• Science of Emotion and Sensibility
• /
• v.8 no.2
• /
• pp.95-101
• /
• 2005

This study is based on previous information regarding reduced cardiac vagal activity in patients with coronary artery disease(CAD), on reduced variance(SDNN : standard deviation of all normal RR intervals), low-frequency power(LF), and the complexity of heart rate variability(HRV) in patients with chronic heart failure(CHF), and on the normalized high-frequency power of HRV is the highest in the right lateral decubitus position among 3 recumbent postures in patients with CAD, However, nothing is known about the nonlinear dynamics of HRV for the 3 recumbent postures in patients with CAD. To investigate the linear and non-linear characteristics of HRV in patients with CAD, 29 patients as CAD group and 23 patients as control group were studied. Electrocardiogram(ECG) with lead II channel was measured on these patients for 3 recumbent postures in random order. The HRV from ECG was analyzed with linear method(for time and frequency domains) and nonlinear method. The lower the high-frequency power in normalized unit(nHF) in the supine or left lateral decubitous position, the higher the increase in nHF when the position was changed from supine or left lateral decubitous to right lateral decubitous. Among the 3 recumbent postures in patients with severe CAD, the right lateral decubitus position was observed to induce the highest vagal modulation, the lowest sympathetic modulation, and the highest complexity of human physiology system.

• Korean Journal of Adult Nursing
• /
• v.12 no.1
• /
• pp.122-133
• /
• 2000

The purpose of this study was to identify the effect of body positioning on $PaO_2$, $SpO_2$, systolic blood pressure, diastolic blood pressure, pulse, and respiration(above all defined physiologic index), of patients with unilateral lung disease. The subjects for this study were eleven patients admitted to I.C.U. of K.H.M.C. with a diagnosis of unilateral lung disease confirmed by chest X-ray and the attending doctor, from January 30th. to April 20th. 1999. A quasi-experimental repeated-measures cross-over design was used to compare three body positions(semi-Fowler's, lateral decubitus with good lung dependent, and lateral decubitus with diseased lung dependent). Each subject spent 30 minutes in semi-Fowler's position and 2 hours in good lung dependent position and diseased lung dependent position. Starting in the semi-Fowler's position, then in the lateral position with the good lung dependent or the diseased lung dependent as assigned in random order. Thirty minutes after each positioning, arterial blood sample was analyzed. Measurements of all physiologic index were recorded at the specified intervals(0, 30, 60 90, and 120 minutes) in good lung dependent and diseased lung dependent position. Statistical comparison of $PaO_2$ value was done using the Wilcoxon Signed Rank Test, and Multivariate repeated-measures analysis of variance was performed to analyse the within-subject effect of two dependent position for 2 hours on the five dependent variables: (1) $PaO_2$ (2) $SpO_2$ (3) systolic blood pressure (4) diastolic blood pressure (5) pulse. The results obtained were as follows: 1. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the diseased lung dependent position(Z=-2.8451, p=.002). 2. The $PaO_2$ value in the good lung dependent position was significantly higher than the $PaO_2$ value in the semi-Fowler's position (Z=-2.6673, p=.003). 3. The difference between the $PaO_2$ value in the semi-Fowler's position and the $PaO_2$ value in the diseased lung dependent position was not significant(Z=-1.2448, p=.10). 4. There were no statistically significance in the trends of physiologic index in the good lung dependent position and the diseased lung dependent position. From the results, it may be concluded that the good lung dependent position is the most effective position for patients with unilateral lung disease that improve oxygenation. Identification of positioning over time may be need further studies.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.89-92
• /
• 1997

Neurolytic splanchnic nerve block is effective for treatment of intractable upper abdominal cancer pain. Conventional approach for splanchnic nerve block is conducted in the prone position to ensure proper orientation and to allow insertion of needles on each side of the vertebral body. However, the prone position has some technical disadvantages as this position is frequently poorly tolerated by a majority of patients with advanced cancer due to severe abdominal pain, ascites and so on. Male patient, 53-year old with transverse colon cancer, carcinomatosis peritonei and $L_1,\;L_2$ vertebral body metastasis, was admitted for treatment of severe right upper quadrant and right iliac crest pain. We performed neurolytic splanchnic nerve block with transdiscal technique in the lateral decubitus position under fluoroscopic guidance, and well noted the usefulness and the advantage of this technique. The benefits of this technique are safe, simple and effective because the lateral position is better tolerated by patients and makes bony landmarks more accessible during fluoroscopy.

• Journal of Yeungnam Medical Science
• /
• v.5 no.2
• /
• pp.201-203
• /
• 1988

Separation of the pubic symphysis in association with delivery is very rare. The Korean orthopedic and obstetrical literature pertaining to this syndrome is absent. The physiological widening is small and asymptomatic, but a separation of more than one centimeter may occur and is usually symptomatic. A twenty-six-year-old woman of separation of symphysis pubis associated with delivery was treated successfully with the treatment of reduction and pelvic band, with absolute bed rest in the lateral decubitus position.

• Journal of the Korean Arthroscopy Society
• /
• v.13 no.3
• /
• pp.235-241
• /
• 2009

The development of good quality small-diametered arthroscopes and refined arthroscopic techniques has contributed to the improvement of the subtalar arthroscopy. The therapeutic indications are synovectomy, removal of loose bodies, debridement and drilling of osteochondritis dissecans, excision of subtalar impingement lesions and osteophytes, lysis of adhesions for post-traumatic arthrofibrosis, removal of a symptomatic os trigonum, calcaneal fracture assessment and reduction, and arthroscopic arthrodesis of the subtalar joint. The subtalar arthroscopy can be done in supine position using thigh holder or in lateral decubitus position. The arthroscope generally used is a 2.7-mm 30 degrees short arthroscope. Noninvasive distraction with a strap around the hindfoot can be helpful. Usually anterolateral, middle and posterolateral portals are utilized for inspection and instrumentation within the joint. Twoportal posterior subtalar arthroscopy in prone position can be performed as well with 4.0-mm 30 degrees arthroscope, depending on the type and location of the subtalar pathology. The subtalar arthroscopy is a technically demanding procedure, which requires proper instrumentation and careful operative technique. Possible complications are nerve damage and persistent wound drainage.

• Clinics in Shoulder and Elbow
• /
• v.26 no.4
• /
• pp.455-461
• /
• 2023

Arthroscopic shoulder procedures are one of the most common procedures used to restore function through minimally invasive techniques. With the demand for shoulder arthroscopic procedures comes the need for safe, effective, and efficient surgery that maximizes patient outcomes while minimizing complications. Many variables contribute to visualization in shoulder arthroscopy including vascular anatomy, blood pressure control, arthroscopic pump systems, turbulence control, epinephrine, and tranexamic acid. Furthermore, patient positioning can have a dramatic effect on visualization with both the beach chair position and lateral decubitus positioning having various strengths and weaknesses depending on the intended procedure being performed. The purpose of this review is to examine the benefits and complications reported in the literature for improving visualization in shoulder arthroscopy.

• Clinics in Shoulder and Elbow
• /
• v.16 no.2
• /
• pp.148-152
• /
• 2013

We report a case of simultaneous anterior and posterior interosseous nerve syndrome in association with shoulder arthroscopy. Shoulder arthroscopy was performed in a 45-year-old male patient with left shoulder instability. In the right lateral decubitus position, under general anesthesia, traction was applied with elbow extension for 2 hours. One week after surgery, the patient revisited the clinic for weakness of the flexor of the thumb, index finger, and extensor of the fingers. Recovery was not achieved after four months of observation. Therefore, nerve exploration was performed in the anterior and posterior interosseous nerve and hourglass-like fascicular constriction was detected in the posterior interosseous nerve. The area of constriction was removed and epineural neurorrhaphy was performed. Three months after exploration, the extension function of the fingers was recovered. Recovery was achieved gradually, and, five months after nerve exploration, the symptoms were completely recovered. Simultaneous anterior and posterior interosseous nerve syndrome following shoulder arthroscopy is rare. However, it could occur due to the traction and position of the patient. Thus, the operator should be careful of traction and position of the patient.

• Clinics in Shoulder and Elbow
• /
• v.5 no.2
• /
• pp.118-123
• /
• 2002

Purpose: The purpose was to identify the effectiveness of beach-chair position in the arthroscopic Bankart repair over conventional lateral decubitus position with distal traction. Materials & Methods: 36 arthroscopic Bankart repair through July 2000 to July 2001 was done under beach chair position. All cases were shoulder instability. Male patients were 6 and female were 4 with average age of 25 years. Arthroscopic suture anchor was used in 24 cases and average number was 3. Results: Interscalene block was tried in 29 patients and 1 case was changed to general anesthesia. Arthroscopic examination to identify Bankart lesion and associated pathology was done without difficulty Bankart lesions were easily reduced to anatomic position and placed suture anchor and hooking approprately. After the arthroscopic examination,3 cases were converted to open procedure without any positional change. Conclusion: Under interscalene block, the preparation was more simple and the patient could watch arthroscopic procedure with confidence. There was no hindrance in arthroscopic examination and arthroscopic repair could be dont: in more anatomic position. It can be easily changed to open repair if it needed

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.73-76
• /
• 1997

Background : Epidural anesthesia is now accepted as a popular technique for pain relief and anesthesia. However, accidental dural puncture may occur during placement of the epidural needle. This study was undertaken to evaluate difference of the epidural depth between parturients and non-parturients. Method : Eighty non-parturients receiving epidural anesthesia were assigned to group I, and eighty parturients whose body weight had not yet increased over 15 kg from pregnancy were assigned to group II. With patients in lateral decubitus position, 18 guage Tuohy needle was punctured by approaching at $L_{3-4}$ interspace. Epidural space was identified using loss-of-resistance to air technique. Result : Epidural depth was 4.18 cm and 4.25 cm in group I and group II respectively. There was no significant statistical difference in body mass index(BMI) and ponderal index(PI) (p<0.05), nor in epidural depth between the two groups. Conclusion : Epidural needle need not be placed deeper in parturients than in nonparturients.

• The Journal of Churna Manual Medicine for Spine and Nerves
• /
• v.1 no.2
• /
• pp.125-135
• /
• 2006

Objectives: The purpose of this study was to investigate the relationship among lumbar lordotic and obesity in Low Back Pain Patient Methods: The subjects of this study were patients with low back pain who visited Jung-Dong Oriental Hospital. X-ray were taken in lateral decubitus. The measurements of the Ferguson angles(FA) and the lumbar lordotic angles(LLA) were performed. We measured BMI and WHR has been accessed bio-impedance analyzer(inbody 3.0). This results were statistically analyzed using SPSS 12.0. Results 1. In female group. FA and LLA were significantly higher than male group. 2. LLA was shown to decrease to rise with increasing WHR and BMI 3. FA had no realtion with WHR and BMI Conclusions: This data shows that obesity related to mechanical structures such as lumbar curvature. Obesity can be a one of the stressor of lumbar spine, and one of the causing factor of low back pain.