Joints ; Mandible ; Maxilla ; Orthognathic Surgery ; Recurrence ; Skull

Analysis of insertional activity is a routine part of the clinical electromyogrphic examination. It provides an information of muscle excitability but it's clinical significance has not perfectively accepted yet. This study was designed to evaluate clinical usefulness of insertional activity through quantitative analysis in the diagnostic field of pathology. Monopolar needle electrode was inserted briefly in the biceps brachii, paralumbar spinal and tibialis anterior muscles of the normal and denervated muscles. Total duration and spike duration of the insertional activity were measured 10 times in each muscle and averaged. Within spike duration we measured turns, mean amplitude, turns/amplitude, RMS, mean frequency and median frequency. The measured parameters of insertional activities were not significantly different according to the muscle in normal controls. In denervated muscles, the turns, mean amplitude, RMS, mean frequency and median frequency were decreased but turns/amplitude was increased compared to those of normal controls. But there were no difference in total duration and spike duration between normal and denervated muscles. In denervated muscles the muscle power was positively correlated with turns, mean amplitude, RMS, mean frequency and median frequency, and the grade of abnormal spontaneous activities was inversely correlated with turns, mean amplitude, RMS, mean frequency and median frequency. Therefore quantitative analysis of insertional activity could be a useful method for the diagnosis of neuromuscular disease.
Diagnosis ; Electrodes ; Muscles ; Needles ; Neuromuscular Diseases ; Pathology

OBJECTIVE: Most spinal cord injured patients suffered form various autonomic dysfunction. The purpose of this study is evaluation of sympathetic skin response (SSR) and R-R interval variability (RRIV) as a method of autonomic function test in spinal cord injured patients. METHOD: Thirty-six spinal cord injured patients were enrolled in this study. SSR was recorded in the palm and sole by electrical stimulation of right median nerve and RRIV during rest, deep breathing and Valsalva maneuver for 1 minute. RESULTS: The higher level of spinal cord injury, the higher rate of the abnormal sympathetic skin response in the palm and sole and more reduced values of Valsalva ratio (p<0.05). The parameters of sympathetic skin response and R-R interval variability were not correlated with injury severity of spinal cord and their autonomic symptoms. CONCLUSION: Evaluation of SSR and RRIV could be helpful methods to evaluate autonomic function in the spinal cord injured patients.
Autonomic Nervous System ; Electric Stimulation ; Heart Rate* ; Heart* ; Humans ; Median Nerve ; Respiration ; Skin* ; Spinal Cord Injuries ; Spinal Cord* ; Valsalva Maneuver

Purpose: The purpose of this study was to understand and describe the meaning of the experience of male nurses working in Intensive Care Units (ICU). Methods: Data were collected through in-depth interviews with 8 male nurses. Data were collected from november 2019 to february 2020 and were analyzed using Colaizzi's method, a phenomenological approach. Results: 8 theme clusters, and 28 themes were identified. The 8 clusters were as follows; the feeling of burden in a busy and sensitive situation, the daily life facing life and death, female colleagues and patients who are still difficult to treat, a reliable and grateful male colleague, being proud of this role that a man can do, various experiences that improve me, constant effort to be recognized as a team member, and wavering and weighing in the career. Conclusion These results could help to expand understanding the role of male nurses working in the ICU and in other areas. In addition, the results provide basic data needed to improve mutual respect and relationships between male and female nurses. It is necessary to offer mentoring programs for male nurses to adapt to nursing field.

Objective: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and is both unpredictable and inevitable. While uterotonic drugs are routinely recommended, there is ongoing debate on the ideal intervention to control uterine bleeding. This review aims to compare the use of non-pharmacologic treatments with peripartum hysterectomy in cases of life-threatening uncontrolled obstetric hemorrhage. The review’s objective is to use a network meta-analysis to help prevent maternal deaths and rank the treatments according to success rates. Methods: We searched MEDLINE (PubMed), Embase, and the Cochrane Library, from January 2014 until December 2018. A second search was carried out in April 2019 before the final data analysis. Network meta-analysis allows for the calculation of the effect size between treatment groups through indirect treatment comparison. Results: We confirmed that balloon-assisted management is the best intervention for uncontrolled postpartum bleeding with pharmacologic treatment. This is followed by uterine artery embolization and surgical procedures, which can help avoid the need for a hysterectomy. The balloon tamponade demonstrated lower failure rate than the surgical procedure with odds ratio (OR) of 0.44 and 95% confidence intervals (CIs) 0.50–30.54. Uterine artery embolization had a lower risk for hysterectomy than the surgical procedure group (OR, 0.74; 95% CI, 0.22–2.50). Conclusion For the quick treatment of postpartum bleeding, balloon tamponade is the best method for uncontrolled postpartum bleeding with pharmacologic treatment, followed by uterine artery embolization and surgical procedures.

Objective: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and is both unpredictable and inevitable. While uterotonic drugs are routinely recommended, there is ongoing debate on the ideal intervention to control uterine bleeding. This review aims to compare the use of non-pharmacologic treatments with peripartum hysterectomy in cases of life-threatening uncontrolled obstetric hemorrhage. The review’s objective is to use a network meta-analysis to help prevent maternal deaths and rank the treatments according to success rates. Methods: We searched MEDLINE (PubMed), Embase, and the Cochrane Library, from January 2014 until December 2018. A second search was carried out in April 2019 before the final data analysis. Network meta-analysis allows for the calculation of the effect size between treatment groups through indirect treatment comparison. Results: We confirmed that balloon-assisted management is the best intervention for uncontrolled postpartum bleeding with pharmacologic treatment. This is followed by uterine artery embolization and surgical procedures, which can help avoid the need for a hysterectomy. The balloon tamponade demonstrated lower failure rate than the surgical procedure with odds ratio (OR) of 0.44 and 95% confidence intervals (CIs) 0.50–30.54. Uterine artery embolization had a lower risk for hysterectomy than the surgical procedure group (OR, 0.74; 95% CI, 0.22–2.50). Conclusion For the quick treatment of postpartum bleeding, balloon tamponade is the best method for uncontrolled postpartum bleeding with pharmacologic treatment, followed by uterine artery embolization and surgical procedures.

Objective: To provide updates on maternal, infant, and perinatal mortality using the national population data of South Korea between 2009 and 2017 and describe the mortality rate by target groups, timing, or causes of events to provide a basis for detecting vulnerable populations and ensuring timely medical and political interventions. Methods: Pregnancy-related mortality in women, as well as deaths of infants, in South Korea was identified using population data from Statistics Korea. Records from death certificates, cremation reports on infant and fetal deaths, and the complementary cause-of-death investigation system were reviewed for the 2009–2017 period. Results: A total of 461 maternal deaths, 11,717 infant deaths, and 12,249 perinatal deaths, including fetal deaths over 28 gestational weeks, were identified from 3,945,159 live births between 2009 and 2017. The maternal mortality ratio was 13.5 deaths per 100,000 live births in 2009 and decreased to 7.8 in 2017. Only the rate of deaths related to hypertensive disorders showed an increasing tendency. Both the infant and perinatal mortality rates improved (from 3.2 deaths per 1,000 live births in 2009 to 2.8 in 2017 and from 3.5 to 2.7, respectively). Among the external causes of infant mortality, assaults including homicides accounted for 25% (n=150), and this proportion was constant throughout the study period. Conclusion Overall improvements were observed in all maternal, infant, and perinatal mortality measures. In-depth analysis and interventions with respect to certain causes, such as hypertensive disorders in mothers or assaults in infants, should be considered priority issues.

Objective: To provide updates on maternal, infant, and perinatal mortality using the national population data of South Korea between 2009 and 2017 and describe the mortality rate by target groups, timing, or causes of events to provide a basis for detecting vulnerable populations and ensuring timely medical and political interventions. Methods: Pregnancy-related mortality in women, as well as deaths of infants, in South Korea was identified using population data from Statistics Korea. Records from death certificates, cremation reports on infant and fetal deaths, and the complementary cause-of-death investigation system were reviewed for the 2009–2017 period. Results: A total of 461 maternal deaths, 11,717 infant deaths, and 12,249 perinatal deaths, including fetal deaths over 28 gestational weeks, were identified from 3,945,159 live births between 2009 and 2017. The maternal mortality ratio was 13.5 deaths per 100,000 live births in 2009 and decreased to 7.8 in 2017. Only the rate of deaths related to hypertensive disorders showed an increasing tendency. Both the infant and perinatal mortality rates improved (from 3.2 deaths per 1,000 live births in 2009 to 2.8 in 2017 and from 3.5 to 2.7, respectively). Among the external causes of infant mortality, assaults including homicides accounted for 25% (n=150), and this proportion was constant throughout the study period. Conclusion Overall improvements were observed in all maternal, infant, and perinatal mortality measures. In-depth analysis and interventions with respect to certain causes, such as hypertensive disorders in mothers or assaults in infants, should be considered priority issues.

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted 1 subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter beta was 0.0005(+/-0.0002), and statistically significant by REM (random effects model).
Arm ; Automobiles ; Blood Pressure ; Classification ; Fingers ; Hand ; Hand Strength ; Hand-Arm Vibration Syndrome ; Osteoarthritis ; Pain Perception ; Skin ; Skin Temperature ; Vibration* ; Water

No abstract available.
Douglas' Pouch* ; Stomach Neoplasms*