• Title/Summary/Keyword: Head tilt

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Effect of fludrocortisone in cervical spinal cord injury patients with orthostatic hypotension - randomized controlled trial (경수부 척수손상 환자의 기립성 저혈압에서 플루드로코티손의 효과 - 무작위 대조군 연구)

  • Lee, Do-Hee;Joo, Min-Cheol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.6
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    • pp.108-115
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    • 2021
  • The purpose of this study was to investigate the therapeutic effect of fludrocortisone in patients suffering from cervical spinal cord injury (SCI) with orthostatic hypotension (OH). Twenty-six patients with cervical SCI diagnosed with OH through a head-up tilt test were randomly assigned, and they were given either conservative treatment or additional fludrocortisone treatment. Fludrocortisone was administered for 2 weeks, increasing from 0.1 mg to 0.2 mg week . Blood pressure (BP), heart rate (HR), and blood parameters were measured at the beginning and after 2 weeks. After 2 weeks of treatment, there was a significant increase in the baseline BP of the treatment groups (p<.05). When analyzing the drop ratio, there was a tendency for a lower orthostatic BP drop in the treatment groups. Mild adverse events were reported in 7.69% of the treatment groups. Fludrocortisone exhibited therapeutic effects such as preventing cardiovascular complications and continuing rehabilitation through increased baseline BP and reduced OH, and can therefore be considered as a treatment option for OH in patients with SCI.

External Auditory Canal Atresia with Otitis Media in a Dog

  • Kim, Ah Reum;Han, Changhee;Hwang, Gunha;Kim, Rakhoon;Go, Woohyun;Lee, Ji Yeong;Lee, Jongbong;An, Soyon;Hwang, Tae Sung;Lee, Dongbin;Lee, Jae-Hoon;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.38 no.3
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    • pp.159-162
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    • 2021
  • A 5-year-old, intact male, poodle dog with right external auditory canal obstruction and subaural mass was presented. Physical examination revealed that right external auditory canal opening was absent and right head tilt was identified. Aspiration in right subaural mass revealed a small amount of dark brown exudate. Streptococcus canis and Staphylococcus spp. were identified on the microbial culture. Radiography of the skull was revealed absence of air-filled ear canal at the right external ear canal (EEC) level. Computed tomography (CT) revealed well capsulated, hypoattenuated mass in the right EEC region. On the contrast enhanced CT images, rim enhancement around the mass and ear canal obstruction were identified. Fluid attenuated material filled with right bulla. Mild thickening of the right tympanic bulla wall with mild lytic lesion of the ventral wall were found. Based on the images findings, the case was tentatively diagnosed as right external auditory canal atresia with otitis media. Total ear canal ablation and lateral bulla osteotomy was performed. The entire ear canal was removed, numerous hair in the canal and the thickening wall were founded. Right ear canal was sent for histopathological evaluation and found to otitis externa. The patient was followed up for two weeks and there were no complications. This report described the CT diagnosis of right EEC atresia with otitis media rarely reported in small breed dogs.

Steroid Responsive Tremor Syndrome in a Maltese Dog (말티즈 견에서 발생한 스테로이드 반응성 진전 증후군)

  • Kang, Byeong-Teck;Jung, Dong-In;Park, Chul;Kim, Ju-Won;Kim, Ha-Jung;Lim, Chae-Young;Ko, Ki-Jin;Cho, Sue-Kyung;Lee, So-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.337-339
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    • 2006
  • A 4-year-old, spayed female Maltese dog was presented for evaluation of acute onset of generalized tremor, right-sided head tilt, horizontal nystagmus, and mild ataxia with 4-day duration. However, the dog was bright, alert, and responsive. The neurological examinations revealed that bilateral horizontal-, positional nystagmus, and mild ataxia. Menace responses were also absent in both eyes. Typically, moderate generalized intension tremors were noted in four limbs and the head. No abnormalities were found in hemogram, radiography, and magnetic resonance imaging(MRI). Cytologic examination of cerebrospinal fluid(CSF) revealed a mild nonsuppurative inflammation. Thus, steroid responsive tremor syndrome(SRTS) was strongly suspected because of its inflammatory and idiopathic features. The dog excellently responded to immunosuppressive doses of corticosteroid. Therefore, we definitively diagnosed the dog as SRTS based on the exclusion of other causes of the tremor, clinical signs, and response to treatment. This is a first case report of SRTS in our country and we here describe clinical and neurological features in SRTS.

Target Strength of Schlegel′s Black Rockfish (Sebastes schlegeli)and Red Seabream (Pagrus major) (조피볼락과 참돔의 표적 강도에 관한 연구)

  • 손창환;황두진
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.38 no.2
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    • pp.119-128
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    • 2002
  • This study investigates dorsal aspect target strength with fish size, tilt angle and frequency characteristics for the schlegel's black rockfish(Sebastes achlegeli) and the red seabream (Pagrus major). This study was carried out on free swimming fish in a cage in order to obtain acoustic data of the biomass estimation using the scientific echo sounder. The results obtained from this study are summarized as follows; 1 The coefficients of the schlegel's black rockfish and the red seabream using maximum TS with fish length were expressed -63.7dB and -62.6dB at a frequency of 38kHz, -64.4dB and -65.4dB at 120kHz, and -62.4dB and -65.0dB at 200kHz, respectively. 2. The coefficients of the schlegel\`s black rockfish and the red seabream using averaged TS with fish length were expressed -68.4dB and -67.9dB at a frequency of 38kHz, -73.4dB and -72.7dB at 120kHz, and -70.BdE and -73.4dB at 2001Hs, respectively. 3. The coefficients of the schlegel's black rockfish and the red seabream using maximum TS with body weight were expressed -52.0dB and -50.9dB at a frequency of 38kHz, -52.7dB and -53.7dB at 120kHz, and -50.7dB and -53.3dB at 200kHz, respectively. 4. The coefficients of the schlegel's black rockfish and the red seabream using averaged TS with body weight were expressed -56.7dB and -56.2dB at a frequency of 38kHz, -61.7dB and -61.0dB at 120kHz, and -59.ldE and -61.6dB at 200kHz, respectively. 5. Varying the tiIt angle of the two red seabream from -26$^{\circ}$to +25$^{\circ}$, the variation width of target strength expressed smaller at a frequency of 38kHz than at 120kHz and expressed about 3~6dB higher head up than head down at 120kHz.

Trigeminocardiac Reflex Induced by Electrohemostasis during Total Ear Canal Ablation in a Dog (개의 전이도적출술 중 전기지혈에 의해 발생한 삼차신경심장반사 1례)

  • Jo, Sang-min;Son, Won-gyun;Jang, Min;Kim, Wan Hee;Lee, Byung-Cheon;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.33 no.4
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    • pp.234-236
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    • 2016
  • A 14 kg, 9-year-old, spayed female, Cocker Spaniel was presented to the Veterinary Medical Teaching Hospital of Seoul National University with a history of head tilt and circling. Otitis externa and media were diagnosed by computerized tomography, and total ear canal ablation was performed. In preanesthetic evaluation, systemic hypertension and second-degree atrioventricular block were observed, but there was no regurgitation through the heart valves. Systemic hypertension was managed with amlodipine (0.1 mg/kg, PO, BID) for the anesthesia. The dog was premedicated with cefazolin (22 mg/kg, IV) and midazolam (0.2 mg/kg, IV). Anesthesia was induced with alfaxalone (2 mg/kg, IV) and maintained with isoflurane and 100% oxygen following intubation. During surgery, vital signs (heart rate, respiratory rate, blood pressure, end tidal carbon dioxide partial pressure and body temperature) were maintained within normal ranges, but bradycardia was observed and corrected with glycopyrrolate (5 ug/kg IV, twice). During subcuticular suture, electrohemostasis was applied at the incision line, which was close to the trigeminal nerve. In no time at all, heart rate dramatically decreased from 110 to 60 beats per minute. No additional treatment was done because mean blood pressure was maintained above 70 mmHg. The heart rate recovered according to the decrease of end tidal isoflurane concentration and there were no complications associated with the anesthesia and surgery. Sudden bradycardia after electrical stimulation around the trigeminal nerve was considered as trigeminocardiac reflex (TCR). It is recommended to be careful of bradycardia from TCR when electrocautery is used in the craniofacial area during surgery.

Effects of Manual Intervention and Self-Corrective Exercise Models of the General Coordinative Manipulation on Balance Restoration of Spine and Extremities Joints

  • Moon, Sang Eun;Kim, Mi Hwa
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.2
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    • pp.573-587
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    • 2013
  • The purpose of this study was conducted in order to analyze the effects of the manual intervention and self-corrective exercise models of general coordinative manipulation(GCM) on the balance restoration of spine & extremities joints with distortions and mal-alignment areas. The subjects were the members who visited GCM Musculoskeletal Prevent Exercise Center from March 1 2012 to December 31 2013 because of spine & extremities joints distortion and mal-alignments, poor posture, and body type correction. All subjects were diagnosed with the four types of the GBT diagnosis. And according to the standards of the mobility vs stability types of the upper & lower body, they were classified into Group 1(40 persons) and Group 2(24 persons). For every other day for three times a week, GCM intervention models were applied to all subjects for four weeks, adding up to 12 times in total. Then the balance restoration effects were re-evaluated with the same methods. The results are as follows. 1) Balance restoration effects of VASdp(Visual analysis scale pain & discomfort) and ER(Equilibrium reaction: ER) came out higher in GCM body type(GBT) II III IV of Group 1. 2) In case of balance restoration effects in Moire and postural evaluation areas, Group 1 was higher and cervical and scapular girdle were higher in Group 2. The balance restoration of the four GBT types was significant in all regions(p<.05), and the scapular girdle came out as high in the order of GBTII IV I. 3) In case of thoracic-lumbar scoliosis and head rotation facial asymmetric cervical scoliosis ribcage forward, the balance restoration effects of the upper body postural evaluation areas came out the highest in Group 1 and Group 2, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in lumbar scoliosis GBTIII I, ribcage forward and thoracic scoliosis GBTII IV. 4) The balance restoration effects of the lower body postural evaluation areas came out higher in Group 1 and Group 2 for pelvis girdle deviation patella high umbilicus tilt and hallux valgus foot longitudinal arch: FLA patella direction, respectively. The balance restoration effects of the four GBT types were significant in all regions(p<.05), and came out the highest in pelvis girdle deviation GBTIII I and patella high-direction GBTIV II I. 5) The balance restoration effects between the same GBT came out significant (p<.05) in all evaluation areas and items. The conclusions of this study was the manual intervention and self-corrective exercise models of the GCM about the mal-alignment of the spine & extremities joints across the whole body indicated high balance restoration effects(p<.05) in spine & extremities joints in all evaluation areas.

Production Technology for Multi-face Convergence Performance (Multi-face Convergence 공연을 위한 제작 기술)

  • You, Mi;Son, Tae-Woong;Kim, Sang-Il
    • Journal of Broadcast Engineering
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    • v.25 no.4
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    • pp.475-486
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    • 2020
  • This paper is a thesis on media art technology for high-tech performances and exhibitions. After creating an interactive stroke in VR, it is projected in real time through a media facade technique. Among our traditional dramas emphasizing linear movements, movements were extracted from the Bongsan mask dance, and the movements of the lines were used in a media art performance called 'Multi-face Convergence'. When motion data enters the virtual space, geometry consisting of faces is created in the VR space. The created strokes can be set with various brush types, and when performing, a stroke with a red fire effect that matches a dynamic movement was used. It was made to be able to harmonize with the dancers performing the Bongsan mask dance. The medium called VR has characteristics that are not suitable for melting into a performance, but in this performance, it has overcome its limitations by using a technique called media façade. We propose the world's first performance technique that combines interactive strokes with traditional dance performances.

Study a Technique for Reducing the Influence of Scattered Rays from Surrounding Organs to the Heart during Gated Cardiac Blood Pool scan (Gated Cardiac Blood Pool scan에서의 심장 주위 배후방사능 관심영역 설정시 산란선의 영향을 감소시키기 위한 연구)

  • Kim, Jung-Yul;Park, Hoon-Hee;NamKoong, Hyuk;Cho, Suk-Won;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.33-38
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    • 2008
  • Purpose: The Gated cardiac blood pool scan is non-invasive method that a quantitative evaluation of left ventricular function. Also this scan have shown the value of radionuclide ejection fraction measurements during the course of chemotherapy as a predictor of cardiac toxicity. Therefore a reliable method of monitoring its cardiotoxic effects is necessary. the purpose of this study is to minimize the overestimate of left ventricular ejection fraction (LVEF) by modified body position to reduce the influence of scattered rays from surrounding organs of the heart in the background region of interest. Materials and Methods: Gated cardiac blood pool scan using in vivo $^{99m}Tc$-red blood cell (RBC) was carried out in 20 patients (mean $44.8{\pm}8.6$ yr) with chemotherapy for a breast carcinoma. Data acquisition requires about 600 seconds and 24 frames of one heart cycle by the multigated acquisition mode, Synchronization deteriorates toward the end of the cycle and with the distance from the trigger signal (R-wave) by ECG gating. Gated cardiac blood pool scan was studied with conventional method (supine position and the detector head in $30-45^{\circ}$ left anterior oblique position and caudal $10-20^{\circ}$ tilt) and compared with modified method (left lateral flexion position with 360 mL of drinking water). LVEF analysis was performed by using the automatically computer mode. Results: The ROI counts of modified scan method were lower than LV conventional method ($1429{\pm}251$ versus $1853{\pm}243$, <0.01). And LVEF of modified method was also decrease compared with conventional method ($58.3{\pm}5.6%$ versus $65.3{\pm}6.1%$, <0.01). Imaging analysis indicated that stomach was expanded because of water and spleen position was changed to lateral inferior compared with conventional method. Conclusion: This study shows that the modified method in MUGA reduce the influence of scattered rays from surrounding organs. Because after change the body position to left lateral flexion and drinking water, the location of spleen, left lobe of liver and stomach had changed and they could escaped from background ROI. Therefore, modified method could help to minimize the overestimate LVEF (%).

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Study the Analysis of Comparison with AROI and MROI Mode in Gated Cardiac Blood Pool Scan (게이트심장혈액풀 스캔에서 자동 관심영역 설정과 수동 관심영역 설정 모드의 비교 분석에 관한 고찰)

  • Kim, Jung-Yul;Kang, Chun-Koo;Kim, Yung-Jae;Park, Hoon-Hee;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.222-228
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    • 2008
  • Purpose: The objectives of this study were to compare the left ventricle ejection fraction (LVEF) from gated cardiac blood pool scan (GCBP) for analysis auto-drawing region of interest mode (AROI) and manual-drawing region of interest mode (MROI), respectively. To evaluation the relationships between values produced by both ROI modes. Materials and Methods: Gated cardiac blood pool scan using in vivo method Tc-99m Red Blood Cell were performed for 33 patients (mean age: $53.2{\pm}13.2\;y$) with objective of chemotherapy using single head gamma camera (ADAC Laboratories, Milpitas, CA). Left ventricular ejection fraction was automatically and manually measured, respectively. Results: There was significant difference statistically between AROI and MROI ($LVEF^{AROI}$: $71.4{\pm}12.4%$ vs. $LVEF^{MROI}$: $65.8{\pm}5.9%$, p=0.003). Intra-observer agreements in AROI was higher than MROI ($\gamma^{AROI}=0.964$, Cronbach's $\alpha^{AROI}=0.986$ vs. $\gamma^{MROI}=0.793$, Cronbach's $\alpha^{MROI}=0.911$), either. Additionally, there was no significant difference statistically at best septal view (${\Delta}LVEF^{BSV}=0.7{\pm}2.3%$, p=0.233), however statistically significant difference was found at badly separated septal view (${\Delta}LVEF=10.9{\pm}11.4%$, p=0.001). Moreover, Intra-observer agreements in best septal view was higher than badly separated septal view ($\gamma^{BSV}=0.939$, Cronbach's $\alpha^{BSV}=0.978$; $\gamma=0.948$, Cronbach's $\alpha=0.981$ at AROI, $\gamma^{BSV}=0.836$, Cronbach's $\alpha^{BSV}=0.936$; $\gamma=0.748$, Cronbach's $\alpha=0.888$ at MROI). Conclusion: When best septal view was acquired, LVEF by AROI and MROI indicated not different. Comparing Intra-observer agreements with AROI and MROI, the AROI tended to show higher. Therefore, it is considered that the AROI than MROI is valuable in reproducibility and objective when ROI analysis by acquire left ventricular of best septal view.

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The characteristics of neurocardiogenic syncope in children (소아 신경-심인성 실신의 특징)

  • Lee, Kyung Yeon;Lee, Jin Young;Kim, Myoung Hyun;Lee, Jeong Eun;Kim, Yong Dae;Lee, Eun Ju;Lim, Young Su;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.512-517
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    • 2008
  • Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)]. Conclusion : Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.