• Title/Summary/Keyword: Segmental Group

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Ipsilesional Movement Deficit of Proximal & Distal Upper Extremity in Patients With Unilateral Brain Damage (편측 뇌손상 환자에서 동측 상지의 근위부 및 원위부의 운동 결함에 관한 분석)

  • Kwon, Yong-Hyun;Choi, Jin-Ho;Shin, Hwa-Kyung;Bai, Dai-Seg
    • Physical Therapy Korea
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    • v.12 no.1
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    • pp.71-79
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    • 2005
  • The purpose of this study was to analyze the presence of ipsilesional movement deficit, with segmental performance in each proximal or distal upper extremity. The visuoperceptual complex task of the ipsilesional upper extremity was investigated in patients with unilateral brain damage and a control group of healthy sex-age-matched controls. Tracking movements were tested in the proximal and distal upper extremities. Movements were measured by the accuracy index, which was normalized to each subject's own range of motion and took into account any differences between subjects in the excursion of the tracking target. The findings revealed that stroke patients experienced difficulties with tracking movement of both proximal and distal segments in the upper extremities on the so-called "non-affected side", irrespectively of the extent of patient's age, time since onset, or severity of contralateral upper extremity. Therefore, the unilateral brain damage affected ipsilateral motor function of the proximal and distal upper limbs in the performance of complex motor tasks, requiring central processing and the higher order cognitive function in the integrity of both hemispheres.

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Cryoanalgesia for the Post-thoracotomy Pain (늑간 신경 냉동요법에 의한 개흉술후 흉부 동통 관리)

  • Kim, Uk-Jin;Choe, Yeong-Ho;Kim, Hyeong-Muk
    • Journal of Chest Surgery
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    • v.24 no.1
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    • pp.54-63
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    • 1991
  • Post-thoracotomy pain is so severe that lead to postoperative complications, such as sputum retention, segmental or lobar atelectasis, pneumonia, hypoxia, respiratory failure due to the patient`s inability to cough, deep breathing and movement. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1974, Nelson and associates introduced the intercostal nerve block using the cryoprobe. The application of cold directly to the nerves causes localized destruction of the axons while preserving the endoneurium and connective tissue, thereby introducing a temporary pain block and able to complete regeneration of intercostal nerves. One hundred and two patients, who undergoing axillary or posterolateral thoracotomy at the Department of Thoracic and Cardiovascular Surgery in Korea University Medical Center between April 1990 and August 1990, were evaluated the effects of cryoanalgesia for the post-thoracotomy pain reduction. The patients were divided into two groups: Group A, control, the patients without the cryoanalgesia[No.=50], Group B, trial, the patients with cryoanalgesia[No.=52]. Before the thorax closed, in the group A, local anesthetics, 2% lidocaine 3cc, were injected to the intercostal nerves[one level with the thoracotomy, one cranial and caudal intercostal level and level of drainage tube insertion]. In the group B, cryoprobe was directly applied for 1 minute at the same level. Postoperative analgesic effects were evaluated by the scoring system which made arbitrary by author: The pain score 0 to 4, The limitation of motion score 0 to 3, The analgesics consumption score 0 to 3, The total score, the sum of above score, 0 to 10. For the evaluation of immediate analgesic effects, the score were evaluated at the operative day, the first postoperative day, the second postoperative day, and the seventh postoperative day. The effects of incision type, and rib cut to the post-thoracotomy pain were also evaluated. The results were as follows; 1. The intercostal block with cryoanalgesia reduced the immediate postoperative pain significantly compare with control group. 2. The intercostal block with cryoanalgesia improved the motion of the operation side significantly compare with control group. 3. The intercostal block with cryoanalgesia reduced the analgesics requirements at the immediate postoperative periods significantly. 4. The intercostal block with cryoanalgesia lowered the total score significantly compare with control group. 5. The intercostal block with cryoanalgesia were more effective to the mid-axillary incision than to the posterolateral incision 6. The intercostal block with cryoanalgesia were more effective to the patients without rib cut than to the patients with rib cut. 7. No specific complication need to be treated were not occurred during follow-up.

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Change in the Alignment and Distal Junctional Kyphosis Development after Posterior Cervical Spinal Fusion Surgery for Cervical Spondylotic Myelopathy - Risk Factor Analysis

  • Lee, Jung Jae;Park, Jin Hoon;Oh, Young Gyu;Shin, Hong Kyung;Park, Byong Gon
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.549-557
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    • 2022
  • Objective : This study analyzed the risk factors in patients who developed distal junctional kyphosis (DJK) after posterior cervical fusion. Methods : We retrospectively analyzed the clinical and radiographic outcomes of 64 patients, aged ≥18 years (51 and 13 male and female patients, respectively), who underwent single-staged multilevel (3-6 levels) posterior cervical fusion surgery due to multiple cervical spondylotic myelopathy. The surgeries were performed by a single spinal surgeon between January 2012 and December 2017. Demographic data, clinical outcomes, and radiological results were collected. We divided the patients into a DJK group and a non-DJK group according to the presence of DJK and investigated the risk factors by comparing the differences between the two groups. Results : Of the 64 patients, 13 developed DJK. No significant differences in clinical results were observed between the two groups before and immediately after the surgery. At the final follow-up, a higher visual analog score for neck pain was observed in the DJK group compared to the non-DJK group (p<0.01). The DJK group had a significantly lower T1 slope and a significantly higher C2-7 sagittal vertical axis (SVA) before surgery compared to the non-DJK group (p=0.03 and p<0.01, respectively). Immediately after surgery, the difference between the two groups decreased and no significant difference was observed. However, at the last follow-up, a significantly higher C2-7 SVA was observed in the DJK group (p<0.01). At the last follow up, there is no discrepancy in T1S-CL. In multiple logistic regression analysis, preoperative higher C2-7 SVA and preoperative lower T1 slope were identified as independent risk factors (p=0.03 and p<0.01, respectively). As a result, it was confirmed that DJK occurred along the process of returning to preoperative values. Conclusion : DJK can be considered to be caused by cervical misalignment due to excessive change in the surgical site in patients with low T1 slope and high C2-7 SVA before surgery. This also affects the clinical outcome after surgery. It is recommended to refrain from excessive segmental lordosis changes during multilevel cervical post fusion surgery, especially in patients with a small preoperative T1 slope and a large SVA value.

Effect of Different Types of Dietary Fat on Renal Functions in Aged Rats (식이 지방의 종류가 흰쥐의 노화 과정 중 신장 기능에 미치는 영향)

  • 김화영
    • Journal of Nutrition and Health
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    • v.31 no.3
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    • pp.253-262
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    • 1998
  • This study was performed to investigated the effect of dietary fat sources on renal senescence in aged rats. Seventeen month old male Sprague-Dawley rats were divided into 3 groups according to urinary protein excretion. Four month old rats were used as a control group. The rats were fed one of three different experimental diets ; 20% beef tallow, 20% corn oil 20% fish oil diet. They were fed experimental diets ad libitum for 16 weeks . The results are summarized as follows. Serum lipid concentrations were higher in aged rats than in control rats, with the beef tallow group showing the highest level, followed by the corn oil and fish oil groups. Old rats showed higher HDL and lower LDL levels than the control groups. Age and dietary fat had no effect on VLDL. GFR for the both age groups were increased with experimental period with the beef tallow group showing the highest value. Urinary protein excretion was also increased with experimental period in both age groups. There was a large increase in urinary protein in old rats that were fed beef tallow and corn oil, but not in old rats fed fish oil. On the contrary , the effect of dietary fat on urinary protein was not found in control groups. There was individual susceptibility in the effect of dietary fat on urinary protein. Old rats fed beef tallow with high initial urinary protein showed highest increase, but , the change was not significant in rats with a low initial value . It was also found that the increase was kept low in rats of the fish oil group with high initial urinary protein. The corn oil group showed in between values. There were no differences in urine and renal tissue concentrations of TXB2 . Aged rats showed a tendency of having higher urinary PGE2 excretion and lower renal cortex content. Since higher PGE2 excretion was reported to be associated with decreased renal function, this might suggest that the aged rats show renal function reduction. Light microscopic examination showed that glomerular segmental sclerosis, mesangial matrix expansion and tubular atrophy were more frequently present in aged rats, and that these changes were more significant in the beef tallow group, followed by corn oil and fish oil groups. The percentage of urinary protein excretion was increased in aged rats in association with increased glomerular sclerosis and mesangial matrix . This change could be partly due to a change in eicosanoids metabolism . Therefore, modification of dietary fat could affect the eicosanoids metabolism in kidney and renal senescence.

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Can the Zero-Profile Implant Be Used for Anterior Cervical Discectomy and Fusion in Traumatic Subaxial Disc Injury? A Preliminary, Retrospective Study

  • Kim, Tae Hun;Kim, Dae Hyun;Kim, Ki Hong;Kwak, Young Seok;Kwak, Sang Gyu;Choi, Man Kyu
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.574-581
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    • 2018
  • Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

A Single-Center Experience of Robotic-Assisted Spine Surgery in Korea : Analysis of Screw Accuracy, Potential Risk Factor of Screw Malposition and Learning Curve

  • Bu Kwang Oh;Dong Wuk Son;Jun Seok Lee;Su Hun Lee;Young Ha Kim;Soon Ki Sung;Sang Weon Lee;Geun Sung Song;Seong Yi
    • Journal of Korean Neurosurgical Society
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    • v.67 no.1
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    • pp.60-72
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    • 2024
  • Objective : Recently, robotic-assisted spine surgery (RASS) has been considered a minimally invasive and relatively accurate method. In total, 495 robotic-assisted pedicle screw fixation (RAPSF) procedures were attempted on 100 patients during a 14-month period. The current study aimed to analyze the accuracy, potential risk factors, and learning curve of RAPSF. Methods : This retrospective study evaluated the position of RAPSF using the Gertzbein and Robbins scale (GRS). The accuracy was analyzed using the ratio of the clinically acceptable group (GRS grades A and B), the dissatisfying group (GRS grades C, D, and E), and the Surgical Evaluation Assistant program. The RAPSF was divided into the no-breached group (GRS grade A) and breached group (GRS grades B, C, D, and E), and the potential risk factors of RAPSF were evaluated. The learning curve was analyzed by changes in robot-used time per screw and the occurrence tendency of breached and failed screws according to case accumulation. Results : The clinically acceptable group in RAPSF was 98.12%. In the analysis using the Surgical Evaluation Assistant program, the tip offset was 2.37±1.89 mm, the tail offset was 3.09±1.90 mm, and the angular offset was 3.72°±2.72°. In the analysis of potential risk factors, the difference in screw fixation level (p=0.009) and segmental distance between the tracker and the instrumented level (p=0.001) between the no-breached and breached group were statistically significant, but not for the other factors. The mean difference between the no-breach and breach groups was statistically significant in terms of pedicle width (p<0.001) and tail offset (p=0.042). In the learning curve analysis, the occurrence of breached and failed screws and the robot-used time per screw screws showed a significant decreasing trend. Conclusion : In the current study, RAPSF was highly accurate and the specific potential risk factors were not identified. However, pedicle width was presumed to be related to breached screw. Meanwhile, the robot-used time per screw and the incidence of breached and failed screws decreased with the learning curve.

A Study of Color Combination based on Fashion Image of Domestic Women's Apparel (국내 여성복 패선 이미지에 따른 배색 연구)

  • Cho Ju-Yeon;Kim Young-In
    • Journal of the Korean Society of Costume
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    • v.56 no.4 s.103
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    • pp.160-170
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    • 2006
  • The purpose of this study is to analyze the image of color combination in fashion design. For this study 14,121 color samples were collected from 116 fashion brands selected by the market segmentation based on the results of the previous studies. The brands have high market share and brand recognition in each segmental market. The color samples were measured by spectrophotometer and analyzed by the Munsell's H V/C and CIE $L^*a^*b^*$ value. The representative colors of each market were selected concerning the tensity in CIE $L^*a^*b^*$ color space and the distance between the color samples. h4 a result, 2,213 representative colors were chosen. These color samples composed top and bottom color combination samples by the program 'Item Comparator' that calculated the color differences$({\Delta}E^*)$. Top includes the items such as blouse, shirt, and coats, bottom includes the items such as skirt and pants. The color combination samples were divided into two groups. In one group ${\Delta}E^*$ was less than 30, and In the other group ${\Delta}E^*$ was 30 or more. For investigating the image of color combination, 480 rotor combination samples were classified. The image adjectives for the survey from preceding studies and brand dictionaries were 'classic', 'modern', 'feminine', 'casual', and 'romantic', which have highly preferred in women's wear brands. The result of the study is as follows; For 'classic' 'image, YR, and greyish tone were generally preferred. In the color combination of 'casual' image, the samples with PB color and greyish tone were preferred. For 'feminine' image, RP was preferred as a top color, R, RP, P were preferred as a bottom color. For 'casual' image, PB was preferred as a top color, PB, B were preferred as a bottom color. For 'romantic' image, RP was preferred as a top color, R, P were preferred as a bottom color. The bigger the color differences between the color combination samples were, the more remarkable the image of color combination samples was.

A Study on Body Composition and IADL of the Elderly according to the Sex (성별에 따른 노인의 신체조성과 IADL에 관한 연구)

  • Um, Ki-Mai;Yang, Yoon-Kwon
    • Journal of Korean Physical Therapy Science
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    • v.7 no.1
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    • pp.321-331
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    • 2000
  • The purpose of this study was to investigate the difference of body composition and IADL of between male elder and female elder. (This study consisted of elder male(n=10) and elder female(n=10),) The mean age of elder male and female was 67.20, 67.50 years. The data were analyzed with t-test, using SPSS PC+ program. Body composition was measured using Inbody 2.0(seoul, korea) of segmental multi-frequency impedance analyzer technique. IADL was measured with Philadelphia Geriatric Center IADL. The result of this study were the following: 1. The difference of Body composition 1) The %fat of elder female was significantly(p<0.05) higher than elder male by 11.48%. 2) The fat mass(kg) of elder female was significantly(p<0.05) higher than elder male by 6.28kg. 3) The free fat mass(kg) of elder male was significantly(p<0.05) higher than elder female by 9.03kg. 4) The muscle mass(kg) of elder male was significantly(p<0.05) higher than elder female by 8.63kg. 5) The WHR(%) elder female was no significantly higher than elder male by 0.03%. 6) The TBW(l) of elder male was significantly(p<0.05) higher than elder female by 6.321. The factor of significant difference of between elder male and female was %fat, fat mass(kg), free fat mass(kg), total body water(l). 2. The difference of IADL 1) IADL of elder male was no significantly higher than elder female by 1.20. As a result of this study, optimal body composition group was elder male group. Optimal body composition of elder had improved IADL. In addition to, this result of this study, it can suggested the consideration of the Health promotion program for elder.

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New Bone Formation in Experimental Model of Vascularized Periosteal Flap for the Bone Defect in the Shaft of the Radius of Rabbit - Radiological, Histological and Immunohistochemical Study - (가토 요골 간부 골 결손시에 혈관 부착 골막 보존 유무에 따른 신생골 형성에 대한 실험적 연구)

  • Chung, Duke-Whan;Yum, Jae-Kwang;Tae, Suk-Kee;Ko, Kwang-Won
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.97-107
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    • 1999
  • The osteogenic capacity of the vascularized periosteum autograft has been extensively demonstrated by experimental works. The objective of this study was to characterize the behavior of experimental model of vascularized periosteal flap(VPF) by observing sequential stages of osteogenesis after simulated VPF in rabbits. In experimental group, segmental resection of bone including the periosteum was performed in 22 radii of 22 New Zealand white rabbits preserving the periosteal circulation of median artery to the periosteum. In order to simulate the transplantation of VPF, the vascular pedicle consisting of median artery and veins was dissected from adjacent soft tissue and the periosteum was longitudinally incised to remove the bone followed by repair of the periosteum. From the first to sixteenth week after the simulated VPF, the changes in VPFs were observed by radiological, light microscopical, scanning electron microscopical methods and the activity of osteocalcin was measured by immunohistochemical method. In control group, the bone tissue and periosteum were completely removed from the mid-shaft of radius and the findings were observed by radiological and light microscopical methods. From the results of this study, it is demonstrated that the experimental model of VPF is vigorously and uniformly osteogenic. Therefore it is thought that VPF can be used as a measure to treat bone defect of shaft of long bone.

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Early Vertebroplasty versus Delayed Vertebroplasty for Acute Osteoporotic Compression Fracture : Are the Results of the Two Surgical Strategies the Same?

  • Son, Seong;Lee, Sang-Gu;Kim, Woo-Kyung;Park, Chan-Woo;Yoo, Chan-Jong
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.211-217
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    • 2014
  • Objective : In Korea, early vertebroplasty (EVP) or delayed vertebroplasty (DVP, which is performed at least 2 weeks after diagnosis) were performed for the treatment of acute osteoporotic compression fracture (OCF) of the spine. The present study compared the outcomes of two surgical strategies for the treatment of single-level acute OCF in the thoracolumbar junction (T12-L2). Methods : From 2004 to 2010, 23 patients were allocated to the EVP group (EVPG) and 27 patients to the DVP group (DVPG). Overall mean age was $68.3{\pm}7.9$ and minimum follow-up period was 1.0 year. Retrospective study of clinical and radiological results was conducted. Results : No significant differences in baseline characteristics were observed between the two groups. As expected, mean duration from onset to vertebroplasty and mean duration of hospital stay were significantly longer in the DVPG ($17.1{\pm}2.1$ and $17.5{\pm}4.2$) than in the EVPG ($3.8{\pm}3.3$ and $10.8{\pm}5.1$, p=0.001). Final clinical outcome including visual analogue scale (VAS), Oswestry Disability Index, and Odom's criteria did not differ between the two groups. However, immediate improvement of the VAS after vertebroplasty was greater in the EVPG ($5.1{\pm}1.3$) than in the DVPG ($4.0{\pm}1.0$, p=0.002). The proportion of cement leakage was lower in the EVPG (30.4%) than in the DVPG (59.3%, p=0.039). In addition, semiquantitative grade of cement interdigitation was significantly more favorable in the EVPG than in the DVPG (p=0.003). Final vertebral body collapse and segmental kyphosis did not differ significantly between the two groups. Conclusion : Our findings suggest that EVP achieves a better immediate surgical effect with more favorable cost-effectiveness.