Purpose: Chronic subdural hematoma (CSDH) is a common disease in elderly patients and is usually treated by burr-hole drainage. However, the optimal surgical technique for treating CSDH has not been determined. In this study, we analyzed outcomes and recurrence rates after burr-hole drainage with or without irrigation in patients with CSDH. Methods: Eighty-two CSDH patients treated with burr-hole drainage at Wonju Severance Christian Hospital from March 2015 to June 2016 were enrolled in this study. The subjects were divided into three groups based on the surgical technique performed as follows: single burr-hole drainage without irrigation (group A, n=47), single burr-hole drainage with irrigation (group B, n=14), or double burr-hole drainage with irrigation (group C, n=21). These three groups were compared with respect to clinical and radiological factors and the recurrence rate, and independent factors predicting recurrence were sought. Results: After burr-hole drainage, CSDH recurred in 15 (18.3%) of the 82 patients, and six patients (7.3%) required reoperation. More specifically, recurrence was observed in 12 patients (25.5%) in group A, one (7.1%) in group B, and two (9.5%) in group C. The number of burr-holes did not significantly affect recurrence (odds ratio [OR]=0.38; 95% confidence interval [CI]: 0.60-2.38), but irrigation had a significant effect (OR=0.20; 95% CI: 0.04-0.97). Conclusions: This study shows that irrigation during burr-hole surgery in CSDH patients significantly reduced the risk of recurrence, regardless of the number of burr-holes used. We therefore recommend the use of active irrigation during burr-hole drainage surgery in CSDH patients.
Shin, Jin Hyeon;Shin, Hye Jeong;Kim, Eui Byeol;An, Yun Young;Yook, Tae Han;Choi, Yoo Min;Song, Beom Yong;Kim, Jong Uk
Journal of Acupuncture Research
/
v.37
no.4
/
pp.209-223
/
2020
The purpose of this study was to evaluate the effectiveness of acupuncture treatment for the symptoms of Alzheimer's disease (AD). There were 11 databases searched for randomized controlled trials using acupuncture treatment for AD. The risk-of-bias assessment tool of the Cochrane Library was used to evaluate the quality of each study. Using the Review Manager (RevMan), a meta-analysis was performed using risk ratio, mean difference, 95% confidence interval, and random effect model. There were 32 studies selected, all of which were conducted in China. There were 16 studies where acupuncture was used as the intervention, and 23 studies used Donepezil as the control group. Acupoint GV20 was most frequently selected during the treatment. The Mini Mental State Examination (MMSE) was the most frequently used outcome variable. A period of 12 weeks was the most common treatment duration. As a result of meta-analysis (n = 25), acupuncture improved the MMSE and activities of daily living scores. Electroacupuncture improved the Alzheimer Disease Assessment Scale-Cognitive Subscale, and scalp acupuncture improved the MMSE score for AD. Acupuncture alleviates the symptoms of AD. However, further research is necessary to provide a better level of evidence.
International Journal of Fluid Machinery and Systems
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v.5
no.3
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pp.109-116
/
2012
Water hammer pumps can effectively use the water hammer phenomenon for water pumping. They are capable of providing an effective fluid transport method in regions without a well-developed social infrastructure. The results of experiments examining the effect of the geometric form of water hammer pumps by considering their major dimensions have been reported. However, these conventional studies have not fully evaluated pump performance in terms of pump head and flow rate, common measures of pump performance. The authors have focused on the effects on the pump performance of various geometric form factors in water hammer pumps. The previous study examined how the hydrodynamic characteristics was affected by the inner diameter ratio of the drive and lift pipes and the angle of the drive pipe, basic form factors of water hammer pumps. The previous papers also showed that the behavior of water hammer pump operation could be divided into four characteristic phases. The behavior of temporal changes in valve chamber and air chamber pressures according to the air volume in the air chamber located downstream of the lift valve was also clarified in connection with changes in water hammer pump performance. In addition, the effects on water hammer pump performance of the length of the spring attached to the drain valve and the drain pipe angle, form factors around the drain valve, were examined experimentally. This study focuses on the form of the lift valve, a major component of water hammer pumps, and examines the effects of the size of the lift valve opening area on water hammer pump performance. It also clarifies the behavior of flow in the valve chamber during water hammer pump operation.
Purpose: A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth. Methods: Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth. Results: Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was $34.4{\pm}3.2$ weeks and weight was $2,266{\pm}697.5$ grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%) and Coagulase-Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was $29.2{\pm}23.0mg/dL{\sim}58.2{\pm}39.5mg/dL$. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034). Conclusion: High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.
Journal of Dental Rehabilitation and Applied Science
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v.27
no.4
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pp.449-454
/
2011
Recently, jawbone osteonecrosis has been largely reported as a potential adverse effect of bisphosphonate (BP)administration. Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60-70% of cases are preceded by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue infection. Tooth extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated, should be provided with preventive dental care in order to minimize the risk of developing this severe condition.
Jeong, Goun;Park, Sung Won;Lee, Yeon Kyung;Ko, Sun Young;Shin, Son Moon
Clinical and Experimental Pediatrics
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v.60
no.3
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pp.70-76
/
2017
Purpose: This study investigated self-food restriction during breastfeeding, reviewed the literature showing the effect of maternal diet on the health of breast-fed infants, and explored the validity of dietary restrictions. Methods: Questionnaire data were collected from breastfeeding Korean mothers who visited the pediatric clinic of Cheil General Hospital & Women's Healthcare Center from July 2015 through August 2015. The survey included items assessing maternal age, number of children, maternal educational attainment, household income, degree of difficulty with self-food restriction, types of self-restricted foods, dietary customs during breastfeeding, and sources of information about breastfeeding. Results: The questionnaire was completed by 145 mothers. More than a third (n=56, 39%) had discomfort from and usually avoided 4-5 types of food (mean, 4.92). Mothers younger than 40 years had more discomfort (odds ratio [OR], 12.762; P=0.017). Primiparas felt less discomfort than multiparas (OR, 0.436; P=0.036). Dietary practices were not influenced by maternal educational attainment or household income. The most common self-restricted foods were caffeine (n=131, 90.3%), spicy foods (n=124, 85.5%), raw foods (n=109, 75.2%), cold foods (n=100, 69%), and sikhye (traditional sweet Korean rice beverage) (n=100, 69%). Most mothers (n=122, 84.1%) avoided foods for vague reasons. Conclusion: Most mothers restricted certain foods unnecessarily. Literature review identified no foods that mothers should absolutely avoid during breastfeeding unless the infant reacts negatively to the food.
Journal of the Earthquake Engineering Society of Korea
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v.5
no.5
/
pp.35-45
/
2001
Recently, the floor systems those require large open space may have low inherent damping due to the decline of the use of curtain walls. Furthermore, the use of the high strength materials has resulted in more flexible and longer spanning in floor systems. The long span structures such as shopping malls, offices and large assembly rooms may lead to significant dynamic response due to human activities. Excessive vibrations make the occupants uncomfortable and deteriorate the serviceability of buildings. It is now proved that footfall loading is the major source of floor vibrations. The common method of application of walking loads for the vibration analysis of structures subjected to walking loads is to inflict measured walking loads and periodic function at a node. But this method could not account for the moving effect of walking. In this study, natural frequency and damping ratio of example structure are evaluated by heel drop tests. And the application of equivalent walking loads is used for on efficient vibration analysis of the plate structures subjected to walking loads.
Purpose: To evaluate the effect of intermittent bleeding method in the distal phalanx replantation. Materials and Methods: From January 2007 through June 2009, authors have replanted 117 cases of distal phalangeal amputation in adults at Soo Hospital and Chonbuk National University Hospital. Cases of zone II were 60 cases and zone III 57 according to Allen classification. Male to female ratio was 8.7:1.3. The most common cause was machinery injury in the factory, 98 cases(83.8%), next one was belt injury of the machine, 11 cases(9.4%) and others, 8(6.8%). At least one digital artery and digital nerve were anastomosed under the operating microscope, but vein was impossible to anastomosis as unable to find out in the zone II and III. After anastomosis of one or more digital arteries and nerves, heparine(6,000-10,000 units) was kept to intravenous injection for 24 hours and at the same time fish mouth incision in 2-3 millimeter diameter was made in the distal radial and ulnar margin of the replanted distal phanlanx. From the first 30 minutes to an hour after replantation, incision site was swabbed with heparinized cotton ball for 5 minutes in every 30 to 40 minutes to make sure perfusion for 24 hours, every an hour at the second day, every two hours at the postoperative third to fifth day. Results: 92 cases(78.6%) was completely survived at average postoperative third week follow-up and satisfied with preservation of the finger nail, digit length, good range of motion of the distal interphalangeal joint and acceptable sensibility at average 1.2 years follow-up. Conclusions: Intermittant bleeding method in replantation of crushed distal phalanx impossible to anastomosis of vein at zone II and III of Allen classification was regarded as one of the notable salvage procedure.
Previous research in our laboratory has demonstrated the importance of lactose in phase I and II pig starter diets. Two experiments were conducted to evaluate the use of a carbohydrate by-product (food by-products) as a replacement for lactose. In Exp. I, 120 weaned pigs ($14{\pm}2d$ and 5.65kg) were allotted in a randomized complete block design (RCBD) to 10 replications with four pigs per pen. This experiment evaluated three carbohydrate sources (lactose, carbohydrate by-product, and 50-50 blend of the carbohydrate by-product and lactose). The carbohydrate sources were added at 26% in the phase I diets and 15% in the phase II diets. Phase I diets contained 7.5% spray dried plasma protein (SDP). The phase I diets were fed from d 0 to 14 and the phase II diets from d 15 to 28. There were no significant differences between carbohydrate sources on pig performance in phase I. However, during phase II pigs fed the diet with lactose had an improved gain/feed ratio (G/F) (p=0.06) compared to pigs fed the carbohydrate by-product. For the entire 28 d trial ADG, ADFI and G/F were similar for the 50-50 blend and those fed lactose. Total replacement of lactose with the carbohydrate byproduct resulted in a reduced G/F (p=0.09). Exp. 2 used 100 weaned pigs ($17{\pm}2d$ and 4.75kg) with five replications with five pigs per pen. This experiment evaluated four carbohydrate treatments (lactose, carbohydrate by-products, 50-50 blend, and corn). All phase I diets contained 3.5% SDP with the carbohydrate sources included at 15%, and were fed d 0 to 14. The phase II diets contained 7.5% of the carbohydrate sources and were fed d 15 to 27. A common phase III diet was fed d 28 to 42. During all phases pigs fed com tended to have a lower ADG than pigs fed the other carbohydrate sources with the 50-50 blend resulting in the highest ADG. The results of both experiments suggest that this carbohydrate by-product can replace at least 50% of the lactose in phase I and phase II pig starter diets.
Objective : Membranous nephropathy (MN) is the most common cause of adult nephrotic syndrome worldwide. MN has been defined as granular subepithelial deposition of IgG immune complexes along the glomerular basement membrane (GBM). We aimed to identify the effects of Chungyeolmaksungbang (CYMSB) treatment on cBSA-induced in MN mouse model. Methods : The effect of Chungyeolmaksungbang treatment was studied on the morphology and protein excretion in the cationized bovine serum albumin (cBSA)induced mouse chronic serum sickness nephritis model. One group of mice was given intra-peritoneal (i.p.) immunizing doses of cBSA and complete Freund's adjuvant. One week later, these animals began a single i.p. injection of cBSA for 4 weeks. A second group followed the same injection protocol, but was given CYMSB p.o. Results : Proteinuria significantly was decreased and serum albumin was increased in the group treated with cBSA and CYMSB extract compared with the control. Serum BUN was significantly decreased on CYMSB compared with control. CD3e+/CD19 cells ratio of peripheral blood was decreased and CD4+/CD8 cells was increased. Level of $IL-1{\beta}$ was significantly decreased, and $IFN-{\gamma}$ was significantly increased. Concentration of IgG and IgM was significantly decreased compared with control. Thickness of GBM was decreased on histological analysis of kidney. Deposition of CD4 and CD8 was decreased on immunohistochemical staining of kidney. Conclusions : We conclude that CYMSB treatment may could be a useful remedy agents for treating the MN with cBSA.
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