Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Kang, Min-Ku
The Journal of Korean Orthopaedic Ultrasound Society
/
v.2
no.2
/
pp.85-89
/
2009
Purpose: To analyze the clinical outcome after ultrasound guided multiple dry needlings and local steroid injection for acute calcific tendinitis of shoulder. Materials and Methods: Twenty patients with acute episode of pain by calcific tendinitis of shoulder with average age 58.2 (50~70 years) and follow-up of 18 months in average (range, 12~24) were included in study. There were 18 patients with right and 2 with left sided involvement. All patients had calcific deposits in the supraspinatus tendon. All patients underwent standardized nonoperative treatment protocol, consisting of 5~12 MHz high resolution ultrasound guided multiple dry needlings with 18 guage needle, followed by 2% lidocaine 1cc and 40 mg/ml depomedrol 1cc injection at site of calcific tendinitis. The outcome was assessed by UCLA shoulder score, range of motion and VAS score. A statistical analysis with ANOVA and Tukey's post-hoc test with the significance level at 5% was performed using SAS 9.1 software (SAS Institute, Cary, NC). Results: All patients got continuous relief of pain right after the procedures until final follow-up. Before the procedures, the UCLA scores were fair in 15 patients and poor in 5. After the procedures, the UCLA scores were excellent in 16 patients and good in 4. All cases revealed no limitation of shoulder function. The average VAS score decreased from 8.9 before the procedures to 0.5 at final follow-up (p<0.0001). No complication was encountered. Conclusion: An ultrasound guided local steroid injections following multiple dry needlings would be one of the useful treatment modality for the acute calcific tendinitis of shoulder.
Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Park, Bum-Suk
The Journal of Korean Orthopaedic Ultrasound Society
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v.2
no.2
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pp.68-73
/
2009
Purpose: We retrospectively studied the outcomes of the shoulder impingement syndrome for the treatment of the ultrasound-guided subacromial bursal steroid injection. Materials and Methods: Sixty-six shoulders of sixty-two patients with shoulder impingement syndrome treated from March, 2006 to April, 2009 were involved in this study. All cases underwent standardized, nonoperative treatment protocol consisting of 5~12 MHz high resolution ultrasound-guided local steroid injection into the subacromial bursa in modified Crass position. The shoulder range of motion, VAS score and impingement signs were evaluated during the initial and 1year visits. After injection, shoulder elevation exercise was encouraged. Statistical analysis with ANOVA model and Tukey's post-hoc test with the significance level at 5% were performed using SAS program. Results: All cases showed improved range of motion without limitation of shoulder function at immediate post-injection, 6-week, 3-month and 1year visits. The average VAS score at one year follow-up decreased to 2.85 from 6.47 before injection. In all cases the impingement signs became negative immediate after injection. However, 6 cases showed positive impingement signs after 6-week, which became negative after reinjection. The range of motion and VAS score were improved at one-year follow-up compared to initial visit (p<0.0001). No complication was noted at all follow-up period. Conclusion: Ultrasound-guided subacromial steroid injection alleviated the need of surgery, because it was successful in all our cases to improve pain and function of the shoulders until one year follow-up period.
A lot of existing wastewater treatment plants (WWTPs) are rebuilt or retrofitted for advanced wastewater treatment processes to cope with reinforced effluent criteria of nitrogen and phosphorous. Moreover, how to treat the wasted sludge from WWTPs has been also issued since the discharge of the wasted sludge into ocean is impossible from 2011 due to the London Convention 97 protocol. These trend changes of WWTPs get a motivation to assess environmental and economic impacts from the construction stage to the waste stage in WWTPs. Therefore, this study focuses on evaluation of environmental and economic impacts of the advanced wastewater treatment processes and waste sludge treatment process by using life cycle assessment. Four advanced wastewater treatment processes of Anaerobic/Anoxic/Oxic ($A_2O$), 5 stages-Bamard Denitrification Phosphate (Bardenpho), Virginia Initiative Plant (VIP), and Modified University of Cape Town (MUCT) are chosen to compare the conventional activated sludge (CAS) and three waste sludge treatment methods of land fill, incineration, and composting are used. To evaluate environmental and economic impacts of each advanced wastewater treatment processes, life cycle assessment (LCA) and life cycle cost (LCC) are conducted based on International organization for standardization (ISO) guidelines. The results clearly represent that the $A_2O$ process with composting shows 52% reduction in the environmental impact than the CAS process with landfill. On the other hand, the MUCT process with composting is able to save 62% of the life cycle cost comparing with the CAS process with landfill. This result suggested the qualitative and quantitative criteria for evaluating eco-environmental and economic technologies of advanced treatment processes and also sludge treatment method, where their main influence factors on environmental and economic impacts are analyzed, respectively. The proposed method could be useful for selecting the most efficient and eco-friendly wastewater treatment process and sludge treatment method when retrofitting the existing WWTPs to advanced treatments.
Database query and reporting tools, OLAP tools and data mining tools are typical front-end tools in Business Intelligence environment which is able to support gathering, consolidating and analyzing data produced from business operation activities and provide access to the result to enterprise's users. Traditional reporting tools have an advantage of creating sophisticated dynamic reports including SQL query result sets, which look like documents produced by word processors, and publishing the reports to the Web environment, but data source for the tools is limited to RDBMS. On the other hand, OLAP tools and data mining tools have an advantage of providing powerful information analysis functions on each own way, but built-in visualization components for analysis results are limited to tables or some charts. Thus, this paper presents a system that integrates three typical front-end tools to complement one another for BI environment. Traditional reporting tools only have a query editor for generating SQL statements to bring data from RDBMS. However, the reporting tool presented by this paper can extract data also from OLAP and data mining servers, because editors for OLAP and data mining query requests are added into this tool. Traditional systems produce all documents in the server side. This structure enables reporting tools to avoid repetitive process to generate documents, when many clients intend to access the same dynamic document. But, because this system targets that a few users generate documents for data analysis, this tool generates documents at the client side. Therefore, the tool has a processing mechanism to deal with a number of data despite the limited memory capacity of the report viewer in the client side. Also, this reporting tool has data structure for integrating data from three kinds of data sources into one document. Finally, most of traditional front-end tools for BI are dependent on data source architecture from specific vendor. To overcome the problem, this system uses XMLA that is a protocol based on web service to access to data sources for OLAP and data mining services from various vendors.
The purpose of this research is to seek SPAIR's reversal time (TI) which satisfies two conditions ; maintaining the suppression ability of fat tissue and simultaneously minimizing the inhomogeneity of fat tissue in T2 high-speed spin echo 3.0T magnetic resonance image (MRI) of the brain, and to compare SPAIR with STIR which is fat-suppression technique. The reversal times (TI) of SPAIR protocol are set to 1/2, 1/3, 1/6 and 1/12 of SPAIR TR (420 msec), namely 210 msec (8 people), 140 msec (26 people), 70 msec (26 people) and 35 msec (18 people) and STIR TI is set with 250 msec (26 people). With these parameter sets, we acquired the axis direction 104 images of the brain. In ROI ($50\;mm^2$) of output image, signal intensities of the fatty tissue, the muscular tissue, and the background were measured and the CNRs of fatty tissue and the muscular tissue were calculated. The inhomogeneity of the fatty tissue is SD/mean, where SD is the standard deviation and 'mean' is a average fatty tissue signal. Consequently, SPAIR TI is determined on either 1/3 or 1/6 of TR (420 ms) ; 140 ms or 70 ms. Because the difference of statistics in fat-suppression ability and inhomogeneity of fatty tissue is very small (p < 0.001), Selecting 140 ms seems to be better choice for the image quality. Meanwhile, Comparing SPAIR (TI : 140 ms) with STIR, the fat-suppression is not able to be considered statistically (p < 0.252), but the image quality is able to be considered statistically (p < 0.01). In conclusion, SPAIR is better than STIR in the image quality.
Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.
Current artificial heart valves have several disadvantages, such as thromboembolism, limited durability, infection, and inability to grow. The solution to these problems would be to develop a tissue-engineered heart valves containing autologous cells. The aim of this study was to optimize the protocol to obtain a porcine acellular matrix and seed goat autologous endothelial cells on it, and to evaluate the biological responses of xenograft and xeno-autograft heart valves in goats. Material and Method: Fresh porcine pulmonic valves were treated with one method among 3 representative decellularization protocols (Triton-X, freeze-thawing, and NaCl-SDS). Goat venous endothelial cells were isolated and seeded onto the acellularized xenograft leaflets. Microscopic examinations were done to select the most effective method of decellularizing xenogeneic cells and seeding autologous endothelial cells. Two pulmonic valve leaflets of. 6 goats were replaced by acellularized porcine leaflets with or without seeding autologous endothelial cells while on cardiopulmonary bypass. Goats were sacrificed electively at 6 hours, 1 day, 1 week, 1 month, 3 months, and 6. months after operation. Morphologic examinations were done to see the biological responses of replaced valve leaflets. Result: The microscopic examinations showed that porcine cells were almost completely removed in the leaflets treated with NaCl-SDS. The seeded endothelial cells were more evenly preserved in NaCl-SDS treatment. All 6 goats survived the operation without complications. The xeno- autografts and xenografts showed the appearance, the remodeling process, and the cellular functions of myofibroblasts, 1 day, 1 month, and 3 months after operation, respectively. They were compatible with the native pulmonary leaflet (control group) except for the increased cellularity at 6 months. The xenografts revealed the new endothelial cell lining at that time. Conclusion: Treatment with NaCl-SDS was most effective in obtaining decellularized xenografts and facilitate seeding autologous endothelial cells. The xenografts and xeno-autografts were repopulated with myofibroblasts and endothelial cells in situ serially. Both of grafts served as a matrix for a tissue engineered heart valve and developed into autologous tissue for 6 months.
Pollens have been known to possess various biological properties. Therefore, pollens have been extensively used in functional food, folk medicine, and beverage industry to improve human health. This study was conducted to establish the optimized protocol for cytoplasm isolation of bee pollen. Data of biochemical parameters and fatty acid profiles were obtained from pollens of Acorn and Darae(Actinidia arguta). Contents of crude protein and crude fat were 24.1% and 11.8% in Acorn pollen, and those of Darae pollen showed 35.8% and 8.7% in crude protein and crude fat respectively. Also after lyophilizing of Acorn pollen, content of crude protein was increased to 26.5%. Main fatty acids were palmitic acid(C16 : 0), oleic acid(C18 : 1), linoleic acid(C18 : 2) and linolenic acid(C18 : 3) in bee pollen. Linoleic acid(37.3%) was dominant fatty acid in Acorn pollen that is one of essential fatty acids. Linolenic acid(48.3%) was dominant fatty acid in Darae pollen that is a polyunsaturated fatty acid. The proportion of unsaturated fatty acids to total acid content was 73.2% in Acorn and 63.2% in Darae pollen, and especially that of polyunsaturated fatty acids was higher than 55%.
Purpose : Rarity of olfactory neuroblastoma makes it difficult for treating Physician to Practice with a consistent protocol. This study is peformed to analyze our experience with various treatment modalities for patients with olfactory neuroblastoma. Discussion includes review of some recently published literatures. Methods and Materials : Between June of 1979 and April of 1997, 20 patients were treated under the diagnosis of olfactory neuroblastoma at Seoul National University Hospital. There were 14 male and 6 female patients. Age at initial treatment ranged from l3 to 77 years with median or 24 years. fifteen or 20 patients had Kadish stage C. They were treated with various combinations of surgery, radiation therapy and chemotherapy; surgery+postoperative radiation therapy+adjuvant chemotherapy for 2 patients, surgery+postoperative radiation therapy for 6, neoadjuvant chemotherapy+surgery for 1, surgery+adjuvant chemotherapy for 1, surgery only for 2, neoadiuvant chemotherapy+ radiation therapy for 3, radiation therapy+adjuvant chemotherapy for 1, radiation therapy only for 3, and no treatment for 1 patient. Results : Follow-up ranged from 2 month to 204 months with mean of 39.6 months. The overall 5- and 10-year survival rates are 20% and 10%, respectably. Four patients are alive at the time of data analysis. One of four living patients was treated with radical surgery, postoperative radiation therapy and adjuvant chemotherapy, two patients with radical surgery and postoperative radiation therapy, and one with radical surgery only. Conclusion : Multidisciplinary approach, including radical surgery, pre- or post-operative radiation therapy and chemotherapy, should be addressed at the initial time of diagnosis. Although limited by small number of the patients, this study suggests importance of local treatment modality, especially radical surgery in the treatment of lofactory neuroblastoma.
To develop a new functional kimchi with antioxidative properties, salted baechu was soaked in black rice water extract for 6 h at room temperature. The antioxidative property of the water extract was $78.75{\pm}1.18%$ that of the control (0.1% [w/v] alpha-tocopherol). The black rice gel was added to the baechu kimchi preparation. The color of baechu kimchi treated with black rice water extract changed to dark violet and/or black. Control kimchi and black rice water-treated kimchi were stored at $4^{\circ}C$ for 30 days. No significant differences were detected between the control and the black rice water-treated group in the early stages of fermentation. As fermentation time increased, pH decreased and titratable acidity increased rapidly in control kimchi. However, such marked changes were not evident in test kimchi. The hardness value of black rice water-treated kimchi was higher than that of control kimchi after the midpoint of the fermentation period. The storage life of baechu kimchi treated with black rice water extract was prolonged by up to 5 days compared with control samples, owing to a decline in lactic acid bacteria and yeast levels during the final fermentation period in black rice water-treated kimchi. The total phenolic levels and the antioxidative capacity of black rice water-treated kimchi (83%) were approximately 1.5-fold higher than in control kimchi (57%). In sensory evaluation, black rice water-treated kimchi scored higher than did control kimchi using a blind test protocol.
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