Background: Conventional spinal saddle block is performed with the patient in a sitting position, keeping the patient sitting for between 3 to 10 min after injection of a drug. This amount of time, however, is long enough to cause prolonged postoperative urinary retention. The trend in this block is to lower the dose of local anesthetics, providing a selective segmental block; however, an optimal dose and method are needed for adequate anesthesia in variable situations. Therefore, in this study, we evaluated the question of whether only 1 min of sitting after drug injection would be sufficient and safe for minor anorectal surgery. Methods: Two hundred and sixteen patients undergoing minor anorectal surgery under spinal anesthesia remained sitting for 1 min after completion of subarachnoid administration of 1 ml of a 0.5% hyperbaric bupivacaine solution (5 mg). They were then placed in the jack-knife position. After surgery, analgesia levels were assessed using loss of cold sensation in the supine position. The next day, urination and 11-point numeric rating scale (NRS) for postoperative pain were assessed. Results: None of the patients required additional analgesics during surgical manipulation. Postoperative sensory levels were T10 [T8-T12] in patients, and no significant differences were observed between sex (P = 0.857), height (P = 0.065), obesity (P = 0.873), or age (P = 0.138). Urinary retention developed in only 7 patients (3.2%). In this group, NRS was $5.0{\pm}2.4$ (P = 0.014). Conclusions: The one-minute sitting position for spinal saddle block before the jack-knife position is a safe method for use with minor anorectal surgery and can reduce development of postoperative urinary retention.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.26
no.3
/
pp.238-244
/
2000
The present study was aimed to investigate the effect of osseointegration according to implant placement timing in the distracted alveolar bone using intraoral distraction device. Six adult mongrel dogs of either sex, weighing about 15kg, were used. The animals were divided into 4-week and 8-week groups according to the timing of implant installation. The left upper and lower premolars and first molars were extracted and an alveoloplasty was performed to simulate an atrophic ridge. After 12 weeks of healing, a segmental osteotomy was made and an intraoral distraction device which was designed for augmentation of vertical height of the edentulous ridge was applied. Latency period was allowed for 5 days and then distraction was made at a rate of 1.2mm/day for 8 days. Four or eight weeks after distraction, implants were installed. Twelve weeks after implant installation, the animals were sacrificed. Macroscopic, radiographic, and histologic examinations of distracted alveolar ridge were performed. No significant abnormalities such as infection and dehiscence of overlying soft tissue were observed. Radiographically, there was slight bone resorption around the medial and distal edges of the alveolar bone segment, and a new bone deposition was observed in the neighboring alveolar crest area in the both groups. The satisfactory osseointegration was achieved in the distracted gap of the both groups, but fibrous tissue appeared on the buccal side of implant in the distracted gap in 4-week group. These results suggest that proper timing of implant installation is 8 weeks rather than 4 weeks after distraction when dental implant is to be placed onto the distracted bone.
Cho, Kyeongwon;Nam, Kyoung Won;Han, Jonghee;Lee, Sangmin;Kim, Dongwook;Hong, Sung Hwa;Jang, Dong Pyo;Kim, In Young
Journal of Biomedical Engineering Research
/
v.34
no.1
/
pp.24-33
/
2013
To enhance the speech perception of hearing aid users in noisy environment, most hearing aid devices adopt various beamforming algorithms such as the first-order differential microphone (DM1) and the two-stage directional microphone (DM2) algorithms that maintain sounds from the direction of the interlocutor and reduce the ambient sounds from the other directions. However, these conventional algorithms represent poor directionality ability in low frequency area. Therefore, to enhance the speech perception of hearing aid uses in low frequency range, our group had suggested a fractional delay subtraction and integration (FDSI) algorithm and estimated its theoretical performance using computer simulation in previous article. In this study, we performed a KEMAR test in non-reverberant room that compares the performance of DM1, DM2, broadband beamforming (BBF), and proposed FDSI algorithms using several objective indices such as a signal-to-noise ratio (SNR) improvement, a segmental SNR (seg-SNR) improvement, a perceptual evaluation of speech quality (PESQ), and an Itakura-Saito measure (IS). Experimental results showed that the performance of the FDSI algorithm was -3.26-7.16 dB in SNR improvement, -1.94-5.41 dB in segSNR improvement, 1.49-2.79 in PESQ, and 0.79-3.59 in IS, which demonstrated that the FDSI algorithm showed the highest improvement of SNR and segSNR, and the lowest IS. We believe that the proposed FDSI algorithm has a potential as a beamformer for digital hearing aid devices.
Objective : Although minimally invasive posterior cervical foraminotomy (MI-PCF) is an established approach for motion preservation, the outcomes are variable among patients. The objective of this study was to identify significant factors that influence motion preservation after MI-PCF. Methods : Forty-eight patients who had undergone MI-PCF between 2004 and 2012 on a total of 70 levels were studied. Cervical parameters measured using plain radiography included C2-7 plumb line, C2-7 Cobb angle, T1 slope, thoracic outlet angle, neck tilt, and disc height before and 24 months after surgery. The ratios of the remaining facet joints after MI-PCF were calculated postoperatively using computed tomography. Changes in the distance between interspinous processes (DISP) and the segmental angle (SA) before and after surgery were also measured. We determined successful motion preservation with changes in DISP of ${\leq}3mm$ and in SA of ${\leq}2^{\circ}$. Results : The differences in preoperative and postoperative DISP and SA after MI-PCF were $0.03{\pm}3.95mm$ and $0.34{\pm}4.46^{\circ}$, respectively, fulfilling the criteria for successful motion preservation. However, the appropriate level of motion preservation is achieved in cases in which changes in preoperative and postoperative DISP and SA motions are 55.7 and 57.1%, respectively. Based on preoperative and postoperative DISP, patients were divided into three groups, and the characteristics of each group were compared. Among these, the only statistically significant factor in motion preservation was preoperative disc height (Pearson's correlation coefficient=0.658, p<0.001). The optimal disc height for motion preservation in regard to DISP ranges from 4.18 to 7.08 mm. Conclusion : MI-PCF is a widely accepted approach for motion preservation, although desirable radiographic outcomes were only achieved in approximately half of the patients who had undergone the procedure. Since disc height appears to be a significant factor in motion preservation, surgeons should consider disc height before performing MI-PCF.
Transition metal PSSA ionomers containing Co(II), Ni(II), Cr(III), Ru(III), and Rh(III) are investigated by IR, Far-IR, UV-Vis and DSC. Reliable IR Spectroscopic criteria are established for assessing the degree of ion-exchange of PSSA ionomers and the local structures around metal cations in them. In the hydrated transition metal PSSA ionomers, the ionic groups are solvated by water molecules and there is no significant interactions between sulfonate group and metal cations. The visible spectra indicated that metal cations are present as [M$(H_2O)_6$]$^{n+}$ with Oh symmetry. Their $T_g$ values increase as the extent of ionic site concentration increases, but there is no direct dependence of $T_g$ on the nature of metal cations or their oxidation states. Thus, the water content in PSSA ionomer is found to have dominant influence on $T_g$ of hydrated transition metal PSSA ionomers. Dehydration of the hydrated transition metal PSSA ionomers results in direct interaction between ionic groups and significant color changes of the ionomers due to the changes of the local structures around metal cations. On the base of spectral data, their local structures are discussed. In case of dehydrated 12.8 and 15.8 mol % transition metal PSSA ionomers, no glass transition is observed in 25-$250^{\circ}C$ region and this is believed to arise from the formation of highly crosslinked structures caused by direct coordination of sulfonate groups of metal cations. In the 6.9 mol % transition metal PSSA ionomers, the glass transition is always observed whether they are hydrated or dehydrated and this is though to be caused by the sufficient segmental mobility of the polymer backbone.
Objective : In the cervical spine, many surgical procedures have been developed to achieve optimal results for various disorders, including degenerative diseases, traumatic injury, and tumor. In this study, we report our experience and follow-up results with a new surgical technique for cervical spine entitled posterior floating laminotomy (PFL) in comparison with conventional laminectomy and fusion (LF). Methods : Data for 85 patients who underwent conventional LF (n=66) or PFL (n=19) for cervical spine disorders between 2012 and 2019 were analyzed. Radiological parameters, including cervical lordosis (CL), T1 slope (T1S), segmental lordosis (SL), and C2-7 sagittal vertical axis (SVA), were measured with lateral spine X-rays. Functional outcomes, comprising the modified Japanese Orthopaedic Association (mJOA), neck disability index (NDI), and visual analog scale (VAS) scores, were also measured. For the patients who underwent PFL, postoperative magnetic resonance image (MRI) was performed in a month after the surgery, and the degree of decompression was evaluated at the T2-weighted axial image, and postoperative computed tomography (CT) was conducted immediately and 1 year after the operation to evaluate the gutter fusion. Results : There was no difference in CL, T1S, SL, and C2-7 SVA between the groups but there was a difference in the preoperative and postoperative SL angles. The mean difference in the preoperative SL angle compared with that at the last follow-up was -0.3° after conventional LF and 4.7° after PFL (p=0.04), respectively. mJOA, NDI, and VAS scores showed significant improvements (p<0.05) during follow-up in both groups. In the PFL group, postoperative MRI showed sufficient decompression and postoperative CT revealed gutter fusion at 1 year after the operation. Conclusion : PFL is a safe surgical method which can preserve postoperative CL and achieve good clinical outcomes.
Purpose: In the revascuarization of ischemic dysfunctional myocardium, stunned myocardium was reported to recover function earlier than hibernating myocardium. It was also suggested that stunning and hibernation could be discriminated by reversibility of perfusion impairment on myocardial SPECT. In this study, we investigated the time course of functional recover after CABG according to reversibility of perfusion impairment. Materials and Methods: In 92 patients with coronary artery disease, Tl-201 rest/dipyridamole stress Tc-99m-MIBI gated SPECT was performed before, 3 months after, and 17 months after CABG. Using a 20-segment model, segmental perfusion and systolic thickening were automatically quantified. Perfusion-impaired segments with abnormal thickening were classified by reversibility into reversible (REV) and irreversible (IRREV) groups. The proportions of function-recovered segments were compared between groups and also between 3 months and 17 months in each group. Results: A total of 129 segments were Included In the analysis, and 76 were REV and 53 were IRREV. At 3 months after CABG, 61 segments (80%) in REV group showed functional recovery while 28 segments (53%) in IRREV group did (p<0.001). However, at 17 months after CABG, 60 segments (79%) in REV group and 37 segments (70%) un IRREV group showed functional recovery (p=n.s.). When comparing 3 months and 17 months in each group, REV group showed no difference, while IRREV group showed significant further improvement (p<0.05). Conclusion: In viable myocardium with ischemic myocardial dysfunction, the segments with reversible perfusion impairment recover function earlier after revascularization than irreversible segments.
Purpose : We investigated the clinical manifestations, radiographic and laboratory findings of children with M. pneumoniae pneumonia(MP) according to their age. Methods : A total of 75 children with MP who admitted to The Catholic University, Daejeon St. Mary's Hospital from July 2003 to February 2004, were classified into the three age groups : the ${\leq}2$ years of age(16 children), the children between 3 and 5 years of age(35 children), and the ${\geq}6$ years and older(24 patients). The diagnosis of MP was depended on the titers of anti-mycoplasma antibody that were measured 2 times, at admission and at discharge. Results : The total duration of the fever and the length of hospitalization were not different among the age groups. Although the white blood cell(WBC) value and differential was significantly different between the groups(P<0.01), a similar number in the WBC and reduced lymphocyte proportion was observed in all age groups compared to age-matched references. The patterns of pneumonia were significantly different according to age, i.e. segmental or lobar patterns were observed in 5 cases(31.3%) in the ${\leq}2$ years old group, but 16 cases(66.6%) in the >6 years old group(P<0.01). Conclusion : Although there was no difference in clinical findings according to age in MP, the radiographic finding was more severe in older children.
Jun, Young Wook;So, Hyun Jeong;Jeong, Youn Do;Um, Sung Heum
Journal of the Korean Society of Radiology
/
v.9
no.7
/
pp.479-486
/
2015
This study was conducted to investigate the effects of upper thoracic joint mobilization technique using Kaltenborn-Evjenth concept on the range of cervical and thoracic motion and pain in patients with chronic neck pain. The subjects were divided into a thoracic joint mobilization group(n=7) and a conservative physical therapy group(n=7). Each of the groups received thoracic joint mobilization or conservative physical therapy three times a week lasted for four weeks. The measurements were performed for the range of thoracic segmental motion(SpinalMouse), the pain(visual analogue scale) and the range of cervical joint motion(Inclinometer, Dualer IQ). They were made four times: before experiment, at 2weeks, 4weeks, and 4weeks after experiment.
Jo, Byung-Wook;Choi, Jae-Kon;Kim, Joon-Seop;Choi, Soo-Kyung
Elastomers and Composites
/
v.40
no.2
/
pp.136-142
/
2005
Liquid crystalline poly(allylsulfone) networks having $SO_2$ in a main chain and mesogens in a side chain were synthesized and their gas permeability and permselectivity were determined. The monomer II having two allyl groups on the each end group was able to form polymer networks by polymerization reaction, while the monomer I having only one allyl group was not. Molecular motion of the poly(allylsulfone) networks were retarded with increasing the cross-linking density, and the segmental motion of networks was developed enough to show isotropic phase transition. Gas permeabilities of poly(II-5 $01/I-OCH_3$ 99) were 2.58 baller for $O_2$ and 18.4 barrer for $H_2$. It means that hydrogen gas are 7 times more permeable than oxygen. Its permselectivities were high as 23.9 for ${\alpha}(H_2/N_2)$. The permselectivity was increased with increasing the cross-linking density. For example, ${\alpha}(H_2/N_2)$ was 36.8 in poly(II-5 $10/I-OCH_3$ 90), which was shown to be the highest value among these poly(allylsulfone) networks.
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