• 제목/요약/키워드: hiatus

검색결과 72건 처리시간 0.03초

천미골 접합부를 이용한 외톨이 신경절 차단법 (Modified Approach through the Sacrococcygeal Junction to Block the Ganglion Impar)

  • 송선옥;권오득;김성기
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.254-257
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    • 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.

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북동태평양지역의 방산충 생층서 및 고해양환경 연구 (Radiolarian Biostratigraphy and Paleoceanographic Study from the Northeast Equatorial Pacific)

  • 김기현;박정희
    • Ocean and Polar Research
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    • 제21권2호
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    • pp.127-136
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    • 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.

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소아 횡격막 질환의 임상적 고찰 (Clinical Study of Congenital Diaphragmatic Diseases in Neonates and Infants)

  • 김수홍;조용훈;유제호
    • Advances in pediatric surgery
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    • 제16권2호
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    • pp.143-153
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    • 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.

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Pulmonary Sequestration [2례 보고] (Pulmonary Sequestration: report of 2 cases)

  • 남충희
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.350-353
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    • 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.

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"문화모델" 개념의 건축적 수용 과정에 관한 연구 - 베르나르 위엣 그룹의 논의를 중심으로 - (On the Architectural Reception of the Concept "Modèles Culturels" - focusing on the discourses of Bernard Huet's group -)

  • 이종우
    • 대한건축학회논문집:계획계
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    • 제35권2호
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    • pp.63-72
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    • 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.

경막외 유착용해술시 투여되는 8%와 10% 고장성 식염수농도의 제통효과 및 부작용의 비교 (Comparative Study for Analgesic and Adverse Effects of 8% and 10% Hypertonic Saline in Epidural Adhesiolysis)

  • 오완수;홍기혁;이상철
    • The Korean Journal of Pain
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    • 제13권1호
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    • pp.74-78
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    • 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%.

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한반도 극한 기온의 선형 및 비선형 변화 경향 (Linear and Nonlinear Trends of Extreme Temperatures in Korea)

  • 김상욱;송강현;김서연;손석우
    • 대기
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    • 제24권3호
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    • pp.379-390
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    • 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.

미추마취시 혼합 주입한 Clonidine의 진통효과 (Analgesic Effects of Epidural Clonidine)

  • 서일숙;박대팔
    • Journal of Yeungnam Medical Science
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    • 제6권2호
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    • pp.57-62
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    • 1989
  • 지연성 호흡저하의 위험성이 없으며 중추신경계에 작용하는 혈압강하제인 Clonidine을 경막외강으로 주입한 강우의 진통효과를 알아보고자 미추마취를 시행할 항문질환 환자 40명을 대상으로 I군(1.33% Lidocaine 15ml)과 II군(1.33% Lidocaine 15ml+Clonidine $75{\mu}g$.)으로 나누어 수술후 진통효과를 관찰해 보았던 바 다음과 같은 결론을 얻었다. 1. Lidocaine단독 주입한 I군에서는 평균 마취시간이 2.42시간이었다. 2. Clonidine $75{\mu}g$을 혼합 주입한 II군의 경우에는 평균 진통시간이 7.32시간이었다. 3. Clonidine을 혼합 주입한 미추마취경우에 진정제 정주로 환자가 수면상태로 된 후 심한 혈압강하 및 맥박감소가 있었으나 Clonidine의 효과인지 진정효과에 인한 변화인지는 알 수 없었으며 진정제를 투여하지 않은 경우에는 혈압강하 및 맥박 감소가 초래되지 않았다. 4. 수술후 Clonidine과 관련된 특별한 증상은 관찰되지 않았다. 이상의 결과로 보아 항문질환 수술후 특히 외래환자의 차원에서 술후 진통을 위한 방법으로는 지연성 호흡저하 및 뇨정체등의 부작용이 없는 Clonidine의 천골강내 투여방법이 바람직한 것으로 사료된다.

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Caudal Neuromodulation with the Transforaminal Sacral Electrode (InterStim): Experience in a Pain Center Regarding 12 Implants

  • Guardo, Laura Alonso;Gala, Carlos Cano;Poveda, David Sanchez;Juan, Pablo Rueda;Sanchez Montero, Francisco Jose;Garzon Sanchez, Jose Carlos;Lamas, Juan Ignacio Santos;Sanchez Hernandez, Miguel Vicente
    • The Korean Journal of Pain
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    • 제29권1호
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    • pp.23-28
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    • 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.

췌장염 증상없이 췌장-흉막루를 통해 발생한 흉막저류 (Pleural Effusion and Pancreatico-Pleural Fistula Associated with Asymptomatic Pancreatic Disease)

  • 박상면;이상화;이진구;조재연;심재정;인광호;강경호;유세화
    • Tuberculosis and Respiratory Diseases
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    • 제42권2호
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    • pp.226-230
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    • 1995
  • 만성 췌장질환에 의한 흉막삼출은 췌장염 증상없이 대량으로 발생하기도 한다. 이런 경우 흉막액내 아밀라제의 현저한 증가는 췌장질환의 발견에 도움이 되며 대부분 보존적 췌장염 치료로 호전된다. 저자들은 췌장염 증상없이 흉막저류가 발생한 환자에서 흉막액내 아밀라제 증가를 발견하여 복부 및 흉부 전산화 단층촬영으로 췌장가낭종과 췌장-흉막루를 진단하고 보존적 치료로 호전되었기에 보고하는 바이다.

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