• Journal of Chest Surgery
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• v.37 no.2
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• pp.146-153
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• 2004

As the experience of coronary artery bypass grafting (CABG) has been accumulated, the number of reoperation after CABG is increasing. We analyzed our clinical experience of redo-CABG. Material and Method: Fourteen patients who underwent redo-CABG between Jan. 1994 and Dec. 2002 were included in this study. The mean period from the first operation to reoperation was 66$\pm$56 (3∼157) months, and the average ages were 62.8$\pm$8.7 (51∼78) years. The survivors were followed up 39$\pm$29 (4∼101) months postoperatively. Indications of reoperation were stenosis or occlusion of previous grafts in 11 patients, progression of native coronary artery disease in one patient, and both etiologies in two patients. Result: There were two in-hospital mortalities (14.3%) resulting from low cardiac output syndrome, Postoperative morbidities were perioperative myocardiac infarction in 2 patients (14.3%), mediastinitis in one patient (7.2%), duodenal perforation in one patient, ischemic necrosis of the lower extremity in one patient, gastric perforation after mesenteric infarct in one patient, delayed brain infarct in one patient, and intraoperative splenic rupture in one patient. There was one late mortality at six months postoperatively during the follow up. There was no angina recurrence during the follow up. Conclusion: Although redo CABG demonstrated relatively high operative mortalities and morbidities, postoperative status and clinical outcome of the survivors were favorable.

• Progress in Medical Physics
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• v.27 no.4
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• pp.250-257
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• 2016

The purpose of this study was to compare the patient setup errors of two different immobilization devices (Feet Fix: FF and Leg Fix: LF) for pelvic region radiotherapy in Tomotherapy. Thirty six-patients previously treated with IMRT technique were selected, and divided into two groups based on applied immobilization devices (FF versus LF). We performed a retrospective clinical analysis including the mean, systematic, random variation, 3D-error, and calculated the planning target volume (PTV) margin. In addition, a rotational error (angles, $^{\circ}$) for each patient was analyzed using the automatic image registration. The 3D-errors for the FF and the LF groups were 3.70 mm and 4.26 mm, respectively; the LF group value was 15.1% higher than in the FF group. The treatment margin in the ML, SI, and AP directions were 5.23 mm (6.08 mm), 4.64 mm (6.29 mm), 5.83 mm (8.69 mm) in the FF group (and the LF group), respectively, that the FF group was lower than in the LF group. The percentage in treatment fractions for the FF group (ant the LF group) in greater than 5 mm at ML, SI, and AP direction was 1.7% (3.6%), 3.3% (10.7%), and 5.0% (16.1%), respectively. Two different immobilization devices were affected the patient setup errors due to different fixed location in low extremity. The radiotherapy for the pelvic region by Tomotherapy should be considering variation for the rotational angles including Yaw and Pitch direction that incorrect setup error during the treatment. In addition the choice of an appropriate immobilization device is important because an unalterable rotation angle affects the setup error.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.121-127
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• 2012

Purpose: To compare coagulation test results of the arthroscopic surgery patients who received thromboprophylaxis with typical two kinds of anticoagulation drugs, we performed coagulation tests before and after surgery with two groups and then compared the results. Materials and Methods: Forty-seven patients who underwent arthroscopic surgery were randomly divided into two groups to rivaroxaban and enoxaparin group, and we performed coagulation tests before and 5 days after arthroscopic surgery to two drugs groups in order to investigate about the difference in clotting capacity. Results: Preoperative coagulation tests did not differ significantly between the two groups. However, coagulation tests after 5 days of the surgery, the level of prothrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT) increased, particularly in patients with rivaroxaban compared with enoxaparin (P<0.05). Conclusion: Anticoagulation for arthroscopic surgery with a drug is effective and has safe range in terms of bleeding tendency, but in the rivaroxaban group, there was one patient who showed high bleeding tendency with abnormal range. Therefore it should be careful of using rivaroxaban for thromboprophylaxis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5730-5736
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• 2013

The study was conducted to determine the effect of trunk pattern training in proprioceptive neuromuscular facilitation(PNF) and weight-shift training on the muscle activity and static balance in patients with hemiplegia due to stroke. Twenty patients with hemiplegia due to stroke were assigned to the trunk pattern training in PNF group(n=10) or weight-shift training group(n=10). Both groups were executed conventional treatment for 5 times per week for 6 weeks 30 minutes per session. Each group performed additional training for 20 minutes. Post training, compared to the weight-shift training group, trunk pattern training in PNF group showed significantly increased on muscle activity of rectus femoris, gastrocnemius and static balance(p<.05). These results support the perceived benefits of trunk pattern training in PNF to augment on the static balance and muscle activity of stroke patients. Therefore, trunk pattern training in PNF is feasible and suitable for stroke patients.

• Korean Journal of Applied Biomechanics
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• v.19 no.3
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• pp.557-566
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• 2009

This study was to investigate gender differences in muscle activities on tibialis anterior muscle, gastrocnemius and vastus medialis obliqus and outside and prime mover, antagonist and assistance mover during golf drive swing by electromyography. Ten healthy professional golfers (KPGA(n)=5, KLPGA(n)=5) volunteered in this experiment. All statistical analyses were performed using SPSS. Statistical differences were assess using t-test (p<.05). The conclusion of this study was as following. Muscle dislocation of differences, according to gender, was the highest in case of males in right side of gastrocnemius with the section from the address to the backswing of top and was the highest in case of females in tibialis anterior muscle. Results also show that prime mover was left side of low muscle in case of male with all the sections and situations and is right side low muscle in case of female. These results were significant differences. In case of males, it was though that primer mover was left side of tibialis anterior muscle with moving weight from backswing of top till the address section. In case of females, primer movers were right side of vastus medialis obliqus and tibialis anterior muscle with pushing action form the right knee to the left knee. Therefore, if they try to do the training be able to development right side of vastus medialis obliqus and tibialis anterior muscle in case of females and left side of vastus medialis obliqus and tibialis anterior muscle in case of males, it is consider that golfers' distance and direction will get better.

• Archives of Plastic Surgery
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• v.32 no.1
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• pp.85-92
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• 2005

Botulinum toxin type A is widely used for anti-wrinkling therapy, and correction of the square face. The toxin ultimately prevent the release of membrane-bound acetylcholine at the neuromuscular junction of striated muscles and thus produce chemical denervation and paralysis of the muscles. Our purpose of study is to know if application of botulinum toxin type A on calf reduction is effective, how much dosage is effective, and what are the possible complications. We reviewed data of 30 consecutive patients subjected to calf reduction in Dong-A University Hospital from February 2003 to April 2003. We injected normal saline 2cc on both calves region in 15 control group patients, and the other patients was divided 3 group. Group 1, Group 2, Group 3 was injected 50U, 100U, 150U botulinum toxin A on each calf region and followed up for 6 month. Maximal circumference of calf was not changed in the control group but an average of 0.7 cm reduction was noted in group 1, average 1.34 cm(right calf) and 1.26cm(left calf) in group 2, average 1.44cm(right calf) and 1.58cm(left calf) in group 3. Maximal area of calf was not changed in the control group but average reduction of 12.5%(right calf) and 12.7%(left calf) was obtained in group 1, average 19.4% (right calf) and 19.9%(left calf) in group 2, average 24.8%(right calf) and 21.07%(left calf) in group 3, as measured on CAT scan. Total fat amount and fat amount in the lower extremity was no change in all the groups, but lean body mass was decreased average 1.27%(right calf) and 1.15%(left calf) in group 1, average 3.47%(right calf) and 2.98%(left calf) in group 2, average 3.58%(right calf) and 3.95%(left calf) in group 3. Photography of the preoperative and postoperative 6 month state revealed higher satisfaction in Group 2, 3 compared to Group 1. Use of botulinum toxin type A in calf reduction is a very simple, safe, non-invasive method and effective in terms of calf contouring rather than reduction of calf circumference.

• Korean Journal of Applied Biomechanics
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• v.19 no.4
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• pp.655-661
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• 2009

This study investigated the effects of different types of shouting actions on the strength of the human body. Both H-reflex and MVIC measures of the rectus femoris muscle were used to investigate effects on impact force and motor performance, in order to find optimum shouting methods. The H-reflex of the soleus muscle gave an electric stimulus to the curve of the knee that contains the tibial nerves. Surface electromyelography was used to collect muscle activity the amplitude increased 28% at action with shouting and 29% at the one immediately after short-time shouting than the one without shouting was. To assess the myoelectric activity of the rectus femoris, a surface electrode was attached to the right side of the lower extremity and to increase 10% and 1% depending upon shouting type. The findings were as follows. Shouting affected not only motor efficiency (H-reflex), but also the amplitude of MVIC, with a positive effect on increased muscle strength. Further comprehensive studies are needed to investigate the many variables of increased muscle strength for general purposes, for instance, shouting and breathing, brain waves, and so on.

• Journal of Veterinary Clinics
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• v.32 no.2
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• pp.148-153
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• 2015

This study was performed to compare two opioid drugs with isoflurane and to determine the difference between isoflurane/remifentanil anesthesia and isoflurane/fentanyl anesthesia in terms of the anesthetic effects in beagle dogs. Isoflurane was maintained at 0.5 MAC, and the opioid drug was administered as a constant rate infusion. The anesthesia was maintained for 2 hours, and isoflurane and opioid drugs were discontinued 2 hours later. After discontinuing the anesthetics, the extremity movement time, eye global positioning time, gag reflex time, head up time, sternal recumbency time, standing time, walking time and complete recovery times were recorded for each dog. Both of the studied anesthetic protocols were suitable in beagle dogs because the anesthetic status was well maintained until the end of the procedure, and rapid recovery times were demonstrated in this experiment. And this study shows that the isoflurane/remifentanil group was more reliable than the isoflurane/fentanyl group because the recovery time CV was lower. Therefore, isoflurane/remifentanil combination anesthesia could be a better choice than isoflurane/fentanyl anesthesia if the patient is severely ill and stable recovery time is needed.

• Archives of Reconstructive Microsurgery
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• v.18 no.2
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• pp.55-61
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• 2009

Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.

• Korean Journal of Applied Biomechanics
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• v.15 no.4
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• pp.153-168
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• 2005

The purposes of this study were to determine the influence of midsole hardness and sole thickness of sports shoes on ball flex angle and position with increment of running velocity. The subjects employed for this study were 10 college students who did not have lower extremity injuries for the last one year and whose running pattern was rearfoot striker of normal foot. The shoes used in this study had 3 different midsole hardness of shore A 40, shore A 50, shore A 60 and 3 different sole thickness of 17cm, 19cm, 21cm. The subjects were asked to run at 3 different speed of 2.0m/sec, 3.5m/sec, 5.0m/sec and their motions were videotaped with 4 S-VHS video cameras and 2 high speed video cameras and simultaneously measured with a force platform. The following results were obtained after analysing and comparing the variables. Minimum angle of each ball flex position were increased with the increment of running velocity and shoe sole thickness(P<0.05), but mid-sole hardness did not affect minimum ball flex angle. The position which minimum angle was shown as smallest was 'D'. Midsole hardness and sole thickness did not affect time to each ball flex minimum angle, total angular displacement of ball flex angle, and total angular displacement of torsion angle(P<0.05). The position which minimum angle was appeared to be earliest was similar at walking velocity, and E and F of midfoot region at running velocity. Total angular displacement of ball flex position tended to increase as shifted to heel. It was found that running velocity had effects on ball flex angle variables, but shoe sole thickness partially affected. It would be considered that running velocity made differences between analysis variables at walking and running when designing shoes. Also, it was regarded that shoes would be developed at separated region, because ball flex angle and position was shown to be different at toe and heel region. It is necessary that midsole hardness and thickness required to functional shoes be analyzed in the further study.