• Title/Summary/Keyword: MD-64

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Clinical Features of Deep Neck Infections and Predisposing Factors for Mediastinal Extension

  • Kang, Shin-Kwang;Lee, Seok-Kee;Oh, Hyun-Kong;Kang, Min-Woong;Na, Myung-Hoon;Yu, Jae-Hyeon;Koo, Bon-Seok;Lim, Seung-Pyung
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.171-176
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    • 2012
  • Background: Deep neck infections (DNI) can originate from infection in the potential spaces and fascial planes of the neck. DNI can be managed without surgery, but there are cases that need surgical treatment, especially in the case of mediastinal involvement. The aim of this study is to identify clinical features of DNI and analyze the predisposing factors for mediastinal extension. Materials and Methods: We reviewed medical records of 56 patients suffering from DNI who underwent cervical drainage only (CD group) and those who underwent cervical drainage combined with mediastinal drainage for descending necrotizing mediastinitis (MD group) from August 2003 to May 2009 and compared the clinical features of each group and the predisposing factors for mediastinal extension. Results: Forty-four out of the 56 patients underwent cervical drainage only (79%) and 12 patients needed both cervical and mediastinal drainage (21%). There were no differences between the two groups in gender (p=0.28), but the MD group was older than the CD group (CD group, $44.2{\pm}23.2$ years; MD group, $55.6{\pm}12.1$ years; p=0.03). The MD group had a higher rate of co-morbidity than the CD group (p=0.04). The CD group involved more than two spaces in 14 cases (32%) and retropharyngeal involvement in 12 cases (27%). The MD group involved more than two spaces in 11 cases (92%) and retropharyngeal involvement in 12 cases (100%). Organism identification took place in 28 cases (64%) of the CD group and 3 cases of (25%) the MD group (p=0.02). The mean hospital stay of the CD group was $21.5{\pm}15.9$ days and that of the MD group was $41.4{\pm}29.4$ days (p=0.04). Conclusion: The predisposing factors of mediastinal extension in DNI were older age, involvement of two or more spaces, especially including the retropharyngeal space, and more comorbidities. The MD group had a longer hospital stay, higher mortality, and more failure to identify causative organisms of causative organisms than the CD group.

Wakes of two inline cylinders at a low Reynolds number

  • Zafar, Farhan;Alam, Md. Mahbub;Muhammad, Zaka;Islam, Md.
    • Wind and Structures
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    • v.29 no.1
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    • pp.55-64
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    • 2019
  • The effect of vortex impingement on the fluid dynamics around a cylinder submerged in the wake of another of different diameters is numerically investigated at a Reynolds number Re = 200. While the diameter (D) of the downstream cylinder is fixed, impinging vortices are produced from the upstream cylinder diameter (d) varied as d/D = 0.24, 0.4, 0.6, 0.8 and 1.0, with a spacing ratio L=5.5d, where L is the distance between the center of the upstream cylinder to the front stagnation point of the downstream cylinder. Two-dimensional simulations are carried out using the finite volume method. Fluid forces acting on the two cylinders are correlated with impinging vortices, vortex shedding, and wake structure. Different facets of wake formation, wake structure, and flow separation and their connections to fluid forces are discussed.

Effectiveness of Active Warming Intervention for Women Undergoing Cesarean Section: A Systematic Review and Meta-analysis (제왕절개 환자에서 적극적 가온 요법의 효과: 체계적 문헌고찰 및 메타분석)

  • Choi, Jung Eun;Kim, Mee Sun;Song, Jin Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.3
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    • pp.167-180
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    • 2017
  • Purpose: The aim of this study was to synthesize the best available evidence for active warming interventions during cesarean section. Methods: A database search was done for randomized controlled trials utilizing active warming interventions. Maternal temperature, shivering and neonatal temperature were evaluated as outcome variables. Data were analyzed using Cochrane Review Manager software Version 5.3. Results: Thirteen studies including 1306 patients were reviewed. The degree of lowering of maternal temperature decreased in the warmed fluids (MD 0.51; p=.004) and warming mattress interventions (MD 0.22; p<.001) compared with control groups. Incidence of shivering was also lower in the active warming group (OR 0.55; p=.003). There was no statistically significant difference in maternal temperature with a forced air warming intervention (MD 0.64; p=.15) or in neonatal temperature (MD 0.12; p=.26). Conclusion: Findings show that with warmed fluids and warming mattresses applied during cesarean sections maternal temperature decline was reduced and also the incidence of shivering declined, but no significant effect was observed for forced air warming interventions. These findings provide a basis for developing a warming guideline for women having a cesarean section and will help to improve the quality of care for cesarean section patients.

Performance Evaluation of Shape Descriptors for Gait Analysis Based on Silhouette Sequence (실루엣 영상기반 보행 분석을 위한 형태 기술자의 성능 평가)

  • Kim, Seon-Jong
    • Journal of Intelligence and Information Systems
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    • v.15 no.4
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    • pp.53-64
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    • 2009
  • This paper presents a performance evaluation of shape descriptors for gait analysis in case of silhouette sequence images. We used moment descriptors(MD), Fourier descriptors(FD) and Zernike descriptors(ZD) as a shape descriptor. To evaluate their performance, we firstly defined the performance index, that is, AI(asymmetry index) and PI(periodic index) based on the periodic property of the gait images. This is why they are represented by periodic parameters due to periodic gait images. This index means that how the shape is represented periodically. According to these indexes, we evaluated the data sets with periodic images, downloaded from internet. The results showed that Zernike descriptors had better performance of AI = 1.09 and PI = 2.21 than others. And in case of FD and ZD, it's efficient to implement the gait analysis with 5~10 parameters.

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Determining the appropriate resting energy expenditure requirement for severe trauma patients using indirect calorimetry in Korea: a retrospective observational study

  • Hak-Jae Lee;Sung-Bak Ahn;Jung Hyun Lee;Ji-Yeon Kim;Sungyeon Yoo;Suk-Kyung Hong
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.337-342
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    • 2023
  • Purpose: This study aimed to compare the resting energy expenditure (REE) measured using indirect calorimetry with that estimated using predictive equations in severe trauma patients to determine the appropriate caloric requirements. Methods: Patients admitted to the surgical intensive care unit between January 2020 and March 2023 were included in this study. Indirect calorimetry was used to measure the patients' REE values. These values were subsequently compared with those estimated using predictive equations: the weight-based equation (rule of thumb, 25 kcal/kg/day), Harris-Benedict, Ireton-Jones, and the Penn State 2003 equations. Results: A total of 27 severe trauma patients were included in this study, and 47 indirect calorimetric measurements were conducted. The weight-based equation (mean difference [MD], -28.96±303.58 kcal) and the Penn State 2003 equation (MD, - 3.56±270.39 kcal) showed the closest results to REE measured by indirect calorimetry. However, the REE values estimated using the Harris-Benedict equation (MD, 156.64±276.54 kcal) and Ireton-Jones equation (MD, 250.87±332.54 kcal) displayed significant differences from those measured using indirect calorimetry. The concordance rate, which the predictive REE differs from the measured REE value within 10%, was up to 36.2%. Conclusions: The REE values estimated using predictive equations exhibited substantial differences from those measured via indirect calorimetry. Therefore, it is necessary to measure the REE value through indirect calorimetry in severe trauma patients.

Clinical Application of Acute Ischemic Stroke in Perfusion Computed Tomography (초급성 허혈성 뇌졸중에서 관류 전산화단층촬영의 임상적 적용에 대한 연구)

  • Lee, Jong-Seok;Yoo, Beong-Gyu;Kweon, Dae-Cheol
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.149-160
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    • 2007
  • Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.

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The Strategy for Improvement of System md Model Development for Upland Area Integrated Improvement Project (밭지역 종합정비를 위반 모델 개발 및 제도개선방안)

  • Kim Young Hwa;Han Kuk Heon;Park Ji Sung;Kim Chae Soo
    • KCID journal
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    • v.11 no.1
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    • pp.64-76
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    • 2004
  • For effective development of upland areas, e development model of upland area integrated improvement project are suggested which on standard type and integrated infrastructure improvement type, rural Income raising type and eco-friendly consolidation type

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Diagnosis of bovine virus diarrhea-mucosal disease in breeding Holstein cows with diarrhea and vesicles (설사 및 수포발생 육성유우에서 바이러스성 설사.점막병의 진단)

  • 이성효;한수철;이종오;윤여백;송희종;채효석
    • Korean Journal of Veterinary Service
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    • v.20 no.4
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    • pp.331-338
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    • 1997
  • The purpose of this study was to establish early diagnosis for bovine virus diarrhea-mucosal disease(BVD-MD) Two Holstein among 22 breeding cows were shown ulcer in the mouth and watery diarrhea. Diarrheal feces and ulcerous lesion of the mouth from 2 cows were sampled for detection of viral antigen. BVD virus was isolated by inoculation of the samples to MDBK cells, and the cytopathic effects were observed in cultured MDBK cells which inoculated with virus isolates from the feces. Viral antigens were detected in the feces and ulceruous lesion by immunogold staining. The serum neutralization titers were shown 1 : 64 or greater in 8 blood samples by using BVD virus (NADL strain). By the RT-PCR, using reverse primer 5'-ACTCCATGTGCCATGTACAG-3', forward primer 5'-ACTCCATGTGCCATGTACAG-3', 285 base pair band specific to BVD virus was detected. In conclusions, the results of above tests which executed using the diarrheal feces and ulcerous lesion of the mouth and the isolates were conformed as BVD virus.

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The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.75-101
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    • 2021
  • Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

Buffered versus unbuffered local anesthesia for inferior alveolar nerve block injections in children: a systematic review

  • Tirupathi, Sunny Priyatham;Rajasekhar, Srinitya
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.271-279
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    • 2020
  • Background: The present study aimed to evaluate and compare the efficacy of buffered and unbuffered local anesthesia solutions during inferior alveolar nerve block (IANB) administration in children. Methods: PubMed, Ovid SP, and Cochrane databases were searched separately by two independent reviewers for potential papers published between 1980 and April 2020 using relevant MeSH terms and pre-specified inclusion and exclusion criteria. T Studies of IANB administration in children comparing buffered and unbuffered local anesthesia solutions were evaluated. The primary outcome evaluated was pain (perception and reaction), while the secondary outcome was the onset of anesthesia. Results: A total of five articles were included in a qualitative analysis; among them, four qualified for quantitative analysis of the primary outcome and three for quantitative analysis of the secondary outcome. A fixed-effects model was used to perform the meta-analysis. Pain perception (child-reported pain): Significantly lower pain scores were reported with buffered local anesthesia solution than with unbuffered solution (P = 0.006, MD: -0.32, 95% CI: -0.55 to -0.09). Pain reaction (observer-reported pain reaction in child): No significant difference was found between buffered and unbuffered solution in terms of observer-reported pain behavior in the child (P = 0.09, MD: -0.21, 95% CI: -0.46 to 0.04). Onset of anesthesia: A significantly lower duration of anesthesia onset was reported with buffered local anesthesia solution than with unbuffered solution (P = 0.00001, MD: -12.38, 95% CI: -17.64 to -7.13]. Conclusion: Buffering local anesthesia solution may reduce discomfort due to IANB injection administration and lower the initial onset time of anesthesia. More randomized control trials with adequate sample sizes should be carried out to validate the accuracy of these results.