• Title/Summary/Keyword: Alternative methods

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Intravenous Patient-Controlled Analgesia with Nalbuphine: Could be an Alternative to Epidural Patient-Controlled Analgesia with Morphine-Bupivacaine for Pain Relief after Cesarean Delivery? (제왕절개술후 자가진통법을 이용한 정맥내 Nalbuphine은 경막외 Morphine과 Bupivacaine 혼합제를 대치할 수 있나?)

  • Lee, Jong-Seok;Lee, Youn-Woo;Yoon, Duck-Mi;Nam, Yong-Taek;Song, Keun-Ho
    • The Korean Journal of Pain
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    • v.10 no.1
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    • pp.34-41
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    • 1997
  • Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

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Comparative Study of Confidence Interval Estimators for Coverage Analysis (Coverage 분석을 위한 신뢰구간 추정량에 관한 비교 연구)

  • Lee, Jong-Suk;Jeong, Hae-Duck J.
    • The KIPS Transactions:PartD
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    • v.11D no.1
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    • pp.219-228
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    • 2004
  • Confidence interval estimators for proportions using normal approximation have been commonly used for coverage analysis of simulation output even though alternative approximate estimators of confidence intervals for proportions were proposed. This is -because the normal approximation was easier to use in practice than the other approximate estimators. Computing technology has no problem with dealing these alternative estimators. Recently, one of the approximation methods for coverage analysis which is based on arcsin transformation has been used for estimating proportion and for controlling the required precision in [12]. In this paper, we compare three approximate interval estimators, based on a normal distribution approximation, an arcsin transformation and an F-distribution approximation, of a single proportion. Three estimators were applied to sequential coverage analysis of steady-state means, in simulations of the M/M/1/$\infty$ and W/D/l/$\infty$ queueing systems on a single processor and multiple processors.

Effects of Samhwangsasim-tang on obesity-related metabolic disease in mice (삼황사심탕(三黃瀉心湯)이 수컷 생쥐의 비만(肥滿) 관련 대사질환(代謝疾患)에 미치는 영향)

  • Lee, Ju-Young;Kook, Yoon-Bum
    • Herbal Formula Science
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    • v.22 no.1
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    • pp.93-104
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    • 2014
  • Objectives : Samhwangsasim-tang (SHSST) is a traditional Korean medication, which has been used in Korea for treatment of hypertension and chest pain. Hyperlipidemia and inflammation could influence hypertension and chest pain. This study investigated whether and how SHSST reduces the hyperlipidemia and inflammation related to high-cholesterol diet-induced obesity in rats. Methods : Mice were divided randomly into four groups: the normal diet group, high-cholesterol diet group, low dose treatment group supplemented with 30% ethanol extract of SHSST (L) and high dose treatment group supplemented with 80% ethanol extract of SHSST (H). L and H groups were orally administered with SHSST at the dose of 50mg/kg a day respectively and others were administered with the same volume of physiological saline. Results : Administration of SHSST resulted in a decrease in serum levels of total cholesterol and low-density lipoprotein. Expression of hepatic genes(SREBP2, LXR, LDLR, and HMG-CoA) related with cholesterol metabolism was also suppressed. In addition, SHSST decreased the expression of inflammation-related gene (TNF-${\alpha}$, IL-6, ICAM-1, VCAM-1, TGF-${\beta}1$ and fibronectin). Histological examinations also showed that the size of the adipocytes was smaller in the SHSST treated group than in the high-colesterol diet group. In an in vitro study, SHSST inhibited the production of nitric oxide in a concentration-dependent manner. Conclusions : This study indicates that SHSST has anti-hyperlipidemia and anti-inflammatory effects. It may also suggest that SHSST may be alternative therapy for treatment of hyperlipidemia and its complications.

A Study on the Landscape Plan for the Sambaek Agricultural Theme Park (삼백 농업·농촌 테마공원 기본계획)

  • Kwon, Jin-Wook;Park, Chan-Yong
    • Journal of Korean Society of Rural Planning
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    • v.20 no.1
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    • pp.147-159
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    • 2014
  • This study aims to draw up a basic plan to construct an agricultural theme park in a farming city as a way of establishing its regional identity represented by "Three Whites". Sangju, Kyongsangbuk-do which is the subject area of the study has been well-known for "Three Whites (rice, silkworm cocoon and dried persimmon)." The purpose of the study is to take a closer look at the folk life and culture of Sangju and develop tourism resources to promote regional development and competitiveness of the city. This study was conducted in several phases in consideration of the characteristics of plan and design, on the basis of the theoretical review of agricultural tourism. In the first phase, planning conditions were analyzed as per development objectives. In the second phase, strategies and concepts were established for the theme park, based on which development methods were decided by phase and facility. Then, a preliminary review was conducted on functions and facilities to introduce to the theme park. In the third phase, a comprehensive plan was drawn up, which includes basic plans for respective parts. In consideration of the characteristics of the study, construction was not looked at in detail. The total size of land subject to the study is approx. $97,960m^2$, which was divided into four separate zones--Sambaek Cultural Experience Zone, Natural Observation & Experience Zone, Agricultural Life Experience Zone and other facilities zone--in order to connect facilities, functions and experience with the physical characteristics of the city, and separate space planning was conducted for each zone. The outcome of the study carries significance as an example of alternative tourism which considers regional characteristics, develops local resources and makes use of obsolete rural facilities, in what is called the eco-friendly development where nature and eco-system, landscape and culture, and recreation and leisure come together as one.

Reliability and Validity of a Smartphone-based Assessment of Gait Parameters in Patients with Chronic Stroke (만성 뇌졸중 환자에서 스마트폰을 이용한 보행변수 평가의 신뢰도와 타당도)

  • Park, Jin;Kim, Tae-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.3
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    • pp.19-25
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    • 2018
  • PURPOSE: Most gait assessment tools are expensive and require controlled laboratory environments. Tri-axial accelerometers have been used in gait analysis as an alternative to laboratory assessments. Many smartphones have added an accelerometer, making it possible to assess spatio-temporal gait parameters. This study was conducted to confirm the reliability and validity of a smartphone-based accelerometer at quantifying spatio-temporal gait parameters of stroke patients when attached to the body. METHODS: We measured gait parameters using a smartphone accelerometer and gait parameters through the GAITRite analysis system and the reliability and validity of the smartphone-based accelerometer for quantifying spatio-temporal gait parameters for stroke patients were then evaluated. Thirty stroke patients were asked to walk at self-selected comfortable speeds over a 10 m walkway, during which time gait velocity, cadence and step length were computed from smartphone-based accelerometers and validated with a GAITRite analysis system. RESULTS: Smartphone data was found to have excellent reliability ($ICC2,1{\geq}.98$) for measuring the tested parameters, with a high correlation being observed between smartphone-based gait parameters and GAITRite analysis system-based gait parameters (r = .99, .97, .41 for gait velocity, cadence, step length, respectively). CONCLUSION: The results suggest that specific opportunities exist for smartphone-based gait assessment as an alternative to conventional gait assessment. Moreover, smartphone-based gait assessment can provide objective information about changes in the spatio-temporal gait parameters of stroke subjects.

Treatment of Recurrent Ischial Pressure Sore Using Sclerotherapy with Absolute Ethanol (순수 에탄올을 이용한 재발된 좌골부위 압박궤양의 경화요법적 치료)

  • Song, Hoon;Park, Sang Keun;Kim, Jong Whan;Hong, In Pyo
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.627-631
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    • 2006
  • Purpose: Ischial region is common site of pressure sore as well as greater trochanteric area. In general, ischial pressure sore associated with a large subcutaneous bursa often requires radical surgical treatment. The authors performed sclerotherapy using absolute ethanol which was considered as an alternative in treating recurrent ischial pressure sore. Methods: From may 2005 to February 2006, 11 ischial pressure sore patients were treated sclerotherapy using absolute ethanol. The authors performed sclerotherapy using absolute ethanol in 11 patients in whom the ischial sore has recurred despite of multiple radical surgical treatment. The patients' original disorders were spinal cord injury in 9 patients, cerebral palsy in 1 patient and giant cell tumor in thoracic vertebrae 1 patient. Results: Recurrence of pressure sore was not found in any patient during the follow-up period. The swap of the bursa taken before the surgery was germ cultured and compared with the discharge from an end of the inserted drain tube. The germ cultured results after the surgery were tested negative in all patients. Conclusion: This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. We felt that aforementioned treatment modality may be considered as an alternative in treating recurrent ischial pressure sore.

Mid-Term Outcomes of Single-Port versus Conventional Three-Port Video-Assisted Thoracoscopic Surgery for Primary Spontaneous Pneumothorax

  • Jung, Hanna;Oh, Tak Hyuk;Cho, Joon Yong;Lee, Deok Heon
    • Journal of Chest Surgery
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    • v.50 no.3
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    • pp.184-189
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    • 2017
  • Background: The benefits of video-assisted thoracoscopic surgery (VATS) have been demonstrated over the past decades; as a result, VATS has become the gold-standard treatment for primary spontaneous pneumothorax (PSP). Due to improvements in surgical technique and equipment, single-port VATS (s-VATS) is emerging as an alternative approach to conventional three-port VATS (t-VATS). The aim of this study was to evaluate s-VATS as a treatment for PSP by comparing operative outcomes and recurrence rates for s-VATS versus t-VATS. Methods: Between March 2013 and December 2015, VATS for PSP was performed in 146 patients in Kyungpook National University Hospital. We retrospectively reviewed the medical records of these patients. Results: The mean follow-up duration was $13.4{\pm}6.5$ months in the s-VATS group and $28.7{\pm}3.9$ months in the t-VATS group. Operative time (p<0.001), the number of staples used for the operation (p=0.001), duration of drainage (p=0.001), and duration of the postoperative stay (p<0.001) were significantly lower in the s-VATS group than in the t-VATS group. There was no difference in the overall recurrence-free survival rate between the s-VATS and t-VATS groups. Conclusion: No significant differences in operative outcomes and recurrence rates were found between s-VATS and t-VATS for PSP. Therefore, we cautiously suggest that s-VATS may be an appropriate alternative to t-VATS in the treatment of PSP.

Estimation of Usual Meat Intake Distribution Considering Meat Content in Processed Foods: Based on the KNHANES 2009 (가공식품 중 육류 함량을 고려한 일상적인 육류 섭취량 분포 추정 연구: 국민건강영양조사 자료(2009년) 활용)

  • Shin, Yun-Jung;Kim, Ae-Jung;Kim, Dong Woo
    • Korean Journal of Community Nutrition
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    • v.25 no.2
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    • pp.150-158
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    • 2020
  • Objectives: This study was conducted to estimate usual meat intake distribution, which may have been over/underestimated when estimations were made using only the third food codes of the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: For this purpose, 24-hour recall data from the 2009 Korea National Health and Nutrition Examination Survey, which conducted a partial 2-day survey of food intake, were used. The Multiple Source Method (MSM) was used to estimate the distribution of the usual intake of red and processed meats. Results: The results of this study show that the mean intake of red meat was 45.07 g while that of processed meat was 4.33 g. These results are slightly higher than the consumption calculated using only tertiary food code, and the difference was statistically significant. Furthermore, characteristics of the estimated usual intake distribution were a smaller standard deviation, increased lower percentiles, and decreased upper percentiles compared to the 2-day mean intake distribution for both red and processed meats. The proportion of individuals not consuming red meat decreased substantially from approximately 37% to 0.7%. The proportion of consumption that exceeded 90 g, which is the upper limit of red meat intake recommended by the National Health Service (NHS), was only approximately 10% in the distribution of usual intake. Conclusions: As the consumption of processed foods is expected to continuously increase, caution is needed regarding the processes used to calculate food (group) intake to avoid over/underestimation. Moreover, use of KNHANES data to calculate the proportion of the population at risk of insufficiency or excess intake of certain nutrients or food (group), based on one day intake that does not address within-individual variation, may lead to biased estimates.

Association of Toll-Like Receptor 5 Gene Polymorphism with Susceptibility to Ossification of the Posterior Longitudinal Ligament of the Spine in Korean Population

  • Chung, Won-Suk;Nam, Dong-Hyun;Jo, Dae-Jean;Lee, Jun-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.8-12
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    • 2011
  • Objective: Ossification of the posterior longitudinal ligament (OPLL) has a strong genetic component. Specific gene polymorphisms may be associated with OPLL in several genes which regulate calcification in chondrocytes, change of extracellular collagen matrix and secretions of many growth factors and cytokines controlling bone morphogenesis. Toll-like receptor 5 (TLR5) may playa role in the pathogenesis of OPLL by intermediate nuclear factor-kappa B (NF-${\kappa}B$). The current study focused on coding single nucleotide polymorphisms (SNPs) of TLR5 for a case-control study investigating the relationship between TLR5 and OPLL in a Korean population. Methods: A total of 166 patients with OPLL and 231 controls were recruited for a case-control association study investigating the relationship between SNPs of TLR5 gene and OPLL. Four SNPs were genotyped by direct sequencing (rs5744168, rs5744169, rs2072493, and rs5744174). SNP data were analyzed using the SNPStats, SNPAnalyzer, Haploview, and Helixtree programs. Multiple logistic regression analysis with adjustment for age and gender was performed to calculate an odds ratio (OR). Results: None of SNPs were associated with OPLL in three alternative models (codominant, dominant, and recessive models; p> 0.05). A strong linkage disequilibrium block, including all 4 SNPs, was constructed using the Gabriel method. No haplotype was significantly associated with OPLL in three alternative models. Conclusion: These results suggest that Toll-like receptor 5 gene may not be associated with ossification of the posterior longitudinal ligament risk in Korean population.

Effects of Reflexology Foot Massage to Improve Quality of Life and Reduce Anxiety for Hospitalized Cancer Patients Undergoing Chemotherapy or Radioisotope Therapy (발반사요범이 항암제 또는 방사선요오드 치료 중인 입원 암환자들의 삶의 질 향상과 불안 우울 감소에 미치는 효능)

  • Choie, Mi-Hee;Jeong, In-Sook;Jeong, Tae-Young;Kim, Kyung-Soon;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.14 no.1
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    • pp.61-74
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    • 2009
  • Objectives: To evaluate the effectiveness of reflexology foot massage (RFM) to improve quality of life and reduce anxiety for hospitalized cancer patients undergoing chemotherapy. Methods: This study was conducted at the East-West Cancer Center at Daejeon University; Using an waiting list and non-treatment control research design, we compared the results of control group and to that of the experimental group. The study consisted of 14 hospitalized cancer patients being admitted to the East-West Cancer Center of Daejeon University Dunsan Oriental Hospital in Korea. We measured FACT-G (Functional Assessment Cancer Therapy-General) and STAI (Spielberger State-Trait Anxiety Inventory) scale before, after and 48 hours after the intervention. The patients received 30 minute RFM 5 times a week. Results: There was an average increase on the FACT-G, Physical, total scale and decrease of STAI 1 scale in the treatment group compared with control group (P < 0.05). Anxiety in the treatment group showed significant decrease compared to control group. It suggests that RFM may alleviate cancer-related anxiety and contribute to the improvement in quality of life among cancer patients. Therefore, there was limited equivalences with experimental group. Conclusions: We concluded that RFM can be considered a supportive treatment used in combination with chemotherapy.

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