We measured, with manual goniometer, the active and passive arc of motion of the shoulder in 31 healthy male subjects who were right-hand dominant and who ranged in age from twenty to thirty-one years. Among ten directions through the four motion plane, the range of motion on the dominant side were significantly smaller than those on the non-dominant side in the motion of six directions. We also measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement(θGH/θST) was 1.6 for the full range of motion in scapular plane. At the lower angles of abduction, scapulothoracic movement was slight compared with glenohumeral movement. The motion fraction of scapulothoracic joint was increased from 60-degree to 150 degree of arm angle especially between 120 to 150 degree. During arm elevation, scapula was also extended from 42 degrees to 20 degrees tilting as well as internal rotation. The measuring technique of glenohumeral to scapulothoracic movement(θGH/θST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment.
Drawing on the deep experience and understanding of the principles of nuclear safety, as well as many years of nuclear power plant design and operation, the EDF led NUWARD SMR Project is developing a design for a Small Modular Reactor (SMR) of 340 MWe composed of two 170 MWe independent units, that will supplement the offering of high-output nuclear reactors, especially in response to specific needs such as replacement of fossil-fuelled power plants. NUWARD SMR is a mix of proven and innovative design features that will make it more commercially competitive, while integrating safety features that comply with the highest international standards. Following the principles of redundancy and diversity and rigorous application of Defence in Depth (DID), with an international view on nuclear safety licensing, the Project also incorporates new safety approaches into its design development. The NUWARD SMR Project has been in development for a number of years, it entered conceptual design formally in mid-2019 and entered Basic Design in 2023. The objective of the concept design phase was to confirm the project technological choices and to define the first design configuration of the NUWARD SMR product, to document it, in order to launch pre-licensing with the French Safety Authority (ASN) and to define its estimated cost and its subsequent development and construction schedules. As a delivery milestone the Safety Options file (called the Dossier d'Options de Sûreté (DOS)) has been submitted to ASN in July 2023 for their opinion. An integral part of the NUWARD SMR Project, is not only to deliver a design suitable for France and to satisfy French regulation, but to develop a product suitable and indeed desirable, for the international market, with a first focus in Europe. In order to achieve its objectives and realise its market potential, the NUWARD SMR Project needs to define and realise its safety approach within an international environment and that is the key subject of this paper. The following paper: • Summarises the foundation principles and technological background which underpin the design; • Contextualises the key design features with regard to the international safety regulatory framework with particular emphasis on innovative passive safety aspects; • Illustrates the Project activities in preparation for first licensing in France, and also a wider international view via the ASN led Joint Early Review of the NUWARD SMR design, including Finnish and Czech Republic regulators, recently joined by the Swedish, Polish and Dutch regulators; • Articulates the collaborative approach to design development from involvement with the Project partners (the Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Naval Group, TechnicAtome, Framatome and Tractebel) to the establishment of the International NUWARD Advisory Board (INAB), to gain greater international insight and advice; • Concludes with the focus on next steps into detailed design development, standardisation of the design and its simplification to enhance its commercial competitiveness in a context of further harmonisation of the nuclear safety and licensing requirements and aspirations.
Ji-Ho Lee;Hyeon-Sun Park;Sang-Hyeon Park;Dong-Ho Keum;Seo-Hyun Park
Journal of Pharmacopuncture
/
v.27
no.1
/
pp.14-20
/
2024
Objectives: Frozen shoulder (FS) is one of the most challenging shoulder disorders for patients and clinicians. Its symptoms mainly include any combination of stiffness, nocturnal pain, and limitation of active and passive glenohumeral joint movement. Conventional treatment options for FS are physical therapy, nonsteroidal anti-inflammatory drugs, injection therapy, and arthroscopic capsular release, but adverse and limited effects continue to present problems. As a result, pharmacoacupuncture (PA) is getting attention as an alternative therapy for patients with FS. PA is a new form of acupuncture treatment in traditional Korean medicine (TKM) that is mainly used for musculoskeletal diseases. It has similarity and specificity compared to corticosteroid injection and hydrodilatation, making it a potential alternative injection therapy for FS. However, no systematic reviews investigating the utilization of PA for FS have been published. Therefore, this review aims to standardize the clinical use of PA for FS and validate its therapeutic effect. Methods: The protocol was registered in Prospero (CRD42023445708) on 18 July 2023. Until Aug. 31, 2023, seven electronic databases will be searched for randomized controlled trials of PA for FS. Authors will be contacted, and manual searches will also be performed. Two reviewers will independently screen and collect data from retrieved articles according to predefined criteria. The primary outcome will be pain intensity, and secondary outcomes will be effective rate, Constant-Murley Score, Shoulder Pain and Disability Index, range of motion, quality of life, and adverse events. Bias and quality of the included trials will be assessed using the Cochrane handbook's risk-of-bias tool for randomized trials. Meta analyses will be conducted using Review Manager V.5.3 software. GRADE will be used to evaluate the level of evidence for each outcome. Results: This systematic review and meta-analysis will be conducted following PRISMA statement. The results will be published in a peer-reviewed journal. Conclusion: This review will provide scientific evidence to support health insurance policy as well as the standardization of PA in clinical practice.
Journal of The Korean Society of Integrative Medicine
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v.12
no.3
/
pp.37-47
/
2024
Purpose : Cancer survivors often suffer from postoperative sequelae. the diagnosing and provision of manual therapy using spiral taping significantly improves the quality of life of cancer patients. The aim of this case study is to investigate the immediate effects of spiral taping on pain, range of motion (ROM), chemotherapy-induced peripheral neuropathy (CIPN), and lymphedema following breast cancer surgery. Methods : The taping techniques were performed as follows by spiral taping. The measurements were taken before, in the middle, and after taping using a mobile phone camera, tape measure, and a numerical rating score (NRS). The evaluation employed a single-group pre-post design based on a primitive experimental design. Results : Out of four patients, all four exhibited Reverse circle flow energy (RCFE), Passive cervical right (Rt) rotation test, anterior-posterior movement pattern, nerve type (+), cold energy (CE), sangcho acupuncture point, blood clot, hwal point. Comparing before and after treatment, almost all values were reduced to zero after treatment in terms of pain complaints. The lack of range of motion (ROM) caused by the shortened tissue after surgery did not increase. The range of motion (ROM) lost due to pain returned to normal. The circumference of lymphedema did not show a tendency. The symptoms of CIPN improved. Conclusion : There was a significant change in joint range of motion, with pain decreasing, but there were structural limitations in the tissue due to total resection, and the chemotherapy-induced peripheral neuropathy scale. It was effectively treated surgical site pain, axillary membrane syndrome-induced pain, and unexplained pain. While there was a treatment effect for lymphedema in the evaluation of circumference values, there was no significant change in circumference. There was a significant effect on chemotherapy-induced peripheral neuropathy, particularly in treating numbness in the feet, which is a side effect of TC anticancer drugs. This case study found that spiral balance taping provides a rapid therapeutic effect for most side effects in patients who have undergone total breast cancer resection. However, the generalization is limited due to the small sample size, and further research is needed to determine the extent to which the effects of one treatment are maintained.
Previous studies of the relationship of TMJ signs and symptoms in elderly people have provided inconsistent findings. The objective of this study was to retrospectively analyze the prevalence of signs and symptoms of temporomandibular disorders(TMD). Additionally, young subjects were examined as a control group. Forty old patients (28 female, 12 male, mean age: $65.2{\pm}2.5$ years) and forty young patients (30 female, 10 male, mean age: $23.3{\pm}2.6$ years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: pain on chief complain, amount of range of mouth opening, TMJ noises(clicking sounds, crepitus), pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles. Differences between the groups were assessed using t-test and the chi-squared test. (SPSS v.17) P value <0.05 was considered statistically significant. Geriatric subjects more often exhibited crepitus on mouth opening (25%), muscular palpation pain of masseter muscles (82.5%) and temporal muscles(60%). In contrast, young subjects more frequently exhibited joint sounds (62.5%), more amount of range of passive mouth opening (p=0.043). It was found that the younger subjects (82.5%) and the older subjects (87.5%) suffered from subjective sign (orofacial pain on chief complain). There were not statistically significant relationships between orofacial pain (VAS) and the groups. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (crepitus on opening, pain on muscular palpation) of TMD, younger subjects more frequently objective signs (clicking sound on mouth opening, amount of mandibular range of motion).
Extra heavy oil reservoirs are distributed over the world but most of them is deposited in the northern part of the Orinoco River in Venezuela, in the area of 5,500 $km^2$, This region, which has been commonly called "the Orinoco Oil Belt", contains estimated 1.3 trillion barrels of original oil-in-place and 250 billion barrels of established reserves. The Venezuela extra heavy oil has an API gravity of less than 10 degree and in situ viscosity of 5,000 cP at reservoir condition. Although the presence of extra heavy oil in the Orinoco Oil Belt has been initially reported in the 1930's, the commercial development using in situ cold production started in the 1990's. The Orinoco heavy oil deposits are clustered into 4 development areas, Boyaco, Junin, Ayachoco, and Carabobo respectively, and they are subdivided into totally 31 production blocks. Nowadays, PDVSA (Petr$\'{o}$leos de Venzuela, S.A.) makes a development of each production block with the international oil companies from more than 20 countries forming a international joint-venture company. The Eastern Venezuela Basin, the Orinoco Oil Belt is included in, is one of the major oil-bearing sedimentary basins in Venezuela and is first formed as a passive margin basin by the Jurassic tectonic plate motion. The major source rock of heavy oil is the late Cretaceous calcareous shale in the central Eastern Venezuela Basin. Hydrocarbon materials migrated an average of 150 km up dip to the southern margin of the basin. During the migration, lighter fractions in the hydrocarbon were removed by biodegradation and the oil changed into heavy and/or extra heavy oil. Miocene Oficina Formation, the main extra heavy oil reservoir, is the unconsolidated sand and shale alternation formed in fluvial-estuarine environment and also has irregularly a large number of the Cenozoic faults induced by basin subsidence and tectonics. Because Oficina Formation has not only complex lithology distribution but also irregular geology structure, geological evolution and characteristics of the reservoirs have to be determined for economical production well design and effective oil recovery. This study introduces geological formation and evolution of the Venezuela extra heavy oil reservoirs and suggest their significant geological characteristics which are (1) thickness and geometry of reservoir pay sands, (2) continuity and thickness of mud beds, (3) geometry of faults, (4) depth and geothermal character of reservoir, (5) in-situ stress field of reservoir, and (6) chemical composition of extra heavy oil. Newly developed exploration techniques, such as 3-D seismic survey and LWD (logging while drilling), can be expected as powerful methods to recognize the geological reservoir characteristics in the Orinoco Oil Belt.
Purpose: This study evaluated the detorque values of screws in a multiple implant-supported superstructure using stone casts made with 2 different impression techniques. Material and methods: A fully edentulous mandibular master model and a metal framework directly connected to four implants (Br${\aa}$nemark $System^{(R)}$; Nobel Biocare AB) with a passive fit to each other were fabricated. Six experimental stone casts (Group 1) were made with 6 non-splinted impressions on a master cast and another 6 experimental casts (Group 2) were made with 6 acrylic resin splinted impressions. The detorque values of screws ($TorqTite^{(R)}$ GoldAdapt Abutment Screw; Nobel Biocare AB) were measured twice after the metal framework was fastened onto each experimental stone cast with 20 Ncm torque. Detorque values were analyzed using the mixed model with the fixed effect of screw and reading and the random effect of model for the repeated measured data at a .05 level of ignificance. Results: The mean detorque values were 7.9 Ncm (Group 1) and 8.1 Ncm (Group 2), and the mean of minimum detorque values were 6.1 Ncm (Group 1) and 6.5 Ncm (Group 2). No statistically significant differences between 2 groups were found and no statistically significant differences among 4 screws were found for detorque values. No statistically significant differences between 2 groups were also found for minimum detorque values. Conclusion: In a multiple external hexagon implant-supported prosthesis, no significant differences between 2 groups were found for detorque values and for minimum detorque values. There seems to be no significant differences in screw joint stability between 2 stone cast groups made with 2 different impression techniques.
The oracle of the I Ching, divination can be understood as 'synchronicity phenomenon' in analytic psychology. In order to experience divination actually, it requires a religious attitude that asks questions with a serious mind when a person is in trouble that consciousness reaches its limit. It is not just a passive attitude, but a modest, active attitude to ask what I can do now. The experience of the oracle of the I Ching connected to supra-consciousness is similar to 'active imagination'-talking with the archetype of collective unconsciousness-and is 'the process of finding the rhythm of Self-archetype, the absolute wisdom of unconsciousness.' One month before my father's death, I took care of him who couldn't communicate verbally and I divination with a question 'What can I do for my father and me now?' The I Ching's answer was hexagram 19 Lin 臨, nine at the beginning. It's message was '咸臨貞吉 joint approach. perseverance brings good fortune.' 志行正也 we must adhere perseveringly to what is right.' Through this phrase, I learned the attitude of waiting for life after death as if 'joyful obedient' to the providence of nature that spring comes after winter. And I found that keeping the touching emotion of meeting infinity (in analytical psychological terms, 'Self') with perseveration is to do the true meaning of life beyond popular money-mindedness. And six months before my father's death, I had a dream about the afterlife. In the process of interpreting that dream, I learned not only from the shock of the direct message that 'it is a truth that there is something after death,' but also the regeneration of the mind through introversion from the similarity between the closed ward and '黃泉'-chinese underworld through amplification. And I learned the importance of an open attitude to accept new things through the 'window to eternity' symbolized by the white iron gate. In my father's catholic funeral ritual, I had hope that the catholic doctrine 'Communio Sanctorum'-A spiral cycle in which the living and the dead help each other may be real as well as a symbol of the individuation process in which consciousness and unconsciousness interact in our minds. Through the consolation received through the funeral visit of many people I met in my life, I found the answer that the path to contact with infinity begins with loving the beings in front of me. I tried to understand this continuous experience by the perspective of analytical psychology.
Lee Kwang Won;Park Jae Guk;Jung Yu Hun;Kim Byung Sung;Kim Ha Yong;Choy Won Sik
Journal of the Korean Arthroscopy Society
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v.7
no.2
/
pp.160-168
/
2003
Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.
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