• Title/Summary/Keyword: Group Replacement

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Thrombocytopenia after Aortic Valve Replacement Using Sutureless Valves

  • Mil Hoo Kim;Soojin Lee;Juhyun Lee;Seohee Joo;You Kyeong Park;Kang Min Kim;Joon Chul Jung;Hyoung Woo Chang;Jae Hang Lee;Dong Jung Kim;Jun Sung Kim;Kay-Hyun Park;Cheong Lim
    • Journal of Chest Surgery
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    • v.57 no.4
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    • pp.371-379
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    • 2024
  • Background: Sutureless valves are widely used in aortic valve replacement surgery, with Perceval valves and Intuity valves being particularly prominent. However, concerns have been raised about postoperative thrombocytopenia with Perceval valves (Corcym, UK). We conducted a comparative analysis with the Intuity valve (Edwards Lifesciences, USA), and assessed how thrombocytopenia affected patient and transfusion outcomes. Methods: Among 595 patients who underwent aortic valve replacement from June 2016 to March 2023, sutureless valves were used in 53 (Perceval: n=23; Intuity: n=30). Platelet counts were monitored during hospitalization and outpatient visits. Daily platelet count changes were compared between groups, and the results from patients who underwent procedures using Carpentier Edwards Perimount Magna valves were used as a reference group. Results: Compared to the Intuity group, the Perceval group showed a significantly higher amount of platelet transfusion (5.48±1.64 packs vs. 0.60±0.44 packs, p=0.008). During the postoperative period, severe thrombocytopenia (<50,000/μL) was significantly more prevalent in the Perceval group (56.5%, n=13) than in the Intuity group (6.7%, n=2). After initial postoperative depletion, daily platelet counts increased, with significant differences observed in the extent of improvement between the Perceval and Intuity groups (p<0.001). However, there was no significant difference in early mortality or the incidence of neurological complications between the 2 groups. Conclusion: The severity of postoperative thrombocytopenia differed significantly between the Perceval and Intuity valves. The Perceval group showed a significantly higher prevalence of severe thrombocytopenia and higher platelet transfusion volumes. However, thrombocytopenia gradually recovered during the postoperative period in both groups, and the early outcomes were similar in both groups.

Improvement of Lipid Oxidation Stability of Seasoned Pork and Formula Development of Seasoning Sauce for Pork Bulgogi with Doenjang and Onion Using Mixture Experimental Design

  • Oh, Hyun-Ju;Kim, Chang-Soon;Chang, Duk-Joon
    • Food Science and Biotechnology
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    • v.17 no.4
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    • pp.772-779
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    • 2008
  • The antioxidative effect of doenjang (fermented soybean paste) and onion added in the seasoned pork, bulgogi was evaluated and the optimum mixture ratio of ingredients in seasoning sauce has been established using mixture experimental design (MED). When the seasoned pork, bulgogi was prepared with soy sauce 12% (control), doenjang 9% (in replacement of soy sauce 9%) added group (DG), and doenjang 9% and onion 33.4% (in replacement of water 33.4%) added group (DOG), and stored at $-25^{\circ}C$ for 6 months, the peroxide value (POV) and thiobarbituric acid (TBA) value of control, DO, and DOG were all lower than that of control from the initial stage of storage. The antioxidative effect of seasoned pork was found to increase with the replacement of doenjang in seasoning sauce for pork bulgogi. Moreover, antioxidative effects in DOG increased more synergistically. Therefore, the lipid oxidation stability of pork bulgogi was improved by the addition of doenjang and onion onto the seasoning sauce. The optimum mixture ratio of seasoning sauce for pork bulgogi followed up by the MED was found to be doenjang 7.10%, soy sauce 9.46%, onion 19.72%, and water 42.58% with excellent sensory quality.

The Effects of a Cardiac Rehabilitation Educational Program on Anxiety, Health Compliance and Quality of Life of the Patient with Cardiac Valve Replacement (심장재활교육이 심장판막대치술 환자의 불안, 건강행위 이행 및 삶의 질에 미치는 영향)

  • Kim, Sook-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.153-162
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    • 1999
  • The purpose of this study was to determine the effects of an rehabilitation educational program on anxiety, health compliance and quality of life of the patient with cardiac valve replacement. The 80 Subjects for the study were surveyed at the outpatient clinic in S medical center in Buchon City in Korea. Among them, 40 patients had been taught about the cardiac rehabilitation education program and 40 patients had not been taught while they were in the hospital. Those 2 groups of patients were surveyed with the instruments of Spilberger's anxiety scale, and the questionnaire of health compliance and quality of life. The data were analyzed by using $X^2$-test, t-test, Pearson's correlation. The results of this study were as follows: 1. Anxiety in educated group was significantly decreased (t=-2.60, p= .011) comparing to u n edu cat ed group. 2. The health compliance in educated group was significantly in creased (t=2.09, p= .040) comparing to uneducated group. 3. The quality of life of the two groups of pa tients was not different significantly (t=1.83, p= .072). 4. The correlation between anxiety and health compliance was significantly reversed (r=- .461, p= .000). The correlation between anxiety and quality of life was significantly reversed (r=- .654, p= .000). The relationship between health compliance and quality of life revealed significant (r=.438, p= .000). Considering above results, the cardiac rehabilitation educational program for the patients with the cardiac valve replacement was strongly recommended to be used.

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The Effect of Continuous Passive Motion and Continuous Active Motion on Joint Proprioception After Total Knee Replacement (슬관절전치환술 후 연속수동운동(CPM)과 연속능동운동(CAM) 적용이 관절 고유수용감각에 미치는 영향)

  • Yang, Jin-Mo;Kim, Suhn-Yeop
    • Journal of Korean Physical Therapy Science
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    • v.17 no.1_2
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    • pp.41-52
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    • 2010
  • Purpose: The purpose of this study was to compare the effects of continuous passive motion(CPM) and continuous active motion(CAM) on proprioception of the knee after total knee replacement(TKR). Methods: Twenty patients with TKR were randomly allocated into two groups, the CPM group(n=10) and the CAM group(n=10). All subjects were evaluated for levels of pain, passive range of motion and angle reproduction of the knee. An angle reproduction test was used to assess the proprioceptive deficit. Two types of angle reproduction test were used: a passive angle reproduction(PAR) test and an active angle reproduction(AAR) test. The relevant examinations were performed before and after intervention(on the 5th day and the 10th day). The statistical significance were calculated using a t-test and a one-way repeated ANOVA. Results: A pre-intervention significant difference was not found between the two groups. Significantly better results were before and after the intervention at 10 days, for the PAR(flexion direction) test; however, only in the CAM group. There were no significant difference, either before or after the intervention, for the AAR test(flexion and extension direction) in both group. Both groups experienced similar levels of pain and passive range of knee motion before and after the intervention. Conclusion: This study revealed that CAM was a better effect to restore position sense of the knee joint after TKR.

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Isokinetic Effect of the Extensors and Flexors in Total Knee Replacement Patients (슬관절전치환술 환자의 슬관절 신전근 및 굴곡근에 대한 등속성운동 효과)

  • Bae, Sung-Soo;Nam, Kun-Woo;Lee, Keun-Heui
    • The Journal of Korean Physical Therapy
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    • v.13 no.1
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    • pp.19-31
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    • 2001
  • The twenty one individuals with total knee replacement who were admitted to Kang-Dong Hospital for comprehensive physical therapy were studied in order to demonstrate the effectiveness of an isokinetic test program using the Cybex 6000 machine. The subjects were divided into three groups with the isometric exercise group receiving isometric exercise. the isokinetic eccentric exercise group, and isokinetic eccentric exorcise group receiving isokinetic exercise(eccentric. concentric) to knee flexors and extensors muscles for a six weeks period using the Cybex 6000. The results were follow :1 . The peak torque was increased significantly in the flexors and extensors of the isokinetic conccentric exorcise among three groups(p<.05). 2. The progress of peak torque was increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups(p<.05). 3. The total work was more increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups(p<.05). 4. The progress of total work was more increased significantly in the flexors and extensors of the isokinetic conccentric exercise among three groups(p<;.05). 5. The ratio of endurance was not increased significantly in all three groups. 6. The extensors in the peak torque was likely to recover rapidly than the flexors. 7.The average R.O.M in the pre-exercise and post-exercise was not different significantly in all three groups. According to the above results, In the muscle strength recovery for total knee replacement patients, isokinetic concentric exercise group was significantly greater than the isokinetic eccentric and isometric exercise groups after a six weeks training.

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Experimental Tracheal Replacement: Angiogenesis and Null Apoptosis Promote Stenosis

  • Santibanez-Salgado, J. Alfredo;Sotres-Vega, Avelina;Gaxiola-Gaxiola, Miguel O.;Villalba-Caloca, Jaime;Lozoya, Karen Bobadilla;Zuniga-Ramos, Joaquin A.
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.191-199
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    • 2021
  • Background: Tracheal replacement is a challenge for thoracic surgeons due to stenosis in the trachea-prosthesis anastomosis. We propose that stenosis occurs due to fibrosis as a result of an abnormal healing process, characterized by an increased expression of wound healing growth factors (vascular endothelial growth factor [VEGF], survivin, and CD31), which promote angiogenesis and decrease apoptosis. We analyzed the immunoreactivity of VEGF, survivin, CD31, and caspase-3 in the development of fibrotic stenosis in prosthetic tracheal replacement. Methods: Fourteen dogs were operated on: group I (n=7) received a 6-ring cervical tracheal segment autograft, while in group II (n=7), a 6-ring segment of the cervical trachea was resected and tracheal continuity was restored with a Dacron prosthesis. The follow-up was 3 months. Immunoreactivity studies for VEGF, survivin, CD31, and caspase-3 were performed. A statistical analysis was done using the Wilcoxon signed rank test. Results: Four animals in group I were euthanized on the 10th postoperative day due to autograft necrosis. Three animals completed the study without anastomotic stenosis. Moderate expression of VEGF (p=0.038), survivin (p=0.038), and CD31 (p=0.038) was found. All group II animals developed stenosis in the trachea-prosthesis anastomotic sites. Microscopy showed abundant collagen and neovascularization vessels. Statistically significant immunoreactive expression of VEGF (p=0.015), survivin (p=0.017), and CD31 (p=0.011) was observed. No expression of caspase-3 was found. Conclusion: We found a strong correlation between fibrosis in trachea-prosthesis anastomoses and excessive angiogenesis, moderate to intense VEGF, CD31, and survivin expression, and null apoptotic activity. These factors led to uncontrolled collagen production.

The Effects of Ankle Mobilization with Movements on the Ankle Range of Motion, Balance, and Gait of Patients after Total Knee Arthroplasty (무릎관절 전치환술을 시행한 환자의 발목관절에 움직임을 동반한 관절가동술이 발목 관절가동범위, 균형, 보행에 미치는 영향)

  • Yoon, Jung-dae;Lee, Jae-nam
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.27 no.1
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    • pp.51-62
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    • 2021
  • Background: The purpose of this study was conducted to investigate the effects of the ankle mobilization with movement (MWM) technique on ankle dorsiflexion range of motion (ROM), balance, and gait in patients who underwent total knee replacement (TKR). Methods: Thirty patients with knee osteoarthritis were recruited and randomly divided into two groups: the experimental group (EG; n=15) and the control group (CG; n=15). For five days a week for 3 weeks, participants in the EG were treated with the ankle MWM technique and traditional total knee replacement (TKR) exercise, and those in the CG only performed traditional TKR exercises. The dorsiflexion ROM, balance, and gait of the patients were before and after exercise. Results: Balance system SD was used compare changes in dynamic balance. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in dynamic balance between the EG and CG groups after the intervention (p<.05). STT-IBS was used to compare changes in velocity, step length, stride length, and ankle dorsiflexion ROM. Patients in the EG group showed statistically significant differences after the intervention (p<.05). In addition, there was a statistically significant difference in the velocity, step length, stride length, and ankle dorsiflexion ROM between the EC and CG groups after the intervention (p<.05). Conclusion: Our results showed that applying the ankle MWM technique with traditional TKR exercises improved ankle dorsiflexion ROM, dynamic balance, and gait in patients.

The Effect of adding Hip Abductor Strengthening to Conventional Rehabilitation on Muscular Strength and Physical Function following Total Knee Replacement

  • Kim, San-Han;Park, Hye-Kang;Lee, Wan-Hee
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.16-23
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    • 2022
  • Objective: This study aimed to investigate the effect of adding hip abductor strengthening to conventional rehabilitation on muscle strength and physical function following total knee replacement (TKR) for knee osteoarthritis. Design: Randomized controlled trial Methods: Thirty-five participants were randomly allocated to exercise groups I (n=18) and II (n=17). Group I underwent hip abductor training and conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. Group II underwent conventional rehabilitation for 30 min per day, 5 days per week for 4 weeks. The participants in both groups also received continuous passive motion therapy for 15 min per day, 5 days per week for 4 weeks. To investigate the effect of the intervention, the Biodex dynamometer was used to measure the peak torque of both knee extensors and hip abductors. This study used the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) to assess physical function, as well as the figure-of-8 walk test (F8W) and the stair climb test (SCT). Results: According to the interventions, exercise groups I and II showed significantly improved muscle strength and KOS-ADLS, F8W, and SCT scores (p<0.001). Compared with that of exercise group II, exercise group I showed significantly improved hip abductor strength (p<0.001) and KOS-ADLS, F8W, and SCT scores (p<0.05). Conclusions: The results of this study indicate that the combination of hip abductor strengthening and conventional rehabilitation is an effective exercise method to increase hip abductor muscle strength and physical function after TKR.

Clinical Results of the St. Jude Medical Valve in Aortic Pposition (쎈트쥬드 대동맥판막의 장기 임상성적)

  • 김종환
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.258-262
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    • 1995
  • We have experienced 18 abdominal aortic aneurysms between March,1987 and June,1994.Unruptured patients were 11 cases and ruptured were 7.The fifth[33.4% ,sixth[27.7% and seventh[27.7% decades were most common age distributions.Sex ratio was 2.6:1[m:f .The most frequent symptoms were abdominal or back pain and palpable pulsating mass.Sixteen patients underwent resection and graft replacement.One patient refused operation.Atherosclerosis was the underlying pathology in 76%.Two ruptured patients died postoperative[28.5% .The frequency of postoperative complication was higher in the ruptured group.

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Double Valve Replacement: A Report of 23 Cases (중복판막이식: 23 치험예)

  • 김용진
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.535-540
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    • 1978
  • Between January 1974 and November 1978, 23 cases of double valve replacement were done in the Department of Thoracic Surgery, Seoul National university Hospital. All had symptoms of rheumatic valvular heart disease and belonged to functional class III or IV according to NYHA classification. Among 23 cases, mitral and aortic valves were replaced in 14, and mitral and tricuspid valves in 9 cases. Six operative deaths [26%] and 4 late deaths [23%] were found. In the former group 5 and in latter one operative death were noted. Main cause of operative death was low cardiac output syndrome due to myocardial failure. Among 4 late deaths, 2 were caused by thromboembolism, one by bacterial endocarditis, and one by arrhythmia.

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