• Journal of Chest Surgery
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• 제26권3호
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• pp.196-203
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• 1993

Fourty-five cases of operation were performed for the correction of tricuspid regurgitation [TR] in Pusan National University Hospital between 1982 and 1991.The mean age of the patients was 32.6 years and female was dominant[M:F=1:2.2].Isolated tricuspid regurgitation was rare and 43 patients underwent concomitant other valvular operation including mitral valve replacement. Functional cause was in 39 cases and organic lesions were found in 6 cases. Operative methods were Kay annuloplasty[29], De Vega annuloplasty[12], and tricuspid valve replacement[4]. Ring annuloplasty was not performed. Operative mortality rate was 11.1%[5/45] and late mortality rate was 6.7%[2/30]. The tricuspid valve surgery itself was not a serious risk factor for hospital death and no heart block nor thrombosis was complicated. By echocardiogram early[within 30 days] and late [mean:4.9years] changes of postoperative TR were evaluated. De Vega annuloplasty seemed to bring better late result than Kay annuloplasty[p<0.05]. In four patients with late severe TR,previously replaced tissue valve degeneration[2], pulmonary hypertension[1] and rheumatic TR[1] were the possible causes. This experience suggests that De Vega annuloplasty can be a reliable method in the majority of patients with moderate-to-severe functional TR.

• Journal of Oral Medicine and Pain
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• 제20권1호
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• pp.89-96
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• 1995

The purpose of this study was to assess the pain-relieving effect of iontophoretically applied prednisolone on the patients with temporomandibular joint (TMJ) pain. 30 TMJ pain patients participated in this study. Inclusion criteria for subject selection were 1) tenderness of TMJ on palpation and 2) visual analog scales (VAS) of above 20 mm. The patients with polyarthralgia, rheumatic arthralgia, and systemic diseases were excluded for this experiment. The patients were randomly assigned to one of three groups; (1) Group 1 for administration of 2% prednisolone, (2) Group 2 for administration of 1% prednisolone, and (3) Group 3 for administration of saline. Phoresor PM600(Motion Control Utah, U.S.A) was used for administration of drugs by iontophoresis. Baseline and post-medication pain levels were recorded by VAS, pressure pain threshold (PPT), and palpation index (PI). Post-medication data were compared with baseline data for each group. The results were as follows : 1. All the groups showed significant decrease of VAS scores after treatment. 2. PPT was significantly increase only in Group 1 and 2 not in Group 3. 3. PI was significantly decreased only in Group 1 and 2 not in group 3.

• Journal of Chest Surgery
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• 제21권1호
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• pp.70-81
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• 1988

From January 1962 to March 1987, 97 patients underwent operation for mitral valve disease. Of these patients, 61 [62.9%] required mitral valve replacement. Thirty-six patients [37.1%] had mitral valve repair. The mean age was 26.9*11.6 years [range 5 months to 48 years]. There were 32 [88.9%] cases of rheumatic valve disease, 4 [11.1%] cases of congenital mitral valve disease. Valve dysfunction was classified into three types: type I [normal leaflet motion], 6 patients; type II [prolapsed leaflet], 1 patient; type III [restricted leaflet motion], 29 patients. Twenty-nine patients [80.6%] had pure or predominant stenosis and 7[19.4%] had pure regurgitation. No patient was in NYHA functional class I. Three patients [16.7%] were in functional class II, 15[83.3%] were in functional class II. The techniques used included closed mitral commissurotomy [16 patients], open mitral commissurotomy [13 patients], localized Wooler type annuloplasty [4 patients], suture repair of leaflet defect [3 patients], chordal shortening [1 patient], Carpentier ring annuloplasty [1 patient], and fenestration of fused chordae [1 patient]. There were two perioperative deaths [5.6%], related to left ventricular failure and reoperation. The survivors were followed up for 94 patient-years [mean 4.68*5.54 years]. One late death [1.1*1.1% per patient-year] occurred and was valve related. Reoperation was required in 3 patients, of whom 2 were deaths. There was 1 case [1.1*1.1% per patient-year] of thromboembolism. No patient received anticoagulant after operation. At 10 year, 92*7.4% of the patients were still alive. The actuarial survival rate of patients free of valve-related complication was 79*6.4% at 6 years, 27*12.1% at 11 years. After surgery, 18 patients [88.9%] were in NYHA functional class I or II.

• Journal of muscle and joint health
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• 제10권2호
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• pp.156-166
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• 2003

Purpose: To investigate the effects of self-management course in patients with ankylosing spondylitis. Method: Forty-nine subjects were sampled according to research criteria, and divided into two groups: 24 of the experimental group and 25 of control group. To the experimental group, self-management course which developed by the investigators was applied for 6 weeks, each session adopted for two hours per week and additional 30-minutes exercise was carried out two times a week. Result: After participating the self-management course in experimental group, 1) the degree of pain was significantly decreased 2) significant improvement in the flexibility of lumbar spine, 3) uncertainty was significantly decreased. 4) Self-efficacy was not changed between the two groups after self-management course. Conclusions: These findings indicate that the self-management course could be effective in improving the flexibility of lumbar spine and decreasing pain, and uncertainty in patients with ankylosing spondylitis.

• Journal of muscle and joint health
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• 제8권1호
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• pp.51-64
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• 2001

The purposes of this study were to examine and to predict the affecting factors on exercise participation of Rheumatoid arthritis Patients. The subjects were 161 adult out-patients who visited the hospital for rheumatic disease in H-university. Data were composed of self-reported questionnaire. The conceptual model of this study consisted of that personal characters(age, marriage, education, income), situational characters(pain intensity, fatigue, IADL, depression), behavioral characters(formerly exercise behavior, life-style), and cognitive-perceptional characters(perceived health status, perceived benefit, perceived barrier, perceived self-efficacy) affected directly to exercise participation. Logistic regression analysis was applied for testing model of this study. The results were as follows : 1. Personal characters(education), situational characters(pain intensity), behavioral characters(formerly exercise behavior, life-style), and cognitive characters(perceived barrier, perceived self-efficacy) were significant difference between current exercise participants(127subjects) and non-exercise participants(34). 2. Personal characters(income), situational characters(pain intensity), behavioral characters(life-style), and cognitive-perceptional characters(perceived barrier, perceived self-efficacy) were correlated to exercise participation. 3. Formerly exercise behavior, perceived barrier, and perceived self-efficacy were significant predictor of exercise participation. The logistic equation predicted overall 81.94% of this study subjects 161.

• Journal of Chest Surgery
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• 제21권1호
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• pp.1-9
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• 1988

The left atrial [LA] dimension and atrial fibrillation [AF] in patients with mitral valvular heart diseases have been thought to be related to hemodynamic burden to the LA depending on severity of stenosis or regurgitation of mitral valve, left ventricular contractility and the heart conditions. If hemodynamic burden persists long, it can affect the LA wall and structural change of the LA wall itself can developed. So the structural change of the LA wall could be thought to be related to the LA dimension and AF. To verify this relation, the LA wall biopsy was performed in 26 patients with rheumatic mitral valvular heart disease at the left atriotomy incision margin which was posterior to the interatrial groove after completion of surgery to the mitral valve such as valve replacement or commissurotomy. Relation of the pathological state of the LA wall to AF and the LA dimension measured by M-mode echocardiography was studied. The conclusions were as follow. 1. There was tendency that degree of fibrosis of myocardium of the LA wall was related to the LA dimension. 2. There was more chance that patients who had severe fibrosis of myocardium of the LA wall had pre and postoperative AF. 3. There was no relation between reduction rate of the LA dimension before and after surgery and degree of fibrosis of myocardium of the LA wall.

• Korean Journal of Adult Nursing
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• 제12권4호
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• pp.560-572
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• 2000

This study was designed to offer descriptive data for nursing intervention for relief of fatigue and pain, and to distinguish by the characteristic difference and the symptoms such as fatigue and pain on Ankylosing Spondylitis (AS), Fibromyalgia(FM), and Systemic Lupus Erythematosus(SLE) patients. The sample consisted of 92 patients(AS 29; FM 30; SLE 33) who visited H-University Rheumatism Hospital in Seoul. The data were collected by a structured questionnaire from May 1, 1999 to April 30, 2000. The results were as follows: Patients of 95% experienced fatigue in the last week and a fatigue score of three disease groups were above average. The fatigue score of FM patients was highest in the other disease, but which was not a statistically significant difference(F=1.417, p=.248). The mean score of AS and FM patients in pain was higher than the SLE patients, and there was the statistical significance among the three groups on pain (F=8.239, p=.001). There wasn't a statistical difference among three groups on coping wtih pain(F=1.451, p=.240). There wasn't any correlation between fatigue and pain in each disease (AS: r=.008, p=.966; FM: r=.328, p=.077; SLE: r=.237,p=.185). Therefore, morning stiffness and pain management during sleeping is needed through good body alignment in the AS patients. Adequate rest for fatigue and multiple coping strategies for pain maybe basic nursing intervention in FM and SLE. According to their fatigue rhythm, a regular exercise program is needed for rheumatic disease because they complained of fatigue above average and their fatigue was repeated better and worse only during the one week.

• Journal of muscle and joint health
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• 제8권2호
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• pp.230-249
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• 2001

This study was conducted to investigate the affecting factors on the adaptation to uncertainty in patients having rheumatoid arthritis. Subjects of the study constituted 222 patients who visited outpatient of rheumatic center in Seoul. Self report questionnaires were used to measure the variables affecting the adaptation to uncertainty. The variables affecting the adaptation to uncertainty were uncertainty, mastery, appraisal of danger, appraisal of opportunity, emotion focused coping, problem focused coping, pain, depression and activity of daily life(ADL). Reliability coefficients of these instruments were found Cronbach's $Alpha\;=\;.70{\sim}.94$. In data analysis, SPSSWIN 10.0 program was utilized for descriptive statistics, Pearson's correlation, and multiple regression analysis. The results were as follows. 1) The range of total pain scores was from 0 to 147 and the mean score of the pain in rheumatoid arthritis patients was 72.64. 2) The range of total depression scores was from 20 to 72 and the mean score of the depression in rheumatoid arthritis patients was 39.86. 3) The range of total ADL scores was from 22 to 80 and the mean score of the ADL in rheumatoid arthritis patients was 72.56. 4) Among the independent variables, significant factors to explain the adaptation to pain in patients were danger appraisal of uncertainty(p<.05) and emotion focused coping(p<.05). 5) Among the independent variables, significant factors to explain the adaptation to depression in patients were danger appraisal of uncertainty(p<.001), opportunity appraisal of uncertainty(p<.001) and mastery(p<.005). 6) Among the independent variables, significant factors to explain the adaptation to ADL in patients were mastery(p<.001) and danger appraisal of uncertainty(p<.05).

• Journal of muscle and joint health
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• 제7권1호
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• pp.53-62
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• 2000

This study was designed to distinguish by the characteristic difference and the degree of symptoms such as fatigue, pain, coping to pain, and efficacy on pain, and to offer descriptive data for nursing intervention for improving coping ability to pain along each characteristics of disease in chronic arthritis and systemic lupus erythematosus. The subjects were 135 outpatients in the hospital for rheumatic disease in H-university, Seoul. The data were collected by structural questionnaire, from April 29 to June 29, 1999. The results were that the fatigue score was high in the OA patients while the RA patients and SLE patients experienced middle range of fatigue score, but which was not statistically different. Although the RA patients felt higher pain than other diseases, they have well coped with their pain than the others. In efficacy on pain the SLE patients had higher score than others but all of the disease showed lower score. No statistically significant difference among the three group was recorded in efficacy on pain. Therefore, pain management in the RA patients was primary nursing intervention because they felt severe pain and have well coped with pain while they had lower pain efficacy score than the others. It is also important that fatigue management and coping strategies on pain for the OA patients and SLE patients are specially supportive in the nursing intervention.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.108-113
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• 2014

Objective : Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies. Methods : Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability. Results : A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases. Conclusions : Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient's symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient's neurological status.