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Relation between Ablation Execution Time and Radiation Exposure Effect in the Treatment of Atrial-fibrillation using Cryo-balloon and 3D Radio-frequency Ablation (냉각 풍선 절제술과 3D 고주파 절제술을 이용한 심방세동 치료 시 절제술 시행 시간과 방사선 피폭 영향과의 연관성)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.427-434
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    • 2022
  • Atrial fibrillation treatment includes 3D RFCA and Cryo-balloon ablation. Both procedures have in common that they enter after understanding the structure of the heart using angiography equipment. Therefore, there is a disadvantage that the effect of exposure according to the procedure time can be a threat to both the patient and the operator, so this study aims to confirm the relationship between the total ablation time and the effect of radiation exposure. We used follow-up data (retrospective) from 41 patients who underwent coronary angiography and arrhythmia at the same time from March 2019 to July 2022. The range for total ablation time was based on the recorded data from the start to the end of the total ablation. The end point of 3D RFCA was when the ablation was completed for 4 pulmonary veins, and in the case of Cryo-balloon ablation, the data that succeeded in electrical insulation were included. As a result of analyzing the total ablation time, the time taken for Cryo-balloon ablation was 1037.29±103.66 s, which was 2448.61 s faster than 3D RFCA using 3485.9±405.71 s, and was statistically significant. (p<0.05) As a result of analyzing the total fluoroscopy time, the exposure time for 3D RFCA was 2573.75±239.08 s, which was less by 1717.15 s than the exposure time for Cryo-balloon ablation, 4290.9±420.42 s, and was statistically significant. In the case of total area dose product, 3D RFCA was 59.04±13.1 uGy/m2, which was lower than Cryo-balloon ablation 980.6±658.07 uGy/m2 by 921.56 uGy/m2, which was statistically significant. As the insulation time of the Cryo-balloon ablation is shorter than that of the 3D RFCA, the method using the Cryo-balloon ablation is considered to be effective when the patient's condition is not good and a quick procedure is required. However, in patients with permanent Atrial fibrillation, there is a high probability of structural changes in the heart, so it is considered that 3D RFCA is better than Cryo-balloon ablation, which is difficult to manipulate.

Edge to Edge Model and Delay Performance Evaluation for Autonomous Driving (자율 주행을 위한 Edge to Edge 모델 및 지연 성능 평가)

  • Cho, Moon Ki;Bae, Kyoung Yul
    • Journal of Intelligence and Information Systems
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    • v.27 no.1
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    • pp.191-207
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    • 2021
  • Up to this day, mobile communications have evolved rapidly over the decades, mainly focusing on speed-up to meet the growing data demands of 2G to 5G. And with the start of the 5G era, efforts are being made to provide such various services to customers, as IoT, V2X, robots, artificial intelligence, augmented virtual reality, and smart cities, which are expected to change the environment of our lives and industries as a whole. In a bid to provide those services, on top of high speed data, reduced latency and reliability are critical for real-time services. Thus, 5G has paved the way for service delivery through maximum speed of 20Gbps, a delay of 1ms, and a connecting device of 106/㎢ In particular, in intelligent traffic control systems and services using various vehicle-based Vehicle to X (V2X), such as traffic control, in addition to high-speed data speed, reduction of delay and reliability for real-time services are very important. 5G communication uses high frequencies of 3.5Ghz and 28Ghz. These high-frequency waves can go with high-speed thanks to their straightness while their short wavelength and small diffraction angle limit their reach to distance and prevent them from penetrating walls, causing restrictions on their use indoors. Therefore, under existing networks it's difficult to overcome these constraints. The underlying centralized SDN also has a limited capability in offering delay-sensitive services because communication with many nodes creates overload in its processing. Basically, SDN, which means a structure that separates signals from the control plane from packets in the data plane, requires control of the delay-related tree structure available in the event of an emergency during autonomous driving. In these scenarios, the network architecture that handles in-vehicle information is a major variable of delay. Since SDNs in general centralized structures are difficult to meet the desired delay level, studies on the optimal size of SDNs for information processing should be conducted. Thus, SDNs need to be separated on a certain scale and construct a new type of network, which can efficiently respond to dynamically changing traffic and provide high-quality, flexible services. Moreover, the structure of these networks is closely related to ultra-low latency, high confidence, and hyper-connectivity and should be based on a new form of split SDN rather than an existing centralized SDN structure, even in the case of the worst condition. And in these SDN structural networks, where automobiles pass through small 5G cells very quickly, the information change cycle, round trip delay (RTD), and the data processing time of SDN are highly correlated with the delay. Of these, RDT is not a significant factor because it has sufficient speed and less than 1 ms of delay, but the information change cycle and data processing time of SDN are factors that greatly affect the delay. Especially, in an emergency of self-driving environment linked to an ITS(Intelligent Traffic System) that requires low latency and high reliability, information should be transmitted and processed very quickly. That is a case in point where delay plays a very sensitive role. In this paper, we study the SDN architecture in emergencies during autonomous driving and conduct analysis through simulation of the correlation with the cell layer in which the vehicle should request relevant information according to the information flow. For simulation: As the Data Rate of 5G is high enough, we can assume the information for neighbor vehicle support to the car without errors. Furthermore, we assumed 5G small cells within 50 ~ 250 m in cell radius, and the maximum speed of the vehicle was considered as a 30km ~ 200 km/hour in order to examine the network architecture to minimize the delay.

Effects of HapKok (LI-4) , SamUmGyo (SP-6) Acupuncture on Uterine Motility and Cyclooxygenase-2 Manifestation in Rats (합곡(合谷), 삼음교(三陰交) 자침(刺鍼)이 백서(白鼠) 자궁(子宮) 운동(運動) 및 Cyclooxygenase-2 발현(發現)에 미치는 영향(影響))

  • Lee, Byung-Chul;Lee, Ho-Sub;Kim, Kyung-Sik;Lee, Geon-Mok;Na, Chang-Soo;Kim, Jung-Sang;Hwang, Woo-Jun
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.187-208
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    • 2000
  • By the activation of ovary hormone, many morphological changes occur in the epithelial cell lines and muscle cells in rat uterus. These two cells in uterus are important to the implantation of embryo, maintaining pregnancy and starting parturition. One important change associated with the morphological change of these two cells in uterus is the change on prostaglandin(PG) metabolism. Its presence and synthesis in endometriurn and myometrium in uterus affects estrous cycle and the start of embryo implantation in uterus. It also performs as an important modulator in parturition. So the abnormally weak expression of PG causes difficulty during labor and over-expression causes pre-term labor. PG biosynthesis starts from either free or liberated arachidonic acids from membrane phospholipid by phospholipase. Such arachidonic acids are converted into PG catalyzed by Cyclooxygenase. Under normal physiological condition, Cyclooxygenase-1(COX-1) having 602 units of amino acids controls the synthesis of PG. It acts as a local hormone regulating vasomodulation of blood flow, flexible muscle movement, increasing the blood permeability and contributing the protective role in preserving integrity of the stomach lining and Cyclooxygenase-2 (COX-2) is induced by the inflammation, pregnancy and increased its expression until parturition. Lipid metabolite like PG is located in uterine and expression of COX-2 increased with pregnancy. Increased expression of COX proteins in epithelial cells and myometrial cells are told to increase the muscle contractility in uterus but decreased right after the labor in rat. It is a good sign indicating that COX proteins are deeply related to the start of labor. Currently, Several studies report the use of PG and COX-2 inhibitor as medication for controlled abortion or to prevent pre-term labor but they entail various side-effects. Our study proposed to suggest use of acupuncture as an another mediator to control abortion or pre-term labor without causing unnecessary side-effects by those medicines. Two acupuncture sites, LI-4 & SP-6 were selected due to their known efficacy. From the immunohistochemical staining of COX-2, normal expression of COX-2 protein in nonpregnant SD rat's uterus revealed that COX-2 protein was primarily detected in the lumina epithelial lining and in the epithelial cell lining contacting the stromal cells. High resolution optical microscopic scanning revealed distinguishable staining in the myometrial mucosa. LI-4 acupuncture administered nonpregnant rat's uterus showed strong expression for COX-2 in endometrium contacted with lumina epithelial lining of rat uterus and in myometrial mucosa. Stromal cells showed more staining than untreated nonpregnant rat's uterus and stronger staining in stromal cells contacting myometrial layer compared to untreated nonpregnant rat's uterus. SP-6 acupuncture administered nonpregnant rat's uterus showed weak expression for COX-2 in myometrial layers and stromal cells but no staining was visible in lumina epitheliai and glandular epithelial cells. Few stromal cells and myometrial mucosa were positively stained for COX-2. Pregnant SD rat's uterus was also immunostained for COX-2 expression after 18 days of pregnancy. Unlike to untreated nonpregnant rat's uterus, luminal epithelial cells were not positively stained for COX-2 but stronger staining for COX-2 was revealed in stromal cells. LI-4 acupunctured SD rat's uterus had very strong expression of COX-2 in luminal epithelial lining. Few stromal cells showed stronger positive COX-2 staining and myometrial layers also showed more expression than untreated pregnant rat. SP-6 acupuncture administered pregnant SD rat's uterus showed positive expression of COX-2 in epithelial cells of luminal mucosa layer but weaker than that of LI-4 acupuncture treatment's case. However, strong positive staining was revealed in stromal mucosa and myometrial layers. Virgin SD rat's uterus motility index during LI-4 acupuncture was 66.52 % (Prob〉T = 0.0197) compared to its motility before the acupuncture treatment but the motility index was slighdy elevated up to 79.58 % (Prob〉T = 0.1175) after the acupuncture. During the SP-6 acupuncture treatment for 30 minutes, uterus motility index was 90.52 % (Prob〉T = 0.1832) showing lesser decrement but consequently reached similar motility index decreasal to 79.95 % (Prob〉T = 0.0215) after the acupuncture treatment as LI-4 showed. LI-4 acupuncture tend to be a quick treatment to reducing the uterus motility in a virgin rat but eventually both two acupuncture administration created very similar reduction of uterus motility seeing the index after the both acupunctures. The uterus movement monitored during the LI-4 acupuncture administered for 30 minutes, Pregnant SD rat showed decreased motility down to 77.90 % (Prob〉 T = 0.0076) compared to uterus motility before the acupuncture and it continuously decreased down to 71.81 %(Prob〉T = 0.0214) after the removal of needle. The statistical analysis using paired t-test showed significance difference for both two motility indexs at =0.05. SP-6 acupuncture administered to pregnant SD rat also had similar pattern of decreasing uterus motility index down to 74.70 % (Prob〉T = 0.1730) during the initial 30 minutes acupuncture administration and it was continuously lowered to 71.52 % (Prob〉T = 0.0155) after the acupuncture. The paired t-test resuit for SP-6 suggest prompt response of uterus motility index to the SP-6 acupuncture treatment but consequently reached same level of inducing the motility reduction as LI-4 at =0.05 level.

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Highly Doped Nano-crystal Embedded Polymorphous Silicon Thin Film Deposited by Using Neutral Beam Assisted CVD at Room Temperature

  • Jang, Jin-Nyeong;Lee, Dong-Hyeok;So, Hyeon-Uk;Hong, Mun-Pyo
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.08a
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    • pp.154-155
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    • 2012
  • The promise of nano-crystalites (nc) as a technological material, for applications including display backplane, and solar cells, may ultimately depend on tailoring their behavior through doping and crystallinity. Impurities can strongly modify electronic and optical properties of bulk and nc semiconductors. Highly doped dopant also effect structural properties (both grain size, crystal fraction) of nc-Si thin film. As discussed in several literatures, P atoms or radicals have the tendency to reside on the surface of nc. The P-radical segregation on the nano-grain surfaces that called self-purification may reduce the possibility of new nucleation because of the five-coordination of P. In addition, the P doping levels of ${\sim}2{\times}10^{21}\;at/cm^3$ is the solubility limitation of P in Si; the solubility of nc thin film should be smaller. Therefore, the non-activated P tends to segregate on the grain boundaries and the surface of nc. These mechanisms could prevent new nucleation on the existing grain surface. Therefore, most researches shown that highly doped nc-thin film by using conventional PECVD deposition system tended to have low crystallinity, where the formation energy of nucleation should be higher than the nc surface in the intrinsic materials. If the deposition technology that can make highly doped and simultaneously highly crystallized nc at low temperature, it can lead processes of next generation flexible devices. Recently, we are developing a novel CVD technology with a neutral particle beam (NPB) source, named as neutral beam assisted CVD (NBaCVD), which controls the energy of incident neutral particles in the range of 1~300eV in order to enhance the atomic activation and crystalline of thin films at low temperatures. During the formation of the nc-/pm-Si thin films by the NBaCVD with various process conditions, NPB energy directly controlled by the reflector bias and effectively increased crystal fraction (~80%) by uniformly distributed nc grains with 3~10 nm size. In the case of phosphorous doped Si thin films, the doping efficiency also increased as increasing the reflector bias (i.e. increasing NPB energy). At 330V of reflector bias, activation energy of the doped nc-Si thin film reduced as low as 0.001 eV. This means dopants are fully occupied as substitutional site, even though the Si thin film has nano-sized grain structure. And activated dopant concentration is recorded as high as up to 1020 #/$cm^3$ at very low process temperature (< $80^{\circ}C$) process without any post annealing. Theoretical solubility for the higher dopant concentration in Si thin film for order of 1020 #/$cm^3$ can be done only high temperature process or post annealing over $650^{\circ}C$. In general, as decreasing the grain size, the dopant binding energy increases as ratio of 1 of diameter of grain and the dopant hardly be activated. The highly doped nc-Si thin film by low-temperature NBaCVD process had smaller average grain size under 10 nm (measured by GIWAXS, GISAXS and TEM analysis), but achieved very higher activation of phosphorous dopant; NB energy sufficiently transports its energy to doping and crystallization even though without supplying additional thermal energy. TEM image shows that incubation layer does not formed between nc-Si film and SiO2 under later and highly crystallized nc-Si film is constructed with uniformly distributed nano-grains in polymorphous tissues. The nucleation should be start at the first layer on the SiO2 later, but it hardly growth to be cone-shaped micro-size grains. The nc-grain evenly embedded pm-Si thin film can be formatted by competition of the nucleation and the crystal growing, which depend on the NPB energies. In the evaluation of the light soaking degradation of photoconductivity, while conventional intrinsic and n-type doped a-Si thin films appeared typical degradation of photoconductivity, all of the nc-Si thin films processed by the NBaCVD show only a few % of degradation of it. From FTIR and RAMAN spectra, the energetic hydrogen NB atoms passivate nano-grain boundaries during the NBaCVD process because of the high diffusivity and chemical potential of hydrogen atoms.

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Recommender Systems using Structural Hole and Collaborative Filtering (구조적 공백과 협업필터링을 이용한 추천시스템)

  • Kim, Mingun;Kim, Kyoung-Jae
    • Journal of Intelligence and Information Systems
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    • v.20 no.4
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    • pp.107-120
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    • 2014
  • This study proposes a novel recommender system using the structural hole analysis to reflect qualitative and emotional information in recommendation process. Although collaborative filtering (CF) is known as the most popular recommendation algorithm, it has some limitations including scalability and sparsity problems. The scalability problem arises when the volume of users and items become quite large. It means that CF cannot scale up due to large computation time for finding neighbors from the user-item matrix as the number of users and items increases in real-world e-commerce sites. Sparsity is a common problem of most recommender systems due to the fact that users generally evaluate only a small portion of the whole items. In addition, the cold-start problem is the special case of the sparsity problem when users or items newly added to the system with no ratings at all. When the user's preference evaluation data is sparse, two users or items are unlikely to have common ratings, and finally, CF will predict ratings using a very limited number of similar users. Moreover, it may produces biased recommendations because similarity weights may be estimated using only a small portion of rating data. In this study, we suggest a novel limitation of the conventional CF. The limitation is that CF does not consider qualitative and emotional information about users in the recommendation process because it only utilizes user's preference scores of the user-item matrix. To address this novel limitation, this study proposes cluster-indexing CF model with the structural hole analysis for recommendations. In general, the structural hole means a location which connects two separate actors without any redundant connections in the network. The actor who occupies the structural hole can easily access to non-redundant, various and fresh information. Therefore, the actor who occupies the structural hole may be a important person in the focal network and he or she may be the representative person in the focal subgroup in the network. Thus, his or her characteristics may represent the general characteristics of the users in the focal subgroup. In this sense, we can distinguish friends and strangers of the focal user utilizing the structural hole analysis. This study uses the structural hole analysis to select structural holes in subgroups as an initial seeds for a cluster analysis. First, we gather data about users' preference ratings for items and their social network information. For gathering research data, we develop a data collection system. Then, we perform structural hole analysis and find structural holes of social network. Next, we use these structural holes as cluster centroids for the clustering algorithm. Finally, this study makes recommendations using CF within user's cluster, and compare the recommendation performances of comparative models. For implementing experiments of the proposed model, we composite the experimental results from two experiments. The first experiment is the structural hole analysis. For the first one, this study employs a software package for the analysis of social network data - UCINET version 6. The second one is for performing modified clustering, and CF using the result of the cluster analysis. We develop an experimental system using VBA (Visual Basic for Application) of Microsoft Excel 2007 for the second one. This study designs to analyzing clustering based on a novel similarity measure - Pearson correlation between user preference rating vectors for the modified clustering experiment. In addition, this study uses 'all-but-one' approach for the CF experiment. In order to validate the effectiveness of our proposed model, we apply three comparative types of CF models to the same dataset. The experimental results show that the proposed model outperforms the other comparative models. In especial, the proposed model significantly performs better than two comparative modes with the cluster analysis from the statistical significance test. However, the difference between the proposed model and the naive model does not have statistical significance.

Policy Study on Korean Retail Micro Business (국제 비교를 통한 소매업 소상공인 현황과 정책적 시사점)

  • Suh, Yong Gu;Kim, Suk Kyung
    • Journal of Distribution Research
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    • v.17 no.5
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    • pp.39-57
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    • 2012
  • The unabated influx of micro businesses has turned the Korean retailing market to a rat race, which causes severe financial distress for micro business owners due to heavy competition. The woes of these micro business owner's are exacerbated by the presence of large scale distributors such as Super Supermarket(SSM) and large discount stores. In summary, the Korean retail market is overburdened an uneconomically viable. Retailing has low barriers to entry which attracts unskilled labor or those with little capital. These start-ups have low opportunity costs since they would make low wages elsewhere in the economy. Thus, these owners are content with relatively low returns on their investment. These 'subsistence ventures' are maintained for economical viability rather than economic growth. These 'subsistence ventures' intensifies competition among small-scale businesses. The presence of large retail corporations also aggravates the situation. The recent stagnation of the economy has worsened the retail market in Korea. The overwhelming competition solidifies the coarse structural system and the prolonged economic sluggishness has increased the risk of insolvency for micro business owners. As the economy continues to stagnate, the imminent risk in retailing market will rise up to surface threatening economic stability. More systematic inflows and outflows of retailers are required in order to redress this structural problem. It has been empirically shown that the self-employment rate is high in Korea compared to other OECD countries. To draw the comparison of self-employment rate by industry, Korea shows high rates among transportation, whole sale, retail, education, lodging, and restaurants. In the case of the transportation and education service sectors, this high rate can be explained by the idiosyncratic nature of Korean culture. In the transportation sector, political policies favor private cap service and private freight carriers. In the education service sector, Koreans put particular emphasis on education that leads to many private institutions that outnumber other OECD countries. For these singular reasons, Korea maintains high micro business, self-employed rates particularly in retailing. A comparable nation is Japan, with its similar social, economic, cultural environment among OECD countries. Unlike Korea, Japan has much lower rates of micro business which continues to decrease. Also Korean retailers are much more destitute than Japanese. The fundamental problem of Korean retailing is the involuntary exit of these 'subsistence ventures,' micro businesses with low margins, in which a small drop in demand can lead to financial difficulties for the owner. This problem will be exacerbated when Korean babyboomers retire and join the micro business ventures. The first priority in order to cope with the severity of oversupply in retailing is to provide better opportunities for the potential self-employers. There should be viable alternatives to subsistent ventures. Strengthening the retirement program, scrutiny of exit process, reconfiguration of policy funds are the recommendations.

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Comparison of Innovation Efficiency of Pre-IPO and Post-IPO in Korea: Case of Pharmaceutical Industry (IPO 전후 혁신의 효율성 비교 연구: 의약산업 중심으로)

  • Kim, Eunhee
    • Journal of Technology Innovation
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    • v.24 no.1
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    • pp.143-167
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    • 2016
  • The purpose of this study is to analyze changes of innovation activities and their performance in pre-IPO and post-IPO of KOSDAQ IPO listed companies in medical and pharmaceutical fields, which require high R&D investment, from 2000 to 2005 in Korea. The innovation efficiencies of the IPO companies were measured before and after three years based on the DEA model. The financial data and patent information of the listed company during total 6 years, which were 3 years before IPO and 3 years after IPO, were collected. The main results of this research are as follows. First, it took an average 12.86 years until IPO in the start-up of the IPO companies in the pharmaceutical sector, and innovation was on average more active than the IPO before. R&D investment was higher than the IPO before, and the number of the applied patent during 3 years after IPO was 16.67 which was increased from 8.43 during 3 years before IPO. In addition, the average scope of technology of the IPO companies was expanded from 11 to 22 technology fields during previous 3 year and after 3 year each, and financial growth after IPO was lower than the previous IPO. Second, the financial performance of R&D investment and the performance of patent activity were weakened in the efficiency after the IPO, and the integrated performance from the patenting activities and the R&D investment was decreased after the IPO. Finally, the efficiency of the financial performance of the patenting activity was lower than the efficiency of the financial performance of the patent and R&D investment and patent activities under the R&D investment. In particular, the inefficiency of the firms' patenting activities performance after the IPO was caused by the decreasing return to scale, according to the results of this study. This results implicate that the expansion of R&D investments through the IPO had not lead to the financial performance of the market, and that the overall inefficiency since the IPO is due to the inefficiencies at the stage for the outcome of innovation activity rather than the output obtained through the R&D investments that appear to lead the performance of the market.

A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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A Preliminary Study for Expending of Hospital-Based Home Health Care Coverage - Focused on Car Accident Inpatients Who has the Compensation Insurance - (병원중심 가정간호관리대상 범위 확대를 위한 기초연구(II) - 자동차보험가입 입원환자를 대상으로 -)

  • Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.7 no.1
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    • pp.58-72
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    • 2000
  • This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

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A Kinematical Analysis of Belle Motion on Parallel Bars (평행봉 Belle 기술동작의 운동학적 분석)

  • Kong, Tae-Ung
    • Korean Journal of Applied Biomechanics
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    • v.15 no.4
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    • pp.43-53
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    • 2005
  • This study is to define how the difference of athletic change influence on the last regrasp after somersault in Belle movement of parallel bars. For his study, the following conclusion was produced by analysis of athletic change by means of three dimensional visual image in three athlete of nation. 1. As the picture of S1, there are total used time(2.01 sec), S3(2.17 sec) and S2(2.19 sec). In case of a short needed time, it is difficult for them to perform the remaining movement of the vertical elevating flight easily and comfortably, it is judged as performing the small movement with restrict swing. 2 In the change of body center sped by each event, it is calculated as $-89.1^{\circ}$ the narrowest in S1, $-81.96^{\circ}$ the widest and then $86.34^{\circ}$ in S3. In E3 event, average compound speed is 4.07m/s, S2 showed the fastest speed of 4.14m/s whereas S1 the narrowest angle of 3.95m/s. 3. A shoulder joint and coxa are the period of mention in E3. In E4 which was pointed out the longest vertical distance, S2 that is indicated the highest vertical height as the period of detach in parallel bars. showed -3.91m. This is regarded as a preparatory movement for dynamic performance after using effectively elastic movement of shoulder joint and coxa while easily going up with turning back movement. In the 5th phrase, long airborne time and vertical change position is showed as the start while regrasping securely air flight movement from high position. 4. In E5, a long flight time and a long vertical displacement were shown as the regrasp after somersault efficiently in high position with stability from the point of the highest peak of the center of the body. Especially, S2 is marked as a little bit long position, while S1 is reversely indicated as performing somersault and unstable motion in a low position. 5. In E3, at the point of the largest extension of the shoulder joint and hip joint the shoulder joint is largely marked in $182^{\circ}$ and the hip point $182^{\circ}$ in S2. The shoulder joint is marked at the smallest angle in $177^{\circ}$ and the hip point $176^{\circ}$ in S1. And S1 is being judged by its performance of the less self - confident motion with lessening a breath of swing. S2 makes the most use of flexion and extension of the shoulder joint and the hip joint effectively. It was performed greatly with swinging and dropping the rotary movement and the rotary inertia naturally. 6. In E6, as the point of regrasp of the upper arm in parallel bars it is recognized by the that of components of vertical and horizontal velocity stably. During this study, the insufficient thing and the study on the parallel bars at a real game later are more activated than now. If it is really used as the basic materials by means of Belle Picked Study of Super E level after Bell movement, you may perceive the technique movement previously and perform without difficulty. Especially, such technique as crucifix is quite advantageous for oriental people thanks to small body shape condition. In conclusion we will nicely prepare for our suitable environment to gradually lessen trials and errors by analyzing and studying kinematically this movement.