• The Korean Journal of Pain
• /
• v.10 no.2
• /
• pp.254-257
• /
• 1997

Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

• Ocean and Polar Research
• /
• v.21 no.2
• /
• pp.127-136
• /
• 1999

Radiolarian assemblages from KODOS area were analyzed in order to understand the biostratigraphy and paleoceanography of deep-sea sediment from the Northeast Equatorial Pacific. The sediment core was divided into two or three units on the basis of the chemical and physical properties. In the upper sediment, mixtures of Quaternary and Tertiary radiolarians are found indicating active reworking processes. Dissolution of radiolarians seem to increase with depth. Radiolarians are seldom in Unit III presumably due to dissolution and corrosion. The middle part of unit I appears to correspond to Collosphaera invaginata Zone (0.21 Ma). Unit II belongs to Collosphaera tuberosa Zone. Based on the absence of Stylatractus universus, we estimate its age to be younger than 0.42 Ma. Based on our analyses of radiolarians in Unit I and II, we estimated the age of unit III as Tertiary, particularly from Oligocene to Miocene. There may to be hiatuses of more than 3 My from late Miocene to Pliocene, which probably resulted from erosion and dissolution by the Antarctic Bottom Water Sedimentation rates during Quaternary range from 0.15 to 0.50 mm/ky with significant variabilities among stations. Radiolarians in the study area were mostly warm-water species.

• Advances in pediatric surgery
• /
• v.16 no.2
• /
• pp.143-153
• /
• 2010

Congenital diaphragmatic disease is one of the common major congenital anomalies, and its mortality remained still high despite recent medical advances. The aim of this study is to examine the clinical characteristics of congenital diaphragmatic diseases. A total of 39 patients with congenital diaphragmatic disease that underwent surgery from January, 1997 to December, 2009 at Pusan National University Hospital were included in this study. Medical records were retrospectively reviewed. The male to female ratio was 30:9. Six out of 39 cases died (NS) before surgery, 17 patients had Bochdalek's hernia (BH), 11 patients hiatus hernia (HH), 4 diaphragmatic eventration (DE), and 1 Morgagni hernia (MH). There were no differences in mean birth weight and mean gestational age. NS (83.3 %). BH (35.3 %) was diagnosed more frequently than other diseases in the prenatal period. Three patients (17.6 %) of BH expired due to pulmonary hypoplasia and 1 patient had co-existing congenital heart disease. BH was diagnosed more frequently in the prenatal stage and had a higher motality rate than other conditions. Therefore, BH needs to be concentrated more than other anomalies.

• Journal of Chest Surgery
• /
• v.14 no.4
• /
• pp.350-353
• /
• 1981

The pulmonary sequestration is an uncommon congenital anomaly characterized by the presence of a part of lung tissue which is supplied by an aberrant artery from the aorta or its branch and usually has no communication with the normal bronchial tree. It was first presented by Hubber in 1777 and presented in details by Pryce in 1946. We present a case of extralobar pulmonary sequestration experienced recently with a case of intralobar type experienced in 1962. The patient was 11 year old male with the complaint of chronic productive cough. Serial chest films showed a large cyst with or without the air-fluid level on the posterobasal segment area of the left lower lobe. Bronchography showed no definite communication between the cyst and bronchial tree. On operation, the cystic lesion was supplied by an aberrant artery from the descending thoracic aorta 5 cm above the aortic hiatus and was sited at the posterobasal segment area of the left lower lobe. We performed the sequestrectomy and the sequestration was surrounded by its own pleura, 6.8x3.9x3.2 cm in size, contained the pale brown mucoid secretion in a large cyst and showed the primitive alveolar structure of the wall. The aberrant artery was 1 -5 cm long, 0.3 mm in internal diameter and arterio-sclerotic. We also compared 6 cases of collection, 5 intralobar and 1 extralobar type, presented in Korea.

• Journal of the Architectural Institute of Korea Planning & Design
• /
• v.35 no.2
• /
• pp.63-72
• /
• 2019

This research deals with context and process of the reception of the sociological concept of "$mod{\grave{e}}les$ culturels" by French architects gathered around Bernard Huet in the late 1960s and the early 1970s. While this concept had its own shortcomings as sociological tool, its reception by some architects in collaboration with sociologists produced a series of meaningful debates when the role of inhabitants in collective housing design was a common issue. Through the analysis this research could situate the architectural reception of the $Mod{\grave{e}}les$ culturels in comparison with other then competing tendencies such as "flexibility tendency" and Design methods movement. It argues that the most significant meaning of the reception of $mod{\grave{e}}les$ culturels lies in its advanced and critical view on the relations and hiatus between the "social space" of the inhabitants characterized in particular by its topological nature and the "architectural space" of the architects characterized by its Euclidian geometrical nature.

• The Korean Journal of Pain
• /
• v.13 no.1
• /
• pp.74-78
• /
• 2000

Background: Epidural Adhesiolysis is an interventional pain management technique for patients with low back pain. In addition to local anesthetics and corticosteroid, hypertonic saline (NaCl) are used for the technique. Present study was aimed to compare analgesic and adverse effects of two different concentration of hypertonic saline in Epidural Adhesiolysis. Methods: Fifty-three subjects with low back pain with radiculopathy were assigned to one of two epidural adhesiolysis treatment groups: 8% (Group I, n=26) or 10% (Group II, n=27) hypertonic saline. 17 G epidural needle was inserted at sacral hiatus and catheter was advanced untill its tip was located at lesion site under fluoroscopic guidance. Subjects in all treatment groups received epidural corticosteroid and local anesthetic. And then, hypertonic saline injection via catheter were carried out daily for 3 days. Evaluation included assessment of pain relief (Numerical Rating Scale; NRS) at post-epidural adhesiolysis 1, 2, 3 days, 1 week, and 1, 3 months. We also looked for complications of epidural adhesiolysis at different concentration of hypertonic saline. Results: Statistical analysis demonstrated that NRS was not significantly different between two groups during 3 months after epidural adhesiolysis. There were no major differences of complications between two groups and disappeard after a few months without residual sequelae. Conclusions: We conclude that epidural adhesiolysis using 8% hypertonic saline is effective for relief of low back pain with proven lumbosacral fibrosis without any residual sequelae compared with 10%.

• Atmosphere
• /
• v.24 no.3
• /
• pp.379-390
• /
• 2014

This study explores the long-term trends of surface air temperatures in 11 KMA stations over the period of 1960~2012. Both linear and nonlinear trends are examined for the $95^{th}$, $50^{th}$, and $5^{th}$ percentiles of daily maximum ($T_{max}$) and minimum temperatures ($T_{min}$) by using quantile regression method. It is found that in most stations linear trends of $T_{max}$ and $T_{min}$ are generally stronger in winter than in summer, and warming trend of the $5^{th}$ percentile temperature (cold extreme) is stronger than that of the $95^{th}$ percentile temperature (warm extreme) in both seasons. The nonlinear trends, which are evaluated by the second order polynomial fitting, show a strong nonlinearity in winter. Specifically, winter temperatures have increased until 2000s but slightly decreased afterward in all percentiles. This contrasts with the $95^{th}$ and $50^{th}$ percentiles of summer $T_{min}$ that show a decreasing trend until 1980s then an increasing trend. While this result is consistent with a seasonal dependence of the recent global warming hiatus, most of the nonlinear trends are statistically insignificant, making a quantitative attribution of nonlinear temperature trends challenging.

• Journal of Yeungnam Medical Science
• /
• v.6 no.2
• /
• pp.57-62
• /
• 1989

Clonidine, ${\alpha}2$-adrenergic agonist, applied spinally or epidurally has been shown to be effective in blocking noxious stimuli in human applications. The purpose of this study is to evaluate the analgesic effect of epidurally administered clonidine. In 40 patients undergoing hemorrhoidectomy or anal fistulectomy, 1.33% lidocaine 15ml (Group I) or 1.33% lidocaine mixed with $75{\mu}g$ clonidine(Group II) administered epidurally through sacral hiatus. Intraoperative changes of vital signs and duration of postoperative analgesic effects were observed. The results were as follows : 1) In the group I, average analgesic duration was 2.42 hours. 2) In the group II, average analgesic duration was 7.32 hours. 3) After epidural clonidine injection, the decrease in heart rate and blood pressure was not significant without sedation. 4) Postoperatively, any complaints related clonidine were not reported. In conclusion, postoperative pain control with epidural clonidine was effective.

• The Korean Journal of Pain
• /
• v.29 no.1
• /
• pp.23-28
• /
• 2016

Background: Sacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode ($Interstim^{(R)}$, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration. Methods: We present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary. Results: Our experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration. Conclusions: The caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.2
• /
• pp.226-230
• /
• 1995

Effusions arising from acute pancreatitis are usually small, left sided and self limiting. The incidence of pleural effusions in acute pancreatitis is reported between 3% and 17%. In chronic pancreatitis, as a consequence of fistula and pancreatitic pseudocyst formation or by spontaneous rupture of a pancreatic psudocyst directly into thoracic cavity, extremely large effusions may be seen. When the underlying pacreatic disease is asymptomatic, the diagnosis is made by measuring the amylase content of the pleural fluid. We experience a case of left sided pleural effusions caused by pancreatico-pleural fistula associated with pancreatic pseudocyst. The diagnosis was made by measuring of pleural fluid amylase level(80000U/L). Abdominal CT scan revealed pancreatic pseudocyct and pancreatitis with extension to left pleural space through esophageal hiatus and extension to left subdiaphragmatic space. Left pleural effusions were decreased after fasting, total parenteral nutrition and percutaneous pleural fluid catheter drainage. We reported a case of pleural effusions and pacreatico-pleural fistula asssociated with asymptomatic pancreatic disease with review of literatures.