pain.

The Effect of Low-dose Ketamine on Post-caesarean Delivery Analgesia after Spinal Anesthesia

  • Han, Seung Yeup;Jin, Hee Cheol;Yang, Woo Dae;Lee, Joon Ho;Cho, Seong Hwan;Chae, Won Seok;Lee, Jeong Seok;Kim, Yong Ik
    • The Korean Journal of Pain
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    • v.26 no.3
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    • pp.270-276
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    • 2013
  • Background: Ketamine, an N-methyl-D-aspartate receptor antagonist, might play a role in postoperative analgesia, but its effect on postoperative pain after caesarean section varies with study design. We investigated whether the preemptive administration of low-dose intravenous ketamine decreases postoperative opioid requirement and postoperative pain in parturients receiving intravenous fentanyl with patient-controlled analgesia (PCA) following caesarean section. Methods: Spinal anesthesia was performed in 40 parturients scheduled for elective caesarean section. Patients in the ketamine group received a 0.5 mg/kg ketamine bolus intravenously followed by 0.25 mg/kg/h continuous infusion during the operation. The control group received the same volume of normal saline. Immediately after surgery, the patients were connected to a PCA device set to deliver 25-${\mu}g$ fentanyl as an intravenous bolus with a 15-min lockout interval and no continuous dose. Postoperative pain was assessed using the cumulative dose of fentanyl and visual analog scale (VAS) scores at 2, 6, 24, and 48 h postoperatively. Results: Significantly less fentanyl was used in the ketamine group 2 h after surgery (P = 0.033), but the difference was not significant at 6, 12, and 24 h postoperatively. No significant differences were observed between the VAS scores of the two groups at 2, 6, 12, and 24 h postoperatively. Conclusions: Intraoperative low-dose ketamine did not have a preemptive analgesic effect and was not effective as an adjuvant to decrease opioid requirement or postoperative pain score in parturients receiving intravenous PCA with fentanyl after caesarean section.

Perioperative Pain Management in the Patient with Complex Regional Pain Syndrome -A case report- (복합부위통증증후군 환자의 이환 부위 수술 전후의 통증관리 -증례보고-)

  • Jo, Ji Yon;Lee, Mi Geum;Lee, Hyo Min;Choi, Yun Suk;Yun, Hey Jeong;Lee, Chul Joong;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.218-222
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    • 2006
  • Complex regional pain syndrome (CRPS) is a syndrome of pain and sudomotor or vasomotor instabilities. The perioperative pain management in CRPS patients is very important, as surgery can aggravate preexisting symptoms, especially when performed around the lesion site. Despite the increasing interest in CRPS research, little is known about the optimal perioperative treatment strategy for CRPS patients. Herein, the case of a female CRPS patient, who underwent elective surgery at the lesion site, is reported. As a preemptive analgesia, the patient was satisfactorily managed with two weeks of patient-controlled epidural analgesia, initiated 2 days prior to surgery. The techniques for the prevention of perioperative pain, including preemptive analgesia, as well as its importance, are discussed.

Determining Checkpoint Intervals of Non-Preemptive Rate Monotonic Scheduling Using Probabilistic Optimization (확률 최적화를 이용한 비선점형 Rate Monotonic 스케줄링의 체크포인트 구간 결정)

  • Kwak, Seong-Woo;Yang, Jung-Min
    • Journal of the Korean Institute of Intelligent Systems
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    • v.21 no.1
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    • pp.120-127
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    • 2011
  • Checkpointing is one of common methods of realizing fault-tolerance for real-time systems. This paper presents a scheme to determine checkpoint intervals using probabilistic optimization. The considered real-time systems comprises multiple tasks in which transient faults can happen with a Poisson distribution. Also, multi-tasks are scheduled by the non-preemptive Rate Monotonic (RM) algorithm. In this paper, we present an optimization problem where the probability of task completion is described by checkpoint numbers. The solution to this problem is the optimal set of checkpoint numbers and intervals that maximize the probability. The probability computation includes schedulability test for the non-preemptive RM algorithm with respect to given numbers of checkpoint re-execution. A case study is given to show the applicability of the proposed scheme.

Research on direction of future Korean military force establishment -focus on North Korea's nuclear threat and neighboring countries' counter military threat operation- (미래 한국군 군사력 건설방향에 대한 연구 - 북한 핵위협과 주변국 위협대비를 중심으로 -)

  • Kim, Yeon Jun
    • Convergence Security Journal
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    • v.14 no.1
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    • pp.11-21
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    • 2014
  • South Korea should not be in subordinate position in international relationships like the past. As the status of middle power. South Korea achieves peaceful unification through overcoming North Korea's nuclear and conventional threats, and builds military power in Northeast Asia as a 'balancer'. This can firstly be achieved by constructing "attack systems triad". 'attack systems triad' can be established through integrating the C41SR as a common strategy for the purposes of preemptive deterrence and retaliatory deterrence against the dangers of the present and the future. Second, denial deterrence can be achieved by establishing "defense system triad" by combining common military power and defensive weapon system. Finally, development of independent advanced technological strategies can be achieved by building defense industry and combination of research and development through constructing "Infra triad". As for constructing and reinforcing the future of the ROK military, a unilateral principle and policy efforts to achieve the aforementioned force construction models are needed. This can only be achieved through the government's national vision to take on the role of mediator and a basis founded upon the consensus of the public.

Effect of preemptive intravenous ibuprofen on postoperative edema and trismus in third molar tooth extraction: A randomized controlled study

  • Gulnahar, Yakup;Kupeli, Ilke
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.3
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    • pp.161-167
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    • 2018
  • Background: This study aimed to evaluate the anti-inflammatory efficacy of preemptive intravenous ibuprofen on inflammatory complications such as edema and trismus in patients undergoing impacted mandibular third molar surgery. Methods: Sixty patients were included and divided into three groups (800 mg IV ibuprofen + 50 mg dexketoprofen, 800 mg IV ibuprofen, and control). In all patients, preoperative hemodynamic values were recorded before the infusions. The operation was started at 15-min post-infusion. Evaluation of edema size on the face and mouth opening (trismus) was conducted in the preoperative period, and at postoperative 48 h and 1 week. Results: No difference was determined among the groups in trismus and edema size in postoperative measurements (P > 0.05). There was a difference between group 2 and group 3 only in measurement value of tragus-corner of the mouth on the postoperative day 2 (P < 0.05). A difference was found between the measurement values of trismus preoperatively and at preoperative day 2, and between postoperative day 2 and 1 week in group 3 based on time (P < 0.05). In group 3, edema on the face on postoperative day 2 increased significantly compared to that in the preoperative period (P < 0.001); in addition, edema increased significantly in groups 1 and 2 in the postoperative period but was less than that in group 3 (P < 0.001). Conclusions: In this study, intravenous ibuprofen was determined to be more effective alone or in combination in alleviating trismus and to better limit the postoperative edema.

A Study on the Model for Preemptive Intrusion Response in the era of the Fourth Industrial Revolution (4차 산업혁명 시대의 선제적 위협 대응 모델 연구)

  • Hyang-Chang Choi
    • Convergence Security Journal
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    • v.22 no.2
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    • pp.27-42
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    • 2022
  • In the era of the Fourth Industrial Revolution, digital transformation to increase the effectiveness of industry is becoming more important to achieving the goal of industrial innovation. The digital new deal and smart defense are required for digital transformation and utilize artificial intelligence, big data analysis technology, and the Internet of Things. These changes can innovate the industrial fields of national defense, society, and health with new intelligent services by continuously expanding cyberspace. As a result, work productivity, efficiency, convenience, and industrial safety will be strengthened. However, the threat of cyber-attack will also continue to increase due to expansion of the new domain of digital transformation. This paper presents the risk scenarios of cyber-attack threats in the Fourth Industrial Revolution. Further, we propose a preemptive intrusion response model to bolster the complex security environment of the future, which is one of the fundamental alternatives to solving problems relating to cyber-attack. The proposed model can be used as prior research on cyber security strategy and technology development for preemptive response to cyber threats in the future society.

Effects of Preemptive Analgesia with Parecoxib Sodium on Haemodynamics and Plasma Stress Hormones in Surgical Patients with Thyroid Carcinoma

  • Wang, Lian-Dong;Gao, Xia;Li, Jun-Ying;Yu, Hong-Yan;Su, Hai-Wen;Liu, Lian-Zhong;Qi, Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3977-3980
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    • 2015
  • Background: To investigate the effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma. Materials and Methods: Fifty-seven patients with thyroid carcinoma who underwent thyroidectomy selectively in Laiwu Hospital Affiliated to Taishan Medical University and Binzhou People's Hospital were selected and randomly divided into three groups, 19 cases in each group. The control group was intravenously injected 0.9% sodium chloride injection before anesthesia induction; trial group I was intravenously injected with parecoxib sodium 20 min before anesthesia induction; based on trial group I, trial group II was injected with parecoxib sodium again 12 h after surgery. The levels of plasma norepinephrine (NE), cortisol (Cor) and blood glucose before, 12 and 24 h after surgery and changes of haemodynamics before surgery, at the end of surgery and 12, 24 and 48 h after surgery were compared in the three groups. Besides, visual analogue scale (VAS) scores were recorded 4, 8, 12 and 24 h after surgery. Results: 12 and 24 h after surgery, the levels of plasma NE and Cor in three groups rose dramatically (P<0.05 or (P<0.01); The levels of plasma NE and Cor in trial groups I and II were evidently lower than in control group (P<0.05 or P<0.01), and those in trial group II slightly lower than in trial group I. 12 h after surgery, the heart rates (HR) and systolic pressures (SBP) in trial groups I and II increased obviously by comparison to surgery before (P<0.05 or P<0.01), but gradually returned to the preoperative level. HR, SBP and diastolic pressures (DBP) in trial groups I and II at the end of surgery and 12 h after surgery were all lower than in the control group, and significant differences were present (P<0.05 or (P<0.01). At 4, 8, 12 and 24 h after surgery, VAS scores in trial groups I and II were markedly lower than in the control group (P<0.05 or (P<0.01), the scores in trial group II being the lowest. Conclusions: Combined application of parecoxib sodium for preemptive analgesia before anesthesia and after surgery can effectively reduce the levels of plasma stress hormones and improve analgesic effects in surgical patients with thyroid carcinoma, and without conspicuous impact on haemodynamics.

An Algorithm for Multiple Compensatory Objectives Problems

  • Yang, Kwang-Min
    • Journal of the Korean Operations Research and Management Science Society
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    • v.7 no.2
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    • pp.31-39
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    • 1982
  • This paper presents an efficient algorithm both in computation speed and storage requirement by exploring the special structure of problems involving multiple objective goals. The algorithm developed here is limited to the problems with multiple, compensatory objectives, however it can be extended to‘traditional’preemptive priority goat programming problems. Computational results are included.

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