• Title/Summary/Keyword: spontaneous methods

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Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

  • Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.523-527
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    • 2012
  • Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.

The Effect of Thoracoscopic Pleurodesis in Primary Spontaneous Pneumothorax: Apical Parietal Pleurectomy versus Pleural Abrasion

  • Huh, Up;Kim, Yeong-Dae;Cho, Jeong Su;I, Hoseok;Lee, Jon Geun;Lee, Jun Ho
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.316-319
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    • 2012
  • Background: The standard operative treatment of primary spontaneous pneumothorax (PSP) is thoracoscopic wedge resection, but necessity of pleurodesis still remains controversial. Nevertheless, pleural procedure after wedge resection such as pleurodesis has been performed in some patients who need an extremely low recurrence rate. Materials and Methods: From January 2000 to July 2010, 207 patients who had undergone thoracoscopic wedge resection and pleurodesis were enrolled in this study. All patients were divided into two groups according to the methods of pleurodesis; apical parietal pleurectomy (group A) and pleural abrasion (group B). The recurrence after surgery had been checked by reviewing medical record through follow-up in ambulatory care clinic or calling to the patients, directly until January 2011. Results: Of the 207 patients, the recurrence rate of group A and B was 9.1% and 12.8%, respectively and there was a significant difference (p=0.01, Cox's proportional hazard model). There was no significant difference in age, gender, smoking status, and body mass index between two groups. Conclusion: This study suggests that the risk of recurrence after surgery in PSP is significantly low in patients who underwent thoracoscopic wedge resection with parietal pleurectomy than pleural abrasion.

Application of Tetrode Technology for Analysis of Changes in Neural Excitability of Medial Vestibular Nucleus by Acute Arterial Hypotension (급성저혈압에 의한 내측전정신경핵 신경세포의 흥분성 변화를 분석하기 위한 테트로드 기법의 적용)

  • Kim, Young;Koo, Ho;Park, Byung Rim;Moon, Se Jin;Yang, Seung-Bum;Kim, Min Sun
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.142-151
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    • 2018
  • Objectives: Excitability o medial vestibular nucleus (MVN) in the brainstem can be affected by changes in the arterial blood pressure. Several animal studies have demonstrated that acute hypotension results in the alteration of multiunit activities and expression of cFos protein in the MVN. In the field of extracellular electrophysiological recording, tetrode technology and spike sorting algorithms can easily identify single unit activity from multiunit activities in the brain. However, detailed properties of electrophysiological changes in single unit of the MVN during acute hypotension have been unknown. Methods: Therefore, we applied tetrode techniques and electrophysiological characterization methods to know the effect of acute hypotension on single unit activities of the MVN of rats. Results: Two or 3 types of unit could be classified according to the morphology of spikes and firing properties of neurons. Acute hypotension elicited 4 types of changes in spontaneous firing of single unit in the MVN. Most of these neurons showed excitatory responses for about within 1 minute after the induction of acute hypotension and then returned to the baseline activity 10 minutes after the injection of sodium nitroprusside. There was also gradual increase in spontaneous firing in some units. In contrast small proportion of units showed rapid reduction of firing rate just after acute hypotension. Conclusions: Therefore, application of tetrode technology and spike sorting algorithms is another method for the monitoring of electrical activity of vestibular nuclear during acute hypotension.

Correlation of Primary Spontaneous Pneumothorax and Air Pollution in Adolescents

  • Gu, Byung Mo;Ko, Ho Hyun;Ra, Yong Joon;Lee, Hee Sung;Kim, Hyoung Soo;Lee, Hong Kyu
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.53-58
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    • 2021
  • Background: We aimed to investigate the characteristics of primary spontaneous pneumothorax (PSP) in adolescents and to analyze the relationship between the occurrence of PSP and air pollutants. Methods: Data pertaining to age, sex, body mass index, smoking status, initial pneumothorax volume, presence of bullae, treatment methods, and city of residence were retrospectively obtained from January 2010 to December 2014. We investigated the association between short-term exposure to air pollutants (SO2, NO2, O3, CO, and PM10) and the occurrence of PSP using a case-crossover design with conditional logistic regression. Results: We collected information from 598 patients who were admitted for PSP, with a mean follow-up duration of 62.9 months. The majority (91.1%) of the patients were male. In the case-crossover design, conditional logistic regression showed that no air pollutant was associated with the occurrence of pneumothorax. The results were consistent across all city subgroups (Anyang, Gunpo, Uiwang, and Gwacheon). Conclusion: In our study, the incidence rate of pneumothorax was 153.8 per 100,000 person-years in male adolescents and 16.7 per 100,000 person-years in female adolescents. The case-crossover design showed that PSP in adolescents is unlikely to be related to air pollution.

Health Risk Behaviors Affecting the Process of Pregnancy (임신경과에 영향을 미치는 건강위험행위)

  • Park, Chai-Soon;Mun, Mi-Seon;Hong, Gin-Hee;Lee, Jeoung-Eun
    • Women's Health Nursing
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    • v.6 no.4
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    • pp.549-565
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    • 2000
  • Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

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A Baseline Study on Housewife-Consumer Education in the Information Society (지식정보화 사회의 주부소비자교육을 위한 기초연구)

  • Kim, Seon-Mi
    • Korean Journal of Human Ecology
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    • v.13 no.3
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    • pp.425-440
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    • 2004
  • This study was conducted to provide a foundation for housewife-consumer education programs appropriate in the information society. For this purpose, the authors reviewed existing literature, analysed consumer counseling cases, and conducted focus group interviews. The need for housewife-consumer education was illustrated, and desirable educational contents and methods were proposed. The existing housewife-consumer education programs did not work effectively because the contents were too general, and mostly structured with non-interactive one-way lectures. More effective programs should be designed to accomodate the educational purpose and contents which fitted with the specific needs of housewives as the representatives of the family consumer units. It should also take the family life cycle stages into consideration. The education programs would work better when they were oriented more toward actively participating, locally-based spontaneous small-groups.

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Clinical Analysis of Esophageal Perforation by Esophageal Foreign Body (식도이물에 의한 식도천공의 임상적 고찰)

  • 김범규;송민성;안성기;김진평;전시영;장인석
    • Korean Journal of Bronchoesophagology
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    • v.9 no.2
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    • pp.44-48
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    • 2003
  • Rupture of the esophagus is an uncommon condition that can be a formidable challenge to treat. Unless early treatment is applied, life-threatening complications, such as mediastinitis, sepsis, occurs and continue to be associated with a mortality rate of more than 20%. Definitive repair of esophageal perforation is considered the preferred treatment in the past. In the present study, conservative treatment acquired a good results by help of the development of antibiotics and nutritional supportive methods. Iatrogenic causes constituted most of the injuries, followed by external trauma, spontaneous, ingested foreign bodies, and malignancy. The incidence of perforation following ingestion of foreign bodies is very rare, so recommendations regarding treatment remain controversial. We analyzed the course of 31 patients with esophageal perforation by foreign bodies, concentrating on the diagnostic & treatment delay and methods of treatment, complications.

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The Case Study of Using GrafEq, by Pre-service Mathematics Teachers for Exploring Secondary School Mathematics (중등수학 탐구를 위한 예비수학교사의 수학프로그램(GrafEq.) 활용 사례)

  • Kim Nam Dee
    • The Mathematical Education
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    • v.43 no.4
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    • pp.405-417
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    • 2004
  • This study is on the use of mathematics program for School Mathematics Education. According to the ‘technology principle’ by NCTM and teaching-learning methods by the 7th curriculum, we developed mathematics learning activities with mathematics program. This activity is to construct designs with graphs by using mathematics program(GrafEq.). In this study, we practiced these learning activities with pre-service mathematics teachers. The mathematics educational effects of these learning activities in this study are analyzed as follows; active & spontaneous search for mathematical knowledge, the experience of problem solving, affirmative view-point of mathematics, understanding of practical use of mathematics, acquisition an interest & motivation of learning mathematics etc. When students learn graphs of function, the concept of inequality in secondary school mathematics class., mathematics teachers can make a good use of constructing designs by mathematics program(GrafEq.). This will help to practice of teaching-learning methods by the 7th curriculum.

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Compensations of Pixel Voltages by Common Electrode Voltages and Simulations of Pixel Characteristics on Inversion Methods in TFT-LCD (TFT-LCD 공통 전극 전압에 의한 화소 전압 보상 및 Inversion 방법에 따른 화소특성 시뮬레이션)

  • Kim, Tae-Hyung;Park, Jae-Woo;Kim, Jin-Hong;Choi, Jong-Sun
    • Proceedings of the KIEE Conference
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    • 2000.07c
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    • pp.1745-1747
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    • 2000
  • TFT-LCD simulator, PDAST(Pixel Design Array Simulation Tool) could simulate the effect of the variation on the pixel characteristics. Since feed-through voltage in TFT-LCD can be a serious problem to pixel voltage characteristics, it should be compensated. It is applicable to various kinds of TFT-LCDs and can be used to calculate the spontaneous part of common electrode voltage accurately. Also, PDAST can estimate pixel voltage according to various inversion methods. It allows high-speed calculation and the information obtained from this study could be utilized to design the larger area and finer image quality panel.

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Weaning Following a 60 Minutes Spontaneous Breathing Trial (1시간 자가호흡관찰에 의한 기계적 호흡치료로부터의 이탈)

  • Park, Keon-Uk;Won, Kyoung-Sook;Koh, Young-Min;Baik, Jae-Jung;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.361-369
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    • 1995
  • Background: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified $O_2$ through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. Methods: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: $105.9{\pm}83.4$ hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial $O_2$ tension was adequate($PaO_2$ > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. Results: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2 %). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. Conclusion: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with $O_2$ supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.

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