Journal of Korean medical science
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J. Korean Med. Sci. · Aug 2014
Randomized Controlled Trial Multicenter StudyEarly prophylactic versus late selective use of surfactant for respiratory distress syndrome in very preterm infants: a collaborative study of 53 multi-center trials in Korea.
Pulmonary surfactant (PS) therapy was proven to be highly successful for the treatment of respiratory distress syndrome in premature infants. As a results, early prophylactic (EP) PS therapy has been introduced recently in Europe, the US and Korea. However, no multi-center study was compared EP and late selective (LS) PS therapies in Korea. ⋯ Compared to the LS group (22.5%), the overall mortality was better in the EP group (19.9%) and there was no increased need for retreatment. There were additional benefits in the EP group such as fewer associated complications. To the best of knowledge, our study is the first nationwide Korean study to compare the outcomes of EP and LS therapies, and it provides evidences that EP PS therapy is important in very preterm infants to improve for survival and reduce morbidities.
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J. Korean Med. Sci. · Aug 2014
Randomized Controlled TrialAminophylline partially prevents the decrease of body temperature during laparoscopic abdominal surgery.
Aminophylline can elicit thermogenesis in rats or increase metabolic rate during cold stress in lambs. We tested the hypothesis that aminophylline would reduce the change in core body temperature during laparoscopic abdominal surgery requiring pneumoperitoneum. ⋯ In the aminophylline group, esophageal temperatures at T45 (36.1±0.38 vs. 35.7±0.29, P=0.024), T60 (36.0±0.39 vs. 35.6±0.28, P=0.053), T75 (35.9±0.34 vs. 35.5±0.28, P=0.025), T90 (35.8±0.35 vs. 35.3±0.33, P=0.011), and T105 (35.8±0.36 vs. 35.1±0.53, P=0.017) and index finger temperatures at T15 (35.8±0.46 vs. 34.9±0.33, P<0.001), T30 (35.7±0.36 vs. 35.0±0.58, P=0.029), T45 (35.8±0.34 vs. 35.2±0.42, P=0.020), T60 (35.7±0.33 vs. 34.9±0.47, P=0.010), T75 (35.6±0.36 vs. 34.8±0.67, P=0.028), T90 (35.4±0.55 vs. 34.4±0.89, P=0.042), and T105 (34.9±0.53 vs. 33.9±0.85, P=0.024) were significantly higher than in the saline control group. Aminophylline is effective in maintaining the core temperature through a thermogenic effect, despite reduced peripheral thermoregulatory vasoconstriction.
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J. Korean Med. Sci. · Aug 2014
Multicenter Study Observational StudyAssociation between bone mineral density and clinical consequences: cross-sectional study of Korean postmenopausal women in an orthopaedic outpatient clinic.
This study is to identify the characteristics of BMD and the related clinical consequences through a nationwide, consecutive, cross-sectional study. A total of 1,281 postmenopausal women was enrolled nationwide and underwent measurement for BMD using dual energy x-ray absorptiometry. Following the T-spine and L-spine plane radiography, they were evaluated for vertebral fracture by a semi-quantitative method using the Genant's method. ⋯ The femur neck and total hip BMDs were significantly lower in hip fracture group (0.646 g/cm(2) and 0.643 g/cm(2), respectively) and wrist fracture group (0.661 g/cm(2) and 0.712 g/cm(2), respectively) than in subjects without fracture (0.721 g/cm(2) and 0.712 g/cm(2), respectively). The BMD was significantly lower with more severe degree of deformity in vertebral fracture and lower scores in mobility, usual activities and pain/discomfort of the EQ-5D. In Korean postmenopausal women, the prevalence of osteoporosis and vertebral, hip and wrist fracture increase and quality of life decreases with lower BMD.
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J. Korean Med. Sci. · Aug 2014
Observational StudyThe influence of depression, anxiety and somatization on the clinical symptoms and treatment response in patients with symptoms of lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (≤ 7) at the end of treatment. ⋯ Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.
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J. Korean Med. Sci. · Aug 2014
The risk of osteoporotic fractures according to the FRAX model in Korean patients with rheumatoid arthritis.
The aim of the current study is to identify patients without osteoporosis who met the criteria of the fracture risk assessment tool (FRAX) of the National Osteoporosis Foundation (NOF) only. The incidence of fractures was investigated in patients who met only the FRAX criteria of the NOF and patients who presented osteoporosis. Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea. ⋯ During the follow-up period, 2 new onset fractures occurred in patients who met only the FRAX criteria and 22 new onset fractures did in patients with osteoporosis by bone mineral density. The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years. Patients who met the FRAX criteria of the NOF only need pharmacological intervention because their numbers of incidence for new onset fractures are similar to those of patients with osteoporosis by BMD.