• 대한물리치료과학회지
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• 제7권2호
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• pp.439-457
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• 2000

The causes, risk factors and sequelae of mastectomy were studied, and the physical therapy approaches on post-mastectomy was discussed in this study. It was found that the patients taken mastectomy have experienced pins and needles in muscle, weakening of muscle, pains, deterioration of motion in joint region and activities of daily living, psychiatric sequelae, and etc even after the conservertive therapies like the chemical therapy, radiotherapy, immunotherapy, and hormone therapy. However, few study on the physical therapy approaches for patients with breast cancer has been carried in Korea at present. The followings were proposed as the physical therapy approaches. 1. Shoulder joint motion approach to relax the limit of range of motion 2. Control of breathing exercise for dealing with removal of the pectorailis muscle 3. Method to reduce the edema of arms for tackling the cut of lymph node 4. Method to reduce pains, pins and needles 5. Support home exercise program after discharging from hospital, sexual life and pregnancy, and activities of daily living training method.

• Journal of Chest Surgery
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• 제55권2호
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• pp.118-125
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• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• 대한수혈학회지
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• 제29권3호
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• pp.291-300
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• 2018

배경: 적혈구를 폐쇄계에서 동결하고 세척하는 경우 동결해동적혈구의 보존기간을 24시간 이상으로 연장할 수 있다. 본 연구에서는 고농도글리세롤법과 자동화 장비인 Haemonetics ACP 215를 이용한 폐쇄계에서 적혈구의 동결과 세척과정을 평가하였다. 방법: ACP 215를 이용하여 35단위의 적혈구에 글리세롤을 최종농도가 40% (wt/vol)가 되도록 첨가하고 30단위는 즉시 동결하였으며, 나머지 5단위는 잔여 글리세롤을 제거한 다음 동결하였다. 동결한 적혈구는 $-80^{\circ}C$에 보관 후 해동 세척하여 SAG-M 보존액에 부유하고, $4^{\circ}C$에서 보존하면서 안정성 및 품질관리 지표를 분석하였다. 결과: 잔여 글리세롤을 제거하지 않은 동결적 혈구는 잔여 글리세롤을 제거한 동결해동적혈구에 비해 해동 후 보존기간 동안 칼륨 유출이 현저히 낮게 나타났다. 잔여 글리세롤을 제거하지 않은 동결해동적혈구를 해동 후 $4^{\circ}C$에서 7일간 보존하는 동안 측정한 모든 안정성 및 품질지표는 AABB와 유럽연합의 기준에 모두 적합하였다. 결론: ACP 215를 사용하여 동결 전 잔여 글리세롤을 제거하지 않고 바로 적혈구를 동결하는 방법은 동결보존과정이 단순하고 동결해동적혈구의 안정성이 향상되어 향후 수혈을 위한 동결적혈구에 현실적으로 적용가능성이 높은 것으로 생각된다.

• 구강회복응용과학지
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• 제31권3호
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• pp.203-211
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• 2015

목적: 완전한 골-임플란트 결합을 가졌던 임플란트가 갑자기 골유착을 잃은 경우의 시간에따른 재골유착을 연구하기 위함이다. 연구 재료 및 방법: 23마리 토끼의 좌우 경골에 각각 2개씩 실험목적으로 제작한 RBM임플란트를 식립 후, 6주 후에 1차로 비틀림 제거력을 측정한 다음, 임플란트를 다시 재위치 침하시키고, 4일, 7일, 11일, 2주, 4주, 6주, 그리고 8주의 재침하시간 경과 후 2차로 비틀림 제거력을 측정하고 시편을 제작하여 조직 형태학적 검사를 하였다. 통계학적 검사를 위해 paired t-test를 시행했고, One-way ANOVA와 Tukey's post-hoc test 통해 그룹간 차이를 비교하여 다음과 같은 결과를 얻었다. 결과: 1차 비틀림 제거력과 비교해봤을 때 2차에서 11일 후에는 증가했으며, 2주 후부터 유의성 있게 증가하였다. 형광조사검사에서, 7일 후부터 골-임플란트 계면 사이에 형광밴드가 나타나는 광물화 현상이 관찰되고, 11일 후부터는 분명한 골 형성이 나타났다. 결론: 토끼에서는 11일 이후가 되면 충분한 재골유착을 얻을 수 있었다.

• Environmental Engineering Research
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• 제17권3호
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• pp.133-138
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• 2012

Polyvinyl alcohol/alginate hydrogel beads containing Mg-Al layered double hydroxide (LDH-PVA/alginate beads) were synthesized for phosphate removal. Results showed that blending PVA with the LDH-alginate beads significantly improved their stability in a phosphate solution. The kinetic reaction in LDH-PVA/alginate beads reached equilibrium at 12 hr-post reaction with 99.2% removal. The amount of phosphate removed at equilibrium ($q_e$) was determined to be 0.389 mgP/g. The equilibrium data were described well by the Freundlich isotherm with the distribution coefficient ($K_F$, 0.638) and the constant (n, 0.396). Phosphate removal in LDH-PVA/alginate beads was not sensitive to solution pH. Also, the removal capacity of LDH-PVA/alginate beads ($q_e$, 1.543 mgP/g) was two orders of magnitude greater than that of PVA/alginate beads ($q_e$, 0.016 mgP/g) in column experiments. This study demonstrates that LDH-PVA/alginate beads with a higher chemical stability against phosphate compared to LDH-alginate beads have the potential for phosphate removal as adsorptive media.

• 대한환경공학회지
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• 제30권6호
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• pp.601-608
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• 2008

본 연구의 목적은 파일롯 규모의 입상활성탄지에서 흡착과 생물학적 제거 기작이 진행되는 장기간의 운전동안 전처리공정으로서 오존처리의 영향을 평가하는 것이다. 공정별로 용존 또는 생분해성 유기물질의 제거, DOM의 성상과 특성변화와 미생물의 증식의 변화를 평가하였다. 오존공정이 존재하는 입상활성탄 공정(전오존처리+활성탄 여과지; Pre O$_3$ + F/A, 후오존처리 + 활성탄 흡착지; Post O$_3$ + GAC)은 오존의 위치(전오존 후오존)에 상관없이 입상활성탄 단독공정(활성탄 여과지; F/A, 활성탄 흡착지; GAC)에 비해 생물학적 제거능이 활성화된 장기간 운영 후에 DOC, 친수성 용존유기물(HPI), BDOC와 AOC의 제거율이 10$\sim$20% 정도로 높았다. 오존공정은 전반적인 DOC 제거에는 큰 영향을 주지는 못했지만, AOC를 약 20% 정도로 감소시켜 관로내 미생물의 재증식을 저감하는데 기여할 것으로 생각된다. 활성탄 여재에 고정된 미생물의 생체량인 Biomass는 전처리로서 오존처리의 유.무에 상관없이 공정별로 큰 차이를 보이지 않은 반면에, 유출수에서의 HPC는 F/A나 GAC에 비해 Post O$_3$ + GAC에서 매우 낮았다.

• 한국물환경학회지
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• 제23권5호
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• pp.642-649
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• 2007

The effectiveness of add-on tertiary treatment processes for the polishing of the effluent of a biological nutrient removal (BNR) system from a modified $A^2/O$ process has been examined under the field condition with pilot-scale plants. The add-on treatment processes of 1) combined biofilm anoxic reactor and sand filtration, and 2) two-stage denitrification filter had been operated with various operating conditions. The experimental results indicated that two-stage denitrification filter could produced a better polished tertiary effluent. Filtration rate of $150m^3/m^2{\cdot}d$ for the 2-stage denitrifying filter could decrease the nitrate removal probably due to shorter detention time that caused insufficient reaction for denitrification. Two stage denitrification filter operated with M/N ratio of 3.0 and filtration rate of $100m^3/m^2{\cdot}d$ produced the tertiary effluent with nitrate and SS concentraitons of 2.8 mg/L and 2.3 mg/L, respectively. When the operating temperature reduced $30^{\circ}C$ to $18^{\circ}C$, $NO_3{^-}-N$ removal efficiency decreased from 73% to 68%.

• 한국전문물리치료학회지
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• 제22권2호
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• pp.41-51
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• 2015

The purposes of this study were 1) to determine the effects of low-dye taping on peak plantar pressure following treadmill walking exercise, 2) to determine whether the biomechanical effectiveness of low-dye taping in peak plantar pressure was still maintained following removal of the tape during treadmill walking, and 3) to determine the trend towards a medial-to-lateral shift in peak plantar pressure in the midfoot region before and after application of low-dye taping. Twenty subjects with flexible flatfoot were recruited using a navicular drop test. The peak plantar pressure data were recorded during five treadmill walking sessions: (1) un-taped, (2) baseline-taped, (3) after a 10-minute treadmill walking exercise, (4) after a 20-minute treadmill walking exercise, and (5) after removal of the taping. The foot was divided into six parts during the data analysis. One-way repeated measures analysis of variance was performed to investigate peak plantar pressure variations in the six foot parts in the five sessions. This study resulted in significantly increased medial forefoot peak plantar pressure compared to the un-taped condition (p=.017, post 10-minute treadmill walking exercise) and (p=.021, post 20-minute treadmill walking exercise). The peak plantar pressure in the lateral forefoot showed that there was a significant decrease after sessions of baseline-taped (p=.006) and 10-minute of treadmill walking exercise (p=.46) compared to the un-taped condition. The tape removal values were similar to the un-taped values in the five sessions. Thus, the findings of the current study may be helpful when researchers and clinicians estimate single taping effects or consider how frequently taping should be replaced for therapeutic purposes. Further studies are required to investigate the evidence in support of biomechanical effectiveness of low-dye taping in the midfoot region.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.319-323
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• 2017

Background Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. Methods Among patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73.14 years) treated for large facial defects from basal cell carcinoma. Based on operative and follow-up records, we investigated the number and type of flaps used, postsurgical complications, and patients' post-surgical satisfaction. Results Two and 3 types of flaps were used for 5 and 2 patients, respectively. Most frequently used were nasolabial flaps (7 times in 6 patients) and forehead flaps (once in each of 4 patients). The average follow-up period was 14 months, with no complications-including necrosis, hematoma, or wound dehiscence-observed. Post-surgical satisfaction averaged 4.4 out of a maximum of 5 points. Conclusions Reconstruction using two or more flaps for large facial defects after skin cancer removal using MMS produced satisfactory outcomes while preventing aesthetic problems. Practitioners should consider using multiple flaps when choosing a reconstruction method for large facial defects following skin cancer removal.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권1호
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• pp.29-37
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• 2022

Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M. Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05. Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05). Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.