• Title/Summary/Keyword: Cuff

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Regular Endurance Exercise Decreases Blood Pressure via Enhancement of Angiogenesis and VEGF Expression in Spontaneously Hypertensive Rats (규칙적인 지구성운동이 고혈압쥐 골격근의 혈관생성과 VEGF 발현의 증가를 통한 혈압감소에 미치는 효과)

  • Li, Wei;Park, Hee-Geun;Lee, Young-Ran;Jang, Hak-Young;Choo, Sung-Ho;Lee, Young-Hwa;Gan, Li;Jun, Jong-Kui;Lee, Wang-Lok;Lee, Sang-Ki
    • Journal of Life Science
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    • v.22 no.5
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    • pp.665-670
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    • 2012
  • This study investigated the effect of endurance exercises on blood pressure, angiogenesis, and the vascular endothelial growth factor (VEGF) expression in the skeletal muscle of spontaneously hypertensive rats (SHR). Five week old SHRs and Wistar-Kyoto rats (WKY) were randomly divided into 3 groups: Wistar-Kyoto rats (WKY, n=9), SHR control (SHR-C, n=9), and SHR endurance exercise training (SHR-E, n=9). Endurance exercise training was performed on a treadmill (12-20 m/min, 0% grade, 60 min/day, 5 days/week, 16 weeks). Systolic blood pressure was monitored with the tail-cuff method. The expression of VEGF protein and capillary density were identified using western blotting and H&E staining in the soleus muscle, respectively. Systolic blood pressure was reduced by endurance exercise in SHR ($p$ <0.05). The capillary density of skeletal muscles in SHR-C was lower than in WKY ($p$ <0.05), but it was recovered by endurance exercise training (SHR-E) compared to SHR-C ($p$ <0.05), and VEGF protein was also increased by endurance exercise training compared to SHR-C ($p$ <0.05). These data suggest that the enhancement of capillary density via an increase of VEGF expression in skeletal muscles by endurance exercise training could be an important factor to inhibit blood pressure elevation in SHR.

The clinical study for the postoperative tracheal stenosis (수술후성 기관협착증에 관한 임사적 고찰)

  • 김기령;홍원표;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.9.1-10
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    • 1977
  • Many etiological factors playa significant role in the development of tracheal stenosis; too high tracheostomy (Jackson, 1921), too small stoma (Greisen, 1966), the treatment with respirator using cuffed tube (Pearson et al., 1968; Lindholm, 1966; Bryce, 1972) and infection (Pearson, 1968). Although the incidence has been reduced due to development of surgical technique and antibiotics, the frequency of tracheal stenosis which produces symptoms after tracheostomy ranges from 1.5 per cent (Lindholm, 1967). In the management of the stenosis, mild cases are treated by mechanical dilatation with silicon tube or stent (Schmigelow, 1929; Montgomery, 1965) combined steroid (Birck, 1970), and in the cases of stenosis causes, these removed under the are bronchoscopy. But in severe stenosis, transverse resection with subsequent end-to-end anastomosis has been used in recent years (Pearson et al., 1968). During about 10 years, 1967 to 1977, a total of 23 patients with tracheal stenosis complicated among the 1, 514 tracheostomies have been treated in Severance Hospital. Now, we have obtained following conclusions by means of clinical analysis of 23 cases of tracheal stenosis. 1. The frequency of tracheal stenosis was 23 cases among 1, 514 cases of tracheostomy (1.5%). 2. Under the age of 5, these are 12 cases (52.2 %). 3. The sex incidence was comprised of 18 males and 5 females. 4. The duration of tracheostomy ranges from 4 days to 16 months. 5. The primary diseases requiring tracheostomy were following; central nerve system lesions 11 cases, upper air way obstruction 10 cases, extrinsic respiratory failure 2 cases. 6. Severe wound infections were only 2 cases. 7. The methods of treatment applied to tracheal stenosis were following; closed observation only 5 cases, nasotracheal intubation combined steroid 5 cases, T-tube stent combined steroid 3 cases, fenestration op. 4 cases, revision 4 cases and transverse resection and end-to-end anastomosis 2 cases.

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Arthroscopic Treatment with Suture Anchor for the Isolated Subscapularis Tear (견갑하근 단독 손상 시 시행한 관절경하 봉합 나사를 이용한 봉합술)

  • Moon, Young-Lae;An, Ki-Yong
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.137-141
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    • 2009
  • Purpose: We wanted to evaluate the results of arthroscopic management of an isolated rupture of the subscapularis tendon using suture anchors. Materials and Methods: Twenty nine patients with unilateral ruptures of the subscapularis tendon and who underwent arthroscopic repair between February 2001 and October 2007 were reviewed prospectively. All the cases were isolated tears of the subscapularis without the involvement of any other rotator cuff tendon. In 19 patients the tear was localized to the superior one third, in 7 cases the tear was localized to the upper two thirds and the entire tendon was involved in 3 cases. The mean follow up period was 12.2 months (range: 6-26 months). The results of the treatment were assessed by evaluating the constant shoulder score and the pain score before surgery and after surgery. Results: The constant shoulder score improved from $49.9\pm7.3$ to $73.8\pm3.0$ points compared to before surgery and the pain score improved from $4.3\pm3.2$ to $11.2\pm3.0$ points postoperatively. Conclusion: Arthroscopic repair of isolated ruptures of the subscapularis tendon using suture anchors is a good option for effectively managing these tears.

A Suture Bridge Transosseous-Equivalent Technique for Bankart Lesions with Deficient Bony Stability - Technical Note - (골안정성 결손을 가진 Bankart 병변에 대한 경 골-유사 교량형 봉합술식 - 술기 보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Chae, Sung-Bum
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.179-182
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    • 2009
  • Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

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Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

A Study on MR Imaging Method for The Patient with Inserting Shoulder Joint Suture Anchor (견관절 삽입술을 시행한 환자의 자기 공명 영상법에 관한 연구)

  • Park, Eui-Cheol;Bae, Seok-Hwan;Ryu, Yeun-Chul;Park, Young-Joon;Kim, Yong-Gwon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.513-519
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    • 2021
  • Metallic suture anchors are very useful and common fixation devices that are inserted into the target bone to sustain the tendon of a patient with musculus supraspinatus tendon ruptures. On the other hand, the presence of a metallic material prosthesis, such as a metal suture anchor, causes severe MR imaging artifacts, including field distortion, signal loss, and failure of fat suppression. The difference in magnetic susceptibility between metal and other organic materials causes magnetic field distortion surrounding the prosthesis. The resulting magnetic field inhomogeneity makes the images with a lower signal-to-noise ratio and distortion. For a patient with a suture anchor implanted, MR imaging is the golden standard for determining the postoperative prognosis, and a fat-saturation sequence is one of the imaging methods most affected by metal-induced artifacts. In this study, three fat-saturation sequences were compared. Artifact quantification and contrast comparison between the supraspinatus tendon and the surrounding muscle were presented. The images obtained using the STIR pulse sequence showed fewer susceptibility artifacts and better visibility in the supraspinatus tendon and the tissue area. Therefore, the STIR sequence is the most appropriate fat-saturation imaging method for patients with a metallic prosthesis.

A Survey on Awareness and Availability on Items of 2018 Assistive Devices Distribution Program for the Disabled in the Occupational Therapists (2018년도 장애인 보조기기 교부사업 품목에 대한 작업치료사의 인식도와 활용도 조사)

  • Kim, Jeong-Eun;Park, Je-Min;Bae, Su-Yeong;Jung, Nam-hae
    • Korean Journal of Occupational Therapy
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    • v.26 no.4
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    • pp.85-95
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    • 2018
  • Objective : The purpose of this study was to investigate the awareness and availability on items of 2018 assistive devices distribution program for the disabled in the occupational therapists. Methods : A total of 132 occupational therapists participated in the survey from May 1 to May 31. Results : 96.2% of the occupational therapists responded that assistive device is helpful in lives of the disabled people. Especially, they responded that assistive device is the most helpful in 'movement and mobility'. Awareness on an angle spoon/fork with built-up handle and universal cuff was the highest, while a visual signaling indicator was the lowest. Availability on an air cushion was the highest, while a visual signaling indicator and a voice guidance system were the lowest. 67.4% responded that 'sometimes' they use the assistive device and 77.3% responded they will utilize the assistive device. To improve awareness and availability, 43.2% needed financial support, 32.6% needed to add insurance bill and 22.7% needed related education. Conclusion : In the future, this result will be available as a basic data for the education about assistive device for the occupational therapists.

A Physiotherapy Program for Adolescent Baseball Players with Scapular Dyskinesis: Comparison of the effects of posterior shoulder stretching combined with scapular stabilization exercises (PSSE) (어깨뼈 운동 이상증을 가진 청소년기 야구선수들을 위한 물리치료적 프로그램: 어깨뼈 안정화 운동과 동반된 뒤쪽 어깨 스트레칭(PSSE) 중재 후 효과 비교)

  • Keon-Cheol, Lee;Hyeon-Su Kim;Yeon-Ki Choo
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.139-150
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    • 2024
  • Purpose : Scapular dyskinesis, it have been shown to be common in overhead athletes and has been associated with RC muscle strength. Posterior shoulder tightness (PST) has been suggested as an important factor causing scapular dyskinesis. Therefore, rehabilitation programs should focus on a posterior shoulder stretch combined with scapular stabilization exercise (PSSE) intervention. Determine the effects of posterior shoulder stretch combined with scapular stabilization exercise on the rotator cuff (RC) muscles strength, functional strength ratio (FSR), range of motion (ROM), and pain. Methods : 30 adolescent baseball players participated and subjects were allocated PSSE group (n=15) or the SSE group (n=15). Both group performed a 6-weeks intervention and measured of isokinetic peak torque/body weight (PT/BW) of concentric external rotator (CER), eccentric external rotator (EER), concentric internal rotator (CIR), eccentric internal rotator (EIR), FSR, ROM, and pain. Results : After 6 weeks PSSE, significant increase CER PT/BW (+6.02±4.76 %), EER PT/BW (+5.39±4.22 %), EER to CIR ratio (+.17±.16), and internal rotation ROM (+15.08±3.57 °). Whereas, significant decrease EIR to CER ratio (-.14±.18), external rotation ROM (-12.00±6.94 °), and GIRD (-17.41±2.84 °) compared with pre-intervention. No significant difference of isokinetic PT/BW of CIR and EER post-intervention. In the SSE group showed no significant difference all measurements for isokinetic PT/BW, FSR, and ROM post-intervention. The pain was significant improve both PSSE group (-3.25±1.60) and SSE group (-2.83±1.85) post-intervention. Conclusion : Both the PSSE and SSE interventions led to more pain relief. However, only the PSSE group showed ROM, CER, EER PT/BW, and FSR improvements. These results might suggest that the PSSE intervention is a more effective program for improving RC muscle strength and balance, in particular, concentric and eccentric ER muscle strength, FSR and can expect to prevent shoulder injuries in adolescent baseball players with scapular dyskinesis.

Concomitant open distal clavicle excision is associated with greater improvement in range of motion without increased risk of acromial stress fracture after reverse total shoulder arthroplasty: a retrospective cohort study

  • Ajay C. Kanakamedala;Dhruv S. Shankar;Neil Gambhir;Matthew R. Boylan;Michael Boin;Matthew G. Alben;Mandeep S. Virk;Young W. Kwon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.357-365
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    • 2023
  • Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA). Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups. Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up. Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

Adjuvant Postoperative Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 수술 후 방사선치료)

  • Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.199-206
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    • 2003
  • Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.