• Title/Summary/Keyword: 신경 해부학

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Ultrasound-Guided Axillary Brachial Plexus Block, Performed by Orthopedic Surgeons (정형외과 의사가 시행한 초음파 유도 액와 상완 신경총 차단술)

  • Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.513-521
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    • 2018
  • Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.

Analysis of Anatomical Relationship between Stensen's Duct and Buccal Branch of Facial Nerve (이하선관과 안면신경의 협근지 사이의 해부학적 관계 분석)

  • Son, Eun Taik;Choi, Hwan Jun;Nam, Doo Hyun;Kim, Jun Hyuk;Lee, Young Man
    • Archives of Craniofacial Surgery
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    • v.14 no.2
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    • pp.102-106
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    • 2013
  • Background: When using the anterior approach for performing superficial parotidectomy, the first thing to do is to find the buccal branch of the facial nerve and the parotid duct. The buccal branch usually runs transversely with the parotid duct from the anterior border of the parotid gland. We wanted to check the relationship between the two structures during the operation and to get clinically helpful information. Methods: Twelve patients with parotid mass were treated with superficial parotidectomy between May 2012 and August 2012. The outline of superficial and deep lobes of the parotid gland, parotid duct, and the buccal branch of the facial nerve were drawn on the transparent film by tracing the structures intraoperatively. Results: In 7 (58.3%) of 12 cases, the buccal branch of the facial nerve was located more caudally than the parotid duct at the anterior border of the superficial lobe of the parotid gland. In 3 cases (25%), the buccal branch was located more cephalically than the parotid duct. The mean distance between two structures were $2.54{\pm}1.48$ mm. In 11 cases, the parotid duct was located deeper than the buccal branch. Conclusion: The buccal branch of the facial nerve tends to be located more caudally than parotid duct and runs more superficially than parotid duct in all cases. We identified the relationship between the parotid duct and the buccal branch of the facial nerve during the operations on living subjects, not from the cadavers, so it would be a clinically helpful study which supplied more accurate anatomical information.

Anatomical Study of Interdigital Neuroma Occurring Site and the Deep Transverse Metatarsal Ligament (DTML) (지간 신경종 발생 위치와 심부 횡 중족 골간 인대의 해부학적 연구)

  • Kim, J-Young;Choi, Jae-Hyuck;Lee, Kyung-Tai;Young, Ki-Won;Park, Jung-Min
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.182-186
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    • 2007
  • Purpose: We examined the relationship of interdigital neuroma occurring site and the surrounding structures, including the deep transverse metatarsal ligament (DTML) by cadaver study and clinical results. Materials and Methods: Seventeen fresh frozen cadavers study were done to evaluate the relationship of interdigital neuroma occuring site and the DTML at two phase of the gait cycle with 60 degree of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from interdigital nerve bifurcation of the common digital nerve to anterior margin of the DTML and longitudinal length of DTML itself. Clinically, we checked the location of interdigital neuroma and DTML length during surgery in 32 feet. Results: In the second and third web space, the mean distance from bifurcation of the common digital nerve of foot to the anterior margin of DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm. 14.6 mm in heel-off position. Second, Third web space ligament itself length were average 12.8 mm, 10.6 mm. Clinically, all of the cases of interdigital neuroma started at the bifurcation area of the common digital nerve and interdigital neuroma was average 7.5 mm (range; 6-11 mm). Conclusion: Interdigital neuroma were located more distally than DTML in both the mid-stance and heel off stage. The main lesion was located between metatarsal head and metatarsophalangeal joint and more distal than the DTML anterior margin.

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Effect of Learning Style of Students on Web based Blended Learning (학습자의 학습양식이 웹 기반 혼합교육의 효과에 미치는 영향)

  • Song, Ju-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.1
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    • pp.469-478
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    • 2011
  • The purpose of this study was to investigate the effects of learning style on blended learning. Subjects were 102 college students(grade 1, department of physical therapy) who enrolled in 'neuroanatomy' course. Blended learning was composed of 13 weeks-3 hour/1week in offline and 16 chapters-24 lessons in online. According to Kolb's learning style, assimilator was the most common. There were no significant differences between the learning style but, they were most preferred blended learning(92.1% of subjects), improved participation and excitation in learning(each 55.5%, 58.8% of subjects), and blended learning was helpful in learning(85.1% of subjects). In student's satisfaction, there was significant difference between the learning style. Statistical difference was found in satisfaction between assimilator(80.7%) and accommodator(67.5%).

Non-Robotic, Endoscopic Hemi-Thyroidectomy via Retro-auricular Single-incision Approach : A Preclinical Feasibility Study in Cadavers (후이개 절개를 이용한 내시경 갑상선 절개술-전임상 사체연구)

  • Lee, So-Yoon;Sun, Dong Il;Ahn, Su Hyun;Lee, Il Hwan;Park, Young Hak
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.10-14
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    • 2014
  • 목 적 CO2 가스 삽입 없이 내시경 보조 갑상선 절제술, 특히 액와 절개를 이용하는 경우의 대부분은 기구 사용을 용이하게 하기 위하여 흉부 또는 유륜에 절개를 넣어 시행하는 것이 대부분이다. 본 연구는 후이개 절개를 통하여 추가적 절개 없이 내시경을 이용한 갑상선 절제술 및 중심 임파선 절제술이 가능한지의 여부를 사체연구를 통하여 확인해 보고자 한다. 방 법 사체 이용 해부 및 수술 후이개 내시경 보조 갑상선 절제술이 가능한지의 확인은 수술 시야 및 접근성, 수술 완성도, 그리고 주요 구조물의 보존 여부인 3가지 항목으로 평가하였다. 결 과 수술 시야는 기구를 다루고 수술을 하기에 충분하였으며, 추가 절개 없이 수술을 완성할 수 있었다. 절제된 갑상선 조직의 피막은 손상되지 않았으며, 잔존 갑상선 조직이 없음을 수술 부위를 통하여 확인하여, 수술의 완성도 여부를 평가할 수 있었다. 모든 사체에서 되돌이 후두신경 및 상 또는 하부갑상선의 보존을 확인하였으며, 주변 구조물들의 손상이 없음을 확인하였다. 결 론 로봇이 아닌 후이개 절개를 이용한 내시경 보조 갑상선 절제술은 시행 가능한 접근법 및 수술방법이라 사료된다.

Anatomical Changes and Anthocyanin Contents of the Exocarp by Ethyl Oleate Treatment on 'Merlot' Grapes (Ethyl oleate 처리에 의한 'Merlot' 포도 과피의 안토시아닌 함량과 해부학적 변화)

  • Lee, Byul-Ha-Na;Kwon, Yong-Hee;Shin, Kyoung-Hee;Park, Hee-Seung
    • Horticultural Science & Technology
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    • v.28 no.3
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    • pp.370-373
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    • 2010
  • Preharvest treatment with 4% ethyl oleate on 'Merlot' ($Vitis$ $vinifera$ L.) grape reduced the thickness of the epidermal and hypodermal layers with significantly enhanced pigmentation. Thickness of the skin in treated berries was $90-107{\mu}m$, whereas those in control berries were $126-189{\mu}m$. Decreases in the thickness of epidermal and hypodermal cell layers seemed to be due to cellular death or dehydration by rapid senescence after the treatment. Immediate change observed in treated berries was the deformation of the wax that appeared melted resulting in color improvement. Total anthocyanin was also increased by ethyl oleate treatment. Separate forms of anthocyanins, acylated and methoxylated anthocyanins increased, whereas hydroxylated anthocyanins tended to decrease.

The Role of Perfusionists during the COVID-19 Pandemic and Clinical Laboratory Technologists: Comparison of Training Systems in Japan and the United States (코로나19를 통해서 바라본 체외순환사의 역할과 임상병리사: 일본과 미국의 양성체계를 비교)

  • Dong-Ok, Aum;Dae Jin, Kim;Dae Eun, Kim;Myong Soo, Kim;Bon-Kyeong, Koo
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.293-297
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    • 2022
  • In 2022, Korea reported a total of 224 perfusionists, employing nurses or clinical laboratory technologists (also known as medical technologists) to provide hospital self-education or reliable education. In 2021, the total number of perfusionists in Japan was 2,100, mainly supported by clinical engineering technologists. During the same period, the number of perfusionists reported in the United States was 4,212, who had received training in the master's program, post-bachelor certificate program, and bachelor's program. Most personnel in the USA were graduates of healthcare sciences or life sciences. Perfusionists must be knowledgeable in heart anatomy, physiology, pharmacology, pathology, hemodynamics, laboratory analysis, and quality assurance, as well as techniques to operate the cardiopulmonary bypass machine (heart-lung bypass machine). These are jobs similarly handled by clinical laboratory technologists. The importance of perfusionists became more prominent during two major crises: the MERS-CoV and COVID-19 pandemic. Currently, perfusionists play a significant role in the rapidly expanding field of extracorporeal membrane oxygenation (ECMO) and extracorporeal circulation during cardiac surgery. Results of the current study indicate that hospitals offering cardiac surgery and infectious disease hospitalization need to be institutionalized to secure a certain number of qualified perfusionists. In the future, we look forward to establishing a perfusion technology association under the Korean Society for Clinical Laboratory Physiology to provide academic exchanges.

Establishment Status of the Mandatory Courses for the Qualification of Sensory Developmental Rehabilitation Specialist - Within Curriculums of Baccalaureate Occupational Therapy Programs (감각발달재활사 자격기준 관련 필수과목 개설현황 조사연구 - 4년제 작업치료학과를 중심으로)

  • Kim, Ji-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.3
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    • pp.23-34
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    • 2017
  • Objective : The purpose of this study was to investigate establishment status of the mandatory courses designated by Ministry of Health & Welfare for qualification of sensory developmental rehabilitation specialist(SDRS), within curriculum of baccalaureate occupational therapy(BOT) programs in Korea Methods : This is a narrative study to investigate and analyze certain courses established in curriculums of all 4-years occupational therapy(OT) programs, which is 32 schools. Results : 1) The shared mandatory subject, 'Understanding Children with Disabilities(UDC)', has been established at 9 schools. For the branch mandatory subjects, 'Neuroscience(NS) or Neuroanatomy' has been established at all 32 schools, 'Sensory Processing Dysfunctions and Intervention(SPDI)' or 'Sensory Integration' has been established at 31 schools, and each of 'Assessment & Evaluation for Children(AEC)' and 'Practicum of Sensory Rehabilitation(PSR)' has been established 7 schools for same. 2) For the mandatory courses, all 32 schools were offering designated- and alternative courses of NS, SPDI, AEC, but there was no change in the number of schools offering the practicum course since there was no case of alterative for it. 3) In terms of general provision score, there were 4 schools for score 7, 4 schools for score 6, 2 schools for score 5, 1 schools for score 4, 2 schools for score 3, and 19 schools for score 2. Conclusion : Establishment of the mandatory courses required to the qualification of SDRS among the BOT programs in nation were investigated. Including alternative courses, all the branch mandatory courses except practicum course are established in all the 32 schools. However, the shared mandatory subject, UDC and the practicum subject were established in only few schools. In the provision level evaluation of BOT programs for the SDRS qualification, it is shown that many schools has been started the provision already but still many schools' curriculum did not reflect the willingness and accuracy well. For the schools planning successful accreditation in near future, it is recommended that they prioritize the establishment of the shared mandatory course and the practicum course since these two subjects are recognized as critical factors for that. In addition, it is also needed of comparative inspections for course title and syllabi based on the guideline provided by Ministry of Health & Welfare.

Surgical Treatment for Metastatic Spinal Tumor (전이성 척추 종양의 수술적 치료)

  • Han, Chung-Soo;Kim, Ki-Tack;Soh, Jae-Ho;Lee, Jung-Hee;Shin, Dong-Jun
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.1-9
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    • 2000
  • Purpose : Spine is one of the most common sites of the metastatic bone tumors. Conservative management such as chemotherapy or radiotherapy has been preferred in most cases. However, the neurologic deficit has not been usually improved, and the quality of life was poor. The purpose of this study was to show the efficacy of the surgical treatments for metastatic spinal tumors in terms of postoperative improvements of neurologic deficit and survival time. Materials and Methods : Authors have reviewed the literatures and analyzed 14 patients of metastatic spinal tumors who were received operative treatments between August 1991 and June 1999 at the our department of orthopaedic surgery. Results : The most frequent primary tumor was breast cancer in women and lung cancer in men. The thoracic region was the most common site. There was a preponderance of females over males, and the age ranged between 4th and 8th decade. The indications of surgical treatment comprised instability, progressive neurologic findings, resistance to radiotherapy, pathological fracture, long life expectancy( >6weeks), isolated metastasis and need for pathological diagnosis. The degree of preoperative neurological deficit might influence on the improvement of clinical symptoms after surgery. Conclusion : The surgical treatment reduced the neurological deficit and pain regardless of the operative methods. In the early stage of neurological deficit, the surgical treatment was important for better prognosis. Recently early active operative treatment was performed for metastatic spinal tumor to minimize the intractable pain and to prevent the progression of the neurologic deficit. Early intervention can improve the quality of life and long term survival.

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Surgical Treatment of Ganglions in Foot and Ankle (족부 및 족관절부 결절종의 수술적 치료)

  • Choi, Ik-Su;Roh, Su-In;Kwak, Cheol-Ho;Kim, Sang-Eun;Lee, Chan-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.1
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    • pp.97-100
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    • 2004
  • Purpose: To evaluate the results of surgical treatment and relationship between the recurrence and characteristics of ganglions in foot and ankle. Materials and Methods: Seventeen cases of ganglions located in foot and ankle, excised at St. Benedict Hospital from Mar. 1993 to Apr. 2003, were included in the study. All of cases were analyzed retrospectively in terms of age, sex of the patients, location and size of the ganglion, symptom, operative method as well as recurrence rate were evaluated. The mean follow up was 1.8 years (11 months${\sim}$6.5 years). Results: The size of ganglion ranged from 0.5 cm to 5.0 cm with mean size of 2.5 cm. The most common area of ganglion was the dorsum of foot and pain was the primary chief complain. The recurrence was found in 4 cases (23.5%): 1 of them occurred among 8 cases the diameter of which was less than 2.5 cm and other 3 occurred among 9 cases larger than 2.5 cm. 12 cases were completely excised mass with no recurrence. But 5 cases were incompletely excised & ligated stalk of mass and 4 cases of them were recurred. A correlation was only observed between complete excision and low recurrence rate. Conclusion: Recurrence rate of ganglions in foot and ankle was high and the correlation was obtained between complete excision and low recurrence rate.

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