• Title/Summary/Keyword: 전의대상

Search Result 321, Processing Time 0.036 seconds

Does a Preoperative Temporary Discontinuation of Antiplatelet Medication before Surgery Increase the Allogenic Transfusion Rate and Blood Loss after Total Knee Arthroplasty? (항 혈소판 제제의 술 전, 일시적 중단은 슬관절 전치환술 이후의 실혈량 및 동종수혈의 필요성을 증가시키지 않는가?)

  • Cho, Myung-Rae;Lee, Young Sik;Kwon, Jae Bum;Lee, Jae Hyuk;Choi, Won-Kee
    • Journal of the Korean Orthopaedic Association
    • /
    • v.54 no.2
    • /
    • pp.127-132
    • /
    • 2019
  • Purpose: The aim of this study was to determine if preoperative temporary discontinuation of antiplatelet medication (aspirin, clopidogrel, or cilostazol) is a safe procedure that does not increase early postoperative bleeding and allogenic blood transfusion after a total knee arthroplasty. Materials and Methods: A retrospective analysis was conducted among consecutive patients who underwent navigation assisted primary total knee arthroplasty performed by a single surgeon, from January 2013 to December 2016. A total of 369 patients enrolled in this study were divided into two groups, 271 patients with no history of antiplatelet therapy and 98 patients who underwent 7 days of temporary withdrawal of antiplatelet therapy. Comparative analysis between the two groups, on the variation of hemoglobin and hematocrit during the first and second postoperative days, was conducted to determine the amount of early postoperative bleeding and the frequency of allogenic blood transfusion during hospitalization. Results: The variation of hemoglobin, hematocrit during the first and second postoperative days and the frequency of allogenic blood transfusion between no history of antiplatelet medication and discontinuation antiplatelet medication before 7 days from surgery were similar in both groups. Of the 369 patients, 149 patients received a blood transfusion during their hospitalization. Compared to patients who did not receive a blood transfusion, those who did received blood transfusion were significantly older in age, smaller in height, lighter in weight, and showed significantly lower preoperative hemoglobin and hematocrit values. No statistically significant differences in sex, preoperative American Society of Anesthesiologists scores, and the history of antiplatelet medication until 7 days prior to surgery were observed between the two groups according to blood transfusion. Conclusion: Compared to patients with no history of antiplatelet medication, the temporary discontinuation of antiplatelet medication 7 days prior to surgery in patients undergoing antiplatelet medication did not increase the amount of postoperative bleeding or the need for allogenic blood transfusion.

Development of Practical Problem-Based Home Economics Teaching.Learning Process Plans by Blended Learning Strategy - Focusing on a Unit 'the Youth and Consumer Life' - (Blended Learning(BL) 전략을 활용한 실천적 문제 중심 가정과 교수 학습 과정안 개발 - '청소년과 소비생활' 단원을 중심으로 -)

  • Lee, Jin-Hee;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
    • /
    • v.20 no.4
    • /
    • pp.19-42
    • /
    • 2008
  • The purpose of this study was to develop practical problem-based home economics teaching.learning process plans about a unit 'the youth and consumer life' of middle school eighth-grade Technology and Home Economics by applying blended learning(BL) strategy. According to ADDIE instructional design model, this study was conducted in the following procedure: analysis, design/development, implementation, and evaluation. In the stage of design and development, the selected unit was converted into a practical problem-based unit, and practical problem-based teaching. learning process plans were designed in detail by using BL strategy. An online study room for practical problem-based home economics instruction grounded in BL strategy was prepared by using Edunet(http://community.edunet4u.net/${\sim}$consumer2). Eight-session lesson plans were mapped out, and study aids for students and materials for teachers were prepared. In the implementation stage, the first-session teaching plans that dealt with a minor question 'what preparations should be made to become a wise consumer' were utilized when instruction was provided to 115 eighth graders who were in three different province, and the other one was in a middle school in the city of Daejeon. The experimental teaching was implemented for two weeks in the following procedure: preliminary program, pre-online learning, main instruction and post- online learning. The preliminary program was carried out in a session in the classroom, and pre-online learning was provided before the main instruction was given in a session in the classroom. After the main instruction was completed, post-online learning was offered. In the evaluation stage, a survey was conducted on all the learners and teachers to find out their opinions and suggestions.

  • PDF

Usefulness of tibia counter rotator (TCR) for treatment of tibial internal torsion in children (경골 내염전 환아에서 경비골 역회전 교정장치(TCR)의 치료 효과)

  • Song, Dong Ho;Lee, Yoon;Eun, Baik-Lin;Lee, Kwang Jae;Kang, Sang Kuk;Vaq, Sung Gin;You, Sung;Shin, Jung Bin;Kim, Bong Ok
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.1
    • /
    • pp.79-84
    • /
    • 2007
  • Purpose : Tibial internal torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Tibial internal torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The aim of this study is to evaluate the therapeutic effect of Tibial Counter Rotator (TCR) in patients with tibial internal torsion. Method : One hundred forty nine children (274 limbs) with tibial internal torsion participated in this study. Transmalleolar angle were measured with gravity goniometer. When tibial internal torsion was detected, TCR was applied at least for 3 hours a day during sleep. The patient's progress was followed monthly and transmalleolar angle was reevaluated by the same examiner. Results : Transmalleolar angle was significantly increased in patients with tibial internal torsion during TCR application (P<0.001). Conclusion : TCR can be one of the effective methods for correcting tibial internal torsion in children under 12 years old of age.

EVALUATION OF CONDYLAR DISPLACEMENT USING COMPUTER TOMOGRAPHY AFTER THE SURGICAL CORRECTION OF MANDIBULAR PROGNATHISM (전산화단층촬영법을 이용한 하악전돌증 환자의 외과적 악교정술후 하악과두 위치 변화 검토)

  • Lee, Ho-Kyung;Jang, Hyun-Jung;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.20 no.3
    • /
    • pp.191-200
    • /
    • 1998
  • This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after orthognathic surgery in 37 patients(male 13, female 24) using computed tomogram that were taken in centric occlusion before, immediate after, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period of intermaxillary fixation, at the 24 hours later removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.42{\pm}5.30mm$ and horizontal long axis of condylar angle was $12.79{\pm}4.92^{\circ}$ on the right, $13.53{\pm}5.56^{\circ}$ on the left side. Condylar lateral poles were located about 12mm and medial poles about 7mm away from the reference line(AA') on the axial tomogram. Mean intercondylar distance was $83.15{\pm}4.62mm$ and vertical axis angle of condylar angle was $76.28{\pm}428^{\circ}$ on the right, $78.30{\pm}3.79^{\circ}$ on the left. 2. In amount of set back, We found the condylar change(T2C-T1C) which had increasing tendency in group III (amount of setback : 10-15mm). but there was no statistical significance(p>0.05). 3. There was some correlation between condylar change(T2C-T1C) and TMJ dysfunction. It seemed that postoperative condylar change had influenced postoperative TMJ dysfunction, through there was no statistical significance (p>0.05). As we have observed the change of condylar axis in the group that complained of TMJ dysfunction in cases of large amount of mandibular setback. So we consider that the more trying to conserve condylar position will decrease occurrence rate of post operational TMJ dysfunction.

  • PDF

Passive restoration under progress in wetland of National Institute of Ecology (국립생태원 습지에서 진행 중인 자발적 복원)

  • An, Ji Hong;Lim, Chi Hong;Nam, Gyung Bae;Jung, Song Hie;Lee, Chang Seok
    • Journal of Wetlands Research
    • /
    • v.18 no.4
    • /
    • pp.465-473
    • /
    • 2016
  • This study was carried out to evaluate restoration process of a few wetlands in the National Institute of Ecology (NIE). Wetlands were composed of the former rice paddies that passive restoration was led through only natural process and by creating waterway, and an ecological pond, a reservoir that restorative treatment was practiced. As the result of analysis on landscape change in the current wetland space, existing wetland in NIE was usually from the former rice field and some parts were from the residential area or forest. Change of species composition was progressed from crops or ruderals resistant to human interferences to plant species, which has removed artificially for cultivation and grow usually in the typical wetland. Both species diversity and occurrence of exotic plants were the highest when restoration project is in progress and stages after and before restoration were followed. In an ecological pond that restorative treatment was done, vegetation introduced as riparian buffer was established successfully and thereby it was expected that it could contribute to buffer environmental stress comming from the outside. Synthesized the above mentioned results, change of wetland vegetation established in NIE resembled the typical trend of early successional stage occurring in the abandoned rice paddy and consequently, it was estimated that successful restoration is under progress. Restoration under progress in an ecological pond where artificial aid in the least level was added, could be evaluated in successful as well. In particular, successful establishment of buffering vegetation, which can play diverse ecological functions, could be evaluated as significant restoration effect. But adaptive management to improve ecological quality for the section that buffering vegetation is insufficient, is required.

Strength Evaluation of Sin91e-Radius Total Knee Replacement (TKR) (인공무릎관절의 단축법위 회전시 근력정가)

  • Wan, Jin-Young;Sub, Kwak-Yi
    • Journal of Life Science
    • /
    • v.14 no.3
    • /
    • pp.484-489
    • /
    • 2004
  • Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.

Petrochmical study on the Volcanic Rocks Related to Depth to the Benioff Zone and Crustal Thickness in the Kyongsang Basin, Korea: A Review (경상분지 화산암류의 지화학적 연구. 섭입대(베니오프대)의 깊이와 지각의 두께)

  • Jong Gyu Sung
    • Economic and Environmental Geology
    • /
    • v.32 no.4
    • /
    • pp.323-337
    • /
    • 1999
  • Late Cretaceous to early Tertiary volcanic rocks in the Kyongsang basin exhibit high-K calc-alkaline characteristics, and originated from the magmatism related genetically to subduction of Kula-Pacific plate. They represent HFSE depletion and LlLE enrichment characteristics as shown by magmas related to subduction. Early studies on the depth of magma generation has been estimated as 180-230 km based on K-h relation should be reevaluated, because the depth of peridotite partial melting with 0.4 wt. % water is 80-120 km at subduction zone, and subducting slab in premature arc can melted even lower than 70 km. Moreover the increase of potassium contents depends on either contamination of crustal material and fluids of subducting slab or low degree of partial melting. If the inclination of subduction zone is 30 degrees and the depth to the Benioff zone is 180-230 km, the calculated distance between the volcanic zone and trench axis would be 310-400 km. It is unlikely because the distance between the Kyongsang basin and trench during late Cretaceous to early Tertiary is closer than this value and not comparable with generally-accepted models in subduction zone magmatism. $K_{55}$ of the volcanics in the Kyongsang basin is 0.3-2.3 wt.% and the average indicate that the depth ranges between 80-170 km on the diagram of Marsh, Carmichael (1974). Fractionation from garnet lherzolite, assumed the depth of 180-230km, is not consistent with the REE patterns of the volcanoes in the Kyongsang basin. Futhermore, the range of depth suggested by many workers, who studied magmatism related to subduction, imply shallower than this depth. Crustal thickness calculated by the content of CaO and $Na_2O$ is about 30 km and about 35 km, respectively. Paleo-crustal thickness during late Cretaceous to early Tertiary times in the Kyongsang basin inferred about 30 km calculated by La/Sm versus LaJYb data, which is also supported by many previous studies.

  • PDF

Proving Causation With Epidemiological Evidence in Tobacco Lawsuits (담배소송에서 역학적 증거에 의한 인과관계의 증명에 관한 소고)

  • Lee, Sun Goo
    • Journal of Preventive Medicine and Public Health
    • /
    • v.49 no.2
    • /
    • pp.80-96
    • /
    • 2016
  • Recently, a series of lawsuits were filed in Korea claiming tort liability against tobacco companies. The Supreme Court has already issued decisions in some cases, while others are still pending. The primary issue in these cases is whether the epidemiological evidence submitted by the plaintiffs clearly proves the causal relationship between smoking and disease as required by civil law. Proving causation is difficult in tobacco lawsuits because factors other than smoking are involved in the development of a disease, and also because of the lapse of time between smoking and the manifestation of the disease. The Supreme Court (Supreme Court Decision, 2011Da22092, April 10, 2014) has imposed some limitations on using epidemiological evidence to prove causation in tobacco lawsuits filed by smokers and their family members, but these limitations should be reconsidered. First, the Court stated that a disease can be categorized as specific or non-specific, and for each disease type, causation can be proven by different types of evidence. However, the concept of specific diseases is not compatible with multifactor theory, which is generally accepted in the field of public health. Second, when the epidemiological association between the disease and the risk factor is proven to be significant, imposing additional burdens of proof on the plaintiff may considerably limit the plaintiff's right to recovery, but the Court required the plaintiffs to provide additional information such as health condition and lifestyle. Third, the Supreme Court is not giving greater weight to the evidential value of epidemiological study results because the Court focuses on the fact that these studies were group-level, not individual-level. However, group-level studies could still offer valuable information about individual members of the group, e.g., probability of causation.

Examination about Utility of Prone Position in PET/CT of Stomach Cancer Patient (위암 환자의 양전자 방출 컴퓨터 단층 검사에서 복와위(伏臥位) 촬영의 유용성에 대한 연구)

  • NamKoong, Hyuk;Park, Hoon-Hee;Oh, Shin-Hyun;Bahn, Yung-Kag;Kim, Jung-Yul;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
    • /
    • v.14 no.2
    • /
    • pp.93-99
    • /
    • 2010
  • Purpose: Currently, PET/CT scan has been known to provide useful information to both preoperative and postoperative examination of cancer patients. Contracted stomach by the long fasting could cause difficulties of interpretation because of its size on reconstructed image data. To solve this problem, after the whole body PET/CT scan, patients were administrated in drinking 300 mL of water to expand stomach and performed additional scan on stomach region. Not only PET/CT scan but also CT performs this water-administration, and patients were take oral solution to make stomach expand for stomach cancer. When this scan performed, patients lay supine position. In this study, we evaluated the capacity of stomach through PET/CT scan with drinking water performed in supine and prone position so that we can distinguish exact location of cancer around pylorus and inferior wall of stomach. Furthermore, image data from supine and prone positions were analyzed the difference of volume of stomach through the change of standardized uptake values. Materials and Methods: From July 2009 to January 2010 in severance hospital, 30 patients who were diagnosed as early gastric cancer or advanced gastric cancer were chosen. All patients had PET/CT scan before the operation and have had follow-up PET/CT. The patients fast for at least 8 hours, and had an injection intravenously with $^{18}F$-FDG, 7.4 MBq (0.2 mCi/kg) per kilogram. They were rested for 60 minutes. Before the examination, all patients were administrated to drink water for 300 mL Patients had PET/CT scan with supine position around the region of stomach, whole body, and around the region of stomach with prone position after drinking another 300 mL of water respectively. Results: As a results of comparison between stomach capacity of 30 patients in supine and prone position, the study draw results that average capacity of stomach body was 460.29 $mm^2$ in supine position, and 641.39 $mm^2$ in prone position for 30 patients. The change of capacity shows 41.3% expanded in prone position. And there was no noticeable difference at maximum standardized uptake values in supine position and prone position. Conclusion: As results, stomach would have more expanded capacity in prone position than supine position. For patients who have physical disabilities to move freely, additional scan in prone position will be obstacle to perform. However, if additional scan in supine position add with the scan in prone position, it will be easier to diagnose stomach cancer. Moreover, we believe that this study will help the research for inventing support tools for patients who have physical disabilities in prone position.

  • PDF

Interventional radiology of Bronchial artery embolization due to massive hemoptysis (대량객혈로 인한 기관지 동맥 색전의 중재적 방사선시술)

  • Min, Byoung-Yun;Lee, Sang-Bock
    • Journal of the Korean Society of Radiology
    • /
    • v.4 no.4
    • /
    • pp.17-24
    • /
    • 2010
  • Hemoptysis which is comparatively common symptom in respiratory disease patients is a clinical symptom which has high risk of death in spite of many curative means. Bronchial tube embolization is a very useful medical procedure when hemoptysis does not stop for treatment of internal medicine or surgery and in addition to the purpose of instant hemostasis, for patients for whom surgical operation is impossible or for the purpose of gaining time to improve the state of the patient before surgical operation. In relation to this, this study is to know of the usefulness of bronchial tube artery embolization. The objects were 60 persons for whom bronchial tube artery embolizations are conducted because of large hemoptysis occurred from March 2007 to December 2009 in J hospital. They had large hemoptysis of 400ml or more per day and 200ml or more at a time or though the quantity of hemoptysis was less than 400ml they did not respond to the treatment of internal medicine for 10 days or longer. The average age was 60.5 years and cause diseases were tuberculosis, bronchiectasis, and pneumonia and lung cancer. Embolus parts were Rt bronchial artery 19 examples, Lt bronchial artery, both bronchial artery, Rt Intercostobronchial artery, and they were the case where embolization for many blood vessels were simultaneously carried out. As embolus materials, PVA (conteour) and microcoil were used. In 76.6% of 60 persons of patients hemorrhage stopped with the lapse of time after the procedure and in 4 examples (6.6) re-embolization was carried out due to re-bleeding after the procedure. Bronchial tube artery embolization has high early success rate and effectively controls hemoptysis in the treatment of hemoptysis and is an effective emergency remedy for hemorrhage due to large hemoptysis and will be a good medical procedure which reduces death rate. In addition, primarily if it is conducted together with the treatment of internal medicine it will be, as an effective curative means for hemorrhage due to large hemoptysis, a good mediate radial rays medical procedure which reduces death rate.