• Korean Circulation Journal
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• 제53권11호
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• pp.775-786
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• 2023

Background and Objectives: Tricuspid valve (TV) repair techniques other than annuloplasty remain challenging and frequently end in tricuspid valve replacement (TVR) in complicated cases. However, the results of TVR are suboptimal compared with TV repair. This study aimed to evaluate the clinical effectiveness of TV edge-to-edge repair (E2E) compared to TVR for severe tricuspid regurgitation (TR). Methods: We retrospectively reviewed 230 patients with severe TR who underwent E2E (n=139) or TVR (n=91) from 2001 to 2020. Clinical and echocardiographic results were analyzed using inverse probability of treatment weighting analysis and propensity score matching. Results: The two groups showed no significant differences in early mortality and morbidities. During the mean follow-up of 106.2±68.8 months, late severe TR and TV reoperation rates were not significantly different between groups. E2E group, however, showed better outcomes in overall survival (p=0.023), freedom from significant tricuspid stenosis (TS) (trans-tricuspid pressure gradient ≥5 mmHg, p=0.021), and freedom from TV-related events (p<0.001). Matched analysis showed consistent results. Conclusions: E2E for severe TR presented more favorable clinical outcomes than TVR. Our study supports that E2E might be a valuable option in severe TR surgery, avoiding TVR.

• 환경생물
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• 제37권4호
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• pp.474-482
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• 2019

자연수계 수산생물의 전염병 모니터링은 자연수계 및 양식 수산생물의 질병 관련성 및 상관관계 구명은 질병 발생 예방 및 확산 방지에 매우 중요한 역할을 한다. 2018년 해구 64개소에서 어류 39종 977마리 및 갑각류 14종 287마리를 선정하여 총 1,264마리에 대하여 병원체 감염 여부를 조사하였다. 어류는 법정전염병 2종(VHS, RSIVD) 및 비법정전염병 3종(MABVD, HRVD, LCD)을 분석하고 갑각류는 법정전염병 6종(WSD, IHHN, TS, IMN, YHD, WTD)을 분석하였다. 조사한 모든 시료에서 전염병이 검출되지 않았지만, 우리나라에서 조사한 자연수계 수산생물이 무병하여 청정국 또는 청정지위 선언에 중요한 정보를 제공할 것이다.

• Journal of Chest Surgery
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• 제46권1호
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• pp.60-62
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• 2013

Quadrangular resection is the gold standard technique for correction of the posterior leaflet prolapse in mitral valve disease. Prompted by the idea that the anterior leaflet of the tricuspid valve corresponds to the posterior leaflet of the mitral valve in its structure and function, we conducted a quadrangular resection of the anterior leaflet of the tricuspid valve in a case of tricuspid endocarditis. Tricuspid regurgitation was well corrected, and the durability of the repair was proven by the patient's freedom from cardiac events for the following 8 years.

• Investigative Magnetic Resonance Imaging
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• 제25권4호
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• pp.218-228
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• 2021

Due to their high degree of freedom to transfer and acquire light, fiber optics can be used in the presence of strong magnetic fields. Hence, optical sensing and imaging based on fiber optics can be integrated with magnetic resonance imaging (MRI) diagnostic systems to acquire valuable information on biological tissues and organs based on a magnetic field. In this article, we explored the combination of MRI and optical sensing/imaging techniques by classifying them into the following topics: 1) functional near-infrared spectroscopy with functional MRI for brain studies and brain disease diagnoses, 2) integration of fiber-optic molecular imaging and optogenetic stimulation with MRI, and 3) optical therapeutic applications with an MRI guidance system. Through these investigations, we believe that a combination of MRI and optical sensing/imaging techniques can be employed as both research methods for multidisciplinary studies and clinical diagnostic/therapeutic devices.

• 재활간호학회지
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• 제4권1호
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• pp.20-30
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• 2001

Stroke is known as a detrimental disease that leaves serious sequelae. The stroke patients suffer from limitations of physical and social activities. The patients try to adapt themselves to the limitations in order to achieve rehabilitation. This study was performed to clarify the lived experience of rehabilitation from the stroke patients. In collecting data for this study, in-depth personal interviews were made by a researcher from February to April in 2001 at rehabilitation clinics and physical therapy centers locate in Iksan city. The methodological approach was van Manen's hermeneutic phenomenological methodology in order to understand the meaning and nature of stroke patients' experiences in rehabilitating their physical limitations. Collected data were analyzed with phenomenological way of study that was develope by van Manen. The 8 patients who agreed to participate in this research were inter viewed by researcher under the private and comfortable environment. Personal interviews were done three or five times per each patients and each interview took 70 to 90 minutes. The statements were analyzed and finally revealed three essential themes : Theme 1 - Desperateness to achieve freedom again Theme 2 - Seizing hope of recovering Theme 3 - Seeking support from family members, relatives and friends Based on these themes, stroke patients' rehabilitation experience are described as following. The stroke patients have strong desire to achieve freedom again in order to escape from social isolation. The stroke patients want to go back to the state of their previous health state. The stroke patients strongly try to do anything for their recovering and also to have positive thinking. In the other hand, they feel pity for themselves through desperation, fear, sorrow, and self-pity. The stroke patients have dissatisfaction about neighbors' rumor and attitude toward themselves. The stroke patients have experiences to rely on neighbors' support seeking a warm word of consolation. This research showed us that van Manen's hermeneutic phenomenological methodology leads us to understand stroke patients' rehabilitation process more comprehensibly. Based on this research, it is suggested that further studies provide a foundation for the development of a rehabilitation theory for Korean stroke patients.

• 의료법학
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• 제16권1호
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• pp.289-312
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• 2015

감염병의 전파력은 무섭다. 누구를 통해, 어디에서 감염되었는지를 알아내는 것 또한 그리 쉬운 일이 아니다. 오늘날은 교통의 발달로 인해 우리나라에는 없었던 바이러스성 감염병이 유입되고 전파될 확률도 그 만큼 커져있는 상황이다. 감염병은 무엇보다 그것이 유입되기 전에 그 예방과 차단을 철저히 해야 한다. 그럼에도 유입된 경우에는 국가는 조속히 그 확산을 방지할 책무가 있다. 어떤 경우에는 감염병이 지역과 국가를 넘어 세계적 유행 상황이 되는 경우도 있다. 물론 이 경우에는 그 어느 때보다 국가 간의 협력과 세계보건기구 등의 역할이 중요해 진다. 그렇지만 이런 상황에서도 국가의 역할이 감소되는 것은 아니다. 우리 감염병예방법과 검역법은 감염위험이 있는 자 외에, 감염위험 의심자에 대해서도 격리조치를 취할 수 있다고 규정하고 있다. 격리는 더 이상의 감염을 막기 위한 매우 실효적인 수단이지만, 또한 격리의 방법과 내용 등에 비례하여 그 대상자의 자유권은 제한된다. 특히 감염병이 빠르게 유행하고 있는 상황에서는 이에 편승하여 자의적, 불합리한 격리가 발생할 수 있는 가능성도 그만큼 커진다. 이 글은 이런 시각에 기초하여 격리를 통한 공중위생 안전의 확보와 인권의 조화 문제를 생각해 보았다.

• 대한예방한의학회지
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• 제1권1호
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• pp.85-104
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• 1997

As the concern about health is increased, the importance of preventive medicine that prevent disease in advance to overcome boundary of disease remedy gets emphasized in the whole world. The fundamental thoughts of oriental medicine are the harmony between the human body and nature, the unified idea regarding mind in the same light with body, and the symmetry of the cosmo dual forces. And oriental medicine is a kind of study that has developed on the ground of prevention thought. from old days, it has been developed the preventive medicine at is called 'Yangseng(養生; recuperation)' etc. with the clinical medicine. The preventive medicine of oriental medicine was taking a serious of the first preventive medicine of an incurable disease thought and the prevention thought that belongs to the second and third preventive medicine is described through the whole oriental medicine. Also the clinical and preventive medicine to apply to the clinics have an in- separable relation. Therefore I inspected the part of the preventive medicine described in some oriental medicine books and studied the characteristics of preventive medicine of oriental medicine as follows; First, the preventive medicine of oriental medicine has the characteristics that is emphasized generally in the first preventive medicine and wholly it is composed in the system of the first, second and third preventive medicine. It has the presentative theory such as 'Jungkijonae sabulkaghan(正氣存內 邪不可干; If good energy is in body, a disease. dosen't occur)', 'Husajukpung Phijeyushi(虛邪賊風 避之有時; When e infectious disease like plague break out, they must avoid the place occurring the disease)', 'Chuninsangeung(天人相應; The harmony of nature and human)' etc.. This is intimately related to the incurable disease thought of the inside diameter and oriental medicine has pursued that. Second, due to the most prerequisite theory of disease production, the balanced condition of environment, the cause of a disease and host is called the health. As oriental medicine has the system of aetiology like that, we can see the host and environments are importance most of all. Namely we can think of the relation of host >> environment > the cause a disease Up to date Jungkijonae Sabulkaghan(正氣存內 邪不可干) that the most oriental medicine doctors have had a knowledge is not whole theory but a pan of oriental medicine science and it is included in oriental medicine theory to avoid infectious disease such as Husajukpung Phijeyushi(虛邪賊風 避之有時). Third, according to the natural result of the first and second contents, we can know that its characteristics stress the remedy without drugs. Because Jungkijonae Sabulkaghan(正氣存內 邪不可干), Husasukpung Phijeyushi(虛邪賊風 避之有時), and Chuninsangeung(天人相應) mean that they prevent disease in condition of freedom from ailment, We can prevent the disease production through the positive preventive methods such as exercise, spirit, food and innate prevention etc.. fourth, the preventive medicine of oriental medicine has developed with therapeutics and it contains all oriental medical methods such as host, environment, exercise, acupuncture and moxibustion, innate or postnatal methods. Also it is the general preventive medicine that has fundamental philosophy of oriental medicine; for examples, the unified idea, the harmony of nature and human, and the unity of mind and body. fifth, to develope the above scientific merit and special features, the preventive medicine of Oriental medicine must be objectified and reemergent stud? gets more and more essential from now on. Especially we need to have the scientific concern of Oriental medicine about the cause of a disease, environmental hygiene, industrial sanitation, and personal hygiene etc..

• Journal of Chest Surgery
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• 제51권5호
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• pp.322-327
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• 2018

Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.

• Journal of Chest Surgery
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• 제38권3호
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• pp.197-203
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• 2005

대동맥판막 치환술 시 사용되는 동종이식편은 훌륭한 혈역학적 기능과 우수한 좌심실 근육량 감소(enhanced left ventricular mass regression), 감염에 대한 내성, 혈색전증 발생 위험이 적다는 등의 많은 장점들이 있다. 저자들은 본원에서 시행한 동종이식편을 이용한 대동맥판막 치환술의 결과를 알아보고자 한다. 방법 및 대상: 1995년 5월부터 2004년 5월까지 18명의 환자(남 : 여=16 : 2, 평균 연령=39.3$\pm$16.2세, 연령 범위 14$\~$68세)에서 동종이식편을 이용한 대동맥판막 치환술은 20예가 시행되었다. 2예의 재수술을 포함하여 대동맥 동종이식편이 17개 사용되었고 폐동맥 동종이식편이 3개 사용되었다. 대동맥 판막에 대한 수술 과거력이 있는 환자는 10명이었다. 동종이식편 사용의 적응증으로는 자가판막 심내막염(n=7), 인공심장판막 심내막염(n=5), 혹은 Behcet 병에 동반된 대동맥판막 질환(n=8) 이었다. 수술방법은 관상동맥하 삽입술(subcoronary implantation)을 시행한 1명을 제외한 모든 환자에서 완전 근부 치환술(full root replacement)을 이용하였다. 결과 : 평균 관찰기간은 41.3$\pm$26.2 개월이었다. 수술사망이 1예 있었으며 합병증으로는 수술 후 출혈이 3예, 총격동염이 1예 발생하였다. 만기 사망 예는 없었으며 3예에서 대동맥판막 재치환술을 시행하였고 3명이 모두 Behcet 병 환자였다(p=0.025). 재수술에 대한 자유도는 1년과 5년에 각각 $87.5\pm8.3\%$, $78.8\pm11.2\%$였다. 심내막염 환자들에서 수술 후 심내막염의 재발은 없었다. 관찰 기간 중 항응고 요법은 사용하지 않았고 판막에 의한 혈색전증은 관찰되지 않았다. 결론: Behcet병과 감염성 심내막염의 수술 위험도를 고려할 때 동종이식편 대동맥판막 치환술의 수술결과 및 술 후 관찰 결과는 양호하였다. Behcet 병은 동종이식편을 이용한 대동맥판막 치환술 후 재수술의 위험요인이었다. 심내막염 환자들에서 동종이식편 대동맥판막 치환술은 최선의 수술방법이라고 생각하며 더 많은 수의 환자들을 대상으로 장기 관찰이 필요할 것이다.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.77-81
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• 2003

목적: 슬관절 주위 골격의 기초과학을 생체역학을 중심으로 설명하고 빈도가 높은 스포츠 손상들에 대해 기술하고자 한다. 해부 밀 운동학: 슬관절은 순수한 경첩 관절이 아니며 적합하지 않으므로 여섯 방향의 운동이 가능하다. 경골대퇴간 운동역학: 슬관절의 굴곡-신전 축은 시상면에 수직이 아닐 뿐 아니라, 관상면상 관절선과 평행하지 않으므로, 경골대퇴관절은 굴곡 시 내반과 내회전이 동반되고 신전 시에는 외반과 외회전이 동반된다. 슬개대퇴 관절: 슬개대퇴 관절 압박력은 슬관절의 굴곡 각도와 사두고근력에 비례한다 슬개골은 신전기전의 moment arm을 증가시켜 신전기전의 효율을 증대시키고 지렛대 역할을 한다. 슬개골 골절: 비전위성 골절이면서 하지 직거상 운동이 보존된 경우에 비수술적 치료의 적응증이 되며 수술적 치료 시 고정 방법의 선택은 골절 양상에 따라 결정되겠으나 어느 술식을 선택하여도 신전지대의 봉합은 필수적이며 중요하다 슬개골 불안정성: 선행 해부학적 이상을 조사해야 하며 급성 탈구에서도 골연골 골절편이 있거나 재발의 위험이 높은 운동선수에서 인대 봉합을 고려할 수 있다. 비수술적 치료 및 재활에도 불수하고 계속되는 재발성 아탈구나 탈구는 수술이 필요하다 학령기 스포츠 손상: Idiopathic Adolescent Anterior Knee Pain, Osgood-Schlatter Disease, Sinding-Larsen-Johansson Disease 등이 흔하다