• Title/Summary/Keyword: Recumbent position

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Evaluated the L-spine Magnetic Resonance Imaging for the Scanning Method of the Lateral Recumbent Position with to the Embarrassed Control of the Acute Low Back Pain (자기공명검사에서 통증제어가 불가능한 급성 요통 환자의 옆으로 누운 자세에 대한 영상평가)

  • Lee, Jaeheun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.255-260
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    • 2014
  • The acute lumbar pain patients who were unavoidable to take MRI examination were made to take altered lateral recumbent position. they were also not able to control their painfulness and to be in supine position. In this study, it is supposed to increase success rate of the MRI examination through taking the altered lateral recumbent position in using spine and body matrix coil. This altered position made relaxing lumber pain and fatigue for the patients who suffered from sever lumber pain. In these reasons, it decreases the motion artifacts through correcting uncomfortable posture. As a result, qualitative analysis for the image quality was estimated to have average points of supine position A group(lateral recumbent position) of normal candidates and B group(lateral recumbent position) of the abnormal candidates who have sever pain at 4.64, 3.44, and 3.40, respectively. In conclusion, while qualitative analysis in the examination with supine position of the normal patients had significantly high points, the qualitative analysis in the examination with lateral recumbent position of the normal patients and abnormal patients who had sever lumbar pain was almost same. In addition, it was judged that radiologists' imagery interpretation had no other problems in the image evaluation of B group who had acute lumbar pain of abnormal patients. Hereupon, if this technique becomes generalized for the patients who suffer from supine position in the examination, it is supposed to be useful in medical field.

A Study on Change Image According to Recumbent Position Holding Time for Patient Safety (In Chest Lateral Decubitus Examination) (환자안전을 고려한 횡와위 유지시간에 따른 영상변화에 관한 연구 (흉부 측와위 촬영 시))

  • Kim, Ki-Jin;Jeong, Chang-Min;Yoo, Se-Jong;Choi, Won-Jin;Kim, Jeong-Ho
    • Journal of the Korea Safety Management & Science
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    • v.18 no.1
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    • pp.147-152
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    • 2016
  • Chest lateral decubitus is a chest examination to determine the persence of pleural fluid in thorax. In this study, we prepare recumbent holding position time standard of chest lateral decubitus. The records of 15 patients with chest lateral decubitus between May and Jun. Recumbent holding time is 30, 60, 90, 120, 180, 210, 240 seconds. The result is fluid level change between 0.88mm to 9.63. Fluid heigh change between 9.9 percent to 42.5 percent. We can confirm fluid level change with chest decubitus image. The proper time for fluid level change is 180 seconds.

Usefulness of Scan Position Change on Dual Time Point PET-CT in Pancreas Cancer (췌장암 Dual Time Point PET/CT 검사에서 Scan Position Change의 유용성 평가)

  • Chang, Boseok;Kim, Jae Ho
    • Journal of the Korean Society of Radiology
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    • v.10 no.5
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    • pp.299-305
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    • 2016
  • Despite of the development of medical equipments and technology. Pancreatic cancer has maked high false positive rate and low survival rate compared to other cancers. Therefore, early catch of pancreatic cancer is the only way to enhance the viability. It is important to find the exact location of the pancreas cancer in early stage. The method of optimum scan for early detection of pancreatic cancer on PET/CT exam is proposed. Examined the anatomical region that potentially can be missing from the supine position of ordinary pet/ct exam. The characteristics and usefulness of angle variation ($0^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $90^{\circ}$) of patients scan position is analyzed. The proposed scan method (named JJ-projection) is bringing advantage of anatomical discrimination by separating stomach, liver, gallbladder duodenum and pancreas. ROC curve analysis is shows to advantage of the JJ-Projection method. The sensitivity has increased 4.6% than the supine delay scan method, the results sensitivity has increased from 91% to 95.2%. The specificity has increased from 75.1% to 84%. Compared with the results observed in cancer by biological biopsy, The accuracy has increased from 86.8% to 94.1%.

Heart Rate Variability in Patients with Coronary Artery Disease (관상동맥질환 환자의 심박동변이도)

  • Kim Wuon-Shik;Bae Jang-Ho;Choi Hyoung-Min;Lee Sang-Tae
    • Science of Emotion and Sensibility
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    • v.8 no.2
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    • pp.95-101
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    • 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.

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Effect of Postpartum Outcomes in Mother's Upright Position During the Second Stage of Labor: Systematic Review (분만 2기 산모의 직립자세가 분만결과에 미치는 효과: 체계적 문헌고찰)

  • Park, Seong-Hi;Hwang, Jeong-Hae;Choi, Yun-Kyoung;Kang, Chang-Bum
    • Women's Health Nursing
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    • v.18 no.3
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    • pp.209-222
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    • 2012
  • Purpose: The purpose of this study was to determine whether upright position is effective in labor through systematic review in randomized controlled trials. Methods: We established the PICO (Patient-Intervention-Comparator-Outcome) strategy, and reviewed 282 literatures from national and international electronic databases, and finally selected 9 references based on inclusion and exclusion criteria. We evaluated the quality of references and carried out a meta-analysis. Results: The maternal outcomes showed that the duration of their second-stage labor was 2.29 minutes shorter than that of the women in the recumbent position, and were less likely to have episiotomy. The other outcomes, including the mode of delivery, blood loss, hemoglobin level, use of oxytocin, use of analgesics, and perineal laceration, did not differ between the groups. The fetal heart rate abnormality occurred less than in the control group. The Apgar scores of the groups did not differ. Conclusion: There is evidence that an upright position in the second stage of labor reduces the duration of the second stage of labor, the incidence of episiotomy, and an abnormal fetal heart rate.

Preventive Strategies of Ventilator Associated Pneumonia

  • Kim, Jin-A;Kim, Keum-Soon
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.42-55
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    • 2009
  • Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

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Three Cases of Tetracyclines Induced Esophageal Ulcer (Tetracyclines이 원인으로 생각되는 약제성 식도궤양 3례)

  • Lee, Heon-Ju;Chung, Moon-Kwan;Kim, Chong-Suhl
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.179-183
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    • 1984
  • In recent years, an increasing number of drugs have been reported to cause direct esophageal damage. More than 30 cases on tetracyclines induced esophageal ulcer have been reported since the first description of tetracycline induced esophageal ulcer by Bokey and Hugh in 1975. In Korea, only one case of doxycycline-induced esophageal ulcer has been reported. Authors have experienced 3 cases of esophageal ulcer probably caused by tetracyclines. The patients had taken their capsules just before going to bed with little fluid intake. About 6-8 hours later they had felt substernal burning sensation and epigastric discomfort. Gastrofiberscopy revealed relatively well demarcated circular ulcers on the mid esophagus. An esophagogram showed no apparent abnormality. Patients's symptomas became negligible with antacid treatment within 2-5 days. One of the causes of the esophageal ulcer is thought to be the delay in transit time of drugs and direct esophageal damage from mucosal contact when tablets are ingested in the recumbent position without an accompanying proper quantity of fluid. If only physicians endow patients with more concern about drug induced esophageal ulcer, they could find out more increasing number of drug induced esophageal ulcers by gastroscopic examination and thereby could prevent tetracycline induced esophageal ulcer.

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A case of canine patent ductus arteriosus showed favorable therapeutic response by surgery combined with needle-acupuncture therapy

  • Kim, Kwang-Shik;Kim, Byung-Young;Kim, Tae-Hwa;Kim, Won-Bae;Liu, Jianzhu;Lee, Jung-Yeon;Kim, Duck-Hwan;Rogers, Philip A.M.
    • Korean Journal of Veterinary Research
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    • v.45 no.4
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    • pp.575-579
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    • 2005
  • A 6-month-old male Poodle was referred with chief complaint of dysponea and cough. Cyanosis was not detected. This dog was diagnosed as a case of canine patent ductus arteriosus (PDA) by X-ray and ultrasonography. Diuretics and bronchodialators were administered for 4 weeks. Clinical symptoms were not improved. Thoracotomy was done at right recumbent position. The length of ductus arteriosus was 8 mm and the diameter was 6 mm, respectively. Double ligation was performed in surgery. Continuous cardiac murmur, cough and strong femoral pulsation were disappeared after surgery. The diameters of the pulmonary artery and vein found to normal by X-ray on 10 days after operation. The diameter of the aorta measured to be larger than that of the main pulmonary artery by ultrasonography. The fractional shortening (FS) on 10 days after surgery was 17.32% by ultrasonography. The needle-acupuncture therapy was used in acupoints BL-15 as local point plus PC-6, HT-7 and HT-5 as distant points for 3 days (15 min/once/a day). The FSs were increased to 21.31% and 29.44% at 1 and on 3 days after acupuncture, respectively. The present patient was a case of typical canine PDA that showed favorable therapeutic responses by surgery combined with needle-acupuncture treatment.

Intrathecal Block with 10% Phenol-Glycerine for Cancer Pain (암성통증(癌性痛症)에 대(對)한 지주막하(蜘蛛膜下) 10% Phenol-Glycerine 차단(遮斷))

  • Oh, Hung-Kun;Lee, Youn-Woo;Yoon, Duck-Mi;Paik, Sang-Ki;Bang, Sou-Ouk;Koh, Shin-Ock
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.47-52
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    • 1988
  • Since 1979 forty-three cancer patients have been given intrathecal block at the pain clinic of Yonsei Medical Center. The male patients numbered 23 and female 20 and most of them were in the 4th and 5th decades of age. In 78.6% of the patients, the diagnosis was rectal cancer in 20 cases, cervix cancer in 7 cases, bladder cancer in 4 cases and colon cancer in 3 cases. Thirty six patients with cancer pain were treated by intrathecal 10% phenol-glycerine block and rest of them had only test block. Fourteen patients whose pain sites were lumbar or lumbar and upper sacral dermatomes were put into the lateral recumbent position on the fluoroscopic table. The spinal puncture was performed as close to the spinal roots to be impregnated as possible. In 22 patients the pain sites were covered by the sacral dermatomes and so the L5-S1 interspace was punctured in the sitting position shifted 15 degree to the affected site. Fifty one blocks were performed and their results are classified into three categories: good, fair antral poor. We achieved good results in 38 patients(77.1%), fair in 6 patients(17.1%) and poor in 2 patient(5.7%). Thus a satisfactory pain relief was achieved in 94.2% of patients. After intrathecal block with phenol glycerine, transient voiding difficulty was noted in 7, defecation difficulty in 1, and transient paresthesia and/or muscle weakness was present in 3 patients. The mean duration of pain relief was 2.5 months and longer than the mean survival time of 2.25 months. When patients are selected carefully and tile block is performed with great caution and good technique, the risk is minimal and a long lasting relief of intractable cancer pain achieves a painless life until death.

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Spinal Anesthesia for Lower Extremities : Comparison of Plain 0.5% Bupivacaine and Hyperbaric 0.5% Tetracaine (하지수술을 위한 0.5% 순수 Bupivacaine 척추마취)

  • Song, Sun-Ok;Koo, Bon-Up
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.121-130
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    • 1990
  • Plain 0.5% bupivacaine and hyperbaric 0.5% tetracaine were compared for spinal anesthesia in 40 patients undergoing operation of lower extremities. Lumbar puncture was performed with a 22 gauge spinal needle with the patient in the lateral recumbent position. The third lumbar interspace was chosen for the puncture, when a free flow of clear CSF was obtained, the local anesthetic solution (2.5ml of 0.5% bupivacaine or 2.0ml of hyperbaric 0.5% tetracaine) was injected at a rate of 0.1ml/sec without barbotage. After injection of anesthetics, clinical features were observed and compared between the two groups. The results were as follows : 1. The two groups were well matched for age, sex, height and weight. 2. In both groups, sensory block to $T_{12}$ dermatome was obtained within 4 minutes, mean maximal level of analgesia was $T_{6-7}$, and the mean time for maximal level was around 20 minutes. 3. The onset times of motor block were similar in both groups and complete motor block was obtained in all cases within 20 minutes. 4. The duration of analgesia above the $T_{12}$ dermatome was 3 hours, postoperative analgesia was 7 hours. These values were significantly prolonged than those of the tetracaine group(p<0.05). 5. The changes in systolic pressure in the bupivacaine group were significantly less than those of the tetracaine group(p<0.05). 6. The complications after spinal anesthesia were headache, numbness, urinary retention and backpain, and were no significant difference in both groups. From the obtained results, we concluded that plain 0.5% bupivacaine was a relatively satisfactory agent for spinal anesthesia for operation of lower extremities. The time of onset, height of block and the complications of postoperative period were similar in both groups. The advantages of plain 0.5% bupivacaine were less hypotension and long duration of analgesia.

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