An, Gyu-Hwan;Sim, Sook-Young;Jwa, Cheol-Su;Kim, Gang-Hyeon;Lee, Jong-Yun;Kang, Jae-Kyu
Journal of Korean Neurosurgical Society
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v.50
no.1
/
pp.1-5
/
2011
Objective : There is no proven regimen to reduce the severity of stroke in patients with acute cerebral infarction presenting beyond the thrombolytic time window. Ozagrel sodium, a selective thromboxane A2 synthetase inhibitor, has been known to suppress the development of infarction. The antiplatelet effect is improved when aspirin is used together with a thromboxane synthetase inhibitor. Methods : Patients with non-cardiogenic acute ischemic stroke who were not eligible for thrombolysis were randomly assigned to two groups; one group received ozagrel sodium plus 100 mg of aspirin (group 1, n=43) and the other 100 mg of aspirin alone (group 2, n=43). Demographic data, cardiovascular risk factors, initial stroke severity [National Institute of Health Stroke Scale (NIHSS) and motor strength scale] and stroke subtypes were analyzed in each group. Clinical outcomes were analyzed by NIHSS and motor strength scale at 14 days after the onset of stroke. Results : There were no significant differences in the mean age, gender proportion, the prevalence of cardiovascular risk factors, stroke subtypes, and baseline neurological severity between the two groups. However, the clinical outcome for group 1 was much better at 14 days after the onset of stroke compared to group 2 (NIHSS score, p=0.007, Motor strength scale score, p<0.001). There was one case of hemorrhagic transformation in group 1, but there was no statistically significant difference in bleeding tendency between two groups. Conclusion : In this preliminary study, thromboxane A2 synthetase inhibitor plus a low dose of aspirin seems to be safe and has a favorable outcome compared to aspirin alone in patients with acute ischemic stroke who presented beyond the thrombolytic time window.
Nagendrababu, Venkateshbabu;Sultan, Omer Sheriff;Kannathasan, Sreedharan;Patel, Amir Shahreza;Chitra, Ebenezer;Neelakantan, Prasanna;Davamani, Fabian
Restorative Dentistry and Endodontics
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v.43
no.1
/
pp.1.1-1.8
/
2018
Objectives: To determine the effect of root canal irrigants on the hydrophobicity and adherence of Staphylococcus epidermidis (S. epidermidis) to root canal dentin in vitro. Materials and Methods: Root dentin blocks (n = 60) were randomly divided into 4 groups based on the irrigation regimen: group 1, saline; group 2, 5.25% sodium hypochlorite (NaOCl); group 3, 5.25% NaOCl followed by 17% ethylenediaminetetraacetic acid (EDTA); group 4, same as group 3 followed by 2% chlorhexidine (CHX). The hydrophobicity of S. epidermidis to root dentin was calculated by cell surface hydrophobicity while the adherence was observed by fluorescence microscopy, and bacteria were quantified using ImageJ software (National Institutes of Health). Statistical analysis of the data was done using Kruskal-Wallis test and Mann-Whitney U test (p = 0.05). Results: The hydrophobicity and adherence of S. epidermidis to dentin were significantly increased after irrigating with group 3 (NaOCl-EDTA) (p < 0.05), whereas in group 4 (NaOCl-EDTA-CHX) both hydrophobicity and adherence were significantly reduced (p < 0.05). Conclusions: The adherence of S. epidermidis to dentin was influenced differently by root canal irrigants. Final irrigation with CHX reduces the bacterial adherence and may impact biofilm formation.
In this double-blind, placebo-controlled trial, we assessed the efficacy and safety of beef tallow extract (BTE) including Cis-9-cetylmyristoleate in patients with arthritis. Between May and December 2003, we selected 80 patients (n=80) who showed/manifested arthritic symptoms and whose radiological findings were suggestive of arthritis, and randomly assigned them to placebo-controlled (n=40) and treatment group (n=40). The placebo (corn starch 350 mg) and BTE (208 mg) were orally administered to placebo-controlled and treatment group three times a day, respectively. We assessed the efficacy and safety based on the visual analogue scale (V AS) and modified knee society knee scores (MKSKS) at baseline and endpoint, respectively. To assess the safety, we monitored the adverse effects noted in liver, kidney, cardiovascular and gastrointestinal system for 3 weeks. Then, we performed not only a questionnaire study but also laboratory tests (e.g., liver function test, kidney function test, urinalysis, electrocardiography [EKG], complete blood cell counts [CBC] and chest X-ray). For statistical analysis, Student (-test and paired (-test were done using SPSS■ Version 11.0. Statistical significance was set at p < 0.05. The scores between V AS and MKSKS showed statistical significance (p < 0.05) with an improvement of $69.2\%$ (27/39) and $3.8\%$ (21/39) of treatment-group patients, respectively. Abnormal laboratory findings were noted in neither placebo-controlled nor treatment group. In conclusion, our results indicate that the administration of BTE was a safe and effective treatment regimen for patients with arthritis. In addition, the efficacy of BTE was more remarkable in alleviating the symptoms rather than improving the function.
Heo, Bong Ha;Park, Ji Hun;Choi, Jung Il;Kim, Woong Mo;Lee, Hyoung Gon;Cho, Soo Young;Yoon, Myoung Ha
The Korean Journal of Pain
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v.28
no.3
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pp.203-209
/
2015
Background: Ketorolac has been used as a postoperative analgesia in combination with opioids. However, the use of ketorolac may produce serious side effects in vulnerable patients. Propacetamol is known to induce fewer side effects than ketorolac because it mainly affects the central nervous system. We compared the analgesic effects and patient satisfaction levels of each drug when combined with fentanyl patient-controlled analgesia (PCA). Methods: The patients were divided into two groups, each with n = 46. The patients in each group were given 60 mg of ketorolac or 2 g of propacetamol (mixed with fentanyl) for 10 minutes. The patients were then given 180 mg of ketorolac or 8 g of propacetamol (mixed with fentanyl and ramosetron) through PCA. We assessed the visual analogue pain scale (VAS) at the time point immediately before administration (baseline) and at 15, 30, and 60 minutes, and 24 hours after administration. Also, the side effects of each regimen and each patient's degree of satisfaction were assessed. Results: There was a significant decline in the VAS score in both groups (P < 0.05). However, there were no significant differences in the VAS scores between the groups at each time point. Satisfaction scores between the groups showed no significant difference. Conclusions: The efficacy of propacetamol is comparable to that of ketorolac in postoperative PCA with fentanyl.
Despite well-known benefits of physical activity for older adults, most older adults remain significantly underactive. The purpose of this study was to examine the effects of an inclusive, choice-based physical activity promotion program to increase lifetime physical activity levels of seniors on physical activity & health-related quality of life outcomes in older adults. The physical activity promotion program guided participants to choose activities that took into account their health, preferences, and abilities. It offered information on ways for them to exercise safely, motivate themselves, overcome barriers, and develop a balanced exercise regimen. A six-month comparison-group trial was conducted with older adults in community senior center. Changes in self-reported physical activity & health-related quality of life(SF-36) by group & within group were evaluated using t-test. Of 30 subjects, 22(73%) completed the trial. Subjects were aged 63 to 75 years(mean=$68.36{\pm}4.02$); 86% were female. The intervention group increased estimated caloric expenditure by 1975 calories/week in moderate intensity activities(MET${\geq}3.0$; p=.008), and by 2312 calories/week in physical activities of any intensity(p=.005). Between-group analyses showed that the changes were significantly different in both measures(p=0.17; p=032). The intervention group also significantly better scores on general health perception(p=.031) & vitality(p=.002). Individually tailored programs to encourage lifestyle changes in seniors may be effective and applicable to health care and community settings.
Mycoplasma pneumoniae pneumonia (MPP) is one of the most common forms of community-acquired pneumonia in children and adolescents. Outbreaks of MPP occur in 3- to 7-year cycles worldwide; recent epidemics in Korea occurred in 2006-2007, 2011, and 2015-2016. Although MPP is known to be a mild, self-limiting disease with a good response to macrolides, it can also progress into a severe and fulminant disease. Notably, since 2000, the prevalence of macrolide-resistant MPP has rapidly increased, especially in Asian countries, recently reaching up to 80%-90%. Macrolide-resistant Mycoplasma pneumoniae (MRMP) harbors a point mutation in domain V of 23S rRNA with substitutions mainly detected at positions 2063 and 2064 of the sequence. The excessive use of macrolides may contribute to these mutations. MRMP can lead to clinically refractory pneumonia, showing no clinical or radiological response to macrolides, and can progress to severe and complicated pneumonia. Refractory MPP is characterized by an excessive immune response against the pathogen as well as direct injury caused by an increasing bacterial load. A change of antibiotics is recommended to reduce the bacterial load. Tetracyclines or quinolones can be alternatives for treating MRMP. Otherwise, corticosteroid or intravenous immunoglobulin can be added to the treatment regimen as immunomodulators to downregulate an excessive host immune reaction and alleviate immune-mediated pulmonary injury. However, the exact starting time point, dose, or duration of immunomodulators has not been established. This review focuses on the mechanism of resistance acquisition and treatment options for MRMP pneumonia.
Mexitalia, Maria;Dewi, Yesi Oktavia;Pramono, Adriyan;Anam, Mohammad Syarofil
Clinical and Experimental Pediatrics
/
v.60
no.4
/
pp.118-123
/
2017
Purpose: Tuberculosis (TB) remains a problem in the community. TB patients usually experience malnutrition, which is characterized by both decreased body weight (BW) and body fat percentage (BFP). Leptin, an important regulator of BW, also plays an important role in cellular immunity, which is integral to defense against Mycobacterium tuberculosis infection. We analyzed the effect of an anti-TB treatment regimen on the leptin level, BW, and BFP of children with TB. Methods: The design of this study was a group interrupted time series. The subjects were children with probable TB according to clinical criteria based on an Indonesian scoring system adopted from the Consensus of Expert Panel. BW; BFP; energy intake; fat and protein intake; and leptin levels before, 2 months after (intensive phase), and 6 months after (continuation phase) anti-TB treatment, were measured. About 40 children, aged 5-14 years, participated in this study. Results: The BW, BFP and leptin level increased from before treatment to after completion of the intensive phase and still showed an increased during the continuation phase: BW 18.65 kg, 19.75 kg, and 20.85 kg; BFP 18.3%, 19.5%, and 20.2%; and leptin level 1.9 mg/dL, 3.07 mg/dL, and 3.4 mg/dL, respectively (P<0.01). Conclusion: Leptin level, BW, and BFP increased throughout the course of anti-TB treatment, compared with pretreatment values. Further research is needed to compare the results with data for healthy children.
Purpose: Diabetic foot infection is one of the most common and severe complications of diabetes mellitus that delays healing of the wound. Deep tissue biopsy is considered to be the gold standard method for antibiotic selection in treating infected chronic diabetic ulcers. However, swab culture or superficial tissue biopsy is often performed for a microbiologic test since deep tissue biopsy has limitations in application. The purpose of this study is to find out whether microbiologic results of swab culture or superficial tissue biopsy could be used for selection of antibiotics in treating diabetic ulcers. Methods: This study involved 42 patients with diabetic foot ulcers with negative results in bone probing test. Tissue samples for microbiologic tests were collected from all the patients by using superficial cotton swab, superficial tissue, and deep tissue. The microbiologic results of deep tissue biopsy were compared with swab culture and superficial tissue biopsy statistically. Results: Microbiology of the deep tissue showed the same results with those of the swab culture and superficial tissue in 67% and 71%, respectively. Statistical analysis demonstrated that the microbiology of the swab culture and superficial tissue does not coincide with that of the deep tissue. Conclusion: These results suggest that the microbiology of the swab culture and superficial tissue is not concordant with that of the deep tissue in infected chronic diabetic ulcers. To select appropriate antibiotic regimen, the speci specimen for the microbiologic test should be obtained from deep tissue.
Kim, Geon;Kim, Su-Hyon;Seo, Sam-Ki;Yoon, Hui-Jong;Kim, Tae-Youl
The Journal of Korean Physical Therapy
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v.20
no.2
/
pp.1-10
/
2008
Purpose: This study examines the effects of elastic band of resistance exercise for balance control of the elderly. Methods: Thirty of eighty participants in experiment subjects who demonstrated balance-impairment through the use of primary screening tests including the one leg standing test (OLST), functional reach test (FRT) and timed up and go (TUG) were selected as subjects. Fifteen subjects that underwent muscle-strengthening exercise using an elastic band were selected as the exercise group and fifteen subjects were selected as a control group. Subjects undertook a home-based exercise program three times per week for 9 weeks. Muscle strength, functional assessment and a balance test were quantitatively measured before and after the exercise regimen. Results: After muscle strengthening exercises, changes in maximal voluntary isometric contraction (MVIC) showed a significant increase in all of the lower extremity muscles of the exercise group subjects. There were statistically significant differences between the exercise and control groups for changes in the OLST, FRT and TUG, which are functional assessments of balance ability, and changes of the unit path length and circumference area, measurement items of quantitative analysis. In addition, from examining correlations between MVIC, balance ability, it was found that an increase of muscle strength in the hip joint group of muscles among the lower extremity muscles had greater improvement in correlation with balance ability in this elderly population. Conclusion: Resistance exercise using elastic bands had significant effects on muscle strengthening in elderly subjects, with a resultant increase of lower extremity muscle strength with significant improvement of balance ability.
Shin Hyun Soo;Seong Jinsil;Oh Won Yong;Kim Gwi Eon
Radiation Oncology Journal
/
v.11
no.1
/
pp.119-126
/
1993
From 1988 to 1991, nineteen patients with unresectable localized pancreatic carcinoma were treated with radiotherapy and/or hyperthermia or in combination with chemotherapy. Radiation dose of 4500-5000 cGy with or without additional 500-1000 cGy was administered over 5 to 6 weeks to the pancreatic tumor area using 10 MV linear accelerator. Five of 19 patients were given chemotherapy, either neoadjuvant or maintenance setting with FAM regimen (5-FU, adriamycin and mitomycin C), which was repeated every 4 weeks for one year or until progression. Symptomatic palliation was achieved in 17 among 19 patients ($89{\%}$) and objective response (complete or partial response in CT finding) was achieved in 5 among 11 patients ($45{\%}$). The median survival time was 9 months and one-year survival rate, $32{\%}$. Local-regional failure was documented in 10 among 13 patients ($77{\%}$) and distant failures were found in the liver (3 patients) and carcinomatosis (2 patients). Prognostic significance of various factors such as age, sex, performance status, tumor location, stage, etc. were assessed. Any factors did not have the prognostic significance in univariate analysis. Treatment was well tolerated in most of the patients with only mild to moderate toxicity.
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