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JYMS : Journal of Yeungnam Medical Science

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Volume 24(2); December 2007
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Review
Implantable Functional Electrical Stimulation with Inductive Power and Data Transmission System.
Joon Ha Lee
Yeungnam Univ J Med. 2007;24(2):97-106.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.97
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AbstractAbstract PDF
Functional electrical stimulation (FES) has developed over the last 35 years to become a scientifically, technologically and clinically recognized field of interest in clinical medicine. FES has been applied to locomotion, grasping, ventilation, incontinence, and decubitus healing. However, all of these achievements illustrate the initial applications of FES; its true potential has not yet been realized. Recently, FES systems, which are miniaturized stimulation devices, have been utilized in the clinical setting. However, because the stimulating electrodes of the current FES devices are percutaneous electrodes, which are susceptible to wire breakage, and skin infection an implantable FES stimulating electrode has been introduced in the U.S. and Japan. In the present study, an external power supply method using radio frequency (RF) coupling and data transmission was developed for the control of the implantable FES device. In addition, we review the current understanding of FES devices and their application in clinical medicine.
Original Articles
Effect of Sleep on Epileptiform Discharges in Epileptic Patients with Structural Lesion: Based on Routine EEG.
Se Jin Lee, Jeong Sang Hah
Yeungnam Univ J Med. 2007;24(2):107-118.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.107
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AbstractAbstract PDF
BACKGROUND
It is well known that non-rapid eye movement(NREM) sleep activates the occurrence of interictal epileptiform discharges(IED) in many epileptic syndromes. We performed this study to assess the effect of NREM sleep on IED in epileptic patients with organic brain lesions. MATERIALS AND METHODS: We analyzed awake and sleep electroencephalopathy(EEG) recorded simultaneously after partial sleep deprivation in 50 patients. We calculated the awake and sleep spike index (ASI and SSI, spikes/epoch), and the percentage increase of ASI and SSI during sleep. RESULTS: In the 50 patients, the IEDs were recorded exclusively during the awake state in 1 (2%) patient, and during the sleep state in 13(26%) patients. The SSI was higher in 44 (88%) patients, and the ASI was higher in 5 (10%) patients. The mean ASI and the SSI in patients with organic brain lesions were 0.058+/-0.121 and 0.148+/-0.187, and it was 0.081+/-0.150 and 0.174 +/-0.226 in patients without organic brain lesions. There were significant increases in the spike index (P<0.05) during NREM sleep in both groups (n=36), but no significant difference in the percent increase of spike index (P>0.05). CONCLUSION: The IEDs were activated significantly during NREM sleep both in patients with and without organic brain lesions, but there were no differences in the degree of activation in both groups. The activating effect of NREM sleep was not correlated with clinical factors such as, frequent nocturnal seizures, frequent generalized tonic clonic seizures, type of epilepsy and taking anticonvulsants. We conclude that the routine EEG used to evaluate epileptiform discharges in epileptic patients should include sleep recordings after partial sleep deprivation.
In Vivo and In Vitro Studies of the Steady State Free Precession-Diffusion-Weighted MR Imagings on Low b-value: Validation and Application to Bone Marrow Pathology.
Woo Mok Byun
Yeungnam Univ J Med. 2007;24(2):119-128.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.119
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PURPOSE: The purpose of this study was a phantom study to measure the diffusion properties of water molecules by steady-state free precession diffusion-weighted imaging (SSFP-DWI) with a low b-value and to determine if this sequence might be useful for application to the evaluation of bone marrow pathology. MATERIALS AND METHODS: 1. The phantom study: A phantom study using two diffusion weighted sequences for the evaluation of the diffusion coefficient was performed. Three water-containing cylinders at different temperatures were designed: phantom A was 3degrees C, B was 23degrees C and C was 63degrees C. Both SSFP and echo planar imaging (EPI) sequences (b-value: 1000 s/mm2) were performed for comparison of the diffusion properties. The Signal to noise ratios (SNR) and apparent diffusion coefficient (ADC) values of the three phantoms using each diffusion-weighted sequence were assessed. 2. The Clinical study: SSFP-DWI was performed in 28 patients [sacral insufficiency fractures (10), osteoporotic lumbar compression fractures (10), malignant compression fractures (8)]. To measure the ADC maps, a diffusion-weighted single shot stimulated echo-acquisition mode sequence (650s/ mm2) was obtained using the same 1.5-T MR imager RESULTS: For the phantom study, the signal intensity on the SSFP as well as the classic EPI-based DWI was decreased as the temperature increased in phantom A to C. The ADC values of the phantoms on EPI-DWI were 0.13x10(-3) mm2/s in phantom A, 0.22x10(-3) mm2/s in B and 0.37x10(-3) mm2/s. in C. The SSFP can be regarded as a DWI sequence in view of the series of signal decreases. CONCLUSION: Bone marrow pathologies with different diffusion coefficients were evaluated by SSFP-DWI. All benign fractures were hypointense compared to the adjacent normal bone marrow where as the malignant fractures were hyperintense compared to the adjacent normal bone marrow.
Chemokines Expression in Children with a Non-productive Cough.
Young Hwan Lee, Hee Sun Kim
Yeungnam Univ J Med. 2007;24(2):129-136.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.129
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PURPOSE: To evaluate the chemokine expression in children with a non-productive cough. MATERIALS AND METHODS: Six children with a non-productive cough who visited Yeungnam University Hospital were evaluated for the mRNA expression of interferon-gamma-inducible protein 10(IP-10), macrophage cationic protein 1 and 3 (MCP-1, 3), interleukin (IL)-8, regulated upon activation in normal T cells expressed and secreted (RANTES), eotaxin and growth-related oncogene-alpha (Gro-alpha) using the reverse transcription polymerase chain reaction. RESULTS: The chemokines IP-10 and MCP-3 were expressed in all samples. The chemokine RANTES was expressed in five cases, and IL-8 was expressed in three among them. However, eotaxin, Gro-alpha and MCP-1 were not expressed at all. The expression of chemokine MCP-3, RANTES and IL-8 were suppressed after the resolution of coughing in just one available case. CONCLUSION: The chemokines MCP-3, RANTES and IL-8 may contribute to airway inflammation in children with a non-productive cough, whereas IP-10 is of secondary importance in this condition.
Development of Rule-based Expert System for Interpretative Report with Health Screening Tests.
Chae Hoon Lee
Yeungnam Univ J Med. 2007;24(2):137-147.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.137
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AbstractAbstract PDF
BACKGROUND
Interpretative reporting is an important aspect of laboratory medicine. The large menu of laboratory tests available today makes it increasingly difficult for the non-specialist to order and interpret all laboratory tests. The aim of this study was to determine the usefulness of an expert system to interpret laboratory tests and help physicians order the appropriate tests. MATERIALS AND METHODS: In order to interpret laboratory tests, a rules-based expert system was developed. In this module, if-then rules were used to interpret the given test result patterns (e.g. urinalysis, anemia, hepatitis B virus, hypercholesterolemia, glucose, syphilis, and tumor markers) and select matching text elements. The system was used to evaluate 535 subjects who visited a health-check program. RESULTS: The overall abnormal rate was 50.5% in the expert system; 34% for cholesterol, 9.9% for urinalysis, 8.0% for anemia, 7.7% for thyroid function tests, 4.5% for tumor marker study, 4.7% for hepatitis virus antigen, 4.3% for serum glucose, and 1.1% for syphilis. CONCLUSION: These results indicate that the application of the expert system for the interpretation of laboratory tests may provide a useful method for the interpretation of reports. However more rules are needed for the application to in-patients.
Introduction of Medical Simulation and the Experience of Computerized Simulation Program Used by MicroSim(R).
Sam Beom Lee, Jae Beum Bang, Joon Sakong
Yeungnam Univ J Med. 2007;24(2):148-153.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.148
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BACKGROUND
Computer- and web-based simulation methods help students develop problem solving and decision making skills. In addition, they provide reality based learning to the student clinical experience with immediate medical feedback as well as repetitive training, on-site reviews and case closure. MATERIALS AND METHODS: Seventy-five third-year medical students participated in a two-week simulation program. The students selected four modules from eight modules as follows: airway and breathing 1, cardiac arrest 1, cardiac arrhythmia 1, and chest pain 1, and then selected the first case within each of the modules. After 2 weeks, a pass score was obtained and the data analyzed. The average pass score of over 70% was considered a passing grade for each module. If the student did not pass each module, there was no score (i.e., pass score was zero). In addition, when at least one of the four modules was zero, the student was not included in this study. RESULTS: Seventy-five students participated in the simulation program. Nineteen students were excluded based on their performance. The final number of students studied was 56 students (74.7%). The average scores for each module 1 to 4 were 86.7%, 85.3%, 84.0%, and 84.0%, and the average obtained pass score was 88.6 for the four modules in all 56 students. CONCLUSION: Medical simulation enabled students to experience realistic patient situations as part of medical learning. However, it has not been incorporated into traditional educational methodology. Here we describe the introduction and the development of various simulation modules and technologies for medical education.
The Clinical Effectiveness of the Bonfils Intubation Fibrescope in Difficult Tracheal Intubation.
Deok Hee Lee, Il Chi Kwon
Yeungnam Univ J Med. 2007;24(2):154-161.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.154
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AbstractAbstract PDF
BACKGROUND
This study was undertaken to evaluate the effectiveness of the Bonfils intubation fibrescope for cases of difficult tracheal intubation. MATERIALS AND METHODS: For patients with an ASA physical status 1 or 2 betwen the ages of 20-90, direct laryngoscopy was performed and the layngoscopic view graded according to the Cormack and Lehane classification. Forty patients with Cormack and Lehane grade 3 or 4 were intubated using the Bonfils intubation fibrescope. During intubation, the success rates for tracheal intubation, overall time to intubation, number of attempts and adverse effects were recorded. The Thyromental and sternomental distances were recorded after the orotracheal intubation. RESULTS: The success rates were significantly higher in Cormack and Lehane grade 3 (96.9%) patients compared to grade 4 (50%) (P<0.01). The time to intubation was significantly faster in patients with grade 3 compared to grade 4 (20 (10-49[7-300]) sec vs. 180 (31-300[10-300]) sec, P=0.01). The number of cases with a SpO2<90% was significantly lower in patients with grade 3 (3.1%) compared to grade 4 (50%) (P<0.01). CONCLUSION: In patients with Cormack and Lehane grade 3, tracheal intubation using the Bonfils intubation fibrescope appears to be an effective technique for the management of a difficult intubation. However, the Bonfils intubation fibrescope can not always be used for the management of a difficult intubation in grade 4 patients; for these patients other effective instruments should be considered for difficult intubations.
The Effects of Preoperative Sprayed 10% Lidocaine on the Hemodynamic Response during Suspension Microlaryngeal Surgery.
Deok Hee Lee, Hyun Seok Do
Yeungnam Univ J Med. 2007;24(2):162-169.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.162
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PURPOSE: It is well known that suspension microlaryngeal surgery produces marked increases in arterial blood pressure and heart rate. In this study, we evaluated the effects of 10% lidocaine preoperatively sprayed for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery. MATERIALS AND METHODS: Fifty American Society of Anesthesiologists (ASA) class 1 patients scheduled for excision of a vocal polyp by suspension laryngoscopy were randomly divided into two groups (n=25 for each group). They were intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites 90 sec prior to intubation (10% lidocaine group). Anesthesia was maintained using desflurane in O2/N2O 50%. The arterial blood pressure and heart rate were measured at preinduction (T0), 1 min (T1), 3 min (T2), 5 min (T3) after tracheal intubation, and 1 min (T4), 3 min (T5), 5 min (T6) and 10 min (T7) after the suspension laryngoscopy. RESULTS: In the 10% lidocaine group, the arterial blood pressure and heart rate at 1 (T1), 3 (T2) min after tracheal intubation and 1 (T4), and 3 (T5) min after suspension laryngoscopy were lower than the same measurements in the control group. CONCLUSION: 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites before intubation was an effective method for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery.
Clinical Characteristics of Adult Patients with Acute Hepatitis A.
Jong Ryul Eun, Heon Ju Lee, Tae Nyeun Kim, Byung Ik Jang, Hee Jung Moon
Yeungnam Univ J Med. 2007;24(2):170-178.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.170
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AbstractAbstract PDF
BACKGROUND
The incidence of acute hepatitis A in adults has recently been increasing. This study was conducted to investigate the epidemiology and clinical characteristics of acute hepatitis A in Daegu province over the past 10 years. MATERIALS AND METHODS: We reviewed the medical records of 55 patients (male/female: 34/21), who were diagnosed with acute hepatitis A by confirmation of the IgM anti-HAV between January 1998 and June 2007. RESULTS: The mean age was 29.7+/-10.3 years (range; 17-65 years). The incidence was most common between March and June (56.1%), in the third and fourth decades of life (78.2%) and 90.9% (50/55) of the patients were diagnosed from 2003 to present. The common symptoms included anorexia, nausea or vomiting (69.1%), fever and chills (49.1%), myalgia (47.3%), weight loss (47.3%), fatigue (40.0%), abdominal pain (36.4%), diarrhea (9.1%) and pruritus (5.5%). The mean duration of hospital stay was 8.6+/-3.4 days (range; 3-20 days). The route of transmission was identified in only 11 patients (20.0%); 7 patients (12.7%) traveled (abroad or domestic), 2 patients (3.6%) ingested raw food and 2 patients (3.6%) had friends with acute hepatitis A. Fifty four patients recovered without complication; one patient developed fulminant hepatitis and recovered after a liver transplantation. CONCLUSION: The incidence of acute hepatitis A in adults is increasing. Because of the cost of treatment and potential for serious disease, persons, under 40 are recommened to have hepatitis A vaccination and confirmation of IgG anti-HAV.

Citations

Citations to this article as recorded by  
  • Pattern of Hepatitis A Incidence According to Area Characteristics Using National Health Insurance Data
    Joo Youn Seo, Jae Hee Seo, Myoung Hee Kim, Moran Ki, Hee Suk Park, Bo Youl Choi
    Journal of Preventive Medicine & Public Health.2012; 45(3): 164.     CrossRef
Power Doppler Sonography for the Upper Urinary Tract Infection in Children.
Jung Youn Choi, Jae Ho Cho, Yong Hoon Park
Yeungnam Univ J Med. 2007;24(2):179-185.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.179
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AbstractAbstract PDF
BACKGROUND
Urinary tract infection (UTI) is common in children. The available gold standard methods for diagnosis, Tc-99m dimercaptosuccinic acid (DMSA) scan and computed tomography (CT) are invasive and expensive. This study was performed to assess the role of power Doppler ultrasound (PDU) for diagnosis of acute pyelonephritis (APN). MATERIALS AND METHODS: A prospective study was conducted in 25 children with aged 2 weeks to 5 years who were hospitalized with the first episode of febrile UTI suggesting acute pyelonephritis. All children were examined in the first 3-5 days of admission by PDU and Tc-99m DMSA scan. The comparison between PDU and DMSA scan was performed on the basis of patients. RESULTS: The sensitivity and specificity of PDU for the detection of affected kidneys were 38.1% and 50.0%, and the positive predictive value and negative predictive value were 61.9% and 50.0%, respectively. Vesicoureteral refluxes (VUR) were identified in 11 patients (44.4%) and 18 kidneys (36%). The PDU and DMSA scan showed a matching perfusion defect in 23.8% and 50.0% respectively. CONCLUSION: These data indicate the PDU has a relatively low sensitivity and specificity for differentiating APN from lower UTI but may be a complement tool to DMSA scan for the prediction of VUR in infants and children.

Citations

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  • Comparison of 99mTc-DMSA Renal Scan and Power Doppler Ultrasonography for the Detection of Acute Pyelonephritis and Vesicoureteral Reflux
    Hee Jung Bae, Yong-Hoon Park, Jae Ho Cho, Kyung Mi Jang
    Childhood Kidney Diseases.2018; 22(2): 47.     CrossRef
  • Urinary tract infections in pediatric oncology patients with febrile neutropenia
    Kyoo Hyun Suh, Sun Young Park, Sae Yoon Kim, Jae Min Lee
    Yeungnam University Journal of Medicine.2016; 33(2): 105.     CrossRef
An Epidemiologic Study of Low Back Pain of Women Working at a General Hospital.
Dong Gu Park, Myun Whan Ahn, Jong Chul Ahn, Sae Dong Kim, Jae Sung Seo
Yeungnam Univ J Med. 2007;24(2):186-196.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.186
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AbstractAbstract PDF
BACKGROUND
The aim of this study was to confirm the risk factors for low back pain and injury to improve the prevention and treatment of lower back pain. MATERIALS AND METHODS: An epidemiologic study of low back pain and injury was performed with questionnaires distributed to 471 women working at Yeungnam university hospital. The differences in low back pain and injuries among various hospital departments were analyzed by a one-way analysis of variance (ANOVA), and the relevant factors included in the questionnaire were determined by a factor analysis. RESULTS: The frequency of low back pain in women in the department of diet and in the maintenance department was higher than among the other departments. The frequency of low back pain was mainly related to the frequency of psychosomatic symptoms. In addition, the low back pain was partially related to the frequency of psychosomatic symptoms and partially related to the frequency of pushing during the workday. The degree of disability from low back pain was increased by lifting and hard physical work and was related to the frequency of psychosomatic symptoms and the degree of work dissatisfaction. The frequency of low back injury was increased by increased standing time during work and hard physical work. The frequency of low back injury was related to advancing age and in part to psychosomatic symptoms. CONCLUSION: Lower back pain and its associated complications are related to psychosomatic factors and type of work. Lower back injury is related to physiological factors such as age. For the prevention and treatment of lower back pain, a multidisciplinary approach is required.

Citations

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  • Effects of the Hand Acupressure and Lumbar Strengthening Exercise on Women with Lower Back Pain
    Eun Young Jeon
    journal of east-west nursing research.2013; 19(2): 63.     CrossRef
The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter?.
Ung Kim, Young Jo Kim, Sang Wook Kang, In Wook Song, Jung Hwan Jo, Sang Hee Lee, Geu Ru Hong, Jong Seon Park, Dong Gu Shin
Yeungnam Univ J Med. 2007;24(2):197-205.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.197
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AbstractAbstract PDF
BACKGROUND
The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history. MATERIALS AND METHODS: Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. RESULTS: The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are 54+/-14%, 56+/-13% in group 1 and 47+/-16%, 52+/-13% in group 2. The differences between each two groups are statistically insignificant (2.2+/-1.5 in group 1 vs 5.4+/-9.8 in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are 40+/-4 mm, 41+/-4 mm in group1 and 44+/-8 mm, 41+/-4 mm in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant (0.6+/-0.9mm in group 1 vs -3.8+/-7.4 mm in group 2, p=0.149). The left atrial volume index before flutter ablation was significantly reduced in group 1 than group 2 (32+/-10 mm3/m2, 35+/-10 mm3/m2 in group 1 and 32+/-10 mm3/m2, 29+/-8 mm3/m2 in group 2, p<0.05). CONCLUSION: The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.
Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia.
Ji Yoon Kim, Dong Won Lee, Il Sook Seo, Sae Yeon Kim
Yeungnam Univ J Med. 2007;24(2):206-215.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.206
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AbstractAbstract PDF
BACKGROUND
The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. MATERIALS AND METHODS:Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by NICO(R). We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. RESULTS: In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. CONCLUSION: The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

Citations

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  • Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions
    Ji Young Moon, Bo Hwan Kim
    Journal of Korean Biological Nursing Science.2015; 17(2): 114.     CrossRef
Parasympathetic Modulation Plays a Key Role in Initiation of Paroxysmal Atrial Fibrillation.
Won Jae Lee, Dong Gu Shin, Geu Ru Hong, Jong Sun Park, Young Jo Kim
Yeungnam Univ J Med. 2007;24(2):216-231.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.216
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AbstractAbstract PDF
BACKGROUND
An acceleration or deceleration of the heart rate (HR), which reflects autonomic effects, is observed before the onset of paroxysmal atrial fibrillation (PAF). The purpose of this study was to assess the discrepancy in the autonomic interactions before the onset of PAF for different patterns of change in the HR. MATERIALS AND METHODS: From 105 Holter tapes with the PAF recorded, 55 episodes (42 patients, 34 men, 58+/-12 years) of PAF (>5 min), preceded by a sinus rhythm for more than 1 hour, were selected and submitted to time-domain and frequency-domain HR variability analyses. Fifty-five episodes were divided into 2 groups: group A PAF (n=30) with acceleration of the HR during the last 2 minutes before the PAF and group B (n=25) with deceleration of the HR. RESULTS: A significant linear decrease in the mean R-R interval was observed in group A (924+/-30 to 835+/-28 ms, P=0.001) and an increase from 831+/-32 to 866+/-31 ms in group B PAF episodes (P=0.046). In the frequency-domain analyses, the LF/HF ratio exhibited a progressive linear increase before the PAF in group A (P=0.005). The HF normalized units (HFnu) and natural logarithm-transformed HF (lnHF) values decreased from 30.8+/-4.0 to 16.1+/-1.8 (P=0.003) and 4.49+/-0.25 to 4.07+/-0.22 (P=0.001), respectively. Contrary to the results in group A, a significant increase in the HF components (HFnu and lnHF) (from 22.6+/-3.2 to 30.2+/-4.0, P=0.005, and 4.27+/-0.27 to 4.75 0.33, P=0.001, respectively) and a resultant decrease in the LF/HF ratio were observed in group B PAF episodes. No significant changes were observed in the LF components in either PAF group. CONCLUSION: Autonomic stimuli leading to an acceleration or deceleration of the HR before the onset of AF are due to parasympathetic modulation. Parasympathetic modulation plays a key role in the initiation of PAF
Trabeculectomy Using Mitomycin C in Aphakic and Pseudophakic Eyes.
Jun hyuk Son, Soon Cheol Cha
Yeungnam Univ J Med. 2007;24(2):232-242.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2.232
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AbstractAbstract PDF
BACKGROUND
The safety and efficacy of trabeculectomy with Mitomycin C (MMC) for surgical treatment in aphakic and pseudophaic eyes were retrospectively evaluated. MATERIALS AND METHODS: The authors reviewed 51 eyes of 45 patients who had been followed up for at least 6 months after trabeculectomy using MMC for aphakic and pseudophakic eyes. The success rate and complications were analyzed. The success criteria included intraocular pressures of 21 mmHg or less with or without glaucoma medications and no loss of light perception. Surgical failure was defined as a postoperative loss of light perception in patients with preoperative vision better than light perception, additional glaucoma surgery, or phthisis bulbi in patients with preoperative vision of no light perception. RESULTS: The average follow up period was 27.7 months and the intraocular pressure was controlled under 21 mmHg in 36 eyes of 51 (70.6%) after the procedure with or without medication for glaucoma. Using the Kaplan-Meier survival analysis, the cumulative success rate at the 3-, 6-, 12-, 24- and 36-month intervals were 98.0%, 94.1%, 91.9%, 83.4% and 75.5%, respectively. The complications observed were hyphema (4 eyes), serous choroidal detachment (4 eyes), hypotony (3 eyes), and endophthalmitis (1 eye). CONCLUSION: Trabeculectomy using Mitomycin C for the treatment of aphakic and pseudophaic eyes was safe and effective.

JYMS : Journal of Yeungnam Medical Science