• Title/Summary/Keyword: Mean Effective Pressure

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Sitagliptin and Vildagliptin Use Evaluation among Dipeptidyl Peptidase 4 Inhibitors in Adult Koreans with Type 2 Diabetes Mellitus (한국인 제2형 당뇨병 환자에 대한 디펩티딜 펩티다제 4 억제제 중 Sitagliptin과 Vildagliptin의 약물 사용 평가)

  • Park, Hyun-Jung;Lee, Ok-Sang;Lim, Sung-Cil
    • YAKHAK HOEJI
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    • v.56 no.2
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    • pp.136-143
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    • 2012
  • Type 2 Diabetes Mellitus (T2DM) is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. Diabetes is often initially managed by increasing exercise and dietary modification. As the condition progresses, medications may be needed such as oral sulfonylurea or others. Recently, dipeptidyl peptidase 4 (DPP- 4) Inhibitor is new drug which can control blood glucose by increasing the active levels of incretin hormone in the body. However, researches have been carried out for mostly Caucasian and Japanese, not for Koreans at all. Therefore, this study was to evaluate the efficacy and safety of DPP-4 inhibitor (Sitagliptin, Vildagliptin) in patients with T2DM in Koreans. This study was carried out retrospectively with reviewing of medical records from the 141 patients who received sitagliptin or vildagliptin over 24 week periods from January 2009, to December 2009. Information including demographics, concomitant medication, disease duration, and exercise was evaluated. $HbA_{1c}$, random blood glucose, post prandial 2 hour glucose, blood pressure, AST, ALT, serum creatinine, total cholesterol, triglyceride levels were also collected at baseline and endpoint (at 24 weeks). In each post-treatment group, $HbA_{1c}$, random blood glucose and post prandial 2 hour glucose levels were decreased significantly from baseline in the sitagliptin group (-0.82%, -28.76 mg/dl, -46.65 mg/dl) and vildagliptin group(-1.22%, -27.96 mg/dl, -67.2 mg/dl). Greater $HbA_{1c}$ mean reductions from baseline to 24 weeks were seen in patients with higher baseline values (>7.0%), with shorter disease durations (${\leq}1$ year) compared with those with lower baseline values (<7.0%), with longer disease durations (>1 year) in both sitagliptin and vildagliptin groups. The incidences of hypoglycemia, headache and upper respiratory infection were 0%, 8.7%, 5.8% in sitagliptin group and 2.8%, 8.3%, 6.9% in vildagliptin group. In conclusion, our results showed DPP-4 inhibitor provided similar efficacy compared with sulfonylurea after 24 weeks of treatment and were safer than sulfonylurea in hypoglycemia for Korean T2DM. Also vildagliptin was associated with significant improvement in $HbA_{1c}$ reduction in Korean patient with subgroup (body mass index<25 $kg/m^2$, metformin dose${\geq}$1000 mg, p<0.05) compared to sitagliptin. Therefore, even though DPP-4 inhibitor use for Korean needs to be studied more consistently in the future, DPP-4 inhibitor is a safe and effective drug for Korean T2DM based on our result.

The Effects of Rhythmic Exercise Program on Physiologic Variables, Life satisfaction, Calcium, Phosphorous, Osteocalcin, Deoxypyridinoline in the Elderly Women (율동적 운동 프로그램이 여성노인의 생리적 지수, 생활만족, Calcium, Phosphorous, Osteocalcin, Deoxypyridinoline에 미치는 영향)

  • Jung, Young-Ju
    • Journal of Korean Biological Nursing Science
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    • v.4 no.2
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    • pp.93-112
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    • 2002
  • Recently, the number of the elderly has increased according to the improvement of socioeconomic status and the efficient medical care system. In spite of the development of medicine, the elderly suffers from the various health problems caused by weakness of musculoskeletal system, cardiopulmonary function and immunologic dysfunction. Regular rhythmic exercise program is known to be one of the effective tools to enhance the health condition in the elderly. However, there has been few studies to evaluate the comprehensive effects of rhythmic movement program on the elderly. This study was focused to evaluate the indices of cardiopulmonary function, life satisfaction, calcium, phosphorous, osteocalcin and deoxypyridinoline which are the essential factors of health problems in the elderly women. Twenty six subjects, aged between 68 and 72, who can do the ordinary activities and do not have cardiovascular dysfunction and mental disorder, participated in this study. They were divided into two groups: 13 in the experimental group and 13 in the control group. The experimental group participated in the rhythmic movement program at the welfare center located in G-city. The program were consisted of three sessions a week during 10 weeks. Each session had three parts: warming up(10 minutes), main exercise(40 minutes), finishing(10 minutes). Heart rate, blood pressure and peripheral arterial oxygen saturation were measured for the evaluation of cardiopulmonary function. Serum calcium, phosphorous, osteocalcin and urine deoxypyridinoline were measured as the indices of bony metabolism. Data were analyzed with mean, standard deviation, $x^2$-test, t-test, paired t-test using SPSS PC+ program. The results of this study were as follows. 1) Heart rate of the experimental group showed significant decrease following the rhythmic movement program. Peripheral arterial oxygen saturation of the experimental group showed significant increase following the program. 2) The degree of life satisfaction of the experimental group showed significant increase following the program. 3) Calcium showed significant decrease following the program but remained within normal range. There was no significant difference of phosphorous between two groups. 4) Osteocalcin, the index of bone formation, showed no significant change following the program, but significant increase in the experimental group comparing with the control group. 5) Deoxypyridinoline, the index of bone resorption, in urine of the experimental group showed significant decrease following the program. In conclusion, the rhythmic exercise program in the elderly showed the improvement of physiologic function and favorable effects on life satisfaction and bony metabolism. According to the above results, the regular rhythmic movement program can be strongly recommended for the improvement of health in the elderly women.

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Quality Improvement in the Trauma Intensive Care Unit Using a Rounding Checklist: The Implementation Results

  • Chang, Ye Rim;Chang, Sung Wook;Kim, Dong Hun;Yun, Jeongseok;Yun, Jung Ho;Lee, Seok Won;Jo, Han Cheol;Choi, Seok Ho
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.113-119
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    • 2017
  • Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.

Which One Is Better to Reduce the Infection Rate, Early or Late Cranioplasty?

  • Oh, Jae-Sang;Lee, Kyeong-Seok;Shim, Jai-Joon;Yoon, Seok-Mann;Doh, Jae-Won;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.59 no.5
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    • pp.492-497
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    • 2016
  • Objective : Decompressive craniectomy is an effective therapy to relieve high intracranial pressure after acute brain damage. However, the optimal timing for cranioplasty after decompression is still controversial. Many authors reported that early cranioplasty may contribute to improve the cerebral blood flow and brain metabolism. However, despite all the advantages, there always remains a concern that early cranioplasty may increase the chance of infection. The purpose of this retrospective study is to investigate whether the early cranioplasty increase the infection rate. We also evaluated the risk factors of infection following cranioplasty. Methods : We retrospectively examined the results of 131 patients who underwent cranioplasty in our institution between January 2008 and June 2015. We divided them into early (${\leq}90days$) and late (>90 days after craniectomy) groups. We examined the risk factors of infection after cranioplasty. We analyzed the infection rate between two groups. Results : There were more male patients (62%) than female (38%). The mean age was 49 years. Infection occurred in 17 patients (13%) after cranioplasty. The infection rate of early cranioplasty was lower than that of late cranioplasty (7% vs. 20%; p=0.02). Early cranioplasty, non-metal allograft materials, re-operation before cranioplasty and younger age were the significant factors in the infection rate after cranioplasty (p<0.05). Especially allograft was a significant risk factor of infection (odds ratio, 12.4; 95% confidence interval, 3.24-47.33; p<0.01). Younger age was also a significant risk factor of infection after cranioplasty by multivariable analysis (odds ratio, 0.96; 95% confidence interval, 0.96-0.99; p=0.02). Conclusion : Early cranioplasty did not increase the infection rate in this study. The use of non-metal allograft materials influenced a more important role in infection in cranioplasty. Actually, timing itself was not a significant risk factor in multivariate analysis. So the early cranioplasty may bring better outcomes in cognitive functions or wound without raising the infection rate.

Perceived Product Value and Attitude Change Affecting Web-based Price Discount Level and Scarcity (웹 기반 가격할인 수준과 희소성이 영향을 주는 지각된 제품 가치와 태도 변화)

  • Zhang, Yutao;Lim, Hyun-A;Choi, Jaewon
    • The Journal of Information Systems
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    • v.27 no.2
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    • pp.157-173
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    • 2018
  • Purpose Product characteristics and price value in website have strongly effects on customer satisfaction. Especially, in the online shopping site, the scarcity limits the customer's opportunity to purchase the product. Thus scarcity has been proposed as a important factor that makes the customer highly aware of the merchantability of the product. The scarcity in the web store is used as an important variable to make purchasing decisions of users easier by psychological pressure. In the case of scarce products with price discounts in online commerce, advertising formats that highlight scarcity value in the web commerce market are very effective in enhancing purchase intentions of consumers. Unlike offline stores, the importance of scarcity becomes more important when reflecting the characteristics of online commerce. Therefore, this study intends to confirm the influence of the degree of price discounts and scarcity information presented by Web sites on consumer purchase behavior in Web purchase behavior. Design/methodology/approach This study conducted a web-based experimental study on price sensitivity and price discount. Therefore, we created experimental web-sites that offer two stimuli according to the discount rate. The 200 respondents were randomly assigned. The stimuli were fictitious based on tourism products. The first stimulus presented the price discount(15% discount) with basic explanation about the package of the tourist package. The stimuli assigned to the second group were used for groups with high price discount intensity(65% discount). In this way, the two stimuli clearly distinguished the level of price discount intensity. This paper conducted t-test analysis and structural equation to analyze the experiemental results after confirming the reliability and validity. Findings The results of this study are as follows. The difference in price discount intensity (15% vs 65%) with scarcity showed the mean difference among all the variables. Therefore, this study concluded that there is a significant difference between the price discount of 15% and 65% for the acquisition value and transaction value of users. In particular, consumers' purchase intention is greater and product recommendation intensity is stronger when the price discount is 65%. As a result, the high degree of the price discount intensity with scarcity exerts a greater influence on consumers' purchase intentions. Product scarcity also have a significant impact on perceived value of users. Therefore, purchase intention of customers increases when perceived value increases their profit and pleasure feeling.

A STUDY ON THE EFFECT OF DENTIN BONDING AGENTS APPLIED OVER ENAMEL ABOUT THE BOND STRENGTH OF COMPOSITE RESIN (접착강화제가 치아경조직과의 접착강도 변화에 미치는 영향에 관한 연구)

  • Choi, Woong-Dae;Park, Sang-Jin
    • Restorative Dentistry and Endodontics
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    • v.20 no.1
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    • pp.1-16
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    • 1995
  • The purpose of this study was to investigate the effect of dentin bonding agents on the bond strength of composite resin restorations in case of applying the dentin bonding agents to acid etched enamel surfaces. Freshly extracted 364 bovine anterior teeth were selected as a adherents. 320 enamel specimens were divided into two groups(unetched group (1) and etched group (2) for testing the shear bond strength, 40 specimens were used for the hardness testing, and 4 specimens of rest were to observe the resin-tag formation into etched enamel surfaces. All surfaces of enamel specimens were polished with 320~1500 SiC paper under continuous running water. In Group (1), 100 enamel specimens were polished and unetched. 220 polished enamel specimens in Group (2) were etched with 37 % phosphoric acid solution for 60 seconds, washed with water for 20 seconds, and dried with a light air pressure for 60 seconds. Three kinds of dentin bonding agents(Gluma, Prisma, Scotchbond 2) were evaluated the effect on the bond strength to conditioned enamel surfaces. Shear bond strengths were measured on the three cases such as a coating of primer only, a coating of sealer only, and a sequential coating of primer and sealer to acid etched enamel surfaces were compared with the bond strengths measured by the coating of enamel bonding agent followed by the bonding of composite resin (Photo clearfil bright, Kuraray, Japan) to unetched and acid etched enamel surfaces. In addition, the hardness tested on the adhesive fractured surface between composite resin enamel as a mean of evaluation of a factor whether the mechanical bond strengths were affected and the penetration of dentin bonding agents into etched enamel surfaces was also observed. Bond strengths were measured using the method of shear bond strength by a universal testing machine (Instron-4467, USA), statistical test were applied to the results using a one way analysis variance(ANOVA), and hardness was measured by the Vicker's Hardness Tester(MHT-i, Matsuzawa, Japan) and the penetration of the resins were observed by the SEM (Hitachi, S-2300, Japan). The following conclusions were drawn; 1. Enamel bonding agent showed to affect the improvement of bond strength of composite resin to enamel surface both unetched and etched. 2. Dentin bonding agents could be resulted in increase of bond strength to unetched enamel surface, but there were no statistical significances. 3. Bond strengths to etched enamel surface were significantly decreased with a coating of dentin primer only. 4. Coating of sealer only and coating of primer and sealer noticed the similar bond strengths of composite resin to etched enamel using the enamel bonding agents. 5. The applying method proved to be more effective than the kinds of dentin bonding agents on the bond strength of composite resin to etched enamel than the kind of dentin. 6. Vicker's hardness numbers of dentin bonding agents were lower than that of composite resin, but the degree of penetration of dentin bonding agents into etched enamel surfaces was excellent.

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The efficacy and safety of Montelukast sodium in the prevention of bronchopulmonary dysplasia

  • Kim, Sang Bum;Lee, Jang Hoon;Lee, Juyoung;Shin, Seung Han;Eun, Ho Sun;Lee, Soon Min;Sohn, Jin A;Kim, Han Suk;Choi, Byung Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Park, Moon Sung
    • Clinical and Experimental Pediatrics
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    • v.58 no.9
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    • pp.347-353
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    • 2015
  • Purpose: The purpose of this study was to evaluate the efficacy and safety of Montelukast sodium in the prevention of bronchopulmonarydysplasia (BPD). Methods: The Interventional study was designed as a multicenter, prospective, and randomized trial, with open labeled and parallel-experimental groups, 66 infants were enrolled and allocated to either the case group (n=30) or the control group (n=36) based on gestational age (GA). Infants in the case group were given Montelukast sodium (Singulair) based on their body weight (BW). Zero week was defined as the start time of the study. Results: The incidence of moderate to severe BPD was not different between the groups (case group: 13 of 30 [43.3%] vs. control group: 19 of 36 [52.8%], P=0.912). Additionally, secondary outcomes such as ventilation index, mean airway pressure and resort to systemic steroids were not significantly different. There were no serious adverse drug reactions in either group, and furthermore the rate of occurrence of mild drug related-events were not significantly different (case group: 10 of 42 [23.8%] vs. control group: 6 of 48 (15.8%), P=0.414). Conclusion: Montelukast was not effective in reducing moderate or severe BPD. There were no significant adverse drug events associated with Montelukast treatment.

A Comparison of Two Intramuscular Doses of a Xylazine-Diazepam-Ketamine Combination in Dogs (개에서 Xylazine-diazepam-ketamine 병용마취 시 두 가지 근육내 투여 용량 비교)

  • Lee, Jae-Yeon;Seo, Ji-Won;Cho, Jae-Geum;Cho, Ha-Eun;Jeong, Seong-Mok;Kim, Myung-Cheol
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.12-17
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    • 2012
  • Many drugs are administered intramuscularly to immobilize and anesthetize dogs. There are many established intramuscular (IM) anesthetic combinations for dogs; however, little information is available on the effects of a xylazinediazepam-ketamine (XDK) combination. The purpose of this study was to investigate the anesthetic effects of the XDK combination in dogs. Twelve adult mixed bred dogs were used. All dogs were anesthetized with an IM injection of diazepam (0.5 mg/kg) and xylazine (1.1 mg/kg) with low-dose ketamine (5 mg/kg; group 1) or high-dose ketamine (10 mg/kg; group 2) in one syringe. After administration of the test dose, the animals were positioned in a right lateral recumbency, and analgesia and cardiopulmonary data were collected and recorded. The duration of anesthesia in group 2 was significantly longer than that of group 1 (mean [sd] 68.0 [7.6] v 51.3 [2.7] minutes). Blood pressure increased significantly after XDK administration in both groups, and $S_aO_2$ levels decreased significantly from baseline at 10, 20, and 30 minutes in both groups. XDK administration produced satisfactory sedation and analgesia in all dogs. In conclusion, intramuscular administration of xylazine-diazepam-ketamine combination at a doses of 1.1 mg/kg xylazine, 0.5 mg/kg diazepam, and 5 or 10 mg/kg ketamine appeared to be effective short duration anesthetic protocols in dogs.

Antagonistic Effects of Atipamezole and Yohimbine on Medetomidine-Midazolam-Ketamine Anesthesia in Beagle Dogs (비글견에서 medetomidine-midazolam-ketamine 마취에 대한 atipamezole과 yohimbine의 길항효과)

  • Hwang, Hag-Kyun;Lee, Jae-Yeon;Jeong, Seong-Mok;Kim, Myung-Cbeol
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.211-218
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    • 2011
  • The aims of this study were to investigate the anesthetic effects of medetomidine-midazolam-ketamine (MMK) combination and to compare antagonistic effects of atipamezole and yohimbine in dogs anesthetized with MMK. Eighteen adult male healthy beagles were used in this study. All dogs were anesthetized with intramuscular (IM) administration of medetomidine (0.04 mg/kg), midazolam (0.2 mg/kg) and ketamine (5 mg/kg) in one syringe. Intravenous (IV) administration of atipamezole (0.24 mg/kg, MMKA), yohimbine (0.2 mg/kg, MMKY) or saline solution (0.1 ml/kg, MMK) was administered 20 minutes after MMK combination anesthesia. Induction and recovery times, scores of sedation and analgesia, heart rate, blood pressure, rectal temperature, respiratory rate and blood gases were determined and recorded for each dog. Mean anesthesia times, sternal recumbency times, standing times and walking times in the MMKA and MMKY groups were significantly shorter than those in the MMK group. But there were not significantly different between MMKA and MMKY groups. In all groups, MMK administration produced a satisfactory sedation and analgesia for all dogs. However, after administration of atipamezole or yohimbine the scores for posture and response to noxious stimuli were significantly lower in the MMKA or MMKY group than those in the MMK group. MMK produced good sedation and anesthesia effects, and atipamezole or yohimbine can be used as a safe and effective agent for antagonizing the MMK anesthesia in dogs.

Cyclic Simple Shear Test Based Design Liquefaction Resistance Curve of Granular Soil (반복단순전단시험에 기반한 조립토의 설계 액상화 저항 곡선 개발)

  • Saeed-ullah, Jan Mandokhail;Park, Duhee;Kim, Hansup;Park, Ki-Chun
    • Journal of the Korean Geotechnical Society
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    • v.32 no.6
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    • pp.49-59
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    • 2016
  • We develop liquefaction resistance curves, which represent the correlation between cyclic resistance ratio (CRR) and number of cycles (N) to estimate the build-up of residual excess pore pressure from simple shear tests performed for this study and also from published literature. The liquefaction curve is calculated from two models. The comparisons show that one of the models is not reliable because it underestimates CRR. The scatter of the data is shown to be significantly reduced when CRR is normalized to the resistance ratio at N = 15 ($CRR_{N=15}$). Use of the normalization is particularly useful because CRR can be easily estimated from field tests. From normalization, we propose mean, upper, and lower curves. The corresponding design equation and its parameters are also proposed. We believe that the proposed curves can be used for effective stress site response analyses and evaluation of the seismic performance of port structures.