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The Effects of Lumbar Sympathetic Ganglion Block in the Patients with Spinal Stenosis and the Skin Temperature Changes according to the Contrast Spread Patterns (요척주관 협착증 환자의 요부 교감신경 차단술의 효과 및 조영 양상에 따른 피부 체온의 변화)

  • Hong, Ji Hee;Kim, Jin Mo;Kim, Ae Ra;Lee, Yong Chul;Kim, Sae Young;Kwon, Seung Ho;Oh, Min Ju
    • The Korean Journal of Pain
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    • v.22 no.2
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    • pp.151-157
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    • 2009
  • Background: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this would demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis. Methods: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe ($DT^{pre}$, $DT^{post}$, $^{\circ}C$), and the DTnet were calculated as follows. $DT^{net}$ = $DT^{post}$ - $DT^{pre}$. Results: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the $DT^{post}$ ($6.1{\pm}1.2^{\circ}C$, P = 0.021), and the DTnet ($6.0{\pm}1.0^{\circ}C$, p = 0.023), as compared to group C. Conclusions: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD, compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C.

A scheme on strengthening of R.O.K reserved force (예비전력 정예화 방안)

  • Kim, Jae-Sam
    • Journal of National Security and Military Science
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    • s.5
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    • pp.1-45
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    • 2007
  • Reserved forces of ROKA are in charge of replacement of TOE in the wartime and mission of rear area operation. But there is institutional inertia in the law and organization oriented to fill human resources rather than take mission. We need to prepare for the investment and arrangement of reserved forces as military power that would be replaced standing forces. In this portion, to reinforce reserve forces elite, First, efficient mobilization regulations and systems are suggested. I covered a maintenance of relevant mobilization ordinances which need to legislated and approved by national assembly for wartime and development of mobilization system which might lose the appropriate time for mobilization due to complicated declaration procedures and measures to overcome the panic at the initial stage of the war and organization and employment of nationwide transportation system and mobilization center. To ensure efficient resource management and mobilization of reserve forces with a number of approximately 3 million, there's a necessity of organization for integration and conciliation. To make it real, I suggested establishing and employing the mobilization center, on first phase, employ the mobilization center focusing on homeland divisions, on second phase, it is advisable to convert to national level mobilization system and develop to central mobilization center focusing on national emergency planning committee. During peacetime, in conjunction with Mobilization Cell, mobilization center can conduct resource survey and integrate and manage mobilization resources and take charge of mobilization training of subordinate units, and during wartime, in conjunction with mobilization coordination team and Cell, can ensure the execution of mobilization. Second, Future oriented reserve forces management system such as service system of reserve forces and support system of homeland defense operations. Current service and trainings of reserve forces by the year have very low connection, as it is very complex to manage the resources and trainings, and service and training lack the equity, re-establishment of service system is required. Also in an aspect of CSS and cultivation support for reserve forces, as the scope and limitation of responsibility between the armed forces and autonomous organization is obscure, conditions to conduct actual-fighting exercises are limited. Concentrated budgetting is extremely difficult because reserve forces training fields are scattered nationwide, and facilities and equipments are rapidly getting older. To improve all these, I suggest the organization of homeland defense battalion with a unit of "City-Gun-District" and supporting the local reserve forces. Conduct unit replacement or personal replacement for those who have finished their 1 or 2 years and homeland defense operation duty for those with 3-5 years for consistency and simplification. Third, I suggest Future oriented Reserved Training(FRT) and Training Center oriented training management to establish a reliable reserve training. Reserves carry out expansion of unit, conventional combat mission, homeland defense and logistics support during wartime, and actual-fighting exercise, and disaster relief, peace keeping activities. Despite diverse activities and roles, their training condition still stays definitely poor. For these reasons, Modernization of weapons and facilities through gradual replacement and procurement is essential to enhance mobilization support system.

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Comparison of peripheral vascular compliance between normal and diabetic groups using the second derivative of photoplethysmogram (PPG 2차 미분을 이용한 정상인과 당뇨병 환자의 말초혈관 탄성도 비교)

  • Kim, Sung-Woo;Lee, Ju-Hyung;Nam, Ki-Chang;Kim, Su-Chan;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.44 no.4 s.316
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    • pp.15-20
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    • 2007
  • Recently the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal(n=850) and diabetic(n=50) groups vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of the second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a rapresents vascular compliance. This study found out that when vascular compliance is decreased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy, $-1.09{\pm}0.14$ is statistically lower than the normal group, $-0.81{\pm}0.09$ (p<0.05). In conclusion, we suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.

Entrepreneurship Education in Internet Business: Current Status & Future Direction (인터넷 창업교육 현황과 발전방안에 관한 연구)

  • Jeong, Jin-Su;Choi, Jong-In
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.3 no.1
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    • pp.29-55
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    • 2008
  • The objective of Starts-up education rears leading company that minimize a risk & connect them with successful idea. Internet Starts-up education is serviced in public & civil parts, it is insufficient to reach successful Starts-up support. This study is targeting on review the present condition of the Internet Starts-up education, research which it sees Internet Starts-up education actual condition investigation through investigation student of education satisfactorily and education contents and the plan to grope an Starts-up education progress coat problem and developmental plan it did. The current events point which has become research result escape first, age of the students of education, followed in educational background and, education motive and education experience presence education satisfactory boat song it appeared in these demand different, base grudge the form which is various it fixed and the education was demanded. Second, currently the department of pedagogy joining in establishment leader against the technical element which is advanced swip, the education reinforcement against an enterprise accomplishment ability back human factor, an enterprise propulsion environment and an enterprise item back enterprise environment element was demanded. Time after support and consulting, completion lifestyle community construction, completion lifestyle for item connection support and the trade name net after third, establishing an enterprise we the king, after toe ring back educating which carries on shoulder the importance of the civil official was embossed. The study which it sees led and like this investigation analysis the education progress for the successful support of the Internet Starts-up and time after connection setup construction it led and the plan which it will put out advancement of Starts-up education and it groped.

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Implications of China's Maritime Power and BRI : Future China- ROK Strategic Cooperative Partnership Relations (중국의 해양강국 및 일대일로 구상과 미래 한·중 협력 전망)

  • Yoon, Sukjoon
    • Strategy21
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    • s.37
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    • pp.104-143
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    • 2015
  • China's new grand strategy, the "One Belt, One Road Initiative" (also Belt Road Initiative, or BRI) has two primary components: Chinese President Xi Jinping announced the "Silk Road Economic Belt" in September 2013 during a visit to Kazakhstan, and the "21st Century Maritime Silk Route Economic Belt" in a speech to the Indonesian parliament the following month. The BRI is intended to supply China with energy and new markets, and also to integrate the countries of Central Asia, the Association of Southeast Asia Nations (ASEAN), and the Indian Ocean Region - though not Northeast Asia - into the "Chinese Dream". The project will be supported by the Asian Infrastructure Investment Bank (AIIB), due to open in 2016 with 57 founding members from all around the world, and China has already promised US$ 50 billion in seed funding. China's vision includes networks of energy pipelines, railways, sea port facilities and logistics hubs; these will have obvious commercial benefits, but also huge geopolitical significance. China seems to have two distinct aims: externally, to restore its historical sphere of influence; and internally, to cope with income inequalities by creating middle-class jobs through enhanced trade and the broader development of its economy. In South Korea, opinion on the BRI is sharply polarized. Economic and industrial interests, including Korea Railroad Corporation (KORAIL), support South Korean involvement in the BRI and closer economic interactions with China. They see how the BRI fits nicely with President Park Geun-hye's Eurasia Initiative, and anticipate significant commercial benefits for South Korea from better connections to energy-rich Russia and the consumer markets of Europe and Central Asia. They welcome the prospect of reduced trade barriers between China and South Korea, and of improved transport infrastructure, and perceive the political risks as manageable. But some ardently pro-US pundits worry that the political risks of the BRI are too high. They cast doubt on the feasibility of implementing the BRI, and warn that although it has been portrayed primarily in economic terms, it actually reveals a crucial Chinese geopolitical strategy. They are fearful of China's growing regional dominance, and worried that the BRI is ultimately a means to supplant the prevailing US-led regional security structure and restore the Middle Kingdom order, with China as the only power that matters in the region. According to this view, once China has complete control of the regional logistics hubs and sea ports, this will severely limit the autonomy of China's neighbors, including South Korea, who will have to toe the Chinese line, both economically and politically, or risk their own peace and prosperity.

Treatment of Venous Stasis Ulcer with $3M^{TM}$ $Coban^{TM}$ 2 Layer Compression System: A Case Report (두겹 압박방식 $3M^{TM}$ $Coban^{TM}$을 이용한 울혈성 정맥궤양의 치료: 증례보고)

  • Chu, Ho-Jun;Son, Dae-Gu;Kim, Jun-Hyung;Han, Ki-Hwan;Kim, Hyung-Tae
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.699-702
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    • 2011
  • Purpose: Venous stasis ulcer is the most severe form of chronic venous insufficiency and this commonly appears in the lower limb. Pharmacological therapy, reconstruction of the venous system, surgical management, cellular therapy and compression therapy are known as the treatments of venous stasis ulcer, but relapses are common, which make it a typical chronic wound. We report here on a case of recurrent venous stasis ulcer that healed with compression therapy without any other treatment. Methods: A 35-year-old man with a 13 years history of venous stasis had developed an ulcer on the distal third portion of the lower left limb which was developed 12-year before enrollment in this study. He had been treated with vacuum assist closure, 2 times of cell therapy and 3 times of skin graft for 8 years, but the lesion recurred. From November, 2008 compression therapy was done with the 3M $Coban^{TM}$ 2 Layer Compression System (3M, St. Paul, USA). The ulcer at that time was oval shaped and $3{\times}4$ cm in size. A comfort layer bandage was applied from the proximal phalanx of the great toe to the knee. A compression layer bandage was applied on the previous layer with it being overlapped one half the width of the comfort layer bandage. The dressing was changed every 4 days and the change was recorded with photography. Results: A total of 12 $Coban^{TM}$ 2 Layer Compression Systems were used. The size of the ulcer decreased to $2.5{\times}2.5$ cm in one month, to $2{\times}2$ cm in 2 months, it was $1{\times}1.8$ cm in size at 3 months and it completely healed in 4 months. Conclusion: The venous stasis ulcer was completely healed using the 3M $Coban^{TM}$ 2 Layer Compression System. This method was easy to apply, made the patient comfortable and it provided an excellent compression effect. As in the previous studies, this compression therapy has been proven to play an important role for the treatment and prevention of venous stasis ulcer.

Usefulness of Venous Graft in Hand Injury (수부 손상에서 정맥이식의 유용성)

  • Lee, Hak-Sung;Kim, Youn-Hwan;Kim, Chang-Yeon;Kim, Jeong-Tae;Ahn, Hee-Chang
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.396-399
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    • 2010
  • Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.

Reconstruction of the Bone Exposed Soft Tissue Defects in Lower Extremities using Artificial dermis(AlloDerm®) (인공 진피(알로덤®)을 이용한 하지의 골이 노출된 연부 조직 결손의 재건)

  • Jeon, Man Kyung;Jang, Young Chul;Koh, Jang Hyu;Seo, Dong Kook;Lee, Jong Wook;Choi, Jai Koo
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.578-582
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    • 2009
  • Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

Bilateral Popliteal Artery Entrapment Syndrome (양측성 슬와동맥 포착증후군)

  • Yoo, Dong-Gon;Kim, Chong-Wook;Park, Chong-Bin
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.136-139
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    • 2007
  • Bilateral popliteal artery entrapment syndrome is a rare vascular disease, which leads to ischemic claudication as a result of disturbance to the blood flow from the abnormal relationship of the popliteal artery to the gastrocnemius muscle, a fibrous band or the popliteus muscle in the young male population. A 58-years-old male patient, complaining of ischemic claudication, coldness and 3rd toe gangrene of left leg of 1 month's duration was admitted to our institution. His left ankle-brachial index was decreased; therefore, a femoral artery angiography was peformed, which revealed a total occlusion below the distal superficial femoral artery of the left leg. An EKG revealed atrial fibrillation, suggestive of a thromboembolism of the popliteal artery due to atrial fibrillation; therefore, Urokinase thrombolysis was attempted. After the Urokinase thrombolysis, popliteal artery entrapment syndrome was diagnosed, with MRI then performed for an anatomical diagnosis. The popliteal artery entrapment was type 1, where the popliteal artery was displaced medial to the Gastrocnemius head. After complete removal of the popliteal artery aneurysm, interposition was performed with a contra lateral greater saphenous vein graft. A mild right popliteal artery aneurysm still remained, but surgery was not performed. Currently, the patent is surviving, without complications. Herein, the good results obtained for the surgical treatment of a severely affected leg, and the conservative treatment of a mildly affected leg, are reported.

Laboratory Experiments for Evaluating Necking Defects in Bored Piles Embedded in Sandy Soils Using Electromagnetic Waves (전자기파를 이용한 모래 지반에 설치된 현장타설말뚝의 네킹 결함 평가를 위한 실내 모형실험)

  • Lee, Jong-Sub;Kim, Youngdae;Yu, Jung-Doung
    • Journal of the Korean Geotechnical Society
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    • v.36 no.5
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    • pp.25-34
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    • 2020
  • Studies on nondestructive evaluation methods using electromagnetic waves have been commonly conducted to evaluate necking defects in bored piles. However, the propagation of electromagnetic waves are affected by water contents of surrounding materials. This study aims to investigate a suitability of electromagnetic waves for evaluating necking defects in bored piles embedded in sandy soils through laboratory experiments. Laboratory experiments are performed with a model pile having a necking defect. The diameter and length of model pile are 600 mm and 1 m, respectively, and the model pile is embedded in sandy soils with different water contents of 10%, 20%, and 30%. For the propagation of electromagnetic waves, a transmission line is configured in reinforcement cage using an electrical wire. The generation and detection of electromagnetic waves are conducted using a time domain reflectometer. Experimental results show that the peak amplitude of electromagnetic waves reflected at the necking defect decreases with an increase in the water content in sandy soils. In addition, the velocity of electromagnetic waves reflected from the toe of the model pile decreases win an increase in the water content. However, estimated locations of the necking defects are almost the same to that of the actual location of the necking defect. This study demonstrates that electromagnetic waves may be an effective method for evaluating necking defects in bored piles embedded in sandy soils