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Factors Affecting the Discharge Destination of Patients With Spinal Bone Metastases
Yoshiteru Akezaki,Eiji Nakata,Masato Kikuuchi,Shinsuke Sugihara 대한재활의학회 2020 Annals of Rehabilitation Medicine Vol.44 No.1
Objective To investigate the factors affecting the discharge destination of patients with spinal bone metastases. Methods We reviewed the medical records of patients admitted to our institute with a diagnosis of skeletal-related events secondary to malignant disease. Exclusion criteria comprised decreased cognitive function and hypercalcemia, brain metastasis, peritoneal dissemination, and pleural dissemination. The factors examined included the discharge destination, age, sex, the Barthel Index (BI) at admission and discharge, pain at admission and discharge, number of co-resident household members, length of hospital stay, treatment strategy, spinal instability neoplastic score, vertebral body collapse, spinal level of bone metastases, and motor paralysis. For the discharge destination, patients at discharge were grouped into two categories. The home group included patients discharged to their own homes, and the non-home group included patients discharged to other hospitals. Results Of 140 patients, the home group comprised 120 patients and the non-home group comprised 20 patients. Activities of daily living (ADL) and pain at rest and during motion improved significantly in the home group, whereas only pain at rest and during motion improved significantly in the non-home group. The results indicated that discharge BI and motor paralysis were the best predictors of the discharge destination; a BI cut-off value of 72.5 predicted discharge to home. Conclusion This study showed that the ADL level on discharge and motor paralysis affected the discharge destination of patients with spinal bone metastases. These results are likely to be helpful in predicting the discharge destination of patients with spinal bone metastases.
Suzuki Koichi,Nakata Eiji,Minami Masayuki,Hibino Etsuhisa,Tani Tomonori,Sakakibara Jyunichi,Yamada Naouki Korean Society of Earth and Exploration Geophysici 2004 지구물리와 물리탐사 Vol.7 No.1
The objective of this study is to estimate the distribution of a zone disturbed by excavation (EDZ) around tunnels that have been excavated at about 500 m depth in pre-Tertiary hard sedimentary rock. One of the most important tasks is to evaluate changes in the dynamic stability and permeability of the rock around the tunnels, by investigating the properties of the rock after the excavation. We performed resistivity and acoustic tomography using two boreholes, 5 m in length, drilled horizontally from the wall of a tunnel in pre-Tertiary hard conglomerate. By these methods, we detected a low-resistivity and low-velocity zone 1 m in thickness around the wall of the tunnel. The resulting profiles were verified by permeability and evaporation tests performed at the same boreholes. This anomalous zone matched a high-permeability zone caused by open fractures. Next, we performed resistivity monitoring along annular survey lines in a tunnel excavated in pre-Tertiary hard shale by a tunnel-boring machine (TBM). We detected anomalous zones in 2D resistivity profiles surrounding the tunnel. A low-resistivity zone 1 m in thickness was detected around the tunnel when one year had passed after the excavation. However, two years later, the resistivity around the tunnel had increased in a portion, about 30 cm in thickness, of this zone. To investigate this change, we studied the relationship between groundwater flow from the surroundings and evaporation from the wall around the tunnel. These features were verified by the relationship between the resistivity and porosity of rocks obtained by laboratory tests on core samples. Furthermore, the profiles matched well with highly permeable zones detected by permeability and evaporation tests at a horizontal borehole drilled near the survey line. We conclude that the anomalous zones in these profiles indicate the EDZ around the tunnel.