• Title/Summary/Keyword: exertion

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A Case of Unresectable Gallbladder Cancer Treated with Chemotherapy Followed by Extended Cholecystectomy (항암화학요법에 이은 확대 담낭절제술로 치료한 절제 불가능한 담낭암)

  • Kwang Hyun Chung;Jin Myung Park;Jae Min Lee;Sang Hyub Lee;Ji Kon Ryu;Yong-Tae Kim
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.104-107
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    • 2013
  • Gallbladder (GB) cancer is highly malignant neoplasm found in advanced stage and chemotherapy commonly plays a palliative role in GB cancer. We report a case of unresectable GB cancer treated with chemotherapy followed by extended cholecystectomy. Fifty-six-year-old male visited our hospital with weight loss and dyspnea on exertion. Computed tomography detected pulmonary embolism and diffuse GB wall thickening with para-aortic lymph node enlargement. The length of common channel was 23mm at magnetic resonance cholangiopancreatography which stands for anomalous union of the pancreaticobiliary duct. Anticoagulation was started for pulmonary embolism. GB wall mass was regarded as unresectable GB cancer with distant lymph node metastasis. Gemcitabine and cisplatin combination chemotherapy was carried out for 6 cycles. Primary tumor was stationary but multiple enlarged lymphnodes were almost completely disappeared. Extended cholecystectomy with hepaticojejunostomy was performed. Post-operative tumor stage was T3N1 (stage IIIB) and R0 resection was achieved. After operation he has no evidence of disease recurrence for 6 months.

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Experimental study on the vertical bearing behavior of nodular diaphragm wall in sandy soil based on PIV technique

  • Jiujiang Wu;Longjun Pu;Hui Shang;Yi Zhang;Lijuan Wang;Haodong Hu
    • Geomechanics and Engineering
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    • v.35 no.2
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    • pp.195-208
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    • 2023
  • The nodular diaphragm wall (NDW) is a novel type of foundation with favorable engineering characteristics, which has already been utilized in high-rise buildings and high-speed railways. Compared to traditional diaphragm walls, the NDW offers significantly improved vertical bearing capacity due to the presence of nodular parts while reducing construction time and excavation work. Despite its potential, research on the vertical bearing characteristics of NDW requires further study, and the investigation and visualization of its displacement pattern and failure mode are scant. Meanwhile, the measurement of the force component acting on the nodular parts remains challenging. In this paper, the vertical bearing characteristics of NDW are studied in detail through the indoor model test, and the displacement and failure mode of the foundation is analyzed using particle image velocimetry (PIV) technology. The principles and methods for monitoring the force acting on the nodular parts are described in detail. The research results show that the nodular part plays an essential role in the bearing capacity of the NDW, and its maximum load-bearing ratio can reach 30.92%. The existence of the bottom nodular part contributes more to the bearing capacity of the foundation compared to the middle nodular part, and the use of both middle and bottom nodular parts increases the bearing capacity of the foundation by about 9~12% compared to a single nodular part of the NDW. The increase in the number of nodular parts cannot produce a simple superposition effect on the resistance born by the nodular parts since the nodular parts have an insignificant influence on the exertion and distribution of the skin friction of NDW. The existence of the nodular part changes the displacement field of the soil around NDW and increases the displacement influence range of the foundation to a certain extent. For NDWs with three different nodal arrangements, the failure modes of the foundations appear to be local shear failures. Overall, this study provides valuable insights into the performance and behavior of NDWs, which will aid in their effective utilization and further research in the field.

Study of Antituberculous Medications in Anthracofibrosis (기관지 탄분 섬유화증에서 항결핵약제의 투여에 관한 고찰)

  • Han, Sang-Hoon;Cha, Geun-Young;Lee, Young-Mok;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Hwang, Jung-Hwa;Kim, Hyun-Jo;Yeum, Wook
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.224-231
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    • 2001
  • Purpose : An anthracofibrosis(AF), dark multiple anthracotic pigmentations combined with narrowing and obstruction of bronchi, was reported to be strongly related with past and active pulmonary tuberculosis. This study was performed to determine whether anti-tuberculous regiemens would be helpful in patients with anthracofibrosis who failed to demonstrate the evidences of pulmonary tuberculosis. Methods : Twenty-two patients with multiple anthracotic pigmentations in bronchial mucosa with luminal narrowing were enrolled in this study. The bacteriological and histological findings for Mycobacterium tuberculosis was reviwed in each patients. They are composed of 8 males and 14 females ranging from 55 to 85 years old in age. Results: The most common symptoms were coughing(73%, 16/22), followed by sputum(41%, 9/22), dyspnea on exertion(32%, 7/22), and hemoptysis(27%, 6/22). The evidence of pulmonary tuberculosis, defined by positive AFB smear or culture of Mycobacterium tuberculosis from sputum or bronchial washing fluid or histological findings of granuloma with caseous necrosis, were found in eleven patients(50%) and the others has showed no evidences. Among 11 patients without pulmonary tuberculosis, only one patient showed the evidences of pulmonary tuberculosis after 16 months, and the 8 patients still showed no evidence of pulmonary tuberculosis during follow-up periods of ranging from 8 months to 60 months. Conclusions : Beause the anthracofibrosis is closely related to tuberculosis, it needs to find out extensively the evidences of tuberculosis in patients with anthracofibrosis. Chemotherapy for tuberculosis should be administrated only with confirmation of tuberculosis on bacteriologic study.

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Relationship between Movements of the Foot and Electromyographic Activities of Lower Leg Muscles in Young Women (젊은 여성의 발동작과 몇몇 하퇴근 근전도와의 관계)

  • Choe, Myoung-Ae;Shin, Dong-Hoon
    • The Korean Journal of Physiology
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    • v.18 no.1
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    • pp.81-96
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    • 1984
  • As the crippled persons work mostly in a sitting position and would be engaged in a foot-pressing job, it is necessary to assess their degree of participation of important muscles in various modes of foot activities. In this regard, it deems to be urgent to establish the reference standards for healthy persons. The present study has been undertaken to determine the degree of participation of the M. tibialis anterior, M. gastrocnemius and M. soleus in heel pressing, foot-flat pressing and forefoot pressing motion under varying forces, and in order to compare the electrical activities of three muscles with each other, and to analyse the time sequence between force and appearance or disappearance of EMG recording. Sixty-three healthy young women ranging from age of 18 to 23 were examined. The results obtained were as follows: 1. Participation of three muscles in foot movement under varying forces: A) Both gastrocnemius muscles or left soleus muscle did not contribute to heel pressing motion. Activity of both tibialis anterior muscles was the greatest among three muscles at heel pressing motion and the degree of their activities was proportional to force. B) Activities of left tibialis anterior muscle and both gastrocnemius muscles were negligible under 3 kg force at foot-flat pressing movement. Left gastrocnemius muscle did not contribute to foot-flat pressing under 6 or 9 kg force. Although activities of both soleus muscles and both tibialis anterior muscles were small, the degree of their activities increased with force at foot-flat pressing movement. C) Activities of both tibialis anterior muscles were negligible under 3 kg force at forefoot pressing motion. Activity of both soleus muscles was the greatest among 3 muscles and the degree of their activities increased with force at forefoot pressing motion. Both tibialis anterior muscles participated in forefoot pressing motion with severe exertion. 2. Electrical activities by foot movement under varying forces : A) Electrical activities were prominent in both tibialis anterior muscles and the level of their activities was linear with force at heel pressing motion. The degree of participation of both soleus muscles was small at heel pressing motion. B) Electrical activity of tibialis anterior muscle was the greatest among 3 muscles at foot-flat pressing movement and was followed by that of soleus muscle. Level of electrical activities increased with force in left soleus muscle and right tibialis anterior muscle at foot-flat pressing movement. C) Electrical activity of both soleua muscles was the greatest among 3 muscles at forefoot pressing movement and that of tibialis anterior muscle was next to soleus muscle. Level of electrical activities was proportional to force in left tibialis anterior muscle, right gastrocnemius muscle and both soleus muscles at forefoot pressing movement. 3. Time between starting signal and initiation of contraction of heel pressing and forefoot pressing motion in 3 muscles was longer than that of foot-flat pressing movement. Time of relaxation in 3 muscles was longer than that of contraction under varying forces. EMG recording appeared before initiation of contraction in both tibialis anterior muscles at heel pressing motion and in both soleus muscles at forefoot pressing movement under varying forces. Time of initiation of contraction was similar in both sides of tibialis anterior muscles under varying forces and time of onset of contraction at foot-flat pressing motion was the shortest. 4. Forefoot pressing movement would be encouraged in paralysis of tibialis anterior muscle, while heel pressing motion would be encouraged in paralysis of triceps surae muscle.

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Clinical Experience of Long-term Home Oxygen Therapy (재택산소요법을 받고 있는 환자들에 대한 임상 관찰)

  • Lee, Young-Suk;Cha, Seung-Ick;Han, Chun-Duk;Kim, Chang-Ho;Kim, Yeun-Jae;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.283-291
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    • 1993
  • Background: Long-term low flow oxygen therapy not only increases survival, but also improves the quality of life in patients with chronic obstructive pulmonary disease (COPD) with chronic hypoxemia. For the assessment and improvement of the status of home oxygen therapy, we analyzed clinical experience of 26 patients who have been administered low flow oxygen at home. Method: Twenty-six patients (18 men and 8 women) who have been received long-term oxygen therapy (LTOT) at home were examined. We reviewed physical characteristics, clinical history, pulmonary function test, ECG, arterial blood gas analysis, hemoglobin and hematocrit, types of oxygen devices, inhalation time per day, concentration of administered $O_2$, duration of $O_2$ therapy, and problems in the home oxygen therapy. Results: The underlying diseases of patients were COPD 14 cases, far advanced old pulmonary tuberculosis 9 cases, bronchiectasis 2 cases, and idiopathic pulmonary fibrosis 1 case. The reasons for LTOT at home were noted for cor pulmonale 21 cases, for dyspnea on exertion and severe ventilatory impairment 4 cases, and for oxygen desaturation during sleep 1 case. The mean values of aterial blood gas analysis before home oxygen therapy were $PaO_2$ 57.7 mmHg, $PaCO_2$ 48.2 mmHg, and $SaO_2$ 87.7%. And the mean values of each parameters in the pulmonary function test were VC 2.05 L, $FEV_1$ 0.92 L, and $FEV_1$/FVC% 51.9%. Nineteen patients have used oxygen tanks as oxygen devices, 1 patient oxygen concentrator, 2 patients oxygen tank and liquid oxygen, and other 4 patients oxygen tank together with portable oxygen. The duration of oxygen therapy was below 1 year in 3 cases, 1~2 years in 15 cases, 3~5 years in 6 cases, 9 years in 1 case, and 10 years in 1 case. All patients have inhalated oxygen with flow rate less than 2.5 L/min. And only 10 patients have inhalated oxygen more than 15 hours per day, but most of them short time per day. Conclusion: For the effective oxygen administration, it is necessary that education for long-term low flow oxygen therapy to patients, their family and neighbor should be done, and also the institutional backup for getting convenient oxygen devices is required.

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The Effects of RPE of Step Aerobics on the Immunologic Function of High School Girls (Step aerobics의 RPE가 여고생의 면역기능에 미치는 영향)

  • Kwon, Sun-Ok;Jeong, Seon-Tae
    • Journal of Life Science
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    • v.20 no.2
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    • pp.304-313
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    • 2010
  • Out of the tenth graders of K girl's high school in J city, 24 students whose %fat was over 30% were divided into 3 groups through Purposing Sampling. Groups A and B were exercise groups and C was the control group. Using Borg's RPE (rating of perceived exertion), RPE 15-17 (hard-very hard) $\times$ 3 sets were set up for group A, RPE 11-13 (fairly light-somewhat hard) $\times$ 3 sets were set up for group B, and both groups performed step aerobics (step box: 68cm in length, 28cm in width, 15cm in hight, 450g in weight) for 50-60 minutes a day, 3 days a week for 8 weeks in total. This research was conducted to find out the effects of various RPE in step aerobics on the immunologic function (neutrophil, lymphocyte, monocyte, eosinophil, basophil, IgG, IgA, and IgM levels) of overweight female high school students. By using SPSS Ver. 14.0, a repeated two-way ANOVA was conducted to find out the effects of interaction between the groups and time period, paired t-test to evaluate data within each group, and pre- and post experiment difference rates (%diff) to perform one-way ANOVA for group comparisons. The following results were found. As for WBC, within group A, neutrophil, monocyte, basophil, and eosinophil levels increased, while lymphocyte levels remained the same. Within group B, eosinophil levels decreased while neutrophil, lymphocyte, monocyte, and basophil levels showed no differences. Within the control group, neutrophil, basophil, and eosinophil levels decreased while lymphocyte and monocyte levels showed no differences. As for the group comparisons, neutrophil levels increased more in group A than group B and the control group. There were no differences in lymphocyte levels among the three groups. Monocyte levels increased more in group A and B than the control group. Basophil and Eosinophil increased more in group A than group B and the control group. As for immunoglobin, within group A, the IgG level increased but the levels of IgA and IgM did not change. Within group B, the IgA level increased but the level of IgG decreased, and the level of IgM did not change. Within the control group, the IgG level decreased but the levels of IgA and IgM did not change. As for the group comparisons, the level of IgA increased more in group A than the control group, and the level of IgG increased more in group A than group B and the control group, but levels of IgM among the three groups did not show any difference. In summary, WBC and Ig levels showed that the three groups remained at the reference interval even after the exercise program. However, group A, which performed RPE 15-17 in step aerobics, showed increase in more measured items than the other groups, and this implies that the immunologic function has improved in the range of the reference intervals. Therefore, it will be effective to conduct step aerobics with the RPE 15-17 (hard-very hard) in order to increase the immunologic function.

Plant Characteristics and Dry Matter Production of Several Rice Varieties (수도품종(水稻品種)의 초형(草型)과 건물생산특성(乾物生産特性)의 변천(變遷))

  • Kim, Hong Kyu;Ahn, Su Bong
    • Korean Journal of Agricultural Science
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    • v.14 no.2
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    • pp.248-262
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    • 1987
  • This experiment was conducted to study plant characteristics and dry matter production of several rice varieties. The results are summarized as follows. 1. Culm length was gradually shortened as varieties were improved and showed significant decrease in Japonica X Indica hybrids. 2. Panicle length seems to be shortened as varieties changed from group I to group III. However, varieties in group IV had longer panicle length in spite of shortening tendency in other groups. 3. Leaf blade length was decreased as varieties improved, but leaf blade width was increased. 4. Panicle exertion showed significant decrease as varieties improved. 5. Number of panicles per square meter among Japonica varieties was gradually increased and similar to the number of spikelets per panicle. Number of spikelets on Indica X Japonica hybrids were higher than Japonica varieties, whereas 1,000 kernel weight was slightly decreased. 6. Dry weight of leaf sheath and culm, and leaf blade was highest at the time of heading and the weight of panicle showed significant increase between 10 and 20 days after heading. 7. The maximum crop growth ratios of leaf blade, stem and panicles were attadined at the stage of heading, booting and milking, respectively. 8. The distribution ratio of dry matter was higher in leaf blade than in stem at the tillering stage. At the heading stage, the distribution ratio of dry matter was higher in order of culm, leaf blade and panicle. At the maturing stage, the ratio was higher in order of panicle, stem and laf blade. 9. Correlation coefficients among grain yield, harvest index, and biological yield were all significant and they were positive.

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A Study on Relationship between Physical Elements and Tennis/Golf Elbow

  • Choi, Jungmin;Park, Jungwoo;Kim, Hyunseung
    • Journal of the Ergonomics Society of Korea
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    • v.36 no.3
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    • pp.183-196
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    • 2017
  • Objective: The purpose of this research was to assess the agreement between job physical risk factor analysis by ergonomists using ergonomic methods and physical examinations made by occupational physicians on the presence of musculoskeletal disorders of the upper extremities. Background: Ergonomics is the systematic application of principles concerned with the design of devices and working conditions for enhancing human capabilities and optimizing working and living conditions. Proper ergonomic design is necessary to prevent injuries and physical and emotional stress. The major types of ergonomic injuries and incidents are cumulative trauma disorders (CTDs), acute strains, sprains, and system failures. Minimization of use of excessive force and awkward postures can help to prevent such injuries Method: Initial data were collected as part of a larger study by the University of Utah Ergonomics and Safety program field data collection teams and medical data collection teams from the Rocky Mountain Center for Occupational and Environmental Health (RMCOEH). Subjects included 173 male and female workers, 83 at Beehive Clothing (a clothing plant), 74 at Autoliv (a plant making air bags for vehicles), and 16 at Deseret Meat (a meat-processing plant). Posture and effort levels were analyzed using a software program developed at the University of Utah (Utah Ergonomic Analysis Tool). The Ergonomic Epicondylitis Model (EEM) was developed to assess the risk of epicondylitis from observable job physical factors. The model considers five job risk factors: (1) intensity of exertion, (2) forearm rotation, (3) wrist posture, (4) elbow compression, and (5) speed of work. Qualitative ratings of these physical factors were determined during video analysis. Personal variables were also investigated to study their relationship with epicondylitis. Logistic regression models were used to determine the association between risk factors and symptoms of epicondyle pain. Results: Results of this study indicate that gender, smoking status, and BMI do have an effect on the risk of epicondylitis but there is not a statistically significant relationship between EEM and epicondylitis. Conclusion: This research studied the relationship between an Ergonomic Epicondylitis Model (EEM) and the occurrence of epicondylitis. The model was not predictive for epicondylitis. However, it is clear that epicondylitis was associated with some individual risk factors such as smoking status, gender, and BMI. Based on the results, future research may discover risk factors that seem to increase the risk of epicondylitis. Application: Although this research used a combination of questionnaire, ergonomic job analysis, and medical job analysis to specifically verify risk factors related to epicondylitis, there are limitations. This research did not have a very large sample size because only 173 subjects were available for this study. Also, it was conducted in only 3 facilities, a plant making air bags for vehicles, a meat-processing plant, and a clothing plant in Utah. If working conditions in other kinds of facilities are considered, results may improve. Therefore, future research should perform analysis with additional subjects in different kinds of facilities. Repetition and duration of a task were not considered as risk factors in this research. These two factors could be associated with epicondylitis so it could be important to include these factors in future research. Psychosocial data and workplace conditions (e.g., low temperature) were also noted during data collection, and could be used to further study the prevalence of epicondylitis. Univariate analysis methods could be used for each variable of EEM. This research was performed using multivariate analysis. Therefore, it was difficult to recognize the different effect of each variable. Basically, the difference between univariate and multivariate analysis is that univariate analysis deals with one predictor variable at a time, whereas multivariate analysis deals with multiple predictor variables combined in a predetermined manner. The univariate analysis could show how each variable is associated with epicondyle pain. This may allow more appropriate weighting factors to be determined and therefore improve the performance of the EEM.

Surgical Treatment of Cardiac Myxoma: A 20 Years of Experiences (심장 점액종의 외과적 치료: 20년 임상경험)

  • Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Yie, Kil-Soo;Baek, Man-Jong;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.288-291
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    • 2007
  • Background: Myxoma makes up close to 50% of adult primary cardiac tumors, and this mainly occurs in the left atrium, and rarely in the right atrium or ventricle. The patients clinically present with symptoms of hemodynamic obstruction, embolization or constitutional changes. Diagnosis is currently established most appropriately with 2-D echocardiography. Surgical resection of myxoma is a safe and effective treatment, Material and Method: We reviewed our clinical experience in the diagnosis and management of 57 cases of cardiac myxoma that were seen over a 20-year period from July 1984 to July 2004. Result: The mean age of the patients was $53.5{\pm}14.0$ years (range: 12 to 76 years). There were 38 (67%) females and 19 (33%) males. The preoperative symptoms included dyspnea on exertion in 27 patients, palpitation in 4, chest pain in 9 and syncopal episode in 4. The diagnosis was made by echocardiography alone in 51, and by combination of echocardiography, CT and angiography in 6. The tumor attachment sites were the interatrial septum in 50, the mital valve annulus in 3 and the left atrial wall in cases, The tumor was excised successfully via biatriotomy in 33 (58%), left atriotomy in 15 (26%), the septal approach via right atriotomy in 3, Inverted T incision in 3 and the extended septal approach in 3. The follow-up time ranged from 1 to 229 months (mean follow-up: $84.0{\pm}71.3$ months). There were no early and late deaths and no recurrence during the follow-up period except for follow-up loss in 5 patients. Conclusion: It's concluded that excision of cardiac myxoma is curative and the long-term survival is excellent. Immediate surgical treatment was indicated because of the high risk of embolization or of sudden cardiac death. Radical tumor excision may prevent recurrences.

Result of Tracheal Resection and End-to-end Anastomosis (기관 절제 및 단단문합술의 성적 고찰)

  • 유양기;박승일;박순익;김용희;박기성;김동관;최인철
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.267-272
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    • 2003
  • Background: Common treatment modalities for tracheal stenosis include conservative methods such as repeated balloon dilatation, removal of obstructive material through bronchoscopy and T-tube insertion as well as operative treatment methods. Recent advances in surgical approaches through tracheal resection and end-to-end anastomosis have been reported to give better functional and anatomical results. Material and Method: Between March 1990 and July 2002, 41 patients who received tracheal resection and end-to-end anastomosis at Asan Medical Center, University of Ulsan were studied retrospectively. Result: The causes for tracheal resection and end-to-end anastomosis included 26 cases of postintubation stenosis, 10 cases of primary tracheal tumors (3 benign, 7 malignant), 1 case of endobronchial tuberculosis, 2 cases of traumatic rupture, and 2 cases of tracheal invasion of a thyroid cancer, Of the 41 patients who received tracheal resection and reconstruction, 29 received tracheal resection and end-to-end anastomosis, and 12 received laryngotracheal anastomosis with cricoid or thyroid cartilage resection. Four of these patients received supralaryngeal release. The average length of the resected trachea was $3.6{\pm}1.0$cm. Of the 41 patients who received tracheal resection and end-to-end anastomosis, 30 (73.2%) experienced no postoperative complications, and 8 (19.5%) experienced granulation tissue growth and/or minor infections which improved after conservative management. Good or satisfactory results were therefore achieved in 92.7%. Complications included repeated granulation tissue growth in 7, wound infection in 2, anastomotic site dehiscence in 2, restenosis resulting in dyspnea on exertion in 1, and repeated postoperative aspiration requiring retracheostomy in 1. There was no early postoperative mortality. There were 3 cases of hospital death. Conclusion: In cases of proper length of tracheal lesion, excellent results were obtained after tracheal resection and end-to-end anastomosis. But, granulation tissue growth is so serious complication, it is necessary for continuous study and efforts to prevent it.