• Title/Summary/Keyword: Prone Position

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Reliability of Early Ambulation after Intradural Spine Surgery : Risk Factors and a Preventive Method for Cerebrospinal Fluid Leak Related Complications

  • Lee, Subum;Cho, Dae-Chul;Kim, Kyoung-Tae;Lee, Young-Seok;Rhim, Seung Chul;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.799-807
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    • 2021
  • Objective : Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC. Methods : For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution. The early group contained 79 patients who started ambulation after 1 day of bedrest without position restrictions, while the late group consisted of 235 patients who started ambulation after at least 3 days of bed rest and were limited to the prone position after surgery. In the early group, Prolene 6-0 was used as the dura suture material, while black silk 5-0 was used as the dura suture material in the late group. Results : The overall incidence rate of CLC was 10.8%. Significant differences between the early and late groups were identified in the rate of CLC (2.5% vs. 13.6%), surgical repair required (1.3% vs. 7.7%), and length of hospital stay (2.99 vs. 9.29 days) (p<0.05). Logistic regression analysis revealed that CLC was associated with practices specific to the late group (p=0.011) and the revision surgery (p=0.022). Conclusion : Using Prolene 6-0 as a dura suture material for intradural spinal surgery resulted in lower CLC rates compared to black silk 5-0 sutures despite a shorter bed rest period. Our findings revealed that suture - needle ratio related to dura defect was the most critical factor for CLC. One-day ambulation after primary dura closure using Prolene 6-0 sutures appears to be a costeffective and safe strategy for intradural spinal surgery.

Evaluation of Acute Toxicity of Pomace Schisandra chinensis Extracts Using SD-rats (SD-rats를 이용한 오미자박 추출물의 급성경구독성 평가)

  • Seokho, Kim;Bo Ra, Yoo;Young-Suk, Kim;Jong-Min, Lim;Bon-Hwa, Ku;Kyeong Tae, Kwak;Byeong Yeob, Jeon
    • Herbal Formula Science
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    • v.30 no.4
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    • pp.281-291
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    • 2022
  • Objectives : In this study, acute oral toxicity test of pomace Schisandra chinensis extracts was conducted in order to up-cycling to a high value-added industry using by-products discarded in the production process of Schisandra chinensis products and active ingredients such as dibenzocyclooctadiene lignans in Schisandra chinensis. Methods : Pomace Schisandra chinensis extracts were orally administered to SD-rats(female, n=3) without a control group according to the 'OECD guidelines'. After, mortality and clinical signs were observed, and the deceased animals were subjected to an autopsy. In addition, acute oral toxicity test was sequentially performed in step I (300 mg/kg), step II(300 mg/kg), step III(2,000 mg/kg), and step IV(2,000 mg/kg) according to the mortality. Results : There were no abnormalities caused by pomace Schisandra chinensis extracts in step I and step II. However, one animal each died in step III and step IV. In addition, clinical signs(salivation, decrease in food intake, prone position, decrease of locomotor activity, loss of locomotor activity, convulsion, hypothermia, lacrimation, staining around mouth, soiled perineal region, reddish urine, chromaturia, decrease of fecal volume, lying on side, blackish stool, no stool, compound-colored stool, refusal to feed, excitement, hypersensitivity, rigidity, dorsal position, etc.) were observed. But, no clinical signs were observed from 5th day, and experiment animals recovered completely. Conclusions : As a result of this study, pomace Schisandra chinensis extracts may exhibit acute toxicity at concentrations of 2,000 to 5,000 mg/kg, and the GHS classification was designated as 'Category 5'.

Effects of Shoulder Abduction Angles on Rounded Shoulders During Lower Trapezius Strengthening Exercise (아래등세모근 강화운동 시 어깨관절의 벌림 각도에 따라 둥근 어깨에 미치는 영향)

  • Hyeon-Su Kim;Ji-Won Han;Keon-Cheol Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.1
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    • pp.131-140
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    • 2023
  • Purpose : The purpose of this study is to find out which shoulder abduction angle among the three representative angles of lower trapezius strengthening exercises most effectively improves rounded shoulder posture. Methods : Thirty-one people with rounded shoulders, the subjects of this study, were selected. With the use of a random number table, group A was randomly assigned to a Y-type exercise, group B to a T-type exercise, and group C to an MPC exercise. In the prone position, both arms are abducted at the angles suggested for each group (145 °, 90 °, and 45 °, respectively), and the hands are holding dumbbells to assume a functional posture. With the start signal, the thumb raised the arm to the sky and the arm is raised to the level of the ear for 10 seconds and then returned to the original position. Each week, the strength required was increased by changing the resistance weight, number of times, and set, and the exercise was performed three times a week for a total of four weeks. Results : There was a significant difference in the change in shoulder height of each group after four weeks of exercise in comparison to the amount of change in height before and after exercise in all groups (p<.05). However, no significant difference was observed between all groups in the change in muscle activity of the lower trapezius muscle in each group following four weeks of exercise (p>.05). Conclusion : The results of this study showed that the three lower trapezius strengthening exercises have a positive effect on the improvement of rounded shoulders. In consideration of these results, it is therefore proposed that the various lower trapezius strengthening exercises be applied in parallel during physical therapy for patients with rounded shoulders in clinical practice.

Comparison of Infraspinatus and Posterior Deltoid Muscle Activities According to Exercise Methods and Forearm Positions During Shoulder External Rotation Exercises (어깨 가쪽돌림 운동 시 운동방법과 아래팔의 자세에 따른 가시아래근과 뒤어깨세모근의 근활성도 비교)

  • Son, Myeong-gi;Kim, Suhn-yeop
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.106-116
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    • 2022
  • Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

Sudden Unexpected Death in Infancy (Analysis of 34 Cases Including 13 Autopsies) (영아 돌연사에 대한 고찰 (13 부검례를 포함한 34례 분석))

  • Moon, Yeo Ok;Choi, Hee Kyoung;Her, Jeoung-A;Shin, Woo Jong;Kim, Myoung-A;Lee, Seong Yong;Jang, Seong Hee;Dong, Eun Sil;Kim, Chong Jae;Ahn, Young Min;Chi, Je Geun
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1065-1074
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    • 2002
  • Purpose : The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. Methods : We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. Results : Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. Conclusion : We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.

Description of Rolling Movement Between the Gender in the Twenties (20대 남녀별 구르기 형태의 분석)

  • Kwon Mi-Ji;Bae Sung-Soo;Chen Jae-Kyun
    • The Journal of Korean Physical Therapy
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    • v.6 no.1
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    • pp.133-145
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    • 1994
  • The purpose of this study were 1) to describe the rolling movements of the twenties, 2) to identify developmental sequences of three body regions and 3) to evaluate the influence gender might have on the movement patterns used for rolling. Fifty males(mean 23.2 years of age) and fifty females(mean 21.1 years of age) performed the 10 trials of rolling from a supine to a prone position while being videotaped. Individual videotaped trials were classified using the described categories for upper extremity, lower extremity and head-trunk component. The most common combination of movement patterns described. The results of this study were as follows : 1. Only $16\%$ of males and $12\%$ of females demonstrated a same combination of movements during rolling. 2. Gender differences were found in the incidence of movement patterns of each body region. 3. This study determined if head-trunk anion might develop in advance of limb action. 4. This study determined if upper extremity action might develop in advance of lower extremity action. The variability of adults' rolling movement provides physical therapists with numeous movement combinations that might be used when teaching patterns to rolling.

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Wind-induced fragility assessment of urban trees with structural uncertainties

  • Peng, Yongbo;Wang, Zhiheng;Ai, Xiaoqiu
    • Wind and Structures
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    • v.26 no.1
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    • pp.45-56
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    • 2018
  • Wind damage of urban trees arises to be a serious issue especially in the typhoon-prone areas. As a family of tree species widely-planted in Southeast China, the structural behaviors of Plane tree is investigated. In order to accommodate the complexities of tree morphology, a fractal theory based finite element modeling method is proposed. On-site measurement of Plane trees is performed for physical definition of structural parameters. It is revealed that modal frequencies of Plane trees distribute in a manner of grouped dense-frequencies; bending is the main mode of structural failure. In conjunction with the probability density evolution method, the fragility assessment of urban trees subjected to wind excitations is then proceeded. Numerical results indicate that small-size segments such as secondary branches feature a relatively higher failure risk in a low wind level, and a relatively lower failure risk in a high wind level owing to windward shrinks. Besides, the trunk of Plane tree is the segment most likely to be damaged than other segments in case of high winds. The failure position tends to occur at the connection between trunk and primary branches, where the logical protections and reinforcement measures can be implemented for mitigating the wind damage.

On the mitigation of surf-riding by adjusting center of buoyancy in design stage

  • Yu, Liwei;Ma, Ning;Gu, Xiechong
    • International Journal of Naval Architecture and Ocean Engineering
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    • v.9 no.3
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    • pp.292-304
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    • 2017
  • High-speed vessels are prone to the surf-riding in adverse quartering seas. The possibility of mitigating the surf-riding of the ITTC A2 fishing vessel in the design stage is investigated using the 6-DOF weakly non-linear model developed for surf-riding simulations in quartering seas. The longitudinal position of the ship's center of buoyancy (LCB) is chosen as the design parameter. The adjusting of LCB is achieved by changing frame area curves, and hull surfaces are reconstructed accordingly using the Radial Basis Function (RBF). Surf-riding motions in regular following seas for cases with different LCBs and Froude numbers are simulated using the numerical model. Results show that the surf-riding cannot be prevented by the adjusting of LCB. However, it occurs with a higher threshold speed when ship's center of buoyancy (COB) is moved towards stem compared to moving towards stern, which is mainly due to the differences on wave resistance caused by the adjusting of LCB.

A Dumbbell-Shaped Meningioma Mimicking a Schwannoma in the Thoracic Spine

  • Kim, Myeong-Soo;Eun, Jong-Pil;Park, Jeong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.264-267
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    • 2011
  • A 50-year-old man presented bilateral hypesthesia on and below the T6 dermatome and paresthesia. Magnetic resonance imaging (MRI) showed an intraspinal extradural tumor, which located from the 6th thoracic vertebral body to the upper margin of the 7th vertebral body, continuing dumbbell-like through the intervertebral foramen into the right middle thorax suggesting a neurogenic tumor (neurofibroma or neurilemmoma). With the patient in a prone position, we exposed and excised the tumor via a one stage posterior approach through a hemi-laminictomy of T6. Histologic examination showed a grade 1 meningothelial meningioma, according to the World Health Organization classification. Initially, we assumed the mass was a schwannoma because of its location and dumbbell shape. However, the tumor was actually a meningioma. Postoperatively, hypesthesia resolved completely and motor power of the leg gradually full recovered. A postoperative MRI revealed no evidence of residual tumor.

Nonaneurysmal Subarachnoid Hemorrhage : Rare Complication of Vertebroplasty

  • Lim, Jae-Bum;Park, Joung-Soo;Kim, Ealmaan
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.386-389
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    • 2009
  • On rare occasions, percutaneous vertebroplasty (PV) may be associated with adverse spinal and extraspinal events. Subarachnoid hemorrhage (SAH) has not been reported complication following a PV. This is a report of two elderly women with spine compressions who developed idiopathic SAH after injecting polymethylmethacrylate into the thoracolumbar region transcutaneously. PV was performed as an usual manner on prone position under local anesthesia for these patients. During the interventions, two patients complained of a bursting nature of headache and their arterial blood pressure was jumped up. Computed tomography scans revealed symmetric SAH on the both hemispheres and moderate degree of hydrocephalus. Any intracranial vascular abnormalities for their SAH were not evident on modern neuroangiography modalities. One patient received a ventricular shunt surgery, but both fully recovered from the procedure-related SAH. The pathophysiologic mechanism that induce SAH will be discussed, with suggesting the manner that prevent and minimize this rare intracranial complication after PV.