• Journal of Chest Surgery
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• v.41 no.1
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• pp.41-48
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• 2008

Background: Accurate assessment of the preload and the fluid responsiveness is of great importance for optimizing cardiac output, especially in those patients with coronary artery occlusive disease (CAOD). In this study, we evaluated the relationship between the parameters of preload with the changes in the stroke volume index (SVI) after fluid loading in patients who were undergoing coronary artery bypass grafting (CABG). The purpose of this study was to find the predictors of fluid responsiveness in order to assess the feasibility of using. certain parameters of preload as a guide to fluid therapy. Material and Method: We studied 96 patients who were undergoing CABG. After induction of anesthesia, the hemodynamic parameters were measured before (T1) and 10 min after volume replacement (T2) by an infusion of 6% hydroxyethyl starch 130/0.4 (10 mL/kg) over 20 min. Result: The right ventricular end-diastolic volume index (RVEDVI), as well as the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), failed to demonstrate significant correlation with the changes in the SVI (%). Only the right ventricular ejection fraction (RVEF) measured at T1 showed significant correlation. with the changes of the SVI by linear regression (r=0.272, p=0.017). However, when the area under the curve of receiver operating characteristics (ROC) was evaluated, none of the parameters were over 0.7. The volume-induced increase in the SVI was 10% or greater in 31 patients (responders) and under 10% in 65 patients (non-responders). None of the parameters of preload measured at T1 showed a significant difference between the responders and non-responders, except for the RVEF. Conclusion: The conventional parameters measured with a volumetric pulmonary artery catheter failed to predict the response of SVI following fluid administration in patients suffering with CAOD.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1223-1235
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• 1998

Background and Objective : Although prone positioning has been reported to improve gas exchange, prone positioning alone does not seem to be sufficient to increase systemic oxygen transport in an acute lung injury. The objective of this study was to investigate whether the combined therapy of low dose nitric oxide (NO) inhalation and prone positioning has an additive effect on the oxygenation and hemodynamics in patients with severe ARDS. Patients and Methods : Twelve patients with ARDS were included. Prone positioning alone, later combined with nitric oxide inhalation (5~10 ppm) from the supine position (baseline) were performed with serial measurement of gas exchange, respiratory mechanics and hemodynamic at sequential time points. The patient was regarded as a responder to prone positioning if an increase in $PaO_2/FiO_2$ of more than 20 mm Hg at 30 min or 120 min intervals after prone positioning was observed compared to that of the baseline. The same criterion was applied during nitric oxide inhalation. Results : Eight patients (66.5%) responded to prone positioning and ten patients (83.3%) including the eight just mentioned responded to the addition of NO inhalation. The $AaDO_2$ level also decreased promptly with the combination of prone positioning and NO inhalation compared to that of prone positioning alone ($191{\pm}109$ mm Hg vs. $256{\pm}137$ mm Hg, P<0.05). Hemodynamic parameters and lung compliance did not change significantly during prone positioning only. Following the addition of NO inhalation to prone positioning, the mean pulmonary artery pressure and pulmonary artery occlusion pressure decreased and cardiac output, stroke volume and oxygen delivery increased (P < 0.05) compared to those of prone 120 min. Conclusion : These findings indicate that NO inhalation would provide additional improvement in oxygenation and oxygen transport to mechanically ventilated patients with ARDS who are in a prone position.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.283-290
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• 2012

Objectives: People who have chronic diseases, as well as gait imbalance or psychiatric drug use, may be susceptible to injuries from falls and slips. The purpose of this study was to evaluate the effect of musculoskeletal diseases on incidental fall-related injuries among adults in Korea. Methods: We analyzed data from the 4th Korea National Health and Nutrition Examination Survey (2007-2009), which are national data obtained by a rolling survey sampling method. The 1-year incidence of fall-related injuries was defined by health service utilization within the last year due to injury occurring after a slip and fall, and musculoskeletal diseases included osteoarthritis, rheumatoid arthritis, osteoporosis, and back pain. To evaluate the effects of preexisting musculoskeletal diseases, adults diagnosed before the last year were considered the exposed group, and adults who had never been diagnosed were the unexposed group. Results: The weighted lifetime prevalence of musculoskeletal disease was 32 540 per 100 000 persons. Musculoskeletal diseases were associated with a higher risk of fall-related injury after adjustment for sex, age, residence, household income, education, occupation, visual disturbance, paralysis due to stroke, and medication for depression (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.03 to 1.93). As the number of comorbid musculoskeletal diseases increased, the risk of fall-induced injuries increased (p-value for trend <0.001). In particular, patients who had any musculoskeletal condition were at much higher risk of recurrent fall-related injuries (OR, 6.20; 95% CI, 1.06 to 36.08). Conclusions: One must take into account the risk of fall-related injuries and provide prevention strategies among adults who have musculoskeletal diseases.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.20 no.1
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• pp.141-148
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• 2020

Unilateral neglect is associated with stroke, a neurological disorder caused by cerebrovascular injury, and is a symptom of not recognizing or responding to the opposite stimulus of the cerebral hemisphere, mainly in the right cerebral hemisphere injury. In this paper, we implemented contents using Virtual Reality based on 10 items and contents of Korean Catherine Bergego Scale(K-CBS), which is used as a behavioral evaluation scale for unilateral neglect. Implemented contents can evaluate body disregard, motility disregard, visual and spatial disregard, auditory attention, etc., which are symptoms of unilateral neglected patients, and can confirmed progression of disease quantitatively by measuring time and rotation angle of head during visual recognition. This method is expected to be useful for rehabilitation training using convenient unilateral neglect diagnosis and its applied contents.

• Therapeutic Science for Rehabilitation
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• v.5 no.1
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• pp.7-22
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• 2016

Objective : This study was conducted to review about instrument for bilateral upper extremity assessment. Methods : We searched published papers in Medline database. The keywords used in the search were 'upper extremity' and 'motor activity', 'activities of daily living' and 'assessment', 'instrument', 'disability evaluations'. In total of 68 papers, 44 assessment instruments was extracted. We analyzed about numbers, subjects, methods, reliability, validity, responsiveness of assessment instruments about bilateral upper limb function comparing unilateral, combined bilateral and unilateral instruments. Results : The numbers of bilateral measurement tool were 2 in a total of upper extremity measurement tools. Also, subjects were patients with stroke and measurement was based on performance. The reliability, validity and responsiveness of tools were high. Conclusions : Futher study will be needed to development and research about instrument of bilateral upper extremity.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.217-225
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• 2017

Objectives: This case study evaluated the effectiveness of Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) in a patient with a pontine hemorrhage and quadriparesis, dysarthria, and dysphagia. Methods: A patient diagnosed with a pontine hemorrhage was treated with Chengsimyeonja-tang-gamibang (Gamicheongsim-tang and Cheongsimsunhwal-tang) acupuncture, and moxibustion. The manual muscle test (MMT), modified Barthel index (MBI), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Mini Mental State Examination-Korea (MMSE-K), and Articulatory Functional Ability of Achievement Scale were administered. Results: Improvements in the MMT, MBI, NIHSS, mRS, and K-MMSE were observed after the treatment. The MMT grade increased from Rt. 3/3- and Lt. 3/3- pretreatment to Rt. 4/4 and Lt. 4+/4+ post-treatment. The MBI increased from 10 to 50 post-treatment. The NIHSS decreased from 24 to 6 post-treatment, and the mRS fell from 5 to 4 post-treatment. Finally, the MMSE-K increased from 0 to 24 post-treatment. The Articulatory Functional Ability of Achievement Scale also improved. Conclusion: This study shows that Chengsimyeonja-tang-gamibang can be used to treat the symptoms of patients with a pontine hemorrhage.

• The Journal of Internal Korean Medicine
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• v.38 no.2
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• pp.180-189
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• 2017

Objectives: The aim of this study is to describe the effects of traditional Korean medicine treatment on a patient with an intracerebral hemorrhage (ICH) at the left basal ganglia, thalamus, and posterior limb of the internal capsule. Methods: The patient was treated with acupuncture, moxibustion, Hyangsayukgunja-tang, and Samul-tang-gami. The effect of these treatments were evaluated using the manual muscle test (MMT), modified Barthel index (MBI), and National Institutes of Health Stroke Scale (NIHSS). Results: After the treatments, the patient's status improved, as shown by his MMT grade, which increased from 1/1 to 4/4. In addition, the patient's MBI score improved from 0 to 77, and his NIHSS score declined from 16 to 2. In addition, the patient's Levin tube and Foley catheter were removed. Conclusion: The results suggest that traditional Korean medicine may be effective in the treatment of patients with ICH.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.438-449
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• 2009

Objectives: Deep vein thrombosis (DVT) is a common complication among stroke patients. The implication of DVT progressing into a fatal pulmonary embolism is one of the main reasons treatment cannot be delayed. However, when there is a contradiction for anticoagulants, such intracranial hemorrhage (ICH), it is difficult to determine the course of treatment. Our team reports a case with both acute DVT and ICH who improved with herbal medicine Hyulbuchuko-tang. Methods : A patient with a variety of thrombosis risk factors (atrial fibrillation, DVT, Cb-inf with intracranial hemorrhage due to thrombolytic complications) showed classic symptoms of DVT (pain, edema, discoloration), disorientation and chest discomfort. The patient was administered Hyulbuchuko-tang three times a day for 24 days without any anticoagulants. Conservative therapy including elastic stocking and leg elevation was co-administered. Laboratory tests and extremity vascular Doppler sonography were carried out 3 times during the treatment period. Results : After our treatment period, both popliteal vein DVT and calf vein DVT were not discovered by sonography, and thrombosis derived factors (eg. D-dimer, fibrinogen) decreased. There was no sign of edema or discoloration after treatment, and the patient no longer complained of leg pain, disorientation or chest discomfort. Conclusion : From these results, we suggest that there is a positive effect of Hyulbuchuko-tang on DVT. Hyulbuchuko-tang should be considered as a treatment option when western medical procedures are unavailable.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.821-829
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• 2020

This case report describes the effects of Korean Medicine for the gait disturbance of Multiple System Atrophy (MSA). Korean Medicine that included chuna manual therapy, pharmaco-acupuncture, herbal medicine, acupuncture, electro-acupuncture, and moxibustion was administered for 23 days. During the hospitalization period, evaluations were performed using the Unified Multiple System Atrophy Rating Scale (UMSARS), Berg Balance Scale (BBS), and 20 m Round Timed Walking Test on day 1, day 15, and day 23. The UMSARS Part I score decreased from 11 to 5, Part II score from 11 to 9, and total score from 22 to 14, and the BBS score increased from 36 to 48. The 20 m Round Timed Walking Test score also improved. The width of the gait decreased from 65 to 40 cm, and the number of staggering incidents decreased from 6 times to 2 times. The findings of this case study suggest that Korean Medicine, including Chuna manual therapy, has potential benefits in MSA patients with gait disturbance.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.5
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• pp.1250-1259
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• 2007

Bambusae Caulis in Liquamen(BCL) has been commonly prescribed for stroke patients in the traditional Oriental medicine. So this study is aims to investigate the anti-apoptotic and neuroprotective effects of Bambusae Caulis in Liquamen(BCL) manufactured by different production process on the focal ischemia induced by intraluminal filament insertion in rats. The focal ischemia was induced by intraluminal filament insertion into middle cerebral artery. The animals were divided into four groups (n=15 in each group). The ischemia induced and not treated group : Control group, the ischemia induced and oral medication of the three kinds of BCL : BCL-A group, BCL-B group, BCL-C group. BCL-A was produced by heating at a low temperature$(250^{\circ} C)$ in electric kiln and filtering. BCL-B was produced by heating at a high temperature$(900^{\circ} C{\sim}1,000^{\circ}C)$ in yellow earth kiln and refining and filtering. BCL-C was produced by heating at a low temperature$(400^{\circ} C)$ yellow earth kiln and no refining and filtering. The anti-apoptotic and neuroprotective effects of the oral medication of BCL were observed by Bax, BCL-2, cytochrome c, mGluR5, cresyl violet and ChAT-stain. Our study suggests that BCl-A(was produced by heating at a low temperature in electric kiln and filtering) and BCL-C(was produced by heating at a low temperature in yellow earth kiln and no refining and filtering) show anti-apoptotic and neuroprotective effects on the focal ischemia induced by intraluminal filament insertion in rats and BCL-C is more effective than BCL-A.