• Title/Summary/Keyword: Interspace

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The Spread of Contrast Media in Celiac Plexus Block (복강신경총 차단시의 조영제 확산)

  • Lee, Jung-Koo;Chung, Jung-Kil;Lee, Sung-Moon
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.211-216
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    • 1994
  • Celiac plexus block is performed to relieve intractable upper abdominal cancer pain. Generally, celiac plexus blocks have been performed under control of X-ray fluoroscopy to determine the position of the needle tip and the spread of contrast media. During the period from March 1992 to February 1994, we have performed 21 cases of neurolytic celiac plexus block to alleviate pain of intra-abdominal malignancy. We retrospectively evaluated the location of the needle tip and the spread of contrast media. P-A views of simple abdomen demonstrated the locations of the needle tip: 66.7% of the left needle tips were in upper 3/1 of L1 (6 cases) and $T_{12}-L_1$ interspace (8 cases), 50% of the right needle tips were in upper 1/3 of $L_1$, (6 cases) and $T_{12}-L_1$ interspace (4 cases). Contrast media from the right needle spread upward to middle 1/3 of $T_{10}$ (5 cases) and middle 1/3 of $T_{11}$ (5 cases), downward to middle 1/3 of $L_1$ (6 cases) and lower 1/3 of $L_1$ (3 cases). Contrast media from the left needle were spread upward to middle 1/3 of $T_{10}$ (5 cases) and evenly to other spaces, downward to middle 1/3 of $L_1$, (4 cases) and $L_1-L_2$ interspace (6 cases). We analyze the spread of contrast media according to distance from needle tip by authors score system. Contrast media of right needle spread upward 6.1 and downward 3.4, that of left needle spread upward 6.5 and downward 3.7.

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Sportive Kiosk Interface Design using Tangible Interaction (촉각적 인터랙션을 활용한 유희적 키오스크 인터페이스 디자인)

  • Lim, Byung-Woo;Jo, Dong-Hee;Cho, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.8 no.5
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    • pp.155-164
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    • 2008
  • Kiosk is an unmanned information system arranged in public places or commercial spaces so that a user may utilize information conveniently. Unlike a personal computer, it targets varied users' brackets, so we have to consider a user's characteristic in designing Kiosk Interface. However, in reality, the Kiosks of public places like subway stations are of Interface Design without considering users and become almost useless with serviceability falling. In this study, we attempt to point out such problems and suggest the concept as to the Interface Design in the public places for a more positive promotion method. For this purpose, we are about to look into the concept of Tangible Interaction and Interspace and the recreation experienced in the process of interaction between a human and a computer and study the sportive Kiosk Interface Design in the Interspace using the principle of the Tangible Interaction. For the conceptual Model in this study, we referred to ARTCOM(ART+COM) Project.

Anterior Cervical Instrumentation Using Intradiscal Cage with Integrated Plate

  • Ahn, Kyoung-Rok;Ryu, Kyeong-Sik;Chang, In-Bok;Cho, Byung-Moon;Park, Se-Hyuck;Oh, Sae-Moon
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.260-264
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    • 2006
  • Objective : The retrospective study is undertaken to report clinical results of anterior cervical interbody fusion with an intradiscal cage with an integrated plate [PCB cervical plating system]. Methods : 38 patients underwent anterior cervical interbody fusion with PCB cervical plating system and followed $6{\sim}24\;months$. The authors investigated overall surgical results; clinical outcome, fusion rate, change of interspace height & lordotic angle, and complications. Results : No complication was observed during the operation. Clinical improvement was identified in 34 cases [89.5%]. Bone fusion observed in 44 out of 49 sites [90.7%]. After operation, the interspace height increased from $5.4{\pm}1.3mm$ to $7.8{\pm}1.5mm$ and maintained $7.4{\pm}1.1mm$ and, interspace angle went up from $4.2{\pm}0.7^{\circ}$ to $4.8{\pm}1.1^{\circ}$ and maintained $4.6{\pm}$0.9^{\circ}. The loosening of screw was observed in 6 cases, one of which had reoperation because of the expulsion of the device accompanied. Conclusion : PCB cervical plating system could restore interbody height and lordosis in anterior cervical interbody fusion. But, if the insertion of the spacer is not precise, the frequencies of hardware failure are relatively high. It is considered necessary for the operator to be careful in the procedure.

High Spinal Block for Chronic Intractable Pain -A case report- (만성 난치성 통증의 치료를 위한 상위척수차단 -증례보고-)

  • Jeong, Mi-Hyang;Hong, Jin-Kyung;Lee, Cheol;Lee, Cheol-Seung
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.403-406
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    • 1996
  • Total spinal block is used as final choice for chronic intractable pain which doesn't respond to other treatments. A 35 years old male patient was admitted to pain clinic due to severe cramping and throbbing pain of whole body, especially left lateral side since 1980. The result of cervical and lumbar epidural block was not good enough, so we decided to try total spinal block. At first, C7-T1 interspace was punctured and 2% mepivacaine 20 ml was injected, but the result was not satisfied. Next day, L3-4 interspace was punctured and 1.5% mepivacaine 40 ml was injected. The sensory block level was C6 and pain score on Visual Analog Scale, was changed from 9 to 4. In both trials, actually even though they were not complete total spinal block, the effect was good enough. If complete total spinal block had been accomplished, better result might be obtained in this chronic intractable pain.

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Analysis of Patients with Cervical Epidural Steroid Injection and Nerve Block (경부 경막외 Steroid 주입 및 차단술을 받은 환자의 분석)

  • Chung, Sung-Won;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.98-101
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    • 1996
  • Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

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Epidural Hematoma Following Continuous Epidural Analgesia in Patient Receiving Anticoagulant Therapy -A case report- (항응고제 사용 환자에서 지속적 경막외 제통술후 발생한 경막외 혈종 1예 -증례 보고-)

  • Yoo, Kyung-Yeon;Im, Woong-Mo;Park, Joon-Seo
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.271-274
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    • 1996
  • Epidural hematoma during anticoagulant therapy is a rare complication of central neural blockade, but it may result in serious neurologic sequelae. A 61-year-old male receiving warfarin due to heart failure was referred to the pain clinic for control of severe herpetic neuralgia. Epidural catheterization was done at $T_{8-9}$ interspace. At that time, PT and aPTT were extremely prolonged. The next morning, severe back pain, motor paralysis and urinary difficulty developed. On spine MRI, epidural hematoma was detected at $T_{8-9}$ interspace. Four days later, he died due to underlying diseases. Central neural blockade in patient with anticoagulant therapy is contraindicated in most cases. If is undertaken, close observation of patients's neurologic functions and monitoring of coagulation profiles(PT, aPTT, etc) are necessary. If epidural hematoma develops, early surgical decompression is mandatory.

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Comparison of Analgesic Efficacy and Shortening of Labor Duration between $L_{1-2}$ and $L_{3-4}$ Epidural Blocks in Nulliparous Normal Vaginal Delivery (초산모에서 경막외 $L_{1-2}$$L_{3-4}$ 차단 시 제통효과와 분만기간의 비교)

  • Kang, Kyu-Sik;Lee, Sang-Yoon;Kim, Jung-Soon;Nam, Kae-Hyun;Park, Wook
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.61-67
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    • 2001
  • Background: Usually, lumbar epidural block is performed on the $L_{3-4}$ interspace. This study was designed to evaluate the analgesic efficacy and shortening of labor duration comparing the $L_{1-2}$ and $L_{3-4}$ interspace epidural blocks in nulliparous normal vaginal deliveries and then investigates side effects following the blocks. Methods: Eighty healthy nulliparous women were divided into two groups, $L_{1-2}$ (n = 40) and $L_{3-4}$ (n = 40). Epidural blocks, lumbar epidural block were performed at the $L_{1-2}$ and $L_{3-4}$ interspace with a catheter advancing 3 cm cephalad. The initial dose of 12 ml (0.167% bupivacaine, fentanyl $50{\mu}g$ and clonidine $75{\mu}g$) was injected epidurally at 4 cm dilatation of cervix and severe pain of labor. If a visual analogue scale (VAS) score was more than 4 points, an additional dose was administered epidurally using the same volume as the above mentioned, but with the exception that the bupivacaine was diluted to 0.1 percentage. The maternal blood pressure, pulse rate, respiration rate and fetal heart rate were measured at 10 min intervals for the first 30 min, at 15 min interval for the next 30 min and at 30 min interval for the last one hour following the blocks. The duration of the first (active) and second stages of labor was counted and the neonatal Apgar score was recorded at one and five min after delivery. The degree of motor block, pruritus, nausea and vomiting were also noted. Results: The patients in group $L_{1-2}$ had lower pain scores than group $L_{3-4}$ at 5, 20, 30, 60 mins. The duration of 1st and 2nd labor stage in the $L_{3-4}$ epidural block were $272{\pm}33.5$ min, $49.2{\pm}27.4$ min respectively but those in the $L_{1-2}$ epidural block were $253.5{\pm}32.5$ min, $37.3{\pm}22.3$ min, respectively. Conclusions: We concluded the analgesic efficacy and shortening of labor duration in $L_{1-2}$ epidural block was better than those in $L_{3-4}$ epidural block. Maternal hemodynamic change, motor block. pruritus, nausea, vomiting and Apgar score showed no significant differences between the two groups.

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