• Asian-Australasian Journal of Animal Sciences
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• v.26 no.7
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• pp.971-980
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• 2013

Dried stoned olive pomace (DSOP) was administered to dairy water buffaloes, and their productive performance and milk composition were analysed. Sixteen pluriparous lactating buffaloes were divided into two uniform groups (control and experimental), taking into consideration the following parameters: milk production (2,192 and 2,102 kg) and duration of lactation (254 and 252 d) of the previous year, distance from calving (51 and 43 d), milk production (9.71 and 10.18 kg/d), body condition score (BCS) (6.44 and 6.31) and weight (617 and 653 kg) at the beginning of the trial. Both diets had the same formulation: second cut alfalfa hay 20%, corn silage 42%, concentrate 38% but the two concentrates differed in their formulation, the experimental one contained 15.50% of DSOP as fed. The employed DSOP showed high amounts of secoiridoids, such as 3,4-dihydroxyphenylethanol (3,4-DHPEA) (1.2 g/kg DM), 3,4-dihydroxyphenylethanol-elenolic acid di-aldehyde (3,4-DHPEA-EDA) (12.6 g/kg DM), p-hydroxyphenylethanol-elenolic acid di-aldehyde (p-HPEA-EDA) (5.6 g/kg DM) and lignans, which are known to be powerful bioactive compounds. The control diet had an energy-protein content of 0.86 Milk FU/kg DM and 143.3 g/kg DM of crude protein, whereas the experimental diet of 0.87 Milk FU/kg DM and 146.6 g/kg DM of crude protein. Each animal of the two groups received 17 kg DM/d and each buffalo of the experimental group, by way of the concentrate, ingested 1.05 kg DM/d of DSOP. The trial lasted 40 days. No significant difference was found between the BCS (6.41 and 6.53), live weight (625.93 and 662.50 kg) and milk production (9.69 and 10.08 kg/d) of the two groups, as was the case for fat, protein, lactose, pH and coagulating parameters of the two milks. The milk fat of the experimental group had a significantly higher content of total tocopherols (10.45 vs $8.60{\mu}g/g$, p<0.01) and retinol (3.17 vs $2.54{\mu}g/g$, p<0.01). The content of the reactive substances with tiobarbituric acid (TBARs) was significantly lower in the milk fat of the experimental group (12.09 vs $15.05{\mu}g$ MDA/g, p<0.01). The acid content of the milk fat of the experimental group had a significantly higher content (p<0.05) of C18:0 and of $C18:3{\omega}6$. LC-MS/MS analysis showed the presence of 3,4-DHPEA ($36.0{\mu}g/L$) in the milk of the DSOP-fed buffaloes, while other phenols were not found. DSOP, in the quantity utilized, can be used in the feeding of the lactating buffalo; the dietetic-nutritional characteristics of the milk are improved due to a greater contribution of tocopherols, retinol and the presence of hydroxytyrosol.

• Asian-Australasian Journal of Animal Sciences
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• v.24 no.8
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• pp.1164-1172
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• 2011

Two experiments were conducted to evaluate the efficacy of Trichoderma reesei derived phytase for pigs fed diets with fixed calcium to total phosphorus ratios (1.5:1). In Exp. 1, 280 weaned pigs (initial BW of $10.32{\pm}1.94$ kg) were allocated to one of five dietary treatments on the basis of weight and gender in a randomized complete block design. Treatments were the low phosphorus (0.6% Ca, 0.4% total P and 0.23% available P) diets supplemented with 0, 250, 1,000, or 2,000 FTU phytase/kg of diet and a positive control diet (PC; 0.85% Ca, 0.58% total P and 0.37% available P). The treatments were applied to seven pens with eight pigs per pen, half male and half female. In Exp. 2, six barrows fitted with ileal T-cannula (initial BW = $35.1{\pm}1.6$ kg) were assigned to three dietary treatments with a double $3{\times}3$ Latin square design. The dietary treatments were the low-phosphorus diet (0.53% Ca, 0.34% total P and 0.14% available P), the low phosphorus diet plus 1,000 FTU phytase/kg and a positive control diet (0.77% Ca, 0.50% total P and 0.30% available P). In Exp. 1, there were linear increases (p<0.01) in weight gain, phosphorus absorption, bone strength, calcium and phosphorus content of fat-free dried bone and plasma phosphorus concentrations with increasing dose rate of phytase. The performance of pigs fed the diets with 250, 1,000, or 2,000 FTU of phytase/kg did not differ from pigs fed the PC diet. Pigs fed diets with 1,000 or 2,000 FTU of phytase/kg did not differ from pigs fed the PC diet in bone characteristics. The apparent digestibility of dry matter, crude protein, ash and energy was not affected by dietary treatment. However, pigs fed the PC diet excreted more fecal phosphorus (g/d, p<0.01) and fecal phosphorus per BW gain (g/kg) than pigs fed the diets with phytase. Phytase linearly decreased (p<0.01) fecal phosphorus excreted per BW gain (g/kg), plasma calcium concentration as well as plasma and bone alkaline phosphatase activity. In Exp. 2, phytase supplementation in the low-P diet increased (p<0.05) the apparent ileal digestibility (AID) of Ca, P, leucine, lysine, phenylalanine, alanine and cysteine, tended to AID of crude protein, isoleucine, threonine, asparagine and serine. In conclusion, the novel phytase originated from Trichoderma reesei is effective in releasing Ca, P, and amino acids from corn soy based diet for pigs.

• Asian-Australasian Journal of Animal Sciences
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• v.21 no.8
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• pp.1189-1195
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• 2008

A study was conducted with 48 weaned barrows ($28{\pm}3d$, $8.45{\pm}0.14kg$) to determine the effect of Achyranthes bidentata polysaccharide (ABPS) supplementation on pig performance, immunological, adrenal and somatotropic responses following Escherichia coli lipopolysaccharide (LPS) challenge. The experiment was a $2{\times}2$ factorial design; the main factors included diet (supplementation with 0 or 500 mg/kg ABPS) and immunological challenge (LPS or saline). On d 14 and 21 of the trial, pigs were given an intraperitoneal injection with either $100{\mu}g/kg$ BW of LPS or an equivalent amount of sterile saline. Blood samples were obtained 3 h after injection for analysis of tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), prostaglandin $E_2$ ($PGE_2$), cortisol, growth hormone (GH), insulin-like growth factor (IGF)-I and immunoglobulin G (IgG). On d 2 after LPS challenge, peripheral blood lymphocyte proliferation (PBLP) was measured. LPS administration decreased average daily feed intake (ADFI) (p<0.05), had a tendency to decrease average daily gain (ADG) (p<0.10) during both the first and second challenge periods and increased (p<0.05) feed:gain ratio only during the first challenge period. ABPS tended to improve ADG (p<0.10) during the first challenge period, and improved ADG (p<0.05) and tended to improve ADFI (p<0.10) during the second challenge period. ABPS did not affect feed:gain ratio. An interaction (p<0.05) between LPS challenge and diet was observed for the plasma concentrations of TNF-${\alpha}$, $PGE_2$ and cortisol after both LPS challenges such that, among LPS-treated pigs, pigs fed the ABPS diet were lower for these indices than those receiving the control diet. In contrast, pigs fed the ABPS diet had higher IGF-I (p<0.05) compared with those fed the control diet. No effect of diet, LPS challenge or both on GH and IgG was observed after both LPS administrations. LPS challenge increased PBLP when these cells were incubated with $8{\mu}g/ml$ of LPS during both the challenge periods, and did likewise when incubated with $8{\mu}g/ml$ of concanavalin A only after the first challenge. ABPS had no effect on PBLP. These data demonstrate that ABPS alters the release of pro-inflammatory cytokines following an immunological challenge, which might enable pigs to achieve better performance.

• Asian-Australasian Journal of Animal Sciences
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• v.30 no.11
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• pp.1620-1632
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• 2017

Objective: This study evaluated the effects of a traditional Chinese medicine formula (TCMF) on muscle fiber characteristics in finishing pigs and the effects of the formula's extract (distilled water, ethyl acetate and petroleum ether extraction) on porcine cell proliferation and isoforms of myosin heavy chain (MyHC) gene expression in myocytes. Methods: In a completely randomized design, ninety pigs were assigned to three diets with five replications per treatment and six pigs per pen. The diets included the basal diet (control group), TCMF1 (basal diet+2.5 g/kg TCMF) and TCMF2 (basal diet+5 g/kg TCMF). The psoas major muscle was obtained from pigs at the end of the experiment. Muscle fiber characteristics in the psoas major muscle were analyzed using myosin ATPase staining. Cell proliferation was measured using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) dye and cytometry. Isoforms of MyHC gene expression were detected by real-time quantitative polymerase chain reaction. Results: The final body weight and carcass weight of finishing pigs were increased by TCMF1 (p<0.05), while the psoas major muscle cross-sectional area was increased by TCMF (p<0.05). The cross-sectional area and diameter of psoas major muscle fiber Ι, IIA, and IIB were increased by TCMF2 (p<0.05). The cross-sectional area and fiber diameter of psoas major muscle fiber IIA and IIB were increased by diet supplementation with TCMF1 (p<0.05). Psoas major muscle fiber IIA and IIB fiber density from the pigs fed the TCMF1 diet and the type IIB fiber density from the pigs fed the TCMF2 diet were lower compared to pigs fed the control diet (p<0.05). Pigs fed TCMF2 had a higher composition of type Ι fiber and a lower percentage of type IIB fiber in the psoas major muscle (p<0.05). The expression levels of MyHC Ι, MyHC IIa, and MyHC IIx mRNA increased and the amount of MyHC IIb mRNA decreased in the psoas major muscle from TCMF2, whereas MyHC Ι and MyHC IIx mRNA increased in the psoas major muscle from TCMF1 (p<0.05). Peroxisome proliferator-activated receptor ${\gamma}$ $coactivator-1{\alpha}$ and CaN mRNA expression in the psoas major muscle were up-regulated by TCMF (p<0.05). Porcine skeletal muscle satellite cell proliferation was promoted by $4{\mu}g/mL$ and $20{\mu}g/mL$ TCMF water extraction (p<0.05). Both $1{\mu}g/mL$ and $5{\mu}g/mL$ of TCMF water extraction increased MyHC IIa, MyHC IIb, and MyHC IIx mRNA expression in porcine myocytes (p<0.05), while MyHC Ι mRNA expression in porcine myocytes was decreased by $5{\mu}g/mL$ TCMF water extraction (p<0.05). Porcine myocyte MyHC Ι and MyHC IIx mRNA expression were increased, and MyHC IIa and MyHC IIb mRNA expression were down-regulated by $5{\mu}g/mL$ TCMF ethyl acetate extraction (p<0.05). MyHC Ι and MyHC IIa mRNA expression in porcine myocytes were increased, and the MyHC IIb mRNA expression was decreased by $1{\mu}g/mL$ TCMF ethyl acetate extraction (p<0.05). Four isoforms of MyHC mRNA expression in porcine myocytes were reduced by $5{\mu}g/mL$ TCMF petroleum ether extraction (p<0.05). MyHC IIa mRNA expression in porcine myocytes increased and MyHC IIb mRNA expression decreased by $1{\mu}g/mL$ in a TCMF petroleum ether extraction (p<0.05). Conclusion: These results indicated that TCMF amplified the psoas major muscle cross-sectional area through changing muscle fiber characteristics in finishing pigs. This effect was confirmed as TCMF extraction promoted porcine cell proliferation and affected isoforms of MyHC gene expression in myocytes.

• Asian-Australasian Journal of Animal Sciences
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• v.23 no.4
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• pp.521-529
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• 2010

Two experiments were conducted to evaluate multi-microbe submerged liquid (SLF) and solid substrate (SSF) fermented probiotic products in broilers. The SLF and SSF probiotics were comprised of Lactobacillus acidophilus ($1.1{\times}10^9$ and $4{\times}10^8$ cfu/g), Bacillus subtilis ($1.1{\times}10^9$ and $4{\times}10^9$ cfu/g), Saccharomyces cerevisiae ($1.5{\times}10^7$ and $1.0{\times}10^4$ cfu/g) and Aspergillus oryzae ($2.6{\times}10^7$ and $4.3{\times}10^7$ cfu/g), respectively. In Exp. 1, 640 day-old Ross chicks were allotted to 4 treatments, each comprising 4 replicates (40 chicks/replicate). The basal diet was prepared without any antimicrobials (negative control, NC), and 20 mg/kg avilamycin (positive control, PC), 0.3% SLF and 0.3% SSF probiotics were added to the basal diets as treatments. Birds fed PC and SSF diets showed improved (p<0.001) overall weight gain and F/G than birds fed NC and SLF diets; whereas, birds fed SLF diet had better weight gain and F/G than birds fed NC diet. Retention of CP was higher (p<0.05) in birds fed the SSF diet than birds fed PC, SLF and NC diets. Birds fed the SLF diet tended to have higher (p<0.10) cecal total anaerobic bacteria than birds fed PC and NC diets; whereas, lesser cecal coliforms were noticed in birds fed PC, SLF and SSF diets than birds fed the NC diet. In Exp. 2, 640 day-old Ross chicks were randomly allotted to 4 treatments in a $2{\times}2$ factorial arrangement. Each treatment had 4 replicates (40 chicks/replicate). Two different multi-microbe probiotic products (0.3% SLF or SSF) each with two different antibiotics (10 mg/kg colistin, or 20 mg/kg avilamycin) were used as dietary treatments. Birds fed the SSF diet had greater weight gain (p<0.001), better F/G (p<0.05), greater retention of energy (p<0.001) and protein (p<0.05), and lesser cecal Clostridium (d 35) than birds fed SLF diet. Birds fed the colistin-supplemented diet had less (p<0.01) cecal coliforms when compared with birds fed the avilamycin diet. Additionally, birds fed the avilamycin diet had greater energy retention (p<0.05) than birds fed the colistin diet. Thus, the results of this study suggest the multi-microbe probiotic product prepared by a solid substrate fermentation method to be superior to the probiotic product prepared by submerged liquid fermentation; moreover, feeding of probiotics with different antibiotics did not elicit any interaction effect between probiotic and antibiotic.

• Asian-Australasian Journal of Animal Sciences
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• v.28 no.3
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• pp.360-368
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• 2015

The present study evaluated the effect of controlled ryegrass-white clover herbage availability from day 128 until day 142 of pregnancy in comparison to unrestricted availability, on the performance of twin-bearing ewes of varying body condition score (BCS; 2.0, 2.5, or 3.0) and their lambs. It was hypothesised that under conditions of controlled herbage availability, the performance of lambs born to ewes with a greater BCS would be greater than those born to ewes with a lower BCS. During the period that the nutritional regimens were imposed, the pre- and post-grazing herbage masses of the Control regimen ($1,070{\pm}69$ and $801{\pm}30$ kg dry matter [DM]/ha) were lower than the ad libitum regimen ($1,784{\pm}69$ and $1,333{\pm}33kg\;DM/ha$; p<0.05). The average herbage masses during lactation were $1,410{\pm}31kg\;DM/ha$. Nutritional regimen had no effect on ewe live weight, BCS and back fat depth or on lamb live weight, indices of colostrum uptake, maximal heat production, total litter weight weaned or survival to weaning (p>0.05). The difference in ewe BCSs and back fats observed among body condition groups was maintained throughout pregnancy (p<0.05). At weaning, ewes from the BCS2.0 group had lower BCS and live weight ($2.4{\pm}0.2$, $74.3{\pm}2.6kg$) than both the BCS2.5 ($2.6{\pm}0.2$, $78.6{\pm}2.4kg$) and BCS3.0 ewes ($2.7{\pm}0.2$, $79.0{\pm}2.6kg$; p<0.05), which did not differ (p>0.05). Ewe BCS group had no effect on lamb live weight at birth or weaning or on maximal heat production (p>0.05). Serum gamma glutamyl transferase concentrations of lambs born to BCS3.0 ewes were higher within 36 hours of birth than lambs born to BCS2.0 ewes and BCS2.5 ewes ($51.8{\pm}1.9$ vs $46.5{\pm}1.9$ and $45.6{\pm}1.9IU/mL$, respectively [p<0.05]). There was, however, no effect of ewe body condition on lamb plasma glucose concentration (p>0.05). Lamb survival was the only lamb parameter that showed an interaction between ewe nutritional regimen and ewe BCS whereby survival of lambs born to BCS2.5 and BCS3.0 ewes differed but only within the Control nutritional regimen ewes (p<0.05). These results indicate farmers can provide twin-bearing ewes with pre- and post-grazing ryegrass-white clover herbage covers of approximately 1,100 and 800 kg DM/ha in late pregnancy, provided that herbage covers are 1400 in lactation, without affecting lamb performance to weaning. The present results also indicate that under these grazing conditions, there is little difference in ewe performance within the BCS range of 2.0 to 3.0 and therefore they do not need to be managed separately.

• Asian-Australasian Journal of Animal Sciences
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• v.25 no.5
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• pp.690-700
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• 2012

The experiment was conducted by in vitro fermentation and bacterial community analysis to investigate the reduction of odorous compounds in response to the use of feed additives (FA) during carbohydrate overload in growing pigs. Soluble starch at 1% (control) and various FA at 0.1% Ginseng meal (FA1); Persimmon leaf (FA2); Gingko nut (FA3) and Oregano lippia (FA4) were added to fecal slurry and incubated anaerobically for 12 and 24 h. In vitro parameters and microbial diversity of the dominant bacteria following fermentation were analyzed using Denaturing Gradient Gel Electrophoresis (DGGE), band cloning and sequencing of the V3 region. Results showed that total gas production increased with the advancement of incubation (p<0.05). pH values of FAs and control groups were decreased except the FA4 group which increased somewhat from 12 to 24 h (p<0.05). Ammonia nitrogen ($NH_3$-N) and $H_2S$ gas concentrations were comparatively lower in both stages in FA4 treatment than in the other groups (p<0.05). Hence, $NH_3$-N concentrations in liquid phases were increased (p<0.05) from 12 to 24 h, but the trend was lowest in FA4 than in the other groups at both stages. The total VFA production was comparatively lower and butyrate levels were moderate in FA4 group than in the the other groups during both stages (p<0.05). Indirect odor-reducing compounds such as $NO_2$, $NO_3$ and $SO_4$ concentrations were higher in the FA4 and FA3 than in the other groups at 24 h (p<0.05). After fermentation, ten dominant bands appeared, six of which appeared in all samples and four in only the FA4 treated group. The total number of DGGE bands and diversity was higher in the FA4-group compared to other groups. Additionally, similarity indices were lowest (71%) in the FA4, which represented a different bacterial community compared with the other groups. These findings indicate that $NH_3$-N, $H_2S$ and VFA production was minimal, and pH was also better in the FA4 group than in the other groups. Furthermore, the conversion of odor-reducing indirect compounds or their intermediates was higher in the FA4 group in compared to the other groups. FA4 group generated less odorous products and more indirect products by in vitro fermentation at 24 h, and their microbial pattern appeared to differ from that of the other groups. These findings suggest that this particular FA could change the microbial population, which may have a beneficial effect on odor reduction. It is recommended that the oregano lippia may be supplied to growing pigs as FA along with excess carbohydrate sources to reduce the production of odorous compounds.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.143-152
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• 2010

Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.

• Asian-Australasian Journal of Animal Sciences
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• v.13 no.11
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• pp.1576-1583
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• 2000

Three experiments were conducted to determine the nutritional value of wheat gluten (WG) and spray-dried porcine plasma (SDPP) in diets for nursery pigs. In Exp. 1, 120 weanling pigs (5.7 kg avg initial BW) were used in a 35-d growth assay. Treatments for d 0 to 14 were: 1) dried skim milk (DSM)-dried whey-SBM based control; 2) WG to replace the protein from DSM; 3) SDPP; and 4) WG-SDPP (50:50 blend on a protein basis) to replace the protein from DSM. From d 14 to 35, all pigs were fed a common corn-SBM-whey-based diet. For d 0 to 14, there were no differences in ADG, ADFI, and gain/feed (p>0.11). However, for d 14 to 35, pigs fed diets with WG had greater gain/feed than those fed SDPP (p<0.05), and pigs fed diets with the WG-SDPP blend had greater ADG than pigs fed diets with WG or SDPP alone (p<0.07). In a second experiment, 60 weanling pigs (5.1 kg avg initial BW) were used in a 28-d growth assay. All pigs were fed the WG-SDPP diet fed in Exp. 1 for d 0 to 14, and changed to experimental diets for d 14 to 28. Treatments were: 1) the whey-SBM-based diet used for d 14 to 28 in Exp. 1; or 2) a whey-SBM based diet with 3% added SDPP. There were no differences in ADG, ADFI, gain/feed, or apparent digestibilities of DM and N among treatments for d 14 to 28 or overall (p>0.14). In a third experiment, 150 weanling pigs (5.6 kg avg initial BW) were used in a 32-d growth assay to determine the optimal blend of WG and SDPP for use after weaning. The SDPP was added as 8% of the control diet, and WG was substituted on a protein basis to yield the desired SDPP:WG blends. Treatments were (d 0 to 14): 1) SDPP; 2) 75% SDPP and 25% WG; 3) 50% SDPP and 50% WG; 4) 25% SDPP and 75% WG; and 5) WG. As in Exp. 1, all pigs were switched to a common corn-SBM-whey-based diet for d 14 to 32. For d 0 to 14, ADG and ADFI increased as replacement of the SDPP was increased up to 50% and decreased when more of the SDPP was removed from the diet (quadratic effects, p<0.004 and 0.02, respectively). Apparent digestibilities of DM and N (at d 13) were not affected by treatments (p>0.18). For d 14 to 32, treatments did not affect ADG (p>0.2), although there were quadratic responses in ADFI (p<0.04), with pigs fed the 50:50 blend suggested the greatest intake of feed. For the overall experimental period (d 0 to 32), ADG, ADFI, and gain/feed increased as WG was used to replace as much as 50% of the SDPP (quadratic effects p<0.04, 0.02, and 0.06, respectively). In conclusion, WG can successfully replace up to 50% of the SDPP in a complex nursery diet, when SDPP is included at the 8% level. There is no advantage to keeping SDPP in the diet after Phase I (d 0 to 14).

• Journal of Chest Surgery
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• v.52 no.4
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• pp.248-329
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• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.