Yonsei medical journal
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Yonsei medical journal · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural and intravenous analgesia for postoperative pain control in pediatric lower extremity surgery.
In recent years epidural anesthesia and analgesia techniques were used in pediatric surgery owing to the development of pediatric epidural catheter needles. And the need of postoperative pain control in pediatric patients is also increasing. We compared combined general-epidural anesthesia and analgesia technique with intravenous fentanyl analgesia after general anesthesia for postoperative analgesic effect and complications in these pediatric patients. ⋯ There was no significant difference in the incidence of postoperative nausea and vomiting. A combined general-epidural anesthesia technique significantly reduces intraoperative end-tidal sevoflurane concentration compared to general anesthesia alone. And continuous patient-controlled epidural analgesia reduces postoperative pain scores significantly more than continuous patient-controlled IV fentanyl analgesia without any serious complications in pediatric lower extremity surgery.
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Yonsei medical journal · Oct 2004
Randomized Controlled Trial Clinical TrialThe effects of urokinase instillation therapy via percutaneous transthoracic catheter in loculated tuberculous pleural effusion: a randomized prospective study.
The purpose of this study was to propose that intrapleural urokinase (UK) instillation could reduce pleural thickening in the treatment of loculated tuberculous pleural effusion. Forty- three patients who were initially diagnosed as having loculated tuberculous pleural effusion were assigned at random to receive either the combined treatment of UK instillation including anti-tuberculosis agents (UK group, 21 patients) or strictly the unaccompanied anti-tuberculous agents (control group, 22 patients). The UK group received 100,000 IU of UK dissolved in 150 ml of normal saline daily, introduced into the pleural cavity via a pig-tail catheter. ⋯ The interval of symptoms observed prior to treatment of patients with RPT > or = 10 mm (6.0 +/- 3.4 wks) was detected to be significantly longer than in those with RPT < 10 mm (2.1 +/- 1.2 wks) in the control group (p < 0.05). However, there were no discernible differences were seen in the pleural fluid parameter in patients with RPT > or = 10 mm, as compared to patients with RPT < 10 mm in the UK group. These results indicate that the treatment of loculated tuberculous pleural effusion with UK instillation via percutaneous transthoracic catheter can cause a successful reduction in pleural thickening.
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Yonsei medical journal · Oct 2004
ReviewTelemedicine in the USA with focus on clinical applications and issues.
Telemedicine usually refers to the use of information-based technologies, such as, computer and communications systems, to provide healthcare across geographic distances. Although telemedicine has the potential to improve healthcare, the number of clinical applications is still small and constrained by custom, regulatory, reimbursement and technical issues. ⋯ Current telemedicine issues in clinics and technological problems to be decided, improved, and challenged, are reviewed. This is followed by conclusions.