A patient's age and disease duration are the most important factors predicting PHN progression, irrespective of thermal findings, and PHN cannot be predicted by infrared thermal imaging.
Objectives In Korea, patients diagnosed with complex regional pain syndrome (CRPS) in the army are typically discharged from the army; however, the course of the disease after discharge is not known. The purpose of this study was to investigate the course of CRPS that occurred in the army and to identify the influences of various clinical and psychosocial factors immediately before discharge on the disease course. Methods Clinical profiles and psychosocial status were collected from the medical records of 16 patients with CRPS type 1 who were discharged during the period between March 2017 and April 2018. The degree of improvement after discharge was assessed by follow-up evaluation through telephone contact. Cox proportional hazards regression was performed to identify clinical and psychosocial predictors for the rate of recovery. Results The median time to recovery after discharge was 39 weeks (95% confidence interval [CI] = 8.8–69.2 weeks). The sole predictor for time to recovery after discharge was the time period from the onset of pain to discharge. Each one-week increase in the duration of pain experienced in the military was associated with a 18.2% (95% CI = 5.3%–29.5%) reduction in the rate of recovery after discharge (P = 0.007). Conclusions Patients who experienced a short period of pain in the military demonstrated a relatively good prognosis after discharge. This may show how prolonged pain in the army could affect the experience of pain from a social point of view, in that it shows the disease course after a change in the social environment.
BackgroundNitrous oxide concentration is easily controlled by respiratory ventilation. It suppresses bone marrow via the inhibition of thymidylate synthesis. The aim of this work was to determine the optimal pressure and exposure duration of nitrous oxide, as well as methotrexate concentration that maximizes the suppression of 4 cancer cells: CCRF-CEM, K562, A549 and MDA-MB-231.MethodsEach cancer cell was cultured in a hyperbaric chamber at 1, 2 and 3 atmosphere of 74% nitrous oxide for 24, 48, and 72 hours at 0, 0.3, 0.7, 1, 2, 5 and 10 µM methotrexate (MTX), respectively. The results were expressed in the ratio of the number of cancer cells cultured under specific conditions (S cells) to that under normal conditions (N cells).ResultsThe S/N ratio of CCRF-CEM cells was 87.4% in 24-hour culture, 95.0% in 48-hour culture and 115.9% in 72-hour culture (P < 0.05). The S/N ratio of K562 cells was 103.6% at 1 atm, 102.4% at 2 atm and 115.6% at 3 atm (P < 0.05). The S/N ratio of A549 cells was 94.3% at 1 atm, 94.1% at 2 atm, 99.3% at 3 atm, 96.2% in 24-hour culture, 99.2% in 48-hour culture and 99.3% in 72-hour culture (P > 0.05). However, the S/N ratio of MDA-MB 231 cells was 66.9% in 24-hour culture, 83.1% in 48 hour culture and 87.8% in 72-hour culture (P < 0.05).ConclusionsOnly the growth of the MDA-MB-231 cells was significantly reduced after a longer exposure time to nitrous oxide, but those of the other cells were not.
Background: This clinical study was designed to evaluate the effect of midazolam as a premedication on the onset of propofol and rocuronium during propofol target-controlled infusion (TCI).Methods: Seventy four patients (ASA class I or II) were randomly allocated to receive either no premedication (control group) or premedication with 0.04 mg/kg intravenous midazolam (midazolam group). Anesthesia was induced and maintained with propofol TCI. Time from propofol injection to loss of consciousness (LOC) and estimated effect concentration at LOC were recorded. After LOC, rocuronium (0.6 mg/kg) was injected. We monitored the degree of neuromuscular blockade by acceleromyography. The following parameters were measured and compared between groups: Time from rocuronium injection to depression of twitch height below 25%, time to maximal depression of twitch height (defined as rocuronium onset time).Results: Systolic blood pressure before induction was lower in midazolam group (125 ± 15 vs 135 ± 20 mmHg), however, there was no difference in blood pressure at LOC between groups (111 ± 16 vs 106 ± 21 mmHg). In midazolam group, time to LOC in propofol TCI was shorter (63 ± 22 vs. 203 ± 118 sec) and estimated effect site concentration of propofol was significantly lower than control group (0.9 ± 0.3 vs. 2.2 ± 0.4 μl/ml). The onset time of rocuronium was not different between groups (120 ± 39 vs. 137 ± 42 sec).Conclusions: Midazolam pretreatment fastens the onset time of propofol and decreases the propofol requirement for LOC. However, it does not influence the onset of rocuronium.
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