The purpose of this study is to demonstrate a new postoperative analgesic which minimize the physiological changes of patients. Recently, it has become popular to administer opioids to epidural space rather than intravenously or by intramuscular administration. However, the side effects of opioids have limited the usefulness of this procedure. We tried to find out a way of providing postoperative analgesia while minimizing the side effects of opioids. This study has tested the effects of administering a mixture of small doses of morphine, fentanyl and bupivacaine and epidural morphine alone. The data of this study has taken from 20 paturients who have scheduled for cesarean section. We have classified into two groups which consist of 10 paturients each. We have administered epidural morphine alone to the first group and a small doses of morphine-fentanyl-bupivacaine mixture to second group. We have evaluated analgesic effects by comparing both groups' pain scores of the operative day and of the first postoperative day and evaluated such side effects as the degree of itching, nausea, vomiting, dizziness and respiratory depression by asking to paturients. This study has found the followings: 1) Pain scores of the first group in the operative day and the first postoperative day are 1.2+/-0.4 and 0.4+/-0.5. The second group's pain scores are 0.2+/-0.4 and 0, and the second group's pain scores have significantly reduced (p<0.05). 2) Frequencies of such side effects as itching, nausea and vomiting are higher in the first group (8) than in the second group(4). In conclusion, small doses of morphine-fentanyl-bupivacaine mixture has demonstrated a more effective postoperative analgesia with minimum side effects in pain controlling after cesarean section than epidural morphine alone.
Analgesia* ; Analgesics, Opioid ; Bupivacaine ; Cesarean Section* ; Dizziness ; Epidural Space ; Female ; Fentanyl ; Humans ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Respiratory Insufficiency ; Vomiting

No abstract available.
Cholesterol* ; Triglycerides*

PURPOSE: To investigate the effect of steroid treatment (intravenous injection, oral) in patients with non-arteritic anterior ischemic optic neuropathy (NAION). METHODS: From January, 2005 to December, 2016, 41 patients who were diagnosed with NAION and observed for more than 6 months were included in this study. The treatment was decided based on patient's choice after explaining the advantages and disadvantages of steroid therapy. The patients were divided into three groups (intravenous steroid injection, oral steroid, no treatment). Initial visual acuity, final visual acuity, degree of visual field defect, fluorescein angiography, visual evoked potential and brain magnetic resonance imaging were analyzed by chart review. RESULTS: The chief complaints of the 41 NAION patients at the first visit were decreased visual acuity (n = 24), visual field defect (n = 10), no symptoms (n = 4), diplopia (n = 2), and floaters (n = 1). The distribution of the patients according to steroid administration method was 15 patients with intravenous steroid injection, 14 patients with oral steroid and 12 patients with no treatment. The improvement in visual acuity was greatest in intravenous steroid injection (87%), oral steroid (43%) and no treatment (33%) in that order. CONCLUSIONS: In a retrospective comparison of treatment effects after explaining the advantages and disadvantages of steroid therapy in patients with NAION, the intravenous steroid injection group showed 87% improvement in visual acuity and an odds ratio of 5.5 (95% confidence interval [CI] 1.05–28.88, p-value 0.04), while the oral steroid group showed 43% improvement and an odds ratio of 1.5 (95% CI 0.30–7.43, p-value 0.62). The steroid treatment group showed better visual acuity improvement than the no treatment group, and the intravenous steroid injection group showed 5.5 times greater improvement in visual acuity compared to the no treatment group.
Brain ; Diplopia ; Evoked Potentials, Visual ; Fluorescein Angiography ; Humans ; Magnetic Resonance Imaging ; Methods ; Odds Ratio ; Optic Neuropathy, Ischemic* ; Retrospective Studies ; Steroids* ; Visual Acuity ; Visual Fields

This study purposed to analyze the relationship between spatial distribution of Diabetes prevalence rates and regional variables. The unit of analysis was administrative districts of city·gun·gu. Dependent variable was the age- and sex- adjusted diabetes prevalence rates and regional variables were selected to represent three aspects: demographic and socioeconomic factor, health and medical factor, and physical environment factor. Along with the traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for the spatial analysis. Analysis results showed that age- and sex-adjusted diabetes prevalence rates were varied depending on regions. OLS regression showed that diabetes prevalence rates had significant relationships with percent of population over age 65 and financial independence rate. In GWR, the effects of regional variables were not consistent. These results provide information to health policy makers. Regional characteristics should be considered in allocating health resources and developing health related programs for the regional disease management.
Diabetes Mellitus ; Disease Management ; Health Policy ; Health Resources ; Prevalence* ; Socioeconomic Factors ; Spatial Analysis

Uterine fibroids are the most common benign tumor of the female genital organ. Menorrhagia is the most common symptom associated with uterine fibroid. Since the first suggestion that embolization of uterine arteries might have a role in the management of fibroids by Ravina et al (France) in 1995,3 uterine artery embolization for management of fibroids has been performed actively in United states, United Kindom and Japan, and excellent therapeutic results have been reported. We have performed uterine artery embolization on patients with symptomatic fibroids or adenomyosis since August 1998. There have been few case reports of expelled fibroids out of vagina after uerine artery embolization, so we present a case in which successful embolization in woman with submucosal myoma resulted in a subsequent vaginal expulsion.
Adenomyosis ; Arteries ; Female ; Genitalia ; Humans ; Japan ; Leiomyoma* ; Menorrhagia ; Myoma ; United States ; Uterine Artery Embolization* ; Uterine Artery* ; Vagina

BACKGROUND: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). METHODS: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. RESULTS: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. CONCLUSION: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.
Angioplasty, Balloon, Coronary* ; Comorbidity ; Delivery of Health Care* ; Health Policy ; Hospitals, General ; Humans ; Inpatients* ; Insurance* ; Insurance, Health ; Length of Stay ; National Health Programs ; Propensity Score* ; Regression Analysis ; Tertiary Care Centers

PURPOSE: This study was conducted to develop and test effects of a child health management program based on cooperative learning for mothers of preschool children. METHODS: For this quasi-experimental study, a nonequivalent control group pretest-posttest design was used. Outcome measures were level of child health management self-efficacy, child health management practices, child's health behavior. Participants were 55 mothers (experimental group 28, control group 27). The program was composed of 6 categories of home health management for preschool children, and provided for three 120-minute sessions. Data were collected from September to October, 2015, at 3 times: baseline, 3 and 6 weeks after beginning the intervention. Data were analyzed using SPSS/WIN 21.0 program. RESULTS: After 3 and 6 weeks, there were significant differences between the two groups in child health management self-efficacy (F=18.33, p<.001), child health management practices (F=8.91, p<.001), and child's health behavior (F=9.91, p<.001). CONCLUSION: Study findings indicate that this child health management program based on cooperative learning is effective and can be recommended as an intervention for mothers of preschool children. It will contribute to enhanced child health management self-efficacy and health management practices and improved child's health behavior.
Child Health* ; Child* ; Child, Preschool* ; Health Behavior ; Humans ; Learning* ; Mothers* ; Non-Randomized Controlled Trials as Topic ; Outcome Assessment (Health Care) ; Self Efficacy

The purpose of this study was to investigate the characteristics or the potassium channels existing in the rat urinary bladders. Smooth muscle strips of rat detrusor urinae were examined by isometric myography. Relaxation responses of detrusor muscle strips to the three potassium channel openers pinacidil, a cyanoguanidine derivative, BRL 38227, a benzopyran derivative and RP 52891, a tertrahydrothiopyran derivative were examined. The potassium channel openers reduced the basal tone, and the rank order of potency was RP 52891>pincidil>BRL 38227. Procaine, an inhibitor of the voltage-sensitive potassium channel tended to increase the basal tone, but it did not affect the relaxant effects of the calcium-activated potassium channel opener did not antagonize the relaxant effects, but it reduced the Emax of RP 52891 and BRL 38227. Glibenclamide, an inhibitor of the ATP-sensitive potassium channel, antagonized the relaxant effects of pinacidil, RP 52891 and BRL 38227 reducing the Emax of RP 52891 and BRl 38227. Galanin which inhibits secretion of insulin through opening the ATP-sensitive potassium channels in pancreatic β-cells rather increased the basal tone of the isolated detrusor strips. These results suggest that the urinary bladder of the rat has mainly the ATP-sensitive, glibenclamide sensitive potassium channel, which is a different type from that in the pancreatic β-islet cells.
Animals ; Cromakalim ; Galanin ; Glyburide ; Insulin ; KATP Channels ; Muscle, Smooth ; Myography ; Pinacidil ; Potassium Channels* ; Potassium Channels, Calcium-Activated ; Potassium* ; Procaine ; Rats* ; Relaxation ; Urinary Bladder

A 19-year-old man noticed a very slowly spreading erythematous macular lesion on his cheek when he was 5 years old. This asymptomatic and well circumscribed patch was covered with fine scales. He sought first medical attention at the age of 12 years and diagnosis was cutaneous tuberculosis was made by skin biopsy. Seven years after the second biopsy was made and it revealed a few spores within giant cells in the upper dermis. By mycologic study, it was identified as Paecilomyces lilacinus. The patient was put on the treatment of topical and oral antifungal agents. The skin lesion showed signs of improvement after 12 weeks of treatment.
Antifungal Agents ; Biopsy ; Cheek ; Child, Preschool ; Dermis ; Diagnosis ; Giant Cells ; Humans ; Paecilomyces* ; Skin ; Spores ; Tuberculosis, Cutaneous ; Weights and Measures ; Young Adult

PURPOSE: The aim of this study was to understand venomous snake bites and to predict the prognosis in the clinical course. METHODS: From April 1995 to October 1999, the case histories of 97 patients with venomous snake bites were reviewed retrospectively. RESULTS: The ages of the patients varied from 17 to 76 (mean age was 49.2 years), and the peak age was in the fourth decade. The sex ratio of males to females was 1.9:1. The accidents occurred mainly in summer (77.3%). According to the grade of envenomation, grade I and II were most common (77.3%). The duration of hospitalization was proportional to the grade of envenomation. The snake bites most commonly occurred in fields (56.7%). The finger was the most common site of the bite (51.5%). 96.9% of the patients arrived at the hospital within 4 hours. 97.9% of the patients were treated with antivenin. The most common local symptoms and signs were edema and pain. The most common general symptoms and signs were blurred vision, dizziness, and hematuria. The most common complication was celluitis. Severe complications such as UGI bleeding and DIC occurred in grade II and III. CONCLUSION: The most important factor for determining the prognosis of venomous snake bites is the grade of envenomation. In grade III or IV envenomation, antivenin should be included as part of intensive systemic treatment.
Dacarbazine ; Dizziness ; Edema ; Female ; Fingers ; Hematuria ; Hemorrhage ; Hospitalization ; Humans ; Male ; Prognosis ; Retrospective Studies ; Sex Ratio ; Snake Bites* ; Snakes* ; Venoms*