1.Extracorporeal Shock Wave Therapy in Peyronie's Disease: Clinical Efficacy and Safety from a Single-Arm Observational Study
Marina DI MAURO ; Giorgio Ivan RUSSO ; Pier Andrea DELLA CAMERA ; Fabrizio DI MAIDA ; Gianmartin CITO ; Nicola MONDAINI ; Marco CAPECE ; Marco FALCONE ; Francesco SESSA ; Andrea MARI ; Riccardo CAMPI ; Carlotta SABINI ; Sergio SERNI ; Mauro GACCI ; Andrea MINERVINI ; Marco CARINI ; Sebastiano CIMINO ; Girolamo MORELLI ; Andrea COCCI
The World Journal of Men's Health 2019;37(3):339-346
PURPOSE: In this study, we aimed to determine the role of extracorporeal shockwave therapy (ESWT) in the management of Peyronie's disease (PD). MATERIALS AND METHODS: A total of 325 patients suffering from PD were enrolled in this single-arm clinical study. All patients were received ESWT using a schedule of 1 treatment/wk. Penile curvature was measured by a goniometer after intracavernosal drug-induced erection using Alprostadil. Plaque size was measured with a ruler and sexual function assessed by the international index of erectile function (IIEF)-15 score. Severity of erectile dysfunction was classified as severe (IIEF-15 ≤10), moderate (IIEF-15 between 11 and 16), or mild (IIEF-15 between 17 and 25). Results were evaluated at baseline and 3 months after the treatment. RESULTS: All the patients completed the study protocol. Median age was 59.0 years (55.0–64.0 years). After treatment, the median (interquartile range, IQR) plaque size reduced from 1.78 cm2 (1.43–2.17 cm2) to 1.53 cm2 (1.31–1.96 cm2) (p<0.001); the median (IQR) penile length in erection increased from 13.0 cm (12.0–14.0 cm) to 14 cm (13.0–15.0 cm) (p<0.001) and the median (IQR) penile curvature from 30.4° (22.2°–35.4°) to 25.0° (20.2°–30.4°) (p<0.001). We also observed a decrease in pain assessed by visual analogue scale (7 vs. 3; p<0.001), an improvement in each of the IIEF sub-domains (p<0.001) and an improvement in all three PD questionnaire domains (p<0.001). CONCLUSIONS: Based on our findings, ESWT could be considered a safe and efficient minimally invasive option for the management of the patients suffering from PD.
Alprostadil
;
Appointments and Schedules
;
Clinical Study
;
Erectile Dysfunction
;
Humans
;
Male
;
Observational Study
;
Penile Diseases
;
Penile Induration
;
Shock
;
Treatment Outcome
2.Undertreatment of Osteoporosis Following Hip Fractures in Jeju Cohort Study.
Sang Rim KIM ; Yong Geun PARK ; Soo Yong KANG ; Kwang Woo NAM ; Yong Gum PARK ; Yong Chan HA
Journal of Bone Metabolism 2014;21(4):263-268
BACKGROUND: Osteoporosis treatment following hip fracture is well known to not enough. We previously performed intervention study for orthopaedic surgeon's education and reported twofold increase in osteoporosis detection and treatment rate observed between 2005 and 2007. This follow-up observational study was conducted to find out the rate in which a diagnostic workup and treatment for osteoporosis were done in patients with hip fracture. METHODS: Medical records and radiographs in patients who were older than 50 years and diagnosed as having femoral neck or intertrochanteric fractures at 8 hospitals in Jeju island, South Korea from 2008 to 2011 were reviewed. The numbers of patients who were studied with bone densitometry and who were treated for osteoporosis after the diagnosis of hip fracture were analyzed. RESULTS: Nine hundred forty five hip fractures (201 in 2008, 257 in 2009, 265 in 2010, and 304 in 2011) occurred in 191 men and 754 women during the study periods. The mean age of the patients was 79.7 years. The mean rate of osteoporosis detection using dual energy X-ray absorptiometry was 36.4% (344/945 hips) (ranged from 24.2% in 2009 to 40.5% in 2011). The mean initiation rate of osteoporosis treatment was 23.1% (218/945 hips) (ranged from 20% in 2009 to 29% in 2008). CONCLUSIONS: Detection and treatment rate of osteoporosis following hip fracture during follow-up periods was still not enough. Additional intervention studies are required to further improvement of osteoporosis treatment rates after hip fracture.
Absorptiometry, Photon
;
Bone Density Conservation Agents
;
Cohort Studies*
;
Clinical Trial
;
Densitometry
;
Diagnosis
;
Education
;
Female
;
Femur Neck
;
Follow-Up Studies
;
Hip
;
Hip Fractures*
;
Humans
;
Korea
;
Male
;
Medical Records
;
Observational Study
;
Osteoporosis*
3.Clinical Study of the Therapeutic Effect of Rinlaxer
Duk Yong LEE ; Choon Ki LEE ; Gang Sup YOON
The Journal of the Korean Orthopaedic Association 1983;18(4):821-826
No abstract available in English.
Clinical Study
4.A Clinical Study of Non-Union and Delayed Union
Kwang Hoe KIM ; Kwang Min WEE ; Seoung Heum BACK
The Journal of the Korean Orthopaedic Association 1983;18(5):921-929
No abstract available in English.
Clinical Study
5.A Clinical Study of the Operative Treatment of the Herniated Lumbar Disc
Byeong Mun PARK ; Nam Hyun KIM ; Soon Won KWON ; Kyu Hyun YANG
The Journal of the Korean Orthopaedic Association 1984;19(1):41-48
No abstract available in English.
Clinical Study
6.Correlation between Tissue Oxygen Saturation and Global Oxygenation Parameters in Emergency Patients: A Pilot Clinical Study.
Young Woong YOON ; Young Mo CHO ; Hyung Bin KIM ; Ji Ho RYU ; Maeng Ryul PARK ; Mun Ki MIN ; Yong In KIM ; Sung Wook PARK
Journal of the Korean Society of Emergency Medicine 2016;27(3):223-230
PURPOSE: Near-infrared spectroscopy (NIRS) can noninvasively assess changes in tissue oxygen saturation (StO₂). The primary concern of the current study is to determine whether StO₂ can be used as a surrogate for global oxygenation parameters such as central venous oxygen saturation (ScvO₂), lactic acid, and base deficit (BD) in patients presenting to the emergency department (ED). METHODS: This was a prospective, observational study in patients requiring central venous catheter placement, admitted to the ED with complaints classified as infectious and non-infectious etiology. The NIRS sensor (15 mm probe) was applied on the thenar eminence for at least 3 minutes and ScvO₂, arterial lactic acid, and BD were measured during insertion of a central venous catheter. Data were analyzed using a simple correlation and Bland-Altman plot. RESULTS: A total of 120 patients were enrolled in the study and further classified as an infection (n=39) and a noninfection (n=81) group. Lactic acid BD showed significant correlation with StO₂ in total and in non-infection patients but the degree of correlation was weak and these correlations were not observed in infection patients. Approximately 94% of the difference between StO₂ and ScvO₂ was placed within limit of agreement but there was a risk that StO₂ may overestimate ScvO₂ when ScvO₂ becomes lower. When patients were assigned to two groups according to laboratory results (lactic acid 4.0 mmol/L; BD > 3.0 mmol/L; ScvO₂> 65% or 75%), no significant difference in StO₂ was observed between the two groups. CONCLUSION: In ED patients suspected of having systemic hypoperfusion, StO₂ showed a weak correlation with lactic acid and BD in non-infection patients and no correlation in infection patients. In addition, as ScvO₂ decreased, the difference between StO₂ and ScvO₂ showed a tendency to increase, and StO₂ was much higher than ScvO₂ at low ScvO₂ level. Therefore, before using StO₂ as surrogate for ScvO₂, lactic acid and BD in critically ill patients presenting to the ED, further investigation should be conducted to overcome the limitations of NIRS addressed in this study.
Central Venous Catheters
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Clinical Study*
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Critical Illness
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Emergencies*
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Emergency Service, Hospital
;
Humans
;
Lactic Acid
;
Microcirculation
;
Observational Study
;
Oxygen*
;
Prospective Studies
;
Spectroscopy, Near-Infrared
7.PECS II block is associated with lower incidence of chronic pain after breast surgery
Alessandro DE CASSAI ; Claudio BONANNO ; Ludovica SANDEI ; Francesco FINOZZI ; Michele CARRON ; Alberto MARCHET
The Korean Journal of Pain 2019;32(4):286-291
BACKGROUND: Breast cancer is complicated by a high incidence of chronic postoperative pain (25%–60%). Regional anesthesia might play an important role in lowering the incidence of chronic pain; however it is not known if the pectoral nerve block (PECS block), which is commonly used for breast surgery, is able to prevent this complication. Our main objective was therefore to detect any association between the PECS block and chronic pain at 3, 6, 9, and 12 months in patients undergoing breast surgery. METHODS: We conducted a prospective, monocentric, observational study. We enrolled 140 consecutive patients undergoing breast surgery and divided them in patients receiving a PECS block and general anesthesia (PECS group) and patients receiving only general anesthesia (GA group). Then we considered both intraoperative variables (intravenous opioids administration), postoperative data (pain suffered by the patients during the first 24 postoperative hours and the need for additional analgesic administration) and development and persistence of chronic pain (at 3, 6, 9, and 12 mo). RESULTS: The PECS group had a lower incidence of chronic pain at 3 months (14.9% vs. 31.8%, P = 0.039), needed less intraoperative opioids (fentanyl 1.61 μg/kg/hr vs. 3.3 μg/kg/hr, P < 0.001) and had less postoperative pain (3 vs. 4, P = 0.017). CONCLUSIONS: The PECS block might play an important role in lowering incidence of chronic pain, but further studies are needed.
Analgesics, Opioid
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Anesthesia, Conduction
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Anesthesia, General
;
Anesthesia, Local
;
Breast Neoplasms
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Breast
;
Chronic Pain
;
Clinical Study
;
Humans
;
Incidence
;
Nerve Block
;
Observational Study
;
Pain, Postoperative
;
Prospective Studies
;
Thoracic Nerves
8.Insulin Initiation in Insulin-Naive Korean Type 2 Diabetic Patients Inadequately Controlled on Oral Antidiabetic Drugs in Real-World Practice: The Modality of Insulin Treatment Evaluation Study.
Sang Soo KIM ; In Joo KIM ; Yong Ki KIM ; Kun Ho YOON ; Ho Young SON ; Sung Woo PARK ; Yeon Ah SUNG ; Hong Sun BAEK
Diabetes & Metabolism Journal 2015;39(6):481-488
BACKGROUND: The Modality of Insulin Treatment Evaluation (MOTIV) study was performed to provide real-world data concerning insulin initiation in Korean type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control with oral hypoglycemic agents (OHAs). METHODS: This multicenter, non-interventional, prospective, observational study enrolled T2DM patients with inadequate glycemic control (glycosylated hemoglobin [HbA1c] > or =7.0%) who had been on OHAs for > or =3 months and were already decided to introduce basal insulin by their physician prior to the start of the study. All treatment decisions were at the physician's discretion to reflect real-world practice. RESULTS: A total of 9,196 patients were enrolled, and 8,636 patients were included in the analysis (mean duration of diabetes, 8.9 years; mean HbA1c, 9.2%). Basal insulin plus one OHA was the most frequently (51.0%) used regimen. After 6 months of basal insulin treatment, HbA1c decreased to 7.4% and 44.5% of patients reached HbA1c <7%. Body weight increased from 65.2 kg to 65.5 kg, which was not significant. Meanwhile, there was significant increase in the mean daily insulin dose from 16.9 IU at baseline to 24.5 IU at month 6 (P<0.001). Overall, 17.6% of patients experienced at least one hypoglycemic event. CONCLUSION: In a real-world setting, the initiation of basal insulin is an effective and well-tolerated treatment option in Korean patients with T2DM who are failing to meet targets with OHA therapy.
Body Weight
;
Diabetes Mellitus, Type 2
;
Humans
;
Hypoglycemic Agents*
;
Insulin*
;
Korea
;
Observational Study
;
Pragmatic Clinical Trials as Topic
;
Prospective Studies
9.Evaluation of Clinical Alarms and Alarm Management in Intensive Care Units
Journal of Korean Biological Nursing Science 2018;20(4):228-235
PURPOSE: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). METHODS: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. RESULTS: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. CONCLUSION: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.
Clinical Alarms
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Critical Care
;
Education
;
Humans
;
Infusion Pumps
;
Intensive Care Units
;
Observational Study
;
Renal Replacement Therapy
;
Ventilators, Mechanical
10.Clinical Study in Female Sexual Dysfunction.
Journal of the Korean Medical Association 1999;42(2):159-165
No abstract available.
Clinical Study*
;
Female*
;
Humans