74 research outputs found

    Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation

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    Objectives: The use of dexmedetomidine and ketamine (DEX–KET) combination for magnetic resonance imaging (MRI) sedation has not been evaluated. We investigated the efficacy and safety of DEX–KET for sedation of patients undergoing MRI of the brain.Methods: This quasi-experimental study was conducted to compare the DEX–KET combination and midazolam for MRI sedation. We included 72 patients undergoing brain MRI following bolus injection of midazolam or DEX–KET. In August 1, 2016 a new MRI sedation protocol was implemented. After protocol implementation, bolus doses of DEX–KET were administered (DEX–KET group). Thirty-six patients from the MIDA group and 36 patients from the DEX–KET group underwent MRI sequences and were compared regarding the MRI scan time and sedation-related complications (desaturation, hypotension, cardiorespiratory arrest, and aspiration pneumonia).Results: All MRI sequences were completed for 30 patients (83.3%) from the MIDA group and for 33 patients (91.7%) from the DEX–KET group (P = 0.476). The median MRI scan time was 100.0 min (interquartile range, 87.0–111.5 min) in the MIDA group and 53.5 min (interquartile range, 45.0–60.5 min) in the DEX–KET group (P < 0.001). Complications occurred in 24 (66.7%) and 8 (22.2%) patients of the MIDA and DEX–KET group, respectively (P < 0.001).Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam

    Quote Recommendation for Dialogs and Writings

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    ABSTRACT Citing proverbs and (famous) statements of other people can provide support, shed new perspective, and/or add humor to one's arguments in writings or dialogs. Recommending quote for dialog or writing can be done by considering the various features of the current text called context. We present five new approaches to quote recommendation: 1) methods to adjust the matching granularity for better context matching, 2) random forest based approach that utilizes word discrimination, 3) convolutional neural network based approach that captures important local semantic features, 4) recurrent neural network based approach that reflects the ordering of sentences and words in the context, and 5) rank aggregation of these algorithms for maximum performance. We adopt as baseline state-of-the-arts in citation recommendation and quote recommendation. Experiments show that our rank aggregation method outperforms the best baseline by up to 46.7%. As candidate quotes, we use famous proverbs and famous statement of other person in dialogs and writings. The quotes and their contexts were extracted from Twitter, Project Gutenberg, and Web blog corpus

    High-resolution analysis of condition-specific regulatory modules in Saccharomyces cerevisiae

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    A novel approach for identifying condition-specific regulatory modules in yeast reveals functionally distinct coregulated submodules

    Dystrophic Calcification and Stone Formation on the Entire Bladder Neck After Potassium-titanyl Phosphate Laser Vaporization for the Prostate: A Case Report

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    Dystrophic calcification can be defined as a calcification that occurs in degenerated or necrotic tissue. It is associated with multiple clinical conditions, such as collagen vascular diseases. It involves the deposition of calcium in soft tissues despite no generalized disturbance in the calcium or phosphorus metabolism, and this is often seen at sites of previous inflammation or damage. Potassium-titanyl phosphate (KTP) laser vaporization of the prostate is safe and relatively bloodless procedure that results in a shorter catheterization, immediate symptomatic improvement, and less severe postoperative irritative symptoms. However, longer follow-up studies or reports about complications are lacking. Here in we report a case of dystrophic calcification and stone formation on the entire bladder neck after performing KTP laser vaporization of benign prostate hyperplasia. That was treated by lithotripsy and transurethral resection

    Factors Affecting Willingness to Undergo Carpal Tunnel Release

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    Background: Factors regarding patient willingness to undergo or avoid joint replacement have been studied; however, these factors have not been studied in patients with carpal tunnel syndrome. To further understand the aspects that are important for a patient with carpal tunnel syndrome in deciding whether to have surgery, we identified factors that affect this decision in women and that are not related to Workers` Compensation status. Methods: We retrospectively reviewed 282 female patients with electrophysiologically confirmed carpal tunnel syndrome without a known cause who were recommended for carpal tunnel release by a single hand surgeon in a tertiary medical setting. Of those, thirty-six female patients who were not entitled to Workers` Compensation canceled the operation during the waiting period, which averaged four weeks. Thirty-three of them were surveyed with a questionnaire sent by mail, and eighteen completed surveys were reviewed at a mean follow-up of thirty-two months. Furthermore, seventy female patients who underwent carpal tunnel release were randomly sampled, and thirty-eight patients completed the survey. The operation and cancellation groups were compared with regard to the reasons for choosing or canceling surgery. Results: The groups were similar with regard to age, sociodemographic variables, follow-up length, initial electro-physiological findings, and functional status. The highest-ranked reason for choosing surgery was symptom severity rather than fear of progression or a positive electrodiagnostic result. Those who canceled the operation rated symptom improvement during the waiting period as the leading reason for doing so, but they were also concerned about transient weakness, the financial burden, and a scar or pillar pain. Disease persistence or recurrence was the issue of most concern in both groups. At the time of the final review, the functional status was significantly improved in both groups and no significant difference between the groups was detected. Conclusions: Women with carpal tunnel syndrome report that subjective symptom severity is the most important reason for undergoing surgery. Understanding this and other patient concerns may help physicians during patient-oriented consultation and decision-making. In particular, recommendations for carpal tunnel release on the basis of symptoms are reasonable from the perspective of the patient who has carpal tunnel syndrome without a known cause.Lee JY, 2008, J SHOULDER ELB SURG, V17, P570, DOI 10.1016/j.jse.2007.12.005Hudak PL, 2008, J BONE JOINT SURG AM, V90A, P1427, DOI 10.2106/JBJS.G.01077Park KK, 2007, CLIN ORTHOP RELAT R, P143, DOI 10.1097/BLO.0b013e31804ea0bcTaylor-Gjevre RM, 2007, CAN FAM PHYSICIAN, V53, P1186Rigler I, 2007, EUR J NEUROL, V14, P783, DOI 10.1111/j.1468-1331.2007.01855.xBallantyne PJ, 2007, ARTHRIT RHEUM-ARTHR, V57, P27, DOI 10.1002/art.22472*AAOS CARP TUNN SY, 2007, AM AC ORTH SURG GUIDSCHOLTEN RJ, 2007, COCHRANE DB SYST REV, V17, P3905Hawker GA, 2006, CURR OPIN RHEUMATOL, V18, P526Mazur DJ, 2005, HEALTH EXPECT, V8, P97FIGARO MK, 2005, J AMBUL CARE MANAGE, V28, P41Hawker GA, 2004, ARTHRIT RHEUM-ARTHR, V51, P635, DOI 10.1002/art.20524Figaro MK, 2004, HEALTH PSYCHOL, V23, P324, DOI 10.1037/0278-6133.23.3.324Chang HJ, 2004, ARTHRIT RHEUM-ARTHR, V51, P117, DOI 10.1002/art.20073AKELMAN E, 2004, HAND SURG, P867Moran M, 2003, J ARTHROPLASTY, V18, P442, DOI 10.1016/S0883-5403(03)00061-5RESENDE LA, 2003, ELECTROMYOGR CLIN NE, V43, P301Ang DC, 2002, MED CARE, V40, P471Hawker GA, 2001, MED CARE, V39, P206Bland JDP, 2000, MUSCLE NERVE, V23, P1280Trousdale RT, 1999, MAYO CLIN PROC, V74, P978Atroshi I, 1999, JAMA-J AM MED ASSOC, V282, P153Homan MM, 1999, SCAND J WORK ENV HEA, V25, P115Padua L, 1998, ITAL J NEUROL SCI, V19, P357Aulisa L, 1998, J HAND SURG-AM, V23A, P687Nathan PA, 1998, MUSCLE NERVE, V21, P711Concannon MJ, 1997, PLAST RECONSTR SURG, V100, P1452Asch DA, 1997, J CLIN EPIDEMIOL, V50, P1129Hudak PL, 1996, AM J IND MED, V30, P372Deber RB, 1996, ARCH INTERN MED, V156, P1414Hudak PL, 1996, AM J IND MED, V29, P602WRIGHT JG, 1994, J BONE JOINT SURG BR, V76B, P229LEVINE DW, 1993, J BONE JOINT SURG AM, V75A, P1585SIMINOFF LA, 1991, SOC SCI MED, V32, P813GRUNDBERG AB, 1983, J HAND SURG-AM, V8, P348

    Bidirectional Association Between Parkinson’s Disease and Obstructive Sleep Apnea: A Cohort Study

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    STUDY OBJECTIVES: Chronic intermittent hypoxia due to obstructive sleep apnea (OSA) causes oxidative stress, which may contribute to the pathophysiology of Parkinson\u27s disease (PD). However, the bidirectional relationship between PD and OSA has not been satisfactorily established. The objective of this study was to try to estimate whether there is a bidirectional relationship between PD and OSA through a retrospective cohort study in the South Korean population. METHODS: This study used data from the Korean National Health Information Database of the National Health Insurance Service, which contains data from 3.5 million individuals evenly distributed. In study 1, patients with OSA were matched in a 1:2 ratio with non-OSA controls. In study 2, patients with PD were matched in a 1:2 ratio with non-PD controls. A stratified Cox proportional hazards model was used to calculate hazard ratios. RESULTS: In study 1, which included 6,396 patients with OSA and 12,792 non-OSA controls, the incidence of PD per 10,000 person-years was 11.59 in the OSA group and 8.46 in the non-OSA group. The OSA group demonstrated a 1.54-fold higher incidence of PD than the non-OSA group (95% confidence interval, 1.14-2.07; CONCLUSIONS: This study supports a possible bidirectional relationship between PD and OSA. CITATION: Jeon S-H, Hwang YS, Oh S-Y, et al. Bidirectional association between Parkinson\u27s disease and obstructive sleep apnea: a cohort study

    Rupture of endotracheal tube cuff during robot-assisted endoscopic thyroidectomy -A case report-

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    We encountered a case of a rupture of an endotracheal tube cuff during robot-assisted thyroid surgery in a 35-year-old male patient. Two hours after commencing surgery, the bellows of the ventilator were not filled and a rupture of the endotracheal tube cuff was suspected. Once the robot-manipulator is engaged, the position of the operating table cannot be altered without removing it from the patient. Reintubation with direct laryngoscopy was performed with difficulty in the narrow space between the patient's head and robot-manipulator without moving the robot away from the patient. The rupture of the endotracheal tube cuff was confirmed by observing air bubbles exiting from the balloon in water. The patient was discharged 3 days after surgery without complications. In robot-assisted thyroid surgery, a preoperative arrangement of the robot away from the patient's head to obtain easy access to the patient is essential for safe anesthetic care

    The Mildly Elevated Serum Bilirubin Level is Negatively Associated with the Incidence of End Stage Renal Disease in Patients with IgA Nephropathy

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    Oxidative stress plays various roles in the development and progression of IgA nephropathy, while bilirubin is known as a potent antioxidant. We therefore hypothesized that serum bilirubin would be associated with renal prognosis in IgA nephropathy. The study subjects comprised 1,458 adult patients with primary IgA nephropathy in Korea. We grouped patients according to the following quartile levels of bilirubin: <0.4 mg/dL (Q1), 0.4-0.5 mg/dL (Q2), 0.6-0.7 mg/dL (Q3), and >0.8 mg/dL (Q4). The outcome data were obtained from the Korean Registry of end-stage renal disease (ESRD). Eighty patients (5.5%) contracted ESRD during a mean follow-up period of 44.9 months. The ESRD incidences were 10.7% in Q1, 8.2% in Q2, 2.8% in Q3, and 2.8% in Q4 (p<0.001). The relative risk of ESRD compared to that in Q1 was 0.307 (95% confidence interval [CI], 0.126-0.751) in Q3 and 0.315 (95% CI, 0.130-0.765) in Q4. The differences of ESRD incidence were greater in subgroups of males and of patients aged 35 yr or more, with serum albumin 4.0 g/dL or more, with normotension, with eGFR 60 mL/min/1.73 m2 or more, and with proteinuria less then 3+ by dipstick test. In conclusion, higher bilirubin level was negatively associated with ESRD incidence in IgA nephropathy
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