• Title/Summary/Keyword: Therapy Room

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Bow Hunter's Syndrome Caused by Bilateral Dynamic Occlusion of the Subaxial Vertebral Arteries during Neck Extension (경추 신전 시 축하 척추동맥의 양측성 동적 폐쇄로 인해 발생한 보우 헌터 증후군)

  • Yi, Jemin;Han, Ho Sung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.85-89
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    • 2020
  • Bow hunter's syndrome is a rare disease that shows the symptoms of vertebrobasilar insufficiency resulting from a dynamic obstruction or stenosis of the vertebral arteries during neck movement. This paper reports a case of a 59-year-old male who visited the emergency room with diplopia, tinnitus, and gait disturbance. Magnetic resonance imaging and angiography revealed a multiple cerebellar infarct, total obstruction of the right vertebral artery, and dynamic obstruction of the left vertebral artery during neck extension. As the infarction worsened, a thrombectomy was done. Posterior decompression and fusion at C5-6 were performed for the left vertebral artery. The left vertebral arterial patency was confirmed by intraoperative and postoperative angiography. No recurrence of the symptoms was observed for six months after surgery. Physicians need to pay attention to the diagnosis of vertebrobasilar insufficiency caused by an obstruction of the vertebral arteries during neck extension in cervical instability patients.

Apatinib as a Third-Line Treatment for HER2-Positive Metastatic Gastric Cancer: A Multi-Center Single-Arm Cohort Study

  • Zhang, Xin;Huo, Haoran;Nie, Yanan;Xue, Jiadong;Yuan, Zengjiang;Zhang, Zhenyi
    • Journal of Gastric Cancer
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    • v.22 no.4
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    • pp.408-417
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    • 2022
  • Purpose: Treatment options are limited after the failure of first-and second-line treatments in patients with HER2+ metastatic gastric cancer (mGC). The present study aimed to explore the efficacy, safety, and prognostic factors of apatinib efficacy as a third-line therapy for patients with human epithelial growth factor receptor 2-positive (HER2+) mGC. Materials and Methods: A total of 59 HER2+ mGC patients who received apatinib as third-line therapy were retrospectively enrolled in this two-center, single-arm, cohort study; the clinical response, survival data, and adverse events were retrieved. Results: The median progression-free survival (PFS) was 5.2 months (95% confidence interval [CI], 3.9-6.5), and the median overall survival (OS) was 8.2 months (95% CI, 6.6-9.8) Furthermore, forward stepwise multivariate Cox regression analysis showed that a higher Eastern Cooperative Oncology Group performance status score and multiple metastases were independently correlated with decreased PFS and OS (both P<0.05). The main adverse events were leukopenia (45.8%), hypertension (44.1%), thrombocytopenia (39.0%), hand-foot syndrome (37.3%), and elevated transaminase (33.9%). Grade 3 adverse events mainly included hypertension (5.1%) and neutropenia (5.1%); grade 4 adverse events did not occur. Conclusions: Apatinib is efficient and well tolerated in patients with HER2+ mGC as a third-line treatment, suggesting that it may be a candidate of choice for these patients.

Design and Dose Distribution of Docking Applicator for an Intraoperative Radiation Therapy (수술중 방사선치료를 위한 조립형 조사기구의 제작과 선량 분포)

  • Chu, Sung-Sil;Kim, Gwi-Eon;Loh, John-Kyu
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.123-130
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    • 1991
  • A docking intraoperative electron beam applicator system, which is easily docking in the collimator for a linear accelerator after setting a sterilized transparent cone on the tumor bearing area in the operation room, has been designed to optimize dose distribution and to improve the efficiency of radiation treatment method with linear accelerator. This applicator system consisted of collimator holder with shielded metals and docking cone with transparent acrylic cylinder, A number of technical innovations have been used in the design of this system, this dooking cone gives a improving latral dose coverage at therapeutic volume. The position of $90\%$ isodose curve under suface of 8 cm diameter cone was extended $4\sim7$ mm at 12 MeV electron and the isodose measurements beneath the cone wall showed hot spots as great as $106\%$ for acrylic cone. The leakage radiation dose to tissues outside the cone wall was reduced as $3\sim5\%$ of output dose. A comprehensive set of dosimetric characteristics of the intraoperative radiation therapy applicator system is presented.

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A Survey on Risk Factors Related to Experience Rate of Low Back Pain in High School Students (일부지역 고등학생들의 요통경험율과 관련 요인 -안동시를 중심으로-)

  • Kim, Shun-Yeop;Yi, Seung-Ju;Park, Sang-Rae;Jang, Young-Ho;Cha, Sang-Eun;Kim, Ji-Sook
    • Journal of Korean Physical Therapy Science
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    • v.2 no.3
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    • pp.653-666
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    • 1995
  • This study was conducted to investigate factors related to experience rate of low back pain(LBP) in the high school students, a questionnaire survey was carried out for 778 high school students in Andong city Kyungsang Pook province from 28th June to 10th July, 1993. The results were as follows: The experience rate of LBP for 778 high school students who were interviewed was 27.1 %. Unknown(47.4 %) was the highest in the cause of LBP. The experience rate of a academical high school students (57.8 %) was higher than the technical high school students(42.7 %) in association according to LBP and school division(P = 0. 001). The experience rate of 18 years old above students (60.2 %) was higher than 17 years old below school students(39.8 %%) in association between LBP and age(P = 0.031). The experience rate of students who go to bed at the hot floored bed (80.1 %) was higher than students who go to bed at the bed room (11.8 %) in association between LBP and room type(P = 0.012). The statisticaly significant variables related to LBP were school division, age and stress. It was revealed by this survey that independent variables related to LBP experience rate of high school students were important health problem. So the prospective research is need by those variables.

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Evaluation of Setup Error Correction for Patients Using On Board Imager in Image Guided Radiation Therapy (Image Guided Radiation Therapy (IGRT) 시 On Board Imager를 이용한 환자 Setup Error 보정평가)

  • Kang, Soo-Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.2
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    • pp.69-81
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    • 2008
  • Purpose: To reduce side effects in image guided radiation therapy (IGRT) and to improve the quality of life of patients, also to meet accurate SETUP condition for patients, the various SETUP correction conditions were compared and evaluated by using on board imager (OBI) during the SETUP. Materials and Methods: Each 30 cases of the head, the neck, the chest, the belly, and the pelvis in 150 cases of IGRT patients was corrected after confirmation by using OBI at every 2∼3 day. Also, the difference of the SETUP through the skin-marker and the anatomic SETUP through the OBI was evaluated. Results: General SETUP errors (Transverse, Coronal, Sagittal) through the OBI at original SETUP position were Head & Neck: 1.3 mm, Brain: 2 mm, Chest: 3 mm, Abdoman: 3.7 mm, Pelvis: 4 mm. The patients with more that 3 mm in the error range were observed in the correction devices and the patient motions by confirming in treatment room. Moreover, in the case of female patients, the result came from the position of hairs during the Head & Neck, Brain tumor. Therefore, after another SETUP in each cases of over 3 mm in the error range, the treatment was carried out. Mean error values of each parts estimated after the correction were 1 mm for the head, 1.2 mm for the neck, 2.5 mm for the chest, 2.5 mm for the belly, and 2.6 mm for the pelvis. Conclusion: The result showed the correction of SETUP for each treatment through OBI is extremely difficult because of the importance of SETUP in radiation treatment. However, by establishing the average standard of the patients from this research result, the better patient satisfaction and treatment results could be obtained.

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An Epidemiological Study on the Neurological Sequelae of Acute Carbon Monoxide Poisoning (급성일산화탄소중독(急性一酸化炭素中毒)의 신경학적(神經學的) 후유증(後遺症)에 관(關)한 역학적(疫學的) 연구(硏究))

  • Park, Byung-Joo;Cho, Soo-Hun;Ahn, Yoon-Ok;Shin, Young-Soo;Yun, Dork-Ro
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.5-24
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    • 1984
  • There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

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The Effect of Listening to Music on Anxiety, Sedation, and Vital Signs of Patients Undergoing Spinal Anesthesia (수술 중 음악청취가 척수마취 환자의 불안, 진정 및 활력징후에 미치는 효과)

  • Moon, Yang-Hee;Kang, In-Soon;Hwang, Sun-Kyung
    • Journal of Korean Biological Nursing Science
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    • v.11 no.2
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    • pp.105-113
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    • 2009
  • Purpose: The aim of this study was to examine the effect of listening to music on the level of anxiety, sedation, and vital signs of patients undergoing surgery with spinal anesthesia. Methods: A convenience sample of 70 adult patients, ASA physical status I-II, scheduled for elective urologic or orthopedic surgery with spinal anesthesia, was included in this study. They were assigned to either an experimental group (n=35), listening to music during surgery, or a control group (n=35), not listening to music. Their anxiety was measured with the Spielberg's Trait and State Anxiety Inventory (STAI-KYZ). Sedation level was monitored with the Bispectral Index, and the vital signs at beginning, 10, 20, 30, and 45 min after operation. Results: The music group reported significantly lower state anxiety level during surgery as compared with the control group (t=3.91, p<.001). Repeated measures of ANOVA indicated a significant by group interaction on BIS index scores of sedation (F=4.23, p=.006). Among the vital signs, only heart rate was a significant by group interaction (F=5.529, p=.004). Conclusion: These findings indicate that listening to music during surgery with spinal anesthesia is a useful and effective nursing intervention to reduce anxiety and to maintain proper sedation.

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Surgical Treatment of Persistent Ductus Arteriosus Complicated by Bacterial Endocarditis with Pulmonary Artery Embolism 1 case report (세균성 심내막염에 의한 폐색전증이 동반된 동맥관 개존증의 수술치험 -1례 보고-)

  • Oh, Jeong-Woo;Oh, Bong-Suk;Lee, Dong-Joon
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.209-212
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    • 1997
  • A fifteen-year-old boy was transported to our hospital emmergency room due to sudden onset of chest pain, hemoptysis and dyspnea. He was diagnosed as persistent ductus arteriosus that had developed acute bacterial endocarditis with pulmonic valve vegetation and pulmonary embolism with pulmonary infarction. After conservative antibiotic therapy (vancomycin + aminoglycoside), we operated this patient successfully - patch closer of the ductus and pulmonary valve valvuloplasty - under the cardiopulmonary bypass.

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Study on the clinical application of the remedy of the synchronus combination of cupping boil and moxibustion (BUDDEUMI) (부항과 쑥뜸의 겸용치료기(부뜸이)의 임상 활용 방안에 대한 기초 연구)

  • Kim, Gyeong Cheol;Lee, Jeong Won;Kim, Yi Soon;Ryang, Han Cho
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.18 no.2
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    • pp.111-120
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    • 2014
  • Objectives In order to extend the bounds of korean medical instruments, we studied on the clinical application of BUDDEUM (the remedy of the synchronus combination of cupping boil and moxibustion) by the industry-academic cooperation. Methods The korean clinic, enterprise and university participated in jointly an educational-industrial complex. We studied on the clinical application of BUDDEUMI according to the structural character, functional efficiency and clinical case. And therefore we confirmed clinically the application of BUDDEUMI. Results The results was as follows. 1. The effects of BUDDEUMI are observed on the detoxification of blood waste material, & the form and appearance of effete matter are various. 2. The BUDDEUMI massage treatment operated in the abdominal and the back in order to recover energy and increase immunity. 3. The heating treatment by BUDDEUMI operated in sickly region, in order to pour into heat of moxibustion. Conclusion According to the results, by the set up the exclusive therapy room and the arrange of the exclusive human agency of BUDDEUMI, the newly and various therapies of korean medicine are possible to develop.

Audiometric Calibration of Aural Acoustic Immittance Instrument: A Review of Acoustic Immittance Instrument's Calibration

  • Kim, Jin-Dong
    • Biomedical Science Letters
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    • v.22 no.4
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    • pp.115-126
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    • 2016
  • Audiometric calibration is a prerequisite for securing the reliability of audiometric test results by checking the internal consistency of the relevant instrument. The purpose of this review is to help instrument operators understand the calibration procedure of aural acoustic immittance instrument which is frequently used for objective assessment. By referring to the latest international standards and the national standards relevant to the aural acoustic immittance instrument, the following parameters will be reviewed: 1) introduction of performance characteristics, 2) detailed procedure of the calibration method. According to the newest international and national standards [IEC 60645-5 (2004), ANSI S3.39-1987 (R2012)], the aural acoustic immittance instrument basically includes six components: 1) calibration cavity, 2) acoustic immittance analysis system, 3) probe assembly/unit and signal, 4) pneumatic air-pressure pump system, 5) acoustic reflex activator system and 6) tympanogram and acoustic reflex plotting system, each of these components should meet set standards. The result of behavioral hearing tests is influenced by various complex factors including the examinee's cooperation, background noise of the examination room, measurement method, skill level of the audiologist and calibration status, but the objective hearing tests is more influenced by the calibration status of the instrument than any other factors. The audiologist should take full responsibility for the reliability of the hearing test result, so he/she should carry out the calibration check and adjustments of aural acoustic immittance instrument periodically and maintain the instrument continuously by referring to the newest standards and the manufacturer's instruction manual.