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Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity

  • Baek, Jongyoon;Kim, Bum Soo;Yu, Hwarim;Kim, Hyuckgoo;Lim, Chaeseok;Song, Sun Ok
    • Journal of Yeungnam Medical Science
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    • v.35 no.2
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    • pp.199-204
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    • 2018
  • Background: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. Methods: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. Results: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures ($0.50{\pm}0.38^{\circ}C$ and $1.41{\pm}0.68^{\circ}C$ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference > $1^{\circ}C$) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). Conclusion: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

AN EXPERIMENTAL STUDY ON THE EFFECTS OF Co-60 IRRADIATION IN THE RAT PERIODONTIUM. (방사선조사가 백서의 치주조직에 미치는 영향에 관한 실험적 연구)

  • Park Dai-Hee;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.16 no.1
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    • pp.41-48
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    • 1986
  • It is known that radiation therapy is a kind of treatment choices of the maxillofacial tumors. This study is designed to investigate the irradiation effects on rat's periodontal tissues as functional tissues which relate to tooth-support, hard tissue formation and destruction. 20 rats (Sprague-Dowley branch, male) were devided into control group of 4 and experimental groupe of 16. Experimental group was singly exposed to Co-60 irradiation with 10 Gy in the head and neck region. Animals were sacrificed on 2 days, 1 week, 2 weeks and 3 weeks after the irradiation. The specimens were observed by histopathological examination employing H-E stain, van-Gieson stain and PA-ACH fluorescent stain. The results were as follows: 1. Cementoblasts and osteoblasts were gradually lost and rearranged along the external surfaces of the cementum and alveolar bone, but osteoclasts were almost not affected. 2. The cell numbers of the periodontal ligament were decreased due to the cellular atrophy and degeneration, but recovered almost normally on the 3rd week after irradiation. 3. The collagen fibers within the periodontal ligament were irregularly oriented, became finer and decreased in number. 4. The vessels of the periodontal ligament were decreased at the initial stage but increased again on the 2nd week after irradiation, and the hemorrhagic appearances, occurred within the tissues, due to the arterial destruction, were lasted until 3 weeks after irradiation. 5. The glycogen within the periodontal ligament was gradually increased and stored in the matrices of the cemental side on the 1st week after irradiation, but recovered almost normally on the 3rd week after irradiation.

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Diatally-Based Medial Crural Adipofascial Flap for Coverage of Medial Foot and Ankle

  • Kim, Min Bom;Lee, Young Ho;Choi, Ho Sung;Kim, Dong Hwan;Lee, Jung Hyun;Baek, Goo Hyun
    • Archives of Reconstructive Microsurgery
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    • v.24 no.2
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    • pp.56-61
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    • 2015
  • Purpose: We report on the clinical result after coverage of a soft tissue defect on the medial foot and ankle with an adipofascial flap based on the perforator from the posterior tibia artery. Materials and Methods: Nine patients with soft tissue defects on the medial foot and ankle area from March 2009 to May 2014 underwent the procedure. Average age was 54 years old (range, 8~82 years). There were five male patients and four female patients. The causes of the defect were trauma (4), tumor (3), and infection (2). The pivot point of transposition of this flap is the lower perforator originating from the posterior tibia artery. The fatty tissue side of this flap could be used to resurface the defect. The donor site was closed primarily with the preserved skin, and a small caliber drain tube was used. The split-thickness skin graft was grafted to the flap and the wound. If the wound was still infected, this skin graft could be performed at a later date. Results: All flaps survived and normal soft tissue coverage was obtained for the medial foot and ankle of all patients after the skin graft. Normal footwear was possible for all cases because of thin coverage. There was an extension contracture on the medial ray of the foot, which was resolved by contracture release and skin graft. Conclusion: For the medial foot and ankle soft tissue defect, the medial crural adipofascial flap based on a perforator branch of the posterior tibia artery could be a good option to cover it.

Recent results on the analysis of viscoelastic constitutive equations

  • Kwon, Youngdon
    • Korea-Australia Rheology Journal
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    • v.14 no.1
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    • pp.33-45
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    • 2002
  • Recent results obtained for the port-pom model and the constitutive equations with time-strain separability are examined. The time-strain separability in viscoelastic systems Is not a rule derived from fundamental principles but merely a hypothesis based on experimental phenomena, stress relaxation at long times. The violation of separability in the short-time response just after a step strain is also well understood (Archer, 1999). In constitutive modeling, time-strain separability has been extensively employed because of its theoretical simplicity and practical convenience. Here we present a simple analysis that verifies this hypothesis inevitably incurs mathematical inconsistency in the viewpoint of stability. Employing an asymptotic analysis, we show that both differential and integral constitutive equations based on time-strain separability are either Hadamard-type unstable or dissipative unstable. The conclusion drawn in this study is shown to be applicable to the Doi-Edwards model (with independent alignment approximation). Hence, the Hadamardtype instability of the Doi-Edwards model results from the time-strain separability in its formulation, and its remedy may lie in the transition mechanism from Rouse to reptational relaxation supposed by Doi and Edwards. Recently in order to describe the complex rheological behavior of polymer melts with long side branches like low density polyethylene, new constitutive equations called the port-pom equations have been derived in the integral/differential form and also in the simplifled differential type by McLeish and carson on the basis of the reptation dynamics with simplifled branch structure taken into account. In this study mathematical stability analysis under short and high frequency wave disturbances has been performed for these constitutive equations. It is proved that the differential model is globally Hadamard stable, and the integral model seems stable, as long as the orientation tensor remains positive definite or the smooth strain history in the flow is previously given. However cautious attention has to be paid when one employs the simplified version of the constitutive equations without arm withdrawal, since neglecting the arm withdrawal immediately yields Hadamard instability. In the flow regime of creep shear flow where the applied constant shear stress exceeds the maximum achievable value in the steady flow curves, the constitutive equations exhibit severe instability that the solution possesses strong discontinuity at the moment of change of chain dynamics mechanisms.

Ultrasound-Assisted Mental Nerve Block and Pulsed Radiofrequency Treatment for Intractable Postherpetic Neuralgia: Three Case Studies

  • Park, Hae Gyun;Park, Pyung Gul;Kim, Won Joong;Park, Yong Hee;Kang, Hyun;Baek, Chong Wha;Jung, Yong Hun;Woo, Young Cheol;Koo, Gill Hoi;Shin, Hwa Yong
    • The Korean Journal of Pain
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    • v.27 no.1
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    • pp.81-85
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    • 2014
  • Postherpetic neuralgia (PHN) is one of the most difficult pain syndromes to treat. Invasive treatments may be considered when patients fail to obtain adequate pain relief from noninvasive treatment approaches. Here, we present three cases of PHN in the mandibular branch treated with ultrasound-assisted mental nerve block and pulsed radiofrequency treatment. None of the patients had adequate pain relief from the medical therapy, so we performed the mental nerve block on the affected side under ultrasound assistance. Two patients showed satisfactory pain relief continuously over 12 months without any further interventions, whereas one patient only had short-term pain relief. For the patient had short-term pain relief we performed pulsed radiofrequency treatment (PRFT) on the left mental nerve under ultrasound assistance. After PRFT, the patient had adequate pain relief for 6 months and there was no need for further management.

A Study on the wild Rhododendron micranthum for being used as Landscape Plant (꼬리진달래의 조경수목화를 위한 기초연구(1) : 자생지의 생육환경을 중심으로)

  • 이기의;유근창;이병용
    • Journal of the Korean Institute of Landscape Architecture
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    • v.17 no.2
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    • pp.41-46
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    • 1989
  • Rhododendron micranthum grown over the area of Kyoung Puck, Kang Weon Province is showy and very attractive evergreen broad-leaned shrub of shade resistance. This shrub is considered very useful for exploiting as a garden plant. Environments, growth characteristics and vegetation association in the wild habitat and in the garden planted with this shrub, were investigated to find out some appropriate means of propagation and cultivation of this shrub. The results thus obtained were stated as follows ; 1. Light intensity for the native habitat ranged in the proximity of 9%. The most abundant stand of this shrub occurred in the northen side of mountains, while still some plants were found in the eastern sides also. 2. Soil of the native habitat was acidic (pH 4.4) and infertility. 3. Average elevation of the native habitat was shown to be 230m above the sea level. 4. The plant of the native habitat showed an average of 3.9 new shoots per branch, whereas that of the garden planted (light intensity 100%) showed 1.2, 5% of an average was for sun-burn leaves were noted, while garden Plants(light intensity 100%) showed 90% of them. 5. Other tree species associated with Rhododendron micrathum in the native habitat were primarily Pinus densiflora and secondarily Sorbus alnifolia, hemerocallis aurautiaca, Rubus crataegifolius, and Salix hulteni. 6. Vegetation rate of plant habitats in the Rhododendron growing area was observed to be 0 to 80% involving 27 to 50 species of associated trees in the vegetation for the 10${\times}$10m quadrat area.

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Shear Behavior Prediction of Reinforced Concrete Columns Using Transformation Angle Truss Model (변환각 트러스 모델에 의한 철근콘크리트 기둥의 전단거동 예측)

  • Kim Sang-Woo;Chai Hyee-Dae;Lee Jung-Yoon;Lee Bum-Sik
    • Journal of the Korea Concrete Institute
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    • v.17 no.3 s.87
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    • pp.435-444
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    • 2005
  • This paper predicted the shear behavior of reinforced concrete columns using Transformation Angle Truss Model (TATM) considered the effects of bending moment and axial force. Nine columns with various shear span- to-depth ratios and axial force ratios were tested to verify the theoretical results obtained from TATM. Fine linear displacement transducers (LVDT) were attached to a side of the column near the shear critical region to measure the curvature, the longitudinal and transverse axial deformations, and the shear deformation of the column. The test was terminated when the value of the applied load dropped to about $85\%$ of the maximum-recorded load in the post-peak descending branch. All the columns were failed in shear before yielding of the flexural steel. The shear strength and the stiffness of the columns increased, as the axial force increased and the shear span-to-depth ratio decreased. Shear stress-shear strain and shear stress-strain of shear reinforcement curves obtained from TATM were agreed well with the test results in comparison to other truss models (MCFT, RA-STM, and FA-STM).

Basic Experimental Study of the Edge-Flame Intensity Variation at High Temperature and with Small Fuel-Concentration Gradient (고온 미소농도구배 조건에서의 에지화염 강도 변화에 관한 실험적 기초 연구)

  • Lee, Min-Jung;Kim, Nam-Il
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.35 no.6
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    • pp.633-640
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    • 2011
  • In this study, the stabilization of an edge flame and the intensity variation of a diffusion branch were investigated using a multi-slot combustor under conditions of high temperature and small fuel-concentration gradient (FCG). The combustor consists of three narrow channels: a quartz channel and two side-heating combustors. For the accuracy of this experimental study, quantitative analysis was carried out for each boundary condition. Stable edge flames could be observed under high-temperature conditions by controlling the FCG and fuel dilution ratio. Moreover, it was found that the intensity of the diffusion flame was increased by increasing the temperature of the mixture. On the contrary, the intensity of the diffusion flame was decreased by increasing the dilution ratio. It was also found that a propane flame is more sensitively affected by these experimental parameters than a methane flame.

Microvascular Anastomosis with Non-penetrating Vascular Clips in Head and Neck Free Flap Surgery (두경부 유리피판 수술에 있어서의 비천공성 혈관 클립을 이용한 미세혈관 문합술)

  • Chang, Hak;Minn, Kyung-Won;Kim, Woo-Ram;Shin, Hyun-Woo;Koh, Kyung-Suck
    • Archives of Reconstructive Microsurgery
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    • v.14 no.1
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    • pp.57-62
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    • 2005
  • Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using small-sized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer.

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Morphological study of brook lamprey, Lampetra reissneri (Agnatha) from Southern Korea (한국 남부지방에 서식하는 다묵장어 Lampetra reissneri (Agnatha)의 형태적 연구)

  • Shim, Jae-Hwan
    • Korean Journal of Ichthyology
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    • v.2 no.2
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    • pp.149-158
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    • 1990
  • The brook lamprey, Lampetra reissneri, was collected from an branch of the Nakdong River (Namwon-gun, Chollabuk-Do) and the Seomjin River (Hadong-Gun, Kyungsangnam-Do) from September, 1989 to April, 1990. Specimens were 95 individuals in number and composed of 21 ammocoetes, 16 metamorphosing animals and 58 adults which do not exceed 200mm in total length. The modal numbers of trunk myomer was 57.5, ranged from 55 to 60. In the dental formula, the supraoral tooth consistently had 2 cusps, and lateral circumorals were 3 in each side with 2 cusps. The infraoral had varying numbers of cusps ranging from 6 to 8. In morphological measurement of adults, prebranchial length was 10.3%, branchial length 9.7%, trunk length 51.3% and tail length 28.3% respectively, in hundreds of total length. No significant differences in morphological characteristics were observed between the two populations studied.

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