• Title/Summary/Keyword: RECOVERY

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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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The biologic effects of safflower(Carthamus tinctorius $Linn\acute{e}$) extract and Dipsasi Radix extract on periodontal ligament cells and osteoblastic cells (홍화 추출물이 치주인대세포, 조골세포 활성도에 미치는 영향)

  • Rhyu, In-Chul;Lee, Yong-Moo;Ku, Young;Bae, Ki-Whan;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.27 no.4
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    • pp.867-882
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    • 1997
  • Safflower(Carthamus tinctorius $Linn\acute{e}$ has been traditionally used for the treatment of blood stasis, and Dipsasi Radix has been used as a drug for fracture in Chinese medicine. The purpose of present study was to examine the biologic effects of safflower extract and Disasi radix extracts on the periodontal. ligament cells and osteoblastic cells and on the wound healing of rat calvarial defect. The ethanolic extract of safflower blossom, safflower seed and Dipsasi Radix(125, 250, and 500 ${\mu}g/ml$) were prepared as test group, and PDGF-BB(lOng/ml) and unsafonifiable fraction of Zea Mays L.(125, 250, and 500 ${\mu}g/ml$) were employed as positive control. The effects of each agents on the growth and survival, ALPase activity, expression of PDGF-BB receptor, chemotactic response of PDL cell and ATCC human osteosarcoma MG63 cells in vitro were examined. The tissue regenerative effect of each extracts was evaluated by histomorphometric measuring of newly formed bone on the 8mm defect in rat calvaria after oral administration of 3 different dosages groups : 0.02, 0.1 and 0.35g/kg, per day. It was also employed the same dosages of unsaponifiable fraction of Zea Mays L. as positive controls. Safflower blossom extract, safflower seed extract, and Dipsasi Radix extract stimulate the cellular activity of MG63 cells in concentration range of $125-500{\mu}g/ml$, and safflower bolssom extract and safflower seed extract stimulate also the cellular activity of periodontal ligament cells in concentration range of $250-500{\mu}g/ml$. In activity of ALPase, $250-500{\mu}g/ml$ of safflower blossom extracts showed significant stimulating effects on MG63 cells, and the same concentration range of safflower seed extracts showed significant effect on periodontal ligament cells. In the recovery on PDGF-BB receptor expression which was depressed by $IL-1{\beta}$, $125-250{\mu}g/ml$ of safflower blossom extracts and $250-500{\mu}g/ml$ of safflower seed extracts showed significant increasing effect on MG63 cells, and $500{\mu}g/ml$ of safflower blossom extract and $250-500{\mu}g/ml$ of safflower seed extracts showed significant effect on periodontal ligament cells. In chemotactic response, among all tested group, safflower seed extracts only were chemotactic to MG63 cells and periodontal ligament cells in concentration range of $125-500{\mu}g/ml$. Also in the view of bone regeneration in rat calvarial defect model, the only group that was orally administrated 0.35g/kg, day of safflower seed extract showed significant new bone formation. These results suggested that safflower extracts might have a potential possibilities as an useful drug for adjunct to treatment for regeneration of periodontal defect.

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Deduction and Verification of Optimal Factors for Stent Structure and Mechanical Reaction Using Finite Element Analysis (스텐트의 구조 및 기계적인 반응에 대한 최적인자 도출과 유한요소해석법을 통한 검증)

  • Jeon, Dong-Min;Jung, Won-Gyun;Kim, Han-Ki;Kim, Sang-Ho;Shin, Il-Gyun;Jang, Hong-Seok;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.201-208
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    • 2010
  • Recently, along with technology development of endoscopic equipment, a stent has been developed for the convenience of operation, shortening of recovery times, and reduction of patient's pain. To this end, optimal factors are simulated for the stent structure and mechanical reaction and verified using finite element analysis. In order to compare to present commercialized product such as Zilver (Cook, Bloomington, Indiana, USA) and S.M.A.R.T (Cordis, Bridgewater Towsnhip, New Jersey, USA), mechanical impact factors were determined through Taguchi factor analysis, and flexibility and expandability of all the products including ours were tested using finite element analysis. Also, important factors were sought that fulfill the optimal condition using central composition method of response surface analysis, and optimal design were carried out based on the important factors. From the centra composition method of Response surface analysis, it is found that importat factors for flexibility is stent thickness (T) and unit area (W) and those for expandability is stent thickness (T). In results, important factors for optimum condition are 0.17 mm for stent thickness (T) and $0.09\;mm^2$ for unit area (W). Determined and verified by finite element analysis in out research institute, a stent was manufactured and tested with the results of better flexibility and expandability in optimal condition compared to other products. Recently, As Finite element analysis stent mechanical property assessment for research much proceed. But time and reduce expenses research rarely stent of optimum coditions. In this research, Important factor as mechanical impact factor stent Taguchi factor analysis arrangement to find flexibility with expansibility as Finite element analysis. Also, Using to Center composition method of Response surface method appropriate optimized condition searching for important factor, these considering had design optimized. Production stent time and reduce expenses was able to do the more coincide with optimum conditions. These kind of things as application plan industry of stent development period of time and reduce expenses etc. be of help to many economic development.

Multi-Component Relaxation Study of Human Brain Using Relaxographic Analysis (Relaxographic 분석법을 이용한 뇌의 다중 자기이완특성에 관한 연구)

  • Yongmin Chang;Bong Soo Han;Bong Seok Kang;Kyungnyeo Jeon;Kyungsoo Bae;Yong-Sun Kim;Duk-Sik Kang
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.2
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    • pp.120-128
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    • 2002
  • Purpose : To demonstrate that the relaxographic method provides additional information such as the distribution of relaxation times and water content which are poentially applicable to clinical medicine. Materials and Methods : First, the computer simulation was performed with the generated relaxation data to verify the accuracy and reliabilility of the relaxographic method (CONTINI). Secondly, in or der to see how well the CONTIN quantifies and resolves the two different ${T_1}$ environments, we calculated the oil to water peak area ratios and identified peak positions of ${T_1}-distribution$ curve of the phantom solutions, which consist of four centrifugal tubes (10 ml) filled with the compounds of 0, 10, 20, 30% of corn oil and distilled water, using CONTIN. Finally, inversion recovery MR images for a volunteer are acquired for each TI ranged from 40 to 1160 msec with TR/TE=2200/20 msec. From the 3 different ROIs (GM, WM, CSF), CONTIN analysis was performed to obtain the ${T_1}$-distribution curves, which gave peak positions and peak area of each ROI location. Results : The simulation result shows that the errors of peak positions were less in the higher peak (centered ${T_1}=600$ msec) than in the lower peak (centered ${T_1}=150$ msec) for all SNR but the errors of peak areas were larger in the higher peak than in the lower peak. The CONTIN analysis of the measured relaxation data of phantoms revealed two peaks between 20 and 60 msec and between 500 and 700 msec. The analysis gives the peak area ratio as oil 10%: oil 20%: oil 30% = 1:1.3:1.9, which is different from the exact ratio, 1:2:3. For human brain, in ROI 3 (CSF), only one component of -distributions was observed whereas in ROI 1(GM) and in ROI 2 (WM) we observed two components of ${T_1}-distribution$. For the WM and CSF there was great agreement between the observed ${T_1}-relaxation$ times and the reported values. Conclusion : we demonstrated that the relaxographic method provided additional information such as the distribution of relaxation times and water content, which were not available in the routine relaxometry and ${T_1}/{T_2}$ mapping techniques. In addition, these additional information provided by relaxographic analysis may have clinical importance.

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Water Treatment Application of a Large Pore Micro-Filtration Membrane and Its Problems (대기공 정밀여과막의 수처리 응용 및 문제점)

  • Yun, Chang-Han;Kim, Jeong-Hak;Lee, Kang Won;Park, Sung Ho
    • Membrane Journal
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    • v.24 no.3
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    • pp.194-200
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    • 2014
  • The purpose of this study was to evaluate the performance of newly developed Large Pore Micro-Filtration (LPMF) membrane in Lab size for the application of water treatment, and to find its problems with solutions. The out-to-inside filtration hollow fiber LPMF membrane of which average pore size was $5{\mu}m$ was used at this study and its material was the PET braid reinforced PVDF. Filtration tests were done through gravity with 30 cm water head difference or pressure below 1.5 bar, and the backwash was done instantaneously with the filtrate after pressurizing it to about 4 bar. The water flux of the LPMF membrane with 0.2 bar TMP (Trans Membrane Pressure) was 2 times higher than $0.4{\mu}m$ MF membrane with $0.05{\mu}m$ UF filtrate of the tap water and it was measured also with 20~30 cm water head difference which showed over 800 LMH at 30 cm water head difference. And Time-To-Filter (TTF) was performed by using $5{\mu}m$ filter paper to optimize coagulants and dosage which enhanced filtrate's turbidity and stabilized filtration flux. When the LPMF was operated with 30 cm gravity with very high dose of inorganic coagulants, the flux was maintained over 80 LMH with 93.5~99.5% turbidity removal. Especially, the filtration was maintained stably in the flux and about 97% of the recovery rate by instantaneous pressurized backwash with about 4 bar of the filtrate when the packing density was about 19%. But there was instability in filtration, since the TMP was continuously going up by inefficient backwash when the packing density was 43%.

The Reactivity for the SO2 Reduction with CO and H2 over Sn-Zr Based Catalysts (Sn-Zr계 촉매 상에서 CO와 H2를 이용한 SO2 환원 반응특성)

  • Han, Gi Bo;Park, No-Kuk;Ryu, Si Ok;Lee, Tae Jin
    • Korean Chemical Engineering Research
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    • v.44 no.4
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    • pp.356-362
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    • 2006
  • The $SO_2$ reduction using CO and $H_2$ over Sn-Zr based catalysts was performed in this study. Sn-Zr based catalysts with Sn/Zr molar ratio (0/1, 1/4, 1/1, 2/1, 3/1, 1/0) were prepared by the precipitation and co-precipitation method. The effect of the temperature on the reaction characteristics of the $SO_2$ reduction with a reducing agent such as $H_2$ and CO was investigated under the conditions of space velocity of $10,000ml/g_{-cat.}h$, $([CO(or\;H_2)]/[SO_2])$ of 2.0. As a result, the activity of Sn-Zr based catalysts were higher than $SnO_2$ and $ZrO_2$. The reactivity for the $SO_2$ reduction with CO was higher than that with $H_2$, and sulfur yield in the $SO_2$ reduction by $H_2$ was higher than that by CO. The reactivity for the $SO_2$ reduction with $H_2$ was increased with the reaction temperature regardless of Sn-Zr based catalyst with a Sn/Zr molar ratio. $SnO_2-ZrO_2$ (Sn/Zr=1/4) had highest activity at $550^{\circ}C$, in the $SO_2$ reduction with $H_2$ and $SO_2$ conversion of 94.4% and sulfur yield of 66.4% were obtained at $550^{\circ}C$. On the other hand, in the $SO_2$ reduction by CO, the reactivity was decreased with the increase over $325^{\circ}C$. At the optimal temperature of $325^{\circ}C$, $SO_2$ conversion and sulfur yield were about 100% and 99.5%, respectively, in the $SO_2$ reduction over $SnO_2-ZrO_2$ (Sn/Zr=3/1). Also, the $SO_2$ reduction using syngas with $CO/H_2$ ratio over $SnO_2-ZrO_2$ (Sn/Zr=2/1) was performed in order to investigate the application possibility of the simulated coal gas as the reductant in DSRP. As a result, the reactivity of the $SO_2$ reduction using syngas with $CO/H_2$ ratio was increased with increasing the CO content of syngas. Therefore, it could be known that DSRP using the simulated coal gas over Sn-Zr based catalyst is possible to be realized in IGCC system

Analysis on the Users′ Behaviors and Satisfaction on the Actual Conditions of Management in Chiri Mountain National Park (지리산국립공원의 이용자 행태분석과 관리실태에 대한 만족도 조사에 관한 연구)

  • 김광래;진희성;김세천
    • Journal of the Korean Institute of Landscape Architecture
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    • v.16 no.2
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    • pp.43-57
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    • 1988
  • The purpose of this thesis is to suggest objective basic data for park management proposal through the quantitative analysis of users' behaviors and satisfaction for the actual conditions of management in the Chiri Mountain National Park. For this users' behaviors and socio-economic characteristics have been cross-analyzed. Specifically, it attempts to investigate users' anticipate and degree of satisfaction applied Expectancy Theory by Likert attitude scale. Users'behaviors patterns of each site have been analyzed by the factor analysis algorithm, and each factor scores of sites have been clustered by the cluster method. And also user' satisfaction for the actual conditions of management have been analyzed by using the multiple regression. The major user groups were students and youth groups accompanied by their friends ranging from 3 to 10. The values of user'post occupancy-evaluation for such as rockwall climbing and praying on the mountain of each site showed higher than those of anticipated, but evaluation values of other activities were lower. The user'behaviors of each site have been analyzed five factors by factor analysis algorithm. By using the control method for the number of factors, T.V. has been obtained as 50.58%. The factor score of factor covering the behavior patterns of student and youth yield high EV. and C.V.. On the analysis of cluster using factor score, factor IV in Hwaomsa temple site and Ssanggyesa temple site, factor II, v in Jungsanri Valley site, factor, I, III in Bangmudong valley site and factor I. IV in Baemsagol vallry site showed very high values, respectively. According to the multiple regression analysis, the major variables related to the satisfaction for the actual conditions of vegetation and landscape managements were reservation of groundcover, recovery of artificial injury, the surroundings of camping and temple site. In the park facilities and operation, the major variables related to the satisfaction were conditions of management such amenity facilities as privy, sign board, junk yard, camping site, and guidance of excursion, campaign and preservation of nature.

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Success Factors of the Supdari(A Wooden Bridge) Restoration in Jeonju-River through Citizens' Initiative (적극적 주민참여를 통한 전통문화시설 복원 성공요인 분석 - 전주천 섶다리 놓기 사업을 중심으로 -)

  • Kim, Sang-Wook;Kim, Gil-Joong
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.1
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    • pp.93-101
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    • 2010
  • This paper aims to analyze success factors for the construction of Supdari(a traditional wooden bridge to connect small streams temporarily), which is a citizens' initiative project to revitalize local community in Jeonju-River, Jeonju City. Recently Supdari has been restored for the use of belongings in local festivals. But Jeonju-River Supdari was designed and built to unite local citizens and connect river-divided villages. This project shows how investing social capital like Supdari makes the community vitalize through citizen's active participation. As a citizen leading project, there were several critical factors for sucess. At first, there were some noticeable ways to encourage local citizen's participation in online and offline. In the online, the Supdari internet cafe introduced what is a Supdari, how to make it and where we build using various media of UCCs and photos. In the offline, the small scaled model of Supdari was made and exhibited in the entrance of the village and related several seminars were hosted to discuss how to construct Supdari with citizens, local assembly men and public officials together. The Second is the movement to restore traditional and cultural resources for the community recovery triggered the supports from local councils and many civic groups. Civic groups supported ecological and structural expertise to guarantee environment friendly and stable construction. And local councils mediated citizen's and administrative office's opinions. The third is flexible administrative management to help citizen's ideas to be realized. Officials extended setting period of Supdari on the condition with the civic-control safety management.

Perspectives on the Composition Facilities of The Royal Garden at Wanggung-ri site, Iksan (익산 왕궁리유적 후원(後苑)의 조성 시설에 관한 고찰)

  • Choi, Moon-Jung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.32 no.3
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    • pp.1-9
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    • 2014
  • This article is the results of excavation data and it aims to interpret the composition facilities of the Royal garden at the Wanggung-ri site. The base of research was prepared through excavation and study on the royal garden at the Wanggung-ri site, which was constructed in Sa-bi period of Baek-je. The elements for the royal garden at the Wanggung-ri site were divided in 3 parts. - 1) Stonework facility 2) Installation for conveyance of water : Large moat-shaped ditch and Winding waterway(1~6 and water catchment) 3) Square cornerstone building. In this article, I arrange the basic data about facilities and function of the royal garden for making recovery of original form. First of all, I reason that stonework facilities were in charge to make space for catchment and boundary. Especially the Round angel rectangular stonework facility took charge of complex roles as catchment and water conveyance, and water can be transferred to the large moat-shaped ditch through joint between them. I confirmed that the round angel rectangular stonework facility and the large moat-shaped ditch which were connected by joint are one of the facilities in the royal garden. The large moat-shaped ditch protected the eastern, the northern walls and workshop site under the inclined plane to minimize the damage. Also, the large moat-shaped ditch took several roles, especially water catchments and landscaping. The large moat-shaped ditch was continually used from the period of Baek-je to the unified Silla, as a result it was completely deposited inside. After that, the 6 winding waterway were built in the western inclined plane with similar needs with the large moat-shaped ditch, and the square cornerstone building was built in same time. I noticed that the square cornerstone building was built as a part of the royal garden in Sa-bi period of Baek-je through the remains of Baek-je tiles around the building. After that, the square cornerstone building was built in same place as reconstruction.

Effect of Accelerated Rehabilitation with Anti-Gravity Treadmill Program : Isokinetic Myofuction and Functional Score of Knee Joint, ROM, and VAS Score in Meniscus Repair Patients (Anti-Gravity Treadmill Program을 적용한 가속재활의 효과 : 반월상연골 봉합술 환자의 슬관절 등속성 근기능 및 기능점수와 관절의 가동범위, 통증지수)

  • Cho, Han-Su;Oh, Du-Hwan;Lee, Jin-Wook;Zang, Seok-Am;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.46-54
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    • 2016
  • This study was conducted to investigate the effects of participation in the accelerated rehabilitation with an anti-gravity treadmill program for 16 weeks on isokinetic myofunction and functional score of knee joint, ROM, and VAS score in meniscus repair patients. A total of 10 male adult patients who underwent meniscus repair by the same doctor were investigated in this study. Both extension and flexion peak torque at $60^{\circ}/sec$ and $180^{\circ}/sec$ significantly increased (p<0.001, p<0.01), while under muscle deficit, extension and flexion peak torque at $60^{\circ}/sec$ and extension peak torque at $180^{\circ}/sec$ significantly decreased (p<0.01, p<0.05). ROM in extension significantly decreased (p<0.05), whereas ROM in flexion significantly increased (p<0.01) in response to the program. VAS score significantly decreased (p<0.001) and lysholm scores significantly increased after completion of the program (p<0.001). These results suggest that 16 weeks of the anti-gravity treadmill accelerated rehabilitation program improves isokinetic muscle strength and functional score of knee joint, ROM, and VAS score in meniscus repair patients. Therefore, the anti-gravity treadmill accelerated rehabilitation program, which is a more scientific and effective method than conventional rehabilitation, leads to faster recovery of paly ground and normal daily activities.