Between November, 1984, and May, 1986, 93 patients underwent combined valvular and coronary artery operation. They were 70 male and 23 female, the age ranging from 29 to 82. From this population 89 patients underwent single valve replacement and 4 patients underwent double valve replacement. Patients with mitral valve disease were in the majority present in the age group between 50 till 70, where as in the group after 60 years, patients with aortic valve disease were dominant. The main indication for aortic valve replacement was aortic stenosis and the indication for mitral valve replacement was equal between mitral stenosis and mitral incompetence, the later was due to papillary dysfunction after myocardial infarction. Dyspnea was a very frequent symptom and it was found in nearly all patients. 28 patients had a previous myocardial infarction and severe left ventricular dysfunction. The grafts were placed prior to valve replacement and periods of myocardial ischemia were kept at a minimum by maintaining coronary perfusion throughout the operation. It is our opinion that simultaneous valve replacement and myocardial revascularization does not increase the risk of cardiac valve replacement substantially.
Purpose: The purpose of this study was to verify the effectiveness of repetitive sit to stand training to improve knee extensor strength and walking ability of total knee replacement patients. Methods: In this study, 12 patients with total knee replacement patients were recruited from a rehabilitation hospital. They were divided into two groups: a repetitive sit to stand group (n=6) and a control group (n=6). They all received 30 minutes of continuous passive motion (CPM). After that, the repetitive sit to stand group performed repetitive sit to stand training, and the control group performed resistance exercise for 15 minutes five times a week for 2 weeks. After 2 weeks of training, knee extensor strength and spatiotemporal gait parameters were measured. Knee extensor strength was measured by Biodex system 3, walking ability was measured by Biodex gait trainer 2. Paired t test was performed to verify the difference between before and after intervention within the group, and analysis of covariance was used to verify the differences between the two groups. Results: After the training periods, the repetitive sit to stand group showed a significant improvement in knee extensor muscle strength, walking speed, step length of the operated side, and step length of the non-operated side (p<0.05). Conclusion: The results of this study showed that repetitive sit to stand training was more effective in improving knee extensor muscle strength and walking ability. Therefore, to strengthen knee extensor muscles and improve the walking ability of total knee replacement patients, it is necessary to consider repetitive sit to stand training.
A system consisting of two continuously and independently operating equipment subject to breakdown and repair, is considered. It is assumed that both equipment age only when in operation, and a group replacement policy is in effect, that is, both equipment are replaced simultaneously by new identical ones as soon as either of them reaches a specified replacement age. First, a system of partial differential equations based on enumerating the various probabilistic events, is derived. Then, solutions of such system of equations for a model considered in the steady-state are obtained. Finally, an economic analysis is performed to determine the optimal replacement ages of both equipment.
Purpose: The purpose of this study was to investigate pain relief and functional recovery after total knee replacement. Methods: The treatment was performed by dividing individuals into a control group ($n_1=5$), ultrasound treatment group ($n_2=5$), and micro-current treatment group ($n_3=5$). The control group applied the hot pack for 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, and Continuous Passive Movement (CPM) for 40 minutes. The ultrasound therapy group applied the frequency of 1 MHz, intensity of 1.0 $W/cm^2$ for five minutes following the same treatment as the control group. The micro-current therapy group applied the intensity of 25 ${\mu}A$, and pulsation frequency 5 pps for 15 minutes following the same treatment as the control group. After treatment, Visual Analogue Scale (VAS), Korean Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), Berg Balance Scale (BBS), Range of Movement (ROM) and wound length was measured. Results: VAS showed significant effect in the control group and micro-current therapy group during the treatment period. According to the treatment of K-WOMACK, BBS, ROM, and Healing wounds showed main effects between groups. Conclusion: According to the results of this study, data showed improvement of pain relief, wound healing effects, and range of motion recovery. Thus, these selected treatments were effective after total knee replacement. In other words, electrical treatment continues to influence pain relief and functional recovery after total knee replacement.
Purpose: This study was conducted to identify menopausal symptoms and quality of life (QOL) according to hormone replacement therapy (HRT) in rural menopausal women. Methods: Menopausal symptoms and QOL were measured by questionnaires. A total of 50 participants in HRT group had received hormone replacement therapy for 12 weeks and another 50 who had not received hormone therapy were assigned to non-HRT group. Results: Vasomotor symptom score of non-HRT group was significantly higher than that of HRT group (p=.013). There were no statistically significant differences between two groups in all menopausal symptoms except for vasomotor symptom. There were no significant differences between two groups in the total scores and sub-scores of QOL. Total scores and sub-scores of QOL were very low in both group. Menopausal symptoms were significantly negatively correlated with QOL. Conclusion: These results showed that there were no statistically significant differences between HRT group and non-HRT group in menopausal symptoms except for vasomotor symptom and QOL. Menopausal symptoms were moderate and QOL was very low in menopausal women. It is necessary to develop nursing interventions to improve menopausal symptoms and QOL in menopausal women.
Lee, Chul Ho;Cho, Jun Woo;Jang, Jae Seok;Yoon, Tae Hong
Journal of Chest Surgery
/
v.53
no.2
/
pp.58-63
/
2020
Background: Despite progress in treatment, Stanford type A aortic dissection is still a life-threatening disease. In this study, we analyzed surgical outcomes in patients with Stanford type A aortic dissection according to the extent of surgery at Daegu Catholic University Medical Center. Methods: We retrospectively analyzed 98 patients with Stanford type A aortic dissection who underwent surgery at our institution between January 2008 and June 2018. Of these patients, 82 underwent limited replacement (hemi-arch or ascending aortic replacement), while 16 patients underwent total arch replacement (TAR). We analyzed in-hospital mortality, postoperative complications, the overall 5-year survival rate, and the 5-year aortic event-free survival rate. Results: The median follow-up time was 48 months (range, 1-128 months), with a completion rate of 85.7% (n=84). The overall in-hospital mortality rate was 8.2%: 6.1% in the limited replacement group and 18.8% in the TAR group (p=0.120). The overall 5-year survival rate was 78.8% in the limited replacement group and 81.3% in the TAR group (p=0.78). The overall 5-year aortic event-free survival rate was 85.3% in the limited replacement group and 88.9% in the TAR group (p=0.46). Conclusion: The extent of surgery was not related to the rates of in-hospital mortality, complications, aortic events, or survival. Although this study was conducted at a small-volume center, the in-hospital mortality and 5-year survival rates were satisfactory.
Purpose: The study was conducted to examine the effects of motivational interviewing intervention on exercise performance and maintenance, exercise and pain self-efficacy, functional status, and quality of life in the patients with total knee replacement. Methods: This study used a nonequivalent control group non-synchronized design. A total of 100 patients with total knee replacement (33 patients in motivational interviewing group (MG), 33 patients in exercise group (EG), 34 patients in comparison group (CG)) were participated in this study. MG and EG had 7 scheduled sessions for 4 weeks. Data were analyzed with repeated measures ANOVAs by using IBM SPSS Statistics 20. Results: MG showed better exercise maintenance, higher exercise and pain self-efficacy, higher muscle strength, and mental component of quality of life than the other groups. MG and EG showed better knee flexion, less knee extension, longer walking distance for 6 minutes, and better functioning than CG. Conclusion: The results showed that motivational interviewing intervention is an effective intervention for elderly patients with total knee replacement. Future study examining long term effects of motivation interviewing intervention is necessary.
Purpose: This study aims to verify the effectiveness of sit-to-stand training with visual feedback to improve balance ability and knee extensor strength of total knee replacement patients. Methods: In this study, 15 patients with total knee replacement participated in this study. Subjects were assigned to two groups: a feedback group (experimental group)(n = 8) and a control group (n = 7). They all received 30 min of continuous passive motion (CPM) and sit-to-stand training for 15 min five times per week for two weeks. Knee extensor and balance ability were measured. Knee extensor was measured by Biodex system 3; balance ability was measured by Balancia software. Results: After the intervention, there was a significant difference in the strengthening of the knee extensor muscles in the feedback group, area 95%, weight distribution of the affected side, and the sit-to-stand test repeated five times (p < 0.05). Conclusion: The results of this study showed that sit-to-stand training with visual feedback was more effective in increasing knee extensor muscle strength and balance ability than the sit-to-stand training without visual feedback. Therefore, in order to improve the knee extensor muscle and the balance of total knee replacement patients, it is necessary to consider providing visual feedback during sit-to-stand training.
Since January 1977 to the end of September 1982, total 60 Ionescu-Shiley pericardial xenograft heart valves were implanted for valve replacement in 50 patients at the Han Yang University Hospital. The operative procedures were as follow: Mitral valve replacement [MVR] in 25 patients, Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 7 patients, Aortic valve replacement [AVR] in 8 patients, Aortic valve replacement [AVR] and Mitral valve replacement [MVR] in 8 patients. Aortic valve replacement [AVR] and Mitral valve replacement [MVR] and Tricuspid valve [TV] annuloplasty in 2 patients. To evaluate the immediate hemodynamic changes after valve replacements, the pressures of each cardiac chamber and ulmonary artery were checked before and after valve replacement on the operation table. Right ventricle [RV] pressure was decreased from 52.09\ulcorner6.71 to 45.57\ulcorner5.03 mmHg, Pulmonary artery [PA] pressure was decreased from 45.97\ulcorner2.69 to 41.00\ulcorner3.99 mmHg, and Left atrium [LA] pressure was decreased from 30.33\ulcorner13.02 to 22.76\ulcorner.97 mmHg before and after valve replacement. In MVR group, RV pressure was decreased from 49.17\ulcorner7.89 to 43.14\ulcorner4.14 mmHg, PA pressure was decreased from 44.67\ulcorner3.18 to 38.67\ulcorner2.85 mmHg, and LA pressure was decreased from 31.46\ulcorner13.47 to 21.91\ulcorner.17 mmHg. In AVR group, RV pressure was decreased from 53.0\ulcorner7.44 to 44.71 \ulcorner3.24 mmHg, PA pressure was decreased from 34.83\ulcorner0.73 to 31.86\ulcorner.36 mmHg, and LA pressure was not changed. In double valve replacement [MVR and AVR] group, RV pressure was decreased from 57.50\ulcorner3.82 to 42.50\ulcorner.80 mmHg, PA pressure was decreased from 51.17\ulcorner1.42 to 43.33\ulcorner4.53mmHig, and LA pressure was decreased from 34.33\ulcorner2.09 to 25.50\ulcorner0.21 mmHg. But in the group where MVR and TV annuloplasty were performed, preoperative RV and PA pressure were markedly increased and no pressure decrease in RV and PA noticed after valve replacement. This study shows good immediate postoperative hemodynamic results after valve replacement using Ionescu-Shiley xenograft valve except in the cases of MVR and TV annuloplasty and advanced disease with pulmonary hypertension.
The Journal of Korean Academic Society of Nursing Education
/
v.22
no.3
/
pp.316-325
/
2016
Purpose: This study was conducted to identify the effects of early exercise education using videos on exercise knowledge and compliance of elderly patients who undergo total knee replacement surgery. Methods: This is a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 70 elderly patients who had total knee arthroplasty in the C university hospital located in G city, Korea. Thirty-five patients were assigned to an experimental group and the other patients were assigned to a control group. After the total knee arthroplasty, the early exercise education accompanied by watching video instruction was conducted on the experimental group at post-operation second and third day for 15 minutes. General exercise education was administered to the control group. The exercise knowledge and compliance of the elderly patients were measured through structured questionnaires. Conclusion: The results of this study indicate that early exercise education using videos has positive effects to improve the exercise knowledge and compliance of elderly patients after total knee arthroplasty. This early exercise education can be used going forward as nursing intervention for elderly patients who undergo total knee replacement surgery.
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