Background: Selective transforaminal epidural block has come to the for as a targetspecific modality in the treatment and diagnosis of spinal pain. Thoracic transforaminal epidural block (TTFEB) has ...the associated risk of pneumothorax. This article describes a retrospective study conducted using computed tomography (CT) imaging to investigate the TTFEB angle and depth appropriate to minimize the risk of pneumothorax in Koreans.
Methods: The subjects of the present study were 100 randomly selected patients between 50 and 70 years of age found be free of thoracic disease according to chest CT performed in the present hospital. On the chest CT, the superior, middle, and inferior thoracic vertebrae were observed at the T2, T7, and T11 levels, respectively.
Results: The average distance and the needle insertion angle from the skin point at which the needle may be inserted without piercing the lung to the intervertebral foramen were 117.8 ± 12.1 mm and 58.1 ± 6.1° at the T2 level, 85.6 ± 10.0 mm and 61.7 ± 4.3° at the T7 level, and 94.3 ± 8.7 mm and 64.4 ± 7.0° at the T11 level, respectively.
Conclusions: The needle insertion at the point further than 40 mm, on the upper, middle thorax, if the needle pass from the inner vertebral body to lamina, it could be safer.
However, on the lower thorax, needle could pierce the lung though the needle start from the inner vertebral body. Thus, it can be safer if the needle pass toward the exterior margin of lamina. KCI Citation Count: 0
The noise power spectrum (NPS) is one of the most general methods for measuring the noise amplitude and the quality of an image acquired from a uniform radiation field. The purpose of this study was ...to compare different NPS methodologies by using megavoltage X-ray energies. The NPS evaluation methods in diagnostic radiation were applied to therapy using the International Electrotechnical Commission standard (IEC 62220-1). In order to measure the region of interest (ROI) of the NPS, we used the following five factors: the overlapping impact, the non-overlapping impact, the penumbra, the flatness and different ROI sizes. We used NPS from four different types of detectors, the CR-IP (computed radiography image plate: photo-stimulable phosphor screen), the CR-IP-lead (hexalon lead screen), the CR-IP-back lanex TM fast back screen: {terbium-doped gadolinium oxysulfide granular phosphor screen (Gd
2
O
2
S:Tb,133 mg/cm
2
)} + 1-mm-thick copper plate and the CR-IP-front (lanex TM fast front screen). A Kodak 2000 RT photo-stimulable phosphor-based computed radiographic (CR) system showed that the normalized noise power spectrum (NNPS) curve gradually decreased, in compliance with increasing spatial resolution. In addition, each detector showed a different reactivity of the NPS to megavoltage. The results of multivariate analysis of variance (MANOVA) test (methods × detectors) revealed significant main effects of the methods F(1, 4) = 53.543, P = 0.001 and of the detectors F(1, 4) = 17.556, P = 0.001. The present study revealed that various factors could be employed to produce megavoltage imaging (MVI) of the NPS and as a baseline standard for NPS control in MVI.
Background: Ketamine and dexmedetomidine are commonly used for sedation and analgesia in patients. We tried to compare theeffects of intravenous ketamine and dexmedetomidine infusion on spinal block ...with bupivacaine. Methods: Ninety American Society of Anesthesiologists physical status class I or II patients, who were scheduled to spinal anesthesia were randomly assigned to one of three groups (n = 30). Normal saline 10 ml, 5 ml/hr (loading dose for 10 minutes, infusion) (Group NS), dexmedetomidine 1 μg/kg, 0.5 μg/kg/hr (Group DEX), or ketamine 0.2 mg/kg, 0.5 mg/kg/hr (Group KET) was infused intravenously before spinal anesthesia. We recorded the time to highest sensory block level, sensory and motor regression, and hemodynamic changes. Results: Patients in Groups KET had a significantly faster onset time of sensory block than patients in Group NS. The highest sensory block levels were not significantly different between groups. Average time of sensory regression and knee flexion, was significantly longer in the Group KET and Group DEX than the Group NS. Conclusions: Intravenous dexmedetomidine and ketamine were found to have a similar synergistic effect with intrathecal bupivacaine. Hemodynamic stability showed better results in Group KET. (Korean J Anesthesiol 2014; 67: 85-89)
The purpose of this study was to compare the ultrasound gel container washing methods for the sterilization of contaminants and to find the useful methods for the prevention of infection caused by ...the ultrasonic gel containers. In this experiment, a 250 mL ultrasonic gel container was used, and the ultrasonic gel used was a non-sterile gel (ECO GEL 99, SeungWon Medical, Korea). In order to evaluate the degree of contamination, new 250 mL 15 containers were divided into 5 groups to perform five types of washing by no treatment, washing with water, washing with soap, washing with bottle cleaner and high disinfection level washing. After the washing process, filled the gel container with gel and after 2 weeks, the number of colonies in the gel container was sampled repeatedly twice in the same ultrasonic laboratory and compared before and after washing. As a result of among the five cleaning methods used in this study, 87.2% and 88.9% of the soapy water washing (p = 0.028) and high level washing (p = 0.027) showed significant bacterial reduction rates, respectively. Our findings conclusively an ultrasonic gel container cleaning method for removing contaminants has been found to be an effective sterilization method at a low cost with a soapy water cleaning method. Therefore, it is expected that it will be helpful to prevent the infection caused by the ultrasonic gel container by suggesting the sterilization cleaning method that is practically useful in this study.
We report on experimentally measured detection efficiency of single-photon detectors (SPDs) based on wavelength-division-multiplexed (WDM) InGaAs/InP avalanche photodiodes (APDs). Multiple SPDs ...combined in a WDM scheme can be used to overcome the detection speed limit of a single SPD. There is a tradeoff between the detection efficiency of parallel SPDs in the WDM scheme and the optical loss caused by the WDM devices.
Background: The main disadvantage of rocuronium is the pain associated with vascular injection. We evaluated the efficacy of palonosetron for reducing pain after rocuronium injection. Methods: Eighty ...patients scheduled for elective surgery were randomly divided into two groups: Group C (normal saline 1.5 ml, n = 40) and Group P (palonosetron 0.075 mg, n = 40). Anesthesia was induced with thiopental 5 mg/kg and the test drug was injected over 10 seconds. Thirty seconds after the injection of the test drug, rocuronium 0.6 mg/kg was injected over 30 seconds and the response was recorded. Injection pain was graded using a 4-point scale. The grade was 0 points for no movement, 1 point for wrist movement, 2 points for elbow or shoulder movement, and 3 points for whole body movement. Mean arterial pressure and heart rate were recorded on arrival in the operating room and before and 30 seconds after rocuronim injection. Results: There was no significant difference in the grade 1 response between the two groups; however, the grade 2 and 3 responses in Group P were 5 (12.5%) and 4 (10%), respectively, which were significantly lower than in Group C, with 13 (32.5%) responses for each grade. There were no significant differences in hemodynamic changes within each group. However, the difference in mean arterial pressure before and after the injection of rocuronium was significantly larger in Group C compared to Group P. Conclusions: Pretreatment with palonosetron 0.075 mg reduced the incidence and severity of withdrawal movement after rocuronium administration.
국제전기기술위원회의 문서 IEC 60601-1의 3판 규격과 IEC 60601-2-45의 개별 규격에서는 진단용 X선 장치에서 X선 피폭 선량 정보를 표시하고 그 정확성을 명시할 것을 권고하고 있다. 하지만 임상에서 사용하는 부착형 공기커마 면적선량계는 교정에 어려움이 있다. 이에 본 연구에서는 임상에 적용 가능한 RQR 표준 선질을 이용하여 공기커마 ...면적선량계의 에너지 의존성과 정확도를 평가하였고 임상에서 간접 교정을 시행할 수 있도록 방법론을 마련하고자 하였다. RQR5의 표준 선질에서 시행한 시험에서 부착형 공기커마 면적선량계는 -7.5%의 오차를 나타냈고, RQR8의 표준 선질에서는 -10.3%의 오차를 나타냈으며 시험한 모든 RQR 선질에 대해 평균 절대오차는 8.30%±2.85%를 나타내 IEC 60580과 AAPM TG 190의 조건을 만족하였다. 본 연구에서 도출한 공기커마 면적선량계의 교정 방법은 임상에서 사용하는 공기커마 면적 선량계의 간접 교정법으로 사용할 수 있을 것으로 기대한다.
According IEC 60601-1 ed3.1 and IEC 60601-2-45 regulation, diagnostic X-ray equipment should be display to measured and calculated air kerma area product. On the clinical X ray equipment, air kerma area product dosimeter would like to have an evidence for dosimeter accuracy and energy dependency. This study was performed to indirect calibration and energy dependency test for attached type air kerma area product (KAP) dosimeter by RQR standards beam quality. On the RQR5 beam quality, attached KAP dosimeter error showed -7.5%, respectably. On the RQR9 beam quality, attached KAP dosimeter error showed -10.4%, respectably. All RQR beam quality, average absolute error was 8.30%±2.85%, respectably. On this study, attached KAP dosimeter was satisfied to IEC 60580 and AAPM TG 190. This calibration method of KAP dosimeter will help to performance maintain for clinical KAP dosimeter.
We review the temporal dynamics of the laser output spectrum and polarization state of 1.55 μm wavelength single-mode (SM) vertical-cavity surface-emitting lasers (VCSELs) induced by external optical ...beam injection. Injection of an external continuous-wave laser beam to a gain-switched SM VCSEL near the resonance wavelength corresponding to its main polarization-mode output was critical for improvement of its laser pulse generation characteristics, such as pulse timing-jitter reduction, linewidth narrowing, pulse amplitude enhancement, and pulse width shortening. Pulse injection of pulse width shorter than the cavity photon lifetime into the SM VCSEL in the orthogonal polarization direction with respect to its main polarization mode caused temporal delay of the polarization recovery after polarization switching (PS), and its delay was found to be the minimum at an optimized bias current. Polarization-mode bistability was observed even in the laser output of an SM VCSEL of a standard circularly cylindrical shape and used for all-optical flip-flop operations with set and reset injection pulses of very low pulse energy of order of the 3.5 ~4.5 fJ.
We report the first experimental invetigation of the polarization-mode switching dynamics and injection-wavelength-dependent polarization-mode bistability of a 1.5-m wavelength single-mode ...vertical-cavity surface-emitting lasers (VCSELs) under external laser beam injection. An injection beam with polarization orthogonal to that of the stand-alone VCSEL caused polarization-mode instability and switching of the VCSEL output. By varying the optical injection detuning for fixed injection power observation was made of a novel form of polarization bistability which will have applications in a new type of all-optical flip-flop and signal processing scheme.
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