This study is to evaluate the change of intra-abdominal pressure related with intravesical and intrarectal pressure in patients with spinal cord injury according to daily activities and postural changes which make the abdominal pressure elevated. The intravesical and the intrarectal pressures were obtained during patient's speech, sneeze, cough, valsalva and various postural changes with supine to decubitus, derubitus to supine, supine to sit, and sit to supine according to empty and full bladders, respectively. The order of higher intravesical and intrarectal pressure rise during various maneuvers were valsalva, sneeze, supine to sit and cough, respectively. Higher correlation coefficient between the intrvesical and intrarectal pressures were noted during cough, sneeze, valsalva and supine to sit in empty bladder than full one. These results demonstrated that the intravesical and intrarectal pressures were influenced by daily activities and postural changes of increasing the intra-abdominal pressure. The intrarectal pressures according to daily activities such as cough, sneeze, valsalva and postural change were significantly related with intravesical pressures.
Background: The success of an injury intervention program can be measured by the proportion of successful return to work (RTW). This study examined factors of successful return to employment among workers suffering from work-related injuries. Methods: Data were obtained from the Social Security Organization, Malaysia database consisting of 10,049 RTW program participants in 2010-2014. The dependent variable was the RTW outcome which consisted of RTW with same employer, RTW with new employer or unsuccessful return. Multinomial logistic regression was performed to test the likelihood of successful return with same employer and new employer against unsuccessful return. Results: Overall, 65.3% of injured workers were successfully returned to employment, 52.8% to the same employer and 12.5% to new employer. Employer interest; motivation; age 30-49 years; intervention less than 9 months; occupational disease; injuries in the lower limbs, upper limbs, and general injuries; and working in the manufacturing, services, and electrical/electronics were associated with returning to work with the same employer against unsuccessful return. Male, employer interest, motivation, age 49 years or younger, intervention less than 6 months, occupational disease, injuries in the upper limbs and services sector of employment were associated with returning to new employer against unsuccessful return. Conclusion: There is a need to strengthen employer commitment for early and intensified intervention that will lead to improvement in the RTW outcome.
Purpose: We aimed to investigate whether visuomotor function would be modulated, when healthy subjects performed tracking task after tDCS application over the primary sensorimotor cortex (SM1) in the non-dominant hemisphere. Methods: Thirty four right-handed healthy participants were enrolled, who randomly and evenly divided into two groups, real tDCS group and sham control group. Direct current with intensity of 1 mA was delivered over SM1 for 15 minutes. After tDCS, tracking task was measured, and their performance was calculated by an accuracy index (AI). Results: No significant difference in AI at the baseline between the two groups was observed. The AI of the real tDCS group was significantly increased after electrical stimulation, compared to the sham control group. Two way ANOVA with repeated measurement showed a significant finding in a large main effects of time and group-by-repeated test interaction. Conclusion: This study indicated that application of the anodal tDCS over the SM1 could facilitate higher visuomotor coordination, compared to sham tDCS group. These findings suggest possibility that tDCS can be used as adjuvant brain modulator for improvement of motor accuracy in healthy individuals as well as patients with brain injury.
The purpose of This study was to compare the effect of Convergence-Based russian current(RC) and transcutaneous electrical nerve stimulation(TENS) on pain, muscle strength, function of knee who had a surgical anterior cruciate ligament reconstruction(ACLR). A total of 40 Participants divided into 2 groups, with ACLR, were assigned to russian current group(RCG) or transcutaneous electrical nerve stimulation group(TENSG). Both groups were measured by varieties of tests: visual analog scale(VAS), knee flexion & extension muscle strength, knee injury and osteoarthritis outcome score(KOOS), korean lower extremity functional scale(LEFS). Both groups has shown significant changes within the measurements of VAS, Knee Flexion & Extension muscle strength, KOOS and LEFS. The RCG had more significant increase within knee extension muscle strength, LEFS compared to TENSG. By studying this research, both interventions were effective to ACLR patients, moreover, RC was more effective for knee muscle strength and lower extremity function than the TENS.
Kim, Myong Cheol;Lee, Jong Wook;Chung, Jin Ah;Ko, Jang Hyu;Seo, Dong Kook;Oh, Suk Joon;Jang, Young Chul
Archives of Plastic Surgery
/
v.33
no.5
/
pp.581-586
/
2006
Purpose: Pediatric burn still generates social problem leading to physical and mental sequelae for ages. We studied to help make a program for the prevention of pediatric burn. Methods: We analyzed retrospectically 2759 acute burn patients under the age of 15 years in recent 5years (January 2000 - December 2004). Results: 1553 males and 1226 females were investigated, with a male to female ratio of 1.25 : 1. The greatest number of burn patients were those with an age of 1 - 2 years(1435, 52%). Scalding burn was the most common cause of injury, which accounted for 1980 (71.8%) patients, followed by contact burns(286, 10.4%), flame burn(229, 8.3%), steam burn(141, 5.1%). Especially steam burn was the second cause of injury in the age under 1 year, while flame burn was the same in the age over 3 years. During recent 5 years, incidence of contact burn increased over twofold despite the others did not changed substantially. Variation of seasonal incidence is minimal and most of the patients(2545 cases, 92.2%) had burns of ${\leq}20%$ TBSA. The median hospital stay was 18.3 days, and the rate of operation was 35.4% with an high rate in electrical burn(70.6%), steam burn(68.8%), contact burn(65%). 27 patients died in this series, which yielded a mortality rate of 1%. Conclusion: We expect that these data will be used as a basis for prevention of pediatric burn.
Background : An area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion. Methods : From January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling. Results : The mean age of patients was $49.9{\pm}12.2$ years, with 8 male and 2 female. The size of the burn wound was an average of $119.6{\pm}36.7cm^2$. The mean expansion duration was $65.5{\pm}5.6$ days, and the inflation volume was an average of $615{\pm}197.6mL$. Mean defect size was $122.2{\pm}34.9cm^2$. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision. Conclusions : Successful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.
Lee, Wonhyo;Kong, Taeyoung;Kim, Seunghwan;You, Je Sung;Park, Yoo Seok;Lee, Jae Gil;Chung, Sung Phil
Journal of Trauma and Injury
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v.26
no.3
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pp.198-206
/
2013
Purpose: This study was performed to calculate and analyze the effective radiation doses from computed tomography (CT) and radiologic intervention in patients in the emergency department (ED) with trauma critical pathway (CP) activation and further to estimate the lifetime attributable risks (LARs) for the incidence of and mortality from cancers induced by the radiation dose. Methods: Through a retrospective electrical chart review of 104 injured patients who trauma critical pathway were activated from November 2012 to March 2013, we calculated effective radiologic doses by taking the product of the dose-linear product of the scan and the conversion coefficient. After a determination of the image results, we divided the patients into two groups, negative or positive, and calculated the effective dose for each group. With these results, we estimated the LARs for the incidence of and the mortality from cancers by using the table in the Biologic Effects of Ionizing Radiation (BEIR)-VII report. Results: A total of 76 patients were enrolled. The mean age was $49.0{\pm}8.5$ years. The mean injury severity score (ISS) was $12.7{\pm}8.4$. The cumulative effective dose (CED) for individual patients varied from 2.8 mSv to 238.8 mSv, and the mean was $47.6{\pm}39.9$ mSv. The CED in patients with an $ISS{\geq}16$($63.2{\pm}26.6$ mSv) was higher than that of patients whose ISS<16($33.5{\pm}23.1$ mSv) (p<0.001). The CED in patients who were treated with surgery or intervention($69.0{\pm}45.2$ mSv) was higher than that of patients who were treated conservatively($33.6{\pm}22.4$ mSv) (p<0.001). The LARs for cancer incidence and mortality were $328.5{\pm}308.6$ and $189.0{\pm}159.3$ per 100,000 people, respectively. Conclusion: The CED and the LAR for trauma CP-activated patients in the ED were significant, so efforts should be made to decrease the effective dose received by severely injured patients.
Park, Kyung-Min;Lee, Dong-Kyu;Lee, Haakil;Lee, Joon-Man;Ahn, Won-Sool
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.3
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pp.35-42
/
2019
Risk assessment and analysis for a medium-to-small sized chemical plant that manufactures a polyester resin by the process of batch-type condensation reaction was conducted using K-PSR technique which is one of the risk assessment methods used to implement the Process Safety Management System (PSM). K-PSR is a risk assessment technique developed by KOSHA to compensate for difficulties caused by the lack of infrastructure of medium-to-small sized chemical plants in the re-evaluation. To apply the K-PSR technique, the entire process of a selected chemical palnt was classified in two review sections, i.e., the condensation reaction process and the dilution/filtration process, and the potential risks of the process about these review sections were identified and classified based on the four guide-words (release, fire.explosion, process trouble, and injury). As the results of the research, refer to recommend of risk rating has been confirmed that non-destructive testing of old facilities and the preparation of LOTO procedures for the electrical equipments are necessary as specific measures to prevent the risk of release and fire.explosion. It was also shown that pressure gauges and thermometers should be installed on the hot-oil supply piping to minimize the process trouble, and exhausting hood should be installed to prevent potential injury.
The motor evoked potentials (MEPs) have been advocated as a method of monitoring the integrity of spinal efferent pathways in various injury models of the central nervous system. However, there were many disputes about origin sites of MEPs generated by transcranial electrical stimulation. The purpose of present study was to investigate the effect of major extrapyramidal motor nuclei such as lateral vestibular nucleus (VN) and medullary reticular nucleus (mRTN) on any components of the MEPs in adult Sprague-Dalwey rats. MEPs were evoked by electrical stimulation of the right sensorimotor cortex through a stainless steel screw with 0.5mm in diameter, and recorded epidurally at T9 - T10 spinal cord levels by using a pair of teflon-coated stainless steel wire electrodes with 1mm exposed tip. In order to inject lidocaine and make a lesion, insulated long dental needle with noninsulated tips were placed stareotoxically in VN and mRTN. Lidocaine of $2{\sim}3\;{\mu}l$ was injected into either VN or mRTN. The normal MEPs were composed of typical four reproducible waves; P1, P2, P3, P4. The first wave (P1) was shown at a mean latency of 1.2 ms, corresponding to a conduction velocity of 67.5 m/sec. The latencies of MEPs were shortened and the amplitudes were increased as stimulus intensity was increased. The amplitudes of P1 and P2 were more decreased among 4 waves of MEPs after lidocaine microinjection into mRTN. Especially, the amplitude of P1 was decreased by 50% after lidocaine microinjection into bilateral mRTN. On the other hand, lidocaine microinjection into VN reduced the amplitudes of P3 and P4 than other MEP waves. However, the latencies of MEPs were not changed by lidocaine microinjection into either VN or mRTN. These results suggest that the vestibular and reticular nuclei contribute to partially different role in generation of MEPs elicited by transcranial electrical stimulation.
Kim, Youn-mi;Baek, Yong-hyeon;Lee, Jae-dong;Park, Dong-seok;Kim, Chang-hwan;Kob, Hyung-kyun
Journal of Acupuncture Research
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v.19
no.5
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pp.234-246
/
2002
Background: Herpes Zoster Oticus, which can be caused from infection by Varicella-zoster virus, is known to be expected poor prognosis, since it has higher possibility of complete injury of facial nerve. Conservative therapy of the Western medicine is effective on the treatment for the herpes zoster and pain. However, its effectiveness on the facial verve palsy has not been proven. Objective : This study was performed to evaluate the treatment of oriental medicine and an analyze prognosis of the facial nerve palsy in Herpes Zoster Oticus. Methods : This retrospctive study was conducted to observe the clinical manifestation of Herpes Zoster Oticus, and the result of electrical diagnostic study on the patients with the facial nerve palsy in Herpes Zoster Oticus who were diagnosed and treated at the Department of Acupuncture & Moxibustion in Kyung Hee Oriental Medical Hospital. Results : 1. According to the six clinical types of Herpes Zoster Oticus, the patients in this study can be grouped as 7 cases of the type II, 2 cases of the type V, and one case of the type IV and the type VI. 2. The shorter the period from onset to the first visit to a hospital, the prognosis of facial nerve palsy in Herpes Zoster Oticus was the better. 3. According to the follow up study, the H-B grades of all cases were improved. 4. According to the follow up study, the result of electrical diagnostic study was improved. Conclusions : We found in our study that the treatment of oriental medicine, such as acupuncture, herbal medicine and aroma therapy, helps the recovery of facial nerve palsy in Herpes Zoster Oticus. The further clinical study about the more cases of facial nerve palsy in Herpes Zoster Oticus and comparative study between the group of oriental medicine and that of western medicine are needed.
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