BACKGROUND: Intrathecal (IT) neostigmine produces analgesia in animal and human. This study was designed to evaluate the efficacy and safety of IT neostigmine for post-cesarean section analgesia. METHODS: Forty-five women undergoing cesarean section under spinal anesthesia were randomly assigned into 3 groups to receive; normal saline 0.2 ml, or neostigmine 12.5 microgram, or neostigmine 25 microgram intrathecally with 0.5% hyperbaric bupivacaine 12 mg. Degrees of sensory and motor blocks, maternal hemodynamic changes, and side effects were recorded. Apgar scores and umbilical vein blood gas analysis (UVBGA) were checked for evaluation of fetal status. Postoperative analgesia was provided by intravenous patient-controlled analgesia (PCA) using fentanyl 500 microgram and ketorolac 150 mg in 100 ml. Pain scores with 10-cm visual analogue scale (VAS), time to first PCA use, cumulative PCA consumptions, and side effects were assessed at 1, 2, 4, 8, 12, 24, and 48 hr after IT injection. RESULTS: There were no significant differences among the three groups in characteristics of spinal anesthesia, maternal blood pressure and heart rate, Apgar scores, and UVBGA data. Compared to saline group, IT neostigmine significantly prolonged time to first PCA use and decreased 24 hr- and 48 hr-PCA consumptions (P<0.05). Pain scores in neostigmine groups were significantly lower than those in saline group for first 4 hr after which there were no differences among the three groups. There were significantly higher incidences of nausea and vomiting in neostigmine groups than in saline group. CONCLUSIONS: These data indicate that IT neostigmine can be an alternative postoperative analgesic without adverse fetal effects for cesarean section. However, high incidence of nausea and vomiting seem to limit its clinical usefulness. Further studies are necessary to enhance its analgesic effects and to decrease its adverse effects.
Analgesia* ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Animals ; Blood Gas Analysis ; Blood Pressure ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Ketorolac ; Nausea ; Neostigmine* ; Passive Cutaneous Anaphylaxis ; Pregnancy ; Umbilical Veins ; Vomiting

PURPOSE: This study was performed to evaluate the efficiency of Platelet-rich plasma (PRP) for acceleration of bone healing process on allograft transplantation after curettage in benign bone tumor. MATERIALS AND METHODS: From December 2007 to February 2009, twenty-one patients who had benign bone tumor and underwent allograft transplantation after curettage were evaluated. Mean follow-up period was 14.6 months (range, 12-26 months). We compared with 13 cases of PRP group and 8 cases of non-PRP group in terms of size of lesion, bone resorption, amount of applied PRP and complications. The mean age at surgery was 23.6 years (range, 4-73 years). The most common diagnosis was simple bone cyst (7) followed by enchondroma (4), giant cell tumor (3), undifferentiated benign bone tumor (3) and so on. RESULTS: The mean size of lesion was 33.5 cm3 (range, 2.3-181.9 cm3) (29.4 cm3 in PRP group and 40.2 cm3 in non-PRP group). The mean volume of injected PRP was 7.4 cc (range, 3-12 cc). Bone union started at 3.0 months (range, 1.5-5.8 months) in PRP group and 5.3 months (range, 4-8 months) in non-PRP group. Three cases for each group were excluded due to recurrence and pathologic fracture. One patient had febrile episode 3 weeks later after surgery which subsided with antibiotics. CONCLUSION: The PRP could accelerate bone union in allograft transplantation after curettage of benign bone tumor. Furthermore, we expect that PRP can accelerate bone union in fracture or non-union.
Acceleration ; Anti-Bacterial Agents ; Bone Cysts ; Bone Resorption ; Chondroma ; Curettage ; Follow-Up Studies ; Fractures, Spontaneous ; Giant Cell Tumors ; Humans ; Platelet-Rich Plasma ; Recurrence ; Transplantation, Homologous ; Transplants

PURPOSE: This study was done to identify factors related to glycemic control in men with diabetes. METHODS: Data from the Korean National Health and Nutrition Examination Survey 2007, 2008 collected by the Korean Center for Disease Control were analyzed using chi-square test and t-test. RESULTS: There was a difference in glycemic control according to the individual factor of economic status. Differences in glycemic control according to health related factors were as follows: fasting blood sugar, cholesterol, triglyceride, sleep duration, experience of depression and suicidal thoughts. CONCLUSION: The results of this study will contribute to improvements in management for men with diabetes through comprehensive identification of factors related to glycemic control.
Blood Glucose ; Centers for Disease Control and Prevention (U.S.) ; Cholesterol ; Depression ; Diabetes Mellitus ; Fasting ; Glucose ; Glycemic Index ; Humans ; Male ; Nutrition Surveys

PURPOSE: This study was conducted to explore the nursing needs and satisfaction of patients who are hospitalized at hospice palliative care institutions. METHODS: This study included 80 hospice patients who were in-patients of the hospice department of two general hospitals in S city. The collected data were analyzed by descriptive statistics, t-test, one-way ANOVA, and Pearson's correlation coefficients using the IBM SPSS 20.0 program. RESULTS: The mean score of nursing needs and satisfaction were 3.58 (+/-0.31) and 3.25 (+/-0.20) respectively. Significant differences in hospice nursing needs and satisfaction were observed in terms of general characteristics including gender, education level, occupation, religion, support for medical expense and functional status. Significant positive correlation was found between the overall nursing needs and nursing satisfaction. CONCLUSION: Based on the results of this study, in order to improve the quality of hospice service, further study is necessary in a comprehensive manner to develop nursing intervention to meet physical, psychological/social, spiritual, and educational/referral nursing needs of hospice in-patients.
Education ; Hospice and Palliative Care Nursing ; Hospices* ; Hospitals, General ; Humans ; Needs Assessment ; Nursing Care ; Nursing* ; Occupations ; Palliative Care ; Personal Satisfaction

Myositis ossificans progressiva (MOP) is a rare, slow progressive autosomal dominant disorder that principally affects children under the age 10 years. It is characterized by progressive fibroblastic proliferation, and subsequent calcification and ossification of subcutaneous fat, muscles, tendons, aponeuroses and ligaments. The disorder is often associated with symmetrical malformations of the digits, especially microdactyly or adactyly of the thumbs and great toes. The disease usually leads to extensive immobility and eventual disability. We experienced a case of MOP in a 2-year-old male child who showed multiple tender nodules on the left occipital, superior and inferior scapular, mid-back and upper buttock area and digital malformations and was treated with etidronate disodium. A brief review of related literatures is also presented.
Buttocks ; Child ; Child, Preschool ; Etidronic Acid ; Fibroblasts ; Humans ; Ligaments ; Male ; Muscles ; Myositis Ossificans* ; Myositis* ; Subcutaneous Fat ; Tendons ; Thumb ; Toes

BACKGROUND: Lidocaine has been used for spinal anesthesia in short surgical procedure. However, transient neurologic symptoms (TNS) frequently occur after spinal anesthesia with lidocaine. Mepivacaine which has a silimar duration of action and rare incidence of TNS may be an alternative to lidocaine for spinal anesthesia. This study was designed to compare the efficacy of hyperbaric 1.5% lidocaine and 1.5% mepivacaine for spinal anesthesia. METHODS: Sixty patients, ASA physical status I or II, scheduled for lower abdominal or lower extremity procedures under spinal anesthesia were randomly allocated into two groups. Lidocaine group received 2% lidocaine 75 mg with 10% dextrose 1.25 ml. Mepivacaine group received 2% mepivacaine 75 mg with 10% dextrose 1.25 ml. After intrathecal injection of the anesthetics, sensorimotor block and recovery, cardiovascular effect and quality of surgical anesthesia were evaluated. TNS was evaluated 1 day after the operation. RESULTS: Both groups were similar with regard to demographic data and surgical procedures. The onset of sensory and motor blocks was similar in both groups. Time to regression to L5 sensory level and complete resolution of motor blockade were significantly prolonged in mepivacaine group than in lidocaine group (p<0.05). The effect of cardiovascular system was similar in both groups. Fentanyl was required for 4 cases only in the lidocaine group. None of both groups developed TNS. CONCLUSIONS: Hyperbaric 1.5% mepivacaine produced longer duration of action than hyperbaric 1.5% lidocaine in spinal anesthesia. This study didn't prove what drug develops a higher incidence of TNS.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Cardiovascular System ; Fentanyl ; Glucose ; Humans ; Incidence ; Injections, Spinal ; Lidocaine* ; Lower Extremity ; Mepivacaine* ; Neurologic Manifestations

PURPOSE: The purpose of this study was to identify factors that influence fatigue in hospitalized women cancer patients receiving chemotherapy. METHODS: The participants were 117 women cancer patients receiving chemotherapy. The instruments used in this study were physical symptoms, mood state, family support, and fatigue scales for patients with cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the IBM SPSS 19.0 program. RESULTS: Fatigue showed significant correlation with physical symptoms such as side effects as well as sub-elements of mood status such as anxiety-depression, vitality, anger and family support. Fatigue-anticipating variables were found to be some sub-elements of mood state such as anxiety-depression (beta=.61, t=10.40, p<.001), digestion organ factor (beta=.78, t=2.54, p=.013) and pain/fatigue factor (beta=.86, t=0.43, p=.045). The total variance explained was 69.7%. CONCLUSION: These results showed that the factors affecting fatigue were physical symptoms, and the mood state of hospitalized women cancer patients receiving chemotherapy. The results of this study provided basic materials for a nursing intervention program to reduce fatigue.
Anger ; Digestion ; Drug Therapy* ; Fatigue* ; Female ; Humans ; Nursing ; Weights and Measures

BACKGROUND: The P50 which is the oxygen tension corresponding to 50% saturation at pH 7.40, PCO2 40 mmHg and temperature 37oC is an accepted and useful reference to characterize the oxygen affinity for hemoglobin. This study evaluated the accuracy of P50 calculated from a single measurement of pH, PO2 and SO2 compared with linear regression and sigmoid Emax model in patients undergoing general anesthesia. This study also compared P50 of just after anesthetic induction to P50 of 90 min later. METHODS: This study was conducted in 10 patients undergoing total abdominal hysterectomy. Just after induction of anesthesia, 20G catheter was indwelled at cephalic vein of forearm and venous return was occluded with a tourniquet. After 4 min, 6 blood samples were obtained every one minute. After 90 min, 6 blood samples were obtained with same method. All blood samples were analyzed with blood gas analyzer within 30 min after withdrawal. P50 was calculated from three methods of calculation, linear regression and sigmoid Emax model. The difference between the actural P50 and calculated P50 was evaluated. RESULTS: P50's calculated from three methods were 25.8+/-1.1, 26.1+/-1.1, 26.0+/-1.2 mmHg respectively. P50's 90min after anesthetic induction (26.1+/-1.3, 26.3+/-1.2, 26.2+/-1.2 mmHg) were significantly greater than P50's just after anesthetic induction (25.5+/-0.8, 25.8+/-1.0, 25.9+/-1.1 mmHg)(P<0.05). Difference between calculated P50 and actual P50 of 120 blood samples from 10 patients according to SO2 were -5.7+/-4.5 (SO2<20%), 0.0+/-1.9 (20%90%). Sigmoidicity of oxygen dissociation curves from 10 patients with sigmoid Emax model was 2.78+/-0.13 (mean SD). CONCLUSIONS: The method calculating P50 from a single measurement of pH, PO2, SO2 was relatively reliable to estimate the change of oxygen dissociation curve of a patient. The affinity of hemoglobin to O2 was reduced during general anesthesia.
Anesthesia ; Anesthesia, General* ; Catheters ; Colon, Sigmoid ; Forearm ; Humans ; Hydrogen-Ion Concentration* ; Hysterectomy ; Linear Models ; Oxygen ; Tourniquets ; Veins

PURPOSE: This study was designed to evaluate the mid-term results and efficacy of subtalar distraction double bone-block arthrodesis for calcaneal malunion. MATERIALS AND METHODS: From January 2004 to June 2007, we operated on 6 patients (10 cases). There were 5 males (9 cases) and 1 female (1 case), four of which presented with bilateral calcaneal malunion. Seven cases were operated on initially. The period between initial injury and arthrodesis was 23 months, and the average follow up period was 58 months. In operation, we applied an extensile lateral approach and arthrodesis was performed through a tricortical double bone-block and cannulated screws. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT were examined to assess union and various parameters. RESULTS: The mean age of the patients was 41 years. All cases achieved radiologic union at the final follow-up. The mean AOFAS Ankle-Hindfoot scale (maximum of 94 points) increased from 43.3 points preoperatively to 85.4 points at the final follow-up. The radiologic analysis of the pre- and postoperative standing lateral radiographs showed improvements of 5.6 mm in talo-calcaneal height, 1.8degrees in talocalcaneal angle, 5.1degrees in talar declination angle and 5.3degrees in talo-first metatarsal angle. CONCLUSION: Subtalar distraction two bone-block arthrodesis provides overall good results not only in the short term but also the mid-term with significant improvement in clinical and radiologic outcomes. This procedure warrants consideration for managing calcaneal malunion with loss of height and subtalar arthritis.
Adult ; Arthrodesis/methods ; Calcaneus/*injuries/surgery ; Female ; Fractures, Malunited/*surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

PURPOSE: The aim of this study was to identify the relationship between awareness of nutrition labeling and menstrual cycle irregularity in women from a nationally representative sample of the Korean population. METHODS: A cross-sectional analysis was performed using hierarchical multivariable logistic regression analysis models. A total of 4,324 women aged 19~54 years from the 2010~2012 Korean National Health and Nutrition Examination Survey participated in the study. The participants were classified into three groups based on self-report responses to a questionnaire about their awareness of nutrition labels: Reading, Not-Reading, and Not-Knowing Groups. RESULTS: The Reading, Not-Reading, and Not-Knowing Groups comprised 46.4%, 44.9%, and 8.7% of the participants, respectively, and 53.6% of the participants had never used nutrition labels. In the Not-Knowing Group, irregular menstrual cycles for more than 3 months were significantly more common than women with irregular menstrual cycles for up to 3 months and women with regular menstrual cycles. Women in the Not-Knowing Group were more likely to exhibit menstrual cycle irregularity (adjusted odds ratio: 1.63, 95% confidence interval: 1.10~2.41) compared to women in the Reading Group after adjusting for age, body mass index, smoking status, alcohol intake, exercise regularity, stress, depression, suicidal ideation, metabolic syndrome, age at menarche, parity, and use of oral contraceptives. CONCLUSION: No awareness of nutrition labeling appears to be associated with a higher prevalence of menstrual cycle irregularity in a nationally representative group of Korean women.
Body Mass Index ; Contraceptives, Oral ; Cross-Sectional Studies ; Depression ; Female ; Food Labeling ; Health Literacy ; Humans ; Korea* ; Logistic Models ; Menarche ; Menstrual Cycle* ; Nutrition Surveys* ; Odds Ratio ; Parity ; Prevalence ; Smoke ; Smoking ; Suicidal Ideation