OBJECTIVE: To compare the analgesic effectiveness and safety of tramadol 37.5 mg/acetaminophen 325 mg combination tablets (tramadol/acetaminophen) with non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of osteoarthrits in elderly patients. METHODS: This randomized controlled study enrolled 48 patients with chronic knee osteoarthritis where the diagnostic period was over 3 months. Patients with at least moderate pain [visual analog scale (VAS) with scores > or =40/100 mm] after the washout period were randomized to tramadol/acetaminophen or NSAID. All patients received tramadol/acetaminophen 1 tablet TID or NSAID (naproxen 500 mg) BID. The primary outcome measures were the final pain VAS scores. Secondary measures included pain relief (5 point Likert scale), adverse events, and overall medication assessments. RESULTS: In total, 43 intent-to-treat (ITT) patients received tramadol/acetaminophen (n=21) or NSAID (n=22). Mean baseline pain VAS scores showed no difference between two groups. ITT analysis showed significantly better mean final VAS scores (38.45 vs 31.24, p=0.004) and mean final pain relief scores (2.18 vs 2.95; p=0.007) for tramadol/acetaminophen rather than for NSAID. The most common treatment related adverse events with tramadol/acetaminophen were nausea/vomiting (47.6%) and constipation (33.3%). Epigastric soreness and heartburn was more frequent in NSAID treatment. CONCLUSION: Tramadol/acetaminophen combination showed better effectiveness in pain reduction compared with NSAIDs when used for the treatment of osteoarthritis in elderly patients.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Constipation ; Heartburn ; Humans ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Outcome Assessment (Health Care) ; Tablets ; Tramadol

Recently refractive corneal surgery has been increasing and intraocular lens implantation is a routine procedure during cataract surgery. Many people have various activities in the evening such as night driving, thus it may be very important measuring the pupil size in the dark in determining the size of the optical zone. We measured pupil size of sixty normal adult candidates in darkness of 0, 20, 60, 100 lux and also in the bright illumination of 200 lux for comparison using near lens camera and slide film. The pupils became larger with younger age and increased darkness. Pupil Size(log mm) = 4.57 - 0.0388 X Age(year) - 0.005 X Luminance(lux). The average pupil size of all age groups were 7.0mm, 6.56mm, 5.97mm, 5.4mm sequencially in darkness and 4.77mm in brightness(200 lux). The average pupil size of 20~30 year old group who are socially active even at night was 7.18mm and 8.4mm in maximum. This has significant meaning clinically. Additionally the size of pupil became larger with increased corneal diameter and the amount of anisocoria tended to be greater with the increase of the darkness.
Adult* ; Anisocoria ; Cataract ; Darkness ; Humans ; Lens Implantation, Intraocular ; Lighting ; Pupil*

This project developed a neural network based on nursing diagnoses among 98 nursing diagnoses Korea Nurses Association recommended when related factors and clinical signs are entered. This nursing diagnosis system consists of five sub-systems: data-input system from which a nurse can obtain knowledge from experts; data-base system in which nurses can manage statistical data; inference support system which provides learning effect; inference system which increases inference ability of nurses using existing data and nursing diagnoses data; and result-retrieve system in which nurses can look at the outcomes of nursing process. This nursing diagnosis system provides a interface which enables maintenance and revision easier as well as to induce a diagnosis through the communication between the nurse and the patient. In addition, this system makes nurses determine the nursing diagnoses in a more accurate manner by linking the learning effect of the system whit intra-neural network algorithm. This nursing diagnosis system will assist nurses to provide foster and more accurate way to implement nursing diagnosis.
Diagnosis ; Humans ; Information Systems* ; Korea ; Learning ; Nursing Diagnosis* ; Nursing Process* ; Nursing*

A 33-year-old male presented with an acute onset of back pain and abdominal pain. He was 189.9 cm tall and had an arm span of 194 cm, and had mild pectus carinatum as well as arachnodactyly. Plain radiographs showed kyphoscoliosis of the lumbar spine, bamboo spine of the thoracic spine, and sacroiliitis of the pelvis. Abdominal computed tomography revealed debakey type 3 aortic dissection. We prescribed beta blockers to control his blood pressure. According to the modified New York criteria, we diagnosed him with HLA negative ankylosing spondylitis and initiated therapy with nabumetone and sulfasalazine. We later diagnosed Marfan syndrome based on the Ghent criteria and mutation screening at the fibrillin-1. After treatment, he has been followed up without symptoms or complications.
Abdominal Pain ; Arachnodactyly ; Arm ; Back Pain ; Blood Pressure ; Butanones ; Humans ; Male ; Marfan Syndrome ; Mass Screening ; Microfilament Proteins ; New York ; Pelvis ; Sacroiliitis ; Spine ; Spondylitis, Ankylosing ; Sulfasalazine

Anisakiasis is a parasitic disease caused by ingestion of raw fish infected with anisakid larvae. Endoscopic changing patterns of submucosal lesions in chronic gastric anisakiasis have not been known yet. Here we report 4 cases of suspected gastric anisakiasis which were improved during follow-up periods without surgical treatment. The patients presented with abdominal pain, nausea and vomiting after consuming raw marine fish, and visited our gastroenterology outpatient department. Their endoscopic findings showed firm and yellowish submucosal masses accompanied with eccentric erosions. Histologic findings showed severe eosinophilic infiltrations. In blood tests, peripheral eosinophil counts and total IgE levels were elevated. We believed that all cases were caused by larval anisakid infections. The submucosal mass lesions disappeared during the follow-up periods of 2 to 4 mo.
Time Factors ; Stomach Neoplasms/diagnosis/pathology ; Seafood/parasitology ; Middle Aged ; Male ; Larva ; Immunoglobulin E/blood ; Humans ; Follow-Up Studies ; Female ; Eosinophils/cytology ; Endoscopy, Gastrointestinal/methods ; Diagnosis, Differential ; Chronic Disease ; Anisakiasis/*diagnosis/parasitology ; Animals