The incidence of postspinal headache is one of the well known complications of spinal anesthesia. The development of postspinal headache is related to age and sex of patients, needle size, needle configuration, pregnancy, direction of needle bevel, number of dural puncture. This study was done to see the effect of various gauge Quincke needles(22, 23, 24, 25, 26gauge) and needle bevel direction on the incidence, severity, onset and location of postspinal headache in the 200 male patients of the third age decade undergoing spinal anesthesia. There were one group consisting of 100 patients who underwent parallel insertion to longitudinal dural fibers and the other group consisting of 100 patients who underwent vertical. Each group consisting of 100 patients had five subgroups with 20 patients in related to each needle gauge. A system of criteria for registering postspinal headache and its severity is proposed. The following results were observed: 1) The incidence of postspinal headache was 10% in one group who underwent parallel insertion to longitudinal dural fibers but 27% in the other group who underwent vertical. 2) The severity of headache was mild level in all the 10 cases with postspinal headache of parallel insertion group but above moderate level in 14 cases of all the 27 cases with postspinal headache of vertical insertion group. 3) The small size of needle had a trend with lower incidence of postspinal headache than the large size . 4) The onset of postspinal headache was within 3 day after spinal anesthesia in the almost patients(92.5%) with postspinal headache. 6) The sites of postspinal headache were 59.5% in frontal, 18.9% in occipital, 16.2% in generalized, 5.4% in parietal region. In conclusion, the method of insertion parallel to longitudinal dural fibers is significantly lower incidence of postspinal headache than that of insertion vertical to longitudinal dural fibers in young males of the third age decade.
Anesthesia, Spinal ; Headache* ; Humans ; Incidence ; Male* ; Needles* ; Pregnancy ; Punctures ; Rabeprazole

No abstract available.
Pulmonary Ventilation*

No abstract available.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Purpose: This study aimed to develop a self-management mobile app for adults with osteoarthritis based on a selfdetermination theory to use it as a nursing intervention tool, and to evaluate the effects of the developed mobile app on adults' basic psychological needs, indexes of osteoarthritis, self-management and quality of life. Methods: The 56 participants were randomly assigned to either the experimental group (n=28) or the control group (n=28). The participants of the experimental group used a self-management mobile app for 12 weeks after the pretest, and two posttests were taken at the end of every 6 weeks. The data were analyzed using IBM SPSS/WIN 25.0 for Chi-square test, Fisher's exact test, independent t-test, and repeated measures ANOVA. Results: Basic psychological needs, indexes of osteoarthritis, self-management, and quality of life score of the experimental group were significantly higher than those of the control group. Conclusion Our findings suggest that mobile app intervention can support improvements in psychological needs, symptoms of osteoarthritis and quality of life in adults with osteoarthritis. It is recommended that the developed mobile app be used as a nursing intervention tool for adults with osteoarthritis in the community.

PURPOSE: This study investigates the social network, self-care agency, and quality of life of high-risk beneficiaries in case management of Medicaid and the correlations between these variables. It also identifies influencing factors on their quality of life. METHODS: The subjects included 187 individuals chosen from the high-risk beneficiaries in case management of Medicaid in D Metropolitan City. Data was collected through direct interviews based on a structured questionnaire on home visits. RESULTS: The perceived health status was the most influential factor in their quality of life, followed by self-care agency, mutual support network, and natural support network in order. These factors explained 40.6% of their quality of life. CONCLUSION: These findings raise a need to develop a nursing intervention program to increase the self-care agency of the high-risk beneficiaries in case management of Medicaid.
Case Management* ; House Calls ; Medicaid* ; Nursing ; Quality of Life* ; Self Care*

The AMBU bag is a useful equipment at the cardiopulmonary resuscitation (CPR) or the respiratory therapy. The AMBU bag eonsists simply of a self-reflating bag, a patient valve and a inlet valve. The patient valve is a non-rebreathing valve and the self-inflating bag is a recoiled rubber bag. The inlet valve on the posterior site of self-inflstion bag is closed during the bag is squeezed, and opened during the bag is released. During reflation of bag, fresh room air through the one-way valve and fresh oxygen through the orifice for oxygen supply will mix. Therefore the inspiratory oxygen concentration is decided by a speed of re- flation of the self-reflating bag. We measured inspiratory oxygen concentration during AMBU bag ventilation under different inspiration : expiration (I:E) ratio, frequency of venti- lation, ventilatory volume and flow rate of oxygen. The results were that factors increase a inspirstory oxygen concentration are 1) decrease of I:E ratio, 2) decrease of frequency of ventilation, 3) decrease of ventilatory volume, 4) inerease of flow rate. We found that haste of physician makes frequent squeezing of AMBU bag and the haste results a decrease of inspiratory oxygen concentration.
Bays ; Cardiopulmonary Resuscitation ; Humans ; Oxygen* ; Respiratory Therapy ; Rubber ; Ventilation*

The antiarrhythmic efficacy if low dose amiodarone treatment was studied in 30 cases of ventricular premature beats(VPBs). Amiodarone was administered 600mg daily in three divided doses for for initial 7-10 days as loadihg dosage,then 100-200mg once daily as maintenance. The results obtained were as follow : 1) The complete control of VPBs was achieved by amiodarone treatment in 90%, 27cases of 30 cases(all 11 cases with simple VPBs and 16 cases of the remainders with complex VPBs). 2) The QT interval and QTc were significantly prolonged, whereas heart rate was reduced significantly after amiodarone treatment. 3) In 27 cases of responder, the frequency of VPBs began to decrease overtly 2-3 days after amiodarone administration, then relatively stablized in 6 days, and complete cnotrol of VPBs was achieved in all cases about 10 days after treatment. 4) No significant side-reaction was observed except the decrease of serm T3 level after treatment.
Amiodarone* ; Arrhythmias, Cardiac* ; Heart Rate ; Selective Estrogen Receptor Modulators

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

BACKGROUND: Obese type 2 diabetic subjects are recently increasing in Korea, indicating the importance of insulin resistance rather than insulin secretory defects in the pathophysioloy of type 2 diabetes. The purpose of this study is to evaluate the safety and efficacy of fixed dose rosiglitazone/metformin combination therapy in poorly controlled subjects with type 2 diabetes mellitus. METHODS: 12 type 2 diabetic subjects who had a HbA1c > 11% or fasting plasma glucose > 15 mmol/L were included. After a 2 week screening period, the subjected took the fixed does rosiglitazone/metformin for 24 weeks. The treatment with rosiglitazone/metformin began at week 0 with an initial dose of 4 mg/1000 mg and, unless tolerability issues arose, subjects would be increased to 6 mg/1500 mg at week 4 and at week 8 to the maximum dose of 8 mg/2000 mg. The primary object of this study was to characterize the magnitude of HbA1c reduction from baseline after 24 weeks of rosiglitazone and metformin treatment in poorly controlled type 2 diabetics. RESULTS: The mean age of the subjects was 48.9 +/- 10.6 years old, body mass index was 25.0 +/- 3.5 kg/m2, HbA1c was 12.0 +/- 1.0%, and fasting plasma glucose was 16.3 +/- 3.1 mmol/L. HbA1c was reduced to 7.54 +/- 1.45% and fasting plasma glucose reduced to 7.96 +/- 2.38 mmol/L at week 24. The proportion of HbA1c responder who showed the reduction from baseline of > or = 0.7% or HbA1c < 7% was 11 among 12 subjects (91.7%). 41% of the subjects (5 among 12 subjects) achieved HbA1c level < 7.0% and 75% (9 among 12 subjects) achieved HbA1c level < 8.0%. CONCLUSIONS: In this study, rosiglitazone and metformin combination therapy was effective in glycemic control in poorly controlled subjects with type 2 diabetes mellitus.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Fasting ; Glucose ; Insulin ; Insulin Resistance ; Korea ; Mass Screening ; Metformin ; Plasma ; Thiazolidinediones

BACKGROUND: Type 2 diabetes is usually preceded by a long and clinically silent period of increasing insulin resistance. The purpose of this study is to demonstrate that rosiglitazone and metformin fixed-dose combination therapy (RSG/MET) will safely and effectively control glycemia as a first line of oral therapy, better than rosiglitazone (RSG) or metformin (MET) monotherapy in Korean type 2 diabetes patients. METHODS: This study was a 32-week, multicenter, randomized, double-blind study. Twenty-seven type 2 diabetes patients (males 14; females 13) were included and randomly divided into the rosiglitazone, metformin group, or rosiglitazone /metformin combination groups. The primary objective of this study was to determine the change in HbA1c from baseline (week 0) to week 32. The secondary end-points were to determine changes in fasting plasma glucose (FPG) and homeostasis model assessment insulin resistance (HOMA-IR), from baseline to week 32. Other cardiovascular risk markers were also assessed. RESULTS: At week 32, there were significant reductions in HbA1c and FPG, in all three treatment groups. There was no statistical difference in HbA1c among the three groups, but the decrease in FPG in the RSG/MET group was statistically significant compared to the MET group (P < 0.05). RSG/MET significantly reduced HOMA-IR at week 32 compared to baseline, but there was no difference among the three groups. RSG/MET significantly decreased high-sensitive C-reactive protein (hs-CRP) value at week 32, compared to baseline. There were increases in adiponectin from baseline to week 32 in the RSG and RSG/MET groups, and the increase in the RSG/MET group was statistically significant compared to that of the MET group (P < 0.05). At week 32, there was a significant decrease in plasminogen activator inhibitor-1 (PAI-1) in all three treatment groups, but no statistically significant difference among them. The RSG/MET group significantly decreased in terms of urinary albumin-creatinine ratio at week 32, compared to baseline. CONCLUSIONS: In this study, rosiglitazone and metformin combination therapy was effective in glycemic control as an initial therapy, and it improved cardiovascular risk markers in Korean type 2 diabetes patients.
Adiponectin ; C-Reactive Protein ; Diabetes Mellitus, Type 2 ; Double-Blind Method ; Fasting ; Female ; Glucose ; Homeostasis ; Humans ; Insulin Resistance ; Metformin ; Plasma ; Plasminogen Activators ; Thiazolidinediones