• The Korean Journal of Pain
• /
• v.22 no.2
• /
• pp.158-162
• /
• 2009

Background: The loss of resistance (LOR) method is most commonly used to identify the epidural space. This method is thought to rely on the penetration of the ligamentum flavum. Unfortunately the exact morphology of the ligamentum flavum is variable at different vertebral levels. Especially, it has been pointed out that the lower cervical ligamentum flavum may be discontinuous in the midline in up to 50% of patients. Thus, the LOR method may be inaccurate to confirm the cervical epidural space. The aim of this study is to determine which method is the safest and most exact for confirming the cervical epidural space. Methods: 100 adult, chronic renal failure patients who were undergoing an arteriovenous bridge graft for hemodialysis at the upper arm under cervical epidural anesthesia were recruited for this study. During the cervical epidural puncture, we identified the cervical epidural space by subjectively feeling the resistance with using a finger just through the ligamentum flavum, and we also used the drip infusion method, the loss of resistance method using air, and the hanging drop method. By using 5 grades, we classified the extent of whether or not the techniques were effective. Results: Using the drip infusion method, we identify the epidural space in all the patients as ＋/＋＋ grade. The catheter insertion method was also successful in identifying those epidural spaces over a ${\pm}$ grade. The pseudo LOR was over ${\pm}$ grade in 47 patients. Conclusions: The combined LOR/hanging drop with drip infusion method is useful for confirming the cervical epidural space.

• Journal of Korean Public Health Nursing
• /
• v.14 no.2
• /
• pp.191-202
• /
• 2000

This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.

• Journal of Radiation Protection and Research
• /
• v.29 no.2
• /
• pp.97-104
• /
• 2004

MIRD-type Korean adult male phantom, 'KMIRD' was constructed to calculate Korean-specific dosimetric quantities for radiation protection consideration. The external shape of KMIRD was based on national physical standard data of Korean. KMIRD has thicket trunk than MIRD5 and arm models divided from trunk. The height and weight of the KMIRD are 171 cm and 63.8 kg. ICRP23 data were referred to constitute organs and tissues of KMIRD. However nine organs were constructed based on Korean reference data provided by Radiation Health Research Institute. In the present study, the MCNPX2.3 Monte Carlo transport code was combined with KMIRD to calculate dose conversion coefficients for photon in the energy range from 0.05 to 10 MeV. The simulated irradiation geometries are broad parallel photon beams in AP, PA, LLAT and RLAT direction. Absorbed dose conversion coefficients were compared with data calculated with MIRD5, MIRD-type phantom based on ICRP23 reference man. In some organs, the discrepancies between two phantoms amount up to nearly 30%. The effective doses conversion coefficients of KMIRD are lower than those of MIRD5. The dose discrepancies between two MIRD-type phantoms ate because of physical differences between Korean and Western, also geometric differences between two phantoms. KMIRD should be revised using the full set of Korean reference data of all organs. The developed MIRD-type Korean adult male phantom can be applied to dose assessment of internal exposure.

• Archives of Plastic Surgery
• /
• v.34 no.1
• /
• pp.52-59
• /
• 2007

Purpose: The venous flap is used as an alternative method to the standard free flap for the management of small and thin soft tissue defects. Especially, the venous flap has advantages of being thin, easy harvest and various donor sites, as well as it having lower morbidity. Yet their clinical applications have been limited by their unstable postoperative course and also by their complications such as partial necrosis. The aim of this study is to extend the clinical indications of venous flaps with using various methods. Methods: From May 2005 to March 2006, total of 19 patients(21 cases) underwent various venous flaps for soft tissue defects as a result of trauma(15 cases), facial skin cancer(3 cases), chronic ulcer(1 case) and surgical wound for congenital anomaly(2 cases). The arterialized venous free flap were applied in 18 cases, the pure venous free flap was applied in 1 case and the pure venous pedicled flap were applied in 2 cases. Among them, two flow-through arterialized venous free flaps were applied that used the great saphenous vein to reconstructed major arteries as well as the injured skin and soft tissues in the arm. All the flap were harvested from the volar wrist(11 cases), dorsum of foot(5 cases), thenar(2 cases), and medial thigh(3 cases). Results: The sizes of the flap ranged from $0.75cm^2$ to $264cm^2$(mean size: $40.06cm^2$). The follow-up period ranged from two to twelve months. In the majority of cases, we obtained satisfying results, which was the excellent reconstruction of skin and soft tissue defects and especially in the case of limb salvage, replantation and cancer reconstruction. However, there were 5 cases of partial necrosis and 2 cases of complete failure. The donor sites were closed primarily in 7 cases and wound closure with skin graft were in 14 cases. Conclusion: We conclude that the venous flap will not only be useful for reconstruction of small defect in the hand and foot, but also be useful for various other clinical indications.

• Journal of dental hygiene science
• /
• v.9 no.5
• /
• pp.545-550
• /
• 2009

This study set out to examine the knowledge about and preventive actions against musculoskeletal diseases among dental hygiene students according to the Health Belief Model, suggest a need for programs to promote health and prevent those diseases, and investigate their relations, A survey was taken among 83 sophomores and 114 juniors at the dental hygiene major of a college in Gyeonggi Province. Analyzed by using SAS 8.0 version. The findings are as follows: 1. The sophomores and juniors scored $22.50{\pm}2.37$ and $22.29{\pm}3.01$ points, respectively, on susceptibility of the Health Belief Model with significant differences between the two groups(P < 0.01). Significant differences were also found between the sophomores that scored $18.82{\pm}2.60$ points and the juniors that scored $18.64{\pm}2.77$ points on benefit(P < 0.05). 2. The juniors experienced a higher level of pain than the sophomores with statistical significance observed on the neck, shoulder, lower back, knee, foot, and ankle(P < 0.05). 3. Of the Health Belief Model, severity had significant positive correlations with 'Placing frequently used tools near the dental technician' and 'Trying to avoid repeating the same task and diversify tasks'(P < 0.01). And benefit was positively correlated with 'Trying to reduce the frequency of bending and stretching out during treatment, 'Trying not to lean much with the neck, back, arm, and wrist' and 'Trying to maintain the torso in the neutral position'(P < 0.01). The results suggest that there should be some instructions to help dental hygiene students practice the preventive actions against musculoskeletal diseases and further prevention programs against those diseases.

• The Journal of Korean Society for School & Community Health Education
• /
• v.4
• /
• pp.1-20
• /
• 2003

This study was not intended to analyze out the realities of the safety accidents in school. The purpose of this study was to find out the personality of elementary school students in 6th grade and analyze the relationship between the personality of elementary school students and the safety accidents in the school. We made a visit 12 elementary school personally in the B city of Gyeonggi Province and gave out 552 questionaries in order to accomplish the purpose of this study. And we analyzed the 501 answer data except the unfittable data 51 sheets-in case of no answer or untruthfulness. The inspection of the personality used the Eysenck Personality Questionnaire(EPQ) and the questionnaires of the safety accidents in the school were reorganized of the questionnaires which were used in Chun-Ok, Joen(1997) and One-Yong, Kim(1999)'s study to correspond with our purpose of study. Answer sheets were gone through the t and x2 test by using the program of SPPS. First, elementary school students are in the formative period in the life of a man. So many students's personality was in the middle group rather than in high and low group. In regard of the distintion between the boy students and the girl students, the boy students had higher score in Psychoticism(P) but the girl students had higher score in Neutroticism(N). And Lie(L) was showing a little more score in the girl students. Second, there was significant difference in the investigation of safety accidents in school according to sex distinction. 1) Comparing the boy students and the girl students, the rate of accidents was higher in boy rather than girl. And there was significant difference. 2) Comparing the grade of the school, the rate of accidents was higher in upper grade than lower grade both girls and boys. 3) In the kind of accidents, the traumatic Injuries were very popular and the next were contusions. There was significant difference in the traumatic injury and nosebleed. 4) The results of injured parts showed that the injuries of foot, leg, hand, arm hold a large majority. And there was a significant difference in head, face, foot, leg and etc. 5) Most accidents broke out during the break time and then accidents happened after school were the next. The flowings were lunch time and class time. There was a significant difference in accidents happened during the class, break time and lunch time. 6) Comparing the subjects, the most accidents broke out in the class of physics. 7) Among the cause of accidents, one's own carelessness was showing the highest rate. There was a significant distintion in the fight and game. 8) The safety accidents took place most in playground, and there was a significant difference. 9) Being slight wound was showing almost in the degrees of damage. And there was a significant difference. Third, the boy students were not showing the significant difference in relation to the personality, the frequency of accidents and the degrees of damage. But the girl students were showing the significant difference in relation to the Extraversion-Introversion(E) and the frequency of accidents. And there were a significant difference between E and N. Also they were showing the intense damages.

• Journal of Korean Society of Spine Surgery
• /
• v.25 no.4
• /
• pp.185-195
• /
• 2018

Study Design: Literature review. Objective: Ultrasound-guided injections are a common clinical treatment for lower lumbosacral pain that are usually performed before surgical treatment if conservative treatment fails. The aim of this article was to review ultrasound-guided injections in the lumbar and sacral spine. Summary of Literature Review: Ultrasound-guided injections, unlike conventional interventions using computed tomography or C-arm fluoroscopy, can be performed under simultaneous observation of muscles, ligaments, vessels, and nerves. Additionally, they have no radiation exposure and do not require a large space for the installation of equipment, so they are increasingly selected as an alternative method. Materials and Methods: We searched for and reviewed studies related to the use of ultrasound-guided injections in the lumbar and sacral spine. Results: In order to perform accurate ultrasound-guided injections, it is necessary to understand the patient's posture during the intervention, the relevant anatomy, and normal and abnormal ultrasonographic findings. Facet joint intra-articular injections, medial branch block, epidural block, selective nerve root block, and sacroiliac joint injections can be effectively performed under ultrasound guidance. Conclusions: Ultrasound-guided injections in the lumbar and sacral spine are an efficient method for treating lumbosacral pain.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.2
• /
• pp.673-680
• /
• 2019

This study was conducted to investigate the effects of plasma homocysteine concentration on the brachial-ankle pulse wave velocity between the normal homocysteine group and the asymptomatic high homocysteine group. 435 subjects who visited the general health examination center from April 1 to October 31, 2016, as well as to compare the direct correlation of the brachial-ankle pulse wave velocity, which indirectly reflects the homocysteine test and arterial stiffness, as a predictor of future cardiovascular outcome. As a result of the study, age, waist circumference, BUN, and plasma creatinine were significantly higher, and HDL was significantly lower in the high homocysteine group (> $15{\mu}mol/L$) than in the normal homocysteine group (< $15{\mu}mol/L$) (p=0.05). In addition, homocysteinemia was associated with smoking and drinking (p<0.001) and was significantly higher in males (p<0.001). The right and left brachial-to-ankle pulse wave velocities were significantly higher in the high homocysteine group (right p<0.001, left p=0.003) before calibrating the relevant variables. There was no significant difference between right and left brachial-to-ankle pulse wave velocities after calibrating the relevant variables. Therefore, further studies on the independent association of lowering homocysteine concentration and prevention of cardiovascular disease and the relationship between homocysteine and renal function are needed.

• Physical Therapy Korea
• /
• v.26 no.3
• /
• pp.1-10
• /
• 2019

Background: Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 kg, 1 kg, 1.5 kg, and 2 kg at shoulder abduction angles of $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, and $90^{\circ}$. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at $0^{\circ}$, $30^{\circ}$ and weight of 2 kg showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of $30^{\circ}$, $60^{\circ}$ and $90^{\circ}$ (p<.05). For UT/SA, significant difference was only observed at $90^{\circ}$ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 kg weights with abduction angles of $0^{\circ}$ and $30^{\circ}$ at shoulder protraction in supine position.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.2
• /
• pp.145-153
• /
• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.