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Comparison of the Clinical Outcomes of an Ultrasound-Guided and C-Arm Guided Cervical Nerve Root Block (초음파와 방사선 투시장치를 이용한 경추 신경근 차단술의 임상결과 비교)

  • Ha, Dae Ho;Shim, Dae Moo;Kim, Tae Kyun;Oh, Sung Kyun;Lee, Hyun Jun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.78-84
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    • 2020
  • Purpose: This paper compares the clinical outcomes of patients who were treated with a cervical nerve block by ultrasound and C-arm and reports the complication. Materials and Methods: A total of 97 patients were treated with an ultrasound-guided nerve root block from May 1, 2015 to February 8, 2018. On the other hand, 94 patients were treated with a C-arm guided nerve root block. The consequences of the cervical pain and the radiating pain before and after the procedures were reviewed using the verbal numeric rating scale (VNRS). In addition, the complications related to the procedures from the daily notes from the chart were inspected. Results: Sixty-six cases out of 97 cases of ultrasound-guided nerve root block were enrolled in the study. The average age of the patients was 57 years, including 41 males and 25 females. Seventy seven out of 94 cases by a C-arm guided root block were included in the study. The average age of the patients was 55 years, including 40 males and 37 females. Before the nerve root block, the mean numeric rating pain scale (NRS) of the cervical pain in ultrasound-guided block decreased from 5.4 points to 2.7 points at three weeks and 1.4 points at six weeks (p=0.0023, p<0.001), and 3.1 points in the C-arm (p<0.001, p<0.001) at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the case of radiating pain, the mean NRS in the ultrasound-guided nerve root block group improved from 6.3 points after the procedure to 2.8 points at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the C-arm guided nerve root block group, the NRS improved from 7.4 points after the procedure to 3.3 points at three weeks and 1.9 points at six weeks. In the case of complications, Horner's syndrome and propriospinal myoclonus were observed in one case of C-arm guided block group. Conclusion: The clinical results of the patients who underwent ultrasound-guided cervical nerve root block were not significantly different from those who underwent a C-arm guided cervical nerve root block.

Reader-Response Criticism about the Functional relation of Romance, Women and Patriarchy -Based on Janice A. Radway's Reading the Romance: Women, Patriarchy and Popular Literature (로맨스, 여성, 가부장제의 함수관계에 대한 독자반응비평 -제니스 A. 래드웨이의 『로맨스 읽기: 여성, 가부장제와 대중문학』을 중심으로)

  • Lee, Jung-Oak
    • Journal of Popular Narrative
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    • v.25 no.3
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    • pp.349-383
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    • 2019
  • This paper examined the meaning and task of romance research with a focus on Reading the Romance(1984) by Janice A. Radway. This book, which analyzes romance texts by examining the situation and meaning of reading romance by women readers integrating between cultural studies and literary studies, is one of the most popular studies on the romance genre. Radway scrutinized the practical significance of reading romance in a community of women readers. Through a study involving questionnaires and in-depth interviews, she found that for women, romance reading is a 'compensatory fiction' that brings happiness and emotional redemption through a sense of liberation achieved by escaping from patriarchal daily life. The romance that women prefer is composed of 4 stages and 13 divisions: 'Encounter → Attest → Recovery → Happy End'. It also maintains a formula that begins with an immature female character's identity crisis and ends with a blissful union that recognizes the intrinsic value of the main character, who has turned into a man who is considerate of the women. Therefore, romance plays the role of pursuit of the 'female utopian fantasy' and at the same time a reconciliation of women to patriarchy. Feminist critics of the day criticized this argument. However, reading romance is a 'feminine reading', and romance is literature about the functional relationship between women's lives and patriarchy. Yet the interpretation could differ depending on the different viewpoints and definitions of the women's utopian fantasy. In recent years, the conditions of female reader's lives, awareness and imagination have been changing rapidly. As a result, the female utopian fantasy has also changed significantly. Nevertheless, women's lives in the real patriarchal system are still contradictory, and their adventurous imagination is spreading in alternative spaces such as the subculture. In this regard, the question is about the definition of romance and the meanings of romance research are still important task.

The Relationship between Neural Foraminal Stenosis and Imaging Features of Lumbar Spine MRI in Patients Older Than 60 Years with Lumbar Radiculopathy (요추신경근병증이 있는 60세 이상의 환자에서 신경공 협착과 자기공명영상 평가를 통한 인자와의 상관관계)

  • Kyeyoung Lee;Hee Seok Jeong;Chankue Park;Maeran Kim;Hwaseong Ryu;Jieun Roh;Jeong A Yeom;Jin Hyeok Kim;Tae Un Kim;Chang Ho Jeon
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.862-875
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    • 2021
  • Purpose To investigate the MRI features associated with neural foraminal stenosis (NFS) in patients older than 60 years with lumbar (L) radiculopathy. Materials and Methods This study included 133 retrospectively selected patients older than 60 years with lumbar radiculopathy who had undergone a lumbar spine MRI (from January 2018 to April 2018). For L4/L5 and L5/sacral (S)1 levels, NFS was reviewed blindly by two radiologists. Spondylolisthesis, retrolisthesis, disc height loss, disc bulging/herniation/central canal stenosis, ligamentum flavum thickening, and facet hypertrophy were evaluated separately for the NFS and non-NFS groups, and they were compared using univariate and multivariate analyses. Results The univariate analysis revealed that disc height loss (p = 0.006) was associated with NFS for L4/L5. For L5/S1, both spondylolisthesis (p = 0.005) and facet hypertrophy (p = 0.006) were associated with NFS. The multivariate logistic analysis revealed that disc height loss was associated with NFS for L4/L5 [odds ratio (OR) = 4.272; 95% confidence interval (CI) 1.736-10.514]. For L5/S1, spondylolisthesis (OR = 3.696; 95% CI 1.297-10.530) and facet hypertrophy (OR = 6.468; 95% CI 1.283-32.617) were associated with NFS. Conclusion Disc height loss was associated with NFS for L4/L5 and spondylolisthesis and facet hypertrophy were associated with NFS for L5/S1.

The Interpretation of German Fairy Tale "Three Dogs" from the Aspect of Analytical Psychology (독일민담 '세 마리 개 Die drei Hunde'(Ludwig Bechstein)의 분석심리학적 관점에서의 이해)

  • Kwang Ja Lee
    • Sim-seong Yeon-gu
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    • v.25 no.2
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    • pp.194-223
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    • 2010
  • I tried here to interpret german fairy tale "Three Dogs" from the aspect of analytical psychology. A poor young shepherd will be 'hero'accidently while wandering the world to find good luck. When he was exhausted and frustrated in wandering life, a stranger appeared before him. A stranger offered barter. So he exchanged three sheep with three black dogs which a stranger had. One dog can bring the food. Another dog can tear everything. The last one can break even steel and iron. After that, shepherd led a satisfactory wandering life. On the way, he met a sad princess who should sacrifice herself for the piece of the country to the dragon which swallows a young girl yearly. But the strong black dog which tears everything, killed the dragon and saved the princess from the sacrifice. After that, a young shepherd promised princess to come back to her after three years of wandering life. In the meanwhile a horse driver played hero false. But the princess couldn't reveal the truth because of the threat of horse driver. Three years later, the young shepherd appeared in the castle. But the true hero was caught in the prison and finally cried out the strongest dog and succeeded in escaping from the prison. And with help of another dog which bring food to him, he could meet the princess and finally married her. So they lived happy life for a long time. But he remembered the poor younger sister. So he wanted to live together with her. After that, three dogs left him with saying, they stayed to see whether he shares his good fortune with his younger sister. Then they turned into birds and disappeared in the air. In this fairy tale can we find many important symbols. With the amplification of symbols and the interpretation of this fairy tale in terms of Jung's analytical psychology, I tried to find the meaning of individuation process in this fairy tale. Hero kills the dragon which could symbolize negative mother archetype. After overcoming the negative mother complex, he could get princess which could be expressive of Anima. This marriage could symbolize coniunctio oppositorum, an important process in individuation. Each fairy tale tells us the individuation process in a different way. And the fairy tale works always in our mind with plain, simple, pure, crystal like nature. Through it can we take precious treasure like wisdom for life.

Early Result of Surgical Management of the Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery (관상동맥-폐동맥 이상 기시증에 대한 수술의 조기 결과)

  • Yoon Yoo Sang;Park Jeong Jun;Yun Tae Jin;Kim Young Hwue;Ko Jae Kon;Park In Sook;Seo Dong Man
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.18-27
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    • 2006
  • Background: Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly, but is one of the most common causes of myocardial ischemia which would result in high mortality within the first year of life. This is our early result of the surgical management for these patients. Material and Method: From June 1989 to July 2003, 6 patients with ALCAPA and one patient with ARCAPA (Anomalous origin of the Right coronary artery from the pulmonary artery) underwent surgical repair. We have reviewed the all medical records, electrocardiogram, chest X-ray and echocardiography retrospectively. Result: Three of the patients were boys and four were girls. The median age at the operation was 5.4 months (Range: 3$\∼$33 months). The average body weight of at the operation was 6.7 kg (Range: 3.7$\∼$11.3 kg). A mean follow up period was 18 months. Only 3 patients were initially diagnosed as ALCAPA. And 3 patients had moderate mitral regurgitation. Immediate coronary artery reimplantation on diagnosis with the aim of restoring a two-coronary system circulation was done. The average bypass time was 114$\pm$37 minutes, and the average aortic cross clamping time was 55$\pm$22 minutes. The average stay of intensive care unit was 5$\pm$3 days, the mean mechanical ventilator time was 38$\pm$45 hours and the hospital stay after operation was 12$\pm$5 days. There were significant improvements in electrocardiogram and chest X-ray of the all patients except one late death patient. The ventricular function showed almost normal recovery after operation; the EF (Ejection Fraction) increased from 41.2$\pm$ 10.3$\%$ to 60.5$\pm$ 15.8$\%$ within 1 month and to 59.8$\pm$13.9$\%$ within 1 year after operation, the SF (Shortening Fraction) increased from 23.6$\pm$4.7$\%$ to 38.6$\pm$8.4$\%$ within 1 month and to 37.4$\pm$7.9$\%$ within 1 year after operation, LVEDDI (Left Ventricular End-diastolic Dimension Index) decreased from 100.8$\pm$25.6 mm/$m^{2}$ to 90.3$\pm$ 19.2 mm/$m^{2}$ within f month and to 79.3$\pm$ 15.8 mm/$m^{2}$ within 1 year after operation. Concomitant mitral repair was done in two patients with anterior mitral leaflet prolapse. In every patient, mitral valve showed less than mild regurgitation during follow up. One late death occurred in which patient Dor procedure was applied 10 months after initial operation due to the dilated cardiomyopathy Conclusion: In the management of this rare and could be fatal Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), early suspicion and correct diagnosis is of most important. But, after diagnosis, immediate restoration of 2 coronary systems could result in good outcome.

Mitral Valve Repair for Mitral Regurgitation in Pediatric Patients (승모판폐쇄부전증를 가진 소아 환자에서 승모판성형술의 임상적 고찰)

  • Sim, Hyung-Tae;Yun, Tae-Jin;Park, Jeong-Jun;Jung, Sung-Ho;Uhm, Ju-Yeon;Jhang, Won-Kyoung;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook;Seo, Dong-Man
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.536-545
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    • 2007
  • Background: Compared to adult patients, mitral regurgitation in pediatric patients is uncommon and it shows a wide spectrum of morphologic abnormalities. We retrospectively evaluated the midterm results of mitral valve repair in pediatric patients. Material and Method: Between December 1993 and August 2006, mitral valve repair was performed in 35 patients who were aged less than 18 years, The mean age was $5.3{\pm}5.3$ years and the mean body weight was $20,0{\pm}16.3\;kg$. 18 patients had associated cardiac anomalies. The most common pathologic finding was leaflet prolapse (n=17). The most common method of repair was the double orifice technique (n=15). Result: There was no early mortality. Eight patients underwent reoperation (24.2%), and five of them required mitral valve replacement. Among the four ring annuloplasty cases, two have developed mitral stenosis. Four out of the 14 double orifice cases required reoperation. One case of early mortality and one case of late mortality occurred in the reoperation cases. The 5-year survival rate and the freedom from reoperation rate were $93.3{\pm}4.6%$ and $76.1{\pm}8.2%$, respectively. The 5-year freedom from mitral valve replacement rate was $83.6{\pm}6.7%$. There was no significant risk factor for reoperation. Conclusion: The midterm results of mitral valve repair are very acceptable in pediatric patients compared to the adult cases, although the reoperation rate is slightly higher.

The Effect of Perceived Shopping Value Dimensions on Attitude toward Store, Emotional Response to Store Shopping, and Store Loyalty (지각된 쇼핑가치차원이 점포태도, 쇼핑과정에서의 정서적 경험, 점포충성도에 미치는 영향에 관한 연구)

  • Ahn Kwang Ho;Lee Ha Neol
    • Asia Marketing Journal
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    • v.12 no.4
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    • pp.137-164
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    • 2011
  • In the past, retailers secured customer loyalty by offering convenient locations, unique assortments of goods, better services than competitors, and good credit policy. All this has changed. Goods assortments among stores have become more alike as national-brand manufacturers place their goods in more and more retail stores. Service differentiation also has eroded. Many department stores have trimmed services, and many discount stores have increased theirs. Customers have become smarter shoppers. They don't pay more for identical brands, especially when service differences have diminished. In the face of increased competition from discount storess and specialty stores, department stores are waging a comeback war. Growth of intertype competition, competition between store-based and non-store-based retailing and growing investment in technology are changing the way consumers shop and retailers sell. Different types of stores-discount stores, catalog showrooms, department stores-all compete for the same consumers by carrying the same type of merchandise. The biggest winners are retailers that have helped shoppers to be economically cautious, simplified their increasingly busy and complicated lives, and provided an emotional connection. The growth of e-retailers has forced traditional brick-and-mortar retailers to respond. Basically brick-and-mortar retailers utilize their natural advantages, such as products that shoppers can actually see, touch, and test, real-life customer service, and no delivery lag time for small-sized purchases. They also provide a shopping experience as a strong differentiator. They are adopting practices as calling each shopper a "guest". The store atmosphere should match the basic motivations of the shopper. If target consumers are more likely to be in a task-oriented and functional mindset, then a simpler, more restrained in-store environment may be better. Consistent with this reasoning, some retailers of experiential products are creating in-store entertainment to attract customers who want fun and excitement. The retail experience must deliver value to turn a one-time visitor into a loyal customer. Retailers need a tool that measures the full range of components that define experience-based value. This study uses an experiential value scale(EVS) developed by Mathwick, Malhotra and Rigdon(2001) which reflects the benefits derived from perceptions of playfulness, aesthetics, customer "return on investment" and service excellence. EVS is useful to predict differences in shopping preferences and patronage behavior of customers. EVS consists of items measuring efficiency, economic value, visual appeal, entertainment value, service excellence, escapism, and intrinsic enjoyment, which are subscales of experiencial value. Efficiency, economic value, service excellence are linked to the utilitarian shopping value. And visual appeal, entertainment value, escapism and intrinsic enjoyment are linked to hedonic shopping value. It has been found that consumers value hedonic experiences activated from escapism and attractiveness of shopping environment as much as the product quality, price, and the convenient location. As a result, many department stores, discount stores, and other retailers are introducing differential marketing strategy based on emotional/hedonic values. Many researches suggest that consumers go shopping not only for buying products but also for various shopping experiences. In other words, they seek the practical, rational value as well as social, recreational values in the shopping process(Babin et al, 1994; Bloch et al, 1994). Retailers may enhance buyer's loyalty to store by providing excellent emotional/hedonic value such as the excitement from shopping, not just the practical value of buying good products efficiently. We investigate the effect of perceived shopping values on the emotional experience and store loyalty based on the EVS(Experiential Value Scales) developed by Holbrook(1994), Mathwick, Malhotra and Rigdon(2001). This study assumes that the relative effect of shopping value dimensions on the responses of shoppers will differ according to types of stores and analyzes the moderating effect of store type(department store VS. discount store) on the causal relationship between shopping value dimensions and store loyalty. Emprical results show that utilitarian values of shopping experience and hedonic value of shipping experience give the positive effect on the emotional response of consumers and store loyalty. We also found the moderating effect of store types. The effect of utilitarian shopping values on the attitude toward discount store is higher than the effect of utilitarian shopping values on the attitude toword department store. And the effect of hedonic shopping value on the emotional response to discount store is higher than on the emotional response to department store. The empirical results reflect on the recent trend that discount stores try to fulfill the hedonic needs of consumers as well as utilitarian needs(i.e, low price) that discount stores traditionally have focused on

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