• Title/Summary/Keyword: Relief

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Clinical Analysis of Surgical Results for Discrete Subaortic Stenosis (분리 대동맥판막하 협착증 수술의 임상적 고찰)

  • Yu Song Hyeon;Lim Sang Hyun;Hong You Sun;Park Young Hwan;Chang Byung Chul;Kang Meyun Shick
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.545-550
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    • 2005
  • Background: Discrete subaortic stenosis is known to recur frequently even after surgical resection. We retrospectively reviewed the preoperative and postoperative changes in pressure gradient through left ventricular outflow tract, and the recurrence rate. Material and Method: Between September 1984 and December 2004, 34 patients underwent surgical treatment. Mean age of patients was $17.1\pm15.2$ years and 19 patients $(55.9\%)$ were male, 16 patients $(47.1\%)$ had previous operations and associated diseases were aortic regurgitation (11), coarctation of aorta (3), and others. Result: Immediate postoperative peak pressure gradient was significantly lower than preoperative peak pressure gradient (21.8 mmHg vs 75.8 mmHg, p<0.04). Peak pressure gradient measured after 50.3 months of follow up was 20.2 mmHg which was also significantly lower than that of preoperative value but not significantly different from that of immediate postoperative value. There was no surgical mortality but one patient developed cerebral infarction. Mean follow up duration was $69.8\pm54.6\;months$. During this period, 5 patients $(14.7\%)$ had reoperation, 3 $(8.8\%)$ of whom were due to recurred subaortic stenosis. We found no risk factors for recurrence and survival for free from reoperation was $76.4\%$. Conclusion: Excision of subaortic membrane combined with or without myectomy in discrete subaortic stenosis showed sufficient relief of left ventricular outflow tract obstruction with low mortality and morbidity, but careful long term follow up is necessary for recurrence, since it is not predictable.

The study of Intercostal Nerve Block and Patient-Controlled Analgesia for Post-Thoracotomy Pain (개흉술 후 동통억제에 대한 신경차단법 및 환자자가 치료법의 비교연구)

  • 김우종;이길노
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.920-926
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    • 1997
  • Remarkable effect of pain relief and prevention of the postoperative Complications after thoracotomy has been achieved by continuous intravenous analgesia. This study was carried out with thirty patients who underwent posterolateral thoraco tony. The patients were divided into three groups: Group I(n= 10), the patients with intermittent intramuscular analgesia(piroxicam 20 mg), Group II(n=10), the patients with continuous epidural analgesia(0.5% bupivacaine 30m1 + normal saline 30 ml + morphine 10 mg), and Group III(n= 10) the patients with controlled intravenous infusion of analgesics(fentanyl 2500 mfg +normal saline 10 ml). The results w re as follows; 1) There were no significant changes of vital signs, between groups. 2) Tidal volume and FVC were significantly improved in the group II and III compared with the group I during the first postoperative day. 3) A significant reduction of immediate post-thoracotomy pain was achieved in the group II and III compared with the group I. 4) The limitation of motion in the operative side was less in the group II and III compared with the group I. 5) A signi(icant reduction of the postoperative analgegics consumption was noticed in group II and III. 6) Significant complications were not occured during follow-up period in all groups.

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Closed Interlocking Intrmedullary Nailing of Metastatic Diaphyseal Fractures of the Humerus (상완골 간부 악성 병적골절의 비관혈적 고합성 골수강내 금속정 고정술)

  • Bahk, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.1-11
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    • 2003
  • Purpose: To analysis of the result of the treatment of metastatic diaphyseal fracture of the humerus with closed interlocking intrameduallry nailing. Materials and Methods: Among surgically treated 29 patients with pathologic or impending fracture of diaphysis of the humeurs, 13 patients (16 cases) treated with closed intramedullary interlocking nail were selected for the study. The final result of pain relief and functional recovery was evaluated by modified rating system of Perez et al. Results: Primary cancer was diagnosed after fracture was developed in 2 patients and pathologic or impending fracture was occurred average period of 28.9 months after primary cancer was diagnosed. The main primary malignancies were multiple myeloma, lung cancer and breast cancer. Mean survival after humeral metastasis was 11.7 months. The final result was superior to fair in 13 of 16 cases, and poor in 3 cases with progression of tumor spread or distant dissemination to the ipsilateral fingers. Except the latter 3 patients and other 3 patients, who died before 3 months postoperatively, bony union was achieved in 10 cases. There were no complications related to surgery. Conclusion: Closed interlocking intrameduallry nailing is accomplished with brief operative time, small amount of bleeding and provides immediate stability with resultant early return of function to the arm. Additionally it allows early postoperative irradiation. However, some of our cases shows that intramedullary nailing can accelerate tumor spread and metastases elsewhere, so that serious consideration must be given in planning this treatment. In conclusion, the functional status before fracture, life expectancy, type of tumor and extent of involvement should be carefully considered to decide operative treatment of metastatic disease.

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Percutaneous Radiofrequency Therapy of Benign Bone Tumors in the Femoral Head (대퇴골두 부위에 발생한 양성 골 종양에 대한 경피적 고주파치료 (증례보고))

  • Seo, Jai-Gon;Kim, Eung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.84-92
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    • 2003
  • Purpose: To report two cases of bone tumors other than osteoid osteoma in the proximal femur and treated with percutaneous high frequency radioablation method. Cases: We reviewed two cases with intracortical chondroma and enchondroma in the femoral head retrospectively. The patient with intracortical chondroma was a thirty one year old woman and had suffered right hip pain of 1 year duration. The lesion was located in the head of right femur and treated with CT guided percutaneous high frequency radioablation after needle biopsy under general anesthesia. The symptom was gone immediately after the procedure and was discharged postop. 1 day. 15 months has passed without symptom recurrence. Second case having enchondroma, was 56 year old woman complaining of gluteal area pain for 3 months. Radiologic evaluation showed osteolytic lesion with sclerotic rim on the inferior portion of the left femoral head. She received a same therapy with CT guided radiofrequency ablation following needle biopsy. She reported dramatic pain relief after the procedure and was discharged postop. 1 day. No symptom has occurred for 3 months until now. Conclusion: We present 2 cases of bone tumor occurred in the hip joint area other than osteoid osteoma which were treated with CT guided radiofrequency ablation.

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The Effects of Glenohumeral Abduction Motion and Intra-articular Movement after Passive Caudal Gliding Mobilization in Frozen Shoulder Patients (상완와관절의 수동하방활주운동이 오십견환자의 외전운동과 관절 내 움직임에 미치는 영향)

  • Seo Jong-Hak;Bae Sung-Soo;Kim Chul-Yong
    • The Journal of Korean Physical Therapy
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    • v.15 no.3
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    • pp.126-152
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    • 2003
  • The purpose of this study was to evaluate the value of passive caudal gliding mobilization of the glenohumeral joint on the range of motion (ROM) of active and passive abduction; to evaluate the value of pain relief through visual analogue scale (VAS); to evaluate the correlation between improvement of shoulder abduction and intra-articular movement measured by fluoroscopy in frozen shoulder patients. The subjects consisted of twenty-one patients with clinically diagnosed frozen shoulder (11 males, 10 females) between 40 and 63 years of age (mean age : 52.7 years). The traction and caudal gliding mobilization based on the convex-concave rule in the resting position and at end range of abduction was peformed for 15 minutes per day and was repeated 10 times during a 2 week period. The ROM of abduction was measured by goniometer and pain was measured by VAS. The intra-articular movement was measured by fluoroscope, Neurostar Plus TOP (Siemens, Germany). ROM measurements of each patient was acquired at pre-treatment, immediate post-treatment and 2 week post-treatment. Statistical analysis was performed using SPSS 10.0 for Windows software and data was analyzed using the paired-test and the pearson correlation. The results of this study are as follows: 1. There was a significant decrease of VAS between pre-treatment data and 2 week post-treatment data (P<.05) but no significant difference between pre-treatment and immediate post-treatment data (P>.05). 2. There was a significant increase in ROM of active and passive abduction in the pre-treatment data, immediate post-treatment data, and in 2 week post-treatment data (P<.05). 3. With regard to results of the joint play test, there was a significant difference in the grade of traction between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05). 4. With regard to results of the joint play test, there was a significant difference in the grade of caudal gliding between pre-treatment data and immediate post-treatment data and between pre-treatment data and 2 week post-treatment data (P<.05). There was no significant difference between immediate post-treatment data and 2 week post-treatment data (P>.05), 5. With regard to the results of fluoroscopic findings, there was a significant change of the glenohumeral joint space between pre-treatment data and immediate post-treatment data and between immediate post-treatment data and 2 week post-treatment data (P<.05). There was no significant change of the glenohumeral joint space between immediate post-treatment data and 2 week post-treatment data (P>.05). 6. With regard to the results of fluoroscopic findings, there was a significant change of acromiohumeral joint space between the three data (pre-treatment data, immediate post-treatment data, 2 week post-treatment data) (P<.05). 7. Mobility grade by joint play test was significantly increased and was correlated to improved ROM of active and passive abduction (P<.05). In this study of frozen shoulder, passive caudal gliding techniques of the glenohumeral joint results in statistically significant changes in active and passive abduction as well as in VAS. There is also a significant correlation between joint play test and ROM of abduction.

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A Study on Automated Lineament Extraction with Respect to Spatial Resolution of Digital Elevation Model (수치표고모형 공간해상도에 따른 선구조 자동 추출 연구)

  • Park, Seo-Woo;Kim, Geon-Il;Shin, Jin-Ho;Hong, Sang-Hoon
    • Korean Journal of Remote Sensing
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    • v.34 no.3
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    • pp.439-450
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    • 2018
  • The lineament is a linear or curved terrain element to discriminate adjacent geological structures in each other. It has been widely used for analysis of geology, mineral exploration, natural disasters, and earthquake, etc. In the past, the lineament has been extracted using cartographic map or field survey. However, it is possible to extract more efficiently the lineament for a very wide area thanks to development of remote sensing technique. Remotely sensed observation by aircraft, satellite, or digital elevation model (DEM) has been used for visual recognition for manual lineament extraction. Automatic approaches using computer science have been proposed to extract lineament more objectively. In this study, we evaluate the characteristics of lineament which is automatically extracted with respect to difference of spatial resolution of DEM. We utilized two types of DEM: one is Shuttle Radar Topography Mission (SRTM) with spatial resolution of about 90 m (3 arc sec), and the other is the latest world DEM of TerraSAR-X add-on for Global DEM with 12 m spatial resolution. In addition, a global DEM was resampled to produce a DEM with a spatial resolution of 30 m (1 arc sec). The shaded relief map was constructed considering various sun elevation and solar azimuth angle. In order to extract lineament automatically, we used the LINE module in PCI Geomatica software. We found that predominant direction of the extracted lineament is about $N15-25^{\circ}E$ (NNE), regardless of spatial resolution of DEM. However, more fine and detailed lineament were extracted using higher spatial resolution of DEM. The result shows that the lineament density is proportional to the spatial resolution of DEM. Thus, the DEM with appropriate spatial resolution should be selected according to the purpose of the study.

Two Dimensional Size Effect on the Compressive Strength of Composite Plates Considering Influence of an Anti-buckling Device (좌굴방지장치 영향을 고려한 복합재 적층판의 압축강도에 대한 이차원 크기 효과)

  • ;;C. Soutis
    • Composites Research
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    • v.15 no.4
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    • pp.23-31
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    • 2002
  • The two dimensional size effect of specimen gauge section ($length{\;}{\times}{\;}width$) was investigated on the compressive behavior of a T300/924 $\textrm{[}45/-45/0/90\textrm{]}_{3s}$, carbon fiber-epoxy laminate. A modified ICSTM compression test fixture was used together with an anti-buckling device to test 3mm thick specimens with a $30mm{\;}{\times}{\;}30mm,{\;}50mm{\;}{\times}{\;}50mm,{\;}70mm{\;}{\times}{\;}70mm{\;}and{\;}90mm{\;}{\times}{\;}90mm$ gauge length by width section. In all cases failure was sudden and occurred mainly within the gauge length. Post failure examination suggests that $0^{\circ}$ fiber microbuckling is the critical damage mechanism that causes final failure. This is the matrix dominated failure mode and its triggering depends very much on initial fiber waviness. It is suggested that manufacturing process and quality may play a significant role in determining the compressive strength. When the anti-buckling device was used on specimens, it was showed that the compressive strength with the device was slightly greater than that without the device due to surface friction between the specimen and the device by pretoque in bolts of the device. In the analysis result on influence of the anti-buckling device using the finite element method, it was found that the compressive strength with the anti-buckling device by loaded bolts was about 7% higher than actual compressive strength. Additionally, compressive tests on specimen with an open hole were performed. The local stress concentration arising from the hole dominates the strength of the laminate rather than the stresses in the bulk of the material. It is observed that the remote failure stress decreases with increasing hole size and specimen width but is generally well above the value one might predict from the elastic stress concentration factor. This suggests that the material is not ideally brittle and some stress relief occurs around the hole. X-ray radiography reveals that damage in the form of fiber microbuckling and delamination initiates at the edge of the hole at approximately 80% of the failure load and extends stably under increasing load before becoming unstable at a critical length of 2-3mm (depends on specimen geometry). This damage growth and failure are analysed by a linear cohesive zone model. Using the independently measured laminate parameters of unnotched compressive strength and in-plane fracture toughness the model predicts successfully the notched strength as a function of hole size and width.

백악기 미국 걸프만 퇴적층의 지구조적, 퇴적학적, 석유지질학적 고찰 (A Review of Tectonic, Sedinlentologic Framework and Petroleum Geology of the Cretaceous U. S. enlf Coast Sedimentary Sequence)

  • Cheong Dae-Kyo
    • The Korean Journal of Petroleum Geology
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    • v.4 no.1_2 s.5
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    • pp.27-39
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    • 1996
  • In the Cretaceous, the Gulf Coast Basin evolved as a marginal sag basin. Thick clastic and carbonate sequences cover the disturbed and diapirically deformed salt layer. In the Cretaceous the salinities of the Gulf Coast Basin probably matched the Holocene Persian Gulf, as is evidenced by the widespread development of supratidal anhydrite. The major Lower Cretaceous reservoir formations are the Cotton Valley, Hosston, Travis Peak siliciclastics, and Sligo, Trinity (Pine Island, Pearsall, Glen Rose), Edwards, Georgetown/Buda carbonates. Source rocks are down-dip offshore marine shales and marls, and seals are either up-dip shales, dense limestones, or evaporites. During this period, the entire Gulf Basin was a shallow sea which to the end of Cretaceous had been rimmed to the southwest by shallow marine carbonates while fine-grained terrigengus clastics were deposited on the northern and western margins of the basin. The main Upper Cretaceous reservoir groups of the Gulf Coast, which were deposited in the period of a major sea level .rise with the resulting deep water conditions, are Woodbinefruscaloosa sands, Austin chalk and carbonates, Taylor and Navarro sandstones. Source rocks are down-dip offshore shales and seals are up-dip shales. Major trap types of the Lower and Upper Cretaceous include salt-related anticlines from low relief pillows to complex salt diapirs. Growth fault structures with rollover anticlines on downthrown fault blocks are significant Gulf Coast traps. Permeability barriers, up-dip pinch-out sand bodies, and unconformity truncations also play a key role in oil exploration from the Cretaceous Gulf Coast reservoirs. The sedimentary sequences of the major Cretaceous reseuoir rocks are a good match to the regressional phases on the global sea level cuwe, suggesting that the Cretaceous Gulf Coast sedimentary stratigraphy relatively well reflects a response to eustatic sea level change throughout its history. Thus, of the three main factors controlling sedimentation (tectonic subsidence, sediment input, and eustatic sea level change) in the Gulf Coast Basin, sea-level ranks first in the period.

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A Study on the Actual Conditions of Smoking in Middle and High School Students in One Region (일 지역 중·고등학생의 흡연실태)

  • Kim, Hyeon-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.149-167
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    • 1999
  • To investigate the actual conditions of smoking in middle and high school students in Chinan County, I used a sturctured questionnaire for 1,579 students attending twelve middle-high schools from December 1, 1998 to December 20, 1998. I collected and data correlated the using an $SPSS-PC^+$ 1. The smoking rate of middle-high schoo1 students in Chinan County was 17.9%, relatively high. This smoking rate was different according to the gender, grade, religion, and economic situation. In mals, high school students, non-religious, students low income family students, the smoking rate was higher. The smoking rate of high school students was almost the same as the smoking rate of adults, generally higher than that of foreign teenagers. Because the smoking rat of studinets in the third grade of middle school and in the first grade of high School was six times higher, increased education should be conducted during this time in an attempt to curb the sudden increase of the smoking rate. The smoking rate of girl students was 5.0%; this has increased mor than three times from ten years ago. Consequently, counter measures should be taken against the smoking of female students as well as juvenile smoking in general. In addition, the smoking rate of middle-high school students showed interesting differences when correnated with enviornmental factors. Students with low grades, who are not satisfied with school life, who don't have both parents, who have uncaring parents who nare too strict or too arbitary, who have smoking parents, or who have experienced smoking commonly smoked. Therefore, to lower the smoking rate we should improve the school environment, improve a student's interest in school life. And parents or siblings should lead by example and quit smoking at home. Schools should educate students more effectively concerning the harmful effects of smoking and create an accurate understanding of its dancers. From the beginning, we should teach students never ever to touch cigaretts. 2. The surve discovered that most students started out of curiosity, or solicitantion from friends or elders at middle school, and had been smoking one to five cigarettes for more than a year. They obtained cigarettes at stores and most of them have friends who smoke. As a result anti-smoking education should be conducted at elementary schools prior to middle school. More than 95% of the teenagers who smoke had friends who smote and smoked out of curiosity or the recommendation of elders. Thus, we must focus on teenagers who smoke in group, rather than individually. Fuyrthermore, the strict application of the regulation of tobacco sales as well as tobacco cooperation from retailers are needed. While students did not show any mood or academic achievement difference after beginning smoking, 58.1% of the students a health situdation that was worse. Juvenile smoking is more harmful to the juvenile than adult smoking is to the adult. This should be focused on in an anti-smoking campaign. 3. Students who smoke hada more positive attitude toward smoking than students who don't smoke. Students who smoke had a tendency to have a nuetral position and are not concerned about smoking compared to non-smoking students. The survey showed that the great number of students had a nuetral position. Because this nuetrality may increase Juvenile smoking, education that provides an exact understanding of smoking should be performed to build the correct attidude toward smoking. 4. Middle school students smoke when angry, gloomy, anxious, a lone and when they have some problems to solve, on when they feel inconveniened in other wores, they smoke to reliver stress. They also smok due to addiction. Because smoking is not a praetical method to relieve stress, a program which helps to acquire positive relief stress should be provided to help reduce smoking. 5. About 65% of students who smoke want to quit smoking because of health problem, 78% of them have tried mor than once to quit but failed due to weak will power and peer pressure from friends who smoke. Juvenile smoking is group, oriented. Thus, the program that advances less smoking will be the one that focuseds on groups. 6. As for advice to students who want to quit smoking, "persuasion" was used most commonly, followed by a "presentation on how to quit smoking". Another method were severe punishment. About 70% of the students wanted the anti-smoking guide at school. 7. Most students (73.5%) had a position that more anti-smoking education at school is needed. Obriously, then, anti-smoking education at middle-high schools should be reinfoced. Although the education which explains the harmful influence of tobacco is known as an efficient way prevent smoking; it does not influence students who already smoke. Therefore, for students who smoke, multi-dimensional approaches must be attempted that include physical training, phychokogical approache, consultation and discussion, medical chek-ups, audio-visual education technigues, and professonal instructors, in addition, because smoking students have more negative on lukewarm attitude to anti-smoking education anti-smoking education should be conducted through a communicative style by dedicated teachers who care about students. In order to increase the effectiveness of this program.

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Accelerated Fractionation In The Treatment of Brain Metastasis From Non-Small Cell Carcinoma of The Lung (비소세포성 폐암환자의 뇌전이에 대한 급속분할조사법)

  • Hong, Seong-Eon
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.165-173
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    • 1994
  • Purpose : Metastatic cancer to the brain is a major problem for the patients with bronchogenic carcinoma, and most of these patients have a limited survival expectancy. To increase tumor control and / or to decrease late morbidity with possible shortening in over-all treatment period, multiple daily fraction technique for brain metastasis was performed. The author reperesented the results of accelerated fractionation radiotherapy in patients with brain metastases from non-small cell lung cancer. Materals and Methods : Twenty-six patients with brain metastases from non-small cell lung cancer between 1991 and 1993 received brain radiotherapy with a total dose of 48 Gy, at 2 Gy per fraction, twice a day with a interfractional period of 6 hours, and delivered 5 days a week. The whole brain was treated to 40 Gy and boost dose escalated to 8 Gy for single metastatic lesion by reduced field. Twenty-four of the 26 patients completed the radiotherapy. Radiotherapy was interupted in two patients suggesting progressive intracerebral diseases. Results : This radiotherapy regimen appears to be comparable to the conventional scheme in relief from symptoms. Three of the 24 patients experienced nausea and or vomiting during the course of treatment because of acute irradiation toxicity. The author observed no excessive toxicity with escalating dose of irradiation. An increment in median survival, although not statistically significant(p>0.05), was noted with escalating doses(48 Gy) of accelerated fractionation(7 months) compared to conventional treatment(4.5 months). Median survival also increased in patients with brain solitary metastasis(9 months) compared to multiple extrathoracic sites(4 months), and in patients with good performance status(9 months versus 3.5 months), they were statistically significant (p<0.01). Conclusion : The increment in survival in patients with good prognostic factors such as controlled primary lesion, metastasis in brain only and good perfomance status appeared encouraging. Based on these results, a multi-institutional prospective randomized trial should be initiated to compare the twice-a-day and once-a-day radiotherapy schemes on patients with brain metastasis with careful consideration for the patients' quality of life.

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