• Title/Summary/Keyword: 가동술

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Effect of Retrograde Autologous Priming in Adult Cardiac Surgery for Minimizing Hemodilution and Transfusion Requirements (성인개심술에서 혈액희석 및 수혈을 최소화하기 위한 역행성 자가 혈액 충전법의 효과)

  • Kim Kyung-Hwan
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.821-827
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    • 2005
  • Background: Hemodilution after priming of the cardiopulmonary bypass is known to increase the possibility of bleeding and homologous transfusion in adult cardiac surgery. We investigated the effects of retrograde autologous priming (RAP) to see whether it would decrease postoperative bleeding and homologous transfusion. Material and Method: We retrospectively reviewed 34 patients wpho underwent RAP and 46 patients who did not. Retrograde autologous priming consisted of arterial lire drainage, venous reservoir and oxygenator drainage and venous line drainage. We compared the amount of priming solution and RAP volume, perioperative hematocrit, postoperative bleeding and transfusion requirements in the two groups. Resuit: Mean withdrawal volume in RAP group was 613.5$\pm$160.6 mL and initial priming volume was 1381.9$\pm$37.2 mL. Hemoatocrits ($\%$) in RAP and control groups were 25.0$\pm$3.7 vs 20.9$\pm$3.6 (5 minutes after CPB), 25.9$\pm$3.7 vs 22.5$\pm$3.6 (30 minutes after CPB), 25.9$\pm$3.4 vs 23.8$\pm$2.8 (60 minutes after CPB), 31.9$\pm$3.9 vs 31.5$\pm$4.5 (postoperative 1 hour), 32.4$\pm$4.4 vs 32.1$\pm$4.5 (postoperative 6 hours), 33.4$\pm$5.0 vs 31.7$\pm$5.1 (postoperative 1 day)[repeated measures ANOVA, p < 0.05]. Chest tube drainages (mL) in the two groups were 357.2$\pm$177.1 vs 411.7$\pm$279.5 (postoperative 6 hours), 599.4$\pm$145.6 vs 678.8$\pm$256.4 (postoperative 24 hours)[t-test, p < 0.05]. Homologous transfusion was performed in 7 out of 34 patients in RAP group (20.6$\%$), and 16 out of 46 (34.8$\%$) in control group (p < 0.05). Conclusion: This study suggests that the effects of reducing the priming volume during cardiopulmonary bypass may result in lesser bleeding and homologous transfusion. Retrograde autologous priming would be used to reduce postoperative bleeding and chance of transfusion after adult cardiac surgery.

Effect of Lumbar Stabilizing Exercise SEBT Training on Isometric Lumbar Strength, Dynamic Balance Ability and Range of Motion in Open Laser Lumbar Microdisectomy Patients (미세 현미경 레이저 요추 디스크 절제술 환자의 요부안정화운동과 SEBT 트레이닝이 등척성 요부근력과 동적균형능력, 관절가동범위에 미치는 영향)

  • Jeon, Ho-Min;Kim, Jung-Hoon;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.212-220
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    • 2020
  • This study examines the effects on isometric lumbar extension strength, dynamic balance ability, and range of motion, after administering 8 weeks SEBT exercise (dynamic balance exercise) and Lumbar Stabilizing exercise, to open laser lumbar microdiscectomy patients. Totally, 14 patients who underwent preservation treatment for 6 weeks after undergoing open laser lumbar microdiscectomy, were enrolled for the study. Patients were randomly assigned to the Lumbar Stabilizing Exercise Group (LSG, n=7) and SEBT Exercise + Lumbar Stabilizing Exercise Group (SGLS, n=7). Results indicate that isometric lumbar extension strength ratio significantly decreases after 8 weeks rehabilitation exercise in both the LSG (p=0.007) as well as SLSG (p=0.024) groups. Normalized reach distance of the three directions in the Y-balance test to examine the dynamic balance capability showed a significant increase in both groups. The dynamic balance capability showed significant increase to the left (LSG, p=0.010; SLSG, p=0.002) and right (LSG, p=0.002; SLSG, p=0.002). Moreover, significant increase was also obtained in the range of joint operation, in both LSG (p=0.006) and SLSG (p=0.017) groups. These results indicate that both groups of rehabilitation exercise achieve positive outcomes on the isometric lumbar extension strength, range of motion, and dynamic balance ability. However, some results suggest that the SEBT program is likely to have a better efficacy.

연구 리포트 - 국가 원자력 신기술 확보 대책과 경쟁력 제고에 대한 제안

  • Lee, Ik-Hwan
    • Nuclear industry
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    • v.36 no.11
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    • pp.29-44
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    • 2016
  • 1980~1990년대 OPR1000 기술 자립을 추진할 때도 그랬지만 한국은 원자력 기술 자립에 대한 도전이 선진국에 비해 늦었지만 과학기술자의 열정과 정부의 적극적인 지원으로 오늘날 원자력 선진국이 될 수 있었고, 원자력산업을 해외 수출 산업으로서 다양한 노력을 시도하고 있다. 특히 국내 가동 중인 원전은 외국과 차별되게 1기당 고장 정지율이 0.1건으로 외국 평균의 5.5건과 크게 대별된다. 또한 운전 신뢰성을 나타내는 발전소 가동률도 10% 이상 차로 월등히 높다. 한마디로 한국은 가장 원전의 기술 개발과 운영을 잘하고 있는 원전 선진국임을 자타가 인정하고 있다. 그러나 현재의 기술 수준에 머물면 미래 원전 기술에서는 다른 선진국 내지 중국, 인도 등 신흥국에 그 자리를 양보할 수밖에 없을 것이다. 미래 원자력이란 시대적 요건인 고유 안전성과 지속 가능성을 확보하고 경제성과 함께 핵확산 저항성이 전제되는 원자력 신기술로서 세계와의 경쟁 대상이다. 여기에 핵연료 자원의 유한성에 지속 가능성을 확보하기 위해서 우라늄 효율을 극대화하는 제4세대의 고속로 개발까지 우리나라는 선도적 위치로 가야 한다. 이 기술 개발 역시 출발은 늦었지만 적극적인 개발을 추진하고 있어 소듐고속로의 시현 원자로인 PGSFR을 2028년까지 완성하는 목표를 달성하면, 이를 근간으로 세계 선진국의 경쟁 대열에 나설 수 있다. 정부의 적극적인 지원이 선도적 위치에 갈 수 있는 지름길이다. 고속로 기술 개발과 관련하여 사용후핵연료(SF)의 국가 정책이 아직 확정되지 않아 재활용주기를 전제하고 있는 고속로 개발에 어려움을 주고 있다. 따라서 SF 부지를 2028년까지 확정하는 일정과 함께 국가 SF 정책이 조속히 확정되어야 한다.

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In-Hospital Outcomes of Acute Renal Failure Requiring Continuous Renal Replacement Therapy in Patients with On-pump CABG (심폐기 가동하 관상동맥우회술 후 발생한 급성신부전 환자들에 있어 지속적 신대체요법의 병원 내 결과)

  • Kim, Young-Du;Park, Kuhn;Kang, Chul-Ung;Yoon, Jeong-Seob;Moon, Seok-Whan;Wang, Young-Pil;Jo, Kuhn-Hyun
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.32-36
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    • 2007
  • Background: Although acute renal failure (ARF) after coronary artery bypass graft (CABG) is relatively rare, but devastating complication with high mortality. Our study aims to evaluate the effectiveness of early application of CRRT in patients with ARF which developed after on-pump CABG. Material and Method: Two hundred and eighty seven patients underwent isolated on-pump CABG between May 2002 and Feb. 2006 at our institution, of whom 15 (5.2%) needed CRRT (11 patients for postoperatively developed ARF and the remaining 4 patients with preexisting dialysis-dependent chronic renal failure (CRF) for postoperative hemodynamic and metabolic control). Criteria for early application of CRRT were as follows; decreased urine output less than 0.5cc/h/kg for 2 consecutive hours and elevated serum creatinine level greater than 2.0 mg/dL. Result: The incidence of ARF requiring CRRT after on-pump CABG was 3.9% (11/283) and the overall hospital mortality of patient with CRRT was 33.3% (5/15). Of 5 deaths, 4 were patients with postoperatively developed ARF, and 1 was a patient with pre-existing dialysis-dependent CRF patient. The mean time between the operation and the initiation of CRRT was $25.8{\pm}5.8$ hours and the mean duration of CRRT was $62.1{\pm}41.2$ hours. Of the 7 survivors who were not on dialysis-dependent preoperatively, 6 patients fully recovered renal function during hospital stay and 1 patient required permanent renal supportive treatment after discharge from hospital. Conclusion: Early application of CRRT could maintain stable postoperative hemodynamic status and make outcomes better than those of previous reports in patients with ARF which developed after on-pump CABG.

The Clinical Experience of The Descending Thoracic and Thoracoabdominal Aortic Surgery (하행대동맥 및 흉복부 대동맥 수술의 임상적 경험)

  • 조광조;우종수;성시찬;최필조
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.584-589
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    • 2002
  • Background : The thoracic and thoracoabdominal aortic surgery is a complicated procedure that has various method of approach and protection. The authors have performed several methods to treat these diseases. Therefore, we attempt to analyze their results and risks. Material and Method: From June of 1992 to August of 2001, we performed 26 cases of thoracic aortic surgery and 10 cases of thoracoabdominal aortic surgery. There were 17 aortic dissections, 17 aortic aneurysms, one coarctation of aorta and one traumatic aortic aneurysm. The thoracic aortic replacement was performed under a femorofemoral bypass, an LA to femoral bypass, or a deep hypothermic circulatory arrest. The thoracoabdominal aortic replacement was performed under a femorofemoral bypass or a pump assisted rapid infusion. Result: There were 7 renal failures, 11 hepatopathies, 7 cerebral vascular accidents, 2 heart failures, 5 respiratory insufficiencies, and 2 sepsis in postoperative period. There were 9 hospital mortalities which were from 2 bleedings, 2 heart failures, 2 renal failures, a sepsis, a respiratory failure, and a cerebral infarction. There were 3 late deaths which were from ruptured distal anastomosis, cerebral infarction, and pneumonia. Conclusion: Deep hypothermic circulatory arrest was not good supportive methods for thoracic aortic replacement. Total thoracoabdominal aortic replacement was a high risk operation.

The Immediate Effect of Soft Tissue Mobilization Before Mobilization with Movement on the Ankle Range of Motion, Muscle Tissue, Balance in Stroke Patients (움직임을 동반한 관절가동술 적용 전 시행된 연부조직가동술이 뇌졸중 환자의 족관절 가동범위, 근 조직, 균형에 미치는 즉각적인 효과)

  • Jang, Woo-seok;Choi, Soon-ho
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.26 no.1
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    • pp.37-46
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    • 2020
  • Background: The present study aimed to investigate the immediate effects of Soft Tissue Mobilization (STM) before Mobilization with Movement (MWM) on ankle ROM, pennation angle, balance in stroke patients. Methods: A total of 22 subjects were randomly assigned to one of two groups: the experimental group and the control group. The experimental group received intervention STM before MWM. STM was applied for one minute, MWM was applied one set of six times, in a total 3 sets. The passive ankle joint range of motion (ROM) was measured using a goniometer, the pennation angle was measured using RUSI, and the balance was measured using Timed Up & Go Test. Results: The ROM of the ankle dorsi-flexion, muscle tissue (pennation angle) and balance were significantly increased. Conclusion: In this study, it was confirmed that the ankle dorsi-flexion ROM, pennation angle of the medial gastrocnemius muscle, and balance were significantly improved in the group where STM was performed before the MWM intervention. Therefore, the physiotherapists should consider these results in their intervention. If MWM is applied to stroke patients, applying STM first is a better intervention.

The Effects of Cervical ROM and Muscle Endurance on Cervical Joint Mobilization of Normal Adults (경추관절가동술이 정상성인의 경부 관절가동범위와 정적근지구력에 미치는 영향)

  • Gong, Won-Tae;Lee, Sang-Yeol;Lee, Yoon-Mi
    • Journal of the Korean Society of Physical Medicine
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    • v.5 no.1
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    • pp.7-13
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    • 2010
  • The purpose of this study was to evaluate the influence of cervical ROM and muscle endurance on cervical joint mobilization of normal adults. Both joint mobilization group(n=20) and control group(n=20) were measured an cervical ROM and muscle endurance time by CROM and stop watch at pre-test, post-test in 1 weeks, post-test in 2 weeks and post-test in 3 weeks. The flexion ROM, extension ROM and muscle endurance of the joint mobilization group were significantly different among the experimental period (p<.05). The Correlation of muscle endurance and extension ROM is significantly Correlation (p<.05). In conclusion, we were found that cervical joint mobilization could increase cervical ROM and muscle endurance and Correlation of muscle endurance and extension ROM.

Rehabilitative Effect of Intramuscular Electrostimulation after Reconstruction of Medial Patellar Luxation in Small Sized Dog (소형견의 내측 슬개골 탈구 정복술 후 근육 내 전기자극의 재활효과)

  • Lee, Shinho;Lee, Joo-Myoung;Park, Hyunjung;Won, Sangcheol;Cheong, Jongtae
    • Journal of Veterinary Clinics
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    • v.32 no.1
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    • pp.16-21
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    • 2015
  • Medial patellar luxation (MPL) of dog is one of the most common joint diseases. This study performed to know rehabilitative effect after reconstruction as application with intramuscular electrostimulation (IMES) on the cranial part of sartorius muscle. In this study, the 12 dogs with operated medial luxation divided into electrostimulation group (n = 8) and no electrostimulation group (n = 4) measured affected sided range of motion, muscle mass, lameness score and weight bearing for hospitalization 2 weeks. IMES group showed significant results after operation on 5th day (p < 0.01). Except lameness score, IMES group showed significant results on 10th day (p < 0.05). As results, in small sized dog after reconstruction of MPL, IMES on the cranial part of sartorius muscle considered a great help in the initial rehabilitation.

경수로형 원전의 초음파 검사 기술현황

  • 홍순신
    • Nuclear Engineering and Technology
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    • v.26 no.2
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    • pp.306-311
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    • 1994
  • 경수로형 원전의 NSSS 및 2 차계통의 주요부품에 대한 가동전. 중 검사로 수행되는 초음파 검사에 관한 내용을 수록하였다. 경수로형 원전에 적용하고 있는 초음파 검사 기술요건으로 ASME Sec. V및 XI 의 과거 10여년간의 변경과정과 검사기술, 강화된 검사 결과 기록 기준, 검사대상 및 범위에 관하여 언급하였다. 초음파검사의 신뢰성 제고를 위한 신기술의 실제 검사 적용을 유도하는 규격화의 조짐이 89년 ASME Sec. V 및 XI 규격에서 나타나고 있으며, 검사 결과의 평가 해석을 정확히 할 수 있도록 컴퓨터 화한 신호 처리 개념이 수록되어 그 요건을 살펴보았다.

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Effect of Accelerated Rehabilitation with Anti-Gravity Treadmill Program : Isokinetic Myofuction and Functional Score of Knee Joint, ROM, and VAS Score in Meniscus Repair Patients (Anti-Gravity Treadmill Program을 적용한 가속재활의 효과 : 반월상연골 봉합술 환자의 슬관절 등속성 근기능 및 기능점수와 관절의 가동범위, 통증지수)

  • Cho, Han-Su;Oh, Du-Hwan;Lee, Jin-Wook;Zang, Seok-Am;Lee, Jang-Kyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.46-54
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    • 2016
  • This study was conducted to investigate the effects of participation in the accelerated rehabilitation with an anti-gravity treadmill program for 16 weeks on isokinetic myofunction and functional score of knee joint, ROM, and VAS score in meniscus repair patients. A total of 10 male adult patients who underwent meniscus repair by the same doctor were investigated in this study. Both extension and flexion peak torque at $60^{\circ}/sec$ and $180^{\circ}/sec$ significantly increased (p<0.001, p<0.01), while under muscle deficit, extension and flexion peak torque at $60^{\circ}/sec$ and extension peak torque at $180^{\circ}/sec$ significantly decreased (p<0.01, p<0.05). ROM in extension significantly decreased (p<0.05), whereas ROM in flexion significantly increased (p<0.01) in response to the program. VAS score significantly decreased (p<0.001) and lysholm scores significantly increased after completion of the program (p<0.001). These results suggest that 16 weeks of the anti-gravity treadmill accelerated rehabilitation program improves isokinetic muscle strength and functional score of knee joint, ROM, and VAS score in meniscus repair patients. Therefore, the anti-gravity treadmill accelerated rehabilitation program, which is a more scientific and effective method than conventional rehabilitation, leads to faster recovery of paly ground and normal daily activities.