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The Study on Correlation between the Degree of Herniated Intervertebral Lumbar Disc at L4~5 Level and Improvement of Low Back Pain Treated by Korean Medicine Therapy (제 4~5번 요추 추간판 탈출 정도와 요통의 한의학적 치료 효과의 상관성 연구)

  • Yoo, Hyung-jin;Lee, Hyun-ho;Jeong, Seong-hyun;Jo, Kyeong-sang;Lee, Gie-on;Lee, Dong-hyun;Kim, Sang-min
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.2
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    • pp.105-121
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    • 2016
  • Objectives The purpose of this study was to compare the effects between the degree of herniated intervertebral lumbar disc (HIVD) at L4-5 level and improvement of low back pain treated by Korean Medicine therapy. Methods 567 patients who received inpatient treatment from May 2014 to December 2015 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 6 groups by the degree of HIVD at L4-5 level confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, Normal stage on Intervertebral Lumbar Disc at L4-5 level group's Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) improvement was $1.30{\pm}1.62$, $4.52{\pm}11.82$ and $0.04{\pm}0.11$ respectively. Bulging group's improvement was $3.25{\pm}2.81$, $8.28{\pm}13.02$ and $0.09{\pm}0.17$ respectively. Spinal canal occupying ratio (SOR) less than 20 group's improvement was $2.15{\pm}1.92$, $11.79{\pm}17.81$ and $0.13{\pm}0.23$ respectively. SOR 20 to less than 40 stage group's improvement was $2.13{\pm}1.92$. $10.79{\pm}15.93$ and $0.10{\pm}0.26$ respectively. SOR 40 to less than 60 group's improvement was $2.16{\pm}2.24$, $9.80{\pm}16.62$ and $0.15{\pm}0.25$ respectively. Surgery group's improvement was $2.47{\pm}2.21$, $11.64{\pm}18.53$ and $0.15{\pm}0.27$ respectively (p<0.03). But there was no statistically significance between 6 group's improvement after treatment (p>0.05). Conclusions After inpatient treatment by Korean Medicine therapy, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically correlation between the degree of HIVD at L4-5 level and improvement of low back pain. So We think that future research of higher quality and correct statistics shall be necessary.

Comparison of the Neurologic Outcome according to the Method of Proximal Graft Anastomosis at the Aortic Side during Off-pump Coronary Artery Bypass Grafting: The Heartstring Sealing System versus Conventional Manual Anastomosis (무심폐기 관상동맥 우회술에 있어서 이식편의 대동맥부 근위부 문합 방법에 따른 수술 후 신경학적 합병증 발생의 비교: 하트스트링을 이용한 방법 대 고식적인 수기 문합술)

  • Cho, Won-Chul;Kim, Joon-Bum;Kim, Hee-Jung;Kim, Hwan-Wook;Kim, Yun-Seok;Jung, Jae-Seung;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.441-446
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    • 2009
  • Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.

The influence of implant diameter, length and design changes on implant stability quotient (ISQ) value in artificial bone (임플란트의 직경, 길이 및 디자인변화가 임플란트 안정성지수(ISQ)에 미치는 영향)

  • Lee, Jeong-Yol;Lee, Won-Chang;Kim, Min-Soo;Kim, Jong-Eun;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.292-298
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    • 2012
  • Purpose: The purpose of this study is to ascertain the stability of the implant by comparing the effects of the change of implant diameter, length and design on implant stability quotient. Materials and methods: To remove the variable due to the difference of bone quality, the uniform density (0.48 g/$cm^3$) Polyuretane foam blocks (Sawbones$^{(R)}$, Pacific Research Laboratories Inc, Vashon, Washington) were used. Implants (Implantium$^{(R)}$, Dentium, Seoul, Korea) were placed with varying diameters (${\phi}3.8$, ${\phi}4.3$ and ${\phi}4.8$) and length (8 mm, 10 mm and 12 mm), to assess the effect on implant stability index (ISQ). Also the influence of the design of the submerged and the non-submerged (SimplelineII$^{(R)}$, Dentium, Seoul, Korea) on ISQ was evaluated. To exclude the influence of insertion torque, a total of 60 implants (n = 10) were placed with same torque to 35 N. Using Osstell$^{TM}$ mentor (Integration Diagnostic AB, Sweden) ISQ values were recorded after measuring the resonant frequency, one-way ANOVA and Tukey HSD test results were analyzed. (${\alpha}$=0.05). Results: 1. The change of the diameter of the implant did not affect the ISQ (P>.05), but the increase of implant length increased the ISQ(P<.001). 2. The change in implant design were correlated with the ISQ, and the ISQ of submerged design was significantly higher than that of the non-submerged design(P<.05). Conclusion: In order to increase implant stability, the longer implant is better to be selected, and on the same length of implant, submerged design is thought to be able to get a higher ISQ than the non-submerged.

Retrospective study of implant stability according to the implant length, diameter and position (임플란트 길이, 직경 및 식립 위치에 따른 임플란트 안정성에 관한 후향적 연구)

  • Kim, Ji-Hye;Jeon, Jin-Yong;Heo, Yu-Ri;Son, Mee-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.4
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    • pp.269-275
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    • 2013
  • Purpose: The aim of this retrospective study was to evaluate the influence of implant diameter, length and placement to implant stability. Materials and methods: Total 90 implants (US II plus$^{TM}$, Osstem co, Busan, Korea) of 72 patients were determined as experimental samples. The factors of diameters(${\phi}$ 4 mm, ${\phi}$ 5 mm), lengths (10 mm, 11.5 mm, 13 mm), and implant placement (maxilla, mandible) were analyzed. The stability of the implants was measured by resonance frequency analysis (RFA) at the time of implant placement and impression taking. The difference of ISQ values according to patient's gender was evaluated by Independent t-test. ISQ values were compared between implant diameter, length and placement using one-way ANOVA and Tukey HSD test (${\alpha}=.05$). To compare ISQ values between at the time of surgery and impression taking, paired t-tests were used (${\alpha}=.05$). Results: The change of implant length did not show significant different on the ISQ value (P>.05). However, 5 mm diameter implants had higher ISQ values than 4 mm diameter implants (P<.05). Implants placed on the mandible showed significantly higher ISQ values than on the maxilla (P<.05). Conclusion: In order to increase implant stability, it is better to select the wider implant, and implants placed on mandible are possible to get higher stability than maxilla. ISQ values at impression taking showed higher implant stability than ISQ values at implant placement, it means that RFA is clinically effective method to evaluate the change of implant stability through the osseointegration. The consideration of the factors which may affect to the implant stability will help to determine the time of load applying and increase the implant success rate.

Testing for Measurement Invariance of Fashion Brand Equity (패션브랜드 자산 측정모델의 등치테스트에 관한 연구)

  • Kim Haejung;Lim Sook Ja;Crutsinger Christy;Knight Dee
    • Journal of the Korean Society of Clothing and Textiles
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    • v.28 no.12
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    • pp.1583-1595
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    • 2004
  • Simon and Sullivan(l993) estimated that clothing and textile related brand equity had the highest magnitude comparing any other industry category. It reflects that fashion brands reinforce the symbolic, social values and emotional characteristics being different from generic brands. Recently, Kim and Lim(2002) developed a fashion brand equity scale to measure a brand's psychometric properties. However, they suggested that additional psychometric tests were needed to compare the relative magnitude of each brand's equity. The purpose of this study was to recognize the psychometric constructs of fashion brand equity and validate Kim and Lim's fashion brand equity scale using the measurement invariance test of cross-group comparison. First, we identified the constructs of fashion brand equity using confirmatory factor analysis through structural equation modeling. Second, we compared the relative magnitude of two brands' equity using the measurement invariance test of multi-group simultaneous factor analysis. Data were collected at six major universities in Seoul, Korea. There were 696 usable surveys for data analysis. The results showed that fashion brand equity was comprised of 16 items representing six dimensions: customer-brand resonance, customer feeling, customer judgment, brand imagery, brand performance and brand awareness. Also, we could support the measurement invariance of two brands' equities by configural and metric invariance tests. There were significant differences in five constructs' mean values. The greatest difference was in customer feeling; the smallest, in customer judgment.

Paradoxical Upper Airway Obstruction and Central Sleep Apnea Developed After Anterior Cervical Spine Fusion (전방경추융합술 후 발생한 역설상기도폐쇄 및 중추성 수면 무호흡)

  • Lee, Sang Haak;Choi, Young Mee;Park, Ye Ree;Kang, Ji Ho;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.295-298
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    • 2005
  • We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

Cerebral Activity by Motor Task in Welders Exposed to Manganese through fMRI (fMRI를 이용한 망간 노출 용접공의 운동수행에 따른 뇌 활성도 평가)

  • Choi, Jae-Ho;Jang, Bong-Ki;Lee, Jong-Wha;Hong, Eun-Ju;Lee, Myeong-Ju;Ji, Dong-Ha
    • Journal of Environmental Health Sciences
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    • v.37 no.2
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    • pp.102-112
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    • 2011
  • Objectives: The purpose of this study is to analyze the effects of chronic exposure by welders to manganese (Mn) through an analysis of the degree of brain activity in different activities such as cognition and motor activities using the neuroimaging technique of functional magnetic resonance imaging (fMRI). The neurotoxic effect that Mn has on the brain was examined as well as changes in the neuro-network in motor areas, and the usefulness of fMRI was evaluated as a tool to determine changes in brain function from occupational exposure to Mn. Methods: A survey was carried out from July 2010 to October 2010 targeting by means of a questionnaire 160 workers from the shipbuilding and other manufacturing industries. Among them, 14 welders with more than ten years of job-related exposure to Mn were recruited on a voluntary basis as an exposure group, and 13 workers from other manufacturing industries with corresponding gender and age were recruited as a control group. A questionnaire survey, a blood test, and an fMRI test were carried out with the study group as target. Results: Of 27 fMRI targets, blood Mn concentration of the exposure group was significantly higher than that of the control group (p<0.001), and Pallidal Index (PI) of the welder group was also significantly higher than that of the control group (p<0.001). As a result of the survey, the score of the exposure group in self-awareness of abnormal nerve symptoms and abnormal musculoskeletal symptoms was higher than those of the control group, and there was a significant difference between the two groups (p<0.05, respectively). In the correlation between PI and the results of blood tests, the correlation coefficient with blood Mn concentration was 0.893, revealing a significant amount of correlation (p<0.001). As for brain activity area within the control group, the right and the left areas of the superior frontal cortex showed significant activity, and the right area of superior parietal cortex, the left area of occipital cortex and cerebellum showed significant activity. Unlike the control group, the exposure group showed significant activity selectively on the right area of premotor cortex, at the center of supplementary motor area, and on the left side of superior temporal cortex. In the comparison of brain activity areas between the two groups, the exposure group showed a significantly higher activation state than did the control group in such areas as the right and the left superior parietal cortex, superior temporal cortex, and cerebellum including superior frontal cortex and the right area of premotor cortex. However, in nowhere did the control group show a more activated area than did the exposure group. Conclusions: Chronic exposure to Mn increased brain activity during implementation of hand motor tasks. In an identical task, activation increased in the premotor cortex, superior temporal cortex, and supplementary motor area. It was also discovered that brain activity increase in the frontal area and occipital area was more pronounced in the exposure group than in the control group. This result suggests that chronic exposure to Mn in the work environment affects brain activation neuro-networks.

Clinical Presentations and Causative Organisms in Children and Adolescents with Osteoarticular Infections: A Retrospective Study (소아청소년기에 발생한 골관절염의 임상 양상 및 원인균에 대한 고찰)

  • Lee, Soyoung;Kim, Han Wool;Cho, Hye-Kyung;Yun, Yoe Hon;Ryu, Kyung Ha;Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.154-163
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    • 2015
  • Purpose: Osteoarticular infections in children and adolescents are important because it can cause functional compromise if appropriate treatment is delayed. Therefore, this study was designed to describe the clinical presentations and causative organisms of osteoarticular infections in children and adolescents in order to propose early diagnosis method and an appropriate empiric antimicrobial therapy. Methods: Forty-two medical records were reviewed retrospectively, which were confirmed as osteomyelitis (OM) or septic arthritis (SA) at Department of Pediatrics or Orthopedic Surgery in patients under 18 years old of Ewha Womans University Mokdong Hospital from March 2008 to March 2015. Results: We identified 21 cases of OM, 13 cases of SA and 8 cases of OM with SA. There were 31 males and 11 females and mean age was 7.1 years old. The most common symptoms were pain and tenderness of involved site. Major involved bones were femur (10 cases, 34.5%), tibia (7 cases, 24.1%) and major involved joints were hip (9 cases, 42.9%), and knee (5 cases, 23.8%). Increased serum C-reactive protein and erythrocyte sedimentation rate were observed in 37 cases (88.1%) respectively. Magnetic resonance imaging was performed in 40 cases among 42 cases and was used to demonstrate osteoarticular infections and other adjacent infections. Nine cases (23.7%) among 38 cases and 20 cases (50.0%) among 40 cases were positive in blood culture and infected site culture respectively. The most common causative organism was Staphylococcus aureus, which was represented in 22 cases (75.9%), of which nine cases (40.9%) were resistant to methicillin. Conclusions: S. aureus was the most common causative organism of osteoarticular infections in children and adolescents and the proportion of MRSA was high in this study. Therefore, we recommend vancomycin as the first empiric antimicrobial therapy and suggest that further study is necessary to elucidate an appropriate guideline for treatment which takes into account MRSA proportion.

Antioxidant Activities of Extracts from Ligustrum ovalifolium H. Leaves (왕쥐똥나무잎 추출물의 항산화 활성)

  • Kim, Yon-Suk;Lee, Seung-Jae;Hwang, Jin-Woo;Kim, Ee-Hwa;Park, Pyo-Jam;Jeong, Jae-Hyun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.12
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    • pp.1642-1647
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    • 2011
  • The free radical scavenging activities of extracts from Ligustrum ovalifolium H. leaves (LOH) as well as various antioxidant activities such as ferric reducing antioxidant power (FRAP), 2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging activity, reducing power and lipid peroxidation inhibition were evaluated by electron spin resonance (ESR). The total polyphenol and flavonoid contents of the water and ethanolic extracts from LOH were $105.5{\pm}1.31$ and $102.1{\pm}1.82$ mg gallic acid equivalent/g extract, respectively, and $84{\pm}1.72$ and $82.8{\pm}1.65$ mg catechin equivalent/g extract. In addition, $IC_{50}$ values for the 1,1-diphenyl-2-picryldrazyl (DPPH), alkyl, and hydroxyl radical scavenging activities of the water and ethanolic extracts were $0.021{\pm}0.002$ and $0.010{\pm}0.003$ mg/mL, $0.011{\pm}0.003$ and $0.012{\pm}0.002$ mg/mL, and $0.395{\pm}0.002$ and $0.443{\pm}0.002$ mg/mL, respectively. The ABTS radical scavenging activities of the water and ethanolic extracts from LOH and BHT were $0.073{\pm}0.12$, $0.130{\pm}0.06$ and $1.461{\pm}0.02$ mM Trolox equivalent/mg extract, respectively. The FRAP values of the extracts from LOH were higher than those of BHT, which was used as a positive control. The LOH extracts showed strong inhibitory effects on lipid peroxidation as measured by ferric thiocyanate (FTC) and thiobarbituric acid (TBA) assay compared to that of ${\alpha}$-tocopherol. Using MTT assay on human liver cells (Chang), extracts from LOH showed no toxicity at a concentration of 0.5 mg/mL. These results indicate that the LOH extracts possessed antioxidant activity.

Effect of Boron Content on Atomic Structure of Boron-bearing Multicomponent Oxide Glasses: A View from Solid-state NMR (비정질 소듐 보레이트와 붕소를 함유한 다성분계 규산염 용융체의 붕소의 함량에 따른 원자 구조에 대한 고상 핵자기 공명 분광분석 연구)

  • Lee, A Chim;Lee, Sung Keun
    • Journal of the Mineralogical Society of Korea
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    • v.29 no.3
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    • pp.155-165
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    • 2016
  • Understanding the effect of boron content on atomic structures of boron-bearing multicomponent silicate melts is essential to reveal the atomistic origins of diverse geochemical processes involving silica-rich magmas, such as explosive volcanic eruption. The detailed atomic environments around B and Al in boron-bearing complex aluminosilicate glasses yield atomistic insights into reactivity of nuclear waste glasses in contact with aqueous solutions. We report experimental results on the effect of boron content on the atomic structures of sodium borate glasses and boron-bearing multicomponent silicate melts [malinkoite ($NaBSiO_4$)-nepheline ($NaAlSiO_4$) pseudo-binary glasses] using the high-resolution solid-state NMR ($^{11}B$ and $^{27}Al$). The $^{11}B$ MAS NMR spectra of sodium borate glasses show that three-coodrinated boron ($^{[3]}B$) increases with increasing $B_2O_3$ content. While the spectra imply that the fraction of non-ring species decreases with decreasing boron content, peak position of the species is expected to vary with Na content. Therefore, the quantitative estimation of the fractions of the ring/non-ring species remains to be explored. The $^{11}B$ MAS NMR spectra of the glasses in the malinkoite-nepheline join show that four-coordinated boron ($^{[4]}B$) increases as $X_{Ma}$ [$=NaBSiO_4/(NaBSiO_4+NaAlSiO_4)$] increases while $^{[3]}B$ decreases. $^{27}Al$ MAS NMR spectra of the multicomponent glasses confirm that four-coordinated aluminum ($^{[4]}Al$) is dominant. It is also observed that a drastic decrease in the peak widths (full-width at half-maximum, FWHM) of $^{[4]}Al$ with an addition of boron ($X_{Ma}=0.25$) in nepheline glasses. This indicates a decrease in structural and topological disorder around $^{[4]}Al$ in the glasses with increasing boron content. The quantitative atomic environments around boron of both binary and multicomponent glasses were estimated from the simulation results of $^{11}B$ MAS NMR spectra, revealing complex-nonlinear variation of boron topology with varying composition. The current results can be potentially used to account for the structural origins of the change in macroscopic properties of boron-bearing oxide melts with varying boron content.