The International Significance of Tourism Studies

Y.J. Edward Kim(Y.J. Edward Kim),Philip L. Pearce(Philip L. Pearce ) 한국관광학회 1997 관광학연구 Vol.21 No.1

A comparison of strength for two continuous peripheral nerve block catheter dressings

Edward R. Mariano,Lindsay Borg,Steven K. Howard,T. Edward Kim,Lauren Steffel,Cynthia Shum 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.5

Background: Despite the benefits of continuous peripheral nerve blocks, catheter dislodgment remains a major problem, especially in the ambulatory setting. However, catheter dressing techniques to prevent such dislodgment have not been studied rigorously. We designed this simulation study to test the strength of two commercially available catheter dressings. Methods: Using a cadaver model, we randomly assigned 20 trials to one of two dressing techniques applied to the lateral thigh: 1) clear adhesive dressing alone, or 2) clear adhesive dressing with an anchoring device. Using a digital luggage scale attached to a loop secured by the dressing, the same investigator applied steadily increasing force with a downward trajectory towards the floor until the dressing was removed or otherwise disrupted. Results: The weight, measured (median [10th–90th percentile]) at the time of dressing disruption or removal, was 1.5 kg (1.3–1.8 kg) with no anchoring device versus 4.9 kg (3.7–6.5 kg) when the dressing included an anchoring device (P < 0.001). Conclusions: Based on this simulation study, using an anchoring device may help prevent perineural catheter dislodgement and therefore premature disruption of continuous nerve block analgesia.

The Outcome of Endoscopic Radiofrequency Anti-Reflux Therapy (STRETTA) for Gastroesophageal Reflux Disease in Patients with Previous Gastric Surgery: A Prospective Cohort Study

Edward John Nevins,James Edward Dixon,Yirupaiahgari Krishnaiah Setty Viswanath 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4

Background/Aims: STRETTA improves the quality of life and reduces the need for anti-reflux medication in select patients,especially those with uncomplicated gastroesophageal reflux disease (GERD). We aimed to review the outcomes of STRETTA inpatients with medically refractory GERD, who had undergone previous gastric surgery. Methods: This was a review of a prospective database in a British center. Since 2016, all GERD patients who underwent STRETTAand had a history of previous gastric surgery were studied (n=11). Anti-reflux medication pre- and post-STRETTA was evaluated. The outcomes were assessed objectively by the change in anti-reflux medication and subjectively through a pre- and post-procedureGERD-health-related quality of life (HRQL) questionnaire. Results: The median length of follow-up was 23 months. Nine patients demonstrated improved GERD-HRQL scoresfollowing STRETTA (82%). Of the 7 patients who underwent fundoplication, all reported improved symptoms, with 3 patientsdiscontinuing the medication and 3 patients on a reduced dose of proton pump inhibitor. Four patients underwent surgery otherthan fundoplication, of which 2 reported improvement and discontinued the proton pump inhibitor. Two patients reported noimprovement. Conclusions: This study demonstrates that STRETTA is successful in reducing refractory GERD in patients with previous gastricsurgery. The outcomes were comparable to published outcomes in patients with uncomplicated GERD with no previous history ofgastric surgery.

Commercial Policy, Terms of Trade and the Equilibrium Real Exchange Rate

Edwards, Sebastian 세종대학교 국제경제연구소 1988 Journal of Economic Integration Vol.3 No.1

In modern theories of real exchange rate behavior movements in the equilibrium value of the real exchange rate will respond to changes in its determinants, including the terms of trade, underlying sustainable capital flows, and long term desired levels of protection (see Edwards, forthcoming). An important implication of this modern approach is that equilibrium movements in the real exchange rate do not require policy interventions. On the contrary, under these circumstances, policy actions aimed at precluding real movements will interfere with equilibrium changes, rendering the adjustment process more difficult. From a policy perspective a crucial aspect of real exchange rate analysis is to understand how the equilibrium real rate changes when the economy is subject to policy-induced or external disturbances. Once the behavior of the equilibrium real exchange rate is understood, it is possible to determine whether the real exchange rate, in a particular moment in time, is overvalued or undervalued. In this paper the effects of reforms of commercial policies (i.e., trade liberalization reforms) and terms of trade changes on the behavior of the equilibrium real exchange rate are analyzed in detail. The paper deals with some important theoretical aspects, and reviews the empirical literature on the subject. The paper is organized in the following form : In Section I the traditional theoretical aspects of the relationship between long run commercial policies and the equilibrium real exchange rate are reviewed. The discussion focuses first on the long-run case, where it is assumed that all factors of production can move freely across sectors next the short-run effects are analyzed ; here it is assumed that only one factor(labor) can move freely across sectors. The transition period is then briefly discussed. In Section II the effect of exogenous changes in the external terms of trade on the equilibrium real exchange rate are analyzed. It is shown that this case is similar to that of tariff changes. The main difference between them lies in the fact that changes in tariffs and changes in world terms of trade generate income effects of different magnitudes. In this section the Dutch Disease case is also discussed. In Section III the empirical literature on the subject is reviewed, and finally, in Section IV some concluding remarks are offered.

Can bedside patient-reported numbness predict postoperative ambulation ability for total knee arthroplasty patients with nerve block catheters?

Edward R. Mariano,Seshadri C. Mudumbai,Toni Ganaway,T. Edward Kim,Steven K. Howard,Nicholas J. Giori,Cynthia Shum 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.1

Background: Adductor canal catheters offer advantages over femoral nerve catheters for knee replacement patients because they produce less quadriceps muscle weakness; however, applying adductor canal catheters in bedside clinical practice remains challenging. There is currently no patient-reported outcome that accurately predicts patients’ physical function after knee replacement. The present study evaluates the validity of a relatively new patient-reported outcome, i.e., a numbness score obtained using a numeric rating scale, and assesses its predictive value on postoperative ambulation. Methods: We conducted a retrospective cohort study pooling data from two previously-published clinical trials using identical research methodologies. Both studies recruited patients undergoing knee replacement; one studied adductor canal catheters while the other studied femoral nerve catheters. Our primary outcome was patient-reported numbness scores on postoperative day 1. We also examined postoperative day 1 ambulation distance and its association with postoperative numbness using linear regression, adjusting for age, body mass index, and physical status. Results: Data from 94 subjects were included (femoral subjects, n = 46; adductor canal subjects, n = 48). Adductor canal patients reported decreased numbness (median [10th–90th percentiles]) compared to femoral patients (0 [0–5] vs. 4 [0–10], P = 0.001). Adductor canal patients also ambulated seven times further on postoperative day 1 relative to femoral patients. There was a significant association between postoperative day 1 total ambulation distance and numbness (Beta = −2.6; 95% CI: −4.5, −0.8, P = 0.01) with R2 = 0.1. Conclusions: Adductor canal catheters facilitate improved early ambulation and produce less patient-reported numbness after knee replacement, but the correlation between these two variables is weak.

Kinematic Analysis, Evaluation and Development of Wheelchair-Mounted Robotic Arms

Edward J. McCaffrey,Redwan M. Alqasemi,Kevin D. Edwards,Rajiv V. Dubey 동국대학교 정보융합기술원 2006 International Journal of Assistive Robotics and Sy Vol.7 No.2

An ultrasound-guided fascia iliaca catheter technique does not impair ambulatory ability within a clinical pathway for total hip arthroplasty

Edward R. Mariano,Seshadri C. Mudumbai,T. Edward Kim,Steven K. Howard,Nicholas J. Giori,Steven Woolson,Toni Ganaway,Alex Kou,Robert King 대한마취통증의학회 2016 Korean Journal of Anesthesiology Vol.69 No.4

Background: Both neuraxial and peripheral regional analgesic techniques offer postoperative analgesia for total hip arthroplasty (THA) patients. While no single technique is preferred, quadriceps muscle weakness from peripheral nerve blocks may impede rehabilitation. We designed this study to compare postoperative ambulation outcome in THA patients who were treated with a new ultrasound-guided fascia iliaca catheter (FIC) technique or intrathecal morphine (ITM). Methods: We reviewed the electronic health records of a sequential series of primary unilateral THA patients who were part of a standardized clinical pathway; apart from differences in regional analgesic technique, all other aspects of the pathway were the same. Our primary outcome was total ambulation distance (meters) combined for postoperative days 1 and 2. Secondary outcomes included daily opioid consumption (morphine milligram equivalents) and analgesic-related side effects. We examined the association between the primary outcome and analgesic technique by performing crude and adjusted ordinary least-squares linear regression. A P value < 0.05 was considered statistically-significant. Results: The study analyzed the records of 179 patients (fascia iliaca, n = 106; intrathecal, n = 73). The primary outcome (total ambulation distance) did not differ between the groups (P = 0.08). Body mass index (BMI) was the only factor (β = −1.7 [95% CI −0.5 to −2.9], P < 0.01) associated with ambulation distance. Opioid consumption did not differ, while increased pruritus was seen in the intrathecal group (P < 0.01). Conclusions: BMI affects postoperative ambulation outcome after hip arthroplasty, whereas the type of regional analgesic technique used does not. An ultrasound-guided FIC technique offers similar analgesia with fewer side effects when compared with ITM.

The necessity of bioanalytical tools for advancing water and sediment quality assessment

Kolodziej, Edward P.,Choi, Kyungho,Marfil-Vega, Ruth,Brooks, Bryan W. The Royal Society of Chemistry 2017 Environmental science Vol.19 No.9

<P>Guest editors Edward Kolodziej, Kyungho Choi, Ruth Marfil-Vega and Bryan Brooks introduce the “Bioanalytical tools for water and sediment quality assessment” themed issue of <I>Environmental Science: Processes & Impacts</I>.</P>

Implementation of clinical practice changes by experienced anesthesiologists after simulationbased ultrasound-guided regional anesthesia training

T. Edward Kim,Edward R. Mariano,Toni Ganaway,T. Kyle Harrison,Steven K. Howard,Cynthia Shum,Alex Kuo 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.3

Background: Anesthesiologists who have finished formal training and want to learn ultrasound-guided regional anesthesia (UGRA) commonly attend 1 day workshops. However, it is unclear whether participation actually changes clinical practice. We assessed change implementation after completion of a 1 day simulation-based UGRA workshop. Methods: Practicing anesthesiologists who participated in a 1 day UGRA course from January 2012 through May 2014 were surveyed. The course consisted of clinical observation of UGRA procedures, didactic lectures, ultrasound scanning, hands-on perineural catheter placement, and mannequin simulation. The primary outcome was the average number of UGRA blocks per month reported at follow-up versus baseline. Secondary outcomes included preference for ultrasound as the nerve localization technique, ratings of UGRA teaching methods, and obstacles to performing UGRA. Results: Survey data from 46 course participants (60% response rate) were included for analysis. Participants were (median [10th–90th percentile]) 50 (37–63) years old, had been in practice for 17 (5–30) years, and were surveyed 27 (10–34) months after their UGRA training. Participants reported performing 24 (4–90) blocks per month at follow-up compared to 10 (2–24) blocks at baseline (P < 0.001). Compared to baseline, more participants at follow-up preferred ultrasound for nerve localization. The major obstacle to implementing UGRA in clinical practice was time pressure. Conclusions: Participation in a 1 day simulation-based UGRA course may increase UGRA procedural volume by practicing anesthesiologists.

Adsorption and Leaching of cis and trans-Permethrin in the Soil

Feagley, Sam Edward,Kim, Jung Ho 한국환경과학회 1995 한국환경과학회지 Vol.4 No.4

Permethrin[3-phenoxybenzyl (1RS)-cis,trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane carboxylatel insecticides were selected to study adsorption and leaching potentials related to pollution on Commerce silty clay loam soil near Baton Rouge, Louisiana, USA. GLC-ECD chromatogram of permethrin included 32.5 % of cis-permethrin and 67.4 % of trans-permethrin. Extraction efficiencies of cis and trans-permethrin were 92.5 % and 92.3 in fortified water, respectively and 85.9 % and 88.8 % in fortified soil, respectively. At a 1:10 soil/water ratio,the Koc values for cis and trans isomers of permethrin were 938 and 877, respectively. Leaching of permethrin was evaluated in soil columns(5.4 cm i.d. × 26 cm length). Total recoveries of the permethrin applied to the soil column were 84.5 ± 3.1 %. When the soil columns were leached with three pore volumes of water, the distributions of cis-permethrin leached were 6.10 % and 0.07 % of amount applied in the untreated zone soil and leachate water, respectively. Trans-permethrin distributions were 5.20 % in the untreated zone soil and 0.05 % in leachate water. Cis and trans-permethrin was strongly adsorbed to soil. The results of the study showed the strong relationship between adsorption and leaching. Cis and trans-permethrin to be leached into the groundwater in soils with shallow aquifers were suggested a low leaching potential.