• The Journal of Korean Physical Therapy
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• 제25권2호
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• pp.81-87
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• 2013

Purpose: The purpose of the current study was to examine the effects of electromyography (EMG)-biofeedback training on lower extremity muscle activity and balance of patients with total knee replacement (TKR). Methods: Subjects were randomly allocated to two groups: experimental and control group. Subjects in the experimental group (n=10) were provided with quadriceps setting exercise by EMG-biofeedback (QSE+BF) and those in the control group were provided with QSE. Subjects in both groups were provided with the respective training programs for 20 minutes per session, five times per week, for a period of six weeks. To test significance, data analysis was performed using repeated-ANOVAs. Results: Statistically significant differences in muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability were observed in the experimental group, compared with the control group. In comparison of the muscle activity of the rectus femoris muscle and the vastus lateralis, and dynamic balance ability between different training periods within the groups, both groups showed statistically significant differences. Conclusion: EMG-biofeedback training is effective in improving lower extremity muscle activity and balance ability of patients with TKR, and should be effective in patients with other diseases.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1312-1317
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• 1992

Autologous blood transfusion is a common method of reducing the need for homologous blood transfusion during cardiac operations. Between June 1991 and May 1992, 12 cases [Group I] were experienced autologous blood transfusion using Cell Saver undergoing double valve replacement or redo-valve replacement. Control group [N=12, Group II] was selected to above similar operation during same period. The Cell Saver system [Haemonetics Corp.] was employed for autologous blood transfusion. The blood shed in the operative field before and after cardiopulmonary bypass and remained cardiotomy reservior was aspirated by means of a locally heparinized collecting system. After centrifused salvaged blood, the resulting red cell concentrate reinfused subsequently. The patient receiving autologous blood transfusion required significantly less homologous blood transfusion than their control group. [Group I; 3519 $\pm$ 869, Group II; 4622 $\pm$ 856, Respectively; P=0.005] There were no clinical infections in the autotransfusion group. And there was no apparent intergroup difference of the clinical findings, hematologio datas and coagulation parameters. We conclude the autotransfusion using Cell Saver is effective for reducing of the hom-ologlous blood transfusion in cardiac surgery.

• Journal of Chest Surgery
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• 제50권4호
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• pp.255-262
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• 2017

Background: Transcatheter aortic valve replacement (TAVR) has been suggested as a less invasive treatment for high-risk patients with aortic valve disease. I n this study, we compared the outcomes of conventional surgical aortic valve replacement (AVR) and TAVR in elderly patients aged over 80. Methods: A total of 108 patients aged 80 years or older who underwent isolated AVR (n=35) or TAVR (n=73) from 2010 through 2015 at Asan Medical Center were identified. Early and late clinical outcomes, including echocardiographic findings, were evaluated in both groups. The mean follow-up duration was $766.4{\pm}528.7days$ in the AVR group and $755.2{\pm}546.6days$ in the TAVR group, and the average timing of the last follow-up echocardiography was at $492.6{\pm}512.5days$ in the AVR group and $515.7{\pm}526.8days$ in the TAVR group. Results: The overall early mortality was 2.8% (0 of 35, 0% in the AVR group vs. 3 of 73, 4.1% in the TAVR group). Permanent pacemaker insertion was significantly more common in the TAVR group (p=0.010). Renal failure requiring dialysis and new-onset atrial fibrillation was more frequent and the length of hospital stay was longer in the AVR group; however, this difference did not reach statistical significance. In the TAVR group, 14 patients (19.2%) were rehospitalized due to cardiac problems, and 13 patients (17.8%) had developed significant paravalvular leakage by the time of the last follow-up echocardiography. Conclusion: TAVR could be a good alternative to conventional surgical AVR in elderly patients. However, TAVR has several shortcomings, such as frequent significant paravalvular leakage or readmission, which should be considered in decision-making.

• Journal of Korean Neurosurgical Society
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• 제60권6호
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• pp.676-683
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• 2017

Objective : The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. Methods : Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. Results : Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. Conclusion : The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.

• Journal of Chest Surgery
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• 제47권4호
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• pp.373-377
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• 2014

Background: This paper aimed to verify the effects of renal replacement therapy on changing the levels of serum creatinine for different veno-arterial and veno-venous configurations in prolonged extracorporeal membrane oxygenation (ECMO) patients. Methods: The subjects were chosen 71 patients who had undergone more than 1,440 minutes (24 hours) of the therapy from among 117 patients who had undergone ECMO insertion between January 2008 and December 2012. The patients were separated into the veno-arterial configuration group I (51 patients) and the veno-venous configuration group II (20 patients). The difference in the level of serum creatinine (${\Delta}Cr$) between before or just after ECMO insertion ($Cr_I$) and the level when the pump time was between 2,880 and 4,320 minutes ($Cr_F$) was checked (${\Delta}Cr=Cr_F-Cr_I$), and the average ${\Delta}Cr$ for each group was compared using a Student t-test at the confidence interval (CI) of 95%. Results: The change in the level of serum creatinine was an increase of 0.341 mg/dL (${\sigma}$=0.9202) for group I and a decrease of 0.120 mg/dL (${\sigma}$=1.5292) for group II. The change was significantly high for group I (p=0.011, CI=95%). Meanwhile, within group I, when renal replacement therapy was not done, there was a significant increase in the level of serum creatinine (p=0.009, CI=95%). Conclusion: For ECMO insertion patients whose pump time was more than 1,440 minutes, there was a significant change in the level of serum creatinine when renal replacement therapy was not done, for the veno-arterial configuration of group I.

• Asian-Australasian Journal of Animal Sciences
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• 제24권1호
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• pp.45-55
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• 2011

A feeding trial was conducted to study the replacement value of concentrates with Barhar (Artocarpus lakocha) leaves on growth performance of kids fed a mixed jungle grass-based diet. Fifteen Sikkim local kids, about 4 months of age and body weight ranging from 5.8 to 9.2 kg, were randomly distributed into three groups of five. Kids were stall fed ad lib with mixed jungle grass collected from the nearby forest and native scrubland. The kids in group I received supplementary concentrate (Maize 35%, mustard cake 32%, rice bran 30%, mineral mixture 2% and common salt 1%) at approximately 2% of BW. For groups II and III, 25 and 50% of the concentrate was replaced with Barhar (Artocarpus lakocha) leaves, respectively. Total dry matter intake (DMI) was not significantly different among groups. Digestibility of CP decreased (p<0.05) and that of NDF increased (p<0.01) with increasing level of Barhar leaves in the diet. Digestibility of ADF (p<0.01), hemi cellulose (p<0.05) and cellulose (p<0.01) was higher in groups II and III than in group I. Ruminal pH and TVFA concentration were not significantly different among groups. Rumen ammonia-N concentration decreased (p<0.01) with increased level of Barhar leaves in the diet. Similarly, plasma urea nitrogen and blood glucose levels were reduced (p<0.05) with increasing level of Barhar leaves in the diet. Replacement of concentrate with Barhar resulted in reduced Hb and lower serum iron concentration. Levels of other serum metabolites including minerals were not altered by the replacement. Average daily gain (ADG) was 53.3, 54.4 and 41.8 g/d in groups I, II and III, respectively. ADG was not adversely affected when the level of replacement was restricted to 25%. However, at 50% of replacement ADG was significantly lower than the control (p<0.05). Thus, it was concluded that Barhar leaves might replace 25% of the supplemental concentrate for growing Sikkim local kids fed on a mixed jungle grass-based diet.

• Journal of Chest Surgery
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• 제47권6호
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• pp.504-509
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• 2014

Background: Most surgeons favor the pledgeted suture technique for heart valve replacements because they believe it decreases the risk of paravalvular leak (PVL). We hypothesized that the use of nonpledgeted rather than pledgeted sutures during mitral valve replacement (MVR) may decrease the incidence of prosthetic valve endocarditis (PVE) and risk of a major PVL. Methods: We analyzed 263 patients, divided into 175 patients who underwent MVR with nonpledgeted sutures from January 2003 to December 2013 and 88 patients who underwent MVR with pledgeted sutures from January 1995 to December 2001. We compared the occurrence of PVL and PVE between these groups. Results: In patients who underwent MVR with or without tricuspid valve surgery and/or a Maze operation, PVL occurred in 1.1% of the pledgeted group and 2.9% of the nonpledgeted group. The incidence of PVE was 2.9% in the nonpledgeted group and 1.1% in the pledgeted group. No differences were statistically significant. Conclusion: We suggest that a nonpledgeted suture technique can be an alternative to the traditional use of pledgeted sutures in most patients who undergo MVR, with no significant difference in the incidence of PVL.

• The Journal of Korean Physical Therapy
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• 제36권1호
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• pp.27-32
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• 2024

Purpose: This study was conducted to verify the effect of applying a pressure biofeedback unit on walking ability and knee joint function while performing knee joint extensor strengthening exercises using resistance exercise equipment in total knee replacement (TKR) patients. Methods: This study was conducted on twelve patients receiving rehabilitation treatment after being admitted to a rehabilitation hospital post-TKR. Of these, six were allocated to a feedback group with a pressure biofeedback unit, and the other 6 were allocated to a control group without a pressure biofeedback unit. The subjects performed an exercise program for 45 minutes per session, five times a week, for two weeks. Walking ability and knee joint function were evaluated and analyzed before and after exercise. Results: The feedback group showed significantly better improvements in walking speed, gait cycle, step length on the non-operation side, time on the foot on the operation side, K-WOMAC stiffness, and K-WOMAC function than the control group (p<0.05). Conclusion: When strengthening the knee joint extensor muscles using resistance exercise equipment in TKR patients, the provision of a pressure biofeedback unit was found to improve walking ability and knee joint function by inducing concentric-eccentric contraction of the knee joint extensor muscles. Therefore, the study shows that exercise based on the provision of a pressure biofeedback unit should be considered when strengthening knee joint extensor muscles to improve the walking ability and knee joint function of TKR patients in clinical practice.

• Journal of Chest Surgery
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• 제25권3호
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• pp.232-239
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• 1992

Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

• 한국재료학회지
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• 제32권3호
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• pp.115-124
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• 2022

Porous basalt aggregate is commonly used in roadbed engineering, but its application in concrete has rarely been studied. This paper studies the application of porous basalt in concrete. Porous basalt aggregate is assessed for its effects on mechanical strength and durability of prepared C50 concrete; because it has a hole structure, porous basalt aggregate is known for its porosity, and porous basalt aggregates can be made full of water through changing the content of saturated basalt; after full-water condition is achieved in porous basalt aggregate mixture of C50 concrete, we discuss its mechanical properties and durability. The effects of C50 concrete prepared with basalt aggregate on the compressive strength, water absorption, and electric flux of concrete specimens of different ages were studied through experiments, and the effects of different replacement rates of saturated porous basalt aggregate on the properties of concrete were also studied. The results show that porous basalt aggregate can be prepared as C50 concrete. For early saturated porous basalt aggregate concrete, its compressive strength decreases with the increase of the replacement rate of saturated aggregate; this occurs up to concrete curing at 28 d, when the replacement rate of saturated basalt aggregate is greater than or equal to 40 %. The compressive strength of concrete increases with the increase of the replacement rate of saturated aggregate. The 28 d electric flux decreases with the increase of the replacement rate of saturated aggregate, indicating that saturated porous basalt aggregate can improve the chloride ion permeability resistance of concrete in later stages.