Harshavardhan B. Rao;Paul K. Vincent;Priya Nair;Anoop K. Koshy;Rama P. Venu
Clinical Endoscopy
/
v.55
no.5
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pp.665-673
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2022
Background/Aims: In patients undergoing endoscopic retrograde cholangiopancreatography (ERCP), calcineurin activates zymogen, which results in pancreatitis. In this study, we aimed to determine the efficacy of tacrolimus, a calcineurin inhibitor, in preventing post-ERCP pancreatitis (PEP). Methods: This was a prospective pilot study in which patients who underwent ERCP received tacrolimus (4 mg in two divided doses); this was the Tac group. A contemporaneous cohort of patients was included as a control group. All patients were followed-up for PEP. PEP was characterized by worsening abdominal pain with an acute onset, elevated pancreatic enzymes, and a duration of hospital stay of more than 48 hours. Serum tacrolimus levels were measured immediately before the procedure in the Tac group. Results: There were no differences in the baseline characteristics between the Tac group (n=48) and the control group (n=51). Only four out of 48 patients (8.3%) had PEP in the Tac group compared to eight out of 51 patients (15.7%) who had PEP in the control group. The mean trough tacrolimus level in patients who developed PEP was significantly lower (p<0.05). Conclusions: Oral tacrolimus at a cumulative dose of 4 mg safely prevents PEP. Further randomized controlled studies are warranted to establish the role of tacrolimus in this context.
Purpose: The purpose of this research is to examine types of music (relax music or preferred music that patients have chosen) can effects on anxiety, blood pressure and pulse, and whether there are differences depending on the kinds of music in order to reduce anxiety of surgical patients using spinal anesthesia. Methods: This research's design is quasi-experimental design and non-equivalent control group pretest-posttest experimental design conducted on 60 surgical patients(experimental group 1=relax music therapy group, experimental group 2=preferred music therapy group, and group 3=control group) using spinal anesthesia. The Variables were trait anxiety, state anxiety, blood pressure, and pulse. Results: 1) In the state anxiety, there was a significant difference among the experimental groups 1, group 2 and the control group. 2) There was a significant difference in systolic blood pressure among the experimental group 1, group 2, and the control group. 3) In pulse, no significant difference among the experimental group 1, group 2 and the control group was detected. Conclusion: Regardless of the types of music, music therapy is thought to be effective nursing mediation to mitigate the state anxiety of surgical patients undergoing spinal anesthesia.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.34
no.2
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pp.187-195
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2008
Purpose: This epidemiologic research was carried out to investigate the degree and aspects of symptoms of patients suffered from TMD using RDC/TMD. Subjects and Methods: Subjects were the patients who had visited to SNUBH dental clinic from Jan. 2005 to Dec. 2005, and total 117 patients were included (M: 22, F:95). The signs and symptoms of physical, psychological and behavioral factors were retrospectively evaluated by questionnaires in the RDC/TMD. The patients were examined through clinical and radiological method, and diagnosed by same investigator. They were divided into 3 groups such as osteoarthritis group (group 1), internal deragnement (group 2), myofascial pain dysfunction syndrome group (MPDS, group 3). In addition, in patient with complex diagnosis they were divided into subgroups in detail (ex. group 1+group 2). In the questionnaire, several items were selected to calculate the graded pain score (grade $0{\sim}IV$), depression and vegetative symptoms, nonspecific physical symptoms(pain items included) and nonspecific physical symptoms(pain items excluded) in each group. Results: As a result of classification by diagnostic criteria of this study, the patients were distributed to 45% of group 1, 47% of group 2, 8% of group 3 in this study. In younger patients (under 25-year old, n=40), group 2 was occupied 57% (n=23) and group 1 was 35%, group 3 was 8%, while group 1 was occupied 75% in elderly-patients (over 40-year old, n=28) in present study (group 2: 21%, group 3: 4%). In the analysis of depression and vegetative symptoms, majority of patients in Group 2 were included in 'normal', and in Group 3 it appeared to have larger proportion of 'moderate' & 'severe' than others. According to nonspecific physical symptoms, there have been tendencies of higher ratio of 'severe' in patients with MPDS. In graded pain score, more than half (58%) of subjects were included in grade 0 and low disability (Grade I and II), and 27% were revealed high disability (grade III, IV).
Purpose: This study was undertaken to identify the effect of providing information on anxiety, knowledge and compliance in permanent pacemaker patients. Method: A quasi experimental design with non-equivalent control group and non-synchronized design was used. The subjects of this study were 50 patients who had received permanent pacemaker implantation at a university hospital in Seoul. They were divided into an experimental group of 22 patients who received education and a control group of 28 patients. The education was composed of group education(twice) and individualized reinforcement education(once) using an education booklet. Results: Anxiety decreased in the experimental group. Knowledge significantly increased in the experimental group compared to that in the control group. Compliance significantly increased in the experimental group. Conclusion: It can be concluded that providing information is effective for reducing anxiety, increasing knowledge and improving compliance of the permanent pacemaker patients.
Purpose: Vitamin D is associated with various pathological conditions such as cardiovascular diseases and cancer. We investigated the relationship between vitamin D and Kawasaki disease (KD). Methods: We performed a retrospective review of the medical records of patients with KD between February 2013 and March 2016 in Daegu Fatima Hospital. Study participants were grouped according to vitamin D serum concentration. Group 1 included patients with 25(OH)-vitamin D ${\geq}20ng/mL$. Group 2 included patients with 25(OH)-vitamin D <20 ng/mL. We analyzed the clinical characteristics and laboratory data of the 2 groups. Results: Of the 91 patients, 52 were included in group 1, and 39 in group 2. Group 1 patients had significantly higher levels of calcium, phosphate, albumin and sodium than group 2 patients did. There were no differences in clinical characteristics, but the proportion of patients with polymorphic rash was significantly higher in group 2. Resistance to intravenous immunoglobulin was more frequent in group 2 (P=0.023). No significant difference in the incidence of coronary artery complications was observed. Conclusion: Low vitamin D levels are associated with resistance to intravenous immunoglobulin therapy in KD. Vitamin D deficiency might be a risk factor for immunoglobulin resistance in KD.
Myasthenia gravis is a neuromuscular transmission disorder characterized by fatigue and weakness of voluntary muscles. Although the pathogenesis is known as reduction of available acetylcholine receptors at neuromuscular junctions by autoimmune attack, the thymic role in myasthenia gravis is still unclear and under investigation. But thymectomy in the management of myasthenia gravis has become increasingly important since the first successful operation with remission of symptoms in 1939 by Blalock. From January 1983 to June 1985, authors performed 17 thymectomies for patients with myasthenia gravis. Among them, 12 patients were free from thymoma [Croup A] and 5 were coupled with thymoma [Group B]. The results were as follows: 1] Sex distribution was 11 females and 6 males. Mean age of the patients was 32.2 year old. Sex and age distribution by the Group A and B are shown Table 1. 2] Clinical manifestations of ocular symptoms were seen in 5 patients [88.2%], extremity weakness in 13 patients, bulbar weakness in 12 patients and dyspnea in 6 patients. According to the Osserman`s classification, 5 patients were in group IIA, 6 in IIB and 6 in IIC. 3] Pre-operatively, all patients were positive response to the anti-cholinesterase test and 12 patients [92.3%] revealed positive findings in electromyography [EMC] which was done in 13 patients. 4] The postoperative complications were respiratory distress in 3 patients, myasthenic crisis in 2 patients and wound disruption in one patients. 5] Pathologic examination of the thymus showed hyperplasia in 10 patients [90%] and thymoma in 5 patients, of which 4 were mixed type with invasion to the adjacent tissues and one lymphocytic type without invasion. Normal thymus was noticed in only 2 patients. 6] In postoperative evaluations, among the 12 patients c free from thymoma [Group A], complete remission of symptoms was noticed in 3 patients and improvement in 7 patients. But among the 5 patients coupled with thymoma [Group B], only one patients showed improvement [Table 8]. Therefore, remission and clinical improvement were noticed in 11 patients [64.7%] of the all and complete remission was noticed in 3 patients [17.6%].
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.23
no.2
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pp.151-162
/
2010
Objective : Bell's palsy is common and has many clinic study. but bell's palsy prognosis is not enough specific. So this study was evaluated bell's palsy prognosis, treatment number, sequela of normal group and bad prognosis group. Methods : From June 2009 to June 2010, patients who visited Dong-seo Oriental Medicine ENT. A clinic study was done on patient who were diagnosed bell's palsy, onset 2weeks within when first visited OPD and treated 3 times over in Dong-seo Oriental Medicine Cental. To evaluate grade of paralysis, House-Brackman Scale was used. We classified treatment numbers of each HB-Scale group, normal gIVroup and bad prognosis group. Results : The distribution of Onset HB-Scale : Gr II 26.25%, Gr III 67.5%, Gr IV 6.25% Onset HB-Scale Gr II patients completely recover 100% Onset HB-Scale Gr III patients completely recover 64.8%, improved 27.8%, nothing change 7.4% Onset HB-Scale Gr IV patients completely recover 40%, improved 60% Onset HB-Scale Gr II & IV patients recovery percentage make no difference of normal group (Group A) and bad prognosis. Onset HB-Scale Gr III patients completely recover Group A 66.7%, Group B 52.9%, improved Group A 23.2%, Group 35.3%, noting change Group A 5.1%, Group B 11.8% Onset HB-Scale Gr II patients has no sequela. Onset HB-Scale Gr III & IV patients has tendency that they treat more times, more improving and less sequela probability Conclusion : Onset HB-Scale is the indicator of acute bell's palsy prognosis.
Journal of Korean Academy of Fundamentals of Nursing
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v.17
no.4
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pp.498-507
/
2010
Purpose: The purpose of this study was to evaluate the effects of preoperative PCA (Patient-Controlled Analgesia) education on pain, patient attitude, and patient satisfaction in surgical patients. Methods: The study was a quasi-experimental research design. The participants were 54 patients who were admitted for surgery at I hospital in G city, Korea. Of the 54 patients, 26 were assigned to the experimental group and the rest to the control group. The PCA education was provided in the nurses' station, individually to patients in the experimental group the day before their operation. Multimedia and brochure, and a real PCA model were used. The control group received only verbal education about PCA. Results: The postoperative pain scores were significantly different for lapse of time in the experimental group compare to the control group. Patient attitude toward using pain medicine was significantly more positive in the experimental group than in the control group. The postoperative patient satisfaction with pain management was significantly higher in the experimental group than in the control group. Conclusion: The study findings indicate that preoperative PCA education could be an effective nursing intervention for pain management of surgical patients.
Objectives The present study retrospectively investigated clinical outcome of patients with structual scoliosis during Chuna treatment. Methods : The study population consisted of 34 patients(14 patients of adolescent and 20 patients of adult) who were diagnosised as scoliosis with radiological finding. All patients were treated with Chuna treatment, and after treatment, evaluated with radiological measurement by calculating the scoliosis correction angle from the Initial and follow-up spine AP and lateral views. Also the evaluation of clinical outcome was done twice pre and post treatment during this study. Results : The results were summarized as follows ; 1) The 85.3 percent of patients complained physical pain. and adult group had various painful lesion compared with adolescent group. 2) Adult group had treated $18.0{\pm}7.2$ times and adolescent group treated $13.5{\pm}5.7$ times with Chuna treatment. 3) Scoliotic angle is reduced in 92.9 percent of adolescent group and had all of adult group after Chuna treatment, especially, statistically significance appeared in adult group. 4) Adult group was superior to adolescent group in correctability and scoliotic angle change. 5) Correction effect was better in the group which initial scoliotic angle was lessor, or had more time of treatment. 6) According to grade of vertebral body rotation, scoliotic angle is larger and correctability was lower. Conclusions : Chuna treatment was efficacious against scoliosis. And it is necessary for adolescent scoliosis patient to be more carefully treated and observed.
Yucel, Birsen;Okur, Yillar;Akkas, Ebru Atasever;Eren, Mehmet Fuat
Asian Pacific Journal of Cancer Prevention
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v.14
no.2
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pp.969-975
/
2013
Aim: The aim of this study was to determine the impact of age on the occurrence, severity, and timing of acute side effects related to radiotherapy. Materials and Methods: We analysed the data of 423 patients. Results: Of the patients, 295 (70%) were under the age of 65 (group 1) and 128 (30%) were over the age of 65 (group 2). The frequencies of radiotherapy-induced side effects were 89% in group 1 and 87% in group 2 (p=0.286). The mean times to occurrence were $2.5{\pm}0.1$ weeks in group 1 and $2.2{\pm}0.1$ weeks in group 2 (p=0.013). Treatment was ended in 2% of patients in group 1 and 6% of those in group 2 (p=0.062). Treatment interruption was identified in 18% of patients in group 1 and 23% in group 2 (p=0.142). Changes in performance status were greater in older patients (p=0.013). There were no significant differences according to the frequency or severity of side effects, except skin and genitourinary complications, between the groups. Conclusions: Early normal tissue reactions were not higher in older versus younger patients, though there was a tendency towards an earlier appearance.
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