• Title/Summary/Keyword: Patient-controlled

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Evaluation of Tongue Coating by Digital Tongue Diagnosis System between Halitosis and Non-Halitosis Patients. (디지털 설진기를 이용한 구취군과 비구취군 간의 설태 평가)

  • Jung, Yong-Jae;Kim, Jin-Sung;Oh, Sung-Hwan;Han, Ga-Jin;Kim, Yoo-Seung;Hong, In-A;Park, Young-Sun;Park, Jae-Woo;Park, Kyung-Mo;Ryu, Bong-Ha
    • The Journal of Korean Medicine
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    • v.31 no.1
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    • pp.23-29
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    • 2010
  • Objective: The aim of this prospective, case-controlled study was to assess the difference of the amount of tongue coating between halitosis and non-halitosis patients using a digital tongue diagnosis system (DTDS). Methods: Sixty-five patients complaining of oral malodor were recruited for the study. The level of volatile sulfur compounds (VSC) in the oral cavity of the patients was measured by a portable gas chromatography. All patients were then divided into two groups, the halitosis group ($H_2S{\geq}1.5ng$/10ml, or $CH_3SH{\geq}0.5ng$/10ml) and the non-halitosis group ($H_2S$<1.5ng/10ml and $CH_3SH$<0.5ng/10ml), according to the VSC level criteria published by Tonzetich. Tongue images of the two groups were acquired and analyzed by DTDS, followed by the analysis of the tongue coating scores. Results: The tongue coating scores of the halitosis group were significantly higher than of the non-halitosis group (P=0.033). Furthermore, the difference of the posterior tongue coating between the two groups was more significant (P=0.000). Conclusions: Halitosis patients were shown to have a thicker tongue coating than those in the non-halitosis group. Moreover, the posterior dorsum of the tongue should be observed more cautiously when dealing with halitosis patients. Also, the progress and state of the patient's symptom of halitosis as diagnosed objectively by the portable gas chromatography could also possibly be analyzed instead by the DTDS tongue coating score.

Infusion Methods for Continuous Interscalene Brachial Plexus Block for Postoperative Pain Control after Arthroscopic Rotator Cuff Repair

  • Byeon, Gyeong Jo;Shin, Sang Wook;Yoon, Ji Uk;Kim, Eun Jung;Baek, Seung Hoon;Ri, Hyun Su
    • The Korean Journal of Pain
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    • v.28 no.3
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    • pp.210-216
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    • 2015
  • Background: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. Methods: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. Results: Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. Conclusions: The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.

Polydeoxyribonucleotide Improves Peripheral Tissue Oxygenation and Accelerates Angiogenesis in Diabetic Foot Ulcers

  • Kim, Seoyoung;Kim, Junhyung;Choi, Jaehoon;Jeong, Woonhyeok;Kwon, Sunyoung
    • Archives of Plastic Surgery
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    • v.44 no.6
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    • pp.482-489
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    • 2017
  • Background Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. Methods This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10). Initial surgical debridement and secondary surgical procedures such as a split-thickness skin graft, primary closure, or local flap were performed. Between the initial surgical debridement and secondary surgical procedures, 0.9% normal saline (3 mL) or PDRN was injected for 2 weeks by the intramuscular (1 ampule, 3 mL, 5.625 mg, 5 days per week) and perilesional routes (1 ampule, 3 mL, 5.625 mg, 2 days per week). Transcutaneous oxygen tension ($TcPO_2$) was evaluated using the Periflux System 5000 with $TcPO_2/CO_2$ unit 5040 before the injections and on days 1, 3, 7, 14, and 28 after the start of the injections. A pathologic review (hematoxylin and eosin stain) of the debrided specimens was conducted by a pathologist, and vessel density (average number of vessels per visual field) was calculated. Results Compared with the control group, the PDRN-treated group showed improvements in peripheral tissue oxygenation on day 7 (P<0.01), day 14 (P<0.001), and day 28 (P<0.001). The pathologic review of the specimens from the PDRN group showed increased angiogenesis and improved inflammation compared with the control group. No statistically significant difference was found between the control group and the PDRN group in terms of vessel density (P=0.094). Complete healing was achieved in every patient. Conclusions In this study, PDRN improved peripheral tissue oxygenation. Moreover, PDRN is thought to be effective in improving inflammation and angiogenesis in diabetic foot ulcers.

Effects of Non-combustible moxibustion on Thermography of Healthy Human Beings (비연소식(非燃燒式) 구법(灸法) 재료(材料)를 이용한 온열자극(溫熱刺戟)이 체열방사(體熱放射)에 미치는 효과)

  • Choi, Won-Jong;Kim, Jae-Hyo;Kim, Kyung-Sik;Sohn, In-Chul
    • Korean Journal of Acupuncture
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    • v.21 no.3
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    • pp.21-38
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    • 2004
  • Objectives : Moxibustion has been become very useful tool to prevent and treat various diseases with acupuncture in oriental medicine. Expecially, moxibustion combining the heat stimulation and chemical stimulation of Artemisiae Argyi has a non-invasive characteristics comparing to the other therapeutic tools. However, because the moxibustion makes the patient's skin be burn by the combustible feature of moxibustion, most of people have been scared of being scald. Methods : In this study, we have developed new non-combustible moxibustion tools in collaboration with company (Hana Medical, co. and ICURE, co.) and tested the efficacy through effects of moxibustion of Cheon-chu $(ST_{25})$ on the abdominal thermography of health subject. The non-combustible moxibustion has main characteristics of controlled heating to inhibit being scald and heat stimulation lasting over 1 hrs. Also, to induce the chemical stimulation, the bottom contacting with skin was coated by the extract of artemisiae argyi. The volunteers who participating in this study had taken rest for 20 - 30 mins in room temperature $(23-25^{\circ}C)$ before the examination and informed them what to prohibit smoking, drinking and administration of drug for the previous day The thermography of abdomen including a below part of the chest was taken using Infra-Red Imaging System (IR 2000, MEDI-CORE Co., Korea) by time interval of 15 minutes. Results : The results showed that moxibustion of Cheon-chu $(ST_{25})$ had more potencies of changes on all the ROIs of abdominal thermography than those of control group. Also, it was observed that the quantities of thermal changes following moxibustion of Cheon-chu $(ST_{25})$ been increased significantly comparing that of control group at all the ROIs (region of interest). Observed the thermography classified by ROI, however, moxibustion of Cheon-chu $(ST_{25})$ could modulate ipsilateral specific areas concerning to the abdominal pathway of Stomach Meridian. Conclusion : These results suggest that new non-combustible moxibusion has some similarity as like as the conventional moxibustion and moxibustion of Cheon-chu $(ST_{25})$ may modulate thermal changes of abdominal areas.

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An Operations Study on the Home Care Nursing Delivery System (지역사회 중심 가정간호사업 운영연구(가정간호사업 운영을 위한 정보전달체계 개발Ⅱ))

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.20-31
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    • 1998
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

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Effects of locally-delivered minocycline hcl on controlled periodontal disease (Minocycline 국소 약물 방출 제제의 치주질환 치료 효과)

  • Chung, Mi-Hyun;Kwon, Young-Hyuk;Herr, Yeek;Lee, Man-Sup;Park, Joon-Bong
    • Journal of Periodontal and Implant Science
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    • v.28 no.1
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    • pp.37-56
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    • 1998
  • The purpose of this study was to evaluate the clinical and microbiological outcomes following the use of 30% minocycline-loaded polycaprolacton film and 2% minocycline-loaded gel that was applied locally into pockets combined with scaling and root planing. 25 human subjects who were non-pregnant, non-lactating, aged 20-50 and diagnosed as moderate to advanced adult periodontitis were enrolled. Subjects were excluded if they had a history of severe acute or chronic systemic disease, if they required antibiotic prophylaxis for dental treatment for any reason, or if they reported a history suggestive of hypersensitivity reactions to minocycline or tetracycline. 4quadrants that had several teeth with a 5-8mm probing pocket depth and radiographic evidence of alveolar bone loss for each patient were selected and divided into test sites and control sites according to the split-mouth design. Scaling and root planing was done for each site at baseline(0week). Test sites received the minocycline gel and strip and control sites had saline irrigation. The patients received both treatments simyltaneously. Subgingival irrigation of sterile saline was applied to the control sites for approximately 30 seconds. Minocycline strip and gel was applied into the periodontal pocket at 1, 2, 3, 4 weeks each after scaling and root planing in the test sites. The clinical and microbiological measurements were made at baseline and at the follow-up visits 6, 10, 14, 20 weeks. The results of this study were as follows; 1. The sulcular bleeding index, probing pocket depth and Periocheck test was significantly reduced and the relative proportions of spirochetes and motile rods were significantly reduced and the proportion of cocci was correspondingly increased, in locally delivered minocycline strip group compared to saline irrigation group. 2. In locally delivered minocycline gel group, The effect was the same with minocycline strip group as compared with saline irrigation therapy. 3. There was no significant differences between minocycline strip group and minocycline gelgroup. In conclusion, minocycline HCl local drug delivery combined with scaling and root planing may provide added improvement of clinical and microbiological responses by inhibiting bacterial recolonization of treated sites. It is suggested that the local administration of minocycline-HCl in the periodontal pocket is effective when combined with subgingival mechanical debridement.

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Effect of Pulsed Electromagnetic Field Treatment on Alleviation of Lumbar Myalgia; A Single Center, Randomized, Double-blind, Sham-controlled Pilot Trial Study

  • Park, Won-Hyung;Sun, Seung-Ho;Lee, Sun-Gu;Kang, Byoung-Kab;Lee, Jong-Soo;Hwang, Do-Guwn;Cha, Yun-Yeop
    • Journal of Magnetics
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    • v.19 no.2
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    • pp.161-169
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    • 2014
  • The aim of this study is to investigate the efficacy of pulsed electromagnetic field (PEMF) on the alleviation of lumbar myalgia. This is a randomized, real-sham, double blind pilot study. 38 patients were divided into the PEMF group and the Sham group, each of which was composed of 19 patients (1 patient dropped out in the Sham group) of randomized allocation. The PEMF group was treated by using the PEMF device and the Sham group by using a sham device on the lumbar muscle and acupuncture points, three times a week for a total of two weeks. Evaluations of Visual Analogue Scale for bothersomeness (VASB), Visual Analogue Scale for pain intensity (VASP), Oswestry Disability Index (ODI), 36-Item Short Form Health Survey Instrument (SF-36), EuroQol-5Dimension (EQ-5D), Beck's Depression Inventory (BDI) and Roland-Morris Disability Questionnaire (RMDQ), etc. before and 1 week after treatment were carried out. The primary outcome measure was the VASB, measured 1 week after the end of the pulsed electromagnetic therapy. VASB scores for the PEMF group changed by $-2.06{\pm}2.12$ from the baseline, and that for the Sham group changed by $-0.52{\pm}0.82$ (p < 0.05). VASP scores for the PEMF group were reduced by $-2.10{\pm}2.12$ from the base line, and that for the Sham group was reduced by $-0.53{\pm}1.50$ (p < 0.05). PEMF group showed significant improvements in all VASB, VASP, ODI, SF-36, EQ-5D, BDI and RMDQ scores, while the Sham group showed significant improvements in all scores, except the VASP score. However, the VASB, VASP and RMDQ scores of the PEMF group were much lower than those of the Sham group. The two groups showed no significant difference in ODI, SF-36, EQ-5D and BDI. This study demonstrates the effectiveness of PEMF treatment for alleviating lumbar myalgia.

Luteal estradiol supplementation in gonadotropin-releasing hormone antagonist cycles for infertile patients in vitro fertilization

  • Kwon, Su-Kyoung;Kim, Chung-Hoon;Lee, Kyung-Hee;Jeon, Il Kyung;Ahn, Jun-Woo;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.3
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    • pp.131-134
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    • 2013
  • Objective: To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI. Methods: One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared. Results: Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010). Conclusion: The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.

Effects of Acupuncture Treatment on the Premenstrual Syndrome: Controlled Clinical Trial (월경전기증후군(月經前期症候群)(Premenstrual Syndrome)에 대한 침치료(鍼治療)의 효과(效果))

  • Kim, Sung-chul;Kim, Sung-nam;Lim, Jeong-a;Choi, chang-min;Sim, Eun-ki;Koo, Sung-tae;Lim, Jeong-a;Ha, Joo-young;Shin, Kyung-rim;Sohn, In-chuI
    • Journal of Acupuncture Research
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    • v.22 no.1
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    • pp.41-60
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    • 2005
  • Objective : The purpose of the present study was to evaluate the effect of acupuncture therapy on the premenstrual syndrome. Methods : Volunteers of twenty subjects were employed using DRSP questionnaire. Subjects were divided into two groups including active-acupuncture treatment group, placebo acupuncture treatment group. In the control group, subjects were needled at $SI_5$, $ST_{40}$ points and in the acupuncture group, subjects were stimulated at two basic points, $SP_6$ and $CV_6$, and several points were inserted additionally depending the symptoms including $LR_2$, $LR_3$, $SP_10$, $LI_4$, and $ST_3$. A total of 13 acupuncture sessions were performed for each patient depending on the individual menstruation cycle over 8 weeks. Concentration of blood progesterone was examined and Digital Infrared Thermal Imaging (DITI) was taken before and after acupuncture treatment.

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A Case of Obstructive Sleep Apnea Syndrome Associated with Primary Hypothyroidism and Dilated Cardiomyopathy (원발성 갑상선 기능저하증과 확장형 심근증이 동반된 폐쇄성 수면무호흡증후군 1예)

  • Yu, Sung-Keun;Park, Ji-Young;Pack, Jong-Hae;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.590-596
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    • 2001
  • The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A-33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CP AP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardiomyopathy with review of the relevant literature.

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